Preparing for our 1st Psych eval

I'd make sure to ask for a full evaluation and hold off on meds for as long as possible. There are behavioral interventions that can work.We had a bad experience with a therapist that spent 10 minutes with our AS, "diagnosed" him with ADHD and wanted to put him on meds right away. I said NO WAY and we're on a wait list for a full neuropsych evaluation and working on some behavior stuff.ETA: our AS is also 5 years old.

In our case, Psych prescribe meds. That is basically all that I have gotten out of my son's psych. I would ask for copies of any paperwork that they will give you. I got copies of all the behavior rating scales that they give the teachers. Information on meds, diagnosis I also would ask them to put in writing answer to your questions because they have a lot of patients and don't always remember what they told you. Questions to ask What should I do if they have side effect? What side effects should I contact you for? What time should I give it to him? Can I just take him off of it or does it need to be done gradually? What circumstances would make me need to see you again before the next scheduled appointment? How do I get a hold of you if something seems to be wrong with the meds? What if we have a question on Friday night after 5, can I get a hold of you? If you get my point...my sons psych is not easy to get a hold of and does not give us enough information. My husband and I attend every appointment and we know what she says and it does always match up to what she said the last time. My son is five and she never has talked to him more than three minutes a visit. Now that we have a diagnosis ADHD and some ODD tendancies our pediatrician has agreed to be our medicine case manager and we will not have to see the psych again, hopefully. We went to a behavior therapist and he recommended play therapy. He taught it to my husband and I and then would monitor us on how we did it and give us feedback. This was not enough for our son and he did need meds too and the behavior therapist could not prescribe it and was over an hr away.

Is it a psychologist or a psychiatrist? Psychiatrists prescribe medications, psychologists generally get information and history and their evaluation has to do with diagnoses, interventions and outcomes.

We were advised if we were NOT interested in meds there is really no point in getting a label of ADHD at this age; my son will be six this summer. He is finally getting his IEP in place at school. Are they going to do a full developmental assessment? Are you and her doc thinking there is something more going on?

MassMom- who can do a full eval? Neuropsych only? I agree on holding off on meds for as long as possible. I want to see what else works first.ladyinred - Thank you! Very helpful.minibus - Ped just said Psych referral. My guess would be Psychiatrist. Should I ask for a referral to a psychologist?shybear - I was hoping this diagnoses would help with the school district. So far we have a diagnoses of SPD but the school district doesn't care. We start Kindergarten in the Fall. My other option is to keep her at this in-home Montessori school (she can do Kindy there) and give her one more year of development. She seems to be doing well school wise ever since we switched to this school in October.I have no idea if they are doing a full developmental assessment. I am waiting for the psych office or the nurse from the Ped's office to call me back. Ped said if I don't hear from someone in 2 weeks to call her back. Our 2 weeks is up this Friday. The Ped said there may be more going on considering her inutero drug exposure. What happened was the Queen was re-evaluated for SPD with her OT back in December. I told the OT my main concerns are her being impulsive & hyperactive at times. The OT said to mention it to the Ped & then the Ped referred us to a Psych.

Parenting - that depends on what you want for her. Do you believe it's an issue that can/should be treated by medication? Do you want to look at other possibilities/options? The child psychiatrists I've worked with are basically MDs who know about psychiatric medications - they sometimes try counseling type interventions, but they don't have a lot of experience in counseling. It's like going to your general practitioner with depression - they will prescribe you an anti-depressant and tell you to find ways to get stress out of your life, but won't look in depth at other possibilities, etc. I would guess that if your main concern is ADHD, then you're getting a referral to a psychiatrist.

We had DJ go through a full developmental assessment last month with a neuropsych. It was very helpful. I think that I would push for that, because the assessment looks at a lot of factors in addition to attention, such as social/emotional development, executive function and cognitive development. She spent 6 hours with DJ, observed him at school, used detailed questionnaires from us and his teacher and met with us alone for an hour. In our case, she was able to rule out ADHD even though she did find that he was more active than average for his age and his teacher reports that he has a hard time staying on task- and she was able to tell us what is likely causing his issues. But I can easily imagine a less thorough process leading us to an inaccurate-in-our-case diagnoses of ADHD. Her recommendation to us involves therapy rather than medication for issues that she thinks probably stem from prenatal drug exposure. I have a friend who has a son that is very similar to my son in behavior. He is 5 and was just diagnosed with ADHD by a psychiatrist. The meds are helping him with attention but are not helping at all with his behavior - which, frankly, is the bigger problem for him. I think it's quite possible that he has some of the same issues that my son does (same exposure history/same behaviors) in addition to ADHD and his less thorough assessment only caught one piece of what is going on for him.

minibus - my main goal is to find out what is going on & what else we can do to help her. Medication is my last resort. I would like to visit other options first. Are there other options? Oak - Good to know. Our kiddo's are just a few weeks apart & sound a lot alike in many ways. The Ped said if I didn't hear from anyone in 2 weeks, to call her office back. Well, the 2 weeks is up tomorrow. So, I think I should call but ask for a NeuroPsych eval. I would love to find out what is really going on with her. I agree that it could be due to drug exposure. However, every time I ask that question I get a "Deer in headlights" look from a physician. Maybe the neuropsych is the best option.Her current teacher doesn't see anything out of the norm. However, her last 2 teachers said they noticed ADHD tendancies that concerned them. One of the teachers wanted her medicated last September then things got really bad & we left. Currently in an in-home Montessori school & she loves it. I would love to send her to Montessori school for several years but who can afford that? Thanks all for the help.

Hi I am an adult adoptee, and had many of the typical 'ADHD' type symptoms as a child. Very restless, talked a lot, couldn't concentrate, zoning in and out, poor memory, manic and anxious, overstimulated, unable to sleep, anger outbursts. This caused me a lot of problems in my life, especially in school and work. I know now as an adult these are reactions to trauma and inability to self-soothe. When we are traumatised, our mind learns to dissocicate and 'wander off', especially when under extreme stress. I would often walk out of a lesson having no clue what I had just done, as the stress of being in class and all the things I had to learn would trigger the dissociation, or 'zoning out'. Please see my post [url]http://forums.adoption.com/attachment-bonding/412292-adult-adoptee-hoping-advice-will-help-young-traumatised-adoptees.html[/url] I found 5-htp, which is a natural way to treat anxiety and depression very helpful. Also, melatonin and vitamin B complex. Omega 3 is good for the brain. Mindfulness is excellent for helping concentration and being 'in the now'. It helps to block out external stimulation and being able to focus on one thing.

Thanks Missmiso. I am going to look into it for my own family and for my future adopted child (that we have not matched with yet). I love new and different therapies.

Both of my children went thourgh a neuropsych eval. recently. I felt like they did not do a thorough evaluation with my ds (4). They did IQ, school skills, etc. I feel like that psychologist just looked at his behavior and made a judgement call. He IS so extremely impulsive and hyperactive (he ran out of the room twice, opened and closed the door about 50 times, turned the light on and off about 100 times and obsessed about the key to the doctor's filing cabinet...). The doctor said he has ADHD and pretty much blamed every concern I have on the fact that he has ADHD, which I thought was a bit odd. The report said he could not be officially diagnosed with ADHD, because there was not a 2nd environment that could confirm the behaviors. But it was suggested he be re-evaluated at 5. So, I was generally not happy with his evaluation. It was suggested that he try stimulant medication. We are on our 3rd medication (Adderall, Focalin, Metadate), and none are helping enough or in the right way. The Metadate, at least, is not causing any really bad side effects and seems to be helping with his focus, but not his impulse control. But, for him, I don't feel like there is any other way to help him. I think that working on behavioral adjustments would help, but only if he could slow down enough to even try to process them. His IQ came back at 118, but I think it is MUCH higher, because they also said he did not know his colors, numbers or letters. He was 3.5 years old when evaluated. He knew all his letters and their sounds, plus all of the other school skills, so I think he was not trying very hard. My 5-year-old dd's psychologist was much better. He did a more thorough evaluation, and he didn't jump to conclusions. He thought that she had many ADHD tendencies, but did not qualify for a full diagnosis of ADHD, mostly because the degree of the symptoms was not severe enough. He did say that he thought that she would qualify once she had a more demanding school schedule. She's in preschool now. He also suggested stimulant medication now. She was immediately helped with Adderall. She's also sensory seeking, and I felt like those behaviors could not be helped with medication. I was so wrong. On the medication, she no longer chews on things. She would cry for gum all day long before the meds, now she hasn't asked for it once. She is calmer, more focused and does not get into her out of control modes. She is on a low dose and it helps so much. She doesn't grab everything and have to touch everything when on it either. So, the benefits for her have been pretty clear. I just wish that they were as positive with my ds :(.

Yes. I believe that there would be counseling and/or behavioral interventions. I'd go for a thorough psychological workup, possibly with a neuropsych eval as well. The more they can tell you about what is going on with your child, combined with the causes of what is going on, the more options they can give you with regard to what you can do about it. If it was in utero exposure, they can explore that and determine the areas of her brain that are impacted and work on solutions from that perspective.

Thank you everyone for the feedback. Ped refused to refer us to a NeuroPsych or Psychologist. She said there hasn't been any concern with brain issues before thus doesn't see the need for NueroPsych unless Psych comes up with something. Amazes me that 9 months of drug exposure & not one physician thinks it would be a good idea to get a NeuroPsych involved or do a brain scan. Anyway, she said let's see what the Psych says first & then go from there. I told her I am not doing meds as a first line of defense.

Parenting - Sadly, our health insurance has stonewalled us, too. My son's pedi sees him maybe twice a year (knock on wood, he's a very healthy kid) and does not see any behaviors, so she does not take me very seriously when I describe them. We paid for DJ's neuropsych evaluation out of pocket - to the tune of $4,500.00. But I'm finally feeling like we're on the right road. It's really sad that that's what it takes, though, because not every parent has that option.

Oak - Wow! So glad you have the ability to pay out of pocket for the NeuroPsych. If I had the ability, I can see how it would be worth it. I am going to follow the process for now. The good news is I worked hard to get her adoption subsidy (took over a year) but she has it now. Yeah! With Medicaid as her secondary insurance, it should open up more doors when my insurance tries to close them.