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Would it help to explain that evals are done to get a complete picture of how a person learns, both strengths and weaknesses, and not just to label or accentuate the weaknesses; and that having this picture will help you as his teacher to understand how to teach him most effectively?

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I think you're giving him too many choices/options, and that may be overwhelming for him. If he agrees that he would like something to help him with his struggles, tell him that is what you are going to do. You are going to see a special doctor that will be able to help him with the things he struggles with.

 

You could explain to him (if they do "label" him), that a label is a tool for themselves that gives a general idea of the types of things he struggles with. For example, if you say "fruit" to your son, he has an idea of the kinds of foods that go into that category. "Fruit" is more specific than "food". When the doctor's label, they are not limiting him, but rather describing his characteristics. People are all different. Even fruit is very different from other fruit.

 

I wouldn't ask him what he wants. I'd just say we have an appointment with a different doctor (whether you choose a therapist or a specialist) who will be better able to help him with the things he struggles with. And mention that the doctor will need to ask him lots of questions so that he can better understand what the issues are.

 

I hope you find something that all of you are happy with. It is hard to struggle through those kinds of issues.

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This is your 9yo?

 

This is too big a decision for a 9yo, and there are so many layers that a 9yo has NO way of understanding.

 

Schedule the appt and get the help that is needed. It's a medical decision--any label that comes out of it can be kept confidential.

 

I agree. I initially assumed it was a teenager, probably because I wouldn't give a 9 yo a choice.

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I'm taking my 11 (almost 12) yr old DD to a neuropsych for a quantitative EEG in a couple of weeks, and I'm not asking her whether or not she wants to go! ;) Frankly, I certainly wouldn't have done it at 9, either...too big of a decision for a kid.

 

What I have done is to tell DD the specifics of why to help engage her cooperation (you know how you are having trouble with your memory at school? This will tell us why and how to help you.). I've explained the procedure in detail to reduce her anxiety, told her that we'll be doing a program over the summer on the computer based on the results and told her (when she balked) that if she chose not to be cooperative, she'd not being doing a camp she wanted to do this summer. I may sound like a meanie, but this is critical for her school success and she does NOT get a vote! I'd love her buy-in, but I'm going forward with or without it.

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I have to wonder if he's got some fears that he's not sharing with you. When I was 8, I saw photos of my youngest brother's birth and didn't understand that all the blood was normal. I seriously thought that my mom had almost died and everyone kept that from me because they didn't want to worry me. Sounds stupid now, but I was 8. I didn't confide my fears to anyone because I felt like I should be the responsible older sister. So I kept them to myself and worried unnecessarily for years.

 

It wouldn't at all surprise me if what's really going on is a fear in your son's mind that you're misleading him about the true purpose of the neuropysch eval.

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I'm going to say this, and then you can throw up your hands and chew me out. While I'm TOTALLY on board with the idea that a parent decides and does what is best for the kid (meaning you make the appointment, you decide, he does it), I *do* think you could have more ways to explore options or delve into what he is thinking. Like the others, I think it would be good to see if, with some quiet time together, his real concerns about this could come out. I mean mercy, at 9 my dd didn't have a clue about labels like that and wouldn't have noticed a thing. So clearly he has some pre-experiences that are coloring what he thinks it means, kwim?

 

Next, I'm not meaning to be critical but just to explore other ways and options to fit with what he is asking. You said you've done OT/PT stuff on your own. Has he been evaluated by an OT who does SPD? I ask, because that person might be able to help you more than you realize. The stuff our OT did wasn't in the books I've found at the library. And the whole process was sort of this unpeeling, where she could say something and all of a sudden have it be obvious WHY dd was doing such and such or feeling or acting a certain way, things I had never been able to guess or fathom. We're talking stuff that DIRECTLY impacted our schoolwork. One hour with the OT and we were changing how we did school. It was that dramatic. Ok, maybe she was unusual. But a good OT can be very helpful to you.

 

In other words, I'm wondering if you could go to the places the neuropsych would in fact send you (a good OT, someone for that auditory processing eval and therapy, etc.) and wait a while on the neuropsych, till he gets more comfortable with the idea. See there's some reason to think working on the sensory with OT would help his attention. Not meaning to denigrate what you've done (which I'm sure is awesome and reflects lots of hard work), just trying to toss out options.

 

I say all this because some of the things that bugged us with dd at the age your ds is are bugging us less now. Some things are still there. But some of it, like the routines (boy do I hear you!) can be helped by IM that an OT could do. And even our VT worked the executive function part of the brain and caused some changes there, palpable changes, like remembering to feed the dog every day. I kid you not. Who would have thought VT would result in your kid remembering to feed the dog!?!

 

Where that's going, I don't know. Also, the thing our OT told us about a neuropsych eval (which she recommended for us btw and which we haven't done yet) is that it would confirm what we had already figured out about the academics. Now I'm REALLY not meaning to be hard here, but when I look at the list of academics you're asking of your 9 yo probable ADD son, I'm just wondering if meds are the only answer, or if some change in approach would help. Really and truly I know you've thought this out. I'm just saying *I* don't expect my dd to do 2 math programs and 5 language arts things and a very sophisticated history curriculum. Kwim? Even when they're spread out, that may not be realistic. What's popular on the boards may not be realistic.

 

There, I've said it. Shoot me.

Edited by OhElizabeth
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A few thoughts.

 

Does he know that his sister had similar testing done? If so, he might have some fears surrounding that.

 

I would be surprised if he even understands what labeling means. I think that might be an adult interpretation of what is going on.

 

As for neuropsych evals, I think they are pretty overrated. If you've been reading about this stuff for years (and it sound like you have), the neuropsych isn't going to tell you anything you don't know (except for specific numbers). Also, neuropsychs tend to diagnose what they are familiar with. So if you go to one whose expertise is ADHD, you'll get ADHD as a diagnosis. Ditto autism spectrum stuff. Not all of them are like this, but many are. You could also pick what you think is the biggest problem and begin by tackling that. Sensory integration is a great place to start and OTs tend to be less expensive than some of the others. OTs also deal with hypotonia and dyspraxia. Also, addressing the sensory stuff can help with attention and autism issues. The auditory processing issues are difficult to deal with. I would just assume that he has it and accommodate accordingly. I would probably hold of on the medication trial until you've got some OT done to see if it helps significantly. If you're not seeing the improvement you need, it's pretty easy to find a doctor who will do a medication trial.

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Ds is absolutely adament that he does not want a neuropsych eval. We explained what they were like (essentially a bunch of games--our dd had regular ones as part of her chemo trial for her brain tumor) and we believe the problem is that he doesn't want to be labelled.

 

I'd say that since this is an issue that affects people other than himself and the fact that's he's only 9 his say in the matter is limited.

 

I agree with those questioning his understanding of labels.

 

Personally, one of the most liberating days of my teenage years was when I got the label of ADD because the fact is that people attach labels to themselves anyway. I sure did. It was wonderful to know I could replace those labels (stupid, lazy, ditzy) with one that had nothing to do with my character and was just a matter of brain chemistry.

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