Does a Neropsych eval mean he will be "pysch" labeled?

[MyLittleBears]

Just to clarify. I am trying to get a neuropsych evaluation for my 12yr old dyslexic. He has a really hard time with math, getting school done in a timely fashion, and I believe, processing speed and working memory. I suspect auditory processing. Anyway, it is long overdue. I called an office that deals with such issues like ADHD but also deals with other types of psychological problems: the kind that can label you for life. They told me that they will not call things "learning disabilities" because insurance won't cover them. If I go ahead with this, am I essentially having my child labeled with issues that will follow him through life? Like say, not being able to get a hunting license when he is older? I really need some good advice. :sad:

[mysticmomma]

So what do they call them?

[geodob]

An evaluation can often help with licences, if their a written test is involved?

Where a person can have the test read to them, and then a scribe will write down their answers.

[PeterPan]

When people say a psych label, they mean *psychiatric*. You're going to a psychologist, not a psychiatrist.

 

Distinguish social stigma from labels that affect insurance rates. In reality the latter is a lot more important to you. It really depends on the company. Some places only care about the label if you received counseling or have taken meds for it. There are legitimate medical reasons (statistics) why this would affect rates. Just having a label (adhd, dyslexia, whatever) doesn't necessarily even show up on the insurance forms. But the minute the dc needs counseling or meds for it, yes then it shows up and becomes part of the medical paper trail. But that's for obvious reasons.

 

Psychs vary quite a bit. If you think it's dyslexia, find someone who deals with a lot of dyslexia. Your state dyslexia association will likely have some docs on the board, or you can see who is doing public speaking in your state on dyslexia. But there are a fair chunk of kids who you think are going to get a dyslexia label who get a different label. The online information you read is not correct and doesn't reflect the DSM (diagnostic code manual). All that matters for coding and labels is the DSM. While there can be instances of psychs simply missing things are coming to different conclusions (we see that on the board), the actual labels of what things are called and what the criteria are are standardized in the DSM. So if you're thinking it's dyslexia, you can google dyslexia DSM IV (or the new DSM V, if you wish to compare and see changes) and see what the criteria are. That's how the labels are chosen. It's not up to the doc to make something new or determine what to call it. The DSM decides all that, and the labels are pretty unflattering. Back in the 80's adhd and dyslexia were lumped under one label: minimal brain dysfunction. Yup, for real. Now it's not dyslexia but reading disorder. So the DSM changes with each edition. The criteria change as well, and they DON'T match the stuff you popularly read online. People use terms colloquially, but once you get into a doc's office it's all about the DSM, the codes, and what the DSM calls it. And then all that gets coded for insurance purposes. It's not really up to the doc.

[Ravin]

Well, you could tell them to be accurate and not alter things for the insurance company's benefit, and be prepared to pay out of pocket if the insurance doesn't like it.

 

I hate the way insurance works sometimes. They should just cover neuropsych or not. Ours will only approve a neuropsych referral in case of head injury or if the primary care doc suspects a nerve problem.

 

 

[EKS]

If you don't want a certain diagnosis, tell the evaluator up front. I'm not kidding. Unfortunately, I did not know to do this back when we got my son evaluated for the second time and the diagnosis came back as Asperger's, which I knew was not right. A subsequent evaluation determined that his issues were *not* Asperger's but dyslexia.

 

I've since found out that the guy who diagnosed him with Asperger's diagnoses *lots* of kids with Asperger's. I honestly think that the best thing parents can do is to do *a lot* of research and figure out as much as possible what the problem is and then go to a person who specializes in that type of problem. Otherwise, if you take your kid to the ADHD guy, he'll get an ADHD diagnosis, and if you take him to the dyslexia guy, he'll get a dyslexia diagnosis, and if you take him to the autism spectrum guy, he'll get an autism diagnosis (actually, I think that if the guy who diagnosed my son with Asperger's had been a *real* autism guy, he would not have diagnosed him with Asperger's).

 

So, after the Asperger's had been undiagnosed and the dyslexia had been diagnosed, believe it or not, I needed IQ and achievement testing done by yet another psychologist. I told that psychologist that I didn't want anything about Asperger's or autism in the report--not as part of the history, not even if she was sure he had it. She could tell me if she thought he did, but I didn't want it documented.

[PrincessAriel]

My ds was diagnosed with ADHD and other LD's and was able to pass his training class and test for hunting. They asked parents if any of the kids had dyslexia, etc., (they did not ask for documentation, just took the parents' word for it) and the test was read to them in a group of about 5 or 6 kids. He did great. In fact, it surprised me how well he did as school has always been such a struggle.

[Tokyomarie]

Psychs vary quite a bit. If you think it's dyslexia, find someone who deals with a lot of dyslexia. Your state dyslexia association will likely have some docs on the board, or you can see who is doing public speaking in your state on dyslexia. But there are a fair chunk of kids who you think are going to get a dyslexia label who get a different label. The online information you read is not correct and doesn't reflect the DSM (diagnostic code manual).

 

Please be careful, Elizabeth, about painting all online information with a broad negative brush. As with other topics, there are online sources that contain blatantly inaccurate information. That's the nature of the internet beast. But there are also sources that have solid, well-reasoned, and well-written explanations of dyslexia- as there are for any topic one might write about. It is important to choose one's sources wisely and also to consult multiple sources.

 

While for insurance purposes, diagnoses that are made by mental health providers, including those for developmental and learning disabilities, must conform to the DSM-IV (soon to be DSM-V) criteria, it's also important to remember that interpretation of the criteria is informed by research and writing by experts on particular disorders. Good clinicians keep up with recent developments which help them to decide whether to assign a diagnosis when there is lack of clarity in the evaluation. It is also true that experts can and do disagree on interpretation. This is why a child might get a different diagnosis from two perfectly competent clinicians.

 

The research on dyslexia is constantly evolving. The new DSM-V will have the diagnosis "Specific Learning Disorder," which combines Reading Disorder, Mathematics Disorder, Written Expression Disorder, and Learning Disorder NOS, because of the recognition that learning difficulties in all of these areas often co-exist. Apparently, somewhere in the description, the word "dyslexia" will appear to acknowledge that it is an internationally used word to describe certain reading deficits.

 

The trouble remains, however, that some experts narrowly confine the use of the word "dyslexia" to describe reading deficits, while others recognize (rightly, IMO) that dyslexia is really a constellation of characteristics that affect not only reading, but math, written expression, and other functions, including executive functions.

[Tokyomarie]

MyLittleBears, it took me a long time to get over the possibility of labels that would have negative consequences for future education or employment. One thing to note is that the information generated is protected medical information. There are only certain conditions under which is can be disclosed without the individual's (or parents for a minor) permission. As others have noted, it can sometimes negatively affect future insurance coverage, but this has changed to some degree over the last decade or so and, I believe will continue to change as we deal with how pre-existing conditions are handled in this country.

 

In the end, I had to realize that it was better to get help for my child than to allow him to continue to languish. And that decision has paid off. I got connected to resources that helped us get past some roadblocks to learning that we were experiencing and helped to set my child on the path to educational success.

 

What was most helpful was that in relatively objective terms, I learned about both my child's learning strengths and learning weaknesses. That made it easier to leverage his strengths to help him learn content while attending to the weaknesses to build up those skills.

 

 

Just to clarify. I am trying to get a neuropsych evaluation for my 12yr old dyslexic. He has a really hard time with math, getting school done in a timely fashion, and I believe, processing speed and working memory. I suspect auditory processing. Anyway, it is long overdue. I called an office that deals with such issues like ADHD but also deals with other types of psychological problems: the kind that can label you for life. They told me that they will not call things "learning disabilities" because insurance won't cover them. If I go ahead with this, am I essentially having my child labeled with issues that will follow him through life? Like say, not being able to get a hunting license when he is older? I really need some good advice. :sad:

[PeterPan]

The trouble remains, however, that some experts narrowly confine the use of the word "dyslexia" to describe reading deficits, while others recognize (rightly, IMO) that dyslexia is really a constellation of characteristics that affect not only reading, but math, written expression, and other functions, including executive functions.

 

 

Bingo, that's the discrepancy you have to watch for in websites (broad definition vs. what DSM is looking for).

[MyLittleBears]

Thank you for all the feedback. You guys are always helpful and encouraging. I appreciate that! I honestly don't know what I would do without this forum!