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ADHD inattentive suspected


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First of all, thank you to all who share information here. It helps me make sense of some of the things that I've been observing for some time now. I now suspect that my DD in middle school has ADHD inattentive type. My question is what sequence should I follow for consultations? I understand that a pediatrician, neuropsychologist, psychiatrist, developmental optometrist, occupational therapist may all be helpful.      

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4 hours ago, Haken said:

I understand that a pediatrician, neuropsychologist, psychiatrist, developmental optometrist, occupational therapist may all be helpful.     

Well first off, welcome to the boards! Sounds like you've been lurking and learning a ton. 😄 

4 hours ago, Haken said:

My question is what sequence should I follow for consultations?

Depends on what is most pressing for your dd and how long the waits are, right?

If you list out the 6-8 things that are big issues right now, how do those correspond to the eval options? Like if she's having headaches from her eyes, up prioritize the developmental optometrist. If her body is hard to live in (sensory, etc.), up prioritize the OT eval. If she has trouble getting out her thoughts, up prioritize SLP. 

You don't technically need any evals to get meds, only the doctor appointment. They'll do their own thing for how that particular doc diagnoses and then write a scrip for meds. The interesting question is whether attention is a greater need or anxiety. Not saying I'm anti-meds, just observing that you end up needing to put more on the table. Many adults with ADHD are self-medicating with caffeine. 

The biggest *surprises* when people get neuropsych evals are usually things like processing speed and comorbidities like anxiety that they weren't expecting. 

The challenge right now is that some psychs are WAY out, like 9-12 months. Covid just messed up everything. So that's why I'm saying you'll have to start with what is most pressing, factoring in what you can actually make happen. Getting an OT eval and testing for reflexes, you can make that happen easily. The psych will be the longest wait (most likely) and everything else will be in the middle. 

Is there any question about social skills or language? And how well does your ps do with evals? If you want timely evals that are multi-factored, they would be your path. 

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Thanks PeterPan for your advise. For us I believe attention is the main issue. We are accidental homeschoolers because of the pandemic so we are going at it on our own. One positive outcome is that because I work with her everyday, I now understand several issues that were coming up when DD was still in Catholic school. For example, I thought there was inadequate instruction at school because it seems we have to go through everything after school. Perhaps because we did so much catching up at home, the issues may have been masked. 

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You will likely have waiting lists for some of the specialists. I would get on a waiting list for a ed psych or a neuropsych (can do a lot of the same things). Definitely speak up to the pediatrician. Ticking off a developmental optometrist should be easy peasy if you have a reputable one nearby. They will find something or not (or say something is skewed but not "enough" to need intervention unless xyz symptoms crop up). 

Having VT between psych evals changed my kids' scores quite a bit, so if there is a vision issue, it can really mess things up on some tests, particularly the VSL ones. Both of my kids "barely" needed VT and had some of the shortest courses of therapy the COVD optometrist had ever prescribed--they compensated well until they fatigued. The developmental optometrist was really shocked at how differently they tested before and after she purposefully fatigued them--as in saying, "I can't believe he ever learned to read like this." My older son's VSL scores were kind of meh before VT. After VT, he hit the ceiling on the whole non-verbal battery and would've kept going if there had been more to test. 

So yeah, get the vision piece going if you think there is any chance there are issues there. 🙂 

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Thanks kbutton for sharing your experience. After making some calls, it seems like we're leaning towards pediatrician and developmental optometrist first just for general health, regular eye check up and then eval for VT just in case DD might be a candidate for it. Then we'll take it from there. I'm also just wondering too if there are any important questions I should ask pediatrician and developmental optometrist. Part of me don't want to just say I suspect ADHD inattentive because I'm not qualified to make that assessment and I don't want to bias their views. I'm wondering if others may have come across an effective way of broaching the issue?

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