Questions for follow up neuropsych evaluation

[MEmama]

DS had a neuropsych evaluation for probable ADHD a couple weeks ago and we meet with the psychologist tomorrow to discuss her findings. He’s currently taking Vyvanse, which after skipping a dose yesterday is clearly a lifeline if maybe not everything it could be.

Other than personal specifics, are there questions and talking points you mental health experts would recommend I bring up? There are a few concerns that we didn’t specifically or thoroughly address during the “interview”, such as anxiety and possible ocd, though idk if the testing he did addressed those as well or if they was adhd and ASD specific. Does anyone know how comprehensive the testing typically is? 
 

Any advice for tomorrow would be much appreciated. 

[Ann.without.an.e]

I'm not a mental health expert or even very experienced in this area. So take it with a grain of salt lol. I think there are many different types of tests and you will need to ask if the tests given would've evaluated potential OCD or ASD as well. Maybe they can give more tests if needed? If you have specific concerns about other issues, bring them up and ask if he can be evaluated further for those things as well. ADHD/Anxiety/OCD/ASD all have a cross in symptoms and I have no idea if it is better to evaluate for all so the treatment is better targeted or to start treating the obvious and see what issues remain? Maybe I'm just bumping this so someone with more experience can chime in with more help 😉 

[MEmama]

47 minutes ago, Ann.without.an.e said:

I'm not a mental health expert or even very experienced in this area. So take it with a grain of salt lol. I think there are many different types of tests and you will need to ask if the tests given would've evaluated potential OCD or ASD as well. Maybe they can give more tests if needed? If you have specific concerns about other issues, bring them up and ask if he can be evaluated further for those things as well. ADHD/Anxiety/OCD/ASD all have a cross in symptoms and I have no idea if it is better to evaluate for all so the treatment is better targeted or to start treating the obvious and see what issues remain? Maybe I'm just bumping this so someone with more experience can chime in with more help 😉 

Thanks. There are a lot of overlapping presentations, which is why I wondered if the evaluations are designed to sort through various potential issues or if they are more targeted. I suppose I’ll find out more tomorrow; I just didn’t want to bring things up if she’s already screened for them.

[kbutton]

Some psychs will do a lot of testing at once; others start with the basics and then add on things as they get a feel for the person in front of them. If you didn’t mention possible ASD, they might not have done anything to screen for it at all.

I would make sure I understand which tests were run, why they were run, and what the results mean. Both of my kids have had multiple evaluations, and we learn things each time. Only one was a waste of my time—the tester was not really equipped to work with 2e kids and didn’t say so. He interpreted results in a very black and white way as a result, and it was not helpful. He was, technically, the most qualified evaluator on paper that we ever used (neuropsych). If we hadn’t had other evaluations before that one, we’d have been pounding sand for years with that child’s issues because it was such a worthless eval. (At least one other boardie here loved him for her kid—go figure!) 

If you think there is any chance at all of ASD, I recommend a follow-up eval with a speech therapist that works with teens in the spectrum. If a kid “passed” for neurotypical but had mild ASD, the issues are almost always going to show up in one of many aspects of language, and it could be subtle but life-changing to get testing/language therapy. 

 

[MEmama]

3 minutes ago, kbutton said:

Some psychs will do a lot of testing at once; others start with the basics and then add on things as they get a feel for the person in front of them. If you didn’t mention possible ASD, they might not have done anything to screen for it at all.

I would make sure I understand which tests were run, why they were run, and what the results mean. Both of my kids have had multiple evaluations, and we learn things each time. Only one was a waste of my time—the tester was not really equipped to work with 2e kids and didn’t say so. He interpreted results in a very black and white way as a result, and it was not helpful. He was, technically, the most qualified evaluator on paper that we ever used (neuropsych). If we hadn’t had other evaluations before that one, we’d have been pounding sand for years with that child’s issues because it was such a worthless eval. (At least one other boardie here loved him for her kid—go figure!) 

If you think there is any chance at all of ASD, I recommend a follow-up eval with a speech therapist that works with teens in the spectrum. If a kid “passed” for neurotypical but had mild ASD, the issues are almost always going to show up in one of many aspects of language, and it could be subtle but life-changing to get testing/language therapy. 

 

I did mention that I suspected ASD when he was younger, but that everyone blew me off (but he’s so smart)! He actually did have a brief stint with speech therapy when he was three (diagnosed with speech apraxia) but we didn’t stick with it. We talked about both of those and some of her questioning to him was (to me) clearly ASD related. So that was on her radar, for sure. I'm curious if she picked up any anxiety or depression since I’m not sure we specifically mentioned those.

We unfortunately have very little time before throwing him back to the wolves at university. It’s good to know that additional testing might be required, even if it can’t happen until winter break.

I'm sorry you had such a bad experience with one of your evaluators—thank goodness you’d had better ones first. We really liked who we saw; DS can be extremely private but he opened up to her immediately. I’m going to ask if she offers telehealth therapy.

[prairiewindmomma]

One thing I've found helpful is to talk and frame things in terms of explaining and addressing behaviors. The neuropsych can help explain some of that, but ultimately what you're trying to accomplish is helping the kid in front of you succeed. I mention this, because even if the testing doesn't give you specific data points to work off of (a really low working memory or high ratings on the anxiety scale), you should still make sure she is aware of the behaviors and challenges and get ideas from her on how to address those.  

 

Edited August 1, 2022 by prairiewindmomma
edited for privacy

[MEmama]

Thank you, @prairiewindmomma.

The neuropsych just called for a private consultation before we all meet again tomorrow. It was sooo helpful and I was able to address my other concerns at length. DS is looking forward to getting some direction tomorrow.

2 hours ago, prairiewindmomma said:

ultimately what you're trying to accomplish is helping the kid in front of you succeed.

Yes, exactly this. 

[Kanin]

3 hours ago, MEmama said:

We unfortunately have very little time before throwing him back to the wolves at university. It’s good to know that additional testing might be required, even if it can’t happen until winter break.

 

I bet the psych will have some suggestions to make this easier.... like maybe he can take a reduced course load or something? 

[MEmama]

20 minutes ago, Kanin said:

I bet the psych will have some suggestions to make this easier.... like maybe he can take a reduced course load or something? 

Yes, she is even going to research supports available at his specific school and how he can get them. She.is.amazing ❤️
 

[Kanin]

1 hour ago, MEmama said:

Yes, she is even going to research supports available at his specific school and how he can get them. She.is.amazing ❤️
 

Aww. That's so great. What a relief to have such an amazing support person in your lives!