Update on ds's appt with dev. ped.

[LisaM]

So ds had his appt with the dev. pediatrician last week. It went really well; I really like the doctor. We were with her for over an hour, and she asked lots of questions. She had me fill out two different questionnaires: the Conners' Teacher Rating Scale (for ADD/ADHD) and the Asperger Syndrome Diagnostic Scale (ASDS).

When she scored the tests, they showed a possibility of ADD/ADHD and he scored "likely" for Asperger Syndrome. However, she also said that the issue could be the sensory issues that we've observed. She also observed that he is gifted academically -- he is reading well above grade level -- so his challenges could stem from that. So I feel like we have a lot of possibilities but not much more than that.

I talked with my mom (she teaches kindergarten in the ps) and she didn't think ds was ADD/ADHD -- at least from her experience. I thought that 5 is a bit young to diagnose ADD or ADHD anyway, especially for a boy. I mean, how many 5-year-old boys DON'T have difficulty playing quietly or waiting their turn? :lol: The possibility of Asperger's kind of surprised me . . . I guess because I've been thinking about sensory processing issues I hadn't considered other possibilities.

The doctor gave me a prescription for an OT eval for the sensory issues; I've called and left a message so I'm waiting for a call back on that. Beyond that, she suggested psycho-educational testing, cognitive behavioral therapy, a social skills group as other possibilities. Any thoughts? My head is kind of spinning right now.

[Alice R]

I thought that 5 is a bit young to diagnose ADD or ADHD anyway, especially for a boy. I mean, how many 5-year-old boys DON'T have difficulty playing quietly or waiting their turn?

I think 5 is about the earliest that they will give a diagnosis of ADD/ADHD.

I do know what you mean about boys and not waiting and being impulsive but there is also the qualtiy and the content of how impulsive and impatient he is. All kids are impulsive and impatient. :lol: It's sometimes a clinical judgement on HOW impulsive he is and how he demonstrates that impulsivity in real life situations.

If he is gifted academically, why the psycho-educational testing? i don't get that one. Is that to rule in or rule out the aspergers?

OT sounds great. Group therapy etc. sounds great.

It sounds like you learned a lot. :group:

[Chalane (FL)]

Lisa,

I think your right about the ADD/ADHD dx, my kids have the same dx along with everything else & that was my response.

I've heard of ABA (applied behavior analysis), but not cognitive behavior therapy did she give you any info or websites to look up? I'd be interested if she did.

Glad you're getting an OT eval. :clap: that should really help w/sensory issues. My ds cousin uses brushing serveral times a day to assist with her sensory issues & I've heard that it's very helpful.

Look up Asperger's on line you should find a check list of sorts for things to look for. I did this with Autism & knew yrs. before the dr. finally dx ds (that was when it was still difficult to get the dx). It might make it obvious one way or the other for you.

Hope she isn't using social skills group as a code for ps. You'll get a lot more people suggesting your ds doesn't get "enough socialitazion" once you have a dx. I just smile and say they do have socialization opportunities.:)

If I'm remembering correctly the psyco-educational testing just measures the IQ. Is that right?

Praying for you as you begin your journey to answers and treatments.:group:

[LisaM]

I think 5 is about the earliest that they will give a diagnosis of ADD/ADHD.

I do know what you mean about boys and not waiting and being impulsive but there is also the qualtiy and the content of how impulsive and impatient he is. All kids are impulsive and impatient. :lol: It's sometimes a clinical judgement on HOW impulsive he is and how he demonstrates that impulsivity in real life situations.

If he is gifted academically, why the psycho-educational testing? i don't get that one. Is that to rule in or rule out the aspergers?

OT sounds great. Group therapy etc. sounds great.

It sounds like you learned a lot. :group:

Thanks for your response, Alice. This is all new to me. Dd had OT and ST as an infant/toddler, but that was because of being a preemie. This feels entirely different to me for whatever reason.

The doctor suggested the psycho-educational testing to confirm giftedness. (Maybe to see how gifted?)

Everything she told me was based on my answers to the questionnaires that she gave me. She did interact with ds on a limited basis, but he was very shy and wouldn't speak with her much. She listened to him read out loud and had him do some writing and answer a few other questions, but mostly it was my input. Dh was not able to come with us, and there is no ps teacher to fill out any evals either.

I guess I'm wondering if we need input from other sources to get a more accurate picture. Should I ask for his teachers at church or co-op to give their input as well? Will the OT eval for sensory issues be more focused on getting information by interacting with ds, or will it be more questionnaires from me? I know that I know ds better than anyone else, but it seems like it would be more helpful to see what he's like himself too. KWIM?

[LisaM]

Lisa,

I think your right about the ADD/ADHD dx, my kids have the same dx along with everything else & that was my response.

I've heard of ABA (applied behavior analysis), but not cognitive behavior therapy did she give you any info or websites to look up? I'd be interested if she did.

Glad you're getting an OT eval. :clap: that should really help w/sensory issues. My ds cousin uses brushing serveral times a day to assist with her sensory issues & I've heard that it's very helpful.

Look up Asperger's on line you should find a check list of sorts for things to look for. I did this with Autism & knew yrs. before the dr. finally dx ds (that was when it was still difficult to get the dx). It might make it obvious one way or the other for you.

Hope she isn't using social skills group as a code for ps. You'll get a lot more people suggesting your ds doesn't get "enough socialitazion" once you have a dx. I just smile and say they do have socialization opportunities.:)

If I'm remembering correctly the psyco-educational testing just measures the IQ. Is that right?

Praying for you as you begin your journey to answers and treatments.:group:
Chalane, thanks for your thoughts as I navigate on this journey. I do want to do more research on Asperger's and see what kinds of things they say to look for. Psycho-educational testing is IQ testing; at least, that's how it was explained to me.

In terms of the cognitive behavioral therapy, the way she described it was that it would be a therapist working with my ds to help him think through different situations that he might find himself in and how to handle these situations. She said if it's a direction that we want to pursue, she could give us a list of therapists . . . I'm not focusing on that right now because I think some other issues are more pressing.

And the social skills group is actually a group they have right at the hospital that meets -- and helps kids work on various social skills. She did say that we would need to talk with the therapist running the group to see what particular focus the group has right now to determine if it would be a good fit for our ds. I guess they vary what they are working on depending on the needs of the kids in the group.

I did tell the doctor that we homeschool, but ds certainly has opportunities to socialize with his peers through classes at church and co-op. She didn't seem at all concerned about homeschooling with him at the initial appt anyway.

[Alice]

ADD/ADHD is tough to diagnose at 5 because as you said many if not most 5 yr old boys might meet the criteria. However, one of the criteria for ADD is that it begins before age 5, meaning that it's really how the brain is wired and not something that suddenly occurs at age 10. I see older kids come in who are just being "diagnosed" because they are now struggling in school, but really when their parents look back we should hear that the issues have always been there but maybe are becoming more of a problem now with higher expectations at school. If I hear that someone has never had any of the symptoms until an older age, I suspect something other than ADD.

I see a lot of kids at 5 who someone is worried about ADD (usually teachers) and I think it's just a kid who needs to mature a bit and ultimately will not have the diagnosis. I also see some kids at 5 (or even younger) who I'm pretty sure will one day be coming back to talk about ADD. Personally, I typically tell parents at age 5 about what the doc told you, that it's possible but not definite. Things like behavior therapy are worthwhile regardless of the official diagnosis. I will not medicate a child at that age, myself, although I have sent a few kids who were very severe to a pyschiatrist as the parents were interested in pursuing medication.

It is helpful to get other input. If you ds has a teacher that sees him regularly you could ask them to fill out the forms/scales also and see if there is a difference between what they see and what you see. The other Alice can probably give a better opinion about what the OT will do, but my experience is that their eval will involve more interaction with the child and less questionnaires on your part.

[Chalane (FL)]

OT eval.--I've always experienced that it's both. You have a questionaires & they eval what the child can/can't do and how they react to different sensations.

The group therapy sounds wonderful, I wish we had it in our area.

Although my kids had psycho-evals. to determine if/how much MR there is I found it very helpful. Hope you find it as enlightening for how gifted your ds is.

What she is calling cognitive behavior therapy sounds like ABA. The good news is that if he is dxed w/ Aspergers some states are requiring ins. co. to pay for ABA; for any child with autism spectrum disorder. I have never heard of anyone who wasn't pleased that they persued ABA.

Leighton's psychologist was very supportive of the fact I'm hs him. ASD dc have a dificult time transfering goals learned in one setting to other settings & therefore it is best to have them learn it in a daily living situation if possible. That is one of the reasons ABA works so well. They come to your home & even work with the child in social settings. Our goals have included things like going to the store and library, as well as life skills like brushing teeth (Leighton is low funcitoning). When ds con't to give his PT a hard time the ABA therapist went with us to a few appts.

[Alice R]

The Other Alice??? :eek: :roflol: I kinda like that...sounds a bit intriging ;)

My mom's name was Alice and I was always Little Alice. :lol:

The OT will do hands on stuff and a lot of interviewing. Probably a mix of both.

The need for parent interview is heavy in a sensory eval because the therapist cannot follow you around all day and see how your child does in the bath, in the car, in church etc. :roflol: So, they depend on you reporting on how your child does in those situations. It's very hard when you have an unrealiable parent. But that is not your situation so you will be fine with an interview. :group:

The social group sounds good. I worked with a speech therapist who ran a group and it sounded really really nice. You can work on all sorts of real life stuff in a nice group. :) If the leader of the group is good, it might be extremely helpful.

Cognitive therapy sounds good but your son is little. I'd like to see how that works with a 5 year old :unsure: However, if the person is good, then it will work. ;) I've heard more about Play Therapy for that age group but who knows?

The psych ed testing will be good also but you can wait on that...you have to prioritize (spelling???) your immediate needs and that one is important but I think the aspergers and the sensory are more pressing.

[Alice]

The Other Alice??? :eek: :roflol: I kinda like that...sounds a bit intriging ;)

My mom's name was Alice and I was always Little Alice. :lol:



That is too funny. My grandmother was Alice and so I was always Little Alice! :lol:

I'm sure we could have a whole conversation about all the "Going to Wonderland?" jokes we've heard in our lifetime.

Ok, thread hijacking is finished. Proceed with helpful posts.....