psychological testing through the school system

Firefly2

New Member
Hi! I haven't posted in a few weeks, and still need to do my signature-sorry. :)
Loooong story short-my 8 year old who was dxd with ADHD and dysthemia in 1st grade is still struggling. He is on Adderall and Zoloft-neither of which is doing a ton of good. Anyway-with the sensory stuff and mood swings and obsessions and some struggles socially, I have finally contacted the school to do an evaluation. They are going to test for Obsessive Compulsive Disorder (OCD) and aspergers. Has anyone had testing done through the school system? Of course there is no cost, which is huge. But what are pros/cons of school testing vs going to an outside psychologist? I just want answers. I want to know HOW TO HELP MY CHILD. I feel overwhelmed, and often helpless. Thanks you all!
 

InsaneCdn

Well-Known Member
Typically, it pays to get both a school evaluation and an outside evaluation. School evaluations are usually not comprehensive - but if they DO turn up something, it qualifies your child for certain supports etc. Outside evaluation... you really want a comprehensive evaluation. The kind that looks at way more than "just" what affects school-work and school behavior.
 

jal

Member
Are they using a school psychiatric to do the evaluation or someone not affiliated with the school? We had an independent neuropsychologist do an evaluation when our son was 4. We paid the copay and insurance covered the rest. He was not yet in school. When he was 8 the school did psychiatric testing on their dime with a dr that didn't work for the school. Next month he is having a neuropsychologist on the schools dime, but I got to choose the neuropsychologist.
 

DDD

Well-Known Member
Based on my experience "it depends". Yeah, I know you are looking for real answers but honestly it does depend on where you live, how the school board operates, whether they have a psychologist on retainer (our County does but he is not well qualified) and/or whether the Special Education Coordinator has a separate budget for testing students with unmet needs. In our family the on retainer man was a nice person who did not have the qualifications to pinpoint difficult child's issues BUT we started with him and subsequently when it is more apparent that the problems were complex the School Board paid for me to take difficult child out of town to a larger city for full neuropsychological examinations.

My suggestion is to let them test and then see how it "feels" to you. If it sounds right...try the corrective path they suggest. Don't hesitate, however, to require more testing if his needs don't appear to be met. Hugs and good luck.
DDD
 

Firefly2

New Member
Thanks everyone-I will follow through with the school testing and see what comes up. I had an appointment with the psychiatric nurse practitioner today. I left the appointment feeling a little worse than when I went in! First of all, my 8 year old son didn't want to be there and clammed up and was crabby and didn't answer questions, but just shrugged his shoulders when she asked him anything.

He (as of now dxd with adhd and dysthemia) is on 15 mg Adderall xr, and 50 mg Zoloft. While it has helped some, we are still far from where we need to me. He still worries a lot, he still has major mood swings 2-4 times a day, still is oppositional and will argue til he is blue in the face, has obsessions that occupy a lot of his time (yes-I have finally admitted "obsessions" is a proper word for what I see), wants to control everything and everyone, has sensory issues, yet can be sweet and loving and funny and a total sweetheart too!

All of this and more happens every day, and I am emotionally exhausted. I try SO hard to remain calm and firm and give consequences when necessary, and compliment him when he is good (I am not as consistent as I would like to be, but I honestly try hard). I have a suspicion that there is more to the story....my gut is telling me that his diagnosis isn't accurate. I talked to the nurse about possible Obsessive Compulsive Disorder (OCD) or aspergers signs that I see, and she basically said even if he was diagnosed with this, we would still be going about his treatment the same way-with therapy and medications. And she also said I need to not worry so much about a diagnosis and focus on treating the symptoms we are seeing right now. Ok-I do tend to worry too much, and I am very concerned about my child. But, I really think theres more going on than just add and dysthemia. Is it wrong to want a correct diagnosis? Is it wrong to want more answers and to learn more about what is going on inside my child's head? I am irritated-really am. She has seen my son 3 times-for a total of maybe 2 hours altogether, and she kept telling me that she felt like we are still dealing with add and anxiety-related symptoms. I spend a lot of time with my son-I KNOW my child! I like this lady-I really do. I have called her several times, and she has always returned my calls. I think she is trying to help us, and I respect her professional opinion. But, I my gut tells me I need to push further until I know exactly what is going on with him. Is it so wrong to question a diagnosis he had when he was 6?

There is so much going on with him, that I don't know where to start....and most of it he saves for ME! Neighbors, teachers and other family members see very mild symptoms. I get the full brunt of his frustrations. And this makes me feel like it is my fault.
His behavior isn't always consistent...one day he will be happy and helpful and kind and maybe have 1 meltdown. Awesome! The next day could be a disaster. One day his little brother could play with his tackle box, and he won't care, and the next day it could trigger a meltdown. He was very irritable and in a bad mood when we went to an outdoor concert the other day-finally laid his head in my lap and covered his ears because it was "too loud". But fireworks don't bother him a bit! He doesn't like people he doesn't know well talking to him-he will ignore them, or barely mumble a "hi" and then is pulling on my arm to go. He is scared to jump a very small ramp we built for his scooter, but he can go on fast carnival rides and have the time of his life! He can be so inconsistent-it throws me off. Sometimes I can predict when he will have one of his bad moods, but sometimes they seem to just happen out of the blue. I can see the look in his eyes, and I know that I am in for at least 30-60 minutes of absolutely exhausting behavior problems. before he snaps out of it.

I have anxiety and add symptoms as well and am taking medication. I know when I get worked up, it makes things with him worse. I am very patient-but my irritation always eventually shows through. I can only take so much!

I am not going to let anyone tell me that I shouldn't push for further testing. If my instincts are wrong, so be it. I have to know if all this other unusual behavior I see is "normal" , or a cause for concern. I feel like I am not helping him as much as I could be doing, and I want to learn what to do better!
 
L

Liahona

Guest
If he has Autism Spectrum Disorders (ASD) or bipolar or ect... It would be better to know because the treatments could be different. I have found that most dr have very big egos. (Even the good ones) I had to develop the back bone to stand up to them. The ones I like are harder for me to stand up to than the idiots.

*And the school won't do complete testing, so you will want to go with a neuropsychologist, Occupational Therapist (OT), Speech Language Pathologist (SLP), ect...
 

InsaneCdn

Well-Known Member
Is it wrong to want a correct diagnosis? Is it wrong to want more answers and to learn more about what is going on inside my child's head? ... But, I my gut tells me I need to push further until I know exactly what is going on with him. Is it so wrong to question a diagnosis he had when he was 6?
Short answer: No.
Long answer: Trust your "mommy gut". It is part of being a warrior parent. Yes, we can be right and the professionals can be wrong. Find another source of help.
 

LittleDudesMom

Well-Known Member
I agree with InsaneCdn when she says, "trust your mommy gut".

As others have said, school evaluations vary in their "quality" depending on the school or the district. We were very fortunate that our school did a fabulous COMPLETE evaluation on difficult child when he was 8. They even requested diagnostic paperwork from his psychiatrist and his therapist. It was the beginning of getting good quality supports for difficult child at school. Once his IEP was in place, things began to improve. You need to know in order to figure out a way to even the school playing field.

One more thing, I actually had his therapist attend his first IEP meeting - the meeting after all the testing when they revealed their findings, qualified him for service, and began to work on an IEP. She was able to help navigate the test results, give some suggestions, and lend her professional opinion to any mods/accoms, etc. The school looks very favorable on professionals. Unfortunately, my insurance didn't cover her "off-site" services and it wasn't cheap - but her office allowed me to pay a little every month till I paid it off -- it was TOTALLY worth it!

*Sharon
 

Firefly2

New Member
Yes-I am trusting my instincts 4 sure. That is a good idea to invite the therapist to the IEP meeting-very good idea. I just may do that! Talked to the school counselor today, and she has already submitted the report to get the ball rolling on the testing. :)
 

BusynMember

Well-Known Member
If it were me, I'd do an outside of school evaluation with a neuropsychologist. He sounds like a lot more is going on than ADD and you can't treat it if you don't know what it is. The schools usually try hard to keep intervention and therefore their diagnoses to the bare minimum such as calling anything and everything ADHD.
 

Firefly2

New Member
Thank you-with our deductible not being met, and all these doctor appts....money is tight! But, I have not ruled out finding a neuropsychologist yet. I want to see what the school testing reveals, and see what our new counselor says about my son as well. If I am not happy with the results, I am definitely going to consider outside testing! For so long, everyone has dismissed his behavior...like it was just "him being him". But I can't dismiss it-I know something is going on and it is more than just adhd. My husband also has seen things going downhill, and has come to realize that our son needs help. Question: the psychiatric nurse practitioner we see just put him on Risperdal in addition to the Zoloft and Adderall. He hasn't taken it yet-I need to pick it up from the pharmacy. Does anyone have any experience with this medication? Thank you!!!!
 

InsaneCdn

Well-Known Member
Risperidone? rxed by a Nurse Practitioner?
I'd be wary.

Can be a great drug.... has serious side effects.
Our psychiatrist will not rx it to younger than teenage.
And even then... only with the kinds of diagnosis that would justify it. (Autism Spectrum Disorders (ASD) is one of those... some kids on the spectrum seem to need the "slow down" effect, it reduces some of the irritability, etc.)
 

BusynMember

Well-Known Member
Our NP can prescribe and some are psychiatric NP. NPs are becoming more and more useful. HOWEVER...Risperdal was very dangerous for our son. Be careful. Also, be wary of ANY professional, psychiatrist included, who overmedicates. That can make things 100X worse. Too much medication is as bad or worse than too little or none. I know this first hand as I was overmedicated and it plain made me suicidal whereas I had not been before the overmedication.

No psychiatric on earth could make me take an antipsychotic, but that's because I don't like the way they make me feel. Everyone is different. I was given Thorazine once to make sure I wasn't schizophrenic and it made me a zombie. My son behaved like a zombie on Risperdal...he slept, cried, had all sorts of aches and pains, and finally developed a movement disorder. So watch your kid. It may help, but it needs careful monitoring.
 

jal

Member
There is also a possible side effect for males. For lack of the medical term at the moment it is documented to cause "man boobs".
 

jal

Member
It's called gynecomastia. My difficult child was on risperdal when he was young. We discontinued because of this.
 
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