What types of evaluations to request?

pattyb

New Member
DS is 4 years old and diagnosed with Mood Disorder not otherwise specified. His main struggles are with meltdowns over seemingly insignificant things, defiance/refusal to participate in things in preschool, and more recently some aggression. He has a hard time learning at times, because he just can't seem to focus or sit still, and seems overstimulated at times, also puts a lot of pressure on himself and gets very frustrated when he can't do things 'right' (he's pretty behind most kids his age as far as writing/drawing etc. - he's starting Occupational Therapist (OT) this week for fine motor skills). He has some sensory issues as well, and he is very shy, very very anxious in social situations, and socially awkward - not sure how to approach a group, won't respond to questions at first in social situations. He's no longer in preschool - he was removed from the program (private preschool) because of behaviors. But as far as evaluations, he's usually very bright, engaged and curious in one-on-one testing type situations. We are meeting with-school district next week to start the evaluation process and decide what evaluations they will do. Autism has been ruled out by several specialists. Not sure what type of testing they will plan to do but they had asked what type of evaluations I want - ??? I have no idea how to answer that. He has not qualified for special education services in the past when he has been evaluated (before he was 3) but that was before his diagnosis and before a lot of the behaviors started. Thanks for any info!
 

keista

New Member
Evaluate for sensory issues, auditory processing issues, AND AUTISM. Yeah, sorry, I don't care if it's been ruled out. Still sounds like it.

I'll tell you I had Autism (Asperger's specifically) ruled out by a professional for DD1 and a year later she got the diagnosis. You know what? I had ruled it out myself. She didn't fit the symptoms in a classic manner, so it was really easy to over look with a quick evaluation. It took a 4 hour in depth evaluation to be able to identify it. Now it seems to scream out at me like neon signs.

Anyway, if the school is willing to do the evaluations, I don't think it could hurt.
 
T

TeDo

Guest
What kind of "specialists" has he seen and how many? To truly rule out Autism Spectrum, you need to have him evaluated by an Autism Specialist. There are specific tests, like the ADOS, that THEY use. No one else is truly qualified. You should ask the school if they have one or have access to one.

What Keista said as well as academic, psychological, behavioral, emotional, language processing, expressive language, and receptive language evaluations are definitely things they should look into. What specific tests they use would be up to them but make sure they are addressing ALL these areas. Since he's only 4 the other areas I would normally recommend (reading, writing, math skills) may not be appropriate yet.
 

pattyb

New Member
Thanks so much for your quick responses! He was evaluated for autism by a developmental pedi., a hospital system's autism team (they used ADOS and a range of other tests but not sure the other names), and a neuropsychologist (who diagnosed him with-mood disorder). We're in the middle of another developmental evaluation. through another office, but I can ask the school as well if that would be a good idea. I have no idea what to think. Just wondered if there are any like specific tests I should be wanting.
 
T

TeDo

Guest
You can't really request specific tests because each school district uses whatever THEY find the most helpful, or in some cases whatever is the cheapest & easiest. All you can really request is areas you want tested.

It wouldn't hurt for the school to do the Autism Spectrum Disorders (ASD) testing also. It just surprises me that he doesn't qualify AT ALL on the spectrum given what you've shared with us. But, if those specialists tested for that specifically then I guess you can't argue. It might be that as he gets older, the signs will be more clear if it is any level of Autism Spectrum Disorders (ASD). I don't remember difficult child 1 back that far so guess I can't tell you one way or the other. I just know it sounds a lot like difficult child 1 as he is now. You're doing all the right things. Keep plugging away and the answers will eventually make sense. On the other hand, if YOU suspect Autism Spectrum Disorders (ASD) of any kind, what you'd normally do to help kids with it works for all kids also. It definitely can't hurt.
 

soapbox

Member
You may need to get some evaluations done outside of school... but based on your descriptions, I'm going to "slightly" disagree with my good friends above... it might be something on the Autism Spectrum Disorders (ASD) spectrum, but it could be just as likely that it is a combination of other things - many of which often occur as part of the Autism Spectrum Disorders (ASD) spectrum and/or are comorbid with it.

evaluations:
1) Occupational Therapist (OT) - sensory and motor skills. Rarely will a school setting provide an in-depth Occupational Therapist (OT) evaluation. Fine to get the school version too - if THEY flag sensor or motor issues, it definitely has to be there! But... I'd still get a private Occupational Therapist (OT) evaluation.

2) Speech Language Pathologist (SLP) evaluation - he's a bit younger than they usually catch some of these problems at, but... he does SO much better one-on-one than in a class? That just screams "Auditory Processing Disorders (APD)" to me... auditory processing disorders, especially auditory figure ground. If you have this problem, it takes so much effort to filter out and pick up on the "words" being spoken, that there isn't enough brain-power left to actually "process" the message. Burn-out, and behavior problems, and "ADHD symptoms", are very common. Auditory Processing Disorders (APD) can be a stand-alone diagnosis, or be co-morbid with a range of other dxes, including ADHD. Where I live, they won't test for auditory figure ground until age 7... but it sounds like there are some screening tools out there that can at least "flag" the possibility... so he can get interventions and accommodations.

And then add in the others listed by other posters... testing for LDs, etc.
 

buddy

New Member
Most school districts have the most commonly used assessment protocols. Each year there is a budget and I know we added one or two yearly. They can also be borrowed from other districts so if you hear of something you want to try no problem. The Occupational Therapist (OT) and PT folks have less options but what they have is pretty standard and good.

They will likely list several tests, including standardized and checklist types. They should also have listed record review, parent interview, and developmental history.

The important thing is to cover the areas
Adaptive Behavior
Behavior Issues
Receptive Language
Expressive Langauge
Social/Pragmatic Communication
Fine Motor
Gross Motor
Sensory
MAYBE ability(he is young, I am not big on ability tests except they can help show learning style etc... )
Cognitive development/Developmental areas overall....

For early childhood several tests cover all of these areas as subtests. Sometimes different professionals do their area of expertise for the subtests, other places the primary assessor does the whole test.

But also make sure that separate more in depth investigation is done by each person.... to just use one test that is an overall dev. test ... it can miss more subtle things. At his age it only takes a few positive answers, very limited items, to pass a cut off.

It is good you are going thru another evaluation. I agree that it will be important, especially since the dev. pediatrician. team felt he did not qualify for an autism diagnosis (yet) .... keep up with the Occupational Therapist (OT) and Speech Language Pathologist (SLP) evaluations. You sound very on top of getting the evaluations so just realize many of us have received on again off again diagnosis for our kids. It is an ongoing challenge. Wish I could say differently but it is just that way.

Remember, when they meet with you about the assessment, you do not have to sign right then. Just say great! I will take it home and review this to make sure I dont have any other ideas and will send it back soon (you have several days)... then feel free to come here and we can at least give ideas about what they are proposing.... it is up to you of course.

You are doing amazing. Just keep digging in there.... HUGS
 

keista

New Member
But also make sure that separate more in depth investigation is done by each person.... to just use one test that is an overall dev. test ... it can miss more subtle things. At his age it only takes a few positive answers, very limited items, to pass a cut off.
I'll echo this. DD1 doesn't make the cutoff on ADOS, but on the subtests she is well within range (frighteningly so). I found this very odd, but it's just like Buddy said. The overall test can miss the subtle details.
 
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