Just scheduled neuropsychological assessment for DS -what to expect?

[4forMe]

Has anyone had their child undergo a neuropsychological assessment? Can you explain the process and what I should expect? It sounds like we will be there all day after talking to the intake coordinator.

DS8 has struggled in school with writing and comleting assignments. His teachers have told us he appears to be very bright and has exceptional verbal skills. He is very quick with answering math facts verbally yet fails the written timed tests. DS also appears to be immature for his age and still does not have good fine motor skills. He has problems with attention, organization, completing work on time, etc. Homework time is a battle every night.

We have known about these problems for over a year. However, DH has been completely against getting him evaluated as he does not want him labeled. DH feels it is just a matter of immaturity and that he will grow out of it. I don't agree as things have gotten worse.

This year started out OK but is now going downhill. DS has been having major meltdowns at school and his sporting events. He uses the fight or flight response and has tried to run away in several instances which was very alarming when it happened at school last month. He also got in a fight at school yesterday. He gets easily upset about losing games, perceived injustices, or he tends to misinterpret someone's intentions. When he is having a meltdown, there is no reasoning with him. He calls himself stupid, hits himself, etc. Or he goes into a rage and wants to destroy things in his room, etc. It totally breaks my heart. I put my foot down with DH and scheduled the evaluation.

This situation has been extremely stressful. I feel like I've failed as a parent. Any suggestions or advice would be appreciated. Thanks for listening.

 

[deerhart]

I left a message for you on your other post.

It sounds like his got the same personality as my oldest child (who is a complete perfectionist!)

 

[clori]

My dd9 just had a neuropsych evaluation in January. In some ways she sounds like your ds such as easily upset about losing, misinterpreting, perceiving injustices etc. DD is also very literal, has trouble making lasting friendships, has trouble with non concrete schoolwork etc though is very bright etc.

For the neuropsych testing dh&I had to fill out some paperwork ahead of time and her teacher was asked to fill out several papers as well. The day of the appt I think we were there about 4 hours. I was in the waiting room for maybe 2/3 of the visit while dd did a bunch of standardized testing. I went in with dd in the very beginning and had a chance to talk to the psychologist alone as well near the beginning and end. I noticed some kids taking breaks but dd didnot take one. In our case we had already done the iep testing at school as well as a psychology evaluation so some of the tests may have been omitted.

I was told to tell dd that we were doing testing to help find out her learning strengths and weaknesses. I met alone with the tester about 3 weeks later for a 1 hour feedback session and got the full neuropsych report to bring home. I get to choice who to share the results with.

I didn't get an actual label for dd but rather was told she meets many of the Aspergers criteria but not all as well as known anxiety issues. What surprised me was the academic weaknesses such as difficulties with some non verbal processing areas and language recall struggles.

 

[bookwormde]

It depends very much on the competence of the clinicians. Any competent clinicians would immediately be thinking of Aspersers, and would use appropriate evaluations to determine the impact of the genetics.
If they did WPS SRS evaluation, a sensory profile and an auditory possessing evaluations in addition to the standard evaluation you probably will get some valuable results.
If you have not already get a copy of the Complete Guide to Aspersers by Tony Attwood which is available on Amazon for about $17. Even if your child does not have clinical levels of the characteristics and malefactions it will help you to understand his differences and amazing gifts, which will reuduce both yours and your childs anxiety (and make life a lot more fun)
It is very common when social complexities increase at the age of 6-8 to begin to show the manifestation of anxiety if they are not understood and supported.
bookwormde

 

[dogodisney]

We are in the process of getting my DGD(6) evaluated. We were sent forms that we and her teacher need to fill out. DH and I (we have custody) have an
appointment the 24th with the neuropsychologist. DGD will have her appointment after that.

Are all of you going at the same time?

 

[deerhart]

It depends very much on the competence of the clinicians. Any competent clinicians would immediately be thinking of Aspersers, and would use appropriate evaluations to determine the impact of the genetics.
If they did WPS SRS evaluation, a sensory profile and an auditory possessing evaluations in addition to the standard evaluation you probably will get some valuable results.

bookwormde

A neuropsych is usually not qualified to do an auditory processing evaluation. In fact, most audiologists have not been trained to do them either. The neuropsych testing may push you in that direction, but that is not the same thing as CAPD testing. CAPD testing is itself several hours worth of audiology testing, both recorded through audiology equipment and verbal interaction between the audiologist and the person.

The one thing that really stuck out with my son's tests were the memory tests. They couldn't determine if there was a real issue, because the scores were all over the place and made no sense and it was the last set of testing they had done after over 4 hours of testing on a 5 year old.

It really turned out to be a combination of him being done and tired AND his, later diagnosed, CAPD throwing the scores off.

Also, with any testing, they will want to know all testing that has been done on the child within the last year. This is to prevent them from getting results they can't use due to not following testing procedures. For example, my son's IQ was tested 8 months prior to his neuropsych testing using the WPPSI. Therefore, they did not want to repeat a verbal IQ test, but rather they did a nonverbal IQ test (based off the results of the WPPSI).

Ours was an autism rule out, adhd rule out, speech/language rule out (we already have 4 speech evaluations), etc.. Our final report was something like 15 pages long. It was the best $35 we ever spent!

 

[JulieWent]

It was the best $35 we ever spent!

I want a referral! Our neuropsych evaluations cost $1300 per. (We have had the initial one done when our son was in 1st grade and diagnosed with NLD -- non-verbal learning disorder; one in 5th grade, and one in 8th grade. We still need to do one more right before DS starts making college applications, etc. $35 would make it a bit less expensive!)

Seriously, though, OP, a good neuropsych workup takes anywhere from 4 hours to a whole day to complete. DS did lots of "standardized testing" formats, but also did block building, facial recognition, pattern completion, motor skills testing.... It's a grueling day, and DS complains about it loudly and obnoxiously every time we have to go. The information we get is worth every penny we spend and every second I have to listen to, "Oh, Mom, I hate going for my re-evals!"

Julie

 

[bookwormde]

Deerheat,
You are correct these evaluation are supposed to be done by a team of specialist and clinicians specially trained in Auditory processing evaluation and EF differentials are the only ones qualified to administer and make recommendations from them. As a note individuals with Autism actually cannot receive a formal diagnosis of CAPD as a primary diagnosis since it so prevalent and is considered a characteristic or co morbid area.
The "technical wait" times for most of the evaluations is 90 days but doing a nonverbal was a very good clinical procedure. I assume that since an Autism diagnosis was ruled out (this is very different from ruling out any Autism genetic characteristics) that the WPS SRS scores were well below 40 in all areas.

bookwormde

 

[deerhart]

Deerheat,
You are correct these evaluation are supposed to be done by a team of specialist and clinicians specially trained in Auditory processing evaluation and EF differentials are the only ones qualified to administer and make recommendations from them. As a note individuals with Autism actually cannot receive a formal diagnosis of CAPD as a primary diagnosis since it so prevalent and is considered a characteristic or co morbid area.
The "technical wait" times for most of the evaluations is 90 days but doing a nonverbal was a very good clinical procedure. I assume that since an Autism diagnosis was ruled out (this is very different from ruling out any Autism genetic characteristics) that the WPS SRS scores were well below 40 in all areas.

bookwormde

He wasn't even close to the cut offs for the autism diagnosis, even from the forms filled out by his SPED teacher who felt he was an aspie!

The reason they did a nonverbal IQ test was that on the WPPSI, his IQ scores on the verbal portions was in the low 70's and his scores for the 3 nonverbal portions of his test (block building, coding and matrix reasoning) he blew out of the water (hitting ceilings, everything 100% correct etc). Since we already knew he had a speech/language issue, the only way to truly evaluate his working IQ was to do a completely nonverbal route, especially as his verbal scores were so so low (I think he scored some 4's and 5's in a couple of subtests and averaged like an 8 on the rest).

His CAPD was easily diagnosed by a certified audiologist. His auditory memory was extremely poor (only able to hold about 2-3 items at a time) and his hearing in background noise was 40-45% in each ear. It explained a lot when everyone started to realize that if they gave him a 10 word sentence, he would only hear about 5 words and of those 5 words his memory would only be able to process 2-3 of them.

We are headed back to the doctor (he's been off ADHD meds for over 2 years) because this year his anxiety and frustration etc has suddenly gotten out of control again (easily frustrated, not wanting to do anything hard). Think its a combination of the added work at school, plus hormones, etc.. so we may be back to a small dosage of focalin to help him (and hopefully won't be running through the gambit of options every 6 months like last time)

 

[deerhart]

I want a referral! Our neuropsych evaluations cost $1300 per. (We have had the initial one done when our son was in 1st grade and diagnosed with NLD -- non-verbal learning disorder; one in 5th grade, and one in 8th grade. We still need to do one more right before DS starts making college applications, etc. $35 would make it a bit less expensive!)


Julie

We did the neuropsych testing through the state university's psychological behavioral health department so the fees were a lot less then a private doc (total our insurance paid was $615). The $35 was our insurance co-pay.

We also did my son's capd testing through a university. That cost us about $125. We did not send it through our insurance as they did not take insurance and it was a sliding fee scale.

 

[4forMe]

Thank you for all the responses. I feel like I have a better idea of what to expect.

My dd9 just had a neuropsych evaluation in January. In some ways she sounds like your ds such as easily upset about losing, misinterpreting, perceiving injustices etc. DD is also very literal, has trouble making lasting friendships, has trouble with non concrete schoolwork etc though is very bright etc.

For the neuropsych testing dh&I had to fill out some paperwork ahead of time and her teacher was asked to fill out several papers as well. The day of the appt I think we were there about 4 hours. I was in the waiting room for maybe 2/3 of the visit while dd did a bunch of standardized testing. I went in with dd in the very beginning and had a chance to talk to the psychologist alone as well near the beginning and end. I noticed some kids taking breaks but dd didnot take one. In our case we had already done the iep testing at school as well as a psychology evaluation so some of the tests may have been omitted.

I was told to tell dd that we were doing testing to help find out her learning strengths and weaknesses. I met alone with the tester about 3 weeks later for a 1 hour feedback session and got the full neuropsych report to bring home. I get to choice who to share the results with.

I didn't get an actual label for dd but rather was told she meets many of the Aspergers criteria but not all as well as known anxiety issues. What surprised me was the academic weaknesses such as difficulties with some non verbal processing areas and language recall struggles.

Thank you so much for telling me how you presented this to your dd. This helps me tremendously!

 

[4forMe]

It depends very much on the competence of the clinicians. Any competent clinicians would immediately be thinking of Aspersers, and would use appropriate evaluations to determine the impact of the genetics.
If they did WPS SRS evaluation, a sensory profile and an auditory possessing evaluations in addition to the standard evaluation you probably will get some valuable results.
If you have not already get a copy of the Complete Guide to Aspersers by Tony Attwood which is available on Amazon for about $17. Even if your child does not have clinical levels of the characteristics and malefactions it will help you to understand his differences and amazing gifts, which will reuduce both yours and your childs anxiety (and make life a lot more fun)
It is very common when social complexities increase at the age of 6-8 to begin to show the manifestation of anxiety if they are not understood and supported.
bookwormde

Thank you so very much for the book recommendation. I received it and plan to start reading it tonight.

 

[dogodisney]

Has anyone had their child undergo a neuropsychological assessment? Can you explain the process and what I should expect? It sounds like we will be there all day after talking to the intake coordinator.

DS8 has struggled in school with writing and comleting assignments. His teachers have told us he appears to be very bright and has exceptional verbal skills. He is very quick with answering math facts verbally yet fails the written timed tests. DS also appears to be immature for his age and still does not have good fine motor skills. He has problems with attention, organization, completing work on time, etc. Homework time is a battle every night.

We have known about these problems for over a year. However, DH has been completely against getting him evaluated as he does not want him labeled. DH feels it is just a matter of immaturity and that he will grow out of it. I don't agree as things have gotten worse.

This year started out OK but is now going downhill. DS has been having major meltdowns at school and his sporting events. He uses the fight or flight response and has tried to run away in several instances which was very alarming when it happened at school last month. He also got in a fight at school yesterday. He gets easily upset about losing games, perceived injustices, or he tends to misinterpret someone's intentions. When he is having a meltdown, there is no reasoning with him. He calls himself stupid, hits himself, etc. Or he goes into a rage and wants to destroy things in his room, etc. It totally breaks my heart. I put my foot down with DH and scheduled the evaluation.

This situation has been extremely stressful. I feel like I've failed as a parent. Any suggestions or advice would be appreciated. Thanks for listening.

Did your son have his evaluation?

 

[4forMe]

Did your son have his evaluation?

Yes, he went for the evaluation a couple of weeks ago. We were there for 7 hours. He had a 15 minute break in the morning and one hour for lunch. He did pretty well getting through the day, and I had tried to prepare him ahead of time which I feel helped. I also had an enormous amount of paperwork to fill out that morning. They also interviewed me for about 1/2 hour.

We have not yet received the results. DH and I have an appointment for next month (in about 3 weeks) to meet with them and go over the results. The appointment day was the earliest day that DH could get a day off of work for this meeting. I am really hoping this meeting will help get DH on board.

My DS8 is continuing to have problems at school. Last week he got in trouble for fighting for "defending" a friend and also forgot his homework 2 days in a row. Therefore on Wednesday, he had 3 days of homework to do and getting through the afternoon/evening was a nightmare! His teacher had to help him last week get his disaster of a desk organized, and he needed lots of reminders about keeping his hands to himself.

I'm just trying to take things one day at a time at this point with him since his outbursts can come about at any time.

I will post an update after we receive his results.

 

[4forMe]

We are in the process of getting my DGD(6) evaluated. We were sent forms that we and her teacher need to fill out. DH and I (we have custody) have an
appointment the 24th with the neuropsychologist. DGD will have her appointment after that.

Are all of you going at the same time?

My DH didn't go with for the evaluation but will be with me to review the results next month.

Did your DGD6 have her evaluation completed? Did you get the results yet?

 

[4forMe]

We received the results last week but I haven't had time to post an update.

DS8 was diagnosed with ADHD-combined type and dysgraphia. It was also reported that he demonstrated mild executive dysfunction. Recommendations include extended time on tests, prefential seating, study guides, organization assistance, etc. per a 504/IEP. For the dysgraphia, it is recommended he be evaluated and monitored by an occupational therapist.

Now for my questions:

Do I inform the school now since it is so close to the end of the year? I did find out from a friend of mine who has a son with ADHD that our district automatically gives an IEP under OHI for an ADHD diagnosis. Do I insist on trying to set up an EIP eligibility meeting prior to the end of the school year (which ends in one month)?

Does the school do the OT evaluation or do I need to go to an outside resource for that? Does insurance typically cover an OT evaluation?

What is the best way to talk to/explain to my DS that he has ADHD?

It was also recommended that we read some books by Russell Barkley regarding ADHD which I have ordered. Any other book suggestions would be appreciated.