Please Help! Evaluation Options? Need to get to root of it

amother

Goldenrod

Tue, Feb 16 2016, 11:54 am

So we are at the end of our ropes with our 14 year old son. He has been struggling since forever in school. At one point, he was diagnosed with auditory processing disorder. We are paying a lot for support in school, tutoring as well as someone who does work with him for the auditory processing. Our last leg of the journey was taking him to a psychiatrist who put him on medication for ADHD.

Now, we got a call from the school that they don't want him back. His behavior in school has been terrible. He is acting defiant and getting in to fights with the other kids. He doesn't keep up with any of the lessons as he can barely read. At home, he has a terrible temper. He fights with the other kids and barely listens. We don't know what to do or where to turn at this point.

Someone suggested a neuro-psych eval or seeing a developmental/behavioral pediatrician. I am open to all suggestions and referrals because I just feel so lost. He needs help, I just don't know what that help is right now, because whatever we've been giving him until now is not working.

We are not in NYC so we can't go through the BOE, but we are in Rockland County, so we can see specialists in the city.

Thank you so much to anyone who can take the time to respond!

seeker

Tue, Feb 16 2016, 12:16 pm

I would go for neuropsych over developmental/behavioral pediatrician. I don't have a specific name for you but maybe try calling Echo?

Big hugs to you. It really sounds like you have done your best and continue to do so. Sometimes a child's difficulties are just part of their "peckel" in life and we can't rescue them from it. Of course you do what you can but it's hard not to feel frustrated when your efforts don't meet with success, so I'm just giving you that pat on the back and trying for some chizuk as you continue this journey.

amother

Goldenrod

Tue, Feb 16 2016, 1:12 pm

Thank you!

Seeker, since you seem to be in this line of work, can you answer some questions about a neuropsych eval?

First of all, what is evaluated? How long does it generally take to get an appointment? How long does it take for the evaluation to be completed? What do I do with the evaluation once the results are in? Do you have any recommendations of where to get this done? Do you know the approximate cost? Do I need someone who specializes in Yiddish - my son speaks english well enough but primary is Yiddish?

seeker

Tue, Feb 16 2016, 1:44 pm

The idea of going to a neuropsychologist/neuropsychiatrist is that they can evaluate both the cognitive and psychological functioning. When you go to one or the other, they tend to miss important things because they're only focused on their field.

How long to get appointment would vary for each practitioner, depends on how their office runs. I would be prepared to expect at least a couple months' delay if not more. Cost too. You could look into insurance coverage, you never know...

How long the evaluation takes would also vary depending on both the person doing it and on your individual needs. Different people require different types/levels of testing and such.

The evaluator should provide you with recommendations of what do do when you discuss the results.

It's always ideal to do an evaluation in the kid's primary language but if he's really fluent in English then that might widen your pool of possible evaluators. You could ask them what they think about that.

myym

Tue, Feb 16 2016, 1:51 pm

It sounds funny, but did you check his eyes? my son who has an auditory processing disorder and when he got glasses he became a different child. literally. So I realize your son has other difficulties as well, but it might help! Certainly worth a visit to the eye dr, if you havent gone recently..

amother

Goldenrod

Tue, Feb 16 2016, 2:03 pm

myym wrote:

Thank you!

We checked his eyes and he has 20/20 vision. He got prism glasses but I feel like they prescribe that for everyone. His problems seem a bit more complex than a pair of glasses.

5*Mom

Tue, Feb 16 2016, 2:24 pm

What a rough ride for your son.

I'm usually the first to shout pediatric neuropsychologist but I hesitate here because your son is already 14 and has been through the ringer already. In his shoes, I know I would have a terrible temper, to say the least.

Do you talk to him about all this stuff? What does he say? How does he feel about school? How does he feel about himself? How do you think he'd react to being shlepped to another professional for another evaluation? He's 14, not 4, so he should really be involved in this discussion.

This may be radical for you, but it sounds like he needs a break from school, where he is forced to spend the majority of his waking hours doing all the things he is not successful at doing. He needs to develop himself separate and apart from all the things he cannot do and all the ways in which he cannot succeed. He needs an opportunity to succeed at something and feel the pride of accomplishment, and only then will you have something to build upon.

seeker

Tue, Feb 16 2016, 5:37 pm

I agree with 5* that this is a good age to involve your son in the process.
And I also think it's a good perspective that maybe he would benefit from a break from therapies and pressure.
But I don't think it's a good idea to delay evaluation if he hasn't had a thorough one yet. finding a good explanation for one's difficulties can be very helpful and empowering. It's very disturbing to go through so much difficulty and not know why.

How long ago was the ADHD psychiatrist? Could the meds be causing an adverse reaction? You didn't mention whether the "terrible behavior" was going on before that, I'm not clear. ADHD has a lot of lookalikes, confusables, and co-occurring conditions - how thorough was the psychiatrist who prescribed the meds for that? Has that doc been on top of the responses?

amother

Forestgreen

Tue, Feb 16 2016, 7:23 pm

The best person for this type of puzzling kid is Dr. Koslowitz in Lakewood. She's like a detective with kids like this, she gets to the bottom of it and figures it out. Best thing is she gets the kid very involved in the evaluation process, gets them interested in the hows and the whys of their own neurodevelopmental profile. It's a shlep for you from Rockland County, but maybe worth it? It sounds like you need that kind of detailed workup from someone who will really look closely at your son and not stop till she has him figured out. I take her parenting class and I work in a school - we send this type of puzzling kid to her routinely. She always gets to the bottom of it. Her reports are long and detailed, with exact recommendations for what to do in school, at home, in therapy, etc. It may be worth a shot just to call her office and see if she'd take it on.

5*Mom

Tue, Feb 16 2016, 11:34 pm

seeker wrote:

But I don't think it's a good idea to delay evaluation if he hasn't had a thorough one yet. finding a good explanation for one's difficulties can be very helpful and empowering.

Sometimes, but sometimes it can have the opposite effect and just make a kid feel worse about himself. It really depends on the individual. If the son is on board, great, definitely go ahead with a ped nueorpsych eval. But 14 is a pivotal age; if he's not on board I'd strongly recommend backing down, getting him out of school and letting him just *be* for a while.

chaiz

Tue, Feb 16 2016, 11:52 pm

5*Mom wrote:

Speaking as an adult who suspects she has ADD, I think part of the discussion should be how is he functioning out of school. If he is managing with his life out of school then I would agree with you. But if he is suffering out of school as well then I would most probably be more forceful for him to get evaluated.

5*Mom

Wed, Feb 17 2016, 12:49 am

chaiz wrote:

The way he's functioning out of school is right now overwhelmingly likely spillover from his school life, which, at 14 in a yeshiva environment, is surely an inappropriate number of hours even for neurotypical young teens. And I'm also guessing not enough physical activity or maybe even none at all. It could really be counterproductive to do an eval now rather than giving him some time and space to depressurize and center himself a bit, find a hobby and some personal satisfaction and create an identity completely independent of school. The precariousness of his age, self-concept and emotional state should not be underestimated. Neither should the importance of lots of love, acceptance and support from parents and family.