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    Ophelia Offline OP
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    I am not sure where else to go for help, and would greatly appreciate thoughts on what seems to be happening with Ds7.

    We have suspected possible HFA/NVLD for several years in both of our children. Ds7 reads at a 9th grade level/spells well, but struggles with math and writing. Nightly homework has been a nightmare; so much crying and meltdowns. In the classroom, he can't seem to focus because he can't keep his mind off of his special interest, as opposed to being distracted by classroom atmosphere (teacher agrees). He's not interested in playing with other children unless it involves his single interest. Other things possibly of note are that he cannot tie his shoes or ride a bike without training wheels, sensory issues, repetition of words/phrases from favorite tv show, reading at 3yo, etc. (There's more, but I'm doing my best to be brief.)

    In effort to try to understand where the problem is with math and writing, I requested an evaluation through his school. Like many others, I was told even if he was given an evaluation, he wouldn't qualify for services because he was testing at benchmark. (He was failing or nearly failing math and ELA at the time.) So, I decided to go the private route, and specifically looked for someone who specialized in 2e and also Asperger's/HFA. I had hoped that if I were able to get something in writing, maybe I could get the school to work with me, or at least individual teachers.

    I am hoping someone here can help me understand how these results relate to what I'm seeing in my child. I was told I simply have a gifted DS, who may have a bit of anxiety when he's not as good at some things. There is no LD/HFA, etc. Finally, I was told that the reasoning for Ds7's all consuming obsession (his single interests have always been cartoon/tv related) that's impacting home and school life is just part of giftedness.

    I don't know whether I'm over-reacting, or if not, what I should be asking. Can anyone offer any guidance? Do you see anything unusual here? Other than the VCI, these seem to be the WISC scores of a child with average intelligence, for the most part. I don't know what to make of this.

    I really don't understand the portion of high math scores on the WIAT in relation to his struggling. He's just not comprehending/can't learn multiplication facts, not grasping division, etc. Thank you!

    WISC-V

    FSIQ 123 / 94 %
    GAI 126 / 96 %
    Quantitative Reasoning 114 / 82 %
    Auditory Working Memory 106 / 66 %
    Nonverbal 111 / 77 %
    Cognitive Proficiency 113 / 81 %

    Verbal Comprehension 139 / 99.5 %
    Visual Spatial 105 /63 %
    Fluid Reasoning 115 /84 %
    Working Memory 100 /50 %
    Processing Speed 119 /90 %

    Similarities 18
    Vocabulary 16
    Information 15

    Matrix Reasoning 12
    Figure Weights 13
    Arithmetic 12

    Digit Span 10
    Picture Span 10
    Letter-Number Sequencing 12

    Block Design 11
    Visual Puzzles 11

    Coding 12
    Symbol Search 15


    WIAT-III

    Age-Based
    Mathematics 132 / 98%
    Math Fluency 113 / 81 %
    Numerical Operations 139 / 99.5%
    Math Problem Solving 121 / 92%
    Math Fluency - Addition 105 / 63%
    Math Fluency -Subtraction 118 / 88%
    Alphabet Writing Fluency 117 / 87%


    Grade-Based
    Mathematics 127 / 96%
    Math Fluency 107 / 68%
    Numerical Operations 137 / >99%
    Math Problem Solving 113 / 81%
    Math Fluency - Addition 100 / 50%
    Math Fluency -Subtraction 112 / 79%
    Alphabet Writing Fluency 114 / 82%

    Grooved Pegboard Test
    Dominant Hand 66%
    Non-dominant Hand 52%

    Beery-Buktenica Developmental Test of Visual-Motor Integration - 6th Ed. (Mean=100)
    Total Score 83 / 13%

    Beery-Buktenica Developmental Test of Visual Perception - 6th Ed.(Mean=100)
    Total Score 104 / 61%







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    Originally Posted by Ophelia
    Ds7 reads at a 9th grade level/spells well, but struggles with math and writing. Nightly homework has been a nightmare; so much crying and meltdowns.

    That alone is a red flag that something is going on. At 7, homework should be a brief affair.

    Originally Posted by Ophelia
    In the classroom, he can't seem to focus because he can't keep his mind off of his special interest, as opposed to being distracted by classroom atmosphere (teacher agrees).

    Did they do any testing for executive function or attention? Any testing along the lines of Conner's Rating Scale? An ADOS (which is the main test used to diagnose autism)? A Vineland test of adaptive skills? Testing on all facets of language skills, with particular attention to expressive and social language use? I would want testing in all those areas.

    I am not a testing expert. But based on my experience as a 2e parent, assuming you sent all the scores, this eval did not really look to rule out ADHD, ASD, or anything else along that line-- it looks very perfunctory and aimed mainly at assessing IQ, achievement, and visual-motor. I would want someone with autism expertise to do an ADOS, possibly a BRIEF, the other things mentioned above, spend time with your child, and interview you about your concerns.

    Originally Posted by Ophelia
    He's not interested in playing with other children unless it involves his single interest. Other things possibly of note are that he cannot tie his shoes or ride a bike without training wheels, sensory issues, repetition of words/phrases from favorite tv show, reading at 3yo, etc. (There's more, but I'm doing my best to be brief.)

    All that raises some ASD flags for me, too. If you talked to a "regular" neuropsych, I'd recommend going to someone who has seen a LOT of kids with autism, whose main practice deals with ruling in or out. We found that at a children's hospital autism center (after several really useless misdiagnoses).

    Originally Posted by Ophelia
    I am hoping someone here can help me understand how these results relate to what I'm seeing in my child. I was told I simply have a gifted DS, who may have a bit of anxiety when he's not as good at some things. There is no LD/HFA, etc.

    That's what they told us when DS14 was 2-3-4 years old, as well. Even though all the ASD hallmarks were there. Many professionals find it VERY hard to see ASD in a kid who has the signs, but also has intact or excellent language skills. They often mistake strong language for strong communication skills, even though they are not the same thing.

    It is not OK to ignore a disability and excuse it as "just gifted"-- it doesn't help the child. I would want to really be thorough and rule all these other things out, and have a real explanation for the problems, before naming it "just gifted." Because so far you have no explanation for the struggles-- garden-variety gifted does not necessarily include or explain those struggles and certainly gives you no path toward a remedy.

    Originally Posted by Ophelia
    Finally, I was told that the reasoning for Ds7's all consuming obsession (his single interests have always been cartoon/tv related) that's impacting home and school life is just part of giftedness.

    Some gifted kids are intense; and some have single interests. But not all are impaired by those interests (most are not). If it's so strong that it's interfering with life, I'd recommend pursuing it.

    I also recommend working on flexibility in all things-- watching other shows to expand his interests, making sure to do activities that are different from his chosen ones, so that he learns to be interested in more things (even though it is hard).

    Originally Posted by Ophelia
    I don't know whether I'm over-reacting, or if not, what I should be asking.

    Not over-reacting at all. The sooner you get help and support, the easier it will be to help DS turn it around and be successful.

    Originally Posted by Ophelia
    I really don't understand the portion of high math scores on the WIAT in relation to his struggling. He's just not comprehending/can't learn multiplication facts, not grasping division, etc. Thank you!

    Some 2Es have a hard time with math facts-- but have a beautiful grasp of more abstract concepts. (Many teachers believe this is impossible, but I've seen it.) Some kids are practically born with math facts installed; for others it takes years to internalize them even if they understand a great deal of math otherwise.

    A simple accommodation is to allow the use of a paper multiplication table when the facts themselves are not what's being tested. Just let him keep growing in math, refer to the table when he needs it, and eventually he will have the facts (or not need them any more because everyone uses a calculator in middle school and onward anyway).

    I would say seek a second opinion privately, and in the meanwhile ask school to make a Response to Intervention plan (RTI) to help DS with the things that are difficult for him. They are not supposed to wait for him to fail-- they are supposed to help.

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    Originally Posted by Ophelia
    Beery-Buktenica Developmental Test of Visual-Motor Integration - 6th Ed. (Mean=100)
    Total Score 83 / 13%

    You've already received excellent advice from spaghetti and DeeDee. I'll add two things:

    1) Your ds' score on the Beery VMI is really low - 13% - did the evaluator say anything at all about why it might be so low? I'm guessing this may have something to do with the reason he isn't tying his shoes or riding his bike yet. FWIW, you might want to google Development Coordination Disorder or Dyspraxia and see if anything you find there fits. There are quite a few symptoms of DCD that overlap with symptoms of autism. I have a DS with DCD - homework was a nightmare for him up until he was diagnosed.

    If the evaluator didn't say anything at all about the 13%, I'm really surprised. If it was a school evaluation, I wouldn't be surprised (here in my local district) because they usually require 7% or below to consider anything a challenge - is it possible that your evaluator was using school district guidelines for diagnosing an LD?

    2) His working memory score on the WISC, at 50%, is lower than his other scores. Discrepancies as large as this don't necessarily mean anything but they *can* be a red flag for challenges. Hopefully aeh will weigh in on the scores smile

    3) I just want to second and third and even fourth one of DeeDee's points:

    Originally Posted by DeeDee
    They often mistake strong language for strong communication skills, even though they are not the same thing.

    Lastly and most importantly, trust your instinct as a mom, and follow up on it.

    Best wishes,

    polarbear

    ps - did the evaluator do any type of executive functioning tests?

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    Is your child accelerated somehow? Why is a 7 year old doing multiplication and division if he struggles with it to such a degree?

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    I think looking at the book Diagnosis and Dual Diagnosis of Gifted Children and Adults by James Webb et al might be helpful to you-- there are definite overlaps between how gifted children and children with ASD might behave, but there are some very specific ways in which they differ too (which the book lays out). It might help you pin point your specific concerns and decide whether or not you think the evaluation you got was a good one. Did they do the ADOS? What about ADD testing? (The focus thing makes me think of that-- ) The "overexcitabilities" that gifted kids have can look a lot like diagnostic criteria for ASD, ADD, OCD, you name it-- and they can be several things, of course. Additionally, reading early is not in and of itself a sign of ASD, at all-- see this article linked below:

    https://www.wisconsinmedicalsociety...-reading-precociousness-or-savant-skill/

    If you do decide to do more testing, I might consider seeing a PT (not being able to tie shoes or ride a bike or having trouble with handwriting can be just a matter of muscle tone). That can help with anxiety too, if he's feeling uncertain in his body.

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    I am most struck by the notable relative weaknesses in visual spatial and working memory areas. Those two areas alone are probably responsible for his challenges in memorizing math facts. His scores are not generally average; they are quite diverse, ranging from Low Average (VMI) to Extremely High (WISC-V VCI), with scores in every category in between (Average, High Average, Very High). He has strong verbal comprehension, and good-but-not-exceptional fluid reasoning and processing speed. At this age, I suspect that his language strengths are enough to keep his math achievement up. His relative weakness in visual spatial may not affect his math achievement until he reaches geometry. Note that there is no measure of multiplication fluency, so the specific deficit that you report was not measured. Given his age, it probably would not have shown a normative deficit, but there might have been a personal relative weakness. Notice also that he did better with the procedural math than with math problem solving.

    The working memory area can affect many different types of basic skills acquisition, including automaticity for math facts, phonetic decoding, handwriting, and spelling/mechanics. (It may or may not affect all of them.)

    I would agree that there are a lot of ASD-type symptoms among the concerns you report, and that without a gold-standard ADOS-2, I would be reluctant to accept ruling-out ASD. I would also take the position that his testing supports something in the NVLD category, as he is relatively weak in exactly the cognitive area (visual spatial) most closely associated with the NVLD formulation. Insufficient academic testing was done to state that there is no learning disability. You have concerns about writing, but no measures of actual written expression were completed (he is too young for most of the WE subtests on the WIAT-III, but surely they had access to something else, like the KTEA-3 or WJIV; I would have liked to see a PAL-2). I find that many children with NVLD don't show early math deficits, but early reading or writing deficits, because primary level math is really a language activity, while early reading/writing skills are highly visual/symbolic. Later, in late elementary or middle school, sometimes as late as high school (at geometry/trig), it flips, when they've had enough practice with reading and writing for it to become automatic, and thus primarily a language task, while math becomes more about higher-level abstraction than basic skills.

    The biggest tip-off that this is not just GT-ness is that he is distressed at school, not just by boredom or underchallenge, but by struggling to perform up to classroom standards in very specific skill areas.

    You may wish to consider further assessment by a hospital/clinic-based team, who would be the most likely to have experience with an ADOS-2. Other members of the evaluation team that might be valuable may include a speech language pathologist and an occupational therapist. Depending on your insurance, you may be able to receive full or partial coverage for this with a referral from your primary care doc.


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    Ophelia Offline OP
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    Originally Posted by spaghetti
    Did he have any tests for autism?

    He had GARS-3, and nothing unusual really was apparent there, which I expected when filling in the questionnaire sheet. I had wondered if this tests is typically used for those who are on the higher functioning end, because it seems like it would miss quite a bit. I could be completely wrong, since I'm just guessing.

    Quote
    Push school to test him even if they think they know the outcome. What you say here would be red flags and I think the school would hopefully hear you out and agree to test for autism.

    Thank you!

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    Originally Posted by DeeDee
    Originally Posted by Ophelia
    Ds7 reads at a 9th grade level/spells well, but struggles with math and writing. Nightly homework has been a nightmare; so much crying and meltdowns.

    That alone is a red flag that something is going on. At 7, homework should be a brief affair.

    We have already resorted to just giving him answers on math a few times because it's heartbreaking to watch. (No, I am not proud of this.) He's supposed to read for 20 minutes each night in addition to normal homework, and so I've signed the paper saying he's done his reading all year. I've never had him read once, because it's not realistic with the amount of time it takes him to get homework done and into bed on time. All of this upsets me because I'm inadvertently teaching him to lie and cheat, essentially, but he tends to follow rules, so I hope he'll be ok. frown

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    Did they do any testing for executive function or attention? Any testing along the lines of Conner's Rating Scale? An ADOS (which is the main test used to diagnose autism)? A Vineland test of adaptive skills? Testing on all facets of language skills, with particular attention to expressive and social language use? I would want testing in all those areas.

    I didn't include the other tests previously because I wasn't sure they were relevant. The remainder of tests/scores were:

    Test Observation Form
    Withdrawn/Depressed 55 /<69%
    Language/Thought Problems 61 /87%
    Anxious 58 /79%
    Oppositional 55 /<69%
    Attention Problems 55 /<69%

    Revised Children's Manifest Anxiety Scale-2

    Inconsistent Responding Index 0
    Defensiveness 62 /88%
    Total Anxiety 60 /84%
    Physiological Anxiety 58 /79%
    Worry 59 /82%
    Social Anxiety 57 /76%

    Gars-3 Mom
    Restricted/Repetitve Behaviors 8 /25%
    Social Interaction 6 /9%
    Social Communication 5 /3%
    Emotional Responses 11 /63%
    Cognitive Style 10 /50%
    Maladaptive Speech 8 /25%

    Teacher
    Restricted/Repetitive Behaviors 4 /2%
    Social Interaction 3 /1%
    Social Communication 2 /<1%
    Emotional Responses 3 / 1%
    Cognitive Style 6 /9%
    Maladaptive Speech 5 / 3%

    BRIEF-2 (Parent)

    Inhibit 61 /88%
    Self-Monitor 74 /98%
    Behavior Regulation Index 66 /95%

    Shift 64 /91%
    Emotional Control 71 /97%
    Emotional Regulation Index 70 /95%

    Initiate 63 /97%
    Working Memory 66 /96%
    Plan/Organize 60 /93%
    Task-Monitor 73 />99%
    Organization of Materials 73 /99%
    Cognitive Regulation Index 68 /99%

    Global Executive Composite 74/ 99%


    BRIEF-2 (Teacher)

    Inhibit 49 /58%
    Self-Monitor 50 /68%
    Behavior Regulation Index 50 /62%

    Shift 48 /60%
    Emotional Control 47 /69%
    Emotional Regulation Index 48 /60%

    Initiate 54 /71%
    Working Memory 54 /77%
    Plan/Organize 51 /69%
    Task-Monitor 54 /76%
    Organization of Materials 65 /93%
    Cognitive Regulation Index 56 /72%

    Global Executive Composite 53/ 67%


    Achenbach Child Behavior Checklist 6-18 (Parent)

    Anxious/Depressed 59 /81%
    Withdrawn/Depressed 62 /89%
    Somatic Complaints 57 /76%
    Social Problems 56 /73%
    Thought Problems 71 />97%
    Attention Problems 61 /87%
    Rule Breaking Behavior 53 /62%
    Aggressive Behavior 57 /76%

    Affective Problems 68 /97%
    Anxiety Problems 60 /84%
    Somatic Problems 50 /<50%
    Attention Defecit/Hyperactivity 66 /95%
    Oppositional Defiant Problems 51 /54%
    Conduct Problems 50 / <50%


    Achenbach Child Behavior Checklist 6-18 (Teacher)

    Anxious/Depressed 51 /54%
    Withdrawn/Depressed 50 /<50%
    Somatic Complaints 50 /<50%
    Social Problems 50 /<50%
    Thought Problems 60 />84%
    Attention Problems 52 /58%
    Rule Breaking Behavior 50 /<50%
    Aggressive Behavior 51 /54%

    Affective Problems 50 /<50%
    Anxiety Problems 50 /<50%
    Somatic Problems 50 /<50%
    Attention Defecit/Hyperactivity 54 /65%
    Oppositional Defiant Problems 54 /65%
    Conduct Problems 50 / <50%


    Quote

    I am not a testing expert. But based on my experience as a 2e parent, assuming you sent all the scores, this eval did not really look to rule out ADHD, ASD, or anything else along that line-- it looks very perfunctory and aimed mainly at assessing IQ, achievement, and visual-motor. I would want someone with autism expertise to do an ADOS, possibly a BRIEF, the other things mentioned above, spend time with your child, and interview you about your concerns.

    I apologize for leaving things out the first time. He did have the BRIEF-2, and I assumed the examiner just decided to use his teacher's scores since mine were so high? -Maybe my answers were not consistant, but it seems my portion was not taken into account. He did interview me for about 20 minutes, and the neuropsych eval. lasted approximately 4-5 hours (as opposed to the one I had a while back, which lasted 8 hours). An assistant was sent for an in-class observation, and the examiner told me she reported no problems. His teacher told me he had a meltdown in class (art club was cancelled, and he was extremely upset) approx. an hour before the observer arrived, and the information was relayed about the meltdown. He had problems for the rest of the day, though.

    Quote
    If you talked to a "regular" neuropsych, I'd recommend going to someone who has seen a LOT of kids with autism, whose main practice deals with ruling in or out. We found that at a children's hospital autism center (after several really useless misdiagnoses).

    Thank you. I see that's the consensus. I had considered it, but the waiting lists for an ASD evaluation are so long here at the hospital based autism centers that I avoided them in hopes of getting him help more quickly. --That's worked out well. smirk


    Quote
    It is not OK to ignore a disability and excuse it as "just gifted"-- it doesn't help the child. I would want to really be thorough and rule all these other things out, and have a real explanation for the problems, before naming it "just gifted." Because so far you have no explanation for the struggles-- garden-variety gifted does not necessarily include or explain those struggles and certainly gives you no path toward a remedy.

    This is exactly how I feel, and also why I'm having so much trouble figuring out whether I'm over-reacting. DS is almost a carbon copy of me in regard to everything I'm seeing, even with the same strength in VCI. I had identical problems in math (not writing), and mine also started with multiplication that I could not memorize. I am now 40 years old, and so I'm painfully aware of how 'gifted issues' can affect someone's entire life. Nobody tried to figure out what my problems were, and when I tried as an adult, nobody took me seriously. (Mensa member w/ 3rd grade math level.) So, I'm trying to balance what I think I seeing with trying to avoid projecting my own stuff. Ok, I am officially rambling. laugh

    Quote
    Some gifted kids are intense; and some have single interests. But not all are impaired by those interests (most are not).

    Yes, this was my understanding, too. He also goes on these tangents a few times a day where he'll start repeating lines from his favorite tv show. (So, when it was Dr. Who, it was "Allons-y!" or "Geronimo!" or "Hello! I'm the Doctor!", etc.) He'll just suddenly start, and will repeat the word or phrase every 20-30 seconds, sometimes for an hour at a time. I usually try to distract him with something else related to that interest in order to get him to stop. This process will happen about 2-3 times a day, and usually every day. Other times, he will do the reciting facts about his interest at people when he's trying to have a conversation. However, he can also have fairly normal conversations at times, too, but will still throw in things about his interest at the end. --I will work on the flexibility.


    Quote
    Some 2Es have a hard time with math facts-- but have a beautiful grasp of more abstract concepts. (Many teachers believe this is impossible, but I've seen it.) Some kids are practically born with math facts installed; for others it takes years to internalize them even if they understand a great deal of math otherwise.
    This would be wonderful, and I agree, because I've heard that before too. We do have a multiplication table printed out for him to use at home, but his teacher wasn't willing to let him use it in class. We will keep it nearby for next year's homework too. He was able to learn 6's and 7's when we made up a stories about Dr. Who with the facts in order. (6, 12, 18, etc.) It seems like it would be a lot of work to recite a story in your head every time you need to know 6x7, though. eek


    Quote
    I would say seek a second opinion privately, and in the meanwhile ask school to make a Response to Intervention plan (RTI) to help DS with the things that are difficult for him.

    Can I ask for this without any actual evidence (on paper) of a problem? He's just finished the year with a D in math and also science. -I'm not sure what happened with the science grade, because I assume there's no math in 2nd grade science.

    Also, do you know whether this is something I need to request before school starts, or just wait until classes resume? They do have office hours over the summer.

    Thanks very much for your helpful feedback smile

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    Originally Posted by aeh
    Depending on your insurance, you may be able to receive full or partial coverage for this with a referral from your primary care doc.

    AEH and I are on the same page.

    In addition, if you go through a hospital for testing, they can likely advise you about funding sources other than your insurance. Some states and/or counties have funding programs that specifically fund testing for developmental disabilities.




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    Quote
    1) Your ds' score on the Beery VMI is really low - 13% - did the evaluator say anything at all about why it might be so low?

    This was attributed to perfectionism, but DS is not a perfectionist at all. He's quite the opposite, actually.

    Quote
    FWIW, you might want to google Development Coordination Disorder or Dyspraxia and see if anything you find there fits. There are quite a few symptoms of DCD that overlap with symptoms of autism.

    Quite a bit fits, but as you've said, there's a lot of overlap with symptoms of autism. The parts that fit also fit for autism. confused

    Quote
    If the evaluator didn't say anything at all about the 13%, I'm really surprised. If it was a school evaluation, I wouldn't be surprised (here in my local district) because they usually require 7% or below to consider anything a challenge - is it possible that your evaluator was using school district guidelines for diagnosing an LD?

    It was a very brief, "Here's this. He's a perfectionist, like most other smart kids." --Except that he's not, of course. It's possible the evaluator was using district guidelines, but I have no way of knowing.


    Quote
    ps - did the evaluator do any type of executive functioning tests?

    The BRIEF-2 was given. I didn't initially post those results, but they're in one my other responses above.

    Thanks very much for your feedback, polarbear! smile

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    Originally Posted by Thomas Percy
    Is your child accelerated somehow? Why is a 7 year old doing multiplication and division if he struggles with it to such a degree?

    He is not accelerated. His entire 2nd grade class is doing the same work. He's in a public charter school. Unfortunately, I can't answer why he's doing it when he's struggling. Both he and the teacher have confirmed that he works much more slowly in math than other children, and is always still working when all of the other children have completed their work.

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    Thanks very much, aeh, for your very informative and helpful feedback.

    Quote
    You may wish to consider further assessment by a hospital/clinic-based team, who would be the most likely to have experience with an ADOS-2. Other members of the evaluation team that might be valuable may include a speech language pathologist and an occupational therapist.


    Yes, I think this is what I'm going to try next. Unfortunately, I won't be able to do this until next year due to finances and also their long waiting list.

    Quote
    Depending on your insurance, you may be able to receive full or partial coverage for this with a referral from your primary care doc.

    My insurance does not cover any autism-related services or evaluations, whatsoever. Because of this, I've used my flex account to pay for evaluations, but I've used all of those funds already for this year. Regardless, I do appreciate your pointing this out since it's important that people know it can be covered.

    Thanks again!

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    In addition, if you go through a hospital for testing, they can likely advise you about funding sources other than your insurance. Some states and/or counties have funding programs that specifically fund testing for developmental disabilities.

    I was not aware of this. How wonderful! Thanks very much smile

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    Originally Posted by Ophelia
    My insurance does not cover any autism-related services or evaluations, whatsoever.

    Ophelia, I'm guessing you've already tried this, but just in case - with some insurance policies, the code used for a referral makes the difference in coverage. For instance, you're looking for an evaluation to look into autism, but your pediatrician might make the referral under a code that doesn't specifically mention autism. I'm sorry I'm not very well-versed at explaining this, but fwiw when we ran into issues like this sometimes our ped's office was able to help, sometimes the office offering the eval or therapy was able to help with codes.

    Best wishes,

    polarbear

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    I responded to everyone yesterday, but apparently, I did something wrong because they never appeared. So, I'll be back later this evening to try again. smile

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    Originally Posted by polarbear
    Ophelia, I'm guessing you've already tried this, but just in case - with some insurance policies, the code used for a referral makes the difference in coverage. For instance, you're looking for an evaluation to look into autism, but your pediatrician might make the referral under a code that doesn't specifically mention autism. I'm sorry I'm not very well-versed at explaining this, but fwiw when we ran into issues like this sometimes our ped's office was able to help, sometimes the office offering the eval or therapy was able to help with codes.

    My insurance usually doesn't require referrals for coverage, but I can try it that way and see if it makes a difference. My understanding after speaking with the insurance company previously is that regardless of the reason for the evaluation, if the diagnosis comes back as ASD related, they will not cover the evaluation. This seems incredibly wrong to me. I wouldn't want to be the parent who's not expecting an ASD diagnosis, receive the diagnosis, and then have to unexpectedly cover the cost of the evaluation. shocked

    So, I will remember what you said when I contact the hospital, and will ask them about it. Thank you smile

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    Originally Posted by spaghetti
    With the Affordable Care Act, habilitation services are now covered (to varying extents), so if you have not checked your insurance coverage recently, you may find that autism is covered.

    You can google your state and see what your standards are for private insurance

    We have private insurance via my husband, and his insurance was "grandfathered." His employer opted out of autism coverage, and since changing jobs is not an option, I'm not sure we have a way around it. frown I have checked into the insurance portion quite a bit, and even asked the employer to opt in, but that didn't work either.

    Thanks for the heads up, anyway. smile

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