Hi mom2one,
I think your ds is in first grade this year? Or kindergarten? I have a few thoughts for you - sort of in backward order from your post, so hopefully that won't be too confusing!
Before the appointment though, I want to be sure that I am asking the right questions.
You're doing a great job of researching as well as observing your ds and thinking through what seem to be challenges for him, correlating it with what you are learning about potential challenges. You're probably already 90% ahead of where most parents are when their child goes in for a neuropsych eval
I think it might help a bit to know that you don't have to know all the right questions to ask or have an idea of what's up before the neuropsych eval - a neurospych eval looks at overall functioning (academics and home), includes a parent interview in which you give a detailed developmental history as well as your current concerns and observations etc. You would tell the neuropsych about how your ds seems to lag behind by a minute as you've described above, but it's ok if you don't know whether or not that's potentially CAPD or ADHD - that's what the neuropsych eval is designed to tease out. The eval starts with a standard set of ability vs achievement tests as well as (usually) behavior surveys and the parent interview, and then the neuropsych chooses additional tests and asks additional questions based on what he/she sees in the testing and from the surveys and parent interview. So many challenges and behavioral symptoms overlap in between diagnoses that it's really difficult and challenging as a parent to know which diagnosis is present. The neuropsych is trained specifically to tease out symptoms and correlate what the total set most likely means - then you are given referrals for follow-up with the professionals who deal with specific diagnoses.
If you have had a CAPD evaluation, did you first do the ADHD eval or both or in some other order ?
Evals for CAPD and ADHD are very different in the details and who does the actual eval... but a neurospych can give an ADHD diagnosis as well as refer your child for a CAPD eval if they see a potential red flag for CAPD during their eval. Because evals cost $ and time, my gut feeling has always been it's easier to start as broad as you can and then follow-up with specific evals once you have a professional who feels the eval should be done. In our area we also have to have referrals from professionals to get private evals (or a referral through the school) - and those referrals (where we live) have to start with your ped. Our ped has always recommended going through the neuropsych eval first, then we've had the neurospych referral (and ped will also then refer) for things like follow-up evals or therapies based on the neuropsych's recommendations.
One of my dds has had a CAPD eval (following a recommendation from a psych eval). She didn't have CAPD, but the same psych (at the same time) also recommended sensory OT which led to her going through a listening therapy program which helped with many of the symptoms I'd thought might be CAPD. She's also my dd who has been suspected of having ADHD. I wondered about both of them when my dd was your ds' age, but ultimately we found out she was having severe vision issues - and it wasn't until we'd been through neuropsych testing that anyone saw enough of her broad functioning picture to realize it was a vision-related issue. I wasn't thinking vision, so I was only seeing the bits and pieces of symptoms that matched things I'd read about or heard about from other parents.
I'm guessing that you're probably thinking what the heck after reading about all the confusion over what was up with my dd - but the reality is that it can be very tough to work through all the complicated puzzle pieces to find what's really going on. Of all the different paths we've taken and evals etc - it was the neuropsych that helped the most as a good starting point simply because it is such a broad overview that takes in "everything".
There seems to be a minute lag between other kids following and him following
My first thought here is that there are so many potential things that could be causing what you are seeing with the lag time. My dyspraxic dysgraphic ds who has challenges with expressive language does this. He says that it just takes him longer to move, and that's a key part of dyspraxia. In conversations when we see the lag, he says it's because it takes him a minute to put his thoughts together - that's most likely due to his expressive language disorder. He also tells us he thinks through what other people want to hear in a response before he responds - that's personality. So there are three things going on in just one kid that result in something similar to what you're seeing. There are so many other things it could be too - including not hearing well in general, not hearing well against background noise or not being able to process what is being heard. ADHD would not be something I'd suspect in that particular situation - but huge disclaimer - I'm not a professional so don't take anything I say as meaning anything other than one parent's conjectures
Best wishes as you move forward - you are doing a great job thinking this through and asking a lot of questions!
polarbear
