Gifted Issues Discussion homepage Forums Twice Exceptional Neuropsych Eval Questions

So it seems the neuropsych my son has been referred travels nationally speaking about ADHD. And while my son has some characteristics of ADHD, a previous assessment ruled that out as a cause. I am looking forward to the upcoming assessment (we still don't have an appointment yet - in the jumping through insurance and referral hoops stage), but there is a bit of concern that with this person's focus on ADHD that there might be a tendency to attribute those characteristics in my son to ADHD.

Any advice on broaching the subject with the neuropsych without twerking his jaw out of joint? I want him to test deeper, because I'm pretty sure the memory issues are not ADHD.

The initial child psychiatrist we met with last week said that this neuropsychologist picks his cases and doesn't accept new patients without a referral and reviewing the case, so I guess we should be grateful to have been accepted. But I don't want my son's case to be part of an "agenda" (not that it will, but it might be).

I'm practicing my eggshell walking techniques, but any advice you all have would be very appreciated.

(Oh, and I finally heard from the math teacher. She's given my kiddo a list of assignments he can redo and turn in on Monday. He will be passing and not needing summer school because of the zeros. Yay for understanding teachers!)

The most gentle touch is known to twerk the jaw of some neuropsychologists out of joint.

One of my clients just had an exam with a neuropsych. He fell asleep, so she threw a shoe at him. That did not end well.

So my advice is to definitely not throw a shoe at him if he falls asleep during the exam. Just wait patiently until he wakes up on his own and pretend nothing happened.

Most Neuropsychs and psychologists have a 'focus' or specialty. I would trust that they are still capable of evaluating each case on it's own, though I'm sure when one focuses a lot on a particular issue, like ADHD, you tend to notice those traits more easily than others.

I think if you are that worried about this issue, that you need to cancel the appointment and travel to see someone who is 'known' for teasing out the complicated picture that giftedness can present.

If this is the only way you can get any help at all, I would work on being open to the possibility that your child does actually have ADHD 'as this particular expert sees it' and try the medication and see for yourself if it helps more than it hurts.

Hope that helps,
Grinity

Neuropsych evaluation reports tend to be pretty formulaic.

If you've read a dozen, you will get a good feel for what they are telling you separate from any diagnosis.

I would be concerned about the specialty issue as well. That's one reason why I steered away from a particular practice where all the bios were ADHD experts. One of the men I spoke to "tsked tsked" me when I said that my DD had that eval when she was younger and it was ruled out. I did feel a little like something was about to be "sold" to me. It's sort of unfortunate for ADD/ADHD in general, with so many latching on to it, it sort of waters it down or makes it less viable.

http://www.greatpotentialpress.com/adhd-autism-and-giftedness-an-invitation-to-a-conversation

I'm hoping that this grows into a really useful resource to parents and professionals.

Might be. Although he may also be good at differential diagnosis.


Definitely share all prior test results up front, and have a detailed list of your concerns at hand. You can ask him what disorders he tests for and what tests he will choose, and what those tests do. I think talking those things through will help you understand where he's coming from.


Do you know why you got referred to this doc and not another one?

I guess I wouldn't assume there's an agenda until you see one. Although it does matter to find a professional who has professional expertise in the particular thing you're trying to figure out, some of these folks do have multiple kinds of expertise.


That sounds workable; good for you for hanging in there. If you can get better supports into place, I hope he can learn to have things more put together next year. Our DS has needed a lot of training in this regard, too...

DeeDee

ABQMom I haven't read up previous posts on your child at all. So I am not commenting on your child in anyway, but I wanted to share our experience briefly.

When my eldest had her first Ed Psych evaluation at 7yrs the psychologist said during the appointment: "Well she presented like a classic case of inattentive ADHD at the start of the assessment but for reasons x,y,z she clearly is not." Despite her having index scores ranging from the 13th percentile (WMI) to the 96th (VCI) there was no mention of possible giftedness being masked by disability OR of disability being masked by giftedness and no diagnosis of anything. We were lead to believe our daughter's primary problem was a poor school fit at the previous school, that things were looking up at the new school and would all be fine soon.

2yrs later, with great intervention at school and home she was doing FAR better, but we realised things still weren't ok. I did some reading and realised that the reasons we were given for her NOT having ADHD-I were pretty much the text book argument for why she DID have ADHD-I. She was re-assessed by a variety of professionals and we have a new list :

1) FSIQ in the gifted range (only just)
2) ADHD-i (only just made the criteria)
3) Dyslexia (only just made the criteria)
4) CAPD (only just made the criteria)
5) borderline for Aspergers, as in so borderline they won't label her but are worried they have missed it and want to make a 3rd assessment in another 6 months.

ADHD of any form had never occurred to us prior to that first psych evaluation, so hearing it mentioned was a surprise and having it dismissed was a relief. We left re-assured and confident. We trusted our psych. And our daughter DID make vast gains in those following 2 years. But I can't can't tell you how badly I wish we had NOT be given the all clear on ADHD-i back then.

Now my child is one of the kids MoN mentions:

"but honestly, we'd sometimes sit in a meeting and hear, "well, we could call it this or this or this, but the bottom line is what we have is the same thing by any name" because often there were multiple overlapping diagnoses. Then as a team, we'd pick the one based on parental report that the parent was most likely to find beneficial, and the one most likely to result in the services needed."

Problem is that we started trying to get the diagnosis AFTER years of doing everything we could to help her. Now she's not quite anything strongly or clearly enough for any single professional to unequivocally give her a label and attack it head on. But she's still not ok. She's a gifted child working her butt off to look barely average.

I totally understand you not wanting your son misdiagnosed with ADHD because it's this psych's specialty. But consider also that the first proffessional might have been wrong. You don't want a missed diagnosis either.

Excellent video, Grinity - thanks for sharing. And thank you all for such helpful advice and input. It helps.

One question that I thought was interesting that the initial psychiatrist asked my son that I thought was interesting: Do you have racing thoughts, where you just can't seem to quiet your mind? When my son said he did, the next question was the one I found interesting - are there a lot of different thoughts and ideas fighting for attention where it is hard to pay attention to any of them or is it one thought that just won't stop - if this then this then that, etc.

My son said it was the latter - a thought that led to more what-if thoughts all in a single line.

The psychiatrist said that the multiple thoughts is one indicator of ADHD, the latter not so much.