I've been calling psychologists to see if I can get my son set up for neuropsyc testing this summer. The first person I talked with said she charges by the hour $200. The process includes an initial assessment, testing & appointment to go over the results. At least 8 hours.. so a minimum of $1600. Is this normal? I was figuring about $800 but this is at least twice that. Is this normal?

And this is on top of the fact that I am already paying for a psychologist & and a education therapist to work with my son. Both whom I've already done intake interviews and have set up a good working relationship. Saw the psychologist for a 2nd time yesterday and I really like her and she seems to connect with my son. Bit frustrated because the psychologist is qualified to do this assessment but doesn't because of logistical reasons.

I might be able to get my insurance to cover 50%, I need to call them. But what this psychologist said was that insurance doesn't usually cover anything unless there is a diagnosis. But we don't know if there is a diagnosis until we do the testing. Catch-22.

Unfortunately, it was normal even 4 years ago, when I asked about the

"cost of IQ & achievement testing"
http://giftedissues.davidsongifted.org/BB/ubbthreads.php/topics/82580/1.html

It depends on what's being tested. It seems like you may be looking for a potential 2E diagnosis, which would include IQ testing. Do you have an idea about what kind of 2E your child has? Or would you need broad testing?

Also, the school district should provide this service for free.

We live in the SF Bay area, and IQ testing cost only $550. We went to a highly recommended woman with a solo practice. I think the larger practices charge a lot more. You might want to look for someone who works alone.

Here's a list of people who do asssessments.

Thanks for the past thread gives me some perspective. And I live in a high rent area and I'm looking for something more complex than IQ testing. I'm going to wait and see what the cost looks like with the other psycologist I've called. And since I've been told I really want a neuropsyc eval the cost per hour isn't going to change much. Partly I didn't expect that it would take a minimum of 8 hours.

It cost us a bundle in NJ too but we went to a place that gave us paperwork and the appropriate codes to put on our health insurance claim so I believe we got about 50% back. Check before committing to see if the tester will do this.

Yes we are looking for a 2E assessment. Specifically trying to figure out if he is having processing problems like his sister or general Anxiety/mental blocks. Psychologist told me we didn't need an IQ test, although I kind of wanted one.

We are pursing this but it wouldn't happen until at least a month into the new school year. DS is 15 and I really wanted some answers before the start of the new semester. And I am not 100% sure I can convince the school to test. They think he is just being defiant and unorganized. I didn't get a lot of love out of this schools special ed program when my daughter had her IEP. But given the cost this is something I need to consider.

I would doubt practitioners in the SF Bay Area would be cheaper than here. Otherwise since we will be there in the end of July I might ask his/her name. Right now I'm going through the list from the psychologist.

Just looked at that list. Wish it was broken up in N. Cal vs. S. Cal. I am going to have to check each link. There doesn't seem to be any overlap with the list I already have. (Just figured out I'm being dumb I can use the are codes.)

I sent you a PM with the information.

ETA: Suggest you check education law regarding testing. In California, they pretty much have to test if they get a "referral," which can come from a parent. They might not like to do the testing, but they have to.

I will check. What I do know is we have to wait 8 weeks from the first meeting and show lack of progress before they will do anything. Problem is a end of year, beginning of school year isn't the best time to show that. And second, I haven't been idle.. didn't want my son to fail his freshman classes so that we could get them to do the testing.

Wow. That's awful. Talk about making things difficult.

Medical insurance will often cover if you are testing for a developmental disability.

Some counties or states have funding specifically for diagnostic testing as well. To find out, call the pediatric psych department at a hospital and ask what is available in your area...

I'm exaggerating a bit. Probably wouldn't have failed all his classes, particularly math & science.

Downside is the school psychs in CA may not have to use extended norms or calculate GAI. It might not matter, but if you're under a discrepancy model at school- you want to make sure that discrepancy is as accurately reflected as possible.

If you're willing to drive to Folsom, I've worked with Lezley Holmes and she is nearly as expensive as Bay Area rates- http://www.hoagiesgifted.org/psychologists.htm#uca

I'd also suggest asking your regular pediatrician - our insurance covered our neuropsych evals (minus deductible) with a referral from our ped for testing.

Our neuropsychs also charged more than what you were quoted (they are definitely not inexpensive!). They didn't charge by the hour, they charged a price for the full assessment and included an hour parent interview (in which you told your concerns and were asked questions about developmental and academic history and could show work samples etc) and a post-testing interview to review the report and results with the neuropsych and ask questions.

And chances are, that if something is found, there will be therapies etc suggested with other practitioners.... so the $ outflow won't stop with the neuropsych unless you can get school to provide whatever is needed.

We're not in the same state as you are, but to progress to the point of getting the type of testing you will get in one day's eval at the neuropsych can take a full school year here, and the quality of services you receive isn't as thorough as private and is also much more difficult to quality for. Our insurance has covered bits and pieces of private therapy, depending on the type and purpose.

It's really a tough situation to be in - but in your shoes, I'd want to know as much as I can as soon as I can.

Sending good wishes your way - I hope you find an affordable route to comprehensive testing.

polarbear

Link to parents' rights in CA:
http://www.cde.ca.gov/sp/se/qa/pssummary.asp

You do have the right to request an eval. You also have the right to request an independent educational evaluation, at the district's expense, if you disagree with the findings of their eval. In this case, this might include having them recalculate index scores using extended norms.

The prices you are seeing are pretty standard, nationwide, although in some areas you could be looking at upwards of $4000 for a comprehensive neuropsych with full achievement. $400-600 for IQ only is pretty standard. A conventional IQ/achievement battery takes about 3-4 hours to administer (often longer with a young but high-functioning kid, as it takes longer to ceiling on every subtest, but you have to start at the same age level), and another couple of hours to write up, plus a half-hour to hour parent interview before, and the same to review results afterward. That's 8 hours worth, right there. Add executive functioning/ADHD, memory, motor, social/emotional/behavioral, classroom observation, attendance at school/IEP meetings at $200-300/hr, and you can see where the $4000+ figure comes from.

A good reason, if finances are a consideration, to let the school eval complete first, before requesting an IEE. BTW, on the initial school eval, they will send you a consent form with specific assessments/assessment types listed. You have a right to add other assessments onto your consent form, and the school district will have to make a reasonable attempt to conduct them. (If you suggest something that is clearly not within the purview of schools, you likely will not get it, like, say, medical testing for endocrinological problems.) E.g., say the consent form comes with just cognitive and academic achievement checked off, but you think there are specific concerns with executive function/ADHD or emotional issues. There is a check-off box that says something to the effect of "I consent to the evaluation, and request these additional assessments." Then a line for you to list them. There is also space provided on the consent form (sometimes it's on the next page, or the back) for parent concerns, in which you can reiterate your concerns with 2e, giftedness, etc. This sheet is more likely to reach the actual school-based evaluator than your original request letter is.

If you've already signed your consent form, you can still send in an addendum with this info, and it will be enforceable.

Please be careful about pursuing an outside eval while you have a school-based eval in process, as it can result in invalidating one or both of the evals, if they inadvertently duplicate testing with the same instruments. Sometimes parents think they are getting an unbiased second opinion by keeping the testers unaware of each other, but really, it does their kids a great disservice, as they may end up with two worthless evals, depending on the instruments and the timing. For the same reason, in the event of an IEE, make sure the second evaluator has all of the results of the first eval.

Thanks. This is a lot of information to think about. Lots of good but conflicting information. Before committing to this testing this summer I am going to talk to the psychologist & educational therapist again. I've been down this route before, with my daughter but we did the school evaluation first and only after that wasn't detailed enough did we do the private. Must be why it wasn't as expensive, the private therapist just did a few more tests but relied on the other testing the school did.

My concern is I am looking for a 2E diagnosis and this is less straightforward than traditional LD's. I am expecting that the school would give him a broader battery test that he will likely do very well on and then stop looking. (But maybe I'm doing the school a disservice here.) My son is simply under performing not failing. And then never actually running the language processing test that I think is the issue. I am suspect a stealth LD, that because the kid is so gifted has been easy to keep under the radar. And because this is a H.S. kid who has commitments in the fall, if we don't do the private testing now it will be tough to fit until January.

You might consider going through a children's hospital for the testing. That's what we did, and the hospital was able to find the right testing situation for us, plus knew what additional tests my son would need to figure out his quirks.

We had the same insurance catch-22 as you, in that if he didn't end up being diagnosed with a LD, we would be responsible for the entire bill. It was frustrating, but as we were fairly sure he had dyslexia, we took a chance and it ended up costing us about $200 total. Does your son's psychologist think he has a LD? That might help influence your decision one way or another.

I agree with your opinion on school testing. The school isn't required to do what's "best" for your son; just what's "fair" and "appropriate" (or is that adequate?). So I wouldn't count on them to unravel a complicated LD.

For two years, my son's school had told me he was at grade level on reading, or within the range of normal, when I knew he should have been a good reader by 2nd grade. But the fact is, grade level expectations are so low in the younger grades that there's no way we could use that to judge whether he had a reading disability, which the teachers were doing.

I think if you can swing it, you should go the private route, especially since there seems to be a countdown in your case.

This is so true. A local public school tested my son last year (he attends a private school), and we/his teacher were saying things like, "it's very difficult to get him to stay on-task," and "his handwriting is at a first-grade level (he was in 5th grade)."

Well. When the tester looked at his handwriting, she said it looked okay to her --- he was forming all the letters, only a few of them were backwards, and he was writing sentences. As for the behavior, she observed him in class and said he was absolutely fine. Then she and another person told us their own stories: they told us about the kids who can barely form letters at 11, much less write complete sentences. They told us about the boy who was lying on the floor during class, trying to slip a sheet of paper through a slit in his desk, and how that boy was "a mild case by our standards."

So even though my son had some dysgraphia at a minimum, his problems were so minor compared to what they see all the time, we all agreed that it would be better for him to stay in the small private school.

It's, I don't know...really sad.

Sorry to step sideways OT here for just a moment, but I wanted to address master of none's comments:


I can so relate to what you've written here mon, because our dysgraphic ds also has this same issue with expressive language in situations that call for processing and responding to speech quickly - actually I'd say for my ds, rather than "quickly" even just a normal rate. Like you, our neuropsych didn't catch this at his initial eval where his dysgraphia was diagnosed, and it was only through random reading-of-the-Eides on my part combined with my slightly-older-ds giving me more info on what it felt like to be living in his head that I finally made the connection that hey, maybe we should consult with an SLP. In our case, we got lucky in terms of having a friend-connection with an SLP that led to an SLP who really was invested in helping our ds and went a bit outside the norm of what SLPs in our area typically see and treat. Sooo... I so empathize with the difficulty in identifying what the real issue is plus in trying to find the right professional to diagnose/remediated etc.

I can tell you that some of the things that our SLP did in formulating her treatment plan are related to dysgraphia - ds needed explicit instruction in various forms of communication, and he needed to repeat repeat repeat. He was really struggling in school for awhile with participating in class discussions because by the time he'd figured out what to say someone else had already blurted out an answer and the class had moved on. Working with the SLP on rapid responses and also just having to be involved in class discussions over and over again helped him get over that wall. He's had similar issues with other types of communication - things that seem like simple skills that come naturally to most kids, but for him he needs to be taught exactly what is expected and repeat repeat repeat. It's all tied up in the challenge with automaticity. This summer we're working on how to make a phone call. Successfully. Picture me banging my head against the proverbial wall.

OK, sorry I rambled without focus. It's just very difficult sometimes to find help for 2e kids.

Back to topic

polarbear

So I talked with another place today. Seems the first estimate is not so expensive the next place quoted me at over $3000. Still have a few other people to call, the psychologist emailed me back with better suggestions out of that list but I didn't see that till late today. I didn't think this would be this difficult or complex to decide on testing. I didn't think it the testing would take 8-10 hours, or that it would cost as much.

I guess my experience is clouded by my experience with my DD. Most of her testing was done by the school. I was actually VERY stubborn and refused to drop her from her IEP and made the high school test her in 11th grade so we had updated scores to send with her to college.

I've decided that I have to go with a neuropsc that is in the school districts list. I am worried about the above experience I put down $2 K or more on top of what I'm already paying the psychologist and nothing shows up. I have a personal recommendation to a big university autism's program that I might be able to get to do testing for no cost to me, but they would be specifically looking for autism.

I'm emotionally wrung out of from another fight with my son. Seems after all the effort I have been putting in and there is still homework he hasn't been doing. It just feels to me that he isn't putting in the effort I want out of him. It doesn't bug me when he has difficulty with something even when he gets blocked, or even does badly on a test I know he has studied for but it angers me off when I feel he isn't even trying.

It sounds like part of the problem is that he is making some poor decisions, with negative consequences. Do you have some insight into that?

This is part of what the psychologist is working on with us. We meet with her next week without him. I understand this is not that unusual for a lot of 15 year olds, but it's still aggravating.

OK so I think I've settled on a provider. I was really hard to make a decision, I just connected better with this doctor. Checked online with the Mental Health insurance plan. The only chance in getting them to cover any of it (50% since it's out of network) is if we get per-authorization. Any suggestions on what to say when I call. Since testing for "educational" reasons is not likely to be covered, I'm considering mentioning DS's anxiety problems? I don't really want to lie and that was his DX 3 years ago when he saw someone. His psychologist did say we were trying to test to see if his block was expressive processing vs. anxiety.

Anyone have a clue what to say. I'm well aware that what language I use is likely to give me a different result. DS's psychologist is going to call me back on another issue so I will ask her as well.

bluemagic, I don't know what words to use - but fwiw, our testing was covered by our *medical* insurance policy, not our mental health, and we had our ped's office fax in the referral, rather than us calling directly (that's pretty much what you *have* to do where we live - if you call in as an individual without a referral from a primary care dr the office staff won't even talk to you, much less make an appointment). Anyway, our ped's office has a standard form that the dr fills out when making a referral which includes what the referral is for as well as the concerns/symptoms etc supporting the referral. Once the psych's office has the referral form, then the office staff has been helpful with determining codes etc that will work for our insurance (both mental health and medical).

polarbear

Thanks polarbear, my insurance doesn't work that way. I used it a few years ago. I call, talk with someone on the phone who is mostly looking for buzzwords. If I meet the right buzzwords they will OK the approval and give me a list providers. I then send in the bill and IF I also have diagnosis they might pay. It's a bunch of work for them covering maybe 50% after a deductable but this is expensive enough to make that worth it. And perhaps some of the psychologists costs. Last time I took my son to get a doctor note that I ended up not needing. That was one miserable appointment for all of us.

Just get off the phone with the psychologist and she thinks I should go with anxiety, and "ruling out autism". She doesn't think my son has ASD but I've had it mentioned to me enough times even from my pediatrician. And asking for it to be ruled out would be a good reason to have a private neuropsychologist do the test. It was also suggested that I stay off school as the reason for testing, but highlight his social issues and possible depression.