We're debating an IQ evaluation for our almost-7 year old, but after such an emotional day I'm thinking it's moreso for some tools for dealing with (what I'm guessing is) sensory sensitivity, perfectionism, and I-have-no-idea-why-such a quickness to explosively crying. Would an IQ assessment with a psychiatrist cover this sort of broad thing? One of the local places I've found is this one: http://pcc.care/our-services/ - but they're not on our insurance. Is this something that could even possibly billed through insurance anyway? We can find an in-network provider, but they don't have a website that lists everything like that one, LOL.

What happened at your kid's evaluation? What sort of report/results did you receive?

We used Dr. Navarro. She is in Long Grove. Her practice is for gifted children and teens. I found her on Hoagies website. I know she accepts BCBS and she will bill others. I'm still waiting for her bill from November as our insurance did not cover testing. We have used her 3 times. Once for DD and nice for DS (second time was for entry to private schools).

HTH,
Sheila

frannieandejsmom, thanks for the response! Did you get other insight into your child's learning style, and perhaps tools for dealing with the less-desilreable qualities, as well as the IQ score?

Our DS was having a lot of issues in school back in grade 1 so we had him tested. The psychologist started with a WISC and then did other testing based on our concerns at the time and what she was seeing through the testing. We came out of it with a 15 page report with all of the test results and recommendations for IEP accommodations and modifications. He was 6.5 so they couldn't formally diagnose his LD at that time but it was enough to get us the same accommodations regardless. It also helped me to have numbers to back up my gut feeling of "he's smart". To be honest we were kind of underestimating him and the scores helped to see the bigger picture.

A couple years later we tested again to confirm the LD. Again she started with the WISC and then did more testing from there. We then got a 14 page report with all of the details.

We have also tested our DD but since we didn't suspect a second E we just asked for the WISC. Her report wasn't as long but it also had a lot of recommendations for the school and was very useful for advocating. It was also a huge wakeup call for us since she isn't as in your face gifted as DS is but has scores that aren't that much different.

We received a nice report and also a consult about 2 weeks after the testing.

Portia, thank you, "psychoeducational evaluation" is exactly the term I didn't know I was looking for. When I call providers I will ask about that.

we had a clinical psychologist (phd) evaluate our children for social issues/aspergers and adhd. The evaluations included some intelligence testing since that makes up a major part of one's psyche, I suppose.

what occurred:
there was a patient intake session, where we parents discussed our child, strengths, weaknesses as we saw them, and any issues with the dr.
there was a session where the dr interviewed each child. there were many forms for us to fill out for personality, mood and behavior ratings. we also had forms to give to teachers for the dr. to understand the behavior from that perspective.
there were forms for the kids to fill out -their own mood and personality rating forms - this may occur more when a child is older than when they are quite young. My daughter was asked to make some drawings. My son was not asked this, I suppose because he is older.

There was intelligence testing, and some other testing done, including a very boring computer test (to test for inhibition and attention).
all this was scored, reviewed and evaluated. in the case of the kids' doctor we received very lengthy report about what all of it meant.
The insurance did pay for a large part of it, as there was in both cases a diagnosis, even though the dr. was out of network.

My husband also had this done recently for himself, with an in-network doctor; the process was pretty similar, but with a somewhat less in depth final report. the insurance paid for all of it with the exception of a couple of small copays.

fjzh,

I glanced through the provider website that you linked. It looks like they do a range of assessments, from basic cognitive out to comprehensive neuropsychs, and they have contracts with allied providers (OT, speech, OG/Wilson/Lindamood-Bell reading remediation). I don't know anything directly about them, beyond their website, but the people I can find info on seem pretty reputable.

Whether the professionals who would see your child would be a good fit will depend also on the rapport you and your child feel with them at the intake. Wherever you decide to go, do not be afraid to back out of it, even after beginning the process (preferably before actual testing has commenced, though), if you or your child feel uncomfortable with them. Even excellent clinicians sometimes have certain clients that just don't connect, for no apparent reason. That's not a knock on either clinician or client--merely a poor fit. And a good reason to give your child a chance to meet them before beginning testing.

As to what kind of eval: Since your questions are really more 2e in nature than straight gifted or straight LD, I think you might be looking more for a neuropsych than a basic psychoed eval, which -could- include everything you need, but might not. More important than the name of the eval you are requesting is describing your concerns, and what you want to gain out of the eval.

E.g.,

1. DC has such and such concerning presentations (emotional dysregulation, sensory defensiveness, perfectionism);
2. we suspect these things may be factors (giftedness, anxiety,...),
3. we would like to gain this information (cognitive level, presence/absence of 2e), and
4. recommendations for these settings and functions (school, home, peer relations), including
---a. remediation,
---b. accommodations, and
---c. realistic future planning.

ITA with portia and aeh, and particularly this:


and very much specially this:


You'll receive IQ scores from a neuropsych eval, so it will answer questions re giftedness and cognitive strengths and weaknesses, so you'll have that info. More importantly, it will help you understand what's at the root of the sensory/etc behaviors that are challenging for your ds.

Neuropsych evals are expensive, *but* they are sometimes partially covered by medical insurance. My recommendation is to start with your pediatrician, outline your concerns, and ask for a referral for a neuropsych eval. Check your insurance to see if it's possibly covered.

I don't have any experience with providers in your area - the link you've provided looks like a place that has a lot of potential upside - especially if they are used to working with your school district re making recommendations etc. However - before choosing a neuropsych I'd first determine if there is a neuropsych covered by your insurance, second, get your ped's advice re where to go and third, try to network with other parents to find out what personal experiences have been with psychs in your area.

I'd also consider - almost everything (but not all) covered by a neuropsych eval can be evaluated by the school district. In our situation, we preferred the neuropsych (private) because it included an extensive parent interview to review our child's developmental history (which was important to his diagnosis). Private neuropsych evals also look more from the perspective of how a disability (if one is found) impacts a child life (including future) rather than just focusing on current academic impact. A private neuropsych can also make recommendations for local private providers if needed for OT/SLP/etc. Those are the "pros" of going private.. on the flip side, the evaluation through school does not cost $ for you as a parent, and if your school district is known to be good at evals, may be worth considering.

Best wishes,

polarbear

Errr?


Does this really indicate a 2nd e?

If so, then I need to get my DD evaluated post haste!

I had thought that these OE's were 'normal' and a natural consequence of intensity.

Aside from our testing being in network, this is almost exactly our experience. Our DS5 (then 4) was having major problems at his second preschool after being kicked out of the first one. As parents we felt like the problem was more with the school or the placement and not so much with our kid, but really wanted an outside observer to check for problems we might have been obvious to like ADHD or ASD or some other behavior disorder. Because it was checking for something "wrong" insurance covered it, as much as they do anything. Since the question involves a bunch of questions about problems as much as about general iq, there's a decent shot at getting it covered if you ask correctly.

It may not, but since the OP is clearly concerned about them, these are important and legitimate concerns to raise before the PCP and psychological examiner. The best possible outcome would be that they are simple overexcitabilities in a gifted child, and the parents receive recommendations appropriate to such. Everyone goes home happy, and insurance also pays (legitimately) for the eval.

aeh, thank you so much, that is a great outline of what I need to ask for. A psychologist with experience for a psychoed eval would be able to do a neuropsych too, yes?

That depends on their additional training and clinical experience. Although neuropsych is a named specialization, the actual skills needed for what constitutes a neuropsych eval are actually part of the training of many clinical, school, and counseling psychs as well. Most psychoeds are conducted by clinical or school psychs (those done in schools are overwhelmingly done by school psychs). Even if the examiner is not ABCN/ABPP certified in neuropsychology, they may still be able to generate a decent neuropsych eval. Mainly, you will want to have a good conversation with them about the kind of referral questions with which they have experience, what they do to investigate them, how they respond to ambiguous or unexpected findings in the midst of an evaluation, etc.

For a directory of board certified neuropsychs, see here (and select pediatric subspecialty):
https://theaacn.org/directory/

Keep in mind that a professional's absence from this list does not necessarily mean that they are not adequately competent, but the presence of a name does mean they have demonstrated a minimum level of training and knowledge on a written exam (similar to the medical boards). I know of a number of neuropsychs in my area to whom I would have no problem making referrals who are not board-certified.

I am liking your post, Portia!

Pained smile indeed. There's no clear line, but for me I guess it happens somewhere around when you move from: it's hard for you to live with them, to it's hard for them to live with themselves.

yes, indeed, we didn't end up at the drs without actual problems being present. Ds had trouble making friends and dd had/has issues not being able to stop talking, beyond even what might be considered 'normal' for young girls (so you know that's a LOT of talking) - and this lack of impulse control was problematic in other areas as well. I say 'was' because we've made progress, however it still comes out when she's tired, etc.

We're going to get a psychoeducational assessment for DS6 for the same reasons (OEs and not for placement, right now). From what I understand, the psychologist who is doing the assessment also does counselling to help GCs develop ways to tone down the intensity a bit. I sure hope she's good!

Oh, and we're lucky that our insurance covers both.

I would add one thing to Portia's note - with young, gifted children, it's easy to find things related to giftedness to suspect as a cause for intense behaviors/etc - and as parents we like to see the things that are wonderful about our children as opposed to seeing a behavior as a symptom of something that might be a challenge. This happened to *me* in a big way - when our ds was young we thought he wasn't writing, for example, because we thought he was a perfectionist. It never occurred to me that a child who was so clearly advanced in verbal language would have any academic or other challenges. As he moved into 2nd grade in school, his unrecognized 2e challenges caused him to have behavior issues that we again, as parents, thought had to be due to boredom since it was so clear to us that he was intellectually way beyond 2nd grade.

madeinuk, your dd has been very successful at school and you've never suspected anything 2e - so chances are there is nothing going on that is in the slightest bit 2e with her. The OP, however, has concerns and has a younger child. I would trust my gut instincts as a parent if I felt at all concerned that there might be something more going on than "gifted overexcitabilities" - especially if I saw the challenges as impacting my child's happiness or ability to function.

I'll also add - it's not impossible for 2nd e's to slip by undetected until middle school, high school, or even adulthood. We've seen that happen in my family, and I've seen it happen with a few adult friends too. The frustrating thing about that with the people I've known well who've experienced it is, they experienced frustration and unhappiness for quite a bit of their lives until finally getting a diagnosis. If a parent suspects a challenge when their child is young, absolutely get an eval and check it out - if nothing is found, the eval was still worth pursuing!

Best wishes,

polarbear

I didn't read this whole thread, but I'll add to polarbear's, that not all evaluators/psychologists seem to understand 2e or that they need to look for discrepancies. They focus on composite scores. Average range...no problem, parent needs to stop stressing. They might call a certain skill a "weakness" but not go any further than that, but many gifted kids with disabilities score average on standardized tests, because they are able to use advanced reasoning ability or other compensatory skills, and concerns are blown off, when there really still should be a concern if there are big gaps between scores, or the child's achievement isn't on par for what you'd expect given their cognitive ability.

I feel like I should give more information. These less-than-desirable traits are pretty much only ever exhibited at home (I can count on one hand the number of times someone other than me has witnessed this). I can't say that it all is completely disruptive to normal life, but I had always thought the screaming/crying fits would be over with by now. And the bad times seem to come in waves. We can go weeks with freak-outs only happening 1-2x in a week, and then we go a few days where it's <10x a day.

We're feeling a bit stuck with where to look for coping tools to navigate the above listed traits. But maybe it's all within an average range of acceptable? A full neuropsych evaluation maybe seems overkill, and I don't know that just an IQ test would offer enough insight...? Perhaps a counselor/therapist is more appropriate without any evaluations? We're in the middle of one of those stretches of bad days and I'm feeling a bit overwhelmed. Thanks for of you all of your insight so far, you all are great.

Although I agree that it is a good sign that the behaviors rarely occur outside the home, I would still be a bit concerned about cyclical episodes of 10+/day for a few days in a row. Even if it turns out to be sub-clinical, whatever is going on still affects your home, your relationship with your child, and your child's perception of himself (since he clearly knows this is not expected behavior in general).

I would also agree that a naked IQ test would not answer the primary questions you are asking. I do not, however, think that a neuropsych would be overkill. Regardless of the specific data, you will receive valuable normative and clinical information about your child. If the outcome is simply that this is within normal limits, and you should just keep doing what you're doing, and wait for him to solve this developmental problem on his own, then that should relieve some anxiety, which certainly has value. If the outcome is that something should change about his setting or interventions, then knowing this sooner than later can spare him and you quite a bit of future distress.

ITA with everything aeh said - I'd pursue the neurospych eval. There's also something else I'd recommend, since the behaviors of concern are happening at home, but not happening consistently - keep a journal of when they happen, and include what your child was doing before they occur, where he is, what he's eaten recently, etc. It's possible that over time you'll find a pattern that either gives a clue to what's causing them or will at least give a clue to how to manage them.

I also wanted to add - I was primarily talking about my 2e ds above in my first reply, but now that you've mentioned the behaviors primarily happening at home I'll tell a little bit about my 2e dd. She's the ultimate tantrum kid - has meltdowns like you wouldn't believe, and that went on for years past the toddler typical meltdown years - at home. She's an angel in public - we get reports about what an amazingly well-behaved child she is *all* *the* *time*. Left dh and I wondering (often) if the person talking to us wasn't mistaking us for some other child's parents lol. The same dd was an academic star the first few years of elementary school, then her reading progress stalled out, first falling to grade level and then falling below grade level. We found out via an educational eval that she has a challenge with associative memory, and we eventually realized that her tantrums often happened at times when she appeared to have a memory glitch. The remarkable thing was, she continued to be able to hold it together at school and outside our home - but it wasn't for an admirable or good reason, it was because she was so caught up in not wanting anyone else in the world to realize she was struggling.

Best wishes,

polarbear