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    Joined: Jul 2011
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    If you had a child with 2e issues and your school were offering you testing but you could afford private testing with a neuropsych, how would you approach it? Would you worry that school might miss something important and inadvertently "block" you from getting more astute results by having to wait to access that test again?

    Additionally if your child had/may have a vision issue (waiting for visit to diagnose), do you resolve that first for more accurate results or plow ahead with testing, hoping to get more diagnostic information about how much is vision and how much other issues at play?

    Hard to pick a next move weighing it all in the balance. Love some BTDT advice from you all.

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    Originally Posted by HappilyMom
    If you had a child with 2e issues and your school were offering you testing but you could afford private testing with a neuropsych, how would you approach it? Would you worry that school might miss something important and inadvertently "block" you from getting more astute results by having to wait to access that test again?

    Additionally if your child had/may have a vision issue (waiting for visit to diagnose), do you resolve that first for more accurate results or plow ahead with testing, hoping to get more diagnostic information about how much is vision and how much other issues at play?

    If possible, do the vision testing first.

    The thing about school and private evals is that they are after different things. If possible, I advocate letting school do their piece so that services or accommodations can be put into place if needed, but also getting the best private information you can.

    School is not allowed to make medical diagnoses. They are doing an "educational eval"-- they look at academic and functional skills within the school setting. A private neuropsych is looking across all contexts, is able to make an actual diagnosis, and has a much more extensive toolkit; you will get more details from a private eval.

    Depending on your district, it can also be a factor that school psychologists may be under pressure to NOT find things for budgetary reasons. This is illegal, but it happens.

    DeeDee

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    I recommend doing private testing first, no matter what, then go through the school's eligibility/testing process. If you're concerned about the school accepting the results, you can ask other parents or a local advocacy group or your pediatrician re advice on which neuropsych to choose for testing (if you're in an area that has more than one ped neuropsych to choose from!).

    My reasons for recommending private testing:

    1) You'll have a chance to be included as a part of the process and your child's developmental history will also be included *for sure* - the neuropsych will interview you and go through a very detailed set of questions re your child's developmental history. Sometimes that can be very helpful in coming up with the proper diagnosis. Plus it will give you a chance to share all of your concerns up front - and through the question/answer process with the neuropsych, you might come up with questions you wouldn't have thought to ask. They may also ask you about *family* history too - and that can be important.

    2) Neuorpsych testing almost always includes more in-depth testing than school evals. For instance, my ds' school eval shows that he qualifies for an IEP under SLD/written expression, but the testing only went as far as testing that showed he qualified. His neuropsych testing included further testing to determine *why* he was having difficulty with writing.

    3) Private neuropsych testing includes a broad as well as detailed look; school testing is focused on where you and/or your child's teachers perceive the challenge is. For instance, we sought out neuropsych testing for our ds in 2nd grade because our ds was struggling in school and his teacher suspected ADHD. We found out he had Dyspraxia and Disorder of Written Expression. We had *no* idea that ds had those challenges. Later when we went through the school testing, we, as parents, had to specifically request the test that showed his writing challenge because the school was not planning to offer it to our ds. Had we gone into the school testing without knowing what his area of challenge was, we would not have known to ask for that test (TOWL).

    4) The focus of the school eval is qualifying (or disqualifying) your child for an IEP based on educational need and looking for a fit with what services the school can and will provide; the focus of the neuropsych evaluation is overall functioning. With a private eval you will get recommendations for therapies whether or not the school can or is obligated to provide them, and you'll get recommendations for a path forward through childhood, not just a one-year set of specific goals.

    5) A private neuropsych will be able to make recommendations for other professionals that you might need to see (OT, SLP, etc)... whereas at school you will only get evals through the school OTs etc if your child qualifies. It's not unusual for a 2e child to *not* qualify for things like this through school yet really benefit from specific therapies that target their areas of challenge.

    6) If you have one ounce of distrust of the school or one tiny worry about anything that happens with the school testing etc... you may find yourself wishing you'd had the private neuropsych. Based on my own experience and what I've heard from other parents, the inverse of that rarely happens - so you're covering your bases at the start, and time is important in a child's life. They grow up and move on from grade to grade quickly, and you want the most complete information you can have asap.

    7) I've honestly just heard too many stories about incomplete school evals and lack of answers from them.

    8) You'll get a diagnosis through a neuropsych, but not necessarily through a school eval. Having a diagnosis has been helpful to us in two ways: understanding how to accommodate/remediate appropriately and also it's been extremely helpful for our ds' self-esteem to have that diagnosis and not worry and wonder that something's "wrong" with him.

    So clearly I'm biased lol! But having the neuropsych has been *extremely* important for my 2e ds.

    You also asked about vision - eval/remediate first and then test, or go ahead and test. I'd go ahead and test, and if you have portions of the tests impacted by vision, repeat testing after the vision issue has been remediated. We have experience with this, and it's worked out ok (and in our case, for the better). My dd was struggling with reading but had ok eye exams through our regular eye dr. She had a neurospych eval in 2nd grade where she performed across the board relatively well on every single test except for two seemingly unrelated subtests which she *bombed* (we're talking lower than 1st percentile bombed). The neuropsych suggested it was related to vision, recommended seeing a behavioral optometrist, and she was absolutely correct - that's how we found out our dd had double vision. DD had vision therapy for a year and made amazing progress. Within just a few months she had fallen in love with reading and was walking around everywhere with a book in front of her face smile We didn't return for more testing because we didn't need to - but she's not *truly* 2e, she's just a kid who needed help seeing. If she'd continued to struggle with things post-VT, we would have followed up with more neuropsych testing - otoh, based on my ds' neuropsych testing, I suspect if there were other issues they would have shown up in other tests that didn't rely on visual interpretation and we would have been working on them at the same time as the vision. It can get really complicated and many of our 2e kids have more than one challenge. That happened with our ds (just not with vision) - he had an underlying disability that didn't show up *until* we had handwriting accommodations in place. But we never would have been able to get to that step where we had those accommodations in place if it weren't for the initial neuropsych eval.

    Best wishes,

    polarbear

    ps - re the vision issues - there is no reason you can't go ahead and do the vision testing while you're waiting for your neuropsych appointment - or any other type of OT/SLP/etc eval - the neuropsych will include the results of those testing in his/her evaluation.

    Last edited by polarbear; 04/30/13 08:49 AM.
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    Originally Posted by DeeDee
    If possible, I advocate letting school do their piece so that services or accommodations can be put into place if needed, but also getting the best private information you can.

    DeeDee could you expound a little bit on "their piece" so I have a better idea what that looks like? My understanding from them is that they want the standard WISC/WIAT. I and they (from their statements) know my kid is an anomaly for them. I want to work together but don't want to miss a window of opportunity that leaves my child suffering with undiagnosed 2e issues that aren't fitting the school mold.

    Vision testing is slated for sooner than school related testing so we will have more info in advance. I think I am questioning whether school related testing should be pushed till after summer therapy for any vision issues or pursued now to help with placement.

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    Thanks Polar! We were posting at the same time. So would you hold back from a WISC at school until the NP gets involved? We haven't scheduled an NP visit yet. Just formulating in my head how we want to approach this.

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    Our experience may be unusual but we got the school testing first. DH and I believed DD was likely dyslexic and I knew she had fine motor/ hand eye coordination issues for years before we could convince the pediatrician to have her evaluated. The extent of her issues absolutely blew away the school psych doing the testing. The benefit was that it was done quickly and we were able to get services up and running immediately. When she started to experience severe headaches we ran her school results by Paul Beljan via a telephone consultation and he told us the get her to a neuropsych eval PDQ. Unfortunately we had a bad experience and paid $3k out of pocket for a set if results deemed to be "invalid." Our consultant got the district to pay for a new neuropsych eval but we then had to wait for an opening.

    So... I guess the bottom line is that the neuropsych testing (done well) is the best route. It can be expensive, though, and can take a long time to get in to one, especially a good one. You will get more detailed results and (hopefully) recommendations from a neuropsych eval but there is no guarantee your district will accept the results. A school evaluation may be a good way to start if you have specific areas of concern and you want to get services up and running quickly.

    I guess knowing what I know now I would have gone ahead with the school testing (it turns out that everyone agrees the school psych did a surprisingly good job) but scheduled with the neuropsych at the same time. It can take up to a year to get in to see a good one. Just make sure when scheduling that (s)he knows what tests were previously done so your appointment is scheduled in a way to avoid "retest artifact".

    Also I would not wait to do vision testing. I say move forward on all the fronts you can.

    Good luck!


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