Right time for neuropsych evaluation??

[nayma]

hi.  i have a daughter who's 5 and has a dx of asperger's syndrome.  she's about to start school for the first time, and when i was recently discussing my desire to more greatly understand some of strengths and challenges, one of her therapists recommended a neuropsych eval.  i spoke to my neighbor, who's a neurology resident, and he recommended getting one sooner than later= he thinks it's really helpful to have one before kids start school.  then i spoke with a friend with a dd on the spectrum, and she said she's always heard that 7 was the right age to do an eval.  anyone have any thoughts/wisdom on the whole thing?

also, for those of you who have done one, was it helpful?  my dd is quite bright, and can hold it together well on the surface.  i wish i had a better sense of "where" she really developmentally functions sometimes, as i think sometimes my expectations (and those of others in my family) are skewed by her large vocabulary and physical size (large for her age).  hope that makes sense :).

thanks!!

[Emmeline II]

I think the generally accepted age for an Asperger's diagnosis is 7yo because there is a wider range of development until around that age, but for what you want to know I agree with doing it now--though it is likely they'll want to do reevals as he ages. Ds' eval was close to this.  Also, having a more detailed eval will help in dealing with the school as they may have inappropriate expectations based what she appears to be capable of.

[FarmerBeth]

I think that the evaluation will give you some useful information before your daughter starts school and will give you and your teachers some tips as to where she is at.  But, keep in mind that some parts of cognitive development don't stabilize until age 7, especially some aspects of visual patterning and fine motor control.  The evaluation will let you know where she is at right now, but it may improve by age 7.  I ,myself, started out with a non verbal learning disability diagnoses (by discrepancy in scores, although nothing was below average) at age 5 and was retested later at age 7 and the low scores had caught up.  I was told when I talked to a psychologist later about this that it was because some types of skills need until age 7 to develop for some children.

About the diagnoses: Here in Canada, Asperger's is increasingly lumped into the ASD continuum and I have seen diagnoses made before age 7.  I think the diagnoses depends more upon seeing an adequate range and severity of symptoms to be sure, and often (though not always) it is hard to tell if some behaviors are developmental quirks and it may take until age 7 or older to tell whether there is a real problem or a "phase".  My own son was in this category, with behaviors at even age 7 that some boys without ASD (especially those with ADD) might normally have.  By age 10, these behaviors were not still the norm.  But some kids do show fairly clear signs at a younger age.  If those diagnosing  and yourself are comfortable with the diagnoses and it "fits" then it's probably OK if it was made before age 7.

[Linda on the move]

I'm curious how she was diagnosed with Asperger's with no eval. I'm kinda lost right there. 

We've done evals at different ages. My DD's last eval was at age 13 and we learned a some things then we couldn't have learned when she was younger because her ability to comply with testing has changed so much. That isn't a reason to wait, though. I'd recommend letting go of the idea that this is something you do once in a life time.

The neuropsych eval will provide detailed information that the special education teacher can use to tailor make an educational plan for your child. I'd get one done ASAP, knowing that depending on how serious things are with your DD, you'll do another one later.

We may end up doing a new when when she is a senior in high school because she is college bound but will require accommodations for college.

[nayma]

i appreciate all your responses!  linda, sorry i wasn't more clear - she had a multidisciplinary eval at a top children's hospital, involving the ADI, the ADOS, and several others.  i feel extremely confident about her diagnosis, and believe that aging will not change the core ways in which her brain seems wired differently.  and i've been researching ASDs for several years now, so i take the whole "a child can't be diagnosed with asperger's until ___" with a grain of salt.  i've read things that say something very different, and the general trend, according to her school (which serves children with adhd and asperger's) and her developmental pediatrician, is diagnosing children at a younger age.

the eval, i'm hoping, would really serve more as a tool for her school to identify her needs most correctly.  and as i mentioned, there are times when, because of her advanced language, etc., it's easy to have expectations for her that i know are totally off. 

so, how do i go about getting one scheduled- i.e., do i get a referral from her regular pediatrician?  it's much easier to get in touch with him than her developmental ped, so i thought i'd start there.  also, should i research the person doing the evaluation first, or are they all generally similar?

again, thanks :)!!

[Emmeline II]

Quote:

Originally Posted by nayma 

i appreciate all your responses!  linda, sorry i wasn't more clear - she had a multidisciplinary eval at a top children's hospital, involving the ADI, the ADOS, and several others.  i feel extremely confident about her diagnosis, and believe that aging will not change the core ways in which her brain seems wired differently.  and i've been researching ASDs for several years now, so i take the whole "a child can't be diagnosed with asperger's until ___" with a grain of salt.  i've read things that say something very different, and the general trend, according to her school (which serves children with adhd and asperger's) and her developmental pediatrician, is diagnosing children at a younger age.

the eval, i'm hoping, would really serve more as a tool for her school to identify her needs most correctly.  and as i mentioned, there are times when, because of her advanced language, etc., it's easy to have expectations for her that i know are totally off. 

so, how do i go about getting one scheduled- i.e., do i get a referral from her regular pediatrician?  it's much easier to get in touch with him than her developmental ped, so i thought i'd start there.  also, should i research the person doing the evaluation first, or are they all generally similar?

again, thanks :)!!

Sorry, I think I led people astray with my first comment--I was trying to point out where the "7years" idea your friend mentioned may have come from--the eval used for ds was broken down by year, month, and week and Ds was 6y11mo when he had his eval. The Dr. (specialty clinic at a children's hospital) said that what put him most in the Asperger's category may change with age and maturity; that, combined with the ADHD and SPD, whose symptoms can overlap with Asperger's, led her to not give the diagnosis at that time/age (because he was under 7yo). I have seen some posts about a poster's child "outgrowing" an Asperger's diagnosis given at a young age, and that some doctor's try to avoid this by giving a more general PDD-NOS to younger children.

The information you seem to be looking for was part of ds' eval for Asperger's (which was like that outline in the link I posted. I think I would try to calling your dev-peds office first, you could probably just leave a message and get the information back the same way without needing a phone consult type of thing; I would also try asking your neighbor if he has any suggestions.

[Linda on the move]

Originally Posted by nayma 

i appreciate all your responses!  linda, sorry i wasn't more clear - she had a multidisciplinary eval at a top children's hospital, involving the ADI, the ADOS, and several others.

...  also, should i research the person doing the evaluation first, or are they all generally similar?

I don't have any helpful advice because I'm not fully understanding exactly what she's already had done so I don't understand how the new eval would be different. I'm just a mom, not a specialist of any sort. Sorry

I did research the person doing the last eval for my DD because she is very complex (she has multiple labels, Asperger's being the main one) and I wanted someone experienced and very, very good at what they are doing. I wasn't there to get an specific DX, but to find out more about how my DD's brain works. I went for the person with the very best reputation in the area we lived, and the waiting list was about a year long. Depending on someone's situation, it might make more sense to get in with someone they could see quicker and get paper work back for the school sooner.

I think the more cut and dry a kid is, the neater they fit into one label, the less important the the evaluator is. But for kids with multiple issues, difficulty communicating, and may be a traumatic life experience thrown in there too, the more you need someone really, really good at what they are doing.

[FarmerBeth]

I'm taking it that you have the ADOS and ADIS as stated, but you don't have the full range of IQ and cognitive testing.  At age 5, the choice is between developmental testing (with equivalent development by age) and IQ.  They give similar information, but for the reasons I stated above, sometimes IQ testing is delayed because some scores take a while to stabilize.  Either will help to give the school better information as to your daughter's abilities.  We started with cognitive testing, so we had a lot of info for DS, and he was given lots of help for nonverbal disabilities (but not including math or patterning) based on the results.  It really got the ball rolling on helping with fine motor and aiding the teacher in understanding that his verbal ability sometimes didn't match understanding due to difficulties witth non concrete language or following routines.