Please talk to me about ASD assessment/evaluation

[expat-mama]

Hi there

I haven't been on this board in a while. Last time I visited was a few months ago when my son K who is now 2 yrs 3 mos was initially diagnosed by his pediatrician with PDD-NOS.

We are having a more thorough evaluation/assessment done on Thursday at a special needs center in our new home city. We live abroad and here this is not covered by insurance nor are there public programs like in Canada or the US. This evaluation is very expensive and I really want it to go well- I just want them to be able to find out what they need to in order to help my son in the ways that he needs. There will be a speech therapist, occupational therapist and a psychologist present and I was told the evaluation will be for an hour and a half.

I am so extremely nervous- nervous that my son won't do what he needs to (whatever that is) for them to see what his problems are- the only appointment I could get this soon runs into his nap time and this could be disastrous. I'm also nervous that they'll tell me he is fine (I've been listening to relatives who see my son once a year or less tell me this and it's extremely frustrating) or that they can't do anything for him. I don't know how they will see him display his typical and obvious ASD behaviours...a lot of them he does only at home or in certain situations and environments (repetitive/odd play and reciting scripts for hours etc). He doesn't interact with other people unless he really knows them so I'm just afraid he'll totally ignore the specialists. 

I have absolutely no idea what to expect. Will they try to talk to him? Play with him? Get him to do tasks like puzzles or something? Just watch him interact with me? Will they ask me questions? Will I be in the same room?

Generally what happens in these things???

Thanks again.

[fizgig]

An asd eval will look very different depending on who is running the show.  There very play based evaluations and then there are more "testing" evals which used standardized measures like the ADOS test.  Play based observation is just that - playing to see how he interacts, responds.  Tests can include puzzles, specific scenarios, and so on. 

Ideally an evaluation would use both strategies.  One thing I did to make sure our eval was accurate was to keep a journal detailing what I saw and what I was worried about.  It was very helpful in making sure I gave them a full picture of DS. 

To be honest I don't really think 1.5 hours is long enough to get an accurate evaluation unless it is a clear cut case.  The good news is that most evaluators are very familiar with the challenges of getting an accurate assessment.  If you are hoping for an asd diagnosis (meaning that is what you think is going on and you want them to see it as well) then the other good news is that him not interacting will support that assessment. 

We've been through a number of evaluations for DS now and I've come to view them as snapshot images of one moment of DS and what is going on with him.  We had a number of confusing and incomplete evals when he was younger (2-2.5) and it wasn't until we went to a developmental pediatrician when he was about 2.10 and she spent over 5 hours with us testing him, observing him at school, and playing with him, that we were able to get what I feel is an accurate dx. 

My main advice is to not pin everything on this one evaluation.  They will see what they see, and you can agree with their assessment or not.  I know that's not what you want to hear - I know I just wanted answers!  And hopefully they will be able to tell you what is going on! 

[expat-mama]

Thanks for the reply! No not exactly what I wanted to hear lol, but I really appreciate the input and hearing your experience. Our appointment is tomorrow, so we'll see how it goes. I'm not sure how many of these types of assessments we can afford, so I'm really really hoping that I get the outcome that is best for my son.

Thanks again.