My 9 yr old DS just received a diagnosis of ADHD - inattentive and Anxiety after having an evaluation with a child psychologist. Her recommendations are to start with therapy and behavior modification/support, then move on to medication if there isn't marked improvement. I submitted her report to DS's school counselor today in hopes of starting the process of putting a 504 plan in place for DS. Given that the educational supports recommended don't require much from anyone in the school setting (i.e. seating arrangements, a reasonable amount of assistance from his teacher in staying on task and getting organized), I don't anticipate much of an issue in getting the plan implemented. However, given that we are still in the shock phase of coming to grips with a diagnosis, I would love some advice from those of you who are more experienced with all of this so that I can make sure that my DS is receiving all the help he needs to be happy and successful.
If educational testing was not part of the evaluation process I'd consider it; hospital clinics that are involved in diagnosing ADHD and/or learning disabilities are normally cheaper than a private practice provider.
Also, you may at some point decide that this provider isn't a good fit for any number of reasons; don't be afraid to "break up" if the relationship isn't working.
Thanks for the link, Emmeline. We are a military family, so Tricare will cover the cost of all testing, therapy, meds etc. that my DS needs. He did not have any educational testing with his eval, mostly because all involved (me, his father, teacher, DS himself) agree that he is an above-average student in spite of the attention and anxiety challenges. He has very strong math and science skills, reads well above his grade level, and is a top notch speller. I suspect that he will test into a gifted program (like his older brother) once his attention deficits are treated. Given what I've reported here about his education situation, does it seem like it would be valuable for us to pursue educational testing too?
A learning disability is not about intelligence (as mentioned in that link above), and is not just for weak students. My ds' K teacher wanted to nominate him for the gifted program a year ahead of when they normally consider it (before his behavior problems overshadowed everything), his 1st grade teacher did (then the school decided to restrict it to 3rd and above); he reads about 2.5-3 grades ahead, is an excellent speller, but a bit weaker in math. One function of educational testing is to help ensure that ADHD is the correct diagnosis; occasionally learning disabilities, even giftedness, will be misdiagnosed as ADHD. Ds has had it done at the children's hospital when we had him evaluated for Asperger's and through the school district (the latter being well aware of his good grades)--it only took about 2.5 hours.
If there is anything about the diagnoses that doesn't ring true to you, I would go for a psyche-ed eval. Depending on his grades, reading ability etc. I'd probably look at a bunch of other stuff too - hearing (screening for CAPD if possible), sight, assesment from an OT and/or Speech Language Pathologist, etc. There's a book called the Mislabeled child (Eide) that is a good start for investigating what's really going on with kids. Keep in mind that many smart kids are very capable of learning alternate strategies that cover up subtle disabilities.
Since his grades and reading are good, another book you might be interested in is
Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, Bipolar, Ocd, Asperger's, Depression, and Other Disorders
What gave you the idea that Soul-O was doubting the diagnosis?? I don't think that is a helpful comment. Actually I find your comments downright offensive. Mothers of children with these types of disabilities are always being asked to prove that their child REALLY has it and how is that fair? Would you ask a mother of a child in a wheelchair to prove their child really couldn't walk? My son has tons of issues - all diagnosed after VERY thorough assessments. He has undergone dozens of hours of testing from all sorts of professionals. I think it is safe to say that any mother who posts on these boards will have done their due diligence in making sure the diagnosis is accurate.
Soul-O - I highly recommend a complete psycho-educational assessment. My son has a normal IQ and is very bright but still struggles with school work. The educational assessment revealed a number of learning disabilities and it has really helped with the school to be able to pinpoint those issues. Even if he isn't presenting with any learning issues there **** might be problems which often come along with those types of disabilities.
I didn't think Jen Muise was being unsupportive of Soul-O. I think she was recommending further exploration to the child's benefit.
ADHD is a highly debated diagnostic category, based on it's frequent co-morbidity, and the fashion and frequency by which it is typically diagnosed. If a psych diagnosed it without doing a psychoeducational assessment, it may very well have been diagnosed via subjective inventories, which are pretty weak tools to use to then potentially medicate and pathologize a child's behaviour. Behaviour which may stem from some other cause, and which could be more effectively remediated if the core challenges were addressed.
Soul-O, if you do decide to pursue further evaluation, a psyched would look at intelligence (both general level and any discrepancies within scores which could explain both anxiety and inattention), achievement, and various other functions, including executive functioning (ADHD is a type of executive function skill, there are others). ADHD diagnostic criteria describe behaviours, but does not indicate cause in the individual. ADHD-type behaviours can have multiple sources, including vision issues, auditory processing issues, lack of academic fit, EF deficits. Or, your child may have more classic ADHD and there are strategies (both meds and behavioural) that can help.
I understand that it's hard when you hear from a professional that your child has some learning differences that will make their life more complicated. It's great that he's got a supportive mom who is seeking help for him.
I appreciate all of the different perspectives you've all shared. I hadn't given much thought to pursuing further educational testing, so thanks for the links and suggestions. I don't doubt the ADHD diagnosis, given the symptoms DS has displayed over several years in a variety of setting. However, given that DS also recently started wearing corrective glasses for far-sightedness, it would make sense that there might be other issues causing him to have challenges in the classroom. Looks like I have a lot of research to do - better get started on all the reading!
I appreciate all of the different perspectives you've all shared. I hadn't given much thought to pursuing further educational testing, so thanks for the links and suggestions. I don't doubt the ADHD diagnosis, given the symptoms DS has displayed over several years in a variety of setting. However, given that DS also recently started wearing corrective glasses for far-sightedness, it would make sense that there might be other issues causing him to have challenges in the classroom. Looks like I have a lot of research to do - better get started on all the reading!
Thanks again
I was aiming more for "cover your bases"; it's just that other issues are sometimes overlooked or misdiagnosed because providers don't necessarily have the tools or knowledge/inclination to delve further once they find the "obvious" diagnosis. If we had just stopped with ds' psychiatrist's ADHD diagnosis we wouldn't have the information about his learning that came with the hospital eval (the hospital also confirmed the ADHD diagnosis, btw).
Soul-o, I may be corrected, if I am wrong, but I think with the 504, if it is like an IEP, then your ds will be reevaluated by staff at his school. I do not know that it is necessary to pursue affirmation or different dx unless you feel that the psych is not a good fit or misdx. The school will not label your ds' dx, but they will evaluate to find which accommodations will help him in the classroom. You may need to present letters requesting evaluation to the principal and classroom teacher. For my ds, the school referred to his psychologists recommendations, but did not offer all as accommodations or work them into his goals. Good luck sorting it all out.
Soul-o, I may be corrected, if I am wrong, but I think with the 504, if it is like an IEP, then your ds will be reevaluated by staff at his school. I do not know that it is necessary to pursue affirmation or different dx unless you feel that the psych is not a good fit or misdx. The school will not label your ds' dx, but they will evaluate to find which accommodations will help him in the classroom. You may need to present letters requesting evaluation to the principal and classroom teacher. For my ds, the school referred to his psychologists recommendations, but did not offer all as accommodations or work them into his goals. Good luck sorting it all out.
504s are from section 504 of the ADA (Americans with Disabilities Act); it spells out the modifications and accommodations that will be needed for these students with a disability ("physical or mental impairment which substantially limits one or more major life activities."), so they have an opportunity perform at the same level as their peers. IEPs come from IDEA (Individuals with Disabilities Education Act), and is designed to meet the unique educational needs of one child, who may have a disability, as defined by federal regulations. In any case, it is a good idea to have a private evaluation done (if you can manage) as that evaluator works for you, not the school; what the school is legally obligated to provide (FAPE -- free and appropriate education) may not be what you think is best for your child.
Quote:
Under IDEA/IEP, if your child has a disability that adversely affects educational performance, your child is entitled to an education that is designed to meet the child's unique needs and from which your child receives educational benefit.
A 504 is helping your child get the same education that everyone else is getting--more for a student that needs accommodations to help them learn (like sitting next to the teacher) or for behavior, and that they are not punished for things that they cannot control due to the ADHD (like needing to work standing up or not sit inside a group).
If you decide to request the school do an evaluation, you need to "start the clock" in your letter of request; the school has 60 days from the date they received parental consent for evaluation to do the evaluation; your written request should note that this letter is the consent for evaluation. (And, if you did not do it in writing, it never happened!).
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