gettingclear wrote:
his current neuropsychologist has not written anything formal, but is treating him with biofeedback to address his attention deficit issues.
Does your insurance cover the bio feedback sessions or do you pay out of pocket to the neuropsych and how long has your ds been getting the bio feedback sessions? Symptoms do overlap and that is why its important that the child be assessed by a clincian who has the expertise to make a differential diagnose. While symptoms do overlap, there are also vast distinctions as well amongst childhood disorders that could only be recognized by an astute clinician. As the parent, if your not satisfied with a diagnosis of LD by the neuropsych and want to rule in or out ADHD, I would at this point have your child assessed by the child psychiatrist.
A doctor should never write a prescription for medication without a conclusive diagnosis. A diagnosis is made and then treatment is discussed. The doctor has to convince you as the parent that the diagnosis they give your child is an accurate diagnosis. Its not the parent that should be trying to convince the doctor that their child might have ADHD. Medication should never be tried to make a diagnosis of ADHD as that could be very dangerous for the child who has undiagnosed bipolar disorder.
I know that journey for you is a long and daunting task and Im sure its been an unnerving experience for you in your search for real answers so it is of my opinion that you should at this point have your child assessed by a child phychiatrist if your of the beleif that your child has ADHD. Your the parent and you know your child better than anyone.
[QUOTE=vickie]Yes. You have to have the MD to write a prescription (as far as psychologist vs psychiatrist). The PhD that psychologists have dose not provide a good education on meds in most cases. [/QUOTE] i understand about only the md can write an rx, but can only an MD write a dx?
it seems like no one wants to declare the ADHD dx - kinda like they dance around it a lot. i guess they're afraid of a lawsuit or something.
i understand luvmykids' question because i have read on this board how some people were misdiagnosed, did the meds with no response, and THEN realized that they didn't have adhd.
On the diagnosis, psychologists seem to be reluctant to give a diagnosis. This may be because of all the disorders that have symptoms that overlap ADHD and can be comorbid with ADHD. My daughter's psychologist wrote a report with the diagnosis only after a psychiatrist ruled out bipolar. The posibility of bipolar caused me alot of worry when starting meds because of the chance of the meds starting a manic episode if the diagnosis was wrong (and she really had bipolar).
gettingclear wrote:
when you say "formal diagnosis", what other protocols are you referring to? if you can be specific, i can follow up.
By formal diagnosis I mean the child goes through a private evaluation process by a qualified specialist and based on the evaluation results, a diagnosis is given based on the physicians expertise and a full written report is given to the parents and recommendations are made.. You state that your ds is under the care of a neuro/psych and she said your ds has a learning disability but my question is did she ever formally diagnose him with ADHD?
[QUOTE=Luvmykids02] Did you ever get a formal diagnosis from the neuro/psychologist to confirm a diagnosis of ADHD?[/QUOTE] hi - after our neuropsychologis (NP) worked with him for about 3-4 months, i asked her what she thought DS's issues were. i did not ask for a formal report, but she believes that he has a learning disability and gets anxious when in new situations. his attention, i guess, suffers when he's in a new situation. he is also fine under routine, predictable tasks. his issues now are socialization-related. he's realizing that he needs friends, and therefore, must cooperate.
when you say "formal diagnosis", what other protocols are you referring to? if you can be specific, i can follow up.
in getting the IEP approved, he had all sorts of "specialists" observe/test him (speech pathologist, school psychologist, etc.). i noticed that no one wants to "come out" and "say" or "write" that "Your Son, John Doe, has ADHD." another private psychologist that we hired had the teachers fill out forms, and this psychologist also met with Aaron. he believed that Aaron had ADHD based on the check-off forms from the teachers (kindergarten, which was 3 yrs ago) and his own interview with DS.
vickie & tonyas - what meds is your child on? can you also give the mg? just curious.My daughter is on 27mg concerta each morning and 2mg guanfacine morning and night. Because she is so thin to start with and started losing weight, the doctor did not want to increase the concerta (although she was not at optimal dose) so he added the guanfacine. It is effective for some adhd symptoms and can help with weight issues. We are working for an optimal dose and times of dose for the guanfacine (we may have it now). The last report card was all Bs and B+s with Os and Gs. This is a huge turnaround from last year (and the first couple weeks this year with out meds), which was Ds and Fs. My daughter is pleasant to be around again and the parent/child bond has become stronger than ever.[QUOTE=Luvmykids02]but my question is did she ever formally diagnose him with ADHD?
[/QUOTE]
the first pediatric psychologist who recommended meds wrote a one-page memo which was the key to getting his IEP approved. is that what you mean?
i don't have the memo in front of me, but it was enough to get the IEP in place.
his current neuropsychologist has not written anything formal, but is treating him with biofeedback to address his attention deficit issues.
does that answer your question?
edited to add: can only an MD or psychiatrist (who is also an MD) write out a dx?
gettingclear39043.5848148148Yes. You have to have the MD to write a prescription (as far as psychologist vs psychiatrist). The PhD that psychologists have dose not provide a good education on meds in most cases. vickie39043.627962963Luvmykids, yes - i agree with what you said about a definitive diagnosis before doing the meds. thank you for the reminder - that seems to be the theme on this board. if i ever pursue the meds route, i will insist on getting a psychiatrist's diagnosis.
[QUOTE=Luvmykids02]Does your insurance cover the bio feedback sessions or do you pay out of pocket to the neuropsych and how long has your ds been getting the bio feedback sessions?[/QUOTE] answer: yes insurance covers 24 sessions and it's been over a year.
My son has ADD and meds have been wonderful for us. I was concerned and worried about the side affects as well but after much research I felt better. We tried Concerta and it worked. He can now focus!! School puts a lot of pressure on our children much more than I can remember. A child with any behavior problem is going to fall behind if they dont have the help they need. In our case, medicine was the solution as well as getting his as much on a schedule as we can at home. His dad and I are divorced so he goes between houses (we live in the same town and share custody) I think that may hinder him a little but he is doing great going on more than two years now. When he forgets his pill it reminds us of how we use to live and it reassures me that the medicine is giving him a better quality of life. Concerta has a free CD that talks about ADD and the medication. My doctor also gave me a great book on ADHD, I forget the name but he gave me two books and he also borrowed my son a book on ADD that he had to read and bring back, it was basically a boy with ADD's journal of his day to day activities and how he dealt with what he was feeling having ADD. (Great book)i have been on the alternative forum since i started on this site. DS7 has an IEP and the dx for adhd was "inferred" based on the forms that the teachers fill out ~ this was 3 years ago. my son has had good results with neurofeedback and he has a good neuro psychologist (NP). the NP has been working with him for about a year now.
he has an IEP and behavioral support plan in place. the school has been good for him and us in terms of working with him and giving him the support he needs.
yesterday we had an updated IEP meeting and the teachers are positive about his progress and that he is making a lot of improvements. however, i am seriously considering going the meds route. DH is probably not in favor of it, but for many reasons, i am seriously thinking of adding in the meds. the teachers are not pressuring us at all to do the meds, but i am wondering whether it will help him.
as they get older, school becomes more challenging. i also see DH yelling at him a lot. DH is a high school teacher and in my eyes, "forgets" about DS's condition.
i'd appreciate any help you can provide.
Going to meds can be a tough decision. Getting the right med and dose for the individual can also be difficult. You can always to a trial of meds to see if there are any positive effects that make you want to go with that route. Meds can make the behavior plan work better as well. Also, you can take a break every school year to see if the meds are still needed or if maturity has reduced or elimiated the need for meds.
My daughter did well in school until the 2nd grade. Then things went downhill until absolute failure (Ds and Fs), anxiety, depression and defiance in the 4th grade. We got an IEP in place and started an behavior plan at school and home. While these things helped, they did not help enough. We did a med trial last summer, then restarted them and optimized the dose after school started (started without meds so we could get a baseline to judge the effects). My daughter is now happy, is keeping friends, is getting As and Bs and the anxiety and depression are gone. My husband was against meds but had no other sugestions so he let me work with the doctor and meds. My husband now sees the positive effects of the whole treatment plan (meds, behavior, special ed help where needed) and is comfortable with the decision.
Whatever you decide, you will find support here.
Its great that your child is making such significant progress You stated that a diagnosis of ADHD was inferred 3 years ago based on forms that the teacher filled out. Did you ever get a formal diagnosis from the neuro/psychologist to confirm a diagnosis of ADHD? When parents devise a plan and strategy to help manage the symptoms of ADHD and what they are doing is not working, these children usually hit the wall by 2nd or 3rd grade. They start to decline very early on. This doesnt seem to be the case with your ds as apparantly, you are seeing very positive results. If you haven't done so already, I would get a formal diagnosis and if you already have a formal diagnosis, ask yourself how severely your child's ADHD is impacting on all area's of life, not only in school. Its a very individual decision and I'm sure feedback from the neuropsycholigist would be very helpful in this case. Good luckI have a 7yo dd with ADHD/ODD. She was just recently diagnosed & just started her meds this past Friday. My dh & I were both very scared about medicating our child. I did a lot of research & talking with people & doctors. We eventually came to the conclusion that we would try meds. We have noticed a complete change in her in this past week. Even she notices it. She is very proud of herself. Her teacher & other school staff have commented at the difference in her behavior. She is participating in class & is able to stay on task & focus. Not to mention that she is wonderful at home too. Also, her handwriting is already looking much better. So for us, it has been the right thing to do. Everyone is different. It is a very tough decision, one that only you can decide for sure. Good luck to you & your son.