Evaluations | ADHD Information

no advice for you...we are just starting this journey as well.  i do know that my kid's school and the psychologist there said that they could run the woodcock johnson to screen for learning disabilities at school and it would be free of cost.

having said that...i've heard mixed opinions on whether it's better to have the testing/evals done outside of the school,etc.

btw- i also live in the minneapolis area...feel free to pm me:)

shelley     

 

  You sound just as confused, lost, and disturbed as I am.  My son is 11 years old, in the 5th grade.  He's currently on 54 mg Concerta but I'm not happy with it, and have a dr's appointment Monday to switch him.  I feel as though I am getting no help, support, or guidance from the prfessionals in his life (school, doctor's, etc).

Feel free to PM me, maybe we can help support each other!  remeber you are not alone, we are all going through this!

 

 

Hello Everybody,

This is my first time posting but I have been a lurker for probably over 6 months.  I can't thank everyone on the board enough for all the comments and suggestions.  I have used alot of them.  You have helped me just as much if not more than the "professionals".  Like many others, desperation has finally got me to register and post. 

My son is in 5th grade.  He was diagnosed with ADHD in 3rd grade., by his pediatrician and using the Conners Rating Scales.  Our problems are mostly with attention.  He does have some restlessness and silliness.  His shyness may mask some hyperness.  He has been on Concerta 36 mg for a year and a half.  It helps slightly.  We wish it would do more for the attention.  We tried going up to 54, but he couldn't sleep at night.  Then we went back down to 36, and he still was having insomnia.  I asked his pediatrician if melatonin was safe- she said OK- it helped us immensely.  However his pediatrician is afraid to go up to 54 again because he is extremely underweight.  He weighs 60 pounds.  He has been underweight since he was an infant, even before we thought about stimulants.

We are lucky in that he is a bright child.  In 4th grade we had to pull him out of high performance reading because he couldn't keep up with the writing work load. He still goes to high performance math.  4th grade went pretty well- he had more homework than most and needed lots of help with big projects, but we managed.  Now in 5th grade, we are stressed out to the max.  Since Christmas break, we have been doing 2.5-3 hours of homework every night. At the 2 hour mark, I have started scribing for him.  The teacher is OK with this, but frankly I think I would have kept doing this even if she had a problem with it. I know the inattention is a part of this, but writing has turned into an enormous problem. He has always had the most trouble with writing output, and of course, in 5th grade there is a lot more required.  I did mention this difficulty in a 504 meeting last year and was told all ADD kids have trouble with writing because it requires such concentration.  I was told he could have an alpha smart if I wanted.  Since he can't type, I said not at this time.  Last year they  were all supposed to switch to cursive.  He mostly kept with his printing.  This year cursive is mandatory.  He doesn't reverse letters or anything, but his writing is extremely laboured.  He writes very slowly and he gets completely worn out and frustrated by it.  I am starting to think he has a fine motor problem.  He can't write as small as they require in the worksheets now.  When they don't provide the lines anymore, he can't keep a straight line but wanders up and down, usually getting bigger as he goes.    His printing letters are neat, his cursive pretty wobbly.

I voiced my concerns to his teacher, and she had the school OT look at him.  The OT gave him a timed test, and said he wrote fast enough that he didn't require extra help.  This is hard for me to believe.

I think I am at the point where I should request a special ed evaluation by the school.  But is this worth my while if the OT at the school said she didn't think he had a problem?  What if she is the one evaluating him.  Even if they do find a problem, would anything be done differently anyway? Is there anything that can be done to help these kids?  Maybe I should just request more accomodations like scribing in the 504. (Right now he gets extra time on tests if needed.  And his teacher checks his planner at the end of the day to help with organization.) I think if I do request, I should do it as soon as possible before he goes to Middle School next year with all the different teachers.

I decided to try and get a private evaluation first.  I tried enquiring in the Neuropsychology  Clinic in the Dept. of Psychiatry at  the University of Minnesota.  This is what someone there answered me "Insurance rules make it impossible for me to see cases involving Learning Disabilities with referral questions related to school functioning.  the carriers basically say this is the domain of the school system. I have not been able to get these kinds of evaluations authorized at all.  Also unfortunate is the fact that our clinic is not geared toweard self-paying services.  I don't take these cases here, but refer then elsewhere.  I would suggest LDA of Minnesota as a possible source for this evaluation."

I went to the LDA of Minnesota web site and filled out an application for an educational evaluation to screen/document learning disabilities.  I was thrilled as this was a nonprofit who charged 0 for the screen instead of the 00 I have been hearing about.  Now I have heard back from them- I had sent in report cards and a writing sample.  They say since his grades are good and his writing makes sense, he probably doesn't have a learning disability, and they don't think it would be worth my while to do their " educational testing".  They suggest going to a Neurologist or a Neuropsychologist to check for fine motor problems.

I thought fine motor problems were a part of educational testing.  The neuropsychologist sent  me to them. 

Now what?  Here in Minnesota HMOs rule and everything must be referred through your primary care physician.  I had gone to the U because I was assuming it wouldn't be covered anyway.  I am thinking to make an appointment with his pediatrician and asking her for a referral to..  what?  a Neurologist?  a Neuropsychologist?

Geez, I am so very sorry I was so long winded.  It just seems this is the one place where people really understand how difficult and frustrating life is for us and our child.

 

Bubbles

 

Bubbles, welcome and feel assured that we all recognize and sympathize with your agony. A few comments about your post:  have you ever done any other testing aside from the original evals with your ped?  If not, I would suggest that you see a psychiatrist (with the MD) to have a full evaluation done.  It should take several hours and will do a better job of pinpointing your child's strengths and weaknesses. Also, it's not unusual for a child to need a medication change after a while, as their metabolism changes and the become "tolerant" of what they are taking. Perhaps a trial of a different med might be a good idea.  Have you inquired about what services are available at the Mayo in Rochester?

As for school, I would have to start rattling cages about the children being required to use cursive.  That's an out-dated school of thought.  They need to learn it, yes, but most progressive schools recognize that using cursive or printing is a personal choice and most of us end up somewhere in between.  Requiring cursive is a fruitless struggle that detracts from learning. My son also has trouble writing neatly without lines, also something I feel is an exercise in pointlessness, so I take a ruler and lightly put lines on in pencil. Haven't heard a complaint about it yet.

Good luck to you. I hope that you can find some answers.  Perhaps you could research a CHADD chapter in your area and pick their brains?  They may have helpful local answers.  Good luck!

 

It might be that the meds are helping just enough to push his testing into the very broad normal range. You might talk to the doctor about using guanfacine (Tenex) to augment the concerta.

My daughter was originally on 27mg concerta, and the doctor was not comfortable increasing the dose to a more effective dose because she was losing weight. Adding the guanfacine was enough to make my daughter successful at school, and she does have a mild learning disorder (you could not read her writing and she spelled phonetically). At school, my daughter is not outwardly hyper at all, but she was teribly unfocussed and would just shut down and not participate in class.

There are several threads on Tenex that have info and articles that you can print and take to the doctor for discussion. Here is a link to one of them:

http://www.adhdnews.com/forum/forum_posts.asp?TID=25634& PN=1

Good luck with this difficult journey.

 

Thank you all so much for your support and replies.  I've decided to ask his pediatrician for a referral to a psychiatrist.  (I don't know if I'll get one- insurance may just say a ped is fine for this.)  I just want someone to look at the meds who works with adhd all day everyday.  My ped is very nice and seems willing to try things if I suggest them, but why doesn't she ever suggest these things to me?

Vicki- your suggestion of guanfacine really got me thinking.  I had looked at this before and thought it wouldn't help us because it is the focus that is our biggest problem that we have never been able to resolve.  I thought it was just for hyperness.  But you say your daughter was always well behaved and it helped her.  And of course any weight gain obtained would be very welcome here.  Thanks for the idea.

Chasemom79- I have been following your tips for weight gain on all the threads for a while now- had already been thinking to ask the doctor about periactin- but I'm wondering- are you sure the weight gain is from the periactin and guanfacine,or could it be from switching from Concerta to Ritalin?

Could anyone tell me how you PM people?

Thank you all for your wonderful help.

 

bubbles

You HAVE been lurking and reading for a while, haven't you...LOL

I am not positive what caused his weight gain this past month.  But I AM sure that the periactin gave him back his appetite.  He also gained back the 5 or so pounds that he had lost previously (since starting the concerta last March) over the course of november and December while on the concerta and periactin. It was heartwarming as a mom to just see him want to eat again!  

He only started the ritalin LA on Christmas break.  I suspect that the guanfacine helped with the weight gain as well.  I know that the guanfacine has helped him with his sleep as well.  It is also on the list at walmart so it is easy on the pocket book as well.  You may try a trial of the ritalin LA....Chase says that it lasts all day and it wears off at lunch, so he eats lunch, then kicks back in for afternoon classes.  I think that it only lasts until early evening, and I have a short acting ritalin for homework if needed....so far I haven't needed to give it, I just make sure that he does his work as soon as he gets home from school and he does fine.

Chase says he much prefers this to the concerta. 

You PM people by clicking on the 'PM' button at the bottom of one of their posts, or by going into the private messengar at the top of the page and writing their name in just like an email....

chasesmom7939115.664525463

 

 

Thanks!

No problem!