Getting Nervous About Psych Evaluation

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angelgarden
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14 Dec 2011, 2:08 am

Did you deal with this too before an evaluation? My son is 4 ½. His first evaluation by a developmental child psychiatrist is less than one week away. I’m starting to get ‘cold feet’ and thinking about postponing the appointment. It’s very expensive, so that doesn’t help. Of course, to help my son, any expense is worth it. However, today we FINALLY found a contact for an English-speaking OT here who does evaluations and works with AS kids, and since many of his issues are sensory, I am considering doing an OT evaluation first.

You know, I am not at all worried about him being officially diagnosed. If anything, I want to know so we can better help him. If we have a clearer picture through a technical diagnosis, then great.

Thing is, a lot of his issues only come up during stressful times, at home, at school, etc. The only things I know a psychological eval should pick up on for sure would be his inability to write/draw/color, his sporadic eye contact (he’s only comfortable with a split second or so but he does make eye contact), his lack of answering questions or responding to his name (takes 3-4 tries sometimes but not every time), and perhaps his reluctance to change activities or to do something differently from how he wants to do it. Even some of those may not be evident, though, if he really likes the evaluator and finds the situation exciting rather than fearful. He can be quite chatty, and happy, and silly if the situation humors him.

I’m also doubting myself and my instincts. At times when he is charming and sweet and talking a blue streak, I wonder if I am ‘over-analyzing’ his issues. Then, he’ll have a meltdown over something I find insignificant, or start stimming (doesn’t happen all the time), or not understand our verbal communication or freak out over us wanting to comb his hair, etc. and then I go back to feeling like we need an evaluation. I keep hearing that early diagnosis is better, but then I also keep hearing that it is difficult to diagnose Asperger’s before 5 or 6 years old.

I wonder if we should delay the psych evaluation for a few weeks and try to squeeze in an OT evaluation first and see what they think.

He is wonderful and sweet and smart, but I still feel like he is generally ‘not happy’ and doesn’t feel ‘at sorts’ with his world. He is frustrated a lot. And although that has gotten better and we have less meltdowns now (mostly b/c we’ve started treating him as if he were AS!), he still has trouble with self-regulating, sensory issues, school behavior, and some fine motor skills. His school behavior does not seem to be getting better, and he does not understand why he is getting in trouble. I think because of this he has started wetting the bed at night occasionally again. /-: Have I answered my own dilemma?? Hate to sound like a broken record. I just need some encouragement (again) from any of you who have time to comment!



KakashiYay
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14 Dec 2011, 8:53 am

I really feel for you.

We're seeing DD's ped tomorrow and will be leaving with a referral.

There are absolutely days where I think, "I am totally over-reading all this stuff," because those are the days when she's *on.* She's present. Invariably, though, she'll go from being engaged and responsive to doing *something* that just raises every red flag in the book.

I've soothed my own raging anxiety by opening myself up to the thought that, yes, she may have autism *but* she may not. If the specialist says, "Oh yes, 299.00 for you guys," then I'll already have processed it. If she's not on the spectrum, then I'll feel *relief.* While I suspect it won't happen, wouldn't it be amazing to sit around with your teen and joke about "back when Mom thought you were autistic, silly Mom!"

I really hope you can relax a bit before the eval- I am the queen of anxiety (I have AS, and autism is one of my "special interests," which makes this journey real fun and relaxing :roll: so I know how hard it is to just let the minutes tick by into days.

Good luck to you. I hope all goes well at the eval!


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My goofy little blog about being an aspie mom to 2 girls- one of whom is not quite NT: http://toregardaraisin.blogspot.com/


Bombaloo
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14 Dec 2011, 11:47 am

I think the anxiety you are feeling is perfectly normal. I guess we were lucky with our DS's evaluation in that he was seen by a team of professionals so the OT, ST, PT, psych and autism specialist all saw him on one day (it was long but he did OK and he was a bit younger than yours is now). So, I would say that both the psych and the OT evaluations will be important for you. If i was you, I would go ahead with the appointment you have scheduled and schedule the OT eval too. I don't think it matters which comes first.

Good evaluators know what to look for and are not often "fooled" by our charming little chatter boxes (mine was the same and I had the EXACT same worries you have expressed). Though it really took them going to the classroom and observing him with his peers before they got the full picture of his issues. Hopefully for you that will ultimately be part of the evaluation. Since the deficits that many ASD kids have are in social skills, it only makes sense to observe them with their peers in order to really get a sense of how well or poorly they may be doing inthat area.



zette
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14 Dec 2011, 3:35 pm

If the ADOS is going to be used, I was very impressed with how it was designed. It picked up things that I wouldn't have known to look for, and should still work even if your child is being chatty and cooperative.

For instance, one of the tests involved telling DS a story about a seagull that caught a fish and then dropped it, and having him retell the story back to the psychologist. She then watched for his use of gestures and eye contact while telling the story. Another was a long picture book about a frog. She asked him to look at each page and tell her the story. His description lacked emotional content. At one point they played with action figures, and she was looking to see if he would create a story and whether he would allow her to change or redirect the story. And of course she noted when he got stuck on an activity and resisted moving on to the next one.

Another thing you could do is write down what kinds of things cause a meltdown, how long it lasts, and how frequently it happens. I took in copies of emails between myself and his preschool teacher, about the issues he was having there. I wasn't trying to get a diagnosis (in fact I was expecting the result to be ADHD), just wanted the evaluation to be based on as complete a picture as possible.



angelgarden
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15 Dec 2011, 6:34 am

Very encouraging, thanks to all of you!

Zette and Bombaloo, thanks for the specifics about an evaluation. That helps a lot. I can see how they might pick up on more in using those situations. I have a lot of info for an evaluator--I think I actually need to edit it down so it's more digestible!

Kakashi, I'll look forward to hearing how your DD's goes eventually. Your comment on 'haha, remember when mom used to think I was autistic' made me laugh. :lol:

I think, too, my husband is struggling with understanding our son a lot more than I am and a sooner evaluation may help clear things up for him and help him be more proactive. If he were a little more behind me and the teacher on this, I think it would be easier! He isn't against it--he admits our son matches most Aspie traits and has some issues that aren't going to just go away, but he's so laid back (with a few AS traits himself) that I feel like I'm dragging him along with us!