Guest guest Posted March 16, 2009 Report Share Posted March 16, 2009 Hello all, I am having a tough time deciding weather or not I should go to the Pedi Neuro appt. that I have for my son in April. The reason I am trying to decide is that we just recently met with Dr. Capoli in Geneva, he is a Developmental Pedi. We got the exact diagnosis of Apraxia as a neurological disorder and recommendations for speech therapy. I also just found out that our insurance company is going to cover his speech therapy which means I don't have any fighting to do. We will be doing an IEP in May sometime as he is phasing out of EI, but will have a 2 page summary about my son to add into that from Dr. Capoli. So do I go to Madison and get a diagnosis that I all ready have or will they tell me something different? Any help is greatly appreciated. Thanks, Terry Mom to Logan 5.5(normal as normal is), Gavin 2.5(apraxic and independant) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 16, 2009 Report Share Posted March 16, 2009 Hi Terry: Is there any other reason you wanted to go to the neurologist besides getting a diagnosis? You could call the neurologist office and see what else the appointment involves and that might help you make up your mind if it is necessary. Do you need any second opinions on anything you and your dev. ped discussed? My son's neurologist gave us the diagnosis and we had to go back 3 times (6 mos. periods) to make sure he was making progress before he was discharged. He didn't have a dev. ped though so at that time the the neuro ped. and his regular ped were the only two doctors he had. HTH, Tina mom to Landon > > Hello all, > > I am having a tough time deciding weather or not I should go to the Pedi Neuro appt. that I have for my son in April. The reason I am trying to decide is that we just recently met with Dr. Capoli in Geneva, he is a Developmental Pedi. We got the exact diagnosis of Apraxia as a neurological disorder and recommendations for speech therapy. > I also just found out that our insurance company is going to cover his speech therapy which means I don't have any fighting to do. > We will be doing an IEP in May sometime as he is phasing out of EI, but will have a 2 page summary about my son to add into that from Dr. Capoli. > So do I go to Madison and get a diagnosis that I all ready have or will they tell me something different? > > Any help is greatly appreciated. > > Thanks, > > Terry > Mom to Logan 5.5(normal as normal is), Gavin 2.5(apraxic and independant) > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 16, 2009 Report Share Posted March 16, 2009 If you want a second opinion I would keep the appointment. If you think he can give you insight or other information that the developmental ped didn't then I would keep the appointment. If you are content with the diagnosis and don't want a second opinion then I would cancel. Amy www.HelpMyChildTalk.com <http://www.helpmychildtalk.com/> On Mon, Mar 16, 2009 at 4:03 PM, smly_21 <smilyremhof@...> wrote: > Hello all, > > I am having a tough time deciding weather or not I should go to the Pedi > Neuro appt. that I have for my son in April. The reason I am trying to > decide is that we just recently met with Dr. Capoli in Geneva, he is a > Developmental Pedi. We got the exact diagnosis of Apraxia as a neurological > disorder and recommendations for speech therapy. > I also just found out that our insurance company is going to cover his > speech therapy which means I don't have any fighting to do. > We will be doing an IEP in May sometime as he is phasing out of EI, but > will have a 2 page summary about my son to add into that from Dr. Capoli. > So do I go to Madison and get a diagnosis that I all ready have or will > they tell me something different? > > Any help is greatly appreciated. > > Thanks, > > Terry > Mom to Logan 5.5(normal as normal is), Gavin 2.5(apraxic and independant) > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 16, 2009 Report Share Posted March 16, 2009 Being you already have a diagnosis I would save off the second appointment until when and if it's needed- unless you just wanted a second opinion. In other words you may be golden right now -but just say you run into a glitch a few months or a year or so from now where you aren't securing the services or placement you want. Then you up the power by providing TWO expert written evaluations to back you up vs. the one. The subject of pediatric neurologist vs. developmental pediatrician is very well covered in The Late Talker as my one co author is a neurodevelopmental pediatrician. In a nutshell I have been told that in most cases it's fine to see one or the other -no need to see both. Below is a bit more pulled from The Late Talker -there's an entire chapter on this so much more in there- you can probably snag a copy from your local library: WHICH SPECIALIST? What kind of specialist is best suited to evaluate your late-talking child—a pediatric neurologist or a developmental pediatrician? If your child has a serious neurological history including a seizure disorder, or hydrocephalus (abnormal accumulation of fluid in the ventricles of the brain), or progressive muscle weakness with difficulty climbing and complains that his legs are tired, you are best advised to see a pediatric neurologist. This is because the pediatric neurologist's training includes the work-up of children who may need brain imaging studies, EEGs to identify a seizure disorder, or electromyography (EMG) to identify a muscle disease. Obviously, you should make such an important decision in consultation with your regular pediatrician who is trained to identify children who might have more serious neurological disorders. If your child does not require the expertise of a pediatric neurologist, the choice of medical expert is less critical. You should, however, certainly try to find a developmental pediatrician with an expertise in communication disorders. Take into account your pediatrician's recommendation, those specialists available through your medical plan, and those you have heard about through the grapevine. You may need to talk with the special needs case coordinator at your insurance carrier for the in-network list of developmental pediatricians or pediatric neurologists, as they may not be clearly listed in your member handbook. Children's hospitals should also be able to recommend good neurodevelopmental pediatricians. Developmental pediatricians tend to look at the " whole child " in the context of the family, and discuss all the developmental domains, feeding and sleep patterns, and behavioral issues. They are able to evaluate children with ADHD and learning disabilities, and may help interface with school personnel in regard to your child's special needs in the classroom. Both developmental pediatricians and pediatric neurologists do, of course, vary in training and background. It is important to find the right neurodevelopmental specialist to get an appropriate diagnosis and also investigate the possibility of associated medical or neurological problems. Getting a neurologic diagnosis with appropriate ICD #9 diagnostic codes may help you secure private speech therapy, occupational therapy, or physical therapy, through your health insurance plan. You may need to ask the specialist to write a " Letter of Medical Necessity " referencing the appropriate neurologic codes in order to get these services. The neurodevelopmental evaluation report may finally give your child the diagnosis needed to obtain additional services to be added to your early intervention IFSP, or have more " appropriate " education and related services written into your preschooler's IEP. To have the best chance of achieving these services, the report needs to be a comprehensive assessment with diagnoses of verbal apraxia, proximal hypotonia, and sensory integration dysfunction (when present). It should contain a detailed plan, and specific recommendations for educational and therapeutic services. The following is an excerpt (the Assessment and Plan) from a neurodevelopmental evaluation of a hypothetical child with oral and verbal apraxia. It is provided as an example of the kind of report most likely to provide the type and intensity of services needed for your child's IEP. The Late Talker book; St 's Press 2003 Agin, Geng, Nicholl ===== Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 16, 2009 Report Share Posted March 16, 2009 Do you have any concerns that would be addressed more appropriately by a neuro than the Dr. you saw? Possible seizure activity, tics, or other things that you would go to a neuro for? Another consideration is how long of a wait is it to get in with the neuro? In some areas you can wait as long as a year (or more.) If you get in now when you have an appointment, even if it seems like overkill, then you may have an easier time getting in if something arises in the future since you are an established patient. Lastly would you be seeking a referral for cognitive testing? I know that the neuro was able to refer my son to a pediatric neuropsychologist who performed very appropriate non-verbal and non-language based IQ testing at a time when the schools were requiring it. The schools were not going to test him appropriately so I found it very important to get him testing from someone I trusted. That's great news that you have a diagnosis and that speech therapy is covered! Miche Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 17, 2009 Report Share Posted March 17, 2009 >Another consideration is how long of a wait is it to get in with the neuro? In some areas you can wait as long as a year (or more.) If you get in now when you have an appointment, even if it seems like overkill, then you may have an easier time getting in if something arises in the future since you are an established patient.> This is very true for some areas...I had to wait 6 mos. to get into the Neurologist. We had to wait 6 months to get into the geneticist. Once we were established patients, it was easier to call and make an appt. for both doctors. So this is something you should consider when deciding to cancel the appt. Blood work? The neuro. might be helpful to get blood work if you haven't done that already. HTH, Tina > > Do you have any concerns that would be addressed more appropriately by > a neuro than the Dr. you saw? Possible seizure activity, tics, or > other things that you would go to a neuro for? > > Another consideration is how long of a wait is it to get in with the > neuro? In some areas you can wait as long as a year (or more.) If > you get in now when you have an appointment, even if it seems like > overkill, then you may have an easier time getting in if something > arises in the future since you are an established patient. > > Lastly would you be seeking a referral for cognitive testing? I know > that the neuro was able to refer my son to a pediatric > neuropsychologist who performed very appropriate non-verbal and > non-language based IQ testing at a time when the schools were > requiring it. The schools were not going to test him appropriately so > I found it very important to get him testing from someone I trusted. > > That's great news that you have a diagnosis and that speech therapy is > covered! > > Miche > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 20, 2009 Report Share Posted March 20, 2009 I meant to add that the neuro was able to code it in a way so it was covered by insurance as well. My son's regular pediatrician couldn't get preapproval when she tried. It was deemed educational and not covered. The neuro referral to the neuro psychologist for some reason made the difference for us. > Lastly would you be seeking a referral for cognitive testing? I know > that the neuro was able to refer my son to a pediatric > neuropsychologist who performed very appropriate non-verbal and > non-language based IQ testing at a time when the schools were > requiring it. The schools were not going to test him appropriately so > I found it very important to get him testing from someone I trusted. > > That's great news that you have a diagnosis and that speech therapy is > covered! > > Miche > Quote Link to comment Share on other sites More sharing options...
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