Re: Follow up Psych Appt Today

May 18, 2009

>

> In the examples I gave, do you agree that's what I should be pushing for? Or

am I off base?

For starters, you can request an autism evaluation from the school district, in

writing, of course. They don't have to wait for the neuropsych. I would

look through the diagnostic criteria, find a concrete example of how your son

fits each pertinent item and put this in the request. This can double as parent

input for the evaluation. Whatever you request in writing--that is, all your

concerns and areas to be evaluated--they must answer to in writing. So, this is

one of your big chances to voice your observations and they must give an answer.

I don't know how they do it in other states, but in ours an autism eval is very

different from a regular SPED eval. It is a whole different set of people and

different tests and criteria. So, just because he already has an IEP doesn't

mean you can't still request an evaluation specifically for autism. They will

have to do their own autism eval to confirm your private one anyway and fill in

any gaps.

You're doing good to confront all these things when your child is so young. I

had to learn all this the hard way through trial and error. We got held off

from the school district autism eval for a couple of years because a school

psych made a judgment call that his symptoms were not severe enough to warrant

calling in the autism team. She confirmed verbally that he had atypical

behaviors that were consistent with AS. If I had known better, all I probably

would have had to do at that point is ask for an autism eval in writing with

appropriate supporting observations. I don't think she would have lied about

her observations that he fit AS. But, I didn't know. It was " okay " getting our

own neuropsych eval done and coming back with it, but we really lost a lot of

time. And that is never good.

Ruth

May 18, 2009

I think that is really silly to say - you might be able to "keep him off the autism spectrum." Where do these people come up with this? He either is on the spectrum or he isn't. It's not a "let's make a deal" kind of thing. Is it just me or is that kind of nuts to say that? Because once you address those issues, more will still be there - because it's a spectrum disorder and it's a neurological disability - it doesn't just fade off into the sunset once he no longer has OCD or something. A pill might help him overcome one thing, but did you address the cause? Does that matter? To me, it would. Even if I can't fix it, I would like knowing the cause. And if you are looking at ASD, why would you not want him to be given the correct dx? Even if it is mild - you can direct your help for him knowing what his correct dx is. It doesn't do anyone any favors to call it something different. Why? To make someone else feel better? Who? Certainly not your ds! To spare him what? The kind of help he probably needs? lol. People will treat him like he has an ASD? Is it better if they treat him like he's annoying and punish him for being bad?

I wish you could get in to see someone sooner rather than this person. Contact your local autism group and see if there are any other people who do assessments or work with ASD kids that you could consult with. Contact the people who have you on the list and ask to be put on the cancellations list...if you can go in on quick notice, that is. You might get in sooner that way.

As for school, he sounds like he needs some major help with social skills. Have you requested an evaluation from the school? Forgive me if you've said that already. It is sometimes hard to keep everyone straight in my head. But if you haven't, I would do that. He could be receiving help with social skills and help with language issues, which would seem a great idea for him. He doesn't need an official dx from anyone to qualify and receive sped services.

Roxanna

Autism Happens

( ) Follow up Psych Appt Today

Hey all!

Figured I'd hit you all up for tips again!

Today's the 1-month follow up with the Psych.

Son Noah is recently 7. Dx ADHD/OCD/Anxiety. Has IEP. Psych said AS was a possibility but he believed he could "keep Noah off of the Autism Spectrum" if he treated the ADHD/OCD. On paper, wrote "Ruling out PDD-NOS." Seemed to think Bipolar was a real possibility too.

Noah has been on Tenex since the last appointment. I have seen no improvement--if anything, his anxiety has worsened. The increase in appetite is NOT worth it.

I'm leaning toward explaining all that and requesting to switch to a stimulant. I'd rather have the decrease in appetite if it has to go ONE direction. What do you think??

Noah's social issues were AWFUL last week. He had to be permanently separated from another student and was told not to speak to her anymore. This was after a meltdown at her and a group of kids. He rose and screamed "I've had enough!" at the top of his lungs. I'm not exactly sure what prompted it, but from what I can tell, he tries to hang with a group of kids, but doesn't take part in the conversations they have--he instead tries to dominate the conversation with his current obsessions (locks and fire alarms) and tries to tell them what they can and can't do. When they don't listen, or try to tell him he's being "wierd" he blows up.

He's also on edge at home--crying at the drop of a hat or getting intensely worked up because we turned the door knob differently than he would.

There is 150-kid waiting list for the Neuropsych exam. They won't even schedule him until he's #10. Probably will be a year. Signed up and waiting with bells on.

HOW DO I GET SOMEONE TO PUT MORE WEIGHT/STRONGLY CONSIDER THE ASPERGERS DX??

In the examples I gave, do you agree that's what I should be pushing for? Or am I off base?

Thanks everyone!

Lori Lashley

We found the real 'Hotel California' and the 'Seinfeld' diner. What will you find? Explore WhereItsAt.com.

May 18, 2009

There is a lot to sort out and your son is very young.

Sometimes stimulants reduce impulsive behavior but increase

anxiety.

Sometimes explosive behavior can be due to a austism spectrum

disorder or due to anxiety or due to a mood disorder.

A protocal often used with kids is to start to treat the

anxiety first and anxiety can take up to 8 weeks to be treated

if it is drug resistent like OCD often is. Sometimes kids

need to get to an adult dose if your son has OCD.

If there are any worsening symptoms on SSRI's you don't know

if your child has BP or is just one of the 25-50% kids

that are sensitive to SSRI's.

You can try a trial of stimulant because this work fast and you will

know if there are adverse reactions rather quickly. I think kids

that are high on dopamine (like BP) don't do well on a stimulatants that often

increase dopamine levels.

If your child does have a mood disorder there are many protocals

for treating this depending on if depression is being treated

or mood cycling.

If there is agressive behavior and Autism then risperdal has

been tested in trials. But some kids gain weight on Risperdal or

Abilify and also some develop some tics.

Trying to figure this out in a little guy is tough.

If you are lucky you may hit on the right med. If it is trial

and error it takes time to be patient with the medications

and see how they work.

Your child is still young one benefit is that he is hopefully

more cooperative than my daughter and perhaps much more cooperative

with medication than a teenager.

You are on the right track. Hope you find a solution quickly

but also be prepared for it taking time and don't lose hope.

You will find a solution.

Oh and the neuropsych report may reveal a learning disorder but it

won't help you figure out the medication protocal unfortunately.

And if his behavior is disruptive at school the school may suggest

a more structured setting in an out of district placement. Which

be prepared for this and not shock and look and see it may be

a good fit.

If you have an IEP why do you need another DX of AS? Is there

other services you want to get that you are not getting.

One advantage I can think of is to keep him out of schools

for kids with conduct disorders. But if he has a IEP

you are already covered aren't you?

Pam

>

> Hey all!

>

> Figured I'd hit you all up for tips again!

>

> Today's the 1-month follow up with the Psych.

>

> Son Noah is recently 7. Dx ADHD/OCD/Anxiety. Has IEP. Psych said AS was a

possibility but he believed he could " keep Noah off of the Autism Spectrum " if

he treated the ADHD/OCD. On paper, wrote " Ruling out PDD-NOS. " Seemed to think

Bipolar was a real possibility too.

>

> Noah has been on Tenex since the last appointment. I have seen no

improvement--if anything, his anxiety has worsened. The increase in appetite is

NOT worth it.

>

> I'm leaning toward explaining all that and requesting to switch to a

stimulant. I'd rather have the decrease in appetite if it has to go ONE

direction. What do you think??

>

> Noah's social issues were AWFUL last week. He had to be permanently separated

from another student and was told not to speak to her anymore. This was after a

meltdown at her and a group of kids. He rose and screamed " I've had enough! " at

the top of his lungs. I'm not exactly sure what prompted it, but from what I can

tell, he tries to hang with a group of kids, but doesn't take part in the

conversations they have--he instead tries to dominate the conversation with his

current obsessions (locks and fire alarms) and tries to tell them what they can

and can't do. When they don't listen, or try to tell him he's being " wierd " he

blows up.

>

> He's also on edge at home--crying at the drop of a hat or getting intensely

worked up because we turned the door knob differently than he would.

>

> There is 150-kid waiting list for the Neuropsych exam. They won't even

schedule him until he's #10. Probably will be a year. Signed up and waiting

with bells on.

>

> HOW DO I GET SOMEONE TO PUT MORE WEIGHT/STRONGLY CONSIDER THE ASPERGERS DX??

>

> In the examples I gave, do you agree that's what I should be pushing for? Or

am I off base?

>

> Thanks everyone!

>

> Lori Lashley

>

May 18, 2009

Hi Lori, just quick thoughts. The doorknob issue seems related to OCD to me.

I'm saying this from the perspective of having a son with OCD and Aspergers. As

to wanting to be in control so that other kids are doing as he says -- well,

harder to say. OCD can cause that too, but then with his obsession about locks &

fire alarms seeming more Aspie-related, it could be related to the AS. Is he

just talking on & on & on...about locks & fire alarms and wants them to listen

(or maybe just keeps on talking when they are no longer listening) or are there

precise things he expects them to say or do and he gets upset when they don't?

>

> Hey all!

>

> Figured I'd hit you all up for tips again!

>

> Today's the 1-month follow up with the Psych.

>

> Son Noah is recently 7. Dx ADHD/OCD/Anxiety. Has IEP. Psych said AS was a

possibility but he believed he could " keep Noah off of the Autism Spectrum " if

he treated the ADHD/OCD. On paper, wrote " Ruling out PDD-NOS. " Seemed to think

Bipolar was a real possibility too.

>

> Noah has been on Tenex since the last appointment. I have seen no

improvement--if anything, his anxiety has worsened. The increase in appetite is

NOT worth it.

>

May 19, 2009

Hi Roxanna

My thoughts EXACTLY as far as not wanting

to call it ASD! How on earth do you keep someone from having a

neurological disability? I still don’t get that! And…exactly

my fear…that he is treated as annoying and punished for being bad,

instead of introducing those around him to the idea that he has issues for a

very good reason. UGH I’m so frustrated.

As for the school, I did request the

evaluation for Aspergers. They did two rounds of tests, both producing the same

results: “At Risk” and “Significant” traits across the

board. They won’t comment further or take any action without getting

the diagnosis from an MD.

I haven’t tried contacting any

Autism groups. That sounds like a good idea. I did ask the waiting list

for Neuropsych to call if there are cancellations, but they told me with 150

kids on the list, it would STILL be a while.

So, when we saw the psychiatrist again

yesterday, I did not bring up ASD. I made sure to emphasize the social

issues he was having. I made sure to emphasize the perseveration and the

sensory issues. The doctor seemed to focus on the obsession. (not

really hard to do since Noah was indulging one of his 2 current obsession—locks.

He would NOT leave the door alone) He also seemed to reference Bi-Polar

and the need to be watching for that.

We will use up the Tenex we have, but will

be starting Prozac today. If any of the anxiety worsens, we will stop

immediately and call him for the next plan. He really wants to put him on

Abilify, but I have to look into the cost.

…still frustrated…

Lori

From:

[mailto: ] On

Behalf Of Roxanna

Sent: Monday, May 18, 2009 3:53 PM

To:

Subject: Re: ( )

Follow up Psych Appt Today

I think that is really silly to say - you might be able to

" keep him off the autism spectrum. " Where do these people come

up with this? He either is on the spectrum or he isn't. It's not a

" let's make a deal " kind of thing. Is it just me or is that

kind of nuts to say that? Because once you address those issues, more

will still be there - because it's a spectrum disorder and it's a neurological

disability - it doesn't just fade off into the sunset once he no longer has OCD

or something. A pill might help him overcome one thing, but did you

address the cause? Does that matter? To me, it would. Even if

I can't fix it, I would like knowing the cause. And if you are looking at

ASD, why would you not want him to be given the correct dx? Even if it is

mild - you can direct your help for him knowing what his correct dx is.

It doesn't do anyone any favors to call it something different.

Why? To make someone else feel better? Who? Certainly not

your ds! To spare him what? The kind of help he probably

needs? lol. People will treat him like he has an ASD? Is it

better if they treat him like he's annoying and punish him for being bad?

I wish you could get in to see someone sooner rather than this person.

Contact your local autism group and see if there are any other people who do

assessments or work with ASD kids that you could consult with. Contact

the people who have you on the list and ask to be put on the cancellations

list...if you can go in on quick notice, that is. You might get in sooner

that way.

As for school, he sounds like he needs some major help with social

skills. Have you requested an evaluation from the school? Forgive

me if you've said that already. It is sometimes hard to keep everyone

straight in my head. But if you haven't, I would do that. He could

be receiving help with social skills and help with language issues, which would

seem a great idea for him. He doesn't need an official dx from anyone to

qualify and receive sped services.

Roxanna

Autism Happens

-----Original

Message-----

From: l8elucretia <LLashleyconditandassoc>

Sent: Mon, 18 May 2009 10:06 am

Subject: ( ) Follow up Psych Appt Today

Hey all!

Figured I'd hit you all up for tips again!

Today's the 1-month follow up with the Psych.

Son Noah is recently 7. Dx ADHD/OCD/Anxiety. Has IEP. Psych said AS was a

possibility but he believed he could " keep Noah off of the Autism

Spectrum " if he treated the ADHD/OCD. On paper, wrote " Ruling out

PDD-NOS. " Seemed to think Bipolar was a real possibility too.

Noah has been on Tenex since the last appointment. I have seen no improvement--if

anything, his anxiety has worsened. The increase in appetite is NOT worth it.

I'm leaning toward explaining all that and requesting to switch to a stimulant.

I'd rather have the decrease in appetite if it has to go ONE direction. What do

you think??

Noah's social issues were AWFUL last week. He had to be permanently separated

from another student and was told not to speak to her anymore. This was after a

meltdown at her and a group of kids. He rose and screamed " I've had

enough! " at the top of his lungs. I'm not exactly sure what prompted it,

but from what I can tell, he tries to hang with a group of kids, but doesn't

take part in the conversations they have--he instead tries to dominate the

conversation with his current obsessions (locks and fire alarms) and tries to

tell them what they can and can't do. When they don't listen, or try to tell

him he's being " wierd " he blows up.

He's also on edge at home--crying at the drop of a hat or getting intensely

worked up because we turned the door knob differently than he would.

There is 150-kid waiting list for the Neuropsych exam. They won't even schedule

him until he's #10. Probably will be a year. Signed up and waiting with bells

on.

HOW DO I GET SOMEONE TO PUT MORE WEIGHT/STRONGLY CONSIDER THE ASPERGERS DX??

In the examples I gave, do you agree that's what I should be pushing for? Or am

I off base?

Thanks everyone!

Lori Lashley

We found the real 'Hotel California' and

the 'Seinfeld' diner. What will you find? Explore WhereItsAt.com.

May 19, 2009

Yeah, the locks & alarms seem on the Aspie part (not OCD). used to just

talk on & on about his " topic " and many times I'd end up saying, " you know no

one's listening now? " because I had talked to him about his going on too long

about things and others losing interest, etc. LOL, attention span isn't a

problem when they are talking on interests or knowledge, etc.

>

> Hi Chris

>

> The doorknob was a bad example to use because that wasn't actually something

> he's exploded about, I was just trying to demonstrate the kind of thing that

May 19, 2009

Wow!

OK, I'll address all the things you talked about. First, about the not needing

the dx because you already have an IEP. Well, if he does have AS, the IEP he

has really does not do it for him in the long term. What about the help he'll

need that isn't affected by his behavior. What if his behavior can change if

those adults around him accept he has AS and change the way they are around him?

I'm all about getting a good dx. This helps you know what the issues can be and

helps get the help from people around you.

Next, as to why the psychologist said what he did. A few reasons could be:

1. Some people do not want to hear that their child could be on the Autism

spectrum. My sister-in-law is one of these. She has been so freaked out about

it that she won't even say the word Autism. She says " A " . Well, thank goodness

recently they found out that her son did not have it. I say thank goodness

because I really don't think she could have handled it.

2. Some doctors believe that Autism has been diagnosed way too often. They try

everything else first.

3. Does he get kickbacks for the prescriptions he prescribes? Does he get more

visits because he prescribed prescriptions?

4. Does he even have a good idea of what Aspergers Syndrome is?

Any of these could be why he won't look at AS yet.

As to the school, are you saying they have made a definite no to AS? Or do they

just not want to say yet? Most schools won't even accept a doctors dx about AS.

They say they have to do the evals themselves. It's strange that they want a

doctor's eval.

Maybe your son is just not old enough for people to realize he might be

different. A lot of people think young people are all obsessed about something.

It's not until they get a little older that people really start to notice that

the child is different. Maybe it's just something that will just have to wait.

Where are you anyway? Are there no other Nuerophychs anywhere around? Maybe a

few hours drive or something? It would really be nice to get a definite yes or

no to AS before you have to give your son tons of Prescriptions to find out if

one works. If it is AS, maybe his behaviors can be helped with the right type

of adult interventions instead of tons of meds.

I hope you get the answeres you need.

ah

4.