If your DC had a neuro-psych evaluation - is this way too short? other tips?

[magnoliaparadise]

I'm getting one of my DCs a neuro-psych evaluation and I have decided to go private outside my school system. I have several questions related to the process since the neuro-psychologists seem to differ a huge amount:

**** Of those who had a neuro-psych, how long was it? And did they give your kid an IQ test? Or feel that paying by insurance somehow decreased what you were able to receive?

Going Private:
I decided to go private because I have been told by many people that the evaluations in my school are not as comprehensive or 'good' as doing it privately. I also want to go private so that I can see the results before I decide whether to involve the school or not. In our school district, the school isn't required under law to follow a private evaluation, but generally does on their own volition (and if I do decide to to involve the school, if they insisted, I would be fine for them to retest my kid).

I have no idea if anything will be found. The school does not think my DC needs a neuro-psych in the first place, though they are offering her some extra math support of their own volition after they gave her a very cursory internal evaluation. I figure it's a win/win because if something is found, I'll be glad to know and if the school is right and nothing is found, that will be great.

Variations:
In calling a few potential private neuro psychologists, I found a lot of variation in how they administer the test.

They all have said that they do a standard test and add on tests 'as necessary'. The procedures, though, vary a lot!! For instance:

- One man told me on Friday that he tests for 4.5 hours. Another said that she did a minimum of 12 hours of testing so I asked the man why he only does 4.5 hours. He said that evaluators who give evaluations for longer are just getting 'fatigue answers' and then the tests end up having different results and it takes more to interpret them in a nuanced manner to make them consistent. ??? I thought that was really odd. I am not saying that he is wrong, but... 4.5 hours seems pretty short for a potential diagnosis that could lead to an IEP... And I am not sure I buy his views that more testing creates fatigue that then creates different (opposing) test results. Does 4.5 hours sound short to you? If the tests are all creating different test results, isn't that significant, too?

- Some administer the IQ test while others don't. The ones who do say that it's important because it acts as a baseline for the other results (eg if someone has a high IQ, but is doing badly at math, it's useful to know that to look at possible learning disabilities that explain why). Did your DC get an IQ test with the neuro-psych eval?

- Other issues include that some neuro-psychs won't take my insurance. However, some said that using insurance often decreases what or how many tests they can use anyway. If that's true, I'd rather everything pay privately. Did you find that your insurance was able to control which tests were administered?

And if you have any tips or thoughts, I'd be grateful to hear them.

TIA!

[hbridge]

It's so confusing...

We do private neuropsychs. They are usually "partially covered" by insurance, but it varies widely by policy. Insurance usually will not cover "academic testing". Our experience is about 8 hours of testing, usually in one session. However, some places break it into two sessions. Also, I think the age of the child has some bearing. Also, ask about scheduling, the wait times to get neuropsychs can be long.

I think they did IQ testing. You should ask about that.

Ethically, I don't think it should matter if insurance is paying or if you are paying. HOWEVER, if the school district is paying, that might change how the testing is administered.

With our insurance both times we did testing, insurance paid about 2/3 of the cost...

Also, remember that if you are looking to get an IEP, it's a long process if you start with a neuropsych. We started the process in late July, had a neuropsych in December, submitted the results to the school in January, the school did their independent testing, and finally received an IEP in April. So be prepared for a long process.

[pastrygirl]

Ours was 3 hours long, but he already had a diagnosis after several visits with a behavioral pediatrician (after a year-long waiting list), so this was more to fine-tune it.

[StantonHyde]

3 sessions at 3-4 hours each. We have done 2 evaluations with 2 different people and it was the same both times. IQ was tested both times.

[willow33]

3 sessions at 3-4 hours each. We have done 2 evaluations with 2 different people and it was the same both times. IQ was tested both times.

Same here

[carolinacool]

We just finished this -- DS was being evaluated for ADD. Ours was two sessions of two hours and then a third for one hour. I don't believe he took an IQ test.

I'm still a little confused about insurance. They told me they only cover four hours of testing. After that you need a pre-authorization. The psychologist we saw includes his analysis for each session (two hours testing/two hours analysis/two hours testing/two hours analysis). So basically insurance paid for the first session and denied the second. We paid out of pocket for the second and the psychologist didn't charge us for the fifth hour.

[hillview]

we have done 3 evals each with the same group. When kids were younger they did 3 sessions of about 1.5 hours - 2 hours each session (with breaks). As they have gotten older the session # changes and becomes a little longer with fewer breaks. They do an IQ test (or try -- both my boys have neuro differences that makes getting a "complete IQ" impossible).

[magnoliaparadise]

I have been meaning to write to say thank you.

I haven't confirmed which neuro-psych I'm going with among the three that I spoke with, mainly because they either didn't get back to me or we traded phone calls, but it's very helpful to hear your responses.

A few other thoughts... I'm amazed how expensive these things are.
The psychologist I really like (and who is a big shot around here, covers some of the sports teams, etc) charges $3K out of pocket (she doesn't take my insurance) which seems like a huge amount! I know in my old state, it would have cost more like $8-10K, which is outrageous, but still, $3K is expensive!!

I also found it weird that many *different* types of people do the test.
The psychologist I really like is not a neuro-psychologist, but got speciality and training in it (and I think a masters, but I'm not sure). She also has many years of experience. I would personally rather go for a full-on neuro-psychologist, but at this point, I am too tired to look farther. She said being a psychologist with a neuro-psych speciality was useful because it gave a 'whole' picture view, having the background of psychology, but I'm sure there advantages of certified neuro-psychologists.

Plus, it amazes me that evaluations are done in such a short amount of time!
The psychologist I like only meets the child one time in a 5 hour visit - so the complete IQ and academic testing is done within that - so minus breaks and lunch, I'd say that is about 4 hours tops. After the testing, analysis, and write up of the evaluation, the psychologist will meet with me again for an hour and then it's done. I find it bewildering that any possible IQ or learning disability could be ascertained in such a small amount of time and that (if a learning disability), a comprehensive report and IEP could be predicated upon it!

Thanks again.

[JBaxter]

2 -- 2 hr sessions of testing after an hour parent meeting before and after the testing. He didn't do more than 2 hr blocks because in his opinion it was to much on the kids.

[MSWR0319]

I have been meaning to write to say thank you.

I haven't confirmed which neuro-psych I'm going with among the three that I spoke with, mainly because they either didn't get back to me or we traded phone calls, but it's very helpful to hear your responses.

A few other thoughts... I'm amazed how expensive these things are.
The psychologist I really like (and who is a big shot around here, covers some of the sports teams, etc) charges $3K out of pocket (she doesn't take my insurance) which seems like a huge amount! I know in my old state, it would have cost more like $8-10K, which is outrageous, but still, $3K is expensive!!

I also found it weird that many *different* types of people do the test.
The psychologist I really like is not a neuro-psychologist, but got speciality and training in it (and I think a masters, but I'm not sure). She also has many years of experience. I would personally rather go for a full-on neuro-psychologist, but at this point, I am too tired to look farther. She said being a psychologist with a neuro-psych speciality was useful because it gave a 'whole' picture view, having the background of psychology, but I'm sure there advantages of certified neuro-psychologists.

Plus, it amazes me that evaluations are done in such a short amount of time!
The psychologist I like only meets the child one time in a 5 hour visit - so the complete IQ and academic testing is done within that - so minus breaks and lunch, I'd say that is about 4 hours tops. After the testing, analysis, and write up of the evaluation, the psychologist will meet with me again for an hour and then it's done. I find it bewildering that any possible IQ or learning disability could be ascertained in such a small amount of time and that (if a learning disability), a comprehensive report and IEP could be predicated upon it!

Thanks again.

You'd be amazed at what those tests tell you in a short amount of time! I think my son met with the psychologist for around 4 hours. The report was so thorough that our pediatrician tried to hire her to work in their practice. She explained so many things about DS that I had always wondered about but never really thought about. They found out that he has slow processing speed in relation to his IQ, which explained why it always takes him a lot longer to make decisions or come up with some answers even though I know he knows them. So even though his processing speed was average, it could be seen as a learning disability because his IQ was so high. It also explained his best learning technique and why he learns better that way. It answered why he doesn't like to do puzzles (the way he learns) which I had always thought was a little odd that he could never figure them out. It also explained some of his emotional issues. I was quite impressed with what we learned from such a short time with her. And just talking to get at the meeting, really opened my eyes. She nailed his personality and the issues we had with him.