Who to go to for an eval of ADD?

[HIU8]

DS has SID. He is in OT right now. However, I've noticed his ability to comprehend things going downhill. We talk to him and he repeats "huh?" "what?" over and over, or just does not respond at all. I'm going to be talking with the OT about whether this to is part of SID and when they are going to start therapeutic listening, but the mommy in me thinks DS may have another issue and I really want to get it diagnosed before he starts K next year. So far we have noticed great strides in his gross motor skills, but not som much in fine motor and like I said, a decline in his ability to comprehend (although he is an extremely stubborn child and may be doing this on purpose--however, I don't think so and I want to get him all the help he needs).

Who do I go to if I think DS may have ADD in addition to SID?

[egoldber]

I thought you recently had a neuropsych eval? They also do screenings for ADHD. You can call whoever did his eval and ask their opinion on this. They may have even included the screening as part of what they did. I forget the exact name of the screening, but there is nothing about attention in the title.

Just as an FYI, there are other issues which can produce ADHD-like symptoms. Anxiety and depression can also have distractibility components. This is why I would not rely on a simple checklist done by yourself or a ped, because it needs to be considered in context with other testing.

There is also some concern about diagnosing ADHD prior to age 7 or 8 because it can be hard to tell what is simply being young vs ADHD.

[HIU8]

The OT did the eval for SID. The child Psy did an eval, but I'm not sure if it included ADD aspects.

I actually have not included the ped in any of this. We had been working with a social worker who helped to guide us.

I have to talk to the child psy again. I'm really concerned that SID isn't it for DS. I'm worried that he seems to not be comprehending things like he was before.

The OT is going to DS's school to observe this week. I'm going to have a lot of questions for her afterwards.

You can tell I'm a worrier. I really want to make sure that DS gets what he needs to function in a school setting. Right now I believe he just sort of follows along. He doesnot offer answers when called on. He barely does the projects (hates art so I get that). I think he knows his letters and numbers, but he refuses to acknowledge they even exist (I know he can count to 12 and I know he knows a few letters, but he says them and points them out one minute and then sees them on paper and gets them wrong every single time--so you can see how I am worried).

[egoldber]

I would ask the psychologist exactly what he/she tested for and what do they think of this new behavior.

[vludmilla]

I would ask the psychologist exactly what he/she tested for and what do they think of this new behavior.

I agree. The child psychologist is the best person to diagnose AD/HD or any attention probelms.

[jamesmom]

Have you had your DS's hearing checked out? You should also consider having him evaluated for Auditory Processing Delays or Difficulties. A lot of the issues you are seeing sounds like auditory processing issues.

DS was diagnosed with auditory processing delays (APD) last year by an PhD audiologist who specializes in this. They usually don't administer the APD test until your child is five. As it turns out, DS has APD in addition to some ADHD. DS just turned 6 and is going to first grade. His IEP specifies measures in the classroom to address both APD and ADHD, which are actually pretty similar (the measures, not the difficulties).

Please PM me if you have any questions about APD.

[mytwosons]

A lot of the issues you are seeing sounds like auditory processing issues.

:yeahthat: What you are describing really sounds to me like APD.

I do want to add it's great you are being so proactive and things can change a lot in a short period of time. If you haven't, I'd encourage you to see a DAN! (defeat autism now) doctor. They work with a wide-range of children from severe autism to mild ADHD. When my son was 4, I thought we were definitely going to end up with an ADHD type diagnosis thrown into the mix, but now we have no concerns regarding hyperactivity or focus. I think biomed has also improved his auditory processing.

[HIU8]

I have had DS's hearing checked about 3 years ago after a series of ear infections. That was the last time. They didn't mention anything to me then. B/c of issues with tongues and ears both DS and DD have been seeing a pediatric ENT. I just checked their website to see if they diagnose APD--didn't say. I'm calling this afternoon to see if they do or if they can recommend someone to take DS to for an eval. I read about APD on the NIDCD website and it looks as if DS exhibits each issue they pointed out (at least to me he does).

[cchavez]

Sounds alot like APD....My DS is SID w/ mild APD.

[pinkmomagain]

Just another POV, dd had alot of sensory issues when she was a preschooler (required OT and other services). We had her tested for auditory issues and it came up negative. Fast forward a few years later and she was dx for ADHD. So you never really know. Beth was right to say that many professionals will not dx ADHD before age 7. DD was dx by a child psychiatrist. That said, just because one might not have a dx, one can still receive therapies for a variety of issues. It was one of the hardest things to accept when dd was young when drs (and we saw many kinds...psychologists, neurologists, neuropsychologists, etc) would say "Don't worry about a dx right now, just focus on treating the issues." Goes against a mother's nature!!!

[erosenst]

Let me preface this with the fact that I am NOT a professional.

Having said that:

* Make sure you're having a neuro-psych or developmental psych do the eval. They're specifically trained to do this.

* It sounds a lot like APD to me, as it does to some prior posters. This is NOT a conclusive test, but can be indicative. On a 'good' day, can he follow multi-step instructions? Not a great example, but something like "Please get a spoon out of the drawer, put in on the table, and then bring the cup from the table to me" - a series of simple, vaguely related tasks that he should be able to complete if asked singly.

* In the FWIW category, there are a lot of people who don't believe that SID is a true diagnosis. There can clearly be sensory issues, but almost always as an offshoot of another diagnosis. When the underlying concern is treated, the sensory issues often diminish as well. Here's one often-cited article discussing this. http://www.quackwatch.com/01QuackeryRelatedTopics/sid.html.

Good luck -

Emily

[Ceepa]

* In the FWIW category, there are a lot of people who don't believe that SID is a true diagnosis. There can clearly be sensory issues, but almost always as an offshoot of another diagnosis. When the underlying concern is treated, the sensory issues often diminish as well. Here's one often-cited article discussing this. http://www.quackwatch.com/01QuackeryRelatedTopics/sid.html.

That's interesting. I've noticed an almost kneejerk suggestion of SID when certain behaviors and observations come up in conversation, even here.

[HIU8]

Some days he can follow a series of simple instructions. Mostly I have to repeat myself several times or say each portion slowly and wait to say the rest after he has completed the portion I just said. I have gotten so used to repeating myself that I let things get to a point where DS is very difficult to manage/handle/discipline/teach.

I hope I am on the road to figuring out what DS's issue is and to get him the help he needs.

Neuro or developmental psch does the apd eval--not an audiologist? This is all new to me. I may have to involve the ped in order to ask for a reference for a neuro psch. The lady who did DS's original eval was just a child psych.

[brittone2]

That's interesting. I've noticed an almost kneejerk suggestion of SID when certain behaviors and observations come up in conversation, even here.

It gets brought up a lot because when parents voice a concern about certain sensory issues, without a professional evaluation, it is impossible to tell whether what is described falls into the realm of typical development vs. something more. So generally if a parent is having concerns about more than one area of sensory development, and it is starting to adversely impact their life or their child's life, it can be beneficial to have an evaluation to determine if what is going on is within the range of typical development or beyond that. (eta: fwiw, I feel the same way about speech or gross motor concerns for example. Since none of us can evaluate a child online, if a parent is having ongoing concerns, it is best that they either discuss w/ their ped, or if they continue to have concerns that are brushed off, directly self-referring to EI. )

FWIW, there are a considerable number of medical docs (I've read reports from more than one developmental pediatrician referencing sensory concerns for example) that do believe there is something to sensory processing disorders.

I think most professionals that believe in sensory disorders as a legitimate concern would agree they can occur in isolation or as part of ADHD, autism, etc.

[erosenst]

Neuro or developmental psch does the apd eval--not an audiologist? My understanding is that a broader evaluation is usually done by a neuro-psych (or similar). Once issues are identified, a more conclusive/specific analysis is done by an audiologist. One of the issues is that many 'problems' can appear very similar at first, and differentiating between them often takes a multi-disciplinary approach.

This article is from the ASHA (American Speech and Hearing Assn) website, so MAY be biased...but it's known to be a very reputable site. http://www.asha.org/public/hearing/disorders/understand-apd-child.htm

(I just checked Wikipedia quickly to see if they had very different info. Interestingly, it relies heavily on ASHA publications - so that's likely the right place to look. http://en.wikipedia.org/wiki/Auditory_processing_disorder)

[HIU8]

Thank you for this information. I am going to call my peds office for a recommendation of a neuro psych in my area to contact about testing.

[DrSally]

If you want an ADHD eval, I would go to a clinical psychologist who specializes in testing children. Your local children's hosp. will usually have a testing program.