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PunkyBoo
08-11-2017, 11:19 AM
Sorry, this is long to give background.
Due to behavioral issues, we are getting DS2 evaluated. He's 8 and just started 3rd grade. We had an SST at school in the spring but it was just a few weeks before the end of the school year so they recommended we take him to see the therapist (LCSW) that DS1 has been seeing (since his concussion last Fall.) The school psychologist told us at the SST that it sounded to her like anxiety. After several sessions with the therapist, she recommended we get him evaluated- the therapist believes he more likely is high functioning autistic and/or SPD. So we made an appointment with the behavioral development specialist our pediatrician recommended. The soonest appointment they could give us was a couple months out, but now it is approaching in about 2 weeks.
The therapist also recommended we request that the school district do the assessments. So we sent a letter to the district over the summer and they responded that they will have the principal schedule another SST to discuss the plan for assessments about 2 weeks after school starts.
School started this week. I chatted with the principal and met the new school psychologist on the first day of school- they said they received the letter and confirmed they will schedule the SST.
My question is- should we keep the private appointment with the behavioral doc or cancel and let the school do the assessment? Should we tell the school about the private appointment? Is there any benefit to having both assessments?
Thanks for any advice you can give me.

StantonHyde
08-11-2017, 01:57 PM
Well the school assessment is free, the private is not. On the flip side, I don't trust our district--they are notorious for finding ways NOT to provide services for kids. So we have always gone the private route. If the money isn't an issue, I would go with both evals. If the school one turns out in your favor, great. But if not, then see what the private one says. If they agree, then that is good info. If they don't, then you really need to start asking questions.

The other question is--when will the school eval get scheduled? 6 months from now? (I know, by law, it has to be done by x date, but that never stopped our district from delaying as much as possible)

PunkyBoo
08-11-2017, 02:58 PM
Well the school assessment is free, the private is not. On the flip side, I don't trust our district--they are notorious for finding ways NOT to provide services for kids. So we have always gone the private route. If the money isn't an issue, I would go with both evals. If the school one turns out in your favor, great. But if not, then see what the private one says. If they agree, then that is good info. If they don't, then you really need to start asking questions.

The other question is--when will the school eval get scheduled? 6 months from now? (I know, by law, it has to be done by x date, but that never stopped our district from delaying as much as possible)
Thanks so much for responding. I'm not sure what timeframe the school will push for, they just responded with the timeframe for the SST. Of course it behooves them to get it going otherwise the teacher will be sending him to the office a lot, I'm sure, like they had to last year. But in the SST do you think we should tell them we're doing the private evaluation (so they know we haven't been idle and have been working toward a solution door him) or do you think the school will then try to shirk their responsibility to evaluate him? I just have the one appointment at the behavior doc so I don't know whether that would be it or if that's more like preliminary consultation and then they'd schedule tests... I have a PPO but I haven't discussed with them how much out of pocket we'll face.

hillview
08-11-2017, 03:33 PM
If you can afford it I'd totally do the private assessment. I think they have a lot less likelihood to have a bias vs the school. Personally I have found a neuropsych eval to be the most helpful thing we did for both DSs (DS1 has dyslexia and DS2 has a NVLD diagnosis). In BOTH cases the school didn't think they needed to be tested. DS2 was finally tested at the public school and they found he had no special needs. ARGH

georgiegirl
08-12-2017, 12:09 AM
Keep the private appointment!!!! My DS1 is the same age, and we just got him assessed a few weeks ago. (Don't have final results.). The school psychologist and the behavioral doc might use different assessment tools. One might be more useful than the other. As someone who has waited months and months for an appointment with a very popular developmental specialist and then had a horrible experience then had to wait another 4 months for another assessment (that was much more thorough), I say keep the appointment. I'm 100% sure my son's school would say he has zero need for services, but he clearly has issues (psychologist said definitely ADHD.)


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PunkyBoo
08-12-2017, 10:15 AM
Thank you. We'll keep the appointment. But should we tell the school that we're also doing the private evaluation? They're scheduling the SST for next week.

StantonHyde
08-12-2017, 01:31 PM
Do not tell the school about the private eval. Do tell the private eval about the school testing.

niccig
08-17-2017, 08:21 PM
I'm a school SLP.

Do both testing... I really hate it when a Dr or therapist tells a parent to have the school test as it's free. We're evaluating for different things and different reasons and that impacts the evaluation process.

The private evaluation is to consider if there's a medical diagnosis and what treatment options are available through the medical model - medications, therapies. The school evaluation is to see if the child has a disability as specified in that state's Education Code that is impacting the child's access to the general education curriculum. The criteria for the education eligibility is NOT the same as diagnostic criteria in the DSM. The school will NOT give a diagnosis, eg report may something like "characteristics of ADHD" and not ADHD. School services are to help child access curriculum at school and are not to remediate the disability or address impact in all settings/contexts.

Schools operate on a narrower scope for eligibility - State defines when we can provide services as you have to justify child missing instructional time. A child had to fall a certain amount below their peers based on standardized and informal assessments. Just under average range typically isn't enough to warrant a child to miss instructional time. To see a private provider, you're missing non-school time, maybe an after school activity. I have a student in 3rd grade that misses over an hour a day of instructional time from several providers - that's a lot to miss out of a school day.

Do both testing and inform both of test results. Why? So we have a full picture, we can't use the other parties evaluation without doing our own, but we can refer to it. We also can't use same test within certain time period.

Don't give up private eval if you suspect anxiety - I think that's better dealt with in medical model than the education model as medical will be looking at home and school when treating, and at school we address how they're doing at school only. We can't do anything with the family. A private practitioner can counsel the entire family.

The school SST process is going to take some time, they have to document interventions and if move to a full evaluation, that takes 60 days from when sign evaluation request. You may get one evaluation and treatment plan in place before the other.

If he isn't eligible for a disability that's impacting education, he may qualify under a 504 plan. My school has several students with ADHD diagnosis from Dr, academically they don't need services, so they didn't qualify for an IEP, but they have a 504 plan with a behavior plan.

Wording for the school SST meeting - we're discussing options with our doctor.





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NCGrandma
08-17-2017, 09:00 PM
I'm a school SLP.

Do both testing... I really hate it when a Dr or therapist tells a parent to have the school test as it's free. We're evaluating for different things and different reasons and that impacts the evaluation process.

The private evaluation is to consider if there's a medical diagnosis and what treatment options are available through the medical model - medications, therapies. The school evaluation is to see if the child has a disability as specified in that state's Education Code that is impacting the child's access to the general education curriculum. The criteria for the education eligibility is NOT the same as diagnostic criteria in the DSM. The school will NOT give a diagnosis, eg report may something like "characteristics of ADHD" and not ADHD. School services are to help child access curriculum at school and are not to remediate the disability or address impact in all settings/contexts.

Schools operate on a narrower scope for eligibility - State defines when we can provide services as you have to justify child missing instructional time. A child had to fall a certain amount below their peers based on standardized and informal assessments. Just under average range typically isn't enough to warrant a child to miss instructional time. To see a private provider, you're missing non-school time, maybe an after school activity. I have a student in 3rd grade that misses over an hour a day of instructional time from several providers - that's a lot to miss out of a school day.

Do both testing and inform both of test results. Why? So we have a full picture, we can't use the other parties evaluation without doing our own, but we can refer to it. We also can't use same test within certain time period.

Don't give up private eval if you suspect anxiety - I think that's better dealt with in medical model than the education model as medical will be looking at home and school when treating, and at school we address how they're doing at school only. We can't do anything with the family. A private practitioner can counsel the entire family.

The school SST process is going to take some time, they have to document interventions and if move to a full evaluation, that takes 60 days from when sign evaluation request. You may get one evaluation and treatment plan in place before the other.

If he isn't eligible for a disability that's impacting education, he may qualify under a 504 plan. My school has several students with ADHD diagnosis from Dr, academically they don't need services, so they didn't qualify for an IEP, but they have a 504 plan with a behavior plan.

Wording for the school SST meeting - we're discussing options with our doctor.





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Nicci, what a great explanation. My family has had plenty of experience with both types of evaluations (and services), and this is a really clear summary.


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PunkyBoo
08-17-2017, 09:23 PM
I'm a school SLP.

Do both testing... I really hate it when a Dr or therapist tells a parent to have the school test as it's free. We're evaluating for different things and different reasons and that impacts the evaluation process.

The private evaluation is to consider if there's a medical diagnosis and what treatment options are available through the medical model - medications, therapies. The school evaluation is to see if the child has a disability as specified in that state's Education Code that is impacting the child's access to the general education curriculum. The criteria for the education eligibility is NOT the same as diagnostic criteria in the DSM. The school will NOT give a diagnosis, eg report may something like "characteristics of ADHD" and not ADHD. School services are to help child access curriculum at school and are not to remediate the disability or address impact in all settings/contexts.

Schools operate on a narrower scope for eligibility - State defines when we can provide services as you have to justify child missing instructional time. A child had to fall a certain amount below their peers based on standardized and informal assessments. Just under average range typically isn't enough to warrant a child to miss instructional time. To see a private provider, you're missing non-school time, maybe an after school activity. I have a student in 3rd grade that misses over an hour a day of instructional time from several providers - that's a lot to miss out of a school day.

Do both testing and inform both of test results. Why? So we have a full picture, we can't use the other parties evaluation without doing our own, but we can refer to it. We also can't use same test within certain time period.

Don't give up private eval if you suspect anxiety - I think that's better dealt with in medical model than the education model as medical will be looking at home and school when treating, and at school we address how they're doing at school only. We can't do anything with the family. A private practitioner can counsel the entire family.

The school SST process is going to take some time, they have to document interventions and if move to a full evaluation, that takes 60 days from when sign evaluation request. You may get one evaluation and treatment plan in place before the other.

If he isn't eligible for a disability that's impacting education, he may qualify under a 504 plan. My school has several students with ADHD diagnosis from Dr, academically they don't need services, so they didn't qualify for an IEP, but they have a 504 plan with a behavior plan.

Wording for the school SST meeting - we're discussing options with our doctor.





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Thank you so much for this, Nicci. This whole process is completely new to us and in the meantime we're dealing with a kid that is often very difficult. I really appreciate your insights and perspective- we were upset that the school told us we should have him evaluated but never explained that there is a process to have the school involved- we had to be told by the therapist that the school would do anything, and do all the research on the process ourselves. It's quite overwhelming. Thank you again!

niccig
08-18-2017, 10:56 PM
Thank you so much for this, Nicci. This whole process is completely new to us and in the meantime we're dealing with a kid that is often very difficult. I really appreciate your insights and perspective- we were upset that the school told us we should have him evaluated but never explained that there is a process to have the school involved- we had to be told by the therapist that the school would do anything, and do all the research on the process ourselves. It's quite overwhelming. Thank you again!

Well at least the school isn't pushing a special education placement that removes him from the classroom. I had that scenario at one of my school's last year. There can be a lot of pressure on us to give an eligibility and recommend removal from general education when there's behavior issues. I see how difficult it is in the classroom for the teacher, but removal into special education and possibly off diploma track is a huge undertaking. I wish teachers had smaller class numbers, any TA support, behavior support, and most importantly, a developmentally appropriate curriculum in the early years. I know I'd have less evaluations for special education if the class environment was different.

I think seeking out both evaluations will have value, and you'll find out more about DS and his strengths/weaknesses. If he's doing well academically, the school may not find he has a disability that requires special education services. We do consider social-emotional impact, but we're limited by the state ED Code, as to what eligibilities a child with social-emotional issues can fall under if they don't fit criteria for Autism or Emotionally Disturbed. A 504 behavior plan may be possible if there is a medical diagnosis. If you have a 504 and DS gets in trouble, you can ask if behavior plan was followed, and if it wasn't, why not? It's not foolproof by any means, I'm yet to see one implemented fully, but it's better than nothing as onus on school to follow their plan.

We had DS evaluated by an educational psychologist and we learned that DS is solidly average, with some mild weakness in executive function when compared to other children his age. Recommendations were to push for IEP at school. To be honest I felt the psychologist was reaching to find something to recommend, as he was 10, and I know how long it takes for executive functioning to develop. DH and I had to accept that DS is average cognitively and academically, whereas both of us always tested above average. He has weaknesses in executive functioning and he struggles more in math, so we're helping him at home with extra tutoring. His issues aren't serious enough to warrant school interventions where he misses class time, he doesn't have a disability, and it's my responsibility as a parent to help him with areas of weakness. Main takeaway for us, was that DS is not us and expecting him to get good grades without studying like we did at school, is unrealistic.

It can't hurt to get both evaluations, it's more information to help figure out how to help DS.


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niccig
08-18-2017, 11:08 PM
Nicci, what a great explanation. My family has had plenty of experience with both types of evaluations (and services), and this is a really clear summary.


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I think many issues come from confusion with medical model and academic model for interventions. It is confusing. I've had Dr write on prescription pads that child needs speech therapy for a language disorder and tell parents to take it to school. I have to explain to parent that a Dr can't tell the school what services to give, a Dr is not licensed to diagnose a language disorder in any state in the USA, the Dr didn't do any Lang testing, and as child tests within average range for their age, they don't have a disorder. And the reply is" but the Dr said ....."


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annex
08-19-2017, 12:33 AM
There can be a lot of pressure on us to give an eligibility and recommend removal from general education when there's behavior issues. I see how difficult it is in the classroom for the teacher, but removal into special education and possibly off diploma track is a huge undertaking. I wish teachers had smaller class numbers, any TA support, behavior support, and most importantly, a developmentally appropriate curriculum in the early years. I know I'd have less evaluations for special education if the class environment was different.

Hijacking a bit, but can you share more? Where does the "pressure" on staff such as SLPs come from to do this? It seems like it would be more expensive to have the student removed into a separate special education room than it would be to provide help in general education - but maybe not? Or is it mainly administrators who are tired of handling disgruntled parents of other students in the classroom that try to influence the IEP team to recommend a new placement? And what consequences do staff face if they disagree and speak out during the IEP?

niccig
08-19-2017, 02:36 AM
I am the only one in the room that can determine if a student qualifies or not for a speech or language disorder, as only one licensed to do so. I explain my findings. If parent disagrees, they don't have to sign the IEP and there are avenues of appeal. All my clinical decisions are made based on age norms - what is age appropriate. Most disagreements are because teacher/parent are expecting more than what is age appropriate. I blame curriculum that isn't developmentally appropriate and push to meet standards.


I suppose administration could complain to my boss if they thought I wasn't qualifying students that should be qualified.










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lizzywednesday
08-27-2017, 02:48 PM
If you can afford it I'd totally do the private assessment. I think they have a lot less likelihood to have a bias vs the school. ...

:yeahthat:

Also, at least in my state, schools can't legally diagnose certain things. They can only make observations and inform parents for referrals. Do the private assessment and take that information with you to any meetings going forward.

Your ultimate goal is to ensure your child is protected under the law, not having any issues he cannot help (due to brain wiring, chemistry, or non-neurotypicality, etc.) treated like "discipline" issues, and his diagnosis in writing so you have a paper trail should he not have access to the resources and support he might need.

Do the private assessment.

HannaAddict
08-28-2017, 05:21 PM
Do not tell the school about the private eval. Do tell the private eval about the school testing.

Good advice until you know the results and can use them in a positive way for your child. Keep the private appointment, good luck.


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PunkyBoo
08-28-2017, 05:36 PM
OP here. Thank you all for your feedback. It really helped me understand the process more. We had the initial visit at the private doctor last week and they will be giving us diagnoses (if warranted) by early October. My issue now is that the doctor gave me a questionnaire regarding ADHD that I need to have the teachers fill out- so I guess I'll have to notify the school that we're also pursuing outside assessments. Hmm. That's going to be even more complicated since he's only been back in school a couple of weeks so the form should probably be filled out collaboratively with his last year teachers.

PZMommy
08-28-2017, 07:12 PM
OP here. Thank you all for your feedback. It really helped me understand the process more. We had the initial visit at the private doctor last week and they will be giving us diagnoses (if warranted) by early October. My issue now is that the doctor gave me a questionnaire regarding ADHD that I need to have the teachers fill out- so I guess I'll have to notify the school that we're also pursuing outside assessments. Hmm. That's going to be even more complicated since he's only been back in school a couple of weeks so the form should probably be filled out collaboratively with his last year teachers.

As a teacher I've been asked to fill out those forms, and it doesn't phase me at all. I just think the parent has talked to their pedi and is pursuing information. Don't worry about giving the form to the teacher, as they get asked to do it all the time! If you don't think his current teacher has enough info to fill it out, then just give it to his previous years' teacher.

Kindra178
09-06-2017, 10:22 AM
School districts are loathe to provide services. Let the school do certain tests and the private eval do other tests. In our experience, schools do fine to administer the WISC and WIAT and the basic language texts. After that, schools just don't have the time to do a thorough eval. You can use the private eval tests to encourage the school to provide services.

We had huge issues with what our former district declared as "average." Frankly, it was maddening. Our current district intervenes at low to middle average, which is helpful to the kids.

I will also add that you have 90th percentile parents and a 50th percentile kid, that's a learning disability. Find it.

SSTE has long posts on using school testing plus private testing here on this board.

lizzywednesday
09-06-2017, 11:31 AM
...My issue now is that the doctor gave me a questionnaire regarding ADHD that I need to have the teachers fill out- so I guess I'll have to notify the school that we're also pursuing outside assessments. ...

I've had DD's teachers fill out assessment forms as part of her outside diagnosis paperwork. In Kindy alone, we had an initial eval from the pediatrician, a follow up from CHOP, and then a repeat CHOP eval during the 1st month of 1st grade because we were approaching her eval appointment (not scheduled for almost 6 months due to various delays on CHOP's end) and having the input of her new teachers in addition to her Kindy teacher's eval was helpful to the team.

Definitely get the evals from both this year's and last year's teachers if possible; the more info the teachers can provide the evaluation team, the better the diagnosis will be, IMO.

georgiegirl
09-06-2017, 12:27 PM
We are supposed give DS's teacher those eval forms every few months to evaluate how his meds are working. The psychiatrist gives them to us.

bisous
09-06-2017, 04:50 PM
This was helpful to me. I have been on the fence about neuropsych testing for DS1 and possibly both DS2 and DS3 (do they have a family discount, lol?) The school has really tried to dissuade me from testing my kids. DS1 is doing "well" but I'm constantly amazed at how incredibly behind he seems in so many ways. I think I'm going to really actively pursue this this year.

georgiegirl
09-06-2017, 05:23 PM
This was helpful to me. I have been on the fence about neuropsych testing for DS1 and possibly both DS2 and DS3 (do they have a family discount, lol?) The school has really tried to dissuade me from testing my kids. DS1 is doing "well" but I'm constantly amazed at how incredibly behind he seems in so many ways. I think I'm going to really actively pursue this this year.

Definitely pursue private testing. No one at our school would have ever said something is "wrong" with DS1. No major behavior issues, on track academically, and zero social issues. However, the private psychologist we took him to (2.5 hours of 1 on 1 testing) had zero doubts DS has ADHD and could benefit from daytime meds. He's only been on meds a short while and we are still working on dosage, but I can already tell DS is going to amazingly well academically this year. While he was never behind compared to his peers, I knew he could do much better. It only took him minimal effort for him to be secure in everything at school, so the fact that he wasn't able to focus would never have signaled a problem to school.


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bisous
09-06-2017, 06:10 PM
Definitely pursue private testing. No one at our school would have ever said something is "wrong" with DS1. No major behavior issues, on track academically, and zero social issues. However, the private psychologist we took him to (2.5 hours of 1 on 1 testing) had zero doubts DS has ADHD and could benefit from daytime meds. He's only been on meds a short while and we are still working on dosage, but I can already tell DS is going to amazingly well academically this year. While he was never behind compared to his peers, I knew he could do much better. It only took him minimal effort for him to be secure in everything at school, so the fact that he wasn't able to focus would never have signaled a problem to school.


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Your DS1 sounds like my DS2! My other two are quite clearly extreme in their classes. But DS2 who was always my "easy" one has always seemed smarter than he is achieving, if that makes sense. And lately he's had some behavioral issues. I'm going to see what I can set up.