ADHD, how do I get a diagnosis? (U.S.)

[CaliDreaming]

My 6 y/o dd is having some behavior problems in school. She frequently refuses to do school work and to participate in group instruction. She also is very emotional and still has melt downs from time to time. However, she is still doing great academically and learning a lot.

Her school has put in several interventions in place for her and she sees the school counselor weekly to help her learn to control her emotions. However, they have not been successful in getting her to complete her schoolwork in class, and her teacher has told me that she'll soon be sent to the office if she keeps refusing.

Dd has had these types of issues in preschool, and back then I got conflicting opinions about whether she had a behavior disorder or not. Some of her teachers thought it was something she might outgrow.

I asked her teacher if I should request that she be evaluated, and she wants to hold off and keep trying with the interventions. However, as dd has gotten older, it is becoming more clear to me that she is suffering from ADHD or something similar. She is doing well academically now, but I fear as things go on she will start to have issues there as well.

Do I need to wait for the school to recommend an evaluation, or do I need to just go ahead now and get her evaluated on my own? I'm not up on IEPs and how those work and all. It's all very confusing.

 

[jd83]

She's only 6, and doing fairly well with her school work. I think I would hold off for now, and let the teachers keep working on interventions to help her. If they can find the right approach to helping her, then she will definitely start improving on the class work. It takes time sometimes for them to find the right approach with each kid, and I'm sure if they truly felt that she was beyond their capabilities as she is, then they would have recommended you get her tested now so that the diagnosis would help them further define a plan on how to help her. Having said that, I'd keep in close contact with her teacher to make sure you are up to date on what they are currently utilizing to help her in class, and any tips on what you can do at home to help her with her learning.

 

[CaliDreaming]

Thanks. I'll keep watching and waiting. I just worry so much about her.

 

[MummyMana]

I'm in the UK, so not clued up on the US, but I'm actually an ambassador for my local ADHD charity have you thought about putting in place some adhd-specific techniques if you strongly feel it's ADHD she has? Whether they help or not would be a good indicator.

If you do want to try and get an assessment, the GP (do you have GPs?) Or school SENCO are a good place to start. Start a diary of her behaviour so you can identify potential triggers. I don't know what it's like over there, but here getting a diagnosis is a long, drawn out process.

 

[krissie328]

I work in the schools as a school psychologist. As a pp said I wouldn't ask for a school eval yet. However, talk with your pediatrician (they can usually diagnose or can refer you to a developmental pediatrician). If you get a medical diagnosis I'd probably request a 504 plan. It doesn't sound like she needs special education, but she would probably benefit from some accommodations in the classroom. I believe the earlier you intervene the better the outcomes.

 

[CaliDreaming]

I'm in the UK, so not clued up on the US, but I'm actually an ambassador for my local ADHD charity have you thought about putting in place some adhd-specific techniques if you strongly feel it's ADHD she has? Whether they help or not would be a good indicator.

If you do want to try and get an assessment, the GP (do you have GPs?) Or school SENCO are a good place to start. Start a diary of her behaviour so you can identify potential triggers. I don't know what it's like over there, but here getting a diagnosis is a long, drawn out process.

Yes, I'd been looking at some adhd-specific techniques and some of them were things that we'd already been doing. The more I read the more the description seems to fit. Would a GP be the equivalent of pediatrician here? She has her yearly checkup soon so I'll raise it then.

I work in the schools as a school psychologist. As a pp said I wouldn't ask for a school eval yet. However, talk with your pediatrician (they can usually diagnose or can refer you to a developmental pediatrician). If you get a medical diagnosis I'd probably request a 504 plan. It doesn't sound like she needs special education, but she would probably benefit from some accommodations in the classroom. I believe the earlier you intervene the better the outcomes.

Thanks. I was really confused about what special ed/IEPs/504 plans entail and this helps make things clearer for me. I googled what 504 plans are and it seems the school has already started to put in place a lot of things that would be included in those. I guess they don't need any official diagnosis to do this?

So based on this, I understand why I should not be requesting a school evaluation right now, but it definitely sounds like I should be getting her in to see a doctor ASAP. Are these evaluations generally covered by insurance?

 

[krissie328]

Yes, your insurance should cover the majority. Especially if it'd just through her pediatrician.

A 504 would require at least a perceived disability. If I had to guess I'd say they are doing interventions and nothing formal. The good thing about are 504 is that it will follow her grade to grade, or if you moved into a different school. Plus it's a formal plan that must be followed by law. It would be reviewed with you annually as well.

 

[CaliDreaming]

Thanks so much! Very helpful!

 

[SarahBear]

You have the right to request an evaluation, however, they do need a certain number of weeks worth of data to see if they can find an intervention that will be successful. I would say though, that I would not be OK with my kid being sent to the office all the time. If she's being sent there, what is she missing? If it's class time, then she's being pulled out of important instruction. If it's recess, she's not being given a physical outlet to help her re-set her mind and body to get ready for learning. Being sent to the office is not an intervention. It's something to manage a situation in the moment but indicates the need to problem solve and do something different. An intervention could, however, be sending her to the office to do her work so that she has a quiet, less distracting environment to complete her work in. My guess is that the office doesn't fit that description, though. I'd advocate for NOT sending her to the office as a punishment for not completing her work and I'd also make sure she's getting her recess time as that's another thing teachers "like" to cut. On top of that, I would request a date to review the data in order to discuss whether or not the interventions are working and to decide whether or not further information is needed before looking at a possible special education need. You could even just ask for a parent-teacher conference to discuss the data. It sounds like although her needs aren't impacting her academically, they are impacting her access to instruction which could later lead to an academic impact. As for ADHD and eligibility goes, every state is different, but in my state at least, schools don't diagnose ADHD. If you are looking for an eligibility based on ADHD in this state, a student needs a medical diagnosis and that medical diagnosis must have an educational impact.The student would then qualify as Other Health Impaired. You'll want to check with your school to find out how it works in your state.

A bit of background: I have worked in schools as a student teacher, instructional assistant, and now as an autism consultant. I also worked for a virtual school as a special education teacher for 3 years.

 

[MummyMana]

I'm in the UK, so not clued up on the US, but I'm actually an ambassador for my local ADHD charity have you thought about putting in place some adhd-specific techniques if you strongly feel it's ADHD she has? Whether they help or not would be a good indicator.

If you do want to try and get an assessment, the GP (do you have GPs?) Or school SENCO are a good place to start. Start a diary of her behaviour so you can identify potential triggers. I don't know what it's like over there, but here getting a diagnosis is a long, drawn out process.

Yes, I'd been looking at some adhd-specific techniques and some of them were things that we'd already been doing. The more I read the more the description seems to fit. Would a GP be the equivalent of pediatrician here? She has her yearly checkup soon so I'll raise it then.

I'd assume so, here the GP would refer you to a paediatrician so if you're already under one it would make sense to see them about it I guess?

 

[CaliDreaming]

Thank you all so much for your help in this. I've asked around and got some recommendations for neuropsychologists in our area that take insurance and will be calling around. We just got her latest report card and for the second term in a row her conduct does not meet expectations. We'll get to meet with her teacher soon and talk to her about our plans to get her evaluated. I've decided not to wait to talk with her pediatrician since our insurance does not require it.

Sarah you hit the nail on the head about why office visits and taking away her recess may not be the right course of action. When I got the teacher's email I felt so unhinged about it but couldn't articulate why. I sure hope we can get to the bottom of this soon.

 

[CaliDreaming]

Is 6 too young for most doctors to diagnose ADHD? I finally found a specialist who accepts our insurance and based on the fact that dd is a "young six" felt that we need to wait to see if she will outgrow the behavior. Or should I keep looking for someone who will see her now?

 

[krissie328]

I'd probably call someone else and get a feel for their thoughts on that. Given she is displaying atypical behavior and is a female I think it'd be easy to diagnose.

 

[CaliDreaming]

Thanks krissie! I'll keep pressing on. The reception at the specialist's office I posted about above dismissed my concerns after a two-minute conversation. I've found a couple of others that will at least do an in-depth consultation for no or low cost.

I just did not expect it to be so hard just to get an evaluation. If it's this hard now, I'm afraid our lives are going to me nothing but struggle struggle struggle from here on out.