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Caribou

Year 2 struggling with Focus.

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Charli73

Get a second opinion... for dx ADHD out paed have us and our child’s teacher extensive questionnaires to fill out.. medication was our saviour..

 

You know your child better than a paed who ‘can’t see it’ that must be so frustrating especially in a 20-30 min appointment slot..

 

Best of luck..

Edited by Charli73

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~Jolly_F~

The ADHD questionnaire was huge.

 

The teacher did one and DH and I did one each!

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José

Hi OP, my DD1 (six) was recently diagnosed with ADHD inattentive. We went through a comprehensive learning assessment with a clinical psychologist, which included the Conners screening assessment as well as tests of executive function, attention, working memory, processing speed and visual spatial ability. The results strongly indicated ADHD, which the paed accepted at the first appointment.

 

It's expensive, but you could consider this pathway to avoid being fobbed off further.

 

i think this is a good idea.

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Caribou

I feel like hitting a brick wall.

 

I spoke to DD's teacher today to ask how she was going in class.

 

'great! she's focusing so well, we're moving her up to the advanced group!' advanced group has 4 kids in it and they all do extension work.

 

I'm like this is such a polar opposite to what I get at home.

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~Jolly_F~

Thats my life...

 

School she is fine, at home its a full blown sh*t show.

 

It is very common with girls and often why they go undiagnosed for so long because its gets dismissed due to the rest of the world not seeing the behaviour.

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CrankyM

Yeah school never sees any of the crap here either... especially with my oldest. I always getting reports of how wonderful he is, how well behaved...

 

And then within 10 mins of getting in the car the wheels fall off and I've got a kid losing it, or down and having the sads, or just sheer exhaustion because forcing the focus, and interacting, and trying to figure out what exactly people want is like him running a marathon for 6 hours.

 

I'd actually make an appointment with the teacher. I have never found those 5-10min conversations with other people around helpful. It may be her focus is improved, but that doesn't mean the teacher isn't see struggled and scaffolding support for her. The small group for extension, is somewhere that she might focus better because it's a small group with less "background" noise. Both my kids do massively better in small groups for this reason, it was a seriously shock to the system for my oldest when he hit year 4/5 and the class sizes increased from 22 to 32 and he was expected to be doing a lot more independent learning. (I think this is actually driving current behaviors). Actually sitting down with the teacher and outlaying your concerns and getting her to tell you what she is seeing is more likely to result in a clearer picture.

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Prancer is coming

When my kid was diagnosed with ADHD, the paed had numerous reports from the school psych (cognitive assessment which included Connors results), OT report with diagnosed learning disability and speech report with test results. I sort of thought the paed’s job was to make an assessment based on all available information or refer you out to get the info, rather than relying on observations? Have you had any other testing done or specialists involved.

 

I would actually go to your doctor with your concerns rather than a particular course of action. I know my GP’s first point of referral was a psych for an assessment. But at the same time the school saw the deterioration (wheels fell off in grade 3 which I heard was quite common) and did the psych stuff, and I had to wait several months for the diagnosis as the paed was not doing anything without the full cognitive assessment (which was done and he had a summary of, but had issues getting it from school to paed).

 

I echo talking to the school and seeing if they see the issues. I m not up in ASD, but with ADHD the issues need to occur in 2 settings - so home and school. If the school do not see any issues, then I think you may struggle with a diagnosis.

 

As for focus, with my younger child who has not been diagnosed (yet....) I need to get him in a room that is totally quiet and make sure he has nothing in his hands to fiddle with. I need to get siblings out of the area. Homework is mainly reading at present, and he is motivated. But otherwise I think a motivation to finish (eg we can do x when you finish homework) is good.

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JoanJett

I would not always put a lot of store by "issues" at school. Their focus is usually the behavioural impact of ADHD, particularly in younger boys with hyperactive/impulsive symptoms that are disruptive to others. It's also early in age/school, so the demands at school are less and it's easier to get by if the child is bright. It's why so many kids with predominantly inattentive symptoms are not diagnosed until later primary school if they don't have behavioural problems.

 

From my personal experience, school also does not always connect the dots. For us, it was them not seeing the "problems" as actual symptoms of an underlying disorder. We would have spent another few years missing the diagnosis if we had relied on their feedback and not initiated testing ourselves. It is also my experience that school are less likely to even consider ADHD if a child is ahead academically.

 

That's when the exhaustive rating scales actually reveal things - the school is prompted to actually consider point by point all the aspects that make up diagnosis, and there are many teachers who don't fully understand all the domains affected by ADHD/ASD. They often reveal far more than interviews ever do, as they examine the information in multiple ways.

 

I agree with PPs about a Pyschology assessment initially as a possible pathway, as well as referral to a Developmental Paed. We had all the testing and a provisional diagnosis via a Psychologist before we saw the Developmental Paed and it helped speed the process - we had to wait months to see the Paed anyway, so we had all the rating scales and exclusion of other problems, we also had many months of formal behavioural intervention support so it meant that the path to medical treatment was quicker.

 

The other benefit of seeing a Psychologist is that if your daughter doesn't have ASD/ADHD, or if even she does, you will have support for your parenting and the feelings you are experiencing, as well as advice about strategies to cope and manage at home.

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ainira

Just wanted to add that the psychologist report included a recommendations section with suggested amendments that could be made to the school environment.

 

My DD has deficits in attention and executive function, so tasks need to be broken down step by step. Minimising distractions is also important.

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Caribou

Sounds like I should ask the GP for a pysch referral first, what use the the paed if the psych does the diagnosis?

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~Jolly_F~

I don’t think a psych alone can diagnosis (that’s what I was told) but they provide valuable information to help the paed.

 

My daughter started with a psych as part of the diagnosis process. She is brilliant, DD loves her and so do we.

 

It’s really important to find a team you trust and are comfortable with. If you senses are saying nope this isn’t the person, listen to that.

Edited by ~J_WTF~
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ainira

Sounds like I should ask the GP for a pysch referral first, what use the the paed if the psych does the diagnosis?

 

You don't need a gp referral for a psychologist.

 

You will need to see a paed to access medication -- if that's something you want to do.

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~Jolly_F~

You don't need a gp referral for a psychologist.

 

 

Are you sure?

 

We needed a referral.

 

Plus if you get a mental health plan you can get 10 free visits.

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CrankyM

Mental health plan does not cover assessments. It only covers appointments that are “therapy” based. You don’t need a GP referral. Some psychologists can diagnosis adhd, but it is normally a clinical neuropsychologist (we had one review my youngest in conjunction with a pead). A warning. These assessments can be $$$ but are worth it when you get a report detailing strengths and weakness even if there is not formal diagnosis.

 

A pead will be required to formalise a diagnosis if the psych doesn’t have that ability (I think their is some sort of qualification involve or Medicare code. Something.). And if you choose to go down the route of medication if it is adhd.

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~Jolly_F~

The whole process really isn’t simple..

 

So many variations on who can do what and costs!

 

ETA sorry, not really the thread to discuss the above.

Edited by ~J_WTF~

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José

I don’t think a psych alone can diagnosis

 

a psych can diagnose adhd.

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froglett

OP - not sure if this has been mentioned, but with DS I booked an appointment with the school counsellor and she gave me/DH and DS's teacher the Connors questionnaire (diagnostic) to fill in.

 

She then wrote a report that analysed the results - NB it doesn't provide a diagnosis at that point. This was all free (NSW public school) - if done privately apparently it can be very expensive.

 

I then went to our GP and got a referral to our paed. She was fabulous and before I had even given her the report or discussed ADHD she asked me if there was a history of ADHD in the family - she'd picked it up by watching him and me talking through his history from babyhood.

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~Jolly_F~

 

 

a psych can diagnose adhd.

 

Yep I understand that now from Maya’s post :)

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CrankyM

JF don’t worry, if ASD is considered a factor, yeah well that pathway is a headache inducing nightmare that is dependant on what state you live in as to who is apparently allowed to ratify that diagnosis. Some states it’s just a pead or psych, others like Wa require assessments from just about every damned person and cost anywhere between $2000-$6000. (3 years in our case and if you ask me my kids ASD was as plain as the nose on your face).

 

I will mention that IF you think ASD is a factor, there is a 1 off 20 subsidies Medicare rebates that can be accessed for various specialists for diagnosis. This “referral” has to be written by a pead though. A GP can’t do it. Here is some info on it http://www.health.gov.au/internet/main/publishing.nsf/Content/autism-children

Edited by mayahlb

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Caribou

OP - not sure if this has been mentioned, but with DS I booked an appointment with the school counsellor and she gave me/DH and DS's teacher the Connors questionnaire (diagnostic) to fill in.

 

 

I would, except I found out the counsellor is a friend of my mum's and I'm not 100% comfortable with discussing DD's issues with that counsellor. my mother is also a counsellor too, I try have a wide berth on any counsellors linked to my mother. I know there's the whole everything is confidential etc etc, but at the end of the day, its still someone who knows my mother and I can't trust that it won't be discussed. I mean for example my mother seems to know what's going on at the school that I haven't even told her nor is it in the newsletter. it's nothing that breaches confidentiality, but if she can get info on DD's school without me telling her, it just makes me feel like she can get info on DD too, and I'm sure she does, but again no proof.

 

I'll just go with making sure the referrals I get are for people out of area.

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barrington

I feel like hitting a brick wall.

 

I spoke to DD's teacher today to ask how she was going in class.

 

'great! she's focusing so well, we're moving her up to the advanced group!' advanced group has 4 kids in it and they all do extension work.

 

I'm like this is such a polar opposite to what I get at home.

In the end, our very bright child never received a diagnosis, because the school could not see a problem with his inattentive behaviour. I would get comments on how organised he was in a parent teacher interviews, even though he came home with one shoe on that day (the other - under his desk).

 

We simply engaged therapists and specialists as needed and gave up on getting help through the school or a formal diagnosis.

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CallMeFeral
A pead will be required to formalise a diagnosis if the psych doesn’t have that ability (I think their is some sort of qualification involve or Medicare code. Something.). And if you choose to go down the route of medication if it is adhd.

 

AFAIK anyone can diagnose something. Diagnosing is just giving something a name, it's not like a special administrative procedure with a particular number or rebate or something. Whether people take that diagnosis seriously depends on the person's qualifications, so a psych would be able to diagnose it (and would have had some level of training in it), and if they were experienced in that area hopefully that would be taken seriously. Currently I believe there are no Medicare codes available for neuropsychological assessment, sadly.

 

But yup, a paed or a child psychiatrist to get meds if required.

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CrankyM

Callmeferal I might be mixing it up with asd. An asd diagnosis in WA isn’t considered valid unless it goes through a specific panel assessment... my youngest was screened for asd at the same time he was assessed for adhd. (Oldest was a more complicated pathway and assessment was done by pead only).

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~Jolly_F~

Qld here and we had to do the ADOS assessment with a panel of specialists to get an ASD diagnosis - most people I have spoken to about ASD have done this.

 

ADHD assessment was done at the same time.

 

Hence why I assumed that’s how it was done for everyone but it appears that it isnt the only way.

 

It really just adds to the confusion of getting a diagnosis.

 

Edited for clarification.

Edited by ~J_WTF~

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CallMeFeral

Callmeferal I might be mixing it up with asd. An asd diagnosis in WA isn’t considered valid unless it goes through a specific panel assessment... my youngest was screened for asd at the same time he was assessed for adhd. (Oldest was a more complicated pathway and assessment was done by pead only).

 

Ah ok I see what you mean. In that context particular organisations (like say dept of education) might have their own criteria about who can issue a diagnosis that will be believed, for the purposes of allocating funding or assistance. Here there has been talk of Centrelink I think it is (not sure) requiring mental health diagnoses to be made by a clinical psych rather than a general psych, and the general psychs get quite upset, because of course they CAN 'diagnose' as in tell what is wrong, but due to Centrelink's rules it doesn't 'count' for Centrelink purposes. However another department might just require it be diagnosed by any psychologist, and it would count. So it's more an administrative limitation of whatever organisation is issuing some kind of benefit.

So for private purposes, i.e. for knowing something yourself, it's really just making sure the person knows what they are talking about so you have faith in the diagnosis. But yes, to get medication a paed/psychiatrist would need to agree, to get special assistance the diagnosis might have to meet certain criteria specific to the organisation granting it.

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