What would an eval look like?

[Deleted]

Follow up to the anger issues post- What would an eval look like for this?  Would there be a certain questionnaire that they would follow?  In reading the books, it doesn't seem like it is in conjunction with anything else except maybe anxiety or maybe ODD.  I think her H is convinced, but she is still unsure.  I suggested the leading children's hospital, so I know that they would have experience working with kids which makes it easier because they will have toys in the office and can do the eval maybe in a game type way to promote interaction.  Her concern is that he would not participate.

[akafred]

It could vary a little by provider, but probably a lot of developmental paperwork (How old when rolled over? How old when crawled? How old when walked? Etc), followed by a parent interview to flesh out the developmental stuff and expand on your concerns, and probably some (possibly more than one) parent and teacher scales. They could be very short like the M-CHAT (well, that is for toddlers, but it is very short) or Vanderbilt, or it could be longer like the Conners or BASC-2 or 3 which is a couple hundred questions. Then there could be some interaction between the evaluator and the child, but it would depend on what they are seeing in the earlier parts as possible issues. Autism has some specific testing that would probably not done if autism isn't likely but ADHD or anxiety are.

Char's eval with a psychologist involved a Vanderbilt (parent and teacher), a ton of developmental paperwork, an hour long interview with the parents, then six one hour sessions with DD and the psych in which he asked questions he has developed over the years, and then we did a BASC-2 (parent and teacher), then one more hour with us to go over his observations.

[Deleted]

Thanks @akafred, it looks like there would be quit a few parent questions and possibly teacher questions, so worst case scenario if he did not cooperate at all, they would still be able to get some results based on parent and teacher responses.

Would a school district do this or better to go through a medical practice like the children's hospital? The school might be harder to convince since they don't see it there as much and not interfering academically or behavior wise in the classroom at this point.

[akafred]

I personally would only use the school district if I were seeking accommodations in school or if I had no other option financially. They can't give medical diagnoses, only educational. They cannot prescribe medication (and really should not recommend it. I would seek a private or group-affiliates psychologist. Some will say to use a developmental pediatrician, but we got no action from the dev pedi office because they (ours) are almost exclusively focused on ASD. That isn't the case everywhere but very much was our experience. I know what you don't want is for her to hear "there are no issues" when you're pretty sure there are issues.

[mrsbuttinski]

I would start with a pediatric teaching hospital. For a lot of reasons.

The eval will likely include some parent and teacher surveys- probably a couple of more global assessments like BASC and Vineland to get a sense of where he is in terms of social and emotional development. Given his age, self-reporting on BASC would be crucial- anger can be a function of irritability which is what depression or bipolar look like in a boy this age.

A private eval should be more comprehensive and robust- it should be a 360 view of the child vs a school eval which is only going to look at him in his occupation as "student". Ideally, a psychologist or behaviorist from the team would observe the boy in a school setting to see how he behaves in a structured as well as unstructured setting.

I would not worry about cooperation. If he doesn't play along, that's a behavior that could lead toward specific dxs. Since he seems to behave differently at school, it could be one of those situations where the parents are not effective at parenting this particular child- he might need something very different than he is getting from them.

Once they have the report, with a potential or firm dx, they can take it to the school and request a MFE for all areas of suspected disability with a plan to create a Sec 504 or IEP. I would wait since he is not struggling at school so much. TBH, a lot of this sounds ODD-ish and that is not a dx I would want to share with a school district because it could lead to an automatic EBD placement should he start to act out in school and I would do whatever it takes to avoid that placement.

[akafred]

I agree completely with mrsbuttinski about the dx of ODD and sharing it with the school district. Plus anxiety very often puts off an ODD vibe (and while I am not in a position to evaluate the authors or the claim, I have seen more than a couple of articles that are saying that ODD really IS anxiety). Unfortunately the way a lot of schools deal with ODD is actually not the best for kids with anxiety. So I would not accept an ODD dx without a lot of consideration, and I would not share that dx with the school district. (Every other possible dx I would share, but not that one.)

[Deleted]

What is EBD placement? I did look it up. Why would we want to avoid? Would that be a self contained classroom? Is that why.

He is mainstreamed now, and given no major issues I think that should continue.

[akafred]

Oct 22, 2016 15:35:46 GMT -5 @clarypax said:

What is EBD placement? I did look it up. Why would we want to avoid? Would that be a self contained classroom? Is that why.

He is mainstreamed now, and given no major issues I think that should continue.

Emotional and behavior disorder. It is either a self contained classroom or even an alternative school. What they used to call "reform school."

In most cases, a dx is helpful because if you don't provide a label, one will be provided for you ("naughty", for example). In this case, an ODD label can be pretty damaging. It isn't well understood (relatively speaking) by behavioral health professionals, much less teachers and school districts. Of course there are exceptions to everything, but in general I would accept a label of "anxiety" far sooner than ODD, even if the placement would otherwise be identical.

[Deleted]

Good to know thank you. I will make sure to let her know if they get that diagnosis. She is trying really hard, and it is so hard for her. Her mom is reading the books too, so that is helpful because she cares for them 1-2 days after school.

[mrsbuttinski]

At the elementary level, EBD generally means some time spent away from mainstream with a bigger focus on behavior than academics. It can become a dumping ground and given how these rooms are staffed, a child will end up more in the care of paraprofessionals than a highly qualified teacher.

At the secondary level, Alternative School could be an option. These can also be a dumping ground for troubled kids (at my district it's going to be kids with mental health problems who can't function in a full day program, kids who are on parole/probabtion, parenting teens, teens who in or transitioning from rehab, and those who have been suspended for certain higher level infractions like drug or weapon incidents. Often there are multiple grades in a classroom and academics tend to level at the lowest common denominator.

I know a couple of families whose kids spend some time in Alternative School. In one situation the girl was older and had bi-polar; the parents wanted an non-public placement and this was a hoop through which they had to jump to make that happen. The other was a very unfiltered boy with ASD whose mom had pissed off the powers that be (she was kinda socially inept as well and had unrealistic expectations about what others should do for her kid). Said boy was placed with juniors and seniors as a middle schooler and picked up all manner of language and ideas.