Asd and developmentl ped

[mirandah]

We saw our dev. pedi at ages 3, 4, and 5; at age 6 he told us it wasn't necessary any more because we were under the care and supervision of a psychiatrist. How confident are you of your GP? Ours was a proponent of us seeing both dev. pedi and him until we saw a psych for anxiety/ADHD; then he agreed it was okay to quit seeing the dev. pedi.

My kid changes a lot these days; we still see our psych every three months or more to adjust meds and check in on weight, height, etc.

[mrsbuttinski]

We saw the dev pedi at least yearly for follow-up, but I know of other practices that do not. DS wasn't dxd by the dev pedi until age 7; we started meds for anxiety and attention a year later with dev pedi as prescribing physician.

DS also had a private psychologist who saw him weekly through elementary school to work on behavioral strategies like CSIT and CBT. He saw the psychologist a couple of times through high school to touch base and has his meds managed by a psychiatrist since he's aged out of pediatrics.

[Deleted]

Thanks everyone. My son does not receive any meds yet, which is why I think he left the door open to call if we need anything. I just wanted to make sure that is normal.

I just feel like it's a life long dx and I'm not sure (if any) who we would see for it.I suppose if we need meds one day we would start at pcp then a psychiatrist.

[Deleted]

Apr 18, 2017 16:07:01 GMT -5 @kitchen said:

How hard is it to get in to see the developmental pedi? If there's a long wait-list for initial appointments it might be worth regular (annual-ish) follow ups to remain on their patient roster so that if an issue arises you're not stuck as a new patient in terms of priority?

That might not even be a concern depending on the supply and demand situation though.

We have to travel 1.5 hours to see one. The wait was about 5 months the first time we saw them.

[mrsbuttinski]

Apr 18, 2017 17:49:54 GMT -5 @asyouwish3 said:

Thanks everyone. My son does not receive any meds yet, which is why I think he left the door open to call if we need anything. I just wanted to make sure that is normal.


Sounds like. Not all kids on spectrum require medication, but as they get older. ADHD (usually a problem in kindie/first) and/or anxiety/depression (depression can kick around middle school when a more self aware kid on spectrum realizes he isn't like the other kids or is bullied as an outlier among an age-group hardwired for conformity) could be an issue. There are also some kids with ASD who start to present with bipolar symptoms around puberty. Learning differences are also more common among kids with ASD- dysgraphia and disordered written expression are very common, some kids struggle with math, dyslexia and comprehension glitches are more common as well. These are all reasons to leave the door open. 

I just feel like it's a life long dx and I'm not sure (if any) who we would see for it.I suppose if we need meds one day we would start at pcp then a psychiatrist.

I would not trust a PCP with psychoactive medications. Generally a child psychiatrist would be the best choice for such meds, but a really good dev pedi might make better sense if the psychiatrists near you aren't familiar with meds for ASD. Unfortunately, where I live the best people don't take insurance, so we pay OOP for the psychiatrist as we did the dev pedi and psychologist when DS was younger.

[anintrovert]

My son's presentation is relatively mild. We see the DP annually. He was Dx at almost 4 and his 8.5 now. Some visits are just a check in and we don't need much. However, I like having her as the overseer. She sometimes catches the overarching issue where everyone else is just focused on their piece.

We REALLY needed her when everything sort of fell apart in Kinder. My son was NOT receiving an appropriate education and having her write a letter was very helpful. Between that letter, my documentation, and bringing an advocate we were able to change schools to a MUCH better fit within a week of our meeting.

I also have access to her social worker. Her SW gets me referrals and lists of specialists when needed. Especially in the early days after Dx she pointed me in the directions of quality resources.

Based on the forms I just got back from his teacher I'm expecting a co-morbid of ADHD at our appointment next month. I want the DP on my team if we need to go the meds route. Oh and she actually IS covered by insurance. My sons psychologist could do the diagnosing of ADHD and I trust her but she does not take most insurances and she can't work with us on meds we'd have to find a psychiatrist. Like MrsB most of the reputable psychologists and psychiatrists don't take insurance or only take limited insurance. They definitely don't take my insurance which has a reputation of low-balling mental health professionals.

I have to call about 4 months ahead to get an appointment but it's worth it.

[mrsbuttinski]

anintrovert, agree with the dev pedi being a big stick when advocating. I got a lot more distance from the MD than the PhD at the IEP table.

If you do need meds at some point, the psychologist can likely refer you to the best psychiatrist in your community for meds management. DS's psychologist referred him to the psychiatrist who is just terrific- so great I sent my niece to him as well when she moved in with me and I recognized the family ADHD. When my mom stayed with me last fall, I tried to send her as well but he doesn't see patients over 75. His colleague agreed to see her after an extensive interview. You think getting mental health providers for kids is hard- try the elderly.