Treatment Help, Part 2
Finding a Specialist
When faced with a pediatrician who keeps telling you there’s nothing to worry about, you should probably request a referral to a specialist in child development and behavior, so your child can be fully evaluated. Depending on your financial situation and your health insurance, you may prefer to locate a specialist or clinic on your own and make the appointment yourself. But if your health insurance requires a referral from your primary-care pediatrician, as many plans do, remember that you are completely within your rights to request it.
A reliable place to look is at the nearest children’s hospital or major university medical center. Most metro areas should have at least one or the other, if not both. There will be a Pediatric Developmental Assessment Clinic at either type of facility. If you’re looking for a recommendation to a certain type of specialist, and your pediatrician can’t or doesn’t provide one that satisfies you, try networking. Ask an official at your child’s school or a neighbor with a child who has learning differences, or someone else you trust who has experience in developmental issues.
It won’t take long for you to discover that there is a broad spectrum of help available. There are many kinds of specialists—with different training, different orientation, different assessment tools—who can offer you different kinds of information.
Some may be more oriented toward practical, everyday function, others more attuned to recognizing syndromes and making diagnoses. You can find experts in a school setting or at a medical center, working alone or as part of a larger organization.
Early intervention (EI) programs, federally funded services for children with developmental needs in the first three years of life, are available in every state. For children under age three, your insurance company may insist on an EI evaluation before it will pay for any other kind of testing.
Another option is to pursue a school evaluation, either because you think it will help provide some answers or because your insurance company requires it or because the school usually covers the expense. School evaluations are often reasonable places to start, but we offer several cautions:
- Waiting lists can be long.
- The quality of the evaluators varies immensely.
- There is no guarantee that any one of the evaluators will have experience with the needs of the quirky child.
We have heard parents complain about school evaluations that seemed rushed, or superficial, or focused on fitting every child into one of a few categories. On the other hand, we have also worked with plenty of gifted school-based professionals who have helped many families enormously. The school-based perspective can direct the evaluation specifically at learning issues that are vitally important for children.
Bottom line: Although you may need or want to start with a school evaluation, and it may yield valuable information, you might need to go further in your quest.
Managing the Maze
As you move through this maze of experts, your job will be to track and evaluate the information offered and to make important decisions about when to look further and when to pause.
Understand the cast of characters. Ask the specialists you see about their qualifications and their particular fields of expertise. It’s important to know whether you’re dealing with a neurologist or a neuropsychologist.
Even if you aren’t completely sure how to integrate the specialist’s background with the assessment and the advice you receive, your pediatrician and the other specialists you see may better understand the opinions you’ve already collected if you can fill them in on who was doing the evaluating.
Talk! Ask questions! Take notes! Some parents just don’t, or can’t, get their questions answered in detail by the professionals evaluating their child. Sometimes this happens because there are still tests to be scored or conversations that need to take place among members of the evaluation team. At the very least, you should come away knowing when you will hear and how you will hear assessment results.
This article comes from the October/November issue of ADDitude.
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