Dr Sarah Olitzky - Educational Testing

Sarah Olitzky, PhD joins us to discuss educational testing for your student, what, where and when. 

Transcript

SPEAKER_04: 0:01

Okay,

SPEAKER_00: 0:02

well, I'm sure we'll get a couple late joiners, but we can get started. Oh, speaking of late joiners... All right, so I'm pretty excited. This is the first like access talk and I'm even more excited that we have Dr. Sarah Olitski to do our presentation tonight. Dr. Sarah is a graduate of Columbia for her undergrad in Spanish and psychology. She has a PhD in school psychology. She is a licensed school psychologist and child psychologist. She has fellowship training from Fraser and from the University of Minnesota. And so I'm going to let her get started so she can have all her time and then we have plenty of time for questions. If you want to drop questions in the chat and we'll hit them at the end. Dr. Sarah, it's all you.

SPEAKER_03: 0:57

Okay, hi all, it's all me and hopefully me and my technology skills will make this work okay. While presenting to groups of people is not my favorite, helping parents navigate some of this testing land and landscape and options is my favorite. So hopefully we'll make it work and I will find the balance of making this helpful for everybody today. My goal today is to give you some beginning information and then leave time for specific questions because I imagine Most of you who joined today have some specific questions more related to your children or other people in your life who you care about, specific curiosities about the systems or various options for evaluation. So you heard a little bit about me. I'm gonna share a little bit more just to give you context in terms of what things I do in the world or in my professional realm and also my personal life that give me some insight into options for evaluating kids or, you know, the term is evaluation. We're going to talk about different places where you can be evaluated, different things that are involved in evaluations, different types of tests. I like to think of it also pretty broadly as just getting more information about some questions you have for your kid, right? You have questions, you're curious, maybe concerns. A lot of what I'll focus on today is our most, all of what I have planned for today, and we can address specific questions otherwise at the end, is when you have a concern or when you have questions about something that you think isn't quite right or some area of support that your child may need or how to support your child in a different realm. So I think I'd like to think of these evaluations just getting more information that you can't get or to kind of double check in a more formal way, get some different opinions, get some data to kind of help your planning for your kid or your school's plan for your kiddo. So as was mentioned already, I'm a licensed school psychologist I'm also a licensed clinical psychologist. I've worked and currently work in lots of different types of realms and systems. I work in schools primarily right now. I also still do some clinic-based outpatient assessment, although only on a small basis. I did years of nothing but autism evaluations at Fraser. Also a little personal context for this is I have four kids of my own, two of which have ADHD, one of whom I've had taken for a neuropsych evaluation in a clinic-based setting, the other of whom has a medical diagnosis and a 504 plan. We can talk about some of the differences between special education IEP services and 504 plan accommodations, if that's something that's relevant to people's questions or concerns. So I'll try to bring in some examples from my day-to-day work life and just sharing a little bit about my own life and children to let you know I've been the professional in both of these types of evaluations and as far as the clinical evaluation, I've been a mom in that scenario too. And it wasn't the first place I jumped when I was looking for questions. So happy to share a little bit about that too. So ideally today, the goal is to focus on two different places where you can get testing done or evaluations completed in the school system, in the educational system, and then also within the medical model in a clinic-based system. So a neuropsychologist, neuropsychological tests, testing with psychologists, neurodevelopmental evaluations. There's some minor differences between those terms, but for the purposes of what we're talking about today, they're within the medical model and can address a lot of the same concerns, no matter what it's being called or who exactly, which type of psychologist exactly is evaluating. So I want to look at the two different types of evaluations, what each might involve. You'll find, you'll hear, there's a lot of overlap. What can the results of either type lead to? And then how might you go about deciding if one of those is right for your kid right now or in the future? And if so, where would you like to start? All right, so what's the difference between the two? So I'm going to start with school-based evaluation. So broad picture, school-based evaluations are free. They're something that a parent or a school can initiate. And a parent request typically results in a school evaluation an evaluation initiation, legally schools have to respond to a parent request. They don't necessarily legally have to give an evaluation or do an evaluation. Typically schools will do them, but if they're not going to, or they want to do a few interventions or address some concerns first, they have to respond within writing within a specific legal amount of time within the timeline designated by the Department of Education. A school-based evaluation is something you would seek if you are a parent who has concerns about your kid and at least one of the places that you have concerns is in school. So if you are a parent who, you know, they're great at school, you hear nothing but wonderful things at school, they're getting all their academics done, they're getting their homework done, and then they're just falling apart at home, right? This would not be the time to do a school-based evaluation because truly the purpose of a school evaluation is to consider whether or not whatever is going on with your kid, what other challenges or whatever patterns of strengths and weakness your child is showing at school is significantly impacting their ability to function at school, either academically or socially or behaviorally, to the extent that the child requires support or would benefit supports through an individualized education plan to be able to address some of those concerns. It can gather... some information when you have concerns in like the rest of the world and school. A school-based evaluation can be helpful because you can get some more real life in vivo data at a school-based evaluation. When I'm doing an evaluation for a kiddo, let's say an autism evaluation for a kiddo in a school, I can observe a child at recess. I can observe a child's social skills in unstructured settings like lunch. I can observe a kiddo in more structured settings like school. When I'm doing an autism evaluation in clinic, I'm relying primarily on parent reports, sometimes teacher forms and reports, and then what I'm able to create in terms of a social scenario for a child within clinic, which does not involve a whole bunch of other kids that they know or have relationships or friendships with. At the end of a school-based evaluation, it's determined whether or not a kid qualifies for an educational classification, not a medical diagnosis. So often when I talk to parents, I talk about about there's kind of two silos of supports or inquiry. One is within the educational system. And if we think about it and we're honest about it, a lot of it has to do with kind of funding and what keys get you in the door to access what funding and what supports. So within schools, if a child qualifies for an educational classification and they can therefore move into special education supports with the individualized plan, that's kind of the key to the door to access the funding and the support, the services, the staffing that's involved in getting a kid a really individualized plan that then has regular goals and data and progress notes and progress reports and regular feedback and meetings with the team that includes parents. Whereas a medical evaluation or through a clinic-based results in a medical diagnosis that then is kind of the key in the door of kind of things that insurance would pay for. Medical insurance demonstrates medical necessity if there's a diagnosis and or a medical diagnosis may help lead you towards figuring out where outside of the school system in therapeutic terms you would seek supports or specialization from a provider. Any questions about the school-based evaluation there before I move on to a lot of what I already just said in terms of the comparison for the neuropsych evaluation. Okay, I'm moving on to the next one. So a clinic-based evaluation is depending on the clinic, depending on the question, depending on your insurance may be covered by your insurance, maybe private pay. And it's conducted in a medical setting or a clinic setting, outpatient setting by a licensed psychologist or a neuropsychologist, developmental psychologist, depending on the question or the clinic. And like I mentioned before, it's focused on identifying a medical or a psychological diagnosis, and it can guide the treatment. It's not always more thorough. I hear from a lot of families like, oh, we're going to start with a neuropsych evaluation or a clinic-based evaluation because we heard that they're more thorough. It's not always more thorough. Sometimes it's different. Where it can have additional elements that a school evaluation might have, I tend to see more, just anecdotally, I tend to see more in some direct assessment of attention. So there's some computerized based attention, memory, impulse control tasks that are often done in clinic-based evaluations, but not done in school-based evaluations. There's a more typically, a more complete, what I would call a diagnostic assessment. So going through into more depth of diagnostic or developmental history, more full jumping into questions about anxiety symptoms, depression symptoms, going through a lot of different mental health elements. I would say largely though, a lot of it is pretty parallel. I do evaluations in both places and a lot of what I'm doing in both settings is pretty similar. If a kiddo qualifies for a medical diagnosis, that is often kind of a key into the door, like I said, for insurance-based treatments, day treatments, therapies, or something we can talk a little bit about, A little later, a 504 plan, which is specifically accommodations, not services, which an IEP can get for you. I'm going to move on to the next one. Like I said, there's a lot of overlap. I would say typically an initial evaluation in a school setting, and then for sure in an outpatient setting would include cognitive testing or IQ testing. That allows to see if there's any patterns of strengths or weaknesses. When a school or a therapist or family is planning for how to support a kid, what strategies to use, how to help the kid build upon their strengths and their areas of big success, IQ testing can be helpful. It also helps rule out that if a kid's having trouble understanding things or coping with the world, helps rule out whether or not low IQ or difficulty learning things or retaining information within kind of the normal range might be one of the reasons that they're having coping challenges or melting down because maybe they're just not understanding or maybe it's not a learning disability. Maybe it's that overall their development of cognition and learning is lower. Both typically include academic achievement. I would say for a clinical evaluation, if you don't have any concerns about academics, you're just curious about anxiety, depression, ADHD, it may not include academic achievement, although often a psychologist would like to see how a child approaches things that might be hard for them. And if things like puzzles in cognitive testing versus reading, writing, math, and academic testing might kind of trigger more of the anxious symptoms or can be observing more of what you might be worried about as a parent in different types of tasks. Speech and communication can be requested to be part of the evaluation in a school, because the school evaluation is done by a multidisciplinary team. It's not just the psychologist. Psychologists will typically do the cognitive component, the behavioral component, executive functioning, so like some attention, working memory, behavior rating scales and observations, autism evaluation. But then there's typically a teacher on that team in that case of a school evaluation A special education teacher trained in academic testing will do academic testing. You can bring, if there's concerns about communication, either articulation or understanding language or producing language or social communication elements of language, a speech person at the school can be brought in as part of that as well. There's also often an occupational therapist that can be brought in as part of evaluation if there's questions about sensory concerns, sensory differences, needs for fine motor supports, such as writing or developmental skills, like tying shoes or getting self-care skills, like getting themselves dressed or getting their snow pants on or things like that. Both typically involve parent and teacher rating scales. I would say sometimes clinic-based settings that I see come through my desk don't have any teacher rating scales. And so I would say if you're a parent who is seeking a clinic-based assessment i would advocate for the opportunity to have the teachers provide some information because otherwise everything that the psychologist is basing you know information or observations about what the kid is like outside of that little box of the testing scenario becomes just your opinion or your observation i think the more observations opinions amount of information of how a kid is looking in different types of settings can be really helpful. Okay, I think we've gone through most of this. One thing I do wanna touch base on is something that is different in a school-based evaluations is typically a school before moving on to an evaluation should and ideally has implemented interventions around areas of concern. So if you are a parent who's thinking, gosh, I'm worried about X area of functioning at school, and I've called the social worker and they're not really doing much of anything, I wanna just request an evaluation. You can do that. I would encourage you to ask, what are the interventions being done? Can we have a meeting? I want to see some data. What are you doing? Is it helping? Is it not helping? That type of data, if your child can benefit from those types of supports within the general education frame and the school is providing those types of general education supports, which they all should be well able to do, it's helpful to get that information ahead of time. And there are lots of kids within the range of normal who can benefit from little tweaks in the general education scenario that don't need special education level supports and then in school-based evaluations often instead of only doing like a big standardized assessment that is not specific to their school or their curriculum they'll do a standardized academic assessment and also go through grades in comparison to other kids at their school. If it's a specific kind of school, like an immersion school, they'll be able to reflect upon various levels of language acquisition that your child is doing compared to benchmarks and how that may or may not be impacting their academic achievement or their acquisition of skills within school. And they can do what's called like curriculum based assessment. So based on the benchmarks of what they're supposed to be learning in school, according to the curriculum of their school, how are they doing? And sometimes that information is different. They may be more or less on track according to the benchmarks of their curriculum versus a big nationally administered and standardized academic assessment. RTI is a big term. for like response to treatment intervention. That's what I'm talking about in terms of different stages of interventions before moving into an assessment where parents and school want to consider whether a child has a specific learning disability through a school evaluation. The school should have data points across two different types of interventions across at least six weeks of each intervention to show if on top of what's happening in the regular classroom with these kind of pullout or small group interventions, maybe one-on-one intervention for the second phase of interventions to see whether or not the child has started to kind of close the gap between what's expected. And that is, I think, an ideal way to be looking at whether or not a child has a disability or if they're just behind and need a little bit of a different way to teach. I'm

SPEAKER_04: 18:43

going

SPEAKER_03: 18:45

to do this. clinic-based assessment. I think I mentioned already that they might go more into the mental health components, the computer-based assessment. And typically in clinics, if you have a question about learning or potential learning disability, they are using what's called a discrepancy model. So is there a big difference between IQ and what their academic achievement is in the area of concern. So in theory, like if there's an average IQ and a low reading, they might call that a learning disability because in theory, we would expect that based on IQ, they should be able to achieve up to a similar level of learning and reading. And if they don't, if they're low, they may call that a learning disability as opposed to in a school, schools are moving more toward a model where if after interventions, evidence-based interventions, child's still not closing the gap, then you can consider a classification for a specific learning disability. I am happy to send this out later. This really is a visual because I love visuals, but I don't want to spend time going through each of these because really I've talked about them all, but I'm happy to share this out for anybody who's interested to have a visual to look at moving forward or when they're sitting and reflecting on any of the information. All right, so which one's right for my kid? Before I move into this, I just want to... remind everybody, reassure everyone, share with everybody, I guess, my professional opinion and somewhat my personal opinion that there's lots of ways to get to the same point, right? You have questions about your kid. There are lots of people who can help you answer some of those questions. You may get some answers in one way, other answers to another type of evaluation, other answers through therapy or trial and error, or knowing other parents who have similar kids and hearing their story. I think often as parents, we're like, okay, what's the, I don't want to make the wrong step, right? So really, I don't think there's any one right way to get there, right? You can go about gathering information What's the worst thing that can happen if you start a school evaluation? Your kid gets pulled for extra testing. It's kind of annoying. They may wonder what that's about. You get a lot of information and they don't qualify, right? And then that information can be used within the general education setting. Or you take them for a neuropsychology evaluation and nothing was identified, or things were identified that you didn't expect. You've got a whole bunch of other information. Of course, the cost, if it's private pay especially, pretty sizable. That's why some families choose to start with a school-based evaluation, just to get some of the initial information covered if, in fact, some of the concerns are showing up at school. So I would say, kind of like I mentioned before, if your kiddo is struggling significantly at school, so they're functioning either academically, behaviorally, they're struggling at school, it's been going on for a while, Things have been tried. You feel like either the school is just not coming up with interventions and following through or things have been tried and it's not enough. And you feel like the teacher is doing the best she can, but she can't be a one-on-one for the kid in the context of 30 other children. That's a good time to look at a school evaluation. you want to explore the idea of an IEP. So I think it's helpful to be sure that parents understand that what you're doing when you're requesting a school evaluation is requesting an evaluation to determine if your child meets criteria. There's specific areas that a child could qualify under, but meets criteria for one of the educational categories that then links them into the special education program. So special education is not only about learning, right, or kids who are who are slower to learn or have differences in their learning. And I don't like the term slower to learn. I'm using that because sometimes I think many of us from back in our own childhood just think of the kids in special education or the kids who are like slow to learn. But kids who have differences or have a different way that their brain needs to or wants to learn certainly fall into the special education umbrella, but then behavior supports, emotional supports, speech supports, things like that fall under that too. If I would consider a school evaluation only if your child is in a public or a charter school. So these federally funded and legally binding evaluations and supports only exist fully in the context of a public or a charter school. You can request an evaluation if your child's in a private school. So I live in St. Louis Park, let's pretend my kid's in a private school in St. and I want to ask the St. Louis Park District to come evaluate my child. I can do that. They can do an evaluation. They can gather information. It does not then result in an IEP in the same way that it would in a public or a charter school. It might result in being able to offer some consultation to their private school teachers, but then the private school teachers are not legally bound to uphold the recommendations within the consultation. You can still get the information, it's more information gathering than linking to any direct services. Dana has a question. Dana, go for it.

SPEAKER_02: 24:29

I just want to clarify that they are bound to provide special education services in a private school, but it does mean that your child, in order to get those services, will need to get on a bus, leave their private school, and go get those services at the public school. Thank you

SPEAKER_03: 24:49

for the clarification. The private school does not have to provide the services. The district is still legally bound to provide services if deemed necessary. And then the team has to work with the family to determine whether or not it's disruptive or helpful or whatever. So yes, the district still has to provide it, but it doesn't necessarily happen at the school.

SPEAKER_02: 25:13

Right. And so they may tell you that it it will happen at 10 a.m. four days a week, and that might be the time that they're gonna get their language arts minutes, except it's in the middle of math, so then you as a parent need to decide, are they gonna miss math at their private school to go receive their special education reading? So

SPEAKER_03: 25:32

not ideal. Yeah, thank you for the clarification, Dana. All right. I did wanna make one point about the school evaluation. your primary concern or question, or you're pretty sure that your kiddo is, your concerns are landing in the ADHD realm of things. I do not recommend starting with a school evaluation. before anything else because there's a good chance that they will say the kiddo doesn't qualify under any of the categories. But if you want to go get an ADHD diagnosis, there's a specific category called other health disabilities that require a medical diagnosis also. So that's kind of a confusing one if people have specific questions. I'm happy to chat about that too. I'd recommend considering a clinical or neuropsych. you are interested in the medical diagnosis, if you have multiple complex concerns that you feel like require more specialized or clinic-based support services in those specific areas, like trauma, for example. Or if your child has a medical diagnosis that's likely to impact cognition, it's often helpful to have kind of a team, like a traumatic brain injury, a neuropsychologist or a psychologist who's specifically working and housed within a team of a hospital or a medical system that is specific to children with genetic traumatic brain injuries or another example of genetic differences. Consider if you've tried outside support like therapies and you feel like you still have questions, you feel like you're missing something, you're not sure how to help. If your primary questions are about functioning outside of school and if a school evaluation was done maybe they didn't qualify or didn't feel like it really got to the root of it or didn't really come up with recommendations because it's not one of the main goals of a school evaluation it didn't really come up with recommendations or suggestions or strategies for how you as a parent can support your kid day to day in your life in your living um Side note, a lot of families feel, assume, or have heard that if you have a question, if you are curious if your child has ADHD, that really the only way to really figure that out is to go for neuropsychological testing or a clinic-based psychology evaluation. You guys are all part of the Lakes Pediatrics community. You have the opportunity to explore that specifically with your pediatrician, and Dr. Hobbs does more than most pediatricians do. in terms of getting some extra questionnaires and some extra data when considering the diagnosis. If you either feel you're pretty sure your kiddo has the diagnosis or you don't think it's necessary to go through IQ testing and lots of other types of testing in order to at least, maybe you're curious about meds and you wanna know, do they qualify? Would meds be helpful? My opinion is you don't need to go for a full psychological evaluation. For example, both of my sons initially got evaluated or worked with pediatrician. And yes, I have more training and I can watch things in my own kiddos. But we started there. And then one of my children, even with that and a couple of years of medical medication support, we felt like we were just missing something. We need more information on how to support him. Then we went for a neuro of psych evaluation. A lot of families do both because if you have a medical diagnosis, for example, if you want IEP supports, you still have to go through a school evaluation. A lot of times, if you've already done the testing recently in a clinic, they can just kind of file review or summarize a lot of the testing done in the clinic. So your child doesn't have to go through all the direct testing again. I do want to stress that it really does not work well when family initiate both around the same time. Then we're doing the same tests, the same things at the same time, and it can mess with the validity of some of the results. So if they do end up happening simultaneously, maybe you've been on a waitlist forever for a clinic, so you decide to start with a school-based evaluation, and then suddenly you move up on the waitlist, just be really transparent and communicate with both sides, sign a release so that, you know, for example, I could call a clinic and say, hey, I'm doing this IQ test did you already do that last week because we can't do it again the results won't be valid um what happens after each evaluation you have a feedback you get the results either way right one in the school you get a the team meeting with all the different types of evaluators involved speech ote psychologist social worker you get a feedback session usually with a psychologist after that clinic-based evaluation you determine at school Do they meet criteria? If yes, and you want to go forward and you want to say you're never bound after a school-based evaluation, even if your child meets criteria to say, yes, now we want to accept special education. That's another step. You can go through the evaluation. They can say your child qualifies and you can say, no, we're going to decline at this time. So at any point, you have the opportunity and the right as a parent to proceed or end it. If a child doesn't meet criteria for an IEP, often they'll say, well, we've identified these areas of need for supports. We would recommend a 504 plan. I'm going to pause and give a little bit of information about the difference between a 504 plan and IEP. An IEP, individualized education plan, gives you access to services and support and staffing and funding, like I mentioned before, and progress notes. A 504 plan is an accommodation plan. It really is quite parallel to something. It's the same thing that would be same document. So if your child has ADHD and they have a 504 plan, it's the same document. It's the same 504 plan coordinator for the school as if a child were in a wheelchair and they needed to be able to access the building. So in a 504 plan, the accommodation would be that the school has to have ramps, that the child has to have seating and the ability to come right up to the front of the room, that there has to be certain opportunities for bathrooming and things like that. And if a child has a 504 plan for something like ADHD, the concept is that it's an accommodation or an adjustment of the general education setting, like extended time or preferential seating, seating toward the front of the room or maybe like sending an email home so that the parents know what the assignments are, if the kid's not likely to remember it. There's no change in services. There's no direct supports for a 504 plan, typically. It's something that's offered to kind of adjust what there is already. Okay, I am definitely over time, I think. So I'm going to open it up to questions. One other thing I just want to ask parents to keep in in mind when they're thinking about evaluations is that there's a range of normal. I think a lot of times families were looking at, like myself included, like, oh my gosh, I'm worried about this. Do we need to have an evaluation, right? So starting with interventions outside of school, like therapy or parenting supports in school with interventions that the school is able to provide allows your child first to live within the range of normal with some extra supports and not jump to an evaluation. not need to or it may not be appropriate to call it something. It may just be how your kid is and what they need. And keeping in mind the wait times right now for clinic-based evaluations are pretty notable in a lot of cases. So often it's helpful to get on more than one wait list and then continue with other interventions or supports while you're waiting. Okay, I talked a lot. I would love to answer any questions anybody has or explore any curiosities people have as part of this conversation.

SPEAKER_00: 34:16

I'm sorry, you can unmute yourself yourself to ask a question or you can type it and I will ask it for you. I have a question while people are putting theirs together. I often hear from parents that the school said they recommend their kid get evaluated. And I'm always confused, like, well, why doesn't the school just evaluate them if they've got a concern about their academic performance? Can you touch on that?

SPEAKER_03: 34:43

Yeah, I think a lot of times the recommendation for evaluation comes from a teacher. For example, at child teacher conferences or something like that. If your teacher says that, I would recommend speaking to the director of student services or the school psychologist in the school or the social worker to get a sense of, have any of these concerns from the teacher been brought to the student support team? Have they looked into any of that? Do they recommend an outside evaluation? Would it be appropriate for a school-based evaluation? I also think a lot of times teachers are saying that if they think a kid has ADHD, to be honest, if they're having a hard time sitting still or paying attention or whatever the reasoning would be so i think that's more more likely in that case

SPEAKER_00: 35:36

and i also hear from parents that the school says that their child has to have neuropsych testing to get any kind of accommodations at school can you speak to that

SPEAKER_03: 35:52

um I can. So in order to receive accommodations at school, a child typically needs a medical diagnosis. So as I mentioned before, neuropsych testing is the only way to get a medical diagnosis. So from my perspective, if pediatrician can give an adhd diagnosis and documentation on paper and a little bit of information about how it impacts the child i would say that then a 504 plan is still appropriate because there's a documented medical diagnosis

SPEAKER_04: 36:31

I

SPEAKER_03: 36:33

do hear from private schools more often, like, okay, well, in order for the kids to have an accommodations or not exactly an IEP, but any type of specific support plan that they need to have a neuropsych evaluation, legally, technically, that's the school's prerogative as a private school that doesn't take federal funding. At least that's my understanding. Dana will have a bit more expertise on that, I think. So correct me if I'm wrong on that, Dana.

SPEAKER_02: 37:02

You're correct. A lot of private schools, especially in the Maze group, so that includes Blake, BRAC, Hilichur, OLG, SPA, they are all requiring neuropsychs in order to give accommodation plans.

SPEAKER_03: 37:24

And Dana, are they specifying neuropsych or to them, is there a difference if it's a neuropsychologist versus a psychologist?

SPEAKER_02: 37:33

No, no. So when I say neuropsych, an evaluation, but they, depending on the school, some are accepting a diagnosis, just a medical, not just, but a medical diagnosis from a pediatrician and some are not accepting a medical diagnosis from a pediatrician. St. Thomas, I know, does not accept a medical diagnosis from a pediatrician. So I think it just depends on the school.

SPEAKER_00: 38:12

Other questions? Otherwise, I'll keep asking them.

UNKNOWN: 38:18

Okay.

SPEAKER_00: 38:20

I often hear that psychologists don't like it when pediatricians just do Vanderbilts to make an ADHD diagnosis. What do you guys think about that?

SPEAKER_03: 38:34

I can tell you what I think. It's not my preference. And you know this because we've talked about this professionally also. It's not my preference because it feels like it's just... I mean, it is just kind of one checklist and it's the checklist of the diagnostic criteria, I believe. So it seems like I never like to base a diagnosis or a school classification based on one type of data. And to me, that's one type of data or one way to ask the questions.

SPEAKER_00: 39:14

That's helpful. I don't see a lot of other questions popping up. Do you have any final words for everybody so we can let people finish at 7.45?

SPEAKER_03: 39:24

It's pretty specific. It's not a broad thought. But I would like to touch on this last bullet point where I have the question of likelihood of diagnosis or educational classification in the process. I'm curious if other people have real-world or professional experience, the people who are part of this conversation or who are listening in, if they have different experiences. I would say that it is fairly unlikely. It seems very uncommon. I can think of one time I've seen an evaluation come across my desk where a child had a clinic-based evaluation and did not leave with some diagnosis. There's lots of, and we could hypothesize all day long as to why, but I like for parents to keep that in mind because while you're looking for information and while you're wondering if there's a diagnosis, typically people, you know, we're all looking for answers to questions. And I think that it is very likely that a child who comes for evaluation will have some sort of diagnosis afterward. So if you're not ready, for that or you think there's a fairly good chance that it's nothing and everything is typical you just need to be reassured keep that in mind when requesting the evaluation or and or even say to the clinician providing your diagnosis that you're comfortable with they're not being into your evaluation you're comfortable they're not being a diagnosis if it's nothing you want it to be nothing like please consider the fact that it's their injured normal just to put that out there I think it's more common that a child who has a school-based evaluation from parent request does not qualify. I'm not saying most of them don't qualify. I'm saying that there are many who don't.

SPEAKER_00: 41:25

Great.

UNKNOWN: 41:26

Helpful.

SPEAKER_03: 41:27

oh i see a question can children be on medicine

SPEAKER_00: 41:32

let me look at this i gotta click i can read it for you can children be on medicine and still be diagnosed after already having an adhd diagnosis Yes.

SPEAKER_03: 41:43

So if they have a day, well, if they're on medication, they have a medical diagnosis in their paperwork from the pediatrician. So in order to provide medical or a prescription, pediatrician has to document an ADHD diagnosis or diagnosis typically. So in order to then go for more information about maybe how the ADHD is affecting them, strengths and weaknesses, yes, you can still do that. It varies from clinician to clinician if they want to see the child on medication for testing, off medication for testing, or one day on and one day off. So different clinicians have different approaches to how to manage that. I'll say that when my son went for ADHE or for a clinic-based evaluation, they asked for him to stay on his medication because our goal was to see what on top of the medication, like what are we missing? What more can we do? So we started with his baseline I didn't have any question. There was no question whether or not he had ADHD. So we worked with the assumption that he had ADHD. He's getting the support. And then in those moments, what more is showing up? Does that answer

SPEAKER_01: 42:58

the question? Yes, it did. Thank you. That was kind of what I was wanting to ask was, is it good to get my child tested above and beyond what the medication helps with?

SPEAKER_03: 43:13

Yeah, I would say that would be, you know, of course, child specific. But if you feel like, okay, well, we've got the medication, it helped a ton. But now what? Is there something else we can do? What are we missing? You know, what are the strengths and weaknesses that we can play to or skills we can build past that?

SPEAKER_00: 43:33

And I would say clinically what I've seen is I've gotten more kids in my practice with issues and challenges is there's a lot of kids who have a little bit of a couple of things, right? They have ADHD and anxiety and you treat the ADHD, but the anxiety is still there. And so that isn't always formally evaluated when they're getting an ADHD workup. So sometimes they go back and do some assessment around that area also, or vice versa. They've been worked up for anxiety and that that's treated, but now they have some ADHD symptoms that everybody thought was related to the anxiety, but they didn't work up the ADHD when they were working up the anxiety.

SPEAKER_03: 44:12

And that's when I, that's one of those like bullet points. If your child has multiple complex things or multiple, you have questions about multiple potential areas. If you, you may have one area, you think you're pretty sure, you know, meets criteria for this, or this is a good way to explain some of what's going on for my kiddo. Now they're older. What are we missing? A clinically based evaluation can often help tease out if there's something in addition or if this is still related to the other or to the original diagnosis.

SPEAKER_00: 44:45

Great. Well, any other questions? Otherwise, we'll wrap it up and I'll thank everybody for attending. And we got the first one done. Two weeks we'll be doing. Wait, let me look. I forgot what the next one is. If you're so interested in two weeks, we've got it's Kendra Mueller talking about back to school sleep on August 6th. And I'll send out a notification soon if people want to sign up for that. Hope everybody has a great night. Otherwise. Oh,

SPEAKER_03: 45:12

thanks, Al.

SPEAKER_00: 45:13

Bye.