I initially made a post on 9/12/02 to ask if anyone else had been required to complete a neurological exam because the child study team would not accept a diagnosis of ADHD from a psychiatrist. I wanted to tell you what happened. I am so disgusted!
My son went ahead with the school’s request and they scheduled the exam on Columbus Day. We were terribly concerned when their neurologist asked us why we were there. She really didn’t know - seems that the case manager forgot to provide her with that info in her fax. She also failed to provide the MD with the info where the completed report was to be mailed! So the doctor asked me to please call her office manager with the name and address of the case manger.
The neurologist examined all of the independent assessment records I had brought and all of the results of his pediatrician’s work up. She made photocopies of everything and said I was most helpful. Then she realized that she was running out of time and had a waiting room full of kids sent by different districts to be evaluated.
The physical exam consisted of me providing her with his height and weight - no scale or examination table in the room. She asked him to get out of his chair, walk a few steps, bend and then hop on one foot. She listened to his heart and lungs, felt his neck, checked to see if his pupils reacted to her flashlight and that was it. She never tested his reflexes or any of the other things that neurologists do. It was time to go - her report would be sent to the social worker in 2 weeks.
Hmmm? What in the world was going on! – When I finally got back my copy of the report there were descriptions of tests that’s that were never performed and low and behold all of the results were normal. I was on the phone to the Director of Special Services and the case manager that day following up with letters – that there must be some mistake – this must be another patient’s report because she never did any of those parts of the exam. The case manager’s response was “Well maybe they were not necessary.” She instructed me not to write the doctor – she would handle it.
Today I got a letter from the case manager that “states the Director of Special Services has spoken to the neurologist and has determined that the assessment was appropriate. Thus it has been decided by the child study team that the neurological assessment completed on October 14 is appropriate for educational purposes”.
What would all of you do? I am so mad I could spit. I plan to ask for an independent evaluation – but how would you answer that ridiculous statement that the assessment is appropriate for educational purposes. Oh, by the way the deadline for the inital evaluation was two weeks ago.
I look forward to your replies.
Re: Special services says bogus neurological exam is appropr
As I’m reading your experience, my blood pressure is rising. I have been through a very similar experience on more than one occassion and I feel for you. The experience you have been through is maddening, I know.
Briefly, the whole “adequate for educational purposes” thing is hooey. I’m sure you put this all together that the person they sent you to is supposed to NOT find as many cases as possible; that is the goal. Because if the school finds it (including the specialists THEY recommend ) then they have to address it at school with the IEP.
So basically with this diagnosis (or lack there of) the concerns you or the school have about your son are unfounded and do not inhibit him from receiving “educational benefit” (one of those key law vocabulary terms) from his existing environment. Therefore the school believes they are providing your child with FAPE.
I learned from the whole neurologist experience and then stopped the special ed administrator in her tracks when she tried to do this again with the audiologist.
I got one step ahead of her this time. We are concerned that my son’s attention issues are not ADD but an auditory processing deficit. At his re-eval I stated that this is the additional info I believe we need. The SPED administrator said, fine we will have OUR people that we use do the eval. But she insisted that this audiologist has NEVER found a case of auditory processing deficit. Hmmmmm, very curious I thought.
So I called this audiologist. He told me that he only does a SCREENING and if he thinks there is something suspicious, he will refer the case out to someone who can ACTUALLY diagnose CAPD.
Why the heck would we go through all of that and get no diagnosis? (((Ah, the ol’ school district filtering system.))) I went back and told the SPED administrator what I found out. She was not very happy with me for researching this myself. But I refuse to go through what she put me through before.
Turns out there is only one audiologist in our area who is qualified to diagnosis CAPD. (((No wonder their guy has never found any cases, he doesn’t have the qualifications to do so, but this is who they use for such referrals.))) Basically, he is the filter to keep referrals and costs down but he is not qualified to make the diagnosis nor can he adequately address our concerns.
I told her I wanted to go to the person who is qualified to dx CAPD. Since she knows that I know whats going on now, she agreed.
Do all of the research yourself and stay one step ahead of them. You have had the bad experience and I have to warn you all of your other concerns will probably be handled the same way unless YOU know whats going on.
Definitely ask for an independent eval and ask for the list of people they are going refer you to. YOU do the calling and interviewing and make the decision who your child will see.
Or take the long shot and tell them exactly who you would like to see even if he’s not on their list; but be prepared to back your decision with your research.
Most importantly, do not settle for this, especially the inadequate report from the dr. Go with you instinct if you think it is worth persuing.
Best wishes
Standard neurological exams given by some physicians routinely fail to spot subtle neurological challenges associated with some cases of ADHD, dyslexia, and so on. The exams at times are looking for major anomalies and can frequently miss moderate and subtle anomalies. In some situations, it is believed the physicians are under a kind of pressure to pass/fail the patient where there is a higher reward associated with overlooking moderate and subtle anomalies vs reporting them. It’s also known that some physicians tend to feel that they can’t do much about some moderate or subtle anomalies so why should they report what they are unable to remedy.
There are many honest physicians out there who can spot the moderate and subtle anomalies and will candidly admit that they may not be able to do much about them other than to note them in a neurological exam. An honest physician is always better than any other kind. That’s my opinion.