Getting Diagnosis for Four Year Old

Updated on September 09, 2010
M.H. asks from Mount Juliet, TN
9 answers

last year we took my daughter to a pyschologist and she was dx with a sensory processing disorder. we have since been taking her to occupational therapy and seen great results.
i want to take her a child development doctor to get an updated diagnosis though, we suspect adhd or odd. any referals? we have good private insurance but if anyone knows of any state help that would be great too. i know early steps ends at 3 years old.
also, when she enters kindergarden what would i need to do to get therapy in school? does anyone know what they offer for a child with spd and we suspect she is adhd. would a private school be better for her.
thanks. any advice would be great.

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So What Happened?

thanks for the advice. i found a very good child development doctor about an hour from our home i am going to take her to. my sisters speech therapist in pa referred me to him and she lives in pa.
i am also going to start calling the school district just to see what they can offer. we live in florida and i have never been pleased with what i hear of our school system but i am going to do the best i can.
we have been taking her to occupational therapy for 8 months, that is the sensory integration treatment for spd. we have put a lot of effort and money into it and seen great results. i just want to do all i can.
have read several books on spd and autism but i am going to pick up those recommended books on adhd. i am add and my husband is adhd so this will help our family a lot!! thanks. keep the advice coming.

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E.G.

answers from Atlanta on

Hi M.,

Talkstotrees is absolutely right. In support of that, here is a website that may be of help for you. By the way, my first-grader has ADD. She takes a medication for it, and she is doing well.

http://florida.schooltree.org/public/Pre-Kindergarten-Ear....

E.

More Answers

E.A.

answers from Erie on

Check with your local school district to see if they have an early intervention program. They will do all the necessary testing and when it's time for her to enter school , they can guide you through an IEP or a 504 if either is necessary.
As far as private vs public, if she requires services and accommodations, they both have to provide whatever the IEP or 504 requires.

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M.R.

answers from Columbus on

A lot of questions!

First, you should contact the nearest children's hospital and get an appointment with a Developmental Pediatrician. This will take many months before you will be seen. Call your insurance company to see if you need a referal.

The diagnosis of SPD will not be recognized by the school system under IDEA. It is not included in any of the 13 categories underwhich she could qualify for services. It may be consisdered as a related service need (for OT) if she has a qualifying diagnosis and needs special education serivices (she must have both a dx and a need to qualify under IDEA.) She will only qualify for the related service of OT if she qualifies for special education. Her need for exculsive OT, even if very great, will not qualify her if she does not have a diagnosis and is still making the grade in school. Many people missunderstand how this works, including doctors and therapists who will tell you that she qualifies. It is not that simple.

If you think that she has ADHD, that is a diagnosis that qualifies for special education under the category of OHI (other health impairment) IF the child needs special education, which in turn, would mean that if she had a need for OT she would get it.

It would be rare for a child with ADHD (unless very severe) to qualify for services prior to kindergarten. While they are not supposed to limit according to dx, they do, and they get away with it just fine, even if they are not supposed to, that is the reality of how IDEA works.

If your child is very bright, and is otherwise doing well in school, she may not qualify at all, no matter what the diagnosis is or what her doctors and private therapists say. If this is the case, and she does not need special education, you will be providing all the services she needs for her disablity, and the choice of public or private is dependent on your situation, and what is available to you. If she does qualify for public school serivices, you will still have to provide private services to maximize her potential, because the public school will assume some, but not all, of this responsiblity. The public school is required to make her "functional" in the classroom setting, you are responsible for maximizing her, or not, but you cannot get that from the school unless they decide to give it to you (rare, but not unheard of.) Chances are that the level of public services will be somewhere in between functional and maximum, but you need to know what maximum is so that you can provide the rest.

If your child is functional in the classroom, you will likely not find her offered special education services until you can prove need, usually at the end of the third grade when they take a State assessment that the school cannot manipulate to deny services. Almost every other assessment can be manipulated by school districts who want to do so, such that your child will not meet the second half of the requirement "educational need." This is the most common conflict that parents with high functioning children face when trying to access public services through IDEA. Being ready is essential. Start reading about advocacy at www.wrightslaw.com to find out how to navigate the system.

You can also, right now, get the school to evaluate your child. Do not put off the private evaluation, you should hold and own the evaluation that contains your child's diagnosis, and you should never know less about your child than the school does. Use your private evaluation to keep the school honest. You are using the correct langauge by saying that you suspect ADHD. If you write to your school district and request an evaluation, by saying that you suspect that your child has a disablity, ADHD, they are then obligated to evaluate her. Read about that process at wrightslaw too.

Dr. Mel Levine and Dr. Russel Barkley are terrific resources for you. They explain ADHD and give great strategies that will be helpful.

Good luck,

M.

Just a quick note, as an educational advocate who deals with IDEA everyday, I can say without any doubt that you will be very disapointed if you put your child in a unalateral private placement and expect to get the school district to pay for it. This almost never happens, and if you go about a placement in this way, it is already been deemed to be unreimbursable by every circut court in the country. Get on wrightslaw and do your due dillegence. The system is far more complicated than most people realize, and while there are good services to be had, you need to know what you are doing to get them. First thing is to learn what the myths are.

Another quick tip: Do not call the school. Write the school to request evaluation. If you call, they can say they will, and then not do a darn thing and get away with it. If it did not happen in writing, it NEVER happened. This is one of the very first rules of advocacy. If you want something, put it in writing. Also, if someone calls you, get their email address and send them an email as soon as you get off the phone that summerizes the entire converstaion, at the end of the email write the following: "If I do not recieve written confirmation that I am inaccuate (by date/ 10 school days forward), I will assume my understanding is correct." You are letting them know many things by doing this. First, they will not try to pull as many things on you, second, they will know that you know your rights, and third, they may not manipulate the data if they think you are going to be able to expose them. WRITE, date, save, make a copy, put it in a binder with every scrap of written mateiral in it, in cronological order. Start out this way, and your life will be much better.

And more...private placements do not have any obligation to provide special education services, to follow an IEP or a 504 plan. Some private placements will have services available for a fee. Some private placements for children with disablities offer excellent educational opportunities, but also very high price tags. The choice of public, vs private is contingent on whether or not your child can do the program as the program comes for private placements that do not cater to the disabled community and they are under no obligation whatsoever to accomodate a disablity beyond ADA access (which is limited) and ADA granted civil rights (discrimination based on disablity.) Private educational services can be sold with any limitation they please on an applicants behavior or academic acheivement and not be in violation of any public law or civil right. MR

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M.D.

answers from Burlington on

Hi M.,

I would go for the raw paleo diet. Not many people would want that, so I will suggest this site instead: http://newideas.net/adhd/adhd-diet. But I wouldn't worry about fish. If you get plenty of selenium, it will take care of the mercury. Best meats are wild or fed a natural diet (ex., grass-fed beef). A healthy animal is healthy food.

Get plenty of exercise. A 30 minute walk can be a family activity. Great time to talk.

Get plenty of minerals. A multiple mineral supplement is good. Children should NOT get a lot of iron. They can get plenty from meat. Too much iron is harmful to children.

Good luck,
: ) MD

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M.J.

answers from Sacramento on

You have some great advice already below. I just want to strongly encourage you NOT to pursue private school. Public schools will be much more accommodating to kids with special needs. Private schools want none of it. Our son was kicked out of private preschool at age three for his ADHD symptoms. Another parent complained about his behavior and combined with the unhappy teacher, he was considered undesirable and kicked out. To this day at age seven, he still remembers being kicked out. Private schools have no obligation -- moral, legal, whatever -- to retain existing students.

We've found the public school to be so night and day difference. When he's had issues at school, they've worked with us on them and there's no lingering threat of him being kicked out. Even if your child has ADHD and gets treatment, you may still have times when behavior gets off track, so you want to be in the most supportive environment possible.

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M.M.

answers from Washington DC on

Not all private schools have the means to offer Special Ed. My girls were in a private Christian school that had no gifted, no special ed, no OT. . THose kids were weaned out of the school. THey did provide speech.

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T.N.

answers from Albany on

Hi M., your daughter's lucky to have parents who are right on top of her needs and looking towards her future. It's been my experience that private schools are less equipped to offer services to a child with special needs of ANY kind. If you lived in New York, you'd be way better off in your public school district. Here generally we have Early Intervention, or Head Start which sounds like your Early Steps, both are state sponsored programs. Generally, when your child is interviewed for kindergarten, is when you can discuss special needs, or whatever your concern is, then she would go through a screening process. I've noticed the more involved/determined a parent is, the more likely the child will get what she needs (you'd be amazed how many parents do not want to hear their child has special circumstances). I would probably start now calling your district offices asking what that have for your daughter, you can try that with private schools you like as well. Here we also have a number of special needs pre-schools that are privately run but will accept state help if your child qualifies, most of them are integrated too. Good Luck! Sounds like your daughter has a very bright future!

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D.K.

answers from Detroit on

1) Since your daughter was diagnosed with a Sensory Processing Disorder, has anyone suggested that you take her to Sensory Integration therapy? My nephew had similar issues and it had the biggest impact on his development. Google it and you will find a lot of information on it. Keep searching until you find someone who specializes in it.
Note: whatever the public school suggests for therapy, double it!
2) Also, if your public school is not able to offer everything that your child needs in order to succeed, then find the private school that does offer it and make your state pay for it... by law they have to...
3) Find yourself a good "parent advocate" - they are free.
4) You and your husband need to educate yourselves on your daughter's issues. You know her the best and are her best advocates!
5) Since you have good insurance, find the best child developmental psychologist around and have them test her. They will do much better testing than the school district. Plus, they can help you advocate for your daughter with the school district on what is best for her...
6) ADHD alone is not reason to put a child in a private school. Lots of kids have it - you need to learn to advocate for your daughter and get the best teacher who is willing to work with your daughter and help her become the best student - who is willing to help her grow and develop and work with you as her parents and also not destroy her sweet, joyful spirit in the meantime! Good book - "Here's How to Reach Me - Matching Instruction to Personaity Types in Your Classroom" by J. Pauley"
7) You need to look at ADHD as part of her wonderful personality and not something awful! I think there is a book called, "The Gift of ADD" - read it! Your daughter needs to feel good about all parts of herself!
8) As for disciplining the ADHD child, try the book "Magic 1-2-3" It also used to be in video - try your local library. You will see that immediate rewards and immediate negative consequences to actions works best! Both you and your husband need to follow it in order for it to work. It truly works!
You can probably find some of the books used online...
Remember, God made you the parents of this precious child. He will equip you properly... just keep asking Him daily for guidance! I wish you well!!

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C.M.

answers from Dallas on

Public schools do have great resources for kids that need some extra help. I did want to mention, though, that you can still get help at private schools and there are preschools that believe in inclusion. The most important thing is to find the right place for your daughter.

We have a little boy with autism in our class. He was at public school but because he is high on the spectrum he had no peers. So, he is at our school and a speeh pathologist from the public school comes in twice a week to observe and work with him and give us some advice. We believe in inclusion and I'm so glad we do because he is such a special boy and so much fun to have in our classroom.

Good luck!

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