Wednesday, May 9, 2012

Evaluating, testing, examining, analyzing

When we last left this issue, Genea's school had agreed to test her learning abilities to potentially put her on an IEP. For us, the IEP was not going to rock our world, just allow for a few little extras that would help keep Genea's mental health needs from mucking up her academics.

So they tested her.
Simultaneously, she was being evaluated by a psychologist referred to us by her pediatrician. The guy who after sitting with us for 20 minutes suggested putting together a team of professionals for her.

Between the 2 entities, Genea has been tested and evaluated for every possible thing. The school gave her speech and language evaluations, physical therapy evaluation, occupational therapy evaluations, reading, writing, listening, breathing. She met with the school social worker, nurse, psychologist, special education teacher,  and surely I am forgetting some. Oh, me! They all talked to me a lot for background and academic history.

The clinic exams took about 6 weeks. The psychologist spent 2-3 hours with her over several appointments and myself and her school teacher filled out evaluations up the wazoo. We got a new psychiatrist and met with him a few times.

Here is what they found about her learning abilities: Genea is stone cold normal. Average. Regular. Nary a learning disability for miles. Not even an obscure one, like non-verbal learning disorder, or speech apraxia. Zip. Indeed, she tested slightly better than she is performing in school these days. Gotcha.

Honestly I was sort of secretly hoping for one of those nifty labels I could point to and say..... "here, this is why she (fill in the blank)". I got nothing. A learning disability is taken seriously. A mass of mental health diagnosis however, can easily be misinterpreted as "just look at that sucky mom". In that regard, we got a boatload.

After filling out the evaluations and pulling apart the middle to figure out the scores myself (oops! the pages fell apart!) I see that Genea scores well over the cut off for "severe". There were several categories of like, mild, moderate and holy-what- the- fuck and Genea scored at the top end of the latter. Officially known as 1. Reactive Attachment Disorder 2. ADHD 3. Mood Disorder NOS 4. Anxiety Disorder NOS. Also meeting the criteria for Intermittent Explosive Disorder and Oppositional Defiant Disorder but by that time, seriously, the psychologist said this, it hardly matters. Right, I hear ya' dude.

At school then, she met almost no criteria for an IEP except for the ADHD. Every single person who met with her commented elaborately on it, and 9 professionals sat in on our meeting. Ultimately, she qualified based on that finding. For which I was not going to sit there and argue that it is much more likely hypervigilance than attention deficit when the fact is, she cannot focus regardless of label. Whatev.

The occupational therapist was the only one who had a significant finding. She tested Genea's handedness, coordination, gross and fine motor skills etc. She can use scissors brilliantly and trace a line with precision rarely seen, crosses her midline like a superstar. However, when it came to using both hands at once the OT said, it was as if the 2 sides of her body had never met. Not only could she not catch a ball, she could not aim her hands to meet together to do it. Now, that was interesting. We're going to work on that!

When I met with the clinic psychologist to get all of his results, I asked him a question. Genea has Reactive Attachment Disorder, what can we do about that?

His answer went like this, "well, of course you should coordinate with the schools and maintain consistency and integrate a routine and involve the services of ...... oh forget it. There is really just about nothing. There is no specific treatment or therapy that is shown to work. There are a few things you can do that will help, you are already doing them, and maybe try some EMDR, there are early studies showing that helps with kids like Genea".

I tell people that and they gasp, heads ricochet backwards, and they are pissed off for me that I would have to hear something like that. For the love of xanax, I was grateful. To hear the truth. Thankful, I was so thankful to know, I really am doing everything I can. I'm not missing something or hurting her with my ignorance of available treatment. I didn't skip over some crucial element that would have changed everything.

(EMDR is technically Eye Movement Desensitization and Reprocessing. The idea is that trauma is stored in the brain in a reactionary sort of way. Using tapping (HI LISA) sort of things, the person walks back through a difficult time while using bilateral stimulation in some way to move the memory or feeling into a more logical region of the brain to create a new insight. Probably if you are interested you should look it up yourself because my explanation here sucks).

So now we have our IEP, a new psychiatrist and a new psycho- therapist who does EMDR. There has been some forward movement though many areas still stagnate. I remind myself, progress for Genea is measured not in weeks or months, but in years.

Incidentally, the clinic evaluations were all sparked off when I asked our pediatrician to evaluate Teena for ADHD. She wanted to refer us to a psychologist for testing and I balked. Ugh, there is a 3-6 month wait, I knew for a fact. Aha, she tells me, she happens to be sleeping with (my words lol) the best evaluating psychologist available and feels sure she can get us in soon. A few days later her husband called us himself to say he would like to go to work on his upcoming day off to see us, can we make it? YEP!

Teena went through the same series of testing, over about 6 weeks, 2-3 hour evals at a time. The results show she has ADHD. In fact, she is in the 97th percentile of attention deficit. I was shocked it was that bad, I guess I've become acclimated a bit. If you go to your nearest bouncy house or Chuck E and pull out 100 random children, only 2 will have a harder time than Teena with focus. Wow.


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