Psychologist or Pediatrician?

[aimee30]

Just need advice, again!

I saw my DD's LCSW today. Took in the reports (Connor's and another one) from the school. She said she is referring us to a child psychologist.

I assumed I would be taking her to the pediatrician. Which one is best to take her to to get a dx? And would a child psychologist give her the once over medically like the pediatrician would?

I've never been to a psychologist and don't know much about them at all. What they can do, if that makes since.

Should I go ahead to the psychologist or should I call the ped first?

I will call the ped anyway just wondering which I should see first.

Thanks!

[AustinsMom]

Here's my 2 cents:

The pediatrician would be the one to determine if there is a medical reason for the problems, so any lab work or physical exam would be done here. They also would be able to prescribe medication and refer you on to a pediatric neurologist or psychiatrist if necessary.

The psychologist is the one who has the tests to determine IQ, achievement level, learning styles, an objective measure of impulsivity, etc. If they are a neuropsychologist they have an extensive battery that helps pinpoint where in the brain the problems are likely to be occuring and can make extremely helpful educational recommendations. But they cannot prescribe meds or do any kind of physical exam.

I'd think you'd want to see the pediatrician first to rule out any medical problems that could be causing the issues. Then a psychologist could help identify strengths, weaknesses, and educational recommendations. Probably as important is the skills of the particular person you see--do they see alot of children and have good experience working with ADHD, etc.

[LitlBaa]

With the kind of insurance we had at that time, I had to have Katie dx'd by a child psychiatrist who could monitor meds and behaviors for the first three months. After that, her care was transferred to her pediatrician.

Psychologists aren't usually medical doctors, so they can't prescribe meds, they just do behavioral things. I think they can dx but then need to refer you to an MD for the meds. Try to find one that specializes in ADHD, that made a world of difference in hubby's dx several months ago.

Check what your health insurance will and won't cover, sometimes they can get stinky about what they term "mental health issues".

[aimee30]

Thanks Austinsmom.

I was a little worried cause the LCSW didn't say anything about seeing her Dr. I thought that was a little strange. I think I will go ahead and call the Dr. in the morning and then wait on seeing the psychologist until I talk to the pediatrician.

I don't know if seeing the psychologist is something I have to do or just need to do. Will talk to the pediatrician and get their opinion too.

[aimee30]

O.K. I just posted and then found LitlBaa's post. Now I'm really confused. Maybe it's best to go on to the psychologist?

I don't know what to do.

[AustinsMom]

Have you seen a medical doctor to rule out any medical causes for the problems? It can be that thyroid issues, lead, blood sugar, or other things can cause problems that need to be treated medically. To get an actual ADHD diagnosis--the M.D. will do that, but often just with talking to you, having you fill out a questionnaire. Many--but not all--will hand out the diagnosis on fairly limited information (in my opinion.)

The psychologist can perform many more tests that can give you a more accurate diagnosis and helpful information. So, yes, IMO I think seeing a psychologist would be the best if you know medical issues have been explored.

[Honeysmom]

If insurance covers it I recommend both for all of the reasons Austinsmom gave.

I see a physcritrist (sp) in my doc's office and she does medical tests and listens to be whine. The best of both worlds!

[mom2tj]

this is just me but I'm a bit of a nut when it come to my kids.... some would say overprotective I always double check with my ped anyway so the first place I went was to her but this was after weeing the school psychologist and she agreed that he sees a psychologist specialising in ADHD I then returned to her for diagnosis from there she sent my to a ADHD clinic that confirmed her diagosis since then I call her every time there is a med change for her oppinion... I was there last monday and for now she will folow him I just trust her and always want to know what she thinks it took me 3 diff ped befor I found one that I trust I dont trust easy

[aimee30]

I called the pediatrician today and they told me they didn't handle ADHD. I needed to call a mental health professional. That kind of shocked me.

The names the LCSW gave me are psychiatrist although I'm sure she said psychologist. Of course like I said before I don't know the difference.

They couldn't get me in until February 16th. That seems like such a long time away. The lady I spoke with today said that DD would have to see a LCSW in their office to do more evaluations. Then if they think she is ADHD they would have her see the psychiatrist.

It just seems like it is all taking so long. I'm worried that they will hold her back in school this year and it seems that I am the only one who gives a whiz.

She is having so many problems in school and the school can't do anything for her (or so they say) until I at least have a dx.

Just feels like there is a wall everywhere I turn.

[eaccae]

aimee30

We weren't able to get an appointment with the neuropsychologist until May of DS's Kindergarten year. DS missed most of kindergarten (nightmare year) - but they didn't hold him back. My pediatrician (who I LOVE) is an expert on ADHD (her two children and her husband have it) but she will NOT make a diagnosis and referred us to a neuropsychologist. She does work with us on the medication. I, personally, feel that neurologists, neuropsychologists, psychologists and psychiastrists are the best people to make a diagnosis as they usually give a long battery of tests (as mentioned above) to rule out other things, check on LDs that may be the problem or a comorbid, etc. Also they will *can* be helpful (hopefully) on giving some behavior modifications, etc. February will be here before you know it - even though it seems so far away! Hope all goes well!!! I know how hard it can be - keep your head up!

[tiniree]

When I suspected something in my son, I first contacted our trusted ped's doctor. We went in and she did a physical exam to rule out any physical problems. This included a thyroid and full blood panel. When these came back normal she suggested a child psychologist.

The psychologist was the one that did the evaluation.

[loveforeric]

Aimee30;
Hi,

I have to agree with the posts I have read. I would see a pediatrician that treats Adhd patients. I had to call my insurance company and the ped. to see if they saw ADHder. The ped. sometimes note this with the insurance companies they accept. I don't know if that will help but I took my boys to the ped. to rule out other problems before the ADd and ADHD diagnosis was brought up.

Have a peaceful day, and good luck on teh search.
Christina

[mctavish23]

Hi,

Another great question. I remember an old commercial where the late baseball great Billy Martin said" I feel strongly both ways."
It doesnt matter to me in which order you do this because I think you need to see them both.Obviously the pediatrician prescribes meds and also knows your child's developmental history. However, the psychologist can help with providing the appropriate therapy; which really should encompass family systems therapy no matter what.

The subject of testing is a hot topic these days because of the findings of some ongoing neuropsych research. The bottom line is that IQ tests do not do the job as well as people have thought over the years.Having said that tho, the most widely used IQ test for kids ( Wechsler Intelligence Scale for Children) was just updated from the WISC-III to the WISC-IV. That may not seem like a big deal but it is as far as testing in general goes. So those data I mentioned earlier were based on WISC-III as far as I know.Hopefully, the changes in the test will be more helpful regarding ADHD.

There are also some very good neuropsych tests out there like the Wide Range Assessment of Memory and Learning(WRAML),which does a much better job of measuring attention as applied to ADHD.

But wait theres more!! By now I'm boring myself so I'll cut to the chase.Computerized Contious Performance Tests(CPT's) DO NOT work for diagnosing ADHD. They are , however, appropriate for research purposes. Once again, I'm qouting Russell Barkley. In my mind he is the leading researcher in the world on ADHD. So the TOVA,Conners CPT , Gordon Diagnostic and the other one that escapes me now, I think the ITPA, are not valid due to the high rate of false negatives(meaning it routinely misses those who really do have it).Part of that is due to the test looking like a new video or computer game to the kid(or adult). The Conners Rating Scales are the best and most accurate measures around AND they are normed on BOTH boys and girls, which is huge.

I'm going to need a nap after this so I hope it helps and doesnt bore you too. Take care.

mctavish23(Robert)