What To Say and What Not to Say . . . Psych Evaluation

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We are having our 4 1/2 year old do an OT and Psych evaluation next week. I have two very basic questions that have probably been asked on here somewhere before, but I can't find them.

1) What did you tell your child about the evaluation? My son has mentioned feeling 'different' from other kids before, and I think he knows he has fears, etc. that other kids don't have and that he can't draw/color like his peers. I'm trying to figure out how much to say. He's a pretty smart little cookie.

2) Did you tell the evaluators what you 'suspected', if you did indeed suspect something? For example, we think he probably has mild Sensory Processing Disorder . . . and we strongly suspect Aspergers based on extensive reading, as well as multiple respected surveys that always result in 'strongly possible' he is ASD. Should I just tell 'about' him, but not mention what we possibly 'suspect'. Is it any different from going in and telling the pediatrician you think your child might have bronchitis?

I'm not trying to over think this, but the more prepared I feel, the better I feel. Can't help it.

I told our son that the appt would help us pick the best school for him. He's not an anxious kid, so I didn't do much to prepare him. Just said the lady was going to ask him to solve puzzles and jump on one foot, and if he listened and cooperated he would get to ride the glass elevator afterward.

I don't know how much your opinion would bias the evaluator. Ours pretty much suspected he had AS just from greeting him in the waiting room, based on the style of his eye contact and bearing. (But I think the ADOS results actually drove the dx.) I think I'd say these are the issues that concern us the most, we'd like to have your professional judgement of whether or not he is on the autism spectrum.

In our case we originally suspected ADHD. I called to get more info on what testing would actually be done because I was uncomfortable with the idea of a dx based on just the parent and teacher surveys. The doctor told me she would do an IQ test, and would start the ADOS, but would cut it short if it was clear he didn't have an ASD. I must've had some sort of gut suspicion, because I asked her to be sure not to stop that test too quickly...

I am a student Doctoral intern who does psychological evaluations, and I am a mom of a DS (11y/o) with AS. I have both been learning to do the evaluations in the past 2 years and going through the process of having my own son evaluated and obtaining services in the school through special education.

We (the facility where I work) usually ask the parents to tell the children that they are going to see a different kind of doctor who will ask them questions, play games, draw pictures and ask them to do puzzles. They will not get a shot or medicine. Part of the evaluation involves asking the child what s/he thinks they are there for to make sure there are no misunderstandings.




Personally, I love when parents come in with their own information about what they suspect. However, a good psychologist will also query about specific information in many areas. You will probably be asked to fill out a detailed history on your child if you have not already done it, so be prepared with answers to questions about when he crawled, walked, talked, potty trained et cetera. Be prepared with examples of the behaviors indicative of the symptoms. For example: It is not helpful when parents say "My child has repetitive behaviors." It is helpful when parents give examples like, "My child covers his ears whenever we go into the grocery store." or "My son walked on his tiptoes most of the time when he was age 2 to 4."

Like the previous poster mentioned. It is important you are getting a full evaluation. Ask what tests are being done. They should do some inventories with the parents and teachers, but they should also do some interactive measures with your child that go beyond just asking questions (like the ADOS).

There is often not enough time (usually 30 min to 1 hour) to tell them all you want to know, so I found it helpful to make my own notes of the key words and a list of examples:

repetitive behaviors - no obsessive interest to talk about, but really likes building, spends hours building from the time he was 3
rituals - none, but needs routine, can become upset when things do not go the way he imagines them happening, principal personally sought him out in morning to tell him about substitutes, guest speakers and changes in the schedule from grades 2 to 4.
social - difficulty with subtleties, doesn't get many jokes, but loves pratfalls, doesn't understand differences in social rules. like its not okay to bump someone in line, but its okay to bump someone in PE. no friends at school few younger friends in neighborhood.

So things like that. I had a page of them, when they asked a question, I could just look to remind me of the examples.

I am not sure about the OT eval, but I am sure there are others on here who could help you with that.

Hope it goes well.

Thanks, Eureka-C--very helpful! Just what I was hoping for . . . some other perspectives and ideas.

Thank you Eureka-C, that was exactly what I needed. My DS has an evaluation at Stanford next week. He's so good with adults, that they often miss things in an interview. I need to make my list of examples.

tell them about his issues when they have been at the worst time, they need to know how severe his problems can become.
i believe strongly that being open with children is so important, my childhood was surrounded by secrets and closed minds and not talking about issues, i feel it has made my life 100 times harder.
speak to him about why you are going, say that you love him and other people will like him for who he his but you want to see the doctor to see if they can help him with anything, maybe say some of the problems he has to do with sensory feelings, if he is clumsy etc and say that the doctor might be able to help but you have to go and speak to them about it first, ask him if he would like to say anything and just be open and honest with him, he'll appreciate it when he's older and things are more straight and less complicated

Thanks brainfizz...I am all for being open and loving him how he is...and letting him know. I actually love how he thinks ...its funny though how we'll have some 'easy' days and then there are days like today that remind me why we are going for an evaluation and that we need some extra help. meltdown over not playing his favorite music which he 'requires' in the car...because it was sisters turn. meltdown over not getting the sugary drink he wanted which resulted in punching his dad, flailing on the ground and crying and screaming. you are right...i need to present the worst moments. this behavior comes even with calm consistent loving gentle discipline.

OK, So I am not the only one with the car music sibling issue! Funny thing, my 2yo is ok with turn taking in the car, my 6yo...not so much. It has casued many a tantrum!

Not at all alone! Yes, and typically my DD--almost 3--is WAY more accommodating and willing to take turns than he is. She may occasionally fuss a little, but typically she gets the concept of sharing and taking turns a lot better. I told him yesterday that we can't all be first--his response was, 'But I can be.' (aka He thinks it's fine that he should always be first!) That's one of the daily ones we are really trying to work on, but he just doesn't get it.

YEP, smae here...my 2 1/2 yo is much more cooperative. It is sad, but she is usually easier to get thru then my 6yo son.