First visit to a Psychologist

Post Reply New Topic

Well, after thinking about it and discussing the merits, we are at the point that we are going to take our 8 year old son in for his first visit with a Clinician.

He is not an "officially" diagnosed Aspie, but we've been going to the Gray Center for a bit, and he has all of the behaviors and we have gotten agreement from the docs that he is indeed an awesome Aspie-like little boy. With his past, (his biological father was killed in a car accident when he was 2 years old, his Mother and I have been together for 4+ years, and married for 6 months so far) he has had to deal with some very adult things very young, and has now started to exhibit some rather large bouts of anxiety, claims to hear voices sometimes (but he's big into Harry Potter right now which I'm not sold on with his issues) and may just need to talk with someone to help him understand and communicate his thoughts with.

I had gone through the available docs in our area to find what I believe to be someone that shows his issues as specialties, including ASD issues, and I think we're ready- but we've never done this before, and I'm nervous both for him, and for us. I just want to do the best for him, and want him to come out of it with something positive. I've been reading so much stuff online and in Aspie-parent blogs to try to prepare for this next phase in our lives that I really can't remember everything. Meds come up, not sure what will come of that either. If it helps him with his anxiety, that would be great, but I'd rather not if it is iffy.

So, I guess my whole point is- what should we be prepared for? For both me and my Wife, and my son. Things we should ask? What about meds? I really don't want him to come out with a prescription on the first visit because to me, you can't know my son that fast. But then again, they're experts, you know? I'm just pulled in so many different directions, I just want to make sure it's the correct one.

I know that rambled, and maybe the only real response is "it'll be ok" but I guess I was feeling like some validation from folks that have been there before would be awesome. I love my son, and only want the best for him...

Help?

My son is 6 and has been diagnosed with high functioning autism/Asperger's. It's hard to say what exactly to expect. I sure would NOT expect to hear a recommendation for medication right off the bat (BTW a psychologist can't prescribe medication only medical docs or psychiatrists can). As many here will say, there is no medication for autism per se. However, many people with autism have co-morbid conditions, the symptoms of which can be alleviated by medication. My son also suffers from high anxiety, we are currently taking some supplements that seem to be helping. We have not ever tried prescription medication. I would expect any decent therapist to do a thorough evaluation and then define some goals for treatment. It's normal to be nervous just know that you are doing the right thing. Also keep in mind that not every client-therapist interaction is a good fit so if perchance this one doesn't work out for you, don't be too discouraged. Good luck!

DS9 is very anxious and had a really bad time of it about a month and 1/2 after starting 1st grade (he is in 3rd now). He would have "bad thoughts" (that is what he called them), mostly about being poisoned, lost or hurt (or me being hurt), but also strange stuff like what if became a turtle and was no longer him anymore. He would wake up not wanting to go to school and start crying saying he could not get these thoughts out of head (OCD like). I had no experience with this and went to the pediatrician who recommended a psychologist who worked with kids. We took him to weekly 1 hr sessions for several months. Started to show real improvement by about 5-6 weeks. I kept him going to the end of the school year, at which time DS said he didn't need to go anymore. My pedestrian warned that he could relapse and that was normal (her DS also had anxiety issues). DS did fine last year (he occasionally said he had bad thoughts, but he could handle/stop them). DS is currently having trouble again and he asked to go back to the psychologist (I am so proud that he asked for help). When this started, I had no idea that DS may be autistic (the school evaluated him this past spring). The psychologist my son worked with did not specialize in autism, and could never give me any kind of diagnosis (autism was never mentioned; ocd, adhd, general anxiety, dyslexia were all mentioned as possibilities, but nothing more than mentioned as possibilites). A diagnosis was not my goal. Getting my DS some coping mechanisms was the goal. She did give him coping tools which helped (so that is why we are going back). I went with DS for the first visit (she also had my husband and I make an appointment to see her without DS). Like PP mentioned, psychologist cannot proscribe meds. DS (so far) has not been on meds.

Thanks for the thoughts, that helps a lot... I think maybe it was needing affirmation that we're on the right track, but I think even just trying to get him help is affirmation that we're on the right track. I think I sometimes have a fear of "wasting time" for lack of a better term by thinking that I have to find him the perfect clinician first, but you're right- it may take a few and a bit of time. I guess I have to look at it as more of a marathon, and even if the clinician isn't the right fit, we'll all learn more together about my son and what will help him cope with his awesome quirks.

Bombaloo- if you don't mind, what are some of your Son's supplements? I'm always open to trying something non-prescription first, especially if it helps him out. I'd love him to be able to let his mind rest! I should read back, I 'm sure some are looked over here on the forum...

Ravenmom- you're right about the goals, and I totally agree- I really don't care about the diagnosis per se, at least at this point. His coping is far more important. It's not because of the "oh, I think if they diagnose him with something I'll feel defeated" or something, it's that it really doesn't matter to us- he's ours, he's awesome, and I just want him to feel good about himself and be able to enjoy being a kid if some of the things he deals with make him feel sad. We've got a few really good coping tools that he's said have really helped him that we came up with as a family, so that was cool. I just think he needs a little bit of help from someone smarter than me.

Thanks!

Under the supervision of a Naturopathic Doc, we are taking GABA and Kalms for kids both to address anxiety and Fructol (high DHA and EPA) for better brain function. I have a friend who has tried some other OTC supplements with her kiddo for anxiety. I definitely recommend seeing a naturopath if you are interested in this. He/she can explain to you the benefits and side-effects of different treatments.

For sure... Thank you for the information, I think I'll look them up and get in contact with a Naturopathic Doc for some more info...

Thanks!

Ok.....first things first.....I know how overwhelming this is.....We've been walking this road for more than a yr now! I know of plenty of parents who struggled 7-11 yrs before getting a propper answer!
We have wasted money on psychologists, even neuro's who don't "buy into ASD"!
First of all....a good neurologist who understands how to work with ASD kids can help to eliminate any epilepsy and help make a diagnosis....A child psychiatrist is also a good opsion...a CLINICAL psychologist may also diagnose, but not prescribe meds.

Does your son have any sensory integration problems? Then a sensory integration quilified Occupational therapist can help him with modulation strategies and also fine and gross motor issues and planning issues, plenty of ASD kids struggle with this!

Does your son have any auditory prosessing issues? Then a good Speech therapist needs to help him with this, because he will need it when starting with word sums and creative writing and comprehension in school?

My son went for a assessment with a clinical psychologist a month ago...She diagnosed mood dysregulation and touched on bipolar, because of his " black" thoughts...and mood swings....But I quickly realized she had a passion for bipolar, and plenty of the simptoms can also be because of ASD, because mood disregulation is part of ASD.

The new Neuro has started my son on VERY low dosage Risperdal...this surely helped him with irritibility, better impulse control and tollerance. He was put on Cipralex (SSRI) by the pdoc, but neuro says its not the best option for anxiety control, she wants to slowly take him of it and maybe replace it with Zoloft, its better for anxiety.

Supplements: Magnesium and Vit B and Omega 3 and 6 can help to calm down a sensitive sensory system......

Good luck, its very overwhelming!

Update time!

First- LovelyBoy, thanks for the info- we actually did talk about SI yesterday, and I'd start by saying that Dr. Matt was awesome at explaining how different parts of the brain function, how SI relates to function, and how DS8 is having issues with some things that he is dealing with. Being that he also deals with ASD patients, he did ask if we had any formal testing yet, which we didn't. He said not to worry about it right now, as we're still working on some grief issues with him, and want to see if some of those are relieved first. He doesn't think that if he did make a diagnosis of Aspergers, that he would be very high on the chart, which is exactly what we think. He has no auditory processing issues whatsoever though, so that helps.

I can feel the pain on the bipolar thing, we found ourselves being careful about what we checked off on the informational paperwork so that they didn't steer him into something we don't think he is experiencing. Like he says that he hears a low droning pitch and someone talking gibberish sometimes. So, he hears voices in his head he says. But, we know about the hyper-sensitive hearing, and he is experiencing grief over the loss of his Biological Dad when he was 2 but is just now starting to need help understanding it. We think some of it can be related, and don't want to push him towards "kid hears voices, med him up" kind of thing. But he didn't really go that way, so that was cool. He asked why we thought it was Aspergers, and we explained the sensory issues, the crowd issues, noise issues, focus on tasks, likes, dislikes, ordering, sorting, meltdowns, etc, etc... and he was completely understanding and familiar.

I think all in all, it was a good session. We go back in 2 weeks to try to work on some more coping skills... Meds have not come up yet. We may look into the supplements, since those are non-invasive. How do you administer yours? Pill/liquid/other creative ways?

Sorry I don't have time to write more right now, but I addressed the supplements we are taking, form, timing etc. in this post:
http://www.wrongplanet.net/postt206051.html
We have increased the GABA to one full tablet in the AM and half a tablet at noon (administered at school). In the above post I said the GABA tablets were 250 mg but as Mama to Grace pointed out, they are actually 200 mg chewable tablets.

Sorry Bombaloo- I didn't want you to think that I didn't heed, I did, our therapist asked that we give him a few weeks before trying any supplements, so he could get a clear snapshot of what's going on. I did mention yours and he said that they do indeed seem to help, and would discuss more, we are just in a holding pattern. I was just also interested in what lovelyboy was doing as well.

Seriously- thanks everyone for your help and support!

So today was DS's first real alone session with his therapist. My wife said it went really well and that the doc said he did a great job.

I do have a question- I'm curious as to what they got to talk about and stuff like that- is it normal practice for your child to not share anything with you/for me not to bother him by asking, or is it something that they can talk about if they wish? I don't want to butt in, but I'm curious what he was able to chat to while playing Lego...

Since we've never done this before, I really don't know what normal protocol is for clinicians... We go in on Nov 5th to discuss his progress, but he has another meeting next week, and I'm just bursting with curiosity...

I only know from my experience. Generally I start by just asking DS9 how it went (usually "good" is the answer) and what did he do ("play in the sand" - there is a sand table and "talk about stuff") just to get him on the subject, then I ask what is really important to me "Do you think the Dr is helping?", "Do you like going?" "Do you want to continue?" "Do you feel better after going?" I usually only get a short answer, but at least I can get an idea of how my son thinks things are going. I give my son the opportunity to talk about specifics (which he doesn't), and I don't push him on details, since I want him to feel like his discussions are private to his doctor, but we can talk about it if he wants. That is just my approach. When I speak with the doctor, she mentions different things they talk about, generally as examples of what she thinks is going on, but I don't ask her specifically what they talk about. We talk more about what she thinks he needs and how I can support DS.

That does make sense- thank you for the thoughts Ravenmom...

We did talk about if he had fun, how he liked it, how he built Legos, etc- and he offered that they talked about how not to get mad if something destroys Legos. Apparently tied in nicely. Smile

It'll be hard for me to let go like that, but he does need his space and his session, it's not for me. I think we'll be great. I think I was having a hard time with the Dr. patient privilege since he's only 8. Smile

Thanks again!

The very best piece of advice I can provide is trust your gut instinct with the psychologist you have chosen. If you gut tells you what the pdoc is saying doesn't feel right then it isn't. Always remember just because they have a degree doesn't mean they are right. I am saying this because, although I hope you have found a wonderful pdoc, if you have found a bad one, they can do a lot of harm. Question everything and don't accept an answer until you fully understand it. The pdoc needs to show that he/she is competent and has reasons to support their suggestions and diagnosis.

That was kind of my tack- I don't want to undermine what he's doing, I just want to know what is going on- we've never done this before. Right now, I only can ask my son if he had fun and leave it up to him to share the rest, is what I've been told- because of the doctor-patient privilege- which I can respect. But, at the same time, I still have great interest in what they are discussing, working on, and how we can help him, and not have to wait for meetings with his Dr. in a couple of weeks.

I like the gut feeling thing, where if you don't think what he is saying is right... But that's my issue for now- I have nothing to gauge on, because I don't know what he is saying. I can't question anything because I know nothing. That's the gist I guess. Maybe it's because it was the first full session, so they didn't talk about much?

I don't know- I'm ok with letting him handle it himself and have his time, but at the same time, he is still an 8 year old boy, our son, and well, I still think we should know what they are working on. Like I suggested to my wife last night, I feel a bit like we're letting our 8 year old talk to a pretty-much stranger, and not even being able to ask either of them what they talked about or worked on.

Ah well- we'll find out. My son loves it, so that's the most important part until they get deep into discussions. Just getting him to accept it is the big deal for now, which is going well. I guess the question is- are clinicians not allowed to talk to parents about what their children are working on in that type of setting, or is it more of a choice by the parents not to ask? I don't want to overstep my bounds, but want to have a perspective for when we meet in a couple of weeks to ask for more info if we're not getting any by then.

Thanks for the thoughts, bjtao!

I don't know but I suspect that Dr. patient privilege may not exist with a child that age. I mean, if you took your child to the pediatrician for any reason, you would stay in the room and the doc would talk to you, right? I can understand that a therapist needs do develop a rapport with his/her patient but when that patient is a minor child, I don't think the therapist can refuse to tell the parent anything.