ADD/ADHD Evaluation and Diagnosis
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ADHD Eval for 5-year-old - Medi-Cal?Sept 2012
I am looking for a great child psychiatrist or developmental pediatrician who accepts Medi-Cal and can do a thorough assessment of my five-year-old. Any suggestions? Worried mom
Hi - Unlikely that you will find a good psychiatrist or behavioral pediatrician in private practice that accepts MediCal. However, the teaching staff at Children's Hospital in Oakland are excellent, as well as the teaching staff/residents at Langley Porter Institute at UCSF. Both are excellent institutions and I believe both take MediCal - likely there will be a wait to get an appointment. Doctor mom
Try the Hyperactivity, Attention, and Learning Problems (HALP) Clinic at UCSF. Ask for HALP specifically when you call: intake and referral service at 415-476-7500 or 800-723-7140 (toll free). Their comprehensive evaluation takes several visits, and there is often a waitlist, but they take medicare/medical. They also develop group treatments for ADHD families, and if the waitlist is long you may be seen faster if you want to be a part of one of these investigations. past UCSF fellow
Our son's teacher recommended that he get evaluated for ADD/ADHD before the start of 4th grade. (He's in 3rd grade, 8 years old, very bright, etc.) His 2nd grade teacher suggested the same but a therapist who worked with him recommended we wait until he is 9 or 10; and his physician said her referral tends to over-diagnose so we waited. He won't be 9 until after 4th grade starts so we need to get him evaluated this summer. I've seen recommendations for Berman, etc., and wasn't too impressed with anyone, and at this point, I am looking for a rundown on which *type* of professional should evaluate him...an MD versus a Psych PhD versus a clinic versus ???. The UC Berkeley study isn't accepting anyone until next fall and I think that might be too late. (It's complicated by the fact that he has amblyopia and has been patching with and without atropine drops for the last two years.) Ideally, it would be someone who takes Anthem Blue Cross PPO and is in the Albany/Berkeley/Oakland area. Any ideas/experience with this? Thanks! Willing but not sure what course to take!
We used Dr. Lane Tanner at Oakland Children's Hospital. He is a behavioral pediatrician and he was great. Good luck! E.
We didn't have great luck finding pediatric services that were covered by our insurance plan. We have HealthNet, so maybe you'll have better luck on that front. We have found excellent, if expensive, private resources. I would start with Marianna Eraklis in Orinda,(925)254-4000. She's both a great doctor and an empathic human being. Ann
After years of debating we are coming to a conclusion that we need to have a behavior evaluation for our bright, smart, imaginative 6-year-old who exhibits a lot of ADHD- like signs. He has always been a high-energy kid, requiring what seems like an above-average level of maintenance, but we always saw him as being just less mature. He is in 1st grade now, and the whole school experience has been quite miserable for him, as well as for us. The universal feedback from teachers is that he is very smart (there are no issues with his academic progress), but he is either not able or not willing to follow instructions and basically he wears them out (it has gotten to a point where he's been asked to leave the classroom on several occasions and sit in the hallway or in the principal's office). This has been a very demoralizing experience for him, and we are witnessing our little guy turning from a confident, full-of- life, imaginative boy into an anxious child with diminishing self-esteem. So at this point we really feel that we need a help of an experienced professional and are looking for recommendations. Thank you! anon
I recommend you get a full neuropsychological evaluation with one of the qualified psychologists in our area. Anyone who does a comprehensive evaluation can tell you if it's a learning disorder, ADHD, other neuropsychological processing issues, and how this is affecting a child's feelings and thoughts about themselves. Check into working with Terry Doyle, Jessica Lipkind, or Caroline Johnson. They all have great reputations for doing in-depth assessments and working closely and supportively with families. been there
We contacted or saw various people for evaluation of our daughter about a year ago when she was in a similar boat and in 1st grade. I give thanks to G_d that someone gave us the name of Mariah Antoniadis PhD. She's a child psychologist and she's not only brilliant, but she cuts to the chase and actually gives you clear answers and instructions for what to do instead of vagueness and hand-waiving. She speaks to the whole child ( not just one slice) and will oversee care. She's also great working with teachers/school if you want her to do that. Her office has moved to Leimert St in Oakland ( from Elmwood).
PS: I know so well that sadness seeing one's open/optimistic child start to not enjoy school, so you have my support! JM
Ugh, I am so sorry to hear about your experience and I feel your pain, having experienced exactly the same thing. First of all hang in there, it'll get better. You are doing the right thing with having him evaluated. It was an eye opening & empowering experience for us, albeit emotional. The hardest part was waiting not only for the evaluation itself, but also for the results. In the meantime, be supportive of your son.
* Dr Renee Wachtel http://www.reneecwachtelmd.com/ - I really liked her, but for insurance reasons, we went with her associate:
* Dr. Lori Wensley, Clinical Psychologist (510) 276-6121. Dr Wensley is wonderful & really helped us to understand our boy. After our evaluation she referred us to:
* MarRem Remington, LFMC (510) 835-4357. MarRem is great! She treats the whole family, not just the child.
In the end we ended up with a diagnosis of Sensory Integration/Processing Disorder & Anxiety. Check out the Sensory Integration website (http://www.sensory-processing-disorder.com/) & go through the check list.
Also read, WHY GENDER MATTERS http://www.whygendermatters.com/ by Dr Leonard Sax and Mel Levine's books (http://www.allkindsofminds.org/). In combination with the diagnosis they have really helped us champion our son. Right there with you....
Does anyone know of a good therapist that can provide testing for ADHD and possible dyslexia? I don't have a lot of money, but can pay over time/installments. How much does such testing cost? I understand that UCB provides testing - the cost is $700 to $2,000; Clearwater Clinic is at upper ned of that range...is that reasonable?
We were recently referred to Marianna Eraklis,MD, a behavioral pediatrician. She came highly recommended, kids and parents both give her good reviews (check online), and she charges $1,800 for an evaluation - questionnaire, parent meeting, child meeting (2 hrs), and follow up parent meeting with recommendations. We haven't met with her yet but have talked by phone, and I felt like she addressed our concerns well. Pat
Have a very young 9th grader struggling academically and socially in public high school. Currently being tested for suspected ADHD, and may be twice exceptional, which masked his ADHD symptoms all these years. He is a bit nerdy, and underweight. Waiting for puberty to kick in. The previous postings on Berk Parents are dated. Would like to hear from other parents about what has worked to help newly diagnosed teens thrive? Most ADHD help classes are geared for elementary school children. (If only he had been so lucky to have been properly diagnosed early on). Would love to hear from others what worked and what didn't work. - Prescription meds, if so, which, and how were the side effects? - Alternative treatment? - Coaching? - Counseling for teen? for parents? - Skills class? - Biofeedback? - Do you have a great doctor (psychiatrist) who ''gets'' 2e kids, if so, feel free to share his/her name. Thank you one and all. Signed, New to world of ADHD teens
We had our son diagnosed with ADHD at the end of 8th grade, and are also regretful that we waited so long. Although the school was willing to test him, they would not (cannot) make the diagnosis. We got recommendations from our pediatrician for a developmental pediatrician to handle the diagnosis and treatment. We selected Marianna Eraklis, MD , in Orinda, to work with our son and we couldn't be happier. She is really a wonderful person and doctor; compassionate, patient, great communicator, accessible and humorous. (She even gives out her cellphone # if you really need to speak with her.) We decided to try medication and our son responded really well. We see her every 3 months so he can talk with her and we have tweaked his dosage and even the actual meds. He is so happy and grateful to be dealing with his ADHD. I know he feels a huge relief to be feeling more alert and really able to block out outside stimulation and focus in class. He is also more functional at home, which has really improved our home life and decreased tensions. We all pitched in to make his room more well organized; everything from hooks for his clothes, boards for writing down memos, to changing and clearing his study area. He has pulled up his grades really significantly this fall, learned to approach his teachers, and he feels so much better about himself. We have lowered his dose recently because he had lost quite a bit of weight. That was ok, since he was slightly pudgy before,(he is thrilled), but Dr. Eraklis thought he could be less stimulated, so we are now working with another, non-stimulating med, which seems really good. I only wish we had done this sooner! We are all much happier. P.S. We all read a couple different books, one by a kid with ADHD, and my husband and I read a couple for parents, which were helpful. (Browse the bookstore or Amazon.) Her contact info: Dr. Marianna Eraklis db pediatrics 925-254-4000 Happier mom and kid
As the mother of a child with ADHD, I suggest you contact Dr. Mariana Eraklis (Orinda). She will be able to diagnose your child and recommend a course of action - including services that need to be provided by the school, outside services that may be helpful, and medication, if appropriate. I see you have asked for specific recommendations regarding medication. I would urge you to disregard any specific recommendations you receive. There is no magic bullet that works for each kid. Dr. Eraklis can explain to you how each of the drugs out there works. Unfortunately, medication is a trial and error process. It took us a long time to figure out what works for our kid - but some people have success right away. Lastly - don't beat yourself up about not having an accurate diagnosis in years gone by. Many people are not diagnosed with ADHD until they are adults! You are ahead of the curve. Fellow parent
My son is suddenly undone by lack of ability to manage his attention as the work load has increased in HIgh School. Who do you recommend to diagnose and help decide whether medication is the answer? Who can oversee managing this with alternatives to medication? Thanks anonymous, anxious
My son had a similar situation when he hit high school. He is smart and articulate and did very well when he had teachers who knew him. But, once in high school with a new teacher for each subject, his inability to manage time and concentrate became very evident.
We saw Dr. Alan Siegel on Alcatraz in Oakland, phone 510- 527-7929. He was wonderful with my son and utterly professional. The full battery of tests were completed and he gave a very detailed report on specific issues and recommendations for treatment. It was well worth the time (several sessions of testing) and expense to have a full report with recommendations on how to address the issues.
Through trial and error we tried several medicines and enrolled him in organizational and time management programs. It took us years to realize that my son was integral to becoming successful. With all we could offer, he still had to stop denying the situation and take charge to find the work-arounds that fit for him and could make his life easier. (Really, we all do this whether we have ADD or not.)
As parents we tried our darndest to hand him the help. I think one of our mistakes was to try too hard to do for him and not share the issues in the report. Once he saw the report (at age 20 when new testing was needed to keep him covered by the Disabled Students Services at college), so many things fell into place for him.
I hope your son's road is easier and with fewer bumps for all of you. My son is now 24 and is truly enjoying his life -- without meds. Good luck! Anonymous Mom
This is for the person who wrote some time back wanting advice about her ADD teen and also a recommendation for an occupational therapist . For an occupational therapist, I highly recommend Kristine Hubner-Levin at 510- 331-3401 or 925-254-1137. We used her several years ago and she was phenomenal. As for the ADD teen, this is such a gigantic topic with so many subtopics, I don't know where to begin and don't have any magic answers, but just know you are absolutely not alone and this is hard and super frustrating for many many parents, not to mention the kids. I recommend reading Driven to Distraction by Hallowell and Ratey, if you haven't yet. anon
We're looking for a local child psychologist/psychiatrist with experience in diagnosing ADD. Our 6th grade daughter has seen 4 therapists in other cities for a variety of ''symptoms'' but no one has suggested ADD. After doing my own research I think it highly likely she has ADD. Now in 6th grade her self esteem is suffering from her forgetfulness, distractedness, day-dreaming and mental confusion. It's been so many years of watching her symptoms with no relief from talk therapy- one therapist said ''oh no it could not be ADD and anyway that's too hard to accurately diagnose with most kids unless the teacher makes enough negative comments. But your daughter behaves well in class so it could not be ADD.'' Help! We just want to discuss her symptoms with someone who really knows ADD in girls. thanks, concerned mom
Wow, I am surprised to hear this. Girls can have a subtype of ADD called ''ADHD-inattentive type'' - and it is exactly what you are describing - the daydreaming - but since they are generally cooperative and not hyperactive they don't fit the mold. If I were in your shoes, I would go the Dr. Ned Hallowell's clinic in San Diego. They are the best, the kindest people. Read Hallowell's books. The important thing is that he looks upon ADD as a gift, and wants the kids and parents to consider their job to 'unwrap' the gift. Much better than pathologizing the child and listing all the ways they don't fit it. You can also listen to some excellent short podcasts of his at http://www.additudemag.com/adhd/article/2711.html So I would follow Hallowell's whole approach if I were in your shoes. The other thing you need to research and consider: your daughter might also have ''executive functioning'' impairment of some sort - the ability to plan, prioritize, problems with the passage of time, messy, does homework but doesn't turn it in, etc. Start attending lectures and doing some internet reading. They need help in their metacognition (thinking about thinking) and often need explicit instruction in social cues. Try speech and language therapist Kris Neugebauer in Alameda. The main thing for you to know is that this is NOT willful behavior on her part and she can't just ''TRY'' harder. Try to change the way she is perceived - like she is the problem. No matter how tempting don't buy into that. Be her champion. Be open to medication (it is very low risk and you can just do a trial to see if it helps) and other therapies which are looking good - eg neurofeedback. Good luck and be positive! Anon
Dr. Steven Sturges MD is an expert on ADD, besides specializing in the prescription of drugs for ADD as a psycho pharmacologist, he is also a caring and sensitive therapist with an in depth knowledge of the field. He is particularly experienced with adolescent patients and would be well suited for this type of diagnosis. He practices in Berkeley. Anonymous
Clearwater, in Oakland, specializes in psychological assessment for children, and our rates are very competitive. ADD assessments can include a school observation as well. We also have an educational therapist on staff. Call 596-8137 or visit our website: www.clearwaterclinic.com for more information. Sally Francis, Ph.D.
Regarding Honors student can't stay focused on homework , Woud you please help with these questions:
- How can I get son tested for ADHD? He also has difficulty retaining the information that he learned/studied for, especially in Math and Science.
- We live in Cupertino, CA, is there a similiar organization as http://www.sos4students.com/ in our area?
Thank you for your help in advance
Your physician is the only one who can diagnose ADHD because it is considered a medical condition. Your son should also be tested for learning capabilities by your school district. If you make a request to the district testing office, they MUST (by law) test your child per your instructions. Good Luck! Jenny
Two routes. To privately evaluate your son there is Plus Four Solutions in Los Altos with Dr. Steve Newton. Or, you could talk to your school counselor about having your son evaluated by the school. (I believe the Cupertino school district does this free of charge but talk to your son first about whether he's comfortable being evaluated while at school.) Mom of ADD kid
I have read most of the posts and recommendations for pediatric psychiatrists and evaluators for ADD. It looks like most of the psychiatrists and evaluators for ADD are private - out of pocket pay (not under HMO's or insurance) AND they are expensive and they have long waiting lists. The HMO's and MD's covered by insurances tend to have to whip through diagnosing and testing and may miss a lot of significant information.
My question is this: Once you have seen a private physician and if his diagnosis seems correct and his recommended treatment - whether it is medication or not, is indeed helping the child - do you have any problems taking this diagnosis from the private physician to you child's primary care physician or a doctor within your HMO or insurance and saying - look here's what this MD did and this is what he prescribed and it works, we want to continue it. Or do they now send you again through their merry-go-round of lightning speed testing and make you live with their diagnosis or continue to pay high out of pocket fees to the private physician? cindy
I think Kaiser does a nice job of handling ADHD once you find a primary care pediatrician who specializes in the medications. There's usually one pediatrician at each facility who sees the ADD kids and knows about the meds. I don't see why they'd want to re-diagnose your child. If you come in with diabetes they don't do that. I have Kaiser and an EPO plan and we go to non-Kaiser doctors for the rare diseases we seem to have in our family but we use Kaiser for all our ADHD needs with great success. good luck
I'd like advice from parents who have had their child worked up for ADD by a practitioner who specializes in ADD diagnosis and treatment. Has anyone had a good experience? Also does anyone have any recommendations regarding Children's Hospital ADD clinic, The Amen clinic or Dr.Josephine Lindt? I've checked the archives and need more specific information. Also,ADD runs in our family and I think I may be affected. Any experience with specialists for adults? I checked with CHADD and they weren't very helpful. Thanks! ADD mom and child
ADD evaluation: Dr. Brad Berman in Walnut Creek. Excellent, expensive, takes a while to get in his office. mom with son with ADHD
My advice (of course based on past experience) is NOT to go directly to the pediatrician (or in Berman's case, developmental pediatrician). Educational testers like the Ann Martin Center and A Learning Place, both in Oakland, cast a wide net and look for much broader possibilities than just ADD. After my son's teacher told us to get him tested for ADD we almost went the medical route. The broader testing really suggested to us that his issues were much more subtle, and the tutoring he's gotten since has been invaluable. ADD DAD
I just had a conversation with my son's teacher which has led me to seek testing for ADD for him. My insurance (Health Net with Insight as their mental health providers) has given me four names of Drs. he can go to and have told me there are additional names and I should start with those. I've looked on the parent's site and one of the Dr.s that comes highly recommended, Dr. Brad Berman, is not one of their providers. Can anyone give me an opinion on any of the following doctors - past experiences, hearsay, whatever and/or recommend other Drs that are providers for Health Net and Inshight? Specifically my son presents symptoms more often associated with girls - such as distractability and innatentiveness among other things. He does not present hyperactivity in it's more traditional forms. Also, can anyone recommend what questions I should ask and what tests should be done? Thanks. Dr. Nemirow Dr. Feingold Dr. Fallenbum Dr. Siegel
I have not heard of the doctors you have listed (and I work in the field). Brad Berman is very good. I have heard that Dr. Landman may be too quick to give the diagnosis. Dr. Diller in W.C. wrote a very interesting book called Running with Ritalin. He is more cautious about medication, even though he speaks of the value for some children. Ann Parker is very good (if she still takes new patients). It's important that any evaluation be done by gathering information from teachers and parents. Also doing a complete history with the parents is essential. It is often difficult to differentiate ADHD (inattentive type) from Learning Disabilities. The school can do testing to help with that.(Put your request in writing). There are no tests that are done to make the diagnosis of ADHD, so it takes someone with experience who knows how to talk with parents (and listen), and who will do some simple educational screening tests with a child.Many people will use a CBCL form for the adults to fill out to gather information. They are various types of reporting forms. I have seen many children have a great deal of success on medication,(including inattentive type) often after they have tried other things. When the diagnosis is made with attention and care, and the situation is evaluated, medication can mean the difference between functioning well or failing and feeling dumb, different, or not liked. I was resistant to medications until recently, and it has made a big difference in my ability to start a task and actually finish it. It's like getting glasses and being able to focus in a new way. I suggest you do as much reading as you can (go on-line an type in ADHD), and talk with other parents. Children with ADHD need to be understood, coached, and guided. Kaiser Richmond does free classes for parents, and I hear that they are open to anyone.
We are looking into having our son evaluated---for possible ADHD, and any other learning disabilities or whatever. Is there anyone out there who has traveled this path and can help me find the right resources? Our son will be 5 next week, and will start Kindergarten in Berkeley in the fall.
We saw Dr. Brad Berman (a developmental/behavioral pediatrician) last year, and we are scheduled to see him again in February. But I am interested in learning more about what's out there, and what sorts of testing we ought to be doing. We will probably need a psychologist, too. Can anyone help?
For people concerned about learning disorders, hopefully they have had their child's vision checked out. Our binocular vision clinic at UC deals with lots and lots of children who have trouble learning because they are not able to see correctly.
Barbara, School of Optometry
I too have been through the ADHD testing and diagnosis. I'll tell my story as an example of a child who needed something else.
My son, Matt, was diagnosed with ADD and prescribed Ritalin in the 3rd grade. His behavior had become so impulsive and dangerous that my husband and I were scared of what he might do next. I was advised to have him tested for learning disabilities because of his reluctance to read and do homework even with our help. So the first thing I did was request testing from the School District Psychologist. Matt was put on a waiting list and tested four months later. The psychologist defined the problem as a short-term auditory memory disability combined with an anxious personality. Matt qualified for the Resource Specialist Program and Title I funding which requires the district to provide him with an individualized educ program geared toward his needs. Since January of 1996 he has been going to a special quiet classroom every afternoon with a group of five other children to practice reading, spelling and writing.
I am so happy and proud to say that he has improved incredibly this year. Not only academically but emotionally and socially as well. He is on the honor roll. He can read and chooses to do it. He does his homework. He cries less than he used to. He is managing his insomnia. He stopped fighting. He has made friends and has a stronger sense of self than ever before.
I think the key is finding what is at the root of the individual's problem. If you find the cause it may be possible to change the behavior that is a result of the problem. Resources I used in my quest for answers were: the web ADD site, the library (books on ADHD, learning disabilities, personality traits, child development, stress, discipline, etc.), other people who have experienced similar problems with their children or themselves, tutoring, family counseling, support groups, the UCB vision clinic, you name it. It took time, energy and patience to figure it out but it was worth it.
I joined a local chapter of CHAD when my son first diagnosed with ADD. My husband and I attended several CHAD meetings, seminars and the like and found them very informative and helpful.
Please note however that there was a huge 20/20 type TV show that addressed the fact that CHAD is primarily funded by the pharmaceutical company that makes Ritalin. Ouch !! Many local chapters including ours pulled out from National Headquarters because of it.
I tend think that any active kid has a good chance of being labeled ADD/ADHD, even with the consensus of both a pediatrician and psychologist, as was the case with our son. (Of course we all know of extreme situations, that are truly valid and must be horrible). We were warned that when the harmones start to kick in, esp. with boys and a bit of maturity develops, the activitity level lessens considerably; as is the case with our son.
Good luck to the Digest Member