It always starts the same for parents. One day your child does or says something that makes the hairs on the back of your neck stand up and a nagging feeling inside you says,“something is wrong with my child”. Maybe your child is very young, a toddler, or maybe you don’t get that feeling until he is school age, but no matter when it dawns on you, it always starts the same, “something is wrong with my child”. For a while you brush it off as paranoia. You rationalize your child’s quirky behavior or lack of comprehension. You point out the things he excels at. You note that there is physically nothing wrong with him. You dig up family history about an Uncle that never spoke or flunked out of school but ended up a millionaire. You listen to friends and families well meaning opinions that there is nothing wrong. You chastise anyone that delicately suggests that you speak to someone about your child. Eventually, though, the denial stops and you come to terms with the fact that there is something wrong, or at least different, about your child. Maybe the child never does start talking. Maybe the child starts school and cannot fit in or is just not learning. Maybe there is an incident at a park or birthday party. Maybe a teacher or babysitter demands you do something. Whatever it is, at a certain point, you, as a parent, come to terms with the fact that your child needs help. Where do you go? Who do you start with? As a proud Mother of an autistic 11 year old boy, I get asked this all the time. And when parents call me, they are frantic, despondent, scared, and desperate for answers and a quick cure. I try to gently break it to them that there are none of either. There is patience and help. But, before a parent can get patience and help, they need to calm down, stop “what ifing”, let go of their expectations and be an example of how to handle life and its dilemmas. The typical route for parents trying to help their child is the referral to a child psychologist for assessment and diagnosis. This referral can come from a pediatrician or maybe the school district and is recommended as a starting point to determine what the child’s needs are. Well, as a parent that has seen many child psychologists, partaken in countless assessments, and heard other parents’ horror stories, my opinion is that the assessment from a child psychologist can wait, if even needed at all. Here is why:
- The child psychologist’s aim is to confirm that your child has an issue and attach a name to it. But, as a parent, your main concern is not whether or not something is wrong, you already know that, or you would not be seeking advice. A parent wants to know how to help his child. The name of the child’s condition is not nearly as important as how to help him. And, my experience with child psychologists is that their practical, working advice is useless. They do not see your child after the assessment, unless it is to follow up “in 6 months to a year”. Brand them and then abandon them.
- The psychologists have this horrible tendency to drag out the assessments. By the time you get an appointment, do their questionnaires, wait for them to observe at school, question the child, write their report, it is two months before you will have the results and recommendations, if you are lucky. And, the recommendations are usually vague. And they ALWAYS recommend weekly work with a speech therapist, occupational therapist or learning specialist, because the psychologist will not actually work with your child himself. So you have wasted a minimum of two months that the child could have been actually working with such a therapist or specialist, actually learning.
- A psychologist’s assessment is VERY costly, possibly $3,000 – 5,000. And, the psychologists probably will not take your insurance, you will need to turn it over to your insurance company, which depending on your insurance, might not be covered. What a racket. Then, to make it even worse, the psychologist is going to recommend therapy or a learning specialist, and the therapist or learning specialist is going to insist on their own assessment, to determine where to begin working with your child, because there will be no such information provided by the psychologist’s assessment. Her assessment will merely assign a label to your child, give reasons for the label, and recommend therapy.
- If the child is school age, the school district may tell you to get an assessment and they might not give you services without one. But, with school district cut backs, you might not like the district services anyway, so the assessment is worthless. Health insurance for children is available here.
- How to pay for speech therapy? Consider an HSA with your individual medical insurance plan or group plan.
What I usually recommend is to find a good speech therapist and ask her to assess your child. Many parents think, “Speech therapist? No. He speaks very well”. But, what parents do not realize, is that often times children, no matter how they speak, have auditory processing issues or social language issues that a speech therapist can spot and help remedy. Your child might speak well, but not comprehend well, and a psychologist’s assessment will not help determine that, but a speech assessment will. If the speech therapist does not feel that your child has a processing, communication or language issue, she will make suggestions where to go next. Either way, her assessment is less costly than a psychologist’s and comes with practical experience that comes from teaching children every day.
There is the issue of medication, and whether that is appropriate for your child. But, for that you need a psychiatrist, not a psychologist, and I almost never advise people to start medication for their child until after they have done some work with a therapist. Therapy or tutoring is the main need for any learning or developmental difference. Medication is just a tool to facilitate the therapy. I cannot emphasize this enough. Therapy first, then medication, if necessary, to further help the child’s learning. There are exceptions to this, of course, particularly if the child is violent, but generally the medication should be part of a therapy or learning plan that you have established. Behavior medications are not magic beans, they will not work if the underlying issues are not addressed. Address medication coverage when getting a medical insurance quote. None of this is to say that there are never circumstances when a child psychologist’s is necessary, especially if there are emotional or post traumatic stress issues, but if it is learning issues that you suspect, then and a qualified therapist or learning specialist can help you from the start of your journey. No matter the issue, difference or problem, the sooner the child gets help, consistently and regularly, the better. When it comes to children, it is not prudent to wait and see. You risk turning a small issue into a larger issue, as with most things in life. Where to find a qualified speech therapist? Ask other parents, your school or your pediatrician. Then, take a deep breath, get started, and be prepared to be impressed with what your child can do when they get the help they need. Learn about the use of ipads and other assistive technology for educational therapy.
