Can/should neuropsych evaluation be done more than once!

Parents Forum Learning Differences and Challenges - LD, ADHD
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A little background:
DS2 was diagnosed with ADHD about 6 years ago after a complete neuropsych evaluation. He is now a freshman in high school at the LPS and is not doing very well. Our LPS uses block scheduling which I think may be part of the problem (I.e. the pace is too fast). He has horrible organization skills and often times forgets to do his homework, or worse, forgets to turn it in after he has done it!

My question is has anyone decided to do a 2nd neuropsych evaluation after 5 or 6 years has gone by? I worry we are missing something.

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Definitely. DD had full-on evaluations in 2nd and 9th grade. While there were a lot of consistencies, there were also new things that cropped up, including a new LD, because some of the tests had increased depth for the older age. These evaluations were both done privately.

She also had a less extensive evaluation in 5th grade, as part of her school IEP, which just showed consistent weaknesses, but did provide for additional age appropriate support.

Now that she’s entering college next year, she may eventually need to have testing done using adult scales; she’s 18. Her 9th grade testing was done late enough in the school year that I’m hoping it’s accepted for college freshman year accommodations. And the report spells out the long history of test results.

We had the testing done in 9th grade so she could apply for PSAT/SAT/AP accommodations with one request. She received accommodations for all 3 college board exams that lasted throughout HS.

Since you’re considering re-testing, it should cover the difference between timed and untimed testing results. That is usually necessary for extra time on the standardized tests.

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A side note–as the workload gets harder and more complicated to manage, especially in 9th and 11th grade, more executive function and concentration problems become apparent. In our extended family, those were years when ADHD medication needed to be increased. Good luck.

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@Maystarmom‌ thank you so much for responding. You confirm what I have been questioning for awhile. The workload and expectations have definitely increased this year over last year for DS2. I have also considered increasing dose of ADHD meds more recently.

What types of PSAT/SAT/AP accommodations are granted besides extra time?

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@Newbie3kids You’re welcome. She was allowed to take as many breaks between sections as needed, although I’m not sure what in her testing accounted for this accommodation. It helped her anxiety, although it made for a really long day.

Another accommodation she received was use of a keyboard for the essay. Writing with a pen or pencil hinders her from rapidly retrieving information and formulating answers. Using a computer makes it easier for her to write and simultaneously compose her thoughts. This was a known LD.

She was in a quiet room by herself, although this may have been because she was the only one using a computer.

She has a verbal retrieval learning disability–she can’t pull up words easily when speaking, and the AP Spanish exam required her to respond rapidly to a computer voice. We didn’t realize this ahead of time, or she might have asked for more response time. But she did well on the exam overall, thankfully, and we let it go.

There are other accommodations but they come out of the testing. If there are no LD’s, it can be tougher to get accommodations. I believe with ADHD processing speed is sometimes affected, which usually allows for extra time.

She has good processing speed but is a very slow reader and suffers from clinical anxiety, so her testing showed she performs better with unlimited time rather than timed tests, and she ended up with time and a half on all the tests. Her friend has dyslexia, and tests over two days with double time.

It’s best to have an educational psychologist who is experienced with the age group, and knows how the college board likes the data presented in the report, do the testing. We found one through the disabilities resource counselor at her high school.

My neice wth ADHD said the biggest difference between her Junior SAT score and her Senior SAT score, is that her medication had been optimized right before Senior year and she could focus better. That really helped her CR score, although it did nothing for her math score. She uses long-acting Ritalin.

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My child has had full neuropsych assessments done 4 times over the years. The first was done at the end of kindergarden, the second in 4th grade prior to moving to a new private school (for 5th), then in 7th grade in prep for moving to a high school and then this year as a high school junior in preparation for applying to college, etc (both for testing accommodation purposes and so she can register with student support services at college as needed). Early on it wasn’t entirely clear what was going on…there was an anxiety and attention deficit component, but the feeling all along it was probably NVLD (non-verbal learning disorder).

She was eventually diagnosed with NVLD once she was old enough to take the appropriate tests and though she does very well in school, A average, she has to work twice as hard to get there. At school she has some accommodations like extra time (if needed) and she uses a keyboard almost exclusively as her handwriting is awful. For math she uses graph paper as necessary (to keep columns lined up). We’ve had the same neuropsychologist do all her assessments so there’s been a great deal of continuity over the years. It’s also been fascinating to see what’s changed and what hasn’t over time and how much the support she’s received over the years has made a difference for her. During elementary school she took Tenex to help with anxiety, but she hasn’t really been on any meds since 4th grade or so…

After testing was completed this fall she applied for, and was granted, accommodations for both the ACT and SAT that include extra time, keyboard for essay, and writing in the text booklet (rather than filling in the scantron). In applying for accommodations the counselor had to provide statements from her various teachers that she used these accommodations in class. She’ll take the ACT this summer (over 2 days) and we’ll see about the SAT but she’ll likely do subject tests at least.

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Just to add…in order to receive accommodations for testing and at college the assessment needs to be fairly recent. That’s one reason we timed things the way we did.

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In our state, with an IEP, there is a requirement for a trienniel evaluation. Testing can be requested at any time, of course, but there is a formal re-assessment every three years, where it is much easier to sort through what neuro-psych testing should be repeated. We always used the LPS district contracted providers, though some feel that a more accurate assessment can only be performed by private providers (there is no potential conflict of interest; plus some testing has a subjective component to it).

Without an IEP, those are probably still good guidelines.