My oldest son is mildly ASD, but he was wildly ADD inattentive. Although his EF was and is top notch, the inattentiveness of his ADD canceled it out. He attended a local CC with a special program for 2E kids. He was placed in classes with handpicked teachers, had a counselor assigned to him and attended meetings and social groups. He ultimately dropped out because he refused to accept that he was required to take English composition to graduate and I refused to continue to pay if he refused to take classes he needed to graduate. The program was very helpful to him. He’s 27 now and is a mail carrier for USPS. He is highly organized in getting his routes done and is in great demand as a loaner to other offices.
He had an IEP throughout school but the ASD diagnosis was only added in 9th grade so that I could send him to a specialized HS.
I agree with starting with a neuro-psych, not a psychiatric eval, as the former can do testing. Get someone who specializes in working with kids. One of my friends backed off in senior year of HS from her child with EF issues and got a coach instead. Her child had an IEP in place. He floundered at first but he graduated and is now on a gap year. He will be starting college this fall. During the gap year, he is working with a nationwide volunteer organization. He is not living at home and is responsible for things like his own laundry, time scheduling (he has to be somewhere at a certain time or else) and other things that require EF. Now that he’s mastering these, his adjustment to college will hopefully be easier.
Good luck with your D. It’s very hard to acknowledge that our children have these issues.
I wanted to correct my earlier post suggesting a psychiatrist, agreed that it is a psychologist that you want. Darn auto correct earlier.
GloriaVaughan you earlier stated that a 504 or IEP in high school was necessary to get accommodations in college and I wanted to make sure to correct that idea. I refer you to your own post.
On another point, it is true that many schools will not take a doctor’s note, even for ADJD, but require a full evaluation. In my mind, this is misguided since ADHD is a clinical diagnosis made by a psychiatrist (or even a primary care doctor). There is NO reliable objective test, even as part of a full neuro-psych, evaluation, partly because the conditions during that evaluation are not natural (though a radio can be played during tasks to test for focus etc. that really doesn’t test for ADHD).
I think, however that a full evaluation can eliminate or uncover other reasons for problems with executive functioning problems, attention, focus, slow processing etc. So it really needs to be done. A full evaluation is expensive. You can try asking your school system to do that. We did that once, in 3rd grade.
If there is any possible medical reason for the challenges your kid has, then it is possible to get private insurance to pay for the evaluation. For instance, my kid was born with a pneumothorax and was put in an oxygen chamber for a bit. That was enough to get insurance to pay. I suggest talking to a supervisor at your insurance company. You can offer to be selective about testing or do whatever else the insurance wants in order to get some coverage.
We got insurance coverage for our evaluation due to a concussion years earlier.
I really agree with @compmom 's post on the benefits and limitations of a neuropsychologist evaluation.
My D with EF problems came out of the six hour np eval without an ADHD diagnosis although a psychiatrist who met with her for six months was absolutely convinced she has ADHD.
Interestingly, when the np broke down the score of various tests, she determined D had truly impaired visual attention. As far as I could understand, there’s not a neat diagnosis for that. She wouldn’t call it ADHD, though she said other nps would.
Another daughter has APD diagnosed through extensive testing by an audiologist. Everyone who knows her recognizes her problem. But the np that evaluated her could not see it because she was evaluated in a quiet room with one person speaking to her.
Meanwhile, through that testing we discovered visual and visual-motor problems, which would have never known about because for us the auditory problems were such a problem that everything else seemed minor.
So through the testing, I really got to understand two of my kids much better. It really helped our relationships and I learned to communicate with them better.
I would add that depending on your insurance you may not need a medical reason. In our case, the school district does not provide a full psychologist evaluation without very strong indicator of need. However our insurance requires no referrals for mental health benefits and the full psychological testing was covered. Call your carrier to see.
I learned for example that he is an exceptionally high verbal learner. And that while his visual is not low, it’s a large gap between the two. Which for me helps me to understand why lists and planners just simply do not work for him but if I tell him something (or a teacher does), then his likelihood of remembering and following through is significantly higher. Not great mind you, but higher.
Just a bit of hope for OP, and some other the others. I have a degree in Speech Pathology, and work on IEP teams regularly. Our daughter has ADHD. I was honestly a wreck when she went to a demanding college on the other coast, and she absolutely EXCELLED. Like, beyond my wildest dreams. I can’t say this is is true for everyone, but it worked for us.
- Request a comprehensive evaluation in writing in the school setting. This is the least expensive and most curriculum related way to assess current skills. Your school has 60 days from your written request to complete the testing and hold the meeting. Request it NOW so she is at the front of the line for Fall. Psych - speech pathologist - learning specialist. It is quite likely that she will not qualify for support services at school: most students who are maintaining excellent grades are not “low” enough to qualify for help. However, go to the meeting, discuss strengths and weaknesses, ask for accomodations if needed, and take your report to the psychiatrist of your choice.
- Find an ADHD coach. ADHD is a funny thing: basically, there is no one test that reveals a diagnosis in most cases. I spent years playing the does she or doesn’t she game. It’s lost time. That said, a psychiatrist can look at your child’s strengths and weaknesses and determine if medication to assist in focus and atttention might be worth a TRIAL. There is basically NO WAY to tell if a trial will be helpful… except doing a trial. Do NOT ask your pediatrician - this is like asking your doctor for a a pair of CVS glasses. Try the meds. Many people are against meds because they have heard they have side effects, cause addiction, etc etc. etc. Guess what - walking through every day with people nagging you and struggling with things others have trouble with has PLENTY of side effects. How would you feel if your mother structured your day? I have watched kids get a negative message from a peer, teacher, or outsider every five minutes in a classroom. What is that doing to her head?
- Find an executive coach, and research tricks to assist her on sites like ADDitude.
- Let her be the driver - if she thinks the meds help, continue them. Be diligent about adjusting the type and dose - I think our daughter changed seven or eight times between 8 and 12th grade. Some choices had side effects - we noticed them early. Others simply didn’t work. Keep trying.
- Don’t think that your daughter isn’t listening if she isn’t following your directives. In our case, I gave my daughter tons and tons of well-researched, evidence based suggestions. She did 5% of them - until she got to college. I was SHOCKED when she got to college and got her first grade. In her words “You know all that stuff you told me to do and I didn’t do, Mom? Well, I didn’t think I needed it then, and I knew that I would need it in college. So… I took it out of the deep freeze and did every single one!!!”
- We took her current testing (which we learned must be within 2 years) to the disabilities office upon arrival. She talked to the Director, and discussed the myriad of options that she had when she needed them. They were EXTREMELY supportive. As it turned out, she never needed anything.
You could be describing my son! He is finishing up his freshman year in high school. He was tested this year by a psychologist and I got a second opinion from a neuropsychologist. I was convinced he had ADHD. Well, according to both providers we saw he doesn’t. He does have a slow processing speed compared to his IQ and this causes him many problems in school, but there is no LD going on. She did mention EF issues but thinks him maturing will help that. They feel anxiety and mild OCD could be to blame and recommended therapy, which we are going to start this summer. So, my question is what can we do in the meantime? Just recently he came to me upset because he had wasted two hours playing with a pair of pliers and messing with his fingernail when he was trying to study. It’s been very upsetting for both of us. I admit there is lots of laziness involved, but his processing speed is such an issue that he can’t finish tests that he should have no problem with. At this rate I’m afraid I will have to go to college with him to keep him on track. His teachers are pretty supportive because they realize he knows the material, just needs extra time, which they don’t really have to give him since he doesn’t qualify for a 504 plan. I am grateful but worried about the future.
@tif1972 If anxiety is a problem that is affecting school performance, it’s possible to get a 504 plan for that.
This is a little hijack but I know you all will understand. I just learned my D with the visual processing weakness mail fail geometry. I knew she was going to run into trouble, but she’d be managing well enough until the third quarter. This was a bright kid who could never add the numbers around a geometric figure to calculate perimeter. 
Mom of kid whose EF skills started sliding in junior year of HS. Evaluated by neurospych and psychiatrist and started with medication and therapy for ADHD senior year. Has accommodations in college but was too late to request anything in hs. Kid commuting from home and finishing first year in nearby university and has done well. I did not do any management with him, aside from just asking how everything is going.
Extended time for exams was a big help for him. Also takes a lighter course load (14 hours in spring instead of 17 as listed in guide). Accommodations also include priority registration. Has some apps for reminders, which he swears by. He likes the flexibility in college scheduling. We were fortunate to have it all work out, especially the parts with a decent university within easy commuting distance, and a fantastic therapist.
While he was admitted to state flagship, he declined in favor of a smaller school. He’s having a lot of opportunities at his current school ,which may not have been possible at a larger university with a more competitive student body. I hope this is helpful- I am so thankful for all the advice that was posted here on CC a couple of years ago, when our journey began.
The reason why a 504/IEP is crucial is that it guarantees your child protections under ADA. Colleges are not bound to the same rules as k-12 in regards to students with disabilities, but they are bound to accommodate under ADA. If your child has a professor who doesn’t want to accommodate, being covered under ADA forces the issue. An IEP/504 also provides some assurance that certain necessary accommodations will be provided. It can to be an uphill battle to try to get an accommodation they didn’t have in HS. Just a diagnosis alone does not legally entitle someone to accommodation. To be legally entitled, the diagnosis or severity of diagnosis must impact one’s abilities in specific life areas to certain degrees. Without documentation to the effect of qualifying someone to ADA protections, any accommodations granted are a courtesy that can be altered/rescinded at any time. In regards to the OP’s situation, getting a formal plan drawn up now is the most direct way to getting accommodations for college.
This is incorrect. Section 504 of the 1973 Rehabilitation Act and the 1990 Americans with Disabilities Act (ADA) are laws that prohibits discrimination against people with disabilities. Any college that receives public funds are bound by them. Students aren’t required to have IEPs or 504 plans in high school to be protected under these laws, and having an IEP or 504 plan in high school won’t guarantee that the student will receive accommodations in college.
Everyone is protected under the ADA. Whether or not they receive accommodations in college depends on what paperwork each college requires. Neither an IEP or 504 plan is legally binding in college, so OP can pursue them or not as she chooses. The process for obtaining accommodations in college is different than the process for obtaining them in high school. It’s important that people read the websites of the colleges where their children are applying so they understand what each college requires.
You really don’t understand how this works, do you? A person can have an LD or other disabling condition without qualifying for ADA protections. For example, one of my children has spina bifida, which can cause mobility/motor issues as well as paralysis in severe cases. That’s the diagnosis. However, my child has a mild case that does not cause enough impairment to meet ADA standards of a disability. People with hearing loss that is completely mitigated by hearing aids also do not qualify for protections under ADA, nor do people with glasses whose lenses correct their vision to a normal acuity. There are specific guidelines for many types of conditions that specify who does and does not qualify as a disabled person under ADA.
“Everyone is protected under the ADA. Whether or not they receive accommodations in college depends on what paperwork each college requires. Neither an IEP or 504 plan is legally binding in college, so OP can pursue them or not as she chooses.”
That’s patently false. Everyone is not protected under ADA. Again, one can have disabilities without being considered disabled under ADA specifications. The papers themselves are not binding, which I have stated, but (assuming your home district does them properly to begin with) if you have an IEP, you’ve already been qualified under ADA. If you can show a college an IEP, they know you meet ADA requirements. If you only walk in with a diagnosis, you are not automatically ADA-covered and therefore not automatically federally entitled to accommodation. If you don’t have paperwork to prove your ADA qualification, schools are not required to accommodate you. For some conditions, doctors can certify your ADA eligibility, but not all depending on what the condition is and what qualifications the doctor holds.
@GloriaVaughn It seems like you are confusing some things regarding ADA and IEPs versus 504 plans.
ADA law requires that the problem impacts one or more life activities. A student who meets that criteria can get a 504 plan in k-12 or appropriate accommodations in college even though they did not qualify for an IEP.
About the hearing loss example, the disability office at my D’s college provided help to kids with hearing impairments mitigated by hearing aids. Hearing impairments affect functioning in many ways and much more than most people realize. In k-12, kids with a hearing impairment can get 504 plans under ADA when if don’t meet the criteria for an IEP.
Everyone IS covered by the ADA, just like everyone is under the IRS code. You may not get accommodations under ADA and you may not pay taxes, but you are still under federal law.
In many cases, if you just ask for an accommodation it will be granted. Need to have no class before 10 am? Maybe the school won’t guarantee it but many will work with the student to get the schedule, services, and accommodations that work best. The schools want the students to succeed.
@MACmiracle I’m not confusing them at all. Perhaps you are. If a hearing loss is corrected by hearing aids then it isn’t considered a disability. If there is a vision loss (less than 20/20 vision) which many people have, but it is corrected to 20/20 vision or under 20/200 with either glasses or contacts, then it isn’t considered a disability. If life activity interference is mitigated by the use of a hearing aid or glasses under the ADA guidelines for their disability loss then they are not considered disable. My uncorrected vision, under ADA guidelines qualifies me as being disabled but with corrective lenses, my vision falls under the level that qualifies me as being disabled, therefore I cannot qualify as being disabled. Someone who’s vision is 20/800 without corrective measures but with corrective measures it becomes 20/100, they are not considered disabled but if with corrective measures their vision is 20/250 then they are considered disabled.
If your D’s college is providing help to kids with hearing impairments then either they are doing it as a courtesy or with hearing aids they still fall over the disabilities line for hearing loss.
In my neck of the woods, a neuropsych eval often costs $7500 or close to it. Is that the norm?
@GloriaVaughn I would hope people in disabilities offices realize the limitations of hearing aids and understand the students’ struggles and want to help them in the areas they are able. For example, a kid may pass a hearing test with hearing aids, but sounds that come from hearing aids are not completely like normal hearing. In a classroom setting, they amplify ALL sounds. Kids have to work harder to understand the professor’s message, so their ability to maintain attention for long periods is affected because it can be exhausting. They may also process language differently and need extra time. It’s generally not a hardship for a college to provide an extra set of notes, a recording device, an FM system, extra time on a test, or space out classes to help with issues like this and college disability offices should be willing to help.
I’m veering off topic AGAIN to discuss the hearing issue, but I think the same can be said for other problems. It might come down to how much an individual college wants to recognize the difficulties of students with disabilities and want to help them, or not. I guess it’s the same as differing interpretations of ADA. Maybe a philosophical difference. I don’t know.
@CHD2013 Neuropsych evals can vary a lot. I think I paid $1800 for one and the quote on the second for a private eval was $1500. Those were the least expensive I could find at the time.
It definitely seems much more expensive if you go to a children’s hospital or another type of educational center versus going to a neuropsychologist’s office. I have friends who paid anywhere form $5,000 to $12,000. The highest cost place included brain MRIs.
I think the important thing is to make sure you go somewhere that’s recommended by a friend who had a good experience or even a pediatrician who has read reports by different psychologists. Higher cost doesn’t necessarily mean better.
Our evaluation was around $1800 after the insurance negotiated rate. There is likely one more bill coming for the report so maybe 2k all in.