The results of all the testing for the 4.5 year old.

We got a lot of information, but a weird and wordy diagnosis from the pediatric neuropsychologist.

The official diagnosis: neurodevelopmental delay and limbic mood dysregulation with intellectual talent.

Okay, I’m not sure why it’s not something recognizable, like SPD or something, but maybe because she’s a neuropsych and the language is different. On the other hand, maybe she’ll have a better time getting services covered by insurance if it’s coded this way. I’ve heard SPD as a diagnosis is sometimes hard to get covered.

The details

There is a huge variance between brain functions. On some tests, she scored as high as a 8 year 5 month year old. On others she scored at the 2 year 6 month level. She’s 4.5. She did want the diagnosis to reflect that high cognitive ability, so that’s where the intellectual talent part of the diagnosis comes in. She forsees that in a few years, once the delays are caught up, she will be considered gifted.

She has a huge gap in her receptive and expressive language: she scored 125 on her receptive and 108 on her expressive. That’s a 17 pt drop. Most kids have 1-2 point difference. a 5 point drop indicates a learning disability.

This difference is explained by her being shut down when she’s on sensory overload.

There’s also a 3 year difference between her visual memory and auditory memory (so she’s a visual learner). I’ve been thinking about this and that’s a lot like me. But in time, this gap in auditory memory could result in an auditory processing disorder. So working on things now is a good thing.

When anxious/overwhelmed, she has repetitive movements – mouth smacking/lip licking/drawing in of the lower lip, etc. Right now they are just nervous habits when she’s overloaded. They could turn into tics if we don’t work on her sensory overload.

She talked about the fact that she feels there is chemical or even electrochemical glitches in her brain. There’s a very small probability that there is seizure activity going on. We may have to go for an EEG in about 6 months.

She has attention problems – trouble focusing, sustaining attention as well as switching gears (ADD). Now, while this may be true, I really have a hard time understanding this, because there are so many things she can focus and sustain her attention on (with me). However, I guess when she is in the shut down mode of her selective mutism, her attention is affected, which is probably why I don’t see it. She’s not selectively mute around me.

She also has some mixed dominance – she is right handed for some things and left handed for others. This apparently can cause some issues with learning and emotions.

So, the “plan” of action to do next that was suggested was

1) sensory OT (and apparently you need a certification for this, because my sister, who is an OT assistant, can’t give her the OT – I checked with her already).
2) using visual pictures as much as possible – get picture books depicting moods and emotions.
3) get a behavioral plan and IEP – she’s going to need help easing into school. This may require getting someone to visit the school and help her transition into school. I’m not sure if this is the same thing as getting an IEP, but I don’t think so, I do think it’s going to be part of the IEP though.
4) get into a movement program – specifically feldenkrais – to help with the mixed dominance issues – it will help coordinate her left and right sides. 8-10 sessions might do the trick.
5) Family therapy to help all of us cope.

Basically, there’s going to be a lot of things going on in the next 6 months if we want to help her the most in the shortest amount of time. Only because of her age, the dr didn’t suggest she go on medication (she’s not big on them anyway), but if she ends up having an abnormal eeg that shows seizure activity, she will probably have to go on meds for that.

Right now, she thinks that the issues will go away once we work on the sensory issues and the mixed dominance.

There’s a lot of professionals will will have to see, but essentially we should see vast improvement in 6 months. But of course if not, we may need to see about getting that EEG.

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