Expert: Jene Aviram - 2/14/2010

Question
Hi Jene, I'm not sure if you remember me or not but I've asked some questions about my 2 year old daughter in the past.  Most of my concerns with her have past - she is still a slow to warm up child but does interact with other children.  Also no more pronoun reversal - sometimes she uses her first name but not too often.
Anyway, my real question is about evals.  I've written in the past that an OT eval noted no issues with sensory or AS concerns.  Our ped recommended a child psychologist anyway who we were extremely uncomfortable with. In lieu of going down that path again, we had a full eval by the school district birth to three program.  They did a comprehensive assessment in home using some methodology - avery ended up ranking a 92 out of 100 on the scale.  They noted no problems whatsoever and no autism concerns either.  At the end of the appt, I gave a brief account of what the child psychologist had said - they were actually kind of shocked as they thought it was way off base.  So - I wanted your opinion if a school district assessment is a good route: we felt it was complete, methodical, and accurate but these individuals are not medical docs.  However in my mind and with talking to them, they work daily with evals, diagnoses, and with kids on the spectrum.  I'd appreciate your opinion.
Heather

Answer
Hi Heather,

How nice to hear from you.  Things sound really positive about your daughter.  I know that because if they weren't, you'd be writing a whole list of new concerns.  Especially because as children grow the differences become more apparent.  But this is clearly not in your daughter's case.

I always think that you have to feel comfortable with the professional you go to.  It doesn't matter if they have every degree and certificate in the book, if you don't mesh well with them and don't feel good about your assessment, it's time to seek someone else.  This is what happened with the psychologist you sought out and if I were in your shoes, I would also not go back to her.

With regards to the school district, I do believe that many of these professionals are accurate in their assessment.  However, I would be a little wary of their findings for two other reasons.  The first one is unless they are a licensed medical professional such as a psychologist or neurologist, they are NOT allowed to diagnose.  Even if they suspect a diagnosis such as autism, they are not allowed to mention it.  The second reason is that IF your daughter is classified or requires services, they will be responsible to pay for these services when she ages out of Early Intervention which is soon.  School districts, like every organization have a lot of politics and budget concerns.  Basically, I wouldn't exactly call them objective.

Although it does sound like your daughter is doing well, if I were in your shoes I would go through the pains of getting one more evaluation from a licensed professional.  Call the Autism Society of America in your area, they might be able to suggest a good person for you to see.  Anyone they recommend will be well versed in all childhood disorders.  I know it's such a hassle to find someone and go through all the paperwork and appointments, but at least that way you can truly have peace of mind.

I hope this has been of help
Very best to you.

Jene Aviram
http://www.nlconcepts.com