dealing with diagnosis

Last month, the Little Guy had a psychological evaluation for the purpose of having his behavioral health services reauthorized for another year. Even after filling out the paperwork to have his info released to me, they only sent me a summary, not the full evaluation. So I didn’t have any of the discussion sections, just the presenting info, diagnosis and recommendations. I was quite surprised to see a second diagnosis listed (his primary is autistic disorder, of course) – Disruptive Behavior Disorder NOS.

This was quite alarming to me, so I began looking up information on this diagnosis. I learned that there are three major disorders under this category – ADHD, Oppositional Defiant Disorder and Conduct Disorder. The NOS (Not Otherwise Specified) distinction would mean that a person had significant impairments but didn’t fully meet the criteria for any of those. The diagnosis is generally given to someone whose main issues are behavior-related; and the best treatment is considered to be parent skills training, presumably because the parents need to learn how to handle a child with one of these disorders to help them succeed as much as possible.

Now I had always heard that most psychologists do not give a diagnosis like this to a person with a Pervasive Developmental Disorder (of which autism is one) because issues with attention and behavior are presumed to exist and to stem from the neurological deficits of PDD. Without the full evaluation, I was at a loss to understand why this label would be appropriate for LG.

I went to the psychologist’s office yesterday to pick up my copy of the full evaluation and to meet with her. I had a list of questions to ask and was basically going to treat this as a fact-finding mission and try not to get too emotional. Well, before I could even start in on my list, she asked if I was concerned about the diagnosis and went on to say that it wasn’t supposed to be on his evaluation. She said that she didn’t have anything in the discussion sections about it and that her supervisor, who reviews all her evals, did not put it in. She believes it was a cut and paste error from using a template when typing up the eval, and they are submitting the change to the insurance company.

So in less than five minutes, I was back out the door, completely amazed by the outcome of the meeting. I don’t know if my request for a meeting is what prompted her review of the eval or if the problem had already been noticed, but I am so relieved and thankful that we don’t have to worry about another label being put onto Little Guy. We have enough to work on as it is!!

P.S. While looking for the diagnostic criteria in a friend’s copy of the DSM-IV, I found a section on caffeine-induced disorders (there are four)! They are sandwiched between amphetamines and cannabis. There was no specific mention made of Mountain Dew, however, so maybe I have Caffeine-Related Disorder NOS!!

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