What to Expect at an ADHD Consultation

Unless its a developmental pediatrician...

- Blood work
- Urine test
- Q's about sleep & diet
(Aka things that mimic ADHD)

And then 'Sounds like it MIGHT be ADHD. Here's a referral / do you have someone you'd like a referral to?' OR "You know, this is looking like it might be _________. (Diet, sleep, allergy, situational). Lets try doing _______ for 2 weeks-3 months and see if that helps/rule it out.

Standard Peds ONLY rule out medical causes (low oxygen, high blood sugar, allergies, malnutrition, sleep dep, illnesss). Some do, but NEVER should, diagnose ADHD. But some do. The send patients to cardiologists, dermatologists, etc... But just ignore that the brain is YHE most complex organ in the body and start mucking about.

A DEVELOPMENTAL Ped is qualified to diagnose psychiatric/neurological disorders. But not a standard Ped.

So expect a 5 minute meet, or an hour long physical, but NOT ADHD diagnosis or treatment plan. That needs a referral to

- Devdlopmental Ped
- Pediatric neurologist
- Psychiatrist
- Psychologist

Do know, a med prof and a psychologist usually TAG TEAM ADHD. Med for diagnosis and medication monitoring IF you are diagnosed AND choose to try meds (many just go with counseling to start, then may or may not add in meds). Psychologist for counseling / coping mechanisms '.

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Note: Nope! Insurance companies do not require the order of meds, like Ritalin first (or rather... It is NOT stabdard, nor best practice. They usually DO require the generic first, though). Many start out with Ritalin family (methylphenidate) first. Many also start out with Adderal or Straterra first. Or one of the other 73 ADHD meds out there. Dexamphetamine, etc.

Since a pediatrician isn't really qualified to diagnose ADHD I would assume they are going to say that some of the answers on the forms might indicate he could be ADHD and that you need to go to a psychologist who is qualified to do diagnoses. Once they see your son and do their evaluations they will sit down with you and discuss the results. If he is diagnosed with ADHD they will refer you to a psychiatrist who does meds for kids. If the one they suggest does not take kids then you'll need to talk to every psychiatrist in your area to find the one or two that do.

A pediatrician is really a kids doc that treats all sorts of kids illnesses and knows just what meds to write scripts for to treat those illnesses. They often think they are up to date on the current meds, what's working, what's being taken off the market, what sorts of side effects are currently going on with the meds...but they are not really qualified to treat this illness.

It's sort of like going to the OB/GYN for a heart condition. They can treat it but they would not know the latest medications or the latest treatments for some illnesses.

I do believe that all insurance companies require a child to be put on Ritalin first. It has been around the longest and has proven itself over and over. If there were any dangerous side effects it would have shown it's self by now. It is the cheapest med out there for this and if it works it works well. Our grandson is on it and I can see a huge difference in him when he has had it.

It does not build up in their system. It is gone after just a couple of hours so they can have their behaviors back very shortly. I think one of the main reasons that Ritialin doesn't work for everyone is that they want a more time released med. That's what most of the others are, time released.

I think you should expect him to give you a referral for a more in depth evaluation. I'm not sure a pediatrician will diagnose ADHD on his own.

Please change diet and modify systems at home before getting this label. The label will help him access treatment but also could be hard on your family. I am a therapist and have just seen this being over diagnosed, I have no idea of your son. Good luck to you, it sounds like you are his best advocate. Ask questions.

We consulted with public school counselor, school social worker, school psychologist and our own pediatrician to understand resources. Upon connecting with local psychologist there were many tests. It was concluded that because at age five there were no school report cards or other feedback of "problems at school - no disruption of class" that there was no ADHD. The psychologist was very helpful and agreed that it was difficult for child to read and answer questions about text...that even though it could not be fit into the ADHD category that there was a difficulty or difference. With a label of "ADHD" the public school makes modification (ie more time to take tests) and there is teamwork between parent and school resources. Without this label, there is still the question of how to support your child and provide appropriate environment for learning and growing...to celebrate what does get accomplished and suggest ways around roadblocks.
Psychologist office in Wheaton that we used was covered by our insurance and was called Dr Madvig's office - ###-###-####. Our pediatrician SUGGESTED three different psychologists (and we picked the first one for the testing). Our public school counselor canvassed staff and agreed that our student would "have difficulty staying on task (but NOT be disruptive) in class"...

Its GOOD to discuss with your pediatrician. We did NOT end up using any medication. I would describe visit to pediatrician as a "consultation" to figure out resources.

The psychologist's testing took multiple days (that school was missed) and we were happy to do it to get answers. We had to take time off from work to get the briefing from the psychologist after all the testing was completed.
The point here is that you don't get the answers quickly.

We have always been thankful that we did the testing at the psychologist's office and the consultation to understand how to help our child.

You are lucky to be seeing that you want to get help for your child at an earlier age to find out what is going on and how to choose next steps.

Hi. I think you need to talk to your son prior to the appointment. Keep it general and positive. With my son, we talked about exploring how to help him make school a better experience by helping him focus.

Your doctor may want or need a more complete questionnaire if it was only ten-- there is a conners scale that may provide more insight. He will probably check heart rate, blood pressure, the basics. You might want to call your pediatrician's office as I 'm sure they can tell you what to expect.

Good luck to you and your son!

I don't understand why you are going to the pediatrician. If the pediatrician suspects ADHD he should have referred you a psychiatrist or a neurologist straight off. I really don't understand why your son has to be at the appointment at all since all the pediatrician is going to do is tell you what the questioners indicate.

I don't like when pediatricians dabble with ADHD, it just has too many faces, there is no way a pediatrician has the time to learn enough about it to be effective.

Anyway with my kids psychiatrist it was just talking so no reason to prepare the child. I think the less you talk about it with your son the more accurate it will be. Since we went to a psychiatrist we left with a script, which actually worked perfectly. Which I have found is pure luck, usually they have to change up the meds before they find one that works well.
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After the what happened, even in an HMO you don't have to *see* the doctor to get a referral. For three years I was in a referral HMO, I just listed why I needed a specialist and my primary care would do the referral. You can also make an appointment with a specialist and they will seek the referral.

Not that I am always a suspicious type but I would wonder what the motivation is of a doctor that doesn't point that out. Ya know, like your pediatrician. Is he hard up for business?