Monday, April 25, 2011

You Can Get a Diagnosis If You Want One

A couple days ago at a routine checkup for Boo, when it was just the two of us, I asked our pediatrician that question Dr. Yap and I had been wondering about for so long: "Do you think we should get [Bean] evaluated for ...anything?" I then rattled off a list that began with Asperger's and trailed off uncertainly with sensory processing issues.

We have gone back and forth wondering whether we needed to ask this question, have Bean's exact level of giftedness tested, or just needed to keep parenting the heck out of her and loving her even though we know not what...

A year ago, at her well-child checkup, we determined to ask.  Before we got that far, Bean imploded, then exploded, giving him the meanest look she could muster, refusing to allow him to examine her, and shutting down.  The visit ended with a referral to a therapist whom we never called. It took several weeks, but we finally got out of her that while he had been making friendly conversation with her at previous visits - commenting on her colorful outfits, agreeing with her that her first grade teacher was wrong about a presumed rash on her face (just eczema) - she misunderstood and thought he was teasing her or making fun of her.

I mentally lined up several alternate pediatricians who were already acquaintances and hoped it wouldn't come to that.  Several months later, Bean was having unpleasant side effects to a medication and I thought it would be better discussing this with someone she already knew than with someone new.  We weren't sure if medication was causing the problem and she was scared about what might be wrong.  As soon as Kid Doc came into the room, she shrank against me.  He listened to me explain the problem, then addressed her directly and asked if she was afraid of him.  She shook her head no, but refused to look at him or talk to him.  I waited a few seconds then asked her if I could tell him what was wrong.  When she consented I relayed to him how she felt about his previous comments.  He immediately told her that he had the utmost respect for her and her moms and brother and apologized for his insensitivity.  She then let him examine her and as he left he thanked her for teaching him an important lesson.  Bean hasn't had a problem with him since.

Back to yesterday's question.  Kid Doc didn't seem surprised by it.  He asked how she was doing academically and socially now and when she was still in school.  After I answered with a few examples  and told him how ambivalent Dr. Yap and are about diagnoses, he thought about his experience with her and said carefully, "You know, we live in a very strange society.  I happen to think that many of the most brilliant people who change our world and create brilliant things could probably have been or were diagnosed and labeled, whether it's necessary or not. I think [Bean] fits in that category...But, eventually, if she goes into a public school or on to college, she may need accommodations." So Kid Doc was almost as ambivalent as we were. But he had information.

After suggesting a few people to call, Kid Doc looked at me and said, "[Bean] would definitely get a diagnosis." Between the lines, his tone and meaningful look said, "If that's what you want and I am not sure it's what you need." He added, "And it would probably be Asperger's."

Exhale. Well, crap.

Or maybe not.  As Oma said, Kid Doc isn't qualified to give that diagnosis.  But he is qualified to give referrals, to a neuropsychologist who could give us a diagnosis, if that's what we want.  And to an educational therapist who could do a thorough academic/neuropsych evaluation, if we want details that we could use to accomodate Bean, without a diagnosis.

Even if I do make the calls this morning, maybe what we (and Bean, eventually) will be getting isn't just a diagnosis, but information.  More information about our daughter that we can take in, absorb, and use or not use.  I realized, after stewing about those seemingly fateful words from Kid Doc that whatever we find out, it will be information, not a prescription for parenting or a lid sealed on her future.  We had no qualms about getting her allergies fully tested and diagnosed, multiple times. Now we have that information and can make informed decisions to medicate or not, to avoid all allergens religiously or haphazardly, to define her by her allergies or not.  Sometimes we list them on forms and sometimes it just doesn't seem necessary.   If I make the calls, we can decide what to do with that information.

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