Neuropsych Results

I received Ryan's results from the Neuropsych today. I have mixed emotions. Now, I already met with her to discuss the results so there isn't any major shock however, reading the results on paper, in black and white...

It hits a nerve.
It makes it REAL.
It sounds so clinical.
It makes him seem so....

AUTISTIC.

I'd like to share with you some of the things that were written in this evlauation. Partly to help clarify my feelings to myself, as well as so that you may understand Autism and Ryan better.

"On examination...it was initially very difficult to get his attention. I approached him in the lobby and he was watching TV. I had to call his name several times in order for him to look away from the television and engage eye contact. He initially seemed confused or perplexed. A few moments after I introduced myself, it was as if things suddenly clicked for Ryan and he initiated an introduction. He appeared rather scripted and intrusive with respect to personal space in doing so, but clearly this is a skill he has been working on. Very shortly into the interview, he began interrupting his mother to tell me things. ...he often repeated back fragments of the questions that had been presented to him. He was also heard underneath his breath repeating some of the words that either his mother or I had used in conversation. Thus, echolalia was quite prominent. Ryan's play seemed as if he was in his own world and seemed to center around scenes or themes from favorite cartoons, TV shows, movies, etc. Nonetheless, he would take breaks from this activity to share stories or engage our attention in some way. When he did, his comments were seemingly random. When he did try to tell a story, it was very difficult to follow him. His discourse was choppy and disjointed. Mild articulation difficulties were appreciated. He showed poor appreciation of figurative speech, irony and humor. Ryan appeared to have a hard time understanding even basic questions. Ryan's spontaneous speech was much better. Overall, Ryan appeared to be a little boy who was largely lost in basic conversation."

sob sob sob

"Emotion regulation and sensory issues appeared particularly prominent. At one point, Ryan bent down and was huffing and tearful. When asked what was wrong, he commented that his pants would not stay tucked into his boots. He was told that he could take off his boots if he wanted to. He immediately kicked off his boots and then when the examiner asked if he felt better after taking off his boots off he seemed to get more frustrated and angry."

"Ryan did seem to want to please the examiner, but he seemed to have difficulty following instructions."

"There was occasionally the sense that he might be tryuing to be directly oppositiona but for the most part Ryan seemed to simply have a hard time complying with what was being asked of him. He usually knew when to say he was sorry for inappropriate behavior. It was interesting that on one occasion while the examiner was waiting for him to answer a question he asked her if she was mad. This suggest some difficulties with accurate reading of nonverbals."

"The Wisconsin Card Sorting Test was attempted, but was discontinued due to poor effort and Ryan's frustration level becoming too high."

"Ryan's performance on force choice questions was impaired as well, suggesting that much of the information was simply not processed or registered."

"Neuropsychological data are suspected of underestimating this bou's intellecual abilities. Ryan's emotional reactivity made it very difficult to know if we were fully getting his best effort throught the course of the assessment. What does seem quite likely based on data and history is that this is a boy who continues to struggle in the verbal domain."

"Ryan strugges with organization of information and planning."

Recommendations from Dr. Amy:

1. Continued therapy.
2. Continued IEP services.
3. Stimulant medication for attention disorder.
4. Continued monitoring of Ryan's cognitive development.