A second opinion on a twelve-year-old’s ODD label, and the difference between trying to defeat a limit and trying to find one. The referral packet used the word random four times. Randomly groans during instruction. Randomly hits classmates. Random outbursts in PE. Random refusals.…
A nine-year-old chess champion, a borderline autism question, and the difference between incapacity and inexperience. Victor was nine, a rated tournament player, and better at chess than most adults who sat across from him. He set up the board during our second session the…
A fifteen-year-old who was easy to like and easy to misread, a hedge the data had not earned, and what it took to correct the record. I want to show you the worst paragraph I wrote last year. Results should be interpreted with caution…
A gifted ten-year-old, two borderline attention tests, and what an examiner owes a family when the data will not decide. His parents had timed it. Thirty-five minutes. That was how long Michael could sit with homework before something in him stood up and left,…
A twelve-year-old artist, the therapist who carried her through grief, and the attention problem giftedness had helped her outrun. Savannah’s therapist keeps her drawings. Five years of them, taped to the office wall in slow rows, from the crayon houses of a seven-year-old to…
Why recovery is tested after discharge, and why the plan has to begin at admission Two clients leave the same residential program on the same Friday. Same primary diagnosis. Same length of stay. On paper, they look nearly identical. Two years later one of…
How to evaluate treatment programs when the stakes are real Most families choose residential or intensive treatment in the worst week of their lives. The decision is urgent, emotional, expensive, and usually made from two things: a polished website and a persuasive admissions call.…
By the time many adults seek an autism evaluation, they are not asking an abstract diagnostic question. They have often spent years feeling misread, mislabeled, overwhelmed, or unable to explain why ordinary life takes so much effort. Some arrive after months or years of…
Why the people around the patient have a stake in the answer Most neuropsychological evaluations are requested by someone who wants to understand a problem. A capacity evaluation is often requested by someone who wants a particular answer to it. That difference changes everything…
Why the evaluation often begins before testing does Families often arrive at neuropsychological assessment after the ordinary structures around a patient have stopped working. The picture is unclear, urgent, or stuck in a way that no one can see clearly anymore. They want answers.…
