Why Should I use a Neuropsychologist?

Someone I have worked with recently shared that they were not sure why they should use a Neuropsychologist rather than someone else to diagnose their three year old child in an IEE.  This had seemed obvious to me as someone who had a background in Clinical Psychology, but others don't necessarily understand the different classifications within the world of clinical psychology and why one title may be preferred over others in different situations.

A neuropsychologist is the elite in the world of educational testing.  They have the most education, the most training,, and the most experience.  All Neurop0sychologists will have a Bachelor's degree (either B.A. or B.S.).  Many have a Masters degree (either M.A. or M.S.).  They will have a doctoral degree (either Ph.D. or PsyD.), and they will have additional education in Neuropsychology.   In addition they must have completed all training as a psychologist, and completed additional training in neuropsychology.  After completing all of the above training and education, they also must past state tests that prove competency.  A neuropsychologist is more than able to diagnose anyone with learning problems and in some ways may be 'overkill' for a younger or more disabled student, but their degree of fitness as an expert is pretty unimpeachable.  The "neuro" part means they have studied the brain in more depth and they are able to administer tests that allow them to make more detailed assumptions about the brain.

A clinical psychologist is also someone that would make an excellent expert, although they have not spent the additional time studying neuropsychology.  For many children this would be adequate, but districts are less likely to admit to the expertness of the Clinical psychologist than the Neuropsychologist.  Keep in mind though, that districts rarely use Clinical psychologists to test the children in the district, so their "experts" in most cases are not as educated or trained as vigorously as most Clinical psychologists.  Testing is the specialty of the Clinical psychologist, although their testing strength may not be in educational testing.  Most often they test for psychological disorders.  They will have had to complete state testing to ensure competency.

A school psychologist must have a Master's Degree and pass a state competency test.  They are allowed only to practice in schools and their education focuses almost exclusively on learning to administer and evaluate educational tests.  They have no continuing education requirements.

An LCSW or Licensed Clinical Social Worker is trained and licensed to be a counselor or therapist.  This person would have an M.S.W. (Master's of Social Work).  They must also complete hours of training and pass a state competency test.  They have some training in administering and evaluating tests, but they have not specialized in educational testing and would not be considered an expert for the purposes of educational testing.

An MFT or Marriage and Family Therapist is very similar to an LCSW, except that their specialty is in relationships and they would receive either an M.A. or and M.S. in Clinical Psychology.  They would also not have the necessary requirements to be considered an expert in educational testing.

A Psychiatrist is a medical doctor who specializes in administering medications for psychiatric conditions.  Many children in special education may see a psychiatrist for medication management but they would not be considered experts in educational testing.  They might be an excellent witness for some aspects of a case involving special education, but they would not be a expert in the area of testing.

There are many other jobs within the area of psychology, including psychiatric nurses, psychiatric techs, behavior specialists, BCBA's, and on and on.  For educational testing however there is one group of specialists that is the top "expert" in the field and that is the Neuropsychologist.  When confronting educational issues/testing it is best to use the Neuropsychologist if possible, if you cannot get a Neuropsychologist then a Clinical Psychologist would be appropriate if they specialize in educational testing.  Although school districts will tell you that the school psychologist is an expert, using one as your "expert" is not in your child's best interest.  And, it is important that you never use someone whose credentials are not adequate in educational testing as your expert as any reports or testimony by the inadequately trained person can not be taken seriously.

Delay Tactics

I have learned over the years that the number one tactic used by the school district is delay tactics.  They have so many ways of doing this that seem legitimate but aren't that it would be impossible to name them all.  I will put down the ones I've encountered or heard about and I hope that those who read this will add to them with what you've faced.

The primary way this is done is to avoid telling you the rules.  They don't have to live up to time lines if what you have not made requests in writing.  So, we must put every request in writing, from evaluation for special education or for speech therapy or whatever issue concerns you.  It doesn't have to be fancy, just a little handwritten note will do, though I do suggest dating it and making a copy before turning it over to the district to be sure that you have proof of your request.

Secondly, if you are coming up on an IEP I have heard, "Why don't we just wait for the regular IEP date?"  We don't wait because we don't need to delay anything any longer than it already has been delayed.  If we are talking the difference of a week, we might wait, but a month?  No waiting, let's have a meeting. 

Another tactic would be to spread the IEP out - not have answers so have to meet again in a month and in the meantime, nothing happens.  Then deciding an evaluation is needed, so another 60 days goes by, and on and on.  Unnecessary evaluations are often a delaying tactic, make sure they explain why an evaluation is necessary, who should do it, and when.  Watch the time-lines, they will use them if they can to delay, most often scheduling meetings at the end of a legal time-line rather than earlier, if they can.

We asked for an evaluation for assistive technology, a speech device, and after the initial time period was done, they told us they had evaluated for one device, but now they needed to evaluate for another, this went on for a year, all the while we were being told it was important not to hurry the process since she needed to get just the right device.  We finally went out and got an outside expert to evaluate and she was able to do the evaluation in a couple of hours.  Still the district had another idea for another device, thus delaying everything by another 6 weeks since we couldn't just choose the device without the entire team getting together again, and that took 30 days to organize.  Once the district received the device we had to wait another three weeks for staff to be trained on the device.  This kind of delay cost our daughter over a year and a half before she got the device.  They were already late at even looking into a communication device, using the excuse that she wasn't using PECS, when in fact she finds the device interesting, but finds PECS boring.  By the time she got the device (thanks to all the delays) it was already outdated for her.  Then when we told them we had purchased an iPad and wanted them to get one for her for at school, the response was, "we need to do another evaluation".  Pretty rich! 

Most recently, our district has told us they cannot discuss placement for when my daughter returns from Home and Hospital instruction until she returns, which makes no sense.  For one thing, she is out on HHI because the school keeps messing around and she doesn't get what she needs at school and in fact they do what they do so badly that she actually develops behaviors and learns almost nothing useful at school.  We asked the doctor to to put her on HHI so we could find the right school and then request that she be placed there, now they say they can't discuss it until she comes back.  So we get a doctor's note, but they want another note - they don't feel we got the note from the right doctor.  These are all delay tactics.  They don't want to talk about placement because they know they are going to have to pay for her to go to a Non-public school because they don't know what they are doing.  It was so gratifying to go to the doctor today to get the second note and have her comment on how much better my daughter's behaviors are now that she hasn't been in school for a while.  She very happily wrote whatever we needed on our note to the school.    

A noted school district attorney group, Fagen, Freidman, and Fulfrost is known for their trainings, one of which is on how to avoid doing what the district is supposed to do "legally".  I correspond with a woman who went to one of their "trainings" in which they belittled parents by using nasty little nicknames such as Mr. Suesalot and Mrs. Evalstoomuch that sort of thing.  The entire training was on how to delay within the law.  So, if it feels like your district is just trying to delay - don't be surprised, they probably are.  They just try to avoid until the child is out of school.  They've probably been trained by attorneys on how to do it.  No wonder so many people have such bad impressions of attorneys.  The only way to deal with this sort of thing is to call it out.  You can call it out directly and see if they decide to stop, you can file a compliance complaint, or you can file for due process.  Even though they are trained to delay 'within the law', it really isn't within the law.  They get away with this because they can and we let them, not because they are right in doing it.  If you take them to court they aren't very likely to be able to keep delaying - because that isn't what education is about.