Nothing Is What It Seems – Part One

Tim moved to a new residential program in June, as he would be aging out of his previous program when he turned 18 in July. We were happy to find one we liked with a program similar to the one he was used to, much, much closer to home. As with most residential programs, after he’d been there 30 days they had a cross-functional staffing. This is basically a meeting with all the different types of professionals that interact with Tim to talk about his diagnosis, plan, and progress. These typically happen again every quarter and, in our case, are required to be done and reported to the State to ensure that he still meets the criteria to qualify for his ICG grant.

The most recent quarterly staffing was this past Tuesday. Typically I interact with doctors and social workers and Tom handles school and IEPs, but I couldn’t get time off to attend the staffing this week, so Tom went. When he got home he handed me a draft copy of the report they were to submit to the State and said, “this doesn’t look right, but I want you to review it.” I got two paragraphs in when the top of my head blew off.

As part of the intake process and initial staffing, Tim was evaluated by the RTC’s staff psychiatrist. The second paragraph of the staffing report had the doctor’s diagnoses based on his initial psychological evaluation. It wasn’t Schizoaffective Disorder. It was Mood Disorder Secondary to Cerebral Dysfunction. I had to look it up. Basically it means his behaviors and issues are due to some either organic or traumatic brain disorder or injury. Tim does have an additional diagnosis of Mild Cognitive Disability, as his last IQ test at age 14 put his IQ at 62.

After I read about it, I had two burning concerns. First, would this diagnosis mean he was no longer qualified for the grant that helps pay for his residential treatment? And second, how would a doctor that has seen Tim maybe 60 minutes over the past several months have the gumption to change the diagnosis that the two psychiatrists that have been treating him since he was 12 gave him?

Read the rest after the jump.

After Tom peeled me off the ceiling, and my compadres in the Parents Like Us club shared my irritation on our Facebook support group, I called and set up an appointment to talk to the psychiatrist in person this morning. If you’ve read any of my posts before you know I have zero patience, so imagine what it was like to live with me yesterday. But I held it together, gathered the last four years of psych evals, and set out this morning to my appointment with the pdoc. Tom reminded me not to go in there with – his words – “guns blazing” if I want to hear the doctor’s reasoning. That’s not my nature. I’m typically a hot-head right off the bat when I’ve been / feel I’ve been wronged and I calm down later. But this time I put on my big girl pants and decided to go in and tell him I had two objectives of the meeting:

Ensure he was aware that Tim is NOT a DCFS kid, and the diagnosis on the psych eval could make him ineligible for his grant
Hear the doctor’s rationale for the new diagnosis

I had a 30 minute appointment with the doctor, and ended up talking with him for an hour. And it was really quite interesting. Right off the bat he admitted that the additional diagnosis he made of Psychosis NOS was omitted from the report in error. He also admitted he didn’t realize Tim was an ICG (and not a DCFS) kid until I – The Mom – called. He planned on correcting the omission from the report before it is submitted to the State. So – first issue handled inside of five minutes. The conversation we had over the next 55 minutes is what I am chewing over in my mind.

I will post that tomorrow.