How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Mark Your Own Question

Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5099
Experience:  Dr. Mark is a PhD in psychology in private practice
Type Your Mental Health Question Here...
Dr. Mark is online now
A new question is answered every 9 seconds

I have a 6 yr old in 2nd grade (she will be 7 in November).

Customer Question

I have a 6 yr old in 2nd grade (she will be 7 in November). She has always had issues with focus, aloofness (or spaced out), weird social skills. She is good with spelling, reading etc. but struggles in math unless she has 1 on 1 teaching. I have always thought she had a mental "glitch" but couldn't quite put my finger on it. I also think she is too young for 2nd grade. I asked her current school to put her back in 1st grade, but they were not open to it.
I asked the school if I could get her evaluated so I could get her in the right school or get her the help she needs to succeed but the school psychologist didn't think that she would qualify to get it done. I strongly feel the need to get her evaluated so I know how to move forward in getting her the right help. She is definitely in the wrong class (her 2nd grade teacher agrees) and I would hate for her to get further behind. I think she needs a smaller classroom and an individualized academic program if possible. Do you think she should get evaluated and if she does show deficiencies what kind of resources are out there?

Thanks
Submitted: 10 months ago.
Category: Mental Health
Expert:  Dr. Mark replied 10 months ago.

Dr. Mark :

Hi! I'll be glad to help you with this issue. Let me ask you a few questions for us to get started, okay?

Dr. Mark :

Does she make friends easy now and in the past? Did she always play in age appropriate ways and does she have good social skills?


Does she tend to obsess on activities she likes and have a hard time stopping when it's time to do something different?


Does she have repetitive motions and movements? Does she also have certain habits she does over and over?


 


Does she have a hard time relating to other people's feelings?

Dr. Mark :

Hi, I see that you are standing by. Do you need more time to reply? Because the chat closes if there is no activity after a certain amount of time, okay?

Customer:

I never saw the initial answer. Could you please respond to my question?

Dr. Mark :

Hi, I'll be glad to respond. In fact, once the chat closed on the other question you asked that is still open, I was typing an answer there. Do you see the questions here that I asked over there that carried over? I also am unclear why you gave a bad rating. Is there a reason?

Dr. Mark :

Would you consider changing the bad rating as it reflects badly on me and I have been merely waiting for your replies?

Customer:

Yes I could not see your answer. maybe it's the site. could y ou resend it somehow?

Dr. Mark :

Do you want me to finish typing the answer there? Or would you like to chat here?

Dr. Mark :

Or both?

Customer:

you can chat here that's fine.

Dr. Mark :

Do you see the questions above that I originally asked you? They're here at the top of this chat.

Customer:

ok yes.

Dr. Mark :

As you work on those questions, let me say I can imagine this is a very frustrating situation for you and I can also sense the worry. And I agree with you that there are grounds for concern. We don't know for sure if there is a problem or not, but there you are noticing enough behavioral anomolies that you're concerned.


 


 

Dr. Mark :

 


I also agree with you that it's very frustrating trying to get schools and school officials to help in such situations. They want things very black and white and extreme. If you are a little concerned, they are usually not interested in considering the issues because they're concerned about allocating time and resources.

Customer:

she has a hard time making friends, she does not have a hard time relating to people's feelings, she does not have repetitive movements, she does get really attached to people and things and has a hard time letting go of them, and yes I will change my rating

Dr. Mark :

Are you concerned about possible developmental problems in the Autism Spectrum area?

Dr. Mark :

That's why my questions, which are specifically aimed at ruling out Asperger Syndrome

Dr. Mark :

What are your thoughts about what the problem might be?

Customer:

Yes I do. I think she may have Asperger's syndrome. If she does, this school will NOT work for her. Don't know what to do :(

Dr. Mark :

I understand; it's a tremendous worry.

Dr. Mark :

Is there a children's hospital in your area?

Customer:

oh yes! plus newly divorced with 2 other children. There is Stanford close by

Dr. Mark :

Good. That gives us a tremendous resource.

Dr. Mark :

I'm very sorry about the divorce. That does throw a new variable into your daughter's behavior, though:

Dr. Mark :

Is this behavior you've described and that is worrying you fitting the timetable of the great tension between her parents?

Dr. Mark :

Not just the actual divorce, but the fighting and the tension between the two of you?

Dr. Mark :

What do you think?

Customer:

She has always been "spaced out" even before the divorce. She was only 3 when I left so I don't think she recalls. Also, we were not the screaming arguing type. we just did not speak to each other.

Dr. Mark :

Thanks so much for answering that. I know it was not easy, it brought up a bad time in your life.

Customer:

I just would love to get her diagnosed or have any mental condition ruled out. I think this would help me to how tomove forward.

Dr. Mark :

Is calling the Children's Hospital or the University Hospital at Stanford available to you as a diagnostic possibility. They would have the most experienced diagnosticians.

Customer:

hmm you are probably right. I think I will take that approach.

Dr. Mark :

Can I also give you some resources? For learning about Asperger's and for working with AS kids?

Customer:

That would be awesome!

Dr. Mark :

Great. Now, I don't want to make it sound as if we've just diagnosed her. That would be unfair. But you have good observational skills clearly and you love her and you're worried. So,

Dr. Mark :

the most important thing is to verify or rule out your worry. At her age, we don't know how severe it would really be as she gets older if it is present and early intervention is so important. Also,

Customer:

yes early intervention is very important which is why I am jumping on it now.

Dr. Mark :

Good for you, and so you can leave the school alone because they don't have the expertise or the knowhow. But Stanford and the children's hospital do.

Dr. Mark :

Can I give you the resources in the previous question you asked me before you opened this chat? Because

Dr. Mark :

It will be easier to give you links to books and articles in that format?

Customer:

you r right! am so disgusted with this school right now but have no idea where to send her. Charter school maybe?

Customer:

or maybe I will wait until I can get her evaluated and worked up.

Dr. Mark :

Don't take action yet on the school part. Focus your time and energy on getting a good diagnostic evaluation from competent professionals, okay?

Customer:

okay. Thank you soooo much!

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5099
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 2 other Mental Health Specialists are ready to help you
Expert:  Dr. Mark replied 10 months ago.

Here is what I was typing to you when you opened up the other chat. If you could give this a positive rating as well, I'd be grateful. I want you very much to be hopeful. I've worked with AS kids and teens. And your daughter (again, IF she does have a developmental issue) is in the category where it would be mild enough to be very treatable with you being educated, a therapist, and some at-least-partly-competent schooling. Don't count on the schools too much. I don't mean to say mean things but I don't want you to put your hopes onto the wrong professionals: schools are just not educated in how to deal with mild developmental problems. They are trained only to deal with the extremes. So, here's what I wrote and it has some excellent resources for you:


Hi! The chat ended as you went offline, so I'll be glad to help you with this issue here in this question/answer format.


First, let me say I can imagine this is a very frustrating situation for you and I can also sense the worry. And I agree with you that there are grounds for concern. We don't know for sure if there is a problem or not, but there you are noticing enough behavioral anomalies that you're concerned.


Please: I am not diagnosing clinically. I am giving you my first impression for what I would want you to rule out.

Let's start with the Mayo Clinic's entry for AS. It's a few pages, so scroll through them:

http://www.mayoclinic.com/health/aspergers-syndrome/DS00551


Let me also give you here a brief description of AS by Tony Attwood who is THE expert in our day on AS:

http://www.aspergersyndrome.org/Articles/What-is-Asperger-Syndrome-.aspx

Let me give you the name of an excellent book I use with parents that has a checklist in the back that you can use to make your own informal evaluation if there is perhaps an Aspergers connection here. The book is Parenting Your Aspergers Child by Sohn and Grayson. Here is the Amazon web page for it:

http://www.amazon.com/Parenting-Your-Asperger-Child-Individualized/dp/0399530703/ref=sr_1_1?s=books&ie=UTF8&qid=1285651809&sr=1-1



I have multiple copies of it in my office to give to parents because I think the proactive approach they use is sensational! They have checklists at the end of the book for symptoms for you to see informally if you think Aspergers may apply to your daughter. She's pretty young but their checklist should help you a lot. AND even if you rule out Aspergers, I think you will find some of the ways of working with her using their principles in getting dressed in the morning will be very helpful.


So now let's move beyond that first impression. Whatever it is, you need to get her to an experienced child psychologist. I would ask for referrals from the university hospital or the children's hospital. Interview the psychologist. Don't just accept the first one. Look at their office; if it looks like the kind of place that has some space set aside where you think a kid would like to be in, that's a good first sign.

Here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (they show you a photo of the therapist!). Here also, interview the therapist and make sure he/she shares your values and you each feel confident in him or her.

http://therapists.psychologytoday.com/rms/

Now Aspergers in girls is a bit different than with boys. So for your education, here's a book about girls and Aspergers. I'm including it for your knowledge, not as a treatment guide. Asperger's and Girls by Tony Attwood. There are other experts who have chapters. It can be a bit repetitive. Here's the Amazon page:

http://www.amazon.com/Aspergers-Girls-Tony-Attwood/dp/193256540X

Now for ABA. This is really a modality for working with autism spectrum disorders. It is used in our work with Aspergers. But my concern is that you are getting into a very professional discussion that you're not going to be interested in. ABA is a comprehensive way to do what the Parenting book I first cited for you does to a great extent in practical terms. ABA focuses on the principle that changing behavior with autism is best accomplished by directing the awareness of the person on the effect of current behavior on the environment around her. This is as opposed to focusing on what it feels like inside to do the behavior. This is a very simplistic and overview type of explanation. But I hope you get the idea: ABA is a way to focus the autistic (or Aspergers) child on what she's doing in the world and how her behavior is having effect in the world rather than inside of her.

So here are two books on it. The first is really for professionals. But if you're interested here it is. It's in a second edition now: Applied Behavior Analysis by Cooper, Heron, and Heward. Here's the Amazon page:

http://www.amazon.com/Applied-Behavior-Analysis-John-Cooper/dp/0131421131/ref=sr_1_1?ie=UTF8&qid=1288661711&sr=8-1

This next one is a lot more parent friendly: The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders by Barbera and Rasmussen. Here's the Amazon page:

http://www.amazon.com/Verbal-Behavior-Approach-Children-Disorders/dp/1843108526/ref=sr_1_10?ie=UTF8&qid=1288661711&sr=8-10

 

Now Aspergers in girls is a bit different than with boys. So for your education, here's a book about girls and Aspergers. I'm including it for your knowledge, not as a treatment guide. Asperger's and Girls by Tony Attwood. Attwood is THE authority in spectrum disorders. There are other experts who have chapters. It can be a bit repetitive. Here's the Amazon page:

http://www.amazon.com/Aspergers-Girls-Tony-Attwood/dp/193256540X

Now for ABA. This is really a modality for working with autism spectrum disorders. It is used in our work with Aspergers. But my concern is that you are getting into a very professional discussion that you're not going to be interested in. ABA is a comprehensive way to do what the Parenting book I first cited for you does to a great extent in practical terms. ABA focuses on the principle that changing behavior with autism is best accomplished by directing the awareness of the person on the effect of current behavior on the environment around her. This is as opposed to focusing on what it feels like inside to do the behavior. This is a very simplistic and overview type of explanation. But I hope you get the idea: ABA is a way to focus the autistic (or Aspergers) child on what she's doing in the world and how her behavior is having effect in the world rather than inside of her.

So here are two books on it. The first is really for professionals. But if you're interested here it is. It's in a second edition now: Applied Behavior Analysis by Cooper, Heron, and Heward. Here's the Amazon page:

http://www.amazon.com/Applied-Behavior-Analysis-John-Cooper/dp/0131421131/ref=sr_1_1?ie=UTF8&qid=1288661711&sr=8-1

This next one is a lot more parent friendly: The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders by Barbera and Rasmussen. Here's the Amazon page:

http://www.amazon.com/Verbal-Behavior-Approach-Children-Disorders/dp/1843108526/ref=sr_1_10?ie=UTF8&qid=1288661711&sr=8-10


Okay, I wish you the very best!

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, Dr. Mark

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education