Due in part to my child's pediatrician being awesome, we were able to get in with a pediatric neurologist this past week. Having never been to a neurologist, pediatric or otherwise, I had no idea what to expect. The four of us spent a little more than 2 hours with the doctor. Talk about thorough! We talked about everything from Nathan's slightly early arrival (insignificant) to his aversion to loud noises (significant). We talked about developmental milestones, injuries, and Nathan's ability to read and spell. A great many things seemed trivial to me, but not the doctor. Guess that's why he has the initials M.D. right?!
Once we were done getting through the details of Nathan's childhood, the good doctor started his physical evaluations: reflexes, listening to the blood flow up to Nathan's brain, walking heel-to-toe and that sort of thing. It was truly fascinating to watch the doctor do this--all the while, Nathan was completely complicit and obedient, if not a little distracted at times.
We came home with a lot of new information to digest, as well as some local resources to help us get started with things. We learned that Nathan's original diagnosis of ADHD is correct--there are just other things mitigating his treatment and responses. There are, indeed, some neurological (and sensory) deficits. Mostly Nathan seems to have auditory and tactile issues, which we knew, and he does exhibit some sensory-seeking behaviors. The doctor also identified hypotonia, both in Nathan's hands and feet. The hypotonia is causing Nathan difficulty with fine and gross motor activities (no wonder the kid has trouble with his bike, and why he refuses to "write" much of anything). Perhaps the most notable piece of information is that Nathan seems to exhibit Autism-like tendencies. This puts him in a category known as ASD, or Autism Spectrum Disorders. More specifically, he seems to have Aspergers's Syndrome.
The treatments for these things will vary greatly, and only the ADHD is treatable with medications. As for the hypotonia and Asperger's, the treatments are non-pharmaceutical. He will need extensive occupational therapy (OT) and physical therapy (PT) as well as social skills training. We have lots of reading to do, and lots of therapy to prepare for. The learning curve will be very steep for a while. There will still be bumps in the road, but now that we have a map and itinerary, we are set for a great trip!