Teaching Reading to a Child Who Can't Sequence

[beaners]

One of my kids can't sequence. We initially thought it was speech related motor planning, but based on the MRIs there is probably more to it than that. He cannot consistently repeat even single syllable "nonsense" words correctly. Words with multiple syllables typically will include none of the target sounds but plenty of other unrelated sounds. (He isn't fronting his speech. These don't match at all.) Since he is still learning English, most words are nonsense words to him. These are sounds present in his first language and his speech was nearly unintelligible to native speakers. It isn't just sounds in words though. He can't put words he *knows* in the correct order, even in simple two or three word phrases, without an exhaustive number of attempts and prompting. Regular hearing test was fine except for one narrow frequency that was barely below the average range and might have been a testing error.

 

We are waiting on auditory processing testing. I already strongly suspect this plays a role, but it isn't the only thing going on. He can't sequence motions without a lot of prompting and multiple attempts. They tried to get him to do the thumb-finger touch test after he had a mild head injury and I had to tell them he couldn't do it before he hit his head either. It took more than two months of writing his name daily to get him to consistently write the four letters in the correct order. (Two letters formed differently than his native language, but other two the same. Highly motivated.) When he gets stuck in an incorrect motor pattern, he gets really stuck. He has been saying the word "smell" as "smell-pa" for six months. ;) He corrects it to smell after two tries now which is a huge improvement. With most kids I would try to use some type of sensory or motor activity to get it in his brain a different way, but I'm running into obstacles. Basically since he can't process things from these other channels either, it's just more static. He has glasses for the first time ever, but he does have some neurological vision loss that they can't fix. He can see well enough to distinguish letters when he is reading.

We are using 100EZ for reading right now. He is only getting started. We've been spending tons of time on phonological skills. He "can" do things we have practiced a ton of times, but he can't apply those same skills to new sounds or words. He can't do the rhyming tasks in the book. He can't consistently point at and recite sounds for two letters that he knows sounds for, let alone blend them. He wants to learn. I think he is at least of average intelligence, but he has a lot of obstacles to work around and he has had zero educational exposure so we are working at a huge deficit. 

I think I had a question when I started this, but since then I've rambled too much and lost track of where I was. Does any of this sound familiar to anyone?

[Jenn in CA]

How long has he been in your family? Living in an English-speaking culture?

 

I have 2 girls adopted from the Congo. They're a lot younger than your son (based on your sig). But all those things were super-hard for them for the first couple years.

 

They still have a lot of trouble applying concepts to new situations.

 

So yes, it sounds familiar. No easy answers, just be very patient. Maybe look up more basic phonological awareness activities to do with him... never mind, you're already doing those... keep doing them.

 

For one of my girls, patterning and sequencing were very difficult. They still are. Over time she's slowly gotten better though. That's what we're after... improvement, no matter how slow. Don't worry about how long it takes. He will still need to pass through all the developmental/reading readiness/academic milestones starting from the beginning. 

 

I've read that it will take until they're double the age they came to the US (in an international adoption situation) until they're fluent in English. I'd say that was true for my girls, who were 2.5 and 3.5 when adopted. Your child is older. It's gonna take a while.

 

Hang in there! you're on the right path, sounds like.

 

 

 

 

[beaners]

Thank you! He is 13, here since the summer. No English exposure before that and really very little language exposure period - he was in an institutional setting instead of a traditional orphanage. I know it will be a long road for fluency! I'm pretty surprised that he already has better vocabulary in English than he did in his first language, but that isn't saying much. He didn't know animals had names beyond the sounds they made when he got here. It's so tricky because he wants to read so badly. And he has a lot of the necessary skills. He just has these huge glaring gaps that are making it tough. :(

[PeterPan]

Well I have no experience with adoptees from countries where they've experienced malnutrition and I have no experience with problems the show up on MRIs, so take this with a grain of salt.  It sounds like part of what you described is dyslexia and you need to change over to programs appropriate to it.  You're not going to make any headway with 100 EZ.  Barton recommends LIPS for people who fail the Barton pretest.  My ds could not rhyme prior to LIPS and the workbook Attention Good Listeners by Jean DeGaetano.  You can buy the DeGaetano book from the publisher (Great Ideas for Teaching).  It's used by therapists and that site will have other things for APD.  Our SLP uses numerous books from there.

 

So one, dyslexia.  Although not to the degree you're describing, my ds also had issues with repeating words and phrases.  He has apraxia, yes, but he had the speech.  It was only a year ago that he started being able to repeat even a simple 2 word phrase.  He had EXTREMELY low working memory btw.  If you've gotten a neuropsych eval, you should have that number. 

 

Has he had an OT eval for praxis yet?  That's what you're describing with the inability to imitate.

 

The screening tool our SLP uses for APD is filled about 1/2 way with stuff that will also be dyslexia.  So don't assume APD (or *only* APD) with those symptoms.  

 

LIPS can be very kinesthetic.  I use it with my ds' ST method (PROMPT).  PROMPT is the only hands-on method for apraxia (motor planning of speech) issues I know of.  If he has overall dyspraxia (which is what you're describing), he may also have praxis of speech.  You can have praxis of speech AND dyslexia.  To find a PROMPT therapist, use the PROMPT Institute website.  It's no good to ask therapists if they do it, because they'll just say of course they "prompt" and mean cueing.  It's not cueing.  Given that his speech was unintelligible, seems like that would be a very good question, whether he has praxis of speech.  A PROMPT therapist will be the best person to sort that out, though actually a developmental pediatrician will sometimes catch it.  Has he been to a developmental ped yet?

 

Sorry this is so rough.  If he has these issues and got no care, it's going to take some time to work through.  Our psych told us the dyslexia and the apraxia came in on the same gene.  Do you know under what circumstances he ended up institutionalized?  Was it because of these problems?  

 

So neuropsych eval by someone with a lot of experience with dyslexia and dyspraxia, OT eval, SLP eval by a certified PROMPT therapist.  The SLP can do the APD screening.  Does he have issues with background noise?  I've talked with multiple audiologists now about my kids, and ALL of them want to hear me mentioning issues with understanding with background noise as the defining characteristic.  If it's distinguishing sounds (phonemic awareness) but no background noise, then dyslexia.  Like I said, half the APD screening from the SLP was stuff that was actually dyslexia flags.  I know that's confusing, ugh.

 

 

[Ottakee]

One program you might try is the I See Sam program.  www.iseesam.com or www.3rsplus.com  It moves VERY slowly and can be adjusted for the child.  No writing is needed.  I starts out with just a few sounds and blends them into words and the uses those same 3 words over and over again and very very slowly adds new sounds/letters.  My daughter had different challenges but it took us WEEKS to learn that the letter I said I.......now she could name it as the letter I but could not read it as the word I (WHY????? I have no idea). The stories are short and you could easily do 10-15 minutes a day and be done for now.

[beaners]

I wrote a great big long response and was working on it to post it - but my computer restarted and it poofed. :( I'll try to retype it, but the last couple days have been a little better which is giving me hope. I've looked at I See Sam before so I might try that. I haven't used Barton, but from everything in the program descriptions and what other people have said, it would be harder for this kid. All the extra ways they are trying to use to cement the information are asking him to juggle more tasks he can't do. 

[OneStepAtATime]

I wrote a great big long response and was working on it to post it - but my computer restarted and it poofed. :( I'll try to retype it, but the last couple days have been a little better which is giving me hope. I've looked at I See Sam before so I might try that. I haven't used Barton, but from everything in the program descriptions and what other people have said, it would be harder for this kid. All the extra ways they are trying to use to cement the information are asking him to juggle more tasks he can't do. 

Could you be more specific here?  We might be able to come up with better suggestions if we knew which specific tasks in Barton are not workable for him.

 

Hugs and best wishes.

[beaners]

Okay, here is some of what I was typing about before that disappeared. I'm hesitant to say "oh it's dyslexia" or "oh it's apraxia" because he is coming from a background of such unbelievable neglect. In the group of 10 kids with special needs he was in when we adopted him, hardly any had intelligible speech. As teens. One of my kids has very mild apraxia, so I'm familiar with it. I just don't know that this is the same thing. I mean, all 10 of those kids didn't have apraxia. They just never were spoken to or had speech modeled and corrected. I lean more toward the likelihood that he does, but there is a huge environmental component. Does that mean we still treat it like apraxia with PROMPT, etc? Maybe. We're still up in the air over that at this point. The closest person locally actually works with other post-institutional children (another family I know) and would be familiar with his type of background. We've just been so busy getting all the immediate medical needs addressed and seeing where we stand after a few months of regular, enriching interaction that it is further down the list. Same for the neuropsych.

 

He was in an institutional setting because that is where kids with any kinds of special needs get funneled. So he wasn't in an orphanage where the kids go to school, or even are spoken to by adults. He spent most of his early years in a group of 30 kids and adults with varying disabilities in an empty room. No toys, no interaction. Kids with only physical disabilities or adults with severe mental illness or anything in between. He has a record of hydrocephalus but it either resolved or was incorrectly diagnosed. If he had been here, he would not be that delayed, but we are starting from absolute scratch (animal names, like I said) with a teenager. He was moved into a group home within the last few years before we got there. That was a better environment but he still wasn't getting regular instruction. Within the last six months he has learned more English words and phrases than he spoke in Russian when we met him. To some extent, I feel like we would be better served by holding off on reading for a while until we have a much firmer foundation of just plain language, life, etc. But he wants to learn very badly and has a lot of the skills he needs to read. If he wasn't so interested, if he was 7 instead of 13, it would be easier to wait.

Lots more still to come, but the kids have me running around, so it will be posted later!

[Jenn in CA]

Thing is, Barton reading works even if your child isn't dyslexic. Maybe it would be worth trying.

 

Maybe since he wants to learn so badly can he take a simple Bob book and learn it by relating after you?

 

 

[Cheryl in CA]

Unless you think curriculum written for younger children would be more appropriate for him (and it might be), I would be more inclined to use something intended to be used by older children such as Dancing Bears or High Noon (there are probably others too).

[beaners]

Developmentally and in terms of interest level, younger stuff is okay. His favorite tv shows skew toward the preschool age range right now and a lot of that information is still new to him, so he isn't going to be offended and he doesn't have the background knowledge a lot of remedial programs for older kids will assume.

 

So, is Barton not sensory, kinesthetic, etc? I was given the strong impression that it is from talking about it before with people. Heck, the main program description about kids saying letter sounds and tracing them in the air...that sounds like a program we couldn't survive. Those alternative pathways that are helpful for most kids - right now he can't use them. The OT was in complete agreement with me that for the time being, he just doesn't have the motor planning to try to combine tasks or use movement to help him process information. Instead of reinforcing, it is adding something that his brain isn't processing as even related to the task at hand. It has gotten better than when we started, but it is still a huge obstacle for him. My 2 year old is able to complete tasks requiring movement and verbal output more easily than he is.

 

If we keep working at this and we find that Barton might be a better choice we would give it a try, but it is a substantial investment for a "maybe we aren't ready to start reading yet." On the plus side, he has been making a bit more progress over the last few days. I have to add in some extra reinforcement and practice on some of the steps, but I am very familiar with the type of program we are using now and comfortable adding and modifying, which is a plus.

[merry gardens]

From what you describe, he may not even pass the Barton student screen-- and if that was the case he wouldn't be ready for Barton even if you wanted to use it with him. Some people need the earlier portion Lindamood-Bell's LiPS program before they can start Barton.  Depending on which portion(s) of the student screen they fail, the student may need a different program.  I'm most familiar with LiPS as that's why my child needed. LiPS teaches how the specific sounds are produced, and it was developed by a speech therapist. I'd suggest you look at that and see if it might be of benefit. The sensory skills in LiPS primarily starts with feeling what's going on with the tongue, jaw, lips and vocal cords when producing various letter sounds. It uses mouth pictures and various other materials, eventually replacing the mouth pictures with letter tiles. Maybe that's too much motor planning tasks, but it's motor planning involving the muscles used in speech. Some speech therapists use LiPS or a similar approach as speech therapy.

 

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I want to add that I'm incredibly impressed with you for taking on children with disabilities. May God bless you abundantly!

 

[Cheryl in CA]

I'm sorry I can't be of any help, but the other ladies here are so very knowledgeable helpful!  Congratulations on your new son and best wishes on finding how to best teach him!!