Ever had a gut feeling that your DC's test scores are inaccurate?

[pitterpatter]

DH and I are still reeling over DD's COVD's test scores (and general experience) and her "need" for vision therapy.

 

She tested low or average in many of the visual perception categories (but, high in the "harder" ones). For the most part, her scores do not reflect what we know and feel about DD. Prior to this test, I would have regarded her visual perception/discrimination skills among her superior strengths. I have started working with her at home with the same kind of activities/tests that the COVD used for the screening. Not surprising to me, most of the activities are very easy for her...to the point where I think there's no way she could get the correct answer because she's barely glanced at the figure.

 

What I have found, though, is that she has poor test-taking skills and does not follow directions well. (Actually, I already knew this and we are working on remediation.) She doesn't deem tests/directions as important. If something doesn't align with her own thoughts/desires, she will make exceptions to the rules and consciously not follow the directions. For example, if she has drawn what she deems a cute diamond and the next step requires her to draw a line through it, she will not (to the point of cannot...it's painful for her) do it. Not marring her cute diamond is worth the consequence of getting the problem wrong. We run into this a lot when following directions for varying assignments/projects. Also, if she gets to an activity where she can't complete it in a manner that is acceptable to her (i.e. she isn't allowed to mark in a test booklet, but she wants to cross off figures as she counts), she refuses to come up with a different strategy and pretty much guesses without making any real effort to get the correct answer.

 

Long story short, DH and I don't feel as though DD's COVD test scores accurately reflect DD's true abilities. The optometrist hinted at such. And, we're not convinced that DD's diagnoses are great enough to warrant $6000 in therapy. We are completely frustrated because we feel the optometrist is trying to play us. We can't sift honest intentions from her desires for a new client. We feel like we need a whole other round of tests by a different doctor to try to tease out DD's actual issues, but we've already paid an arm for what we have, plus glasses (which came across to us at out last appointment as an, "Oops, I already prescribed glasses? Oh, well...it won't hurt her to wear them." Not exact words there, of course. They haven't helped, by the way.) Honestly, our gut tells us dyslexia and not vision issues. We're beginning to wonder whether DD's "slight" convergence excess diagnosis was more for our insurance company than anything.

 

Is it possible that DD's scores are inaccurate in part due to the aforementioned variables, among others?

[Crimson Wife]

Yes, an uncooperative child makes getting accurate test results difficult.

 

The risk is that sometimes low test results can get chalked up to non-cooperation when they actually reflect a real issue. My little one's hearing loss got missed for quite some time because when she didn't respond to a question or when she responded with a non-sequitor, that got dismissed as non-cooperation.

 

I hate to say this, but the inflexibility thing you mentioned could be characteristic of autism. You might want to read up on the signs of ASD in girls to see if there are more "red flags".

[PeterPan]

Has she had a psych eval yet to get the dyslexia diagnosed? 

 

And what's the status on getting a 2nd opinion?  You've been bugged about this for a while, so it certainly seems reasonable to pursue.  That said, things change.  I had done stuff with my dd for visual processing (you know, books Timberdoodle sold, that kind of thing) and thought she was fine, then when she had her actual testing with a proper, objective, standardized, normed test, her scores were very low.  I don't know how to explain that, except to say that it happened and that they objectively improved with therapy.

 

Whatever you do, start with just a simple appt with the new doc, not the long eval again.  Personally, I would think the person doing the testing at the other place would have commented if behavioral things were present.  Maybe she just hides it well and doesn't say much?  But convergence, that's super easy to see and confirm, and that's what you really need to get sorted out.  A good dev. optom. can check that during a regular appt and it will be $60.

[kbutton]

Convergence is relatively easy to see, but sometimes it requires some fatigue/distraction/stress (like lack of sleep) to produce a convergence problem (my older son had convergence insufficiency, and my younger one is showing some mild signs). In the case of my older son, we were told that his issues would get worse at some point, and that is when therapy would come about. He watched for symptoms, and sure enough, they eventually came about with longer reading assignments, smaller fonts, crowded text, etc. My younger one is more of a mystery. We do have at least one grandparent with similar issues that are very, very mild, so it's not a big surprise.

 

Anyway, while you are asking around, ask if it is likely to get worse or show up for distinctly down the road. That might help you get a better feel for how important it is to act right now. Mild anything is such a bear to figure out. You want to be happy the problem is mild, but it can be a real headache to figure out what you're really seeing. 

[merry gardens]

Yes. We saw two covd. I didn't believe the first report accurately portrayed my ds. (As in the covd forgot everything we had discussed about all the dyslexia remediation and blamed all his reading troubles on his eyes because he passed the little dyslexia screen. Duh! After years of Barton and LiPS, he passed it.) But I worried maybe there was something to it, we saw a different covd. That one heard me out, read the other covd ' s report, and did some more testing. He went to vt at that second clinic.

[pitterpatter]

So in the end, there was something to it, but your DS is dyslexic too? Did VT make a difference?

 

Yes. We saw two covd. I didn't believe the first report accurately portrayed my ds. (As in the covd forgot everything we had discussed about all the dyslexia remediation and blamed all his reading troubles on his eyes because he passed the little dyslexia screen. Duh! After years of Barton and LiPS, he passed it.) But I worried maybe there was something to it, we saw a different covd. That one heard me out, read the other covd ' s report, and did some more testing. He went to vt at that second clinic.

 

[merry gardens]

So in the end, there was something to it, but your DS is dyslexic too? Did VT make a difference?

Yes, he's dyslexic. That was clear, no doubt I my mind. (Phonological problems to the point where a speech therapist documented and tried to treat it, and he still couldn't pass the Barton screen a year later.) But he ALSO had something going on with his eyes that made reading harder for him too. After vt, his eyes didn't tire as much so he could read for longer periods of time. On a side note, his batting average for baseball also improved dramatically the next baseball season after vt.

 

So, yes there was something there, but not everything the first covd thought. His vt with the second covd went even faster than the second covd initially expected. It wasn't nearly as much as the first. My son was good about doing the homework on his own. I couldn't help him as the exercises gave me massive headaches. If I were younger, I'd be a vt candidate--but that doesn't get in the way of my reading, so I was initially quite distrustful of the whole idea of vt to help reading problems. The second covd won my confidence when she told me that if I was just going to do one thing for his reading it should be an Orton - Gillingham program like we were already using. There was no promise that vt would fix his reading, but just the suggestion that it may lighten one more difficulty he had with his eyes in addition to his dyslexia.

 

If you are in doubt, get a second or even third opinion.

[FairProspects]

Yes, I experienced this as well. I went and got a second opinion (neuropsych) and a third opinion (different COVD fellow). When the second and third opinion concurred, I felt like I had the real pieces of the puzzle. The thing is, there *were* real issues there as Crimson Wife suggested. They just weren't the issues identified by the first opinion (original COVD fellow). My humble recommendation is that you need more opinions to get to the root of the issues you are seeing, and it may not be what you initially suspect.

[displace]

I had one COVD say XYZ were problems, a second COVD say Y or Z but not X, a Peds ophtho say not X or Y.

 

So maybe a third COVD opinion is in order for us.

[PeterPan]

I had one COVD say XYZ were problems, a second COVD say Y or Z but not X, a Peds ophtho say not X or Y.

 

So maybe a third COVD opinion is in order for us.

Oh that is hilarious, lol.  Did any of them actually DEMONSTRATE the problems to you so you could decide for yourself?  Our COVD doc was very concrete.  She'd show you the tool, do the test, and you could see for yourself what was happening.  She'd telling you the number of cycles of the skill was appropriate for the age.  I suppose if you had different types of docs using different targets for the skills, you could get different results.  Sort of like saying X is good enough at this place but the other place wants X to fit more parameters and so X skill was formative enough at the first place but not quite where the 2nd place wanted it.  Not a disagreement so much as different expectations and degrees of what they were looking for.  Sort of like saying my cartwheel is good enough for tumbling and cheerleading but not good enough for Olympic competition, kwim?  The more problems you're having, the higher you sometimes set the bar.  If a person has few problems, the strain of a minor bit of this or that is not a big deal.  Once a person has problems, you try to get them quite a bit better, so that when they regress a bit (as the normal nature of things), they're still within a range of normal and have reduced enough struggles that it's not being compounded by the other problems, kwim?  So differences of expectations, that's my *guess* as to the discrepancies.

[geodob]

But XYZ is a very rare condition, which is often confused with YZX.

As well as ZXY.

Yet their is a suggestion that it is a spectrum, with: XYZ, XZY, ZXY, ZYX, YZX and YXZ.

 

[PeterPan]

But XYZ is a very rare condition, which is often confused with YZX.

As well as ZXY.

Yet their is a suggestion that it is a spectrum, with: XYZ, XZY, ZXY, ZYX, YZX and YXZ.

:lol: 

[BlsdMama]

Yes, but not in the same area as you.

 

We had our son initially tested by the school system's psychologist.

She came back and left us reeling.  We were certain she was wrong.  Paid $1500 for a full work-up by a private neuropsych.  She was much more thorough and gave us a far better understanding of how his brain worked.  The school psych?  Completely off.

[Tiramisu]

I'm sorry if I don't remember but what problems took you for an evaluation for VT in the first place?

 

I have a friend whose son did VT (not sure for what) who did not improve when comparing the first evaluation with the eval after VT with a very good covd doc. The explanation was that ADHD was interfering. I have another friend who just got the news that her son has reached a limit with what VT will accomplish and the covd doc recommended other evals before doing any further VT. (The call from my friend telling me this was timely, soon after Heathermomster's post last week on VT and DCD.) This makes me think it might be very helpful and economic for the OP to get other evals before pursuing VT if she has doubts about the VT dx and there may be other issues interfering with a reliable eval.

 

My youngest is, ironically, a great reader and has no typical symptoms for a developmental vision problem. However, she has the writing problems of my second dd who had CI and a tracking problem, and I recognized the same delay in focusing when screened by our family optometrist. Neither the optometrist or covd doc thought she had enough symptoms to bother having her evaluated, but an OT insisted I get it done. I told the covd doc what the OT said and that if I didn't finally rule out a vision issue, it would always be nagging at me. So he did the eval. I could see that dd was very focused for the entire time and how she really struggled with parts of the eval. There was major face scrunching and squinting going on that was not present in my three other kids. It turns out she had the most problems after all and I could have told anyone that by just watching the eval. I'm relieved I didn't have to question the doc's dx or obsess over the gap between her dx and her apparent lack of symptoms. I had exactly the same experience when my oldest was evaluated and dx'd with CAPD. I was present for the eval and I didn't have to wait for the report to know something was wrong. I'm sharing this story to say that it's helpful to be there and pay attention to what's going on during evals. I think it could help a mom determine whether the report they give you is accurate. I've had the opposite experience with a different OT, when the report grossly exaggerated what happened during the eval, and I knew not to trust the report or that particular OT again. If you were there for the eval and have reservations, go with your gut.

 

[Tiramisu]

About the glasses issue. That's really weird and if it were me, I couldn't trust that doc or her abilities after that.

 

Our covd doc recommended a trial of reading glasses for one of our kids to rule out an issue he couldn't help with. He made the same suggestion for another dd to try to take the stress off her eyes until she started therapy. In both cases, he just told me to get a pair of +1's off the rack at a store. I found a cool retro style on Amazon for less than $10 including shipping for my dd who is in school and appearance conscious, and she says they are helping. The other doesn't like the feel of the reading glasses we tried on, so I'll just wait for the therapy for her. I'm so glad I didn't have to invest in prescription glasses for either of them! Since this great doctor was content with glasses off the shelf, I decided to buy a three pack of reading glasses for myself at BJ's because I know they would help me read some teeny-tiny print. 

[geodob]

Tiramisu,

 

You raise a really important issue about the diagnostic process?

The presence of a parent during the evaluation?

Which really deserves serious consideration?

 

The value of observing their child's difficulty with some tests?

As opposed to just reading about it in the report?

 

Tell me and I will know.

Show me and I will understand.

 

It is standard practice for the parent to sit outside during the testing.

Without any participation.

But it is really worth consideration of the value of a parent being a passive observer?

How this would this would change the later discussion of the report?

 

Give real meaning to the sub-tests and their scores!

The parent as a participant in the evaluation process?

 

Which raises the idea of the parent being presented with same paper based sub-test that their child is doing?

So that they can see what their child is trying to do?

Maybe they could also attempt some of the tests?

 

Where I'm thinking about how this would change the whole diagnostic process?

Instead of sending their child alone into the room for an evaluation?

The parent and child go in together.

Where the parent attempts the same sub-tests.

Which aren't submitted for a later report.

But are attempted to provide an understanding.

 

Then later when a discussion of the report is carried out?

Perhaps you could imagine how it would change the dialogue?

[pitterpatter]

Yeah, this is something I'm really struggling with right now. DD has used the glasses since we got them...a good month now. They have not helped at all. There is no discernible difference in her reading. I have DD wear them, but it's an internal struggle for me. She says she can't tell a difference besides words/things being a little bigger. She doesn't prefer them in any way, shape or form, but doesn't throw a fit about wearing them either. She knows she has too, so she does. (Having said that, they are a bit of a distraction sometimes.) We both aren't sure why she's wearing them, though. I want to set them aside, but I feel like I can't. I'm the type of person to not take medicine unless it's absolutely warranted, so wearing them just because we have them is driving me batty.

 

Life has been hectic these past couple of months. After this week, things should settle quite a bit and we'll be able to get her to the other eye doctor for a second opinion.

 

 

About the glasses issue. That's really weird and if it were me, I couldn't trust that doc or her abilities after that.

 

Our covd doc recommended a trial of reading glasses for one of our kids to rule out an issue he couldn't help with. He made the same suggestion for another dd to try to take the stress off her eyes until she started therapy. In both cases, he just told me to get a pair of +1's off the rack at a store. I found a cool retro style on Amazon for less than $10 including shipping for my dd who is in school and appearance conscious, and she says they are helping. The other doesn't like the feel of the reading glasses we tried on, so I'll just wait for the therapy for her. I'm so glad I didn't have to invest in prescription glasses for either of them! Since this great doctor was content with glasses off the shelf, I decided to buy a three pack of reading glasses for myself at BJ's because I know they would help me read some teeny-tiny print.