Phonological awareness: what helps?

[Jenn in CA]

My 7yodd has been going to Scottish Rites for almost 2 months. The initial testing is done. The SLP said my dd has phonological weakness and RAN weakness. Which to me was just one step above saying "Your dd has trouble with reading." IOW yes, I know she has those weaknesses but how do I help her?

 

SLP says she'll hit those areas heavily each week. My perspective is that her PA (phon. Awareness) has improved a lot with Barton (currently L3) but when asked to do tasks outside of Barton it's not transferring. What *really* helps with PA? Is it really just practice?

 

She is generally very unaware of auditory things. SLP didn't feel an auditory processing eval was necessary. I don't even know if an apd eval would help... Even if she was diagnosed there is no magic bullet to make her become more auditorily aware right?

 

I started doing LIPS this summer. I stopped after doing all that Susan Barton said to do because she is doing fine with the tasks required in Barton. The amount we did, I didn't see that it made a difference.

 

Sorry, getting rambly. Any thoughts about PA would be great. I know what all the exercises are but I don't think I see long term improvement.

[merry gardens]

My first thought when I saw the thread title was "LiPS." But you've gone as far as we did in the before we moved to Barton. Barton also covers phonemic awareness--and it's not just in level 1. It covers those concepts pretty much throughout the program, although heaviest in the first few levels. Your daughter is just on level 3 of Barton, and she'll continue to build on and develop those skills if she continues on Barton.

 

What exactly do you mean when you say she can't do it outside of Barton? Remember that Barton uses hand signals and such to help a student discover the sounds within the words until such time as they become more automatic. The hand gestures eventually get dropped in Barton, but she's not there yet. Those hand gestures, tile work, etc. really helps to "make visible" something that is otherwise merely auditory. If people testing her phonological skills aren't using them and she's able to do in when going through Barton but unable to outside of Barton session, then I'd take that as evidence that Barton is working for her. The program eventually drops those supports. It sounds to me like she still needs the kind of help that Barton builds into the program.

 

As to you statement that she's "basically unaware of auditory things", I'm not sure what to make of that. ? I have one child with an APD diagnosis. His auditory processing problems show up only in certain circumstances, like in the presence of background noise. Your slp's office is probably quiet, so the slp may not experience what happens in noisier environments. Maybe something's going on or maybe it's not. Seven is on the young side for APD testing, but if your concerns persist, I suggest consulting an audiologist who is familiar with APD. It might catch a problem or it might just ease your worries. My 9 year old saw the audiologist who diagnosed her older brother and I was somewhat surprised and relieved to find out her auditory processing is within normal.  A child doesn't need a perfect score to test "normal' and apparently some degree of "obliviousness" is just part of being a kid.

[displace]

I would get at least a hearing check (not a screen from Peds but a check in the booth) if you haven't already. Audiologist may not be necessary if there are no other concerns. APD concerns can be found on a lot of websites for screening if testing should be done. Scap, stat, and others may be used.

 

Phonological awareness should improve with time. I would work on it daily m-f but branch out from Barton. There are books on PA activities. Or Pinterest. There are different things that can be focused on. Beginning, ending, middle sounds. Vowel sounds, rhyming sounds. Ability to manipulate sounds. I guess it depends on what she can and cannot do currently.

[PeterPan]

Sounds like she was saying something vague but accurate because she wasn't allowed (by qualifications, by law) to say anything more precise.  I wouldn't take that kind of vague assignment to mean your dc needs more review with LIPS unless she specifically says it.  Is that person now tutoring her or are you?  

 

A statement like "not transferring" is pretty vague too.  Makes it sound like not at all, which probably isn't precisely, mathematically accurate.  Sure it's worth working on, but that doesn't mean she can't make progress.  My ds is just barely formative on rhyming, and he's fine in Barton 4.  He can't hear voiced vs. voiceless final plurals (/s/ vs. /z/), but he can read fine.  In fact, the fact that she's having those continued issues not only reflects the dyslexia but could be due to EF (executive function) issues or other reasons.  EF includes meta-linguistics, which basically means noticing the bits.  

 

Sure, it would be fine to get her hearing checked.  I took my kids to a state univ. and got them both checked, with a regular hearing eval (full) and the screening on the older (part of the screening on ds, as he was too young) for just $35.  Your dd is old enough to have the full APD screening, so you certainly can if you want to.  If you're having any kind of figure/ground issues, issues with hearing when there is background noise (like in Chipotle), etc. you OUGHT to, without a doubt.

 

Are you planning on getting full evals (neuropsych, psych, whatever) at some point?  Our neuropsych ran the CELF5 on ds as part of his mix, and that was where we found the grammar and metalinguistic issues.  The SLP could also run that, as it's more commonly an SLP test anyway.

[Jenn in CA]

Merry Gardens, thank you for your thoughts about Barton. You have a good point. I was discouraged by what the SLP said because she's been doing so much better when we do Barton. But when I do other PA exercises that the SLP gave, which aren't "graded" according to what we've covered in Barton, she can't figure them out. Also Barton doesn't do anything w/rhymes and she still has trouble w/that.

 

It's like when we open up Barton, she goes into the Barton groove and can do everything really well. As an analogy/ex., during Barton I use this certain kind of paper for her to write on, w/a dotted midline. But when she gets worksheet w/blanks that have a dotted midline, she doesn't know what to do w/it. 

 

I guess I got worried that she'll be able to do Barton without it ever transferring to real reading. She still doesn't think she can read 3-letter words in other books, but she will if I make her (which I'm not supposed to do), but in Barton she can read "bunch of shrimp". I suppose it will still take a lot more time.

 

Back to PA and being "auditorily unaware." DH puts it this way "she's not detail-oriented." Mispronounces things. Gets F and TH sounds mixed up. Doesn't notice or is bothered. Mishears everyone constantly. Not a good listener; long detailed instructions of course she doesn't get, and listening to read alouds she doesn't get most of it. Doesn't hear or get rhymes but it's improving. 

 

As part of her Scottish Rites homework she had to clap the syllables in 4-5 syllable words. Super hard. We are only one one-syllable words in Barton. While clapping "refrigerator" she pronounced it a bunch of different ways with varying numbers of syllables... let alone trying to get the right # of claps.

 

So anyway, is it just try, try again? I see the value of Barton's slower pace. For ex., the syllable clapping, if that were part of Barton it would start w/1-2 syllable words and work up, KWIM? Maybe the SLP simply needs the feedback of "this is way too hard" so she'll scale it back for her. (She just meets w/dd for 1 hr/week, and I'm still doing Barton 3-4 x/week.)

 

I would also like to know how an APD diagnosis would benefit her. I really feel like that's the issue. But if she gets that diagnosis, isn't the "fix" for phonemic awareness still the same?  Although OhE you mentioned EF, maybe a full workup would break out the weaknesses into specific areas? Full evals are not currently in the works; first step was Scottish Rites, second is to see what the school will do (which I don't think is much).

 

 

[PeterPan]

Your ps SLP can run the CELF5, which is the same detailed language testing our private neuropsych did.  The ps will not tend to be as thorough or spend as much time, so make a list of your symptoms and know what you're trying to ask them to do.  

 

The ps should at least be able to do an APD screening.  You'll just have to ask.  Do they test hearing or have a referral, like to the county health dept, to get it done?

[Jenn in CA]

OhE thanks for the reminder about checking with our local uni for evals.

 

Here's another question: where does PA weakness come from if not from an auditory processing issue? I wonder what's the point of doing PA exercises if there's an underlying APD. I have suspected APD for a long time but she is young and also there's the cost of an eval. Also the fact that some symptoms have improved over time.

[displace]

CAPD can encompass many things: inability to discern phonemes (sounds), but also: where in space did the sound come from (left, up, behind, etc), auditory performance (sounds with outside noises or poor quality sounds), auditory sequencing, auditory memory.

 

PA I think only incorporates hearing the sounds (begin, mid, end) in isolation +/- manipulating. I think it can just be part of a brain pattern in those with dyslexia. Does she hear different phonemes (letter sounds) when she is paying attention?

 

The cost of audiologist may be covered by insurance. I would start the process of at least looking into it after a hearing test.

 

Why? There are treatments for CAPD, that can be used. I think the PA won't improve as much if there is untreated CAPD. It's always better to start at the foundation.

 

As for Scottish rites, they should slow down and tutor her where she is, but they are likely on a mindset of getting her to grade level. Current 2nd grade level reading in public schools is pretty advanced in most counties so the eval may be based on that, with remediation going to her level and building up.

[LaughingCat]

Does she now pass the section 3 Barton test?  If not then IMO she needs more LIPS.  To me the two things, LIPS and Barton 1+ are different -- my DD could do the things in Barton 1 before I started LIPS -- but she still needed LIPS.  I did way more than suggested by Ms. Barton or LIPS with the mouth pictures -- and DD's mispronouncing (similar to your descrption) went away.

 

Regarding rhyming -- I never worked on it explicitly but DD 'got' it sometime in 3/4th grade.

 

Regarding will she ever really 'get' phonemes -- well, my DD didn't according to recent NP test.  The NP insists we need to start at phonemes -- and didn't seem to understand how much work we'd already done on this and that it wouldn't be 'starting' but 'reviewing'.  Of course we hadn't done anything for a few years now (since DD's reading was past that by most programs) so I'm sure DD has lost whatever speed she did have.  So currently I plan on adding a 5 minute daily phoneme section - beyond that it seems a waste of time to me.  Isn't that what dyslexia is?  So how can she ever get to a point where she can test well on that if it didn't happen before?

[gardenmom5]

. Seven is on the young side for APD testing, but if your concerns persist, I suggest consulting an audiologist who is familiar with APD. It might catch a problem or it might just ease your worries. My 9 year old saw the audiologist who diagnosed her older brother and I was somewhat surprised and relieved to find out her auditory processing is within normal.  A child doesn't need a perfect score to test "normal' and apparently some degree of "obliviousness" is just part of being a kid.

:iagree:

testing for APD can only be done by an audiologist (experienced in this area). seven is generally the youngest they will test - you know your child.  it requires cooperation. my son is 10 1/2, and it was pushing him to cooperate (he's not very cooperative.) even though I have been 99% sure for years he's had APD.  (I used to joke his HD and his GUI wouldn't talk to each other - computer acronyms.)

there are three subgroups of APD.

decoding

prosodic - intonation, tone, etc.

integration  - speech and language are in opposite hemispheres of the brain

 

a child can struggle in just one area, or all three. the measure is on a scale - and they do not have to be 100% for their hearing to be in the normal range.  just as it doesn't have to be super low for it to benefit from therapy.  because kids do vary, a program should be tailored to them.

my son is still really struggling with integration (despite many previous therapies, which have helped in the other areas), he is now scheduled for an eval by the hearing clinic's SLP to determine there.

 

 

 

 

 

Back to PA and being "auditorily unaware." DH puts it this way "she's not detail-oriented." Mispronounces things. Gets F and TH sounds mixed up. Doesn't notice or is bothered. Mishears everyone constantly. Not a good listener; long detailed instructions of course she doesn't get, and listening to read alouds she doesn't get most of it. Doesn't hear or get rhymes but it's improving. 

 

 

I would also like to know how an APD diagnosis would benefit her. I really feel like that's the issue. But if she gets that diagnosis, isn't the "fix" for phonemic awareness still the same?  Although OhE you mentioned EF, maybe a full workup would break out the weaknesses into specific areas? Full evals are not currently in the works; first step was Scottish Rites, second is to see what the school will do (which I don't think is much).

 

schools will do nothing about APD.  they may work with reading and writing, but they will use more general programs as opposed to ones tailored for the specific problems.

from just the few things it sounds like decoding and prosodic.

my son did two rounds of tomatis (similar to ILS) early on, and I did notice improvement afterwards.  I'm wondering if those were the areas for him it helped.  he used to mishear words constantly, couldn't rhyme, etc.

verbal instructions are short term memory and is integration.

Your ps SLP can run the CELF5, which is the same detailed language testing our private neuropsych did.  The ps will not tend to be as thorough or spend as much time, so make a list of your symptoms and know what you're trying to ask them to do.  

 

The ps should at least be able to do an APD screening.  You'll just have to ask.  Do they test hearing or have a referral, like to the county health dept, to get it done?

good luck with getting the ps to do an APD screen.  I repeatedly asked, even when they were doing a huge work-up on him.  they never even did a preliminary screen to see if testing would be warranted.  they don't do the testing, the audiologists in the school  do a basic test for a physical hearing problem.  for APD, the first test was a very thorough hearing screen in a sound booth to rule out something physical.

[Storygirl]

 

Regarding will she ever really 'get' phonemes -- well, my DD didn't according to recent NP test.  The NP insists we need to start at phonemes -- and didn't seem to understand how much work we'd already done on this and that it wouldn't be 'starting' but 'reviewing'.  Of course we hadn't done anything for a few years now (since DD's reading was past that by most programs) so I'm sure DD has lost whatever speed she did have.  So currently I plan on adding a 5 minute daily phoneme section - beyond that it seems a waste of time to me.  Isn't that what dyslexia is?  So how can she ever get to a point where she can test well on that if it didn't happen before?

 

So I am entirely not an expert. I know there are people who will tell you that if a child does not get phonemes, give up and teach reading in another way. I was given that advise by an "expert" I met at a homeschool convention, who told me that phonics would probably never work for my daughter if she was struggling with it, and that I should pick a different way to teach her. So that opinion is definitely out there.

 

On the other hand, DD's new OG tutor is dyslexic herself. She was able to learn the phonemes and phonics well enough that she now teaches it.

 

I think there's hope. :)

 

PS. I put "expert" in quotes, because this was a speaker who had written a curriculum. She was lecturing not on how to use her program but on reading issues. She gave me the advice to give up on phonics for my daughter even though she had never met her and only heard a brief description of her problems from me :001_huh: .

[PeterPan]

OhE thanks for the reminder about checking with our local uni for evals.

 

Here's another question: where does PA weakness come from if not from an auditory processing issue? I wonder what's the point of doing PA exercises if there's an underlying APD. I have suspected APD for a long time but she is young and also there's the cost of an eval. Also the fact that some symptoms have improved over time.

She's not too young.  7 is the minimum age and she's there.  One private audiologist I called wanted a full psych eval and full SLP eval (seriously, both) before they would even see you.  And if you had ADHD diagnosed, they wanted you on the meds.  Another private audiologist I called didn't give a rip about prior evals and would just see you.  University said the same deal, just come in.  On the ADHD question, the university just said make sure they're able to comply (sit still, behavioral in control, etc.).  One audiologist said her experience with before/after testing with meds was that meds could make a dramatic shift in the SCAN3 (APD) scores.  So to me, and this is just me, I would go to a place that will see you without the meds, because then you know what you're dealing with.  Then you buy into geodob's theory of APD as auditory inattention, say thank you very much, and go on the meds if you want.  And I'm assuming with some kids it's so severe it shows up even WITH the meds.  

 

I'm just saying it wouldn't have been helpful/informative to test my dd and imply oh it's not happening, when actually it was.  She has figure/ground issues and we needed an explanation.  But because they were on the other side of the cutoff, they just attributed it to the ADHD and weren't going to go farther and diagnose.  So at that point it's a relative weakness.  But taking the meds prior to testing would have masked the weakness and kept us from the explanation.  In diagnosable APD, it goes farther, much farther, with much more severe symptoms.  I'm saying in her case it was subclinical, enough to be a problem and not enough to get a diagnosis.  

 

In any case, she's plenty old enough and time is a wasting.  She might seem young to you, because she's 7.  I didn't start getting evals on my dd till she was 10/11, and then more at 12, and finally the hearing at 15.  If I had it to do over, that 6/7 would have been the right time.  You're seeing *something* and that *something* deserves explanations.  Waiting won't make things go away, sigh.  You're out of that window and now into making the choice to get explanations.

 

Sometimes a psych or SLP at the ps will do the SCAN3.  There's another APD screening tool our SLP did, but it was pretty worthless.  But if the ps will do the SCAN3, then you're golden.  All you can do is ask.  Same deal with the CELF5.  Some of these tests take so much time, they don't offer.  You kind of have to go in knowing what you're wanting them to test, what is happening, sigh.  (I see language issues where she's not comprehending directions, missing endings on words, etc., can you run the CELF5...  I notice she has issues with background noise and hearing the teacher in SS or coop when the ac is on, can you run an APD screening tool...)

 

You asked where the symptoms are coming from?  I assume you already got told by them dyslexia, right?  Does she have speech problems or anything else? It's normal to have nasty phonemic awareness issues with dyslexia.  In fact, I've pretty much concluded, and maybe Displace or someone trained can speak to this, that anything you teach gets forgotten, lost, down the toilet later anyway, and that only what we keep reinforcing *might* stick because it's such a disability.  That's why I got to my cynical point of I'm going to work on the functional level he needs but not *more* than he needs, because at some point I'd be spending time on something that won't stick anyway.  But discriminating vowels, etc., there's a lot he does need.  He needs more work and I just ordered him some more things.  But his CELF5 testing showed that it's actually from the EF issues, the meta-linguistics.  We talk about EF (executive function) with ADHD and mean organization, working memory, etc., but actually EF also has a "meta" aspect to it.  So meta-cognitive is thinking about your cognitive.  Meta-linguistics is thinking about your linguistics, noticing the bits.  (I'm non-technical here.)  So the bits of grammar, the bits of what makes rhyming, the bits of why words sound the same but aren't the same, all these bits are things that get missed because of the EF and meta issues.  And so the inverse, the reversing of that is to increase their noticing of the bits.  But it's all EF.  So the psych might say to you "I see lots of EF issues" and they aren't meaning that she has a sloppy room but that she's really weak on the meta-level.

[LaughingCat]

So I am entirely not an expert. I know there are people who will tell you that if a child does not get phonemes, give up and teach reading in another way. I was given that advise by an "expert" I met at a homeschool convention, who told me that phonics would probably never work for my daughter if she was struggling with it, and that I should pick a different way to teach her. So that opinion is definitely out there.

 

On the other hand, DD's new OG tutor is dyslexic herself. She was able to learn the phonemes and phonics well enough that she now teaches it.

 

I think there's hope. :)

 

PS. I put "expert" in quotes, because this was a speaker who had written a curriculum. She was lecturing not on how to use her program but on reading issues. She gave me the advice to give up on phonics for my daughter even though she had never met her and only heard a brief description of her problems from me :001_huh: .

I have seen some studies showing that past a certain age more phonics does not help a child to read better -- I brought that up to the NP and she dismissed it as false.  But the part she clearly wasn't understanding was... how much DD worked on phonics and phonemic awareness. And it wasn't that she wasn't 'getting' it -- she could do everything correctly but far more slowly than 'required' ...and yet here some years later she still tests at 8% for phonological awareness (and <1% for p. memory!). 

 

Although as I said, I am not completely dismissing the NP advice -- I am just not dropping everything to 'start' working on phonemic awareness either.

[gardenmom5]

I agree  - do NOT have your child on meds when they test/eval.  you want them to see the child as they are, not what a medicated child looks like.

 

when we did dudelings eval at the child development center, I took him off the supplements (some of which were quite noticeable) we'd barely started him on - and started feeding him his favorite foods I'd had to take out of his diet because of ill effects.

 

my kids were all asking me when we were going to put him back on his supplements.  testing starts in two weeks, and takes three weeks.  so - five weeks . . . .but they saw him for what he was like.

[Jenn in CA]

We have a clinic thru our local university's speech/audiology dept. Today I got on the waiting list for APD eval with an audiologist for $250. They said it's a two day process, 1.5-2 hrs each day. Does that sound right? I'm so happy. Two other slps that I had previously asked about APD eval thought I'd have to drive 2 hrs away and pay lots of money so I hope this will be worthwhile.

 

OhE interesting that you mention geodob and auditory inattention. As in ADHD inattention? Dd is not on any meds but 'auditory inattention' is exactly the words I would use to describe her weakness.

 

Today I dictated a long sentence for Barton that ended in shrimp. After repeating the sentence a couple times, and she even came up with a hand motion for shrimp, she randomly changed shrimp to fish and didn't even notice. That's the kind of thing that kills me.

[displace]

I think the length of time sounds about right.

[merry gardens]

We have a clinic thru our local university's speech/audiology dept. Today I got on the waiting list for APD eval with an audiologist for $250. They said it's a two day process, 1.5-2 hrs each day. Does that sound right? I'm so happy. Two other slps that I had previously asked about APD eval thought I'd have to drive 2 hrs away and pay lots of money so I hope this will be worthwhile.

 

OhE interesting that you mention geodob and auditory inattention. As in ADHD inattention? Dd is not on any meds but 'auditory inattention' is exactly the words I would use to describe her weakness.

 

Today I dictated a long sentence for Barton that ended in shrimp. After repeating the sentence a couple times, and she even came up with a hand motion for shrimp, she randomly changed shrimp to fish and didn't even notice. That's the kind of thing that kills me.

Sounds right. Our APD tests were scheduled for 3-4 hours. They don't take nearly all that time if the child understands the directions and cooperates.

 

The substitution of the word "fish" for "shrimp" sounds like issues with memory and how words are stored and retrieved. Shrimp is a more specific type of fish. She was close but not quite right. It likely wasn't a hearing/auditory processing problem, but something else with language. (My son with a dyslexia dx makes those kinds of mistakes, but my son with an APD dx doesn't.) There can be a lot of overlap in these language processing disorders, so there could be more than one thing going on.

 

Two interesting books you might like reading: "When the Brain Can't Hear" is about APD. "It's on the Tip of My Tongue" is about word retrieval.

[Jenn in CA]

Merry Gardens, that's interesting about fish vs shrimp... it makes perfect sense. I never thought of it that way. I've had her pegged as having auditory weakness for so long. 

 

That makes me wonder if it's better to do a neuropsych eval before an apd eval? I know for sure my insurance won't cover it; how much does it usually cost?

 

An interesting tidbit about her. We adopted her from Africa. She was taken in by a (Swahili-speaking) foster family at about 18 mo old, then the foster family put her in the orphanage at about age 3. She was really upset about leaving the foster family and did not speak at all for a long time. Days or weeks, I can't remember. The orphanage people spoke French, but probably some Swahili to her because she didn't speak French. Then 7 mo later she comes to America. Swahili is 99% forgotten and she's speaking French. So I really wonder how much of her language troubles are due to this happening to her at this critical language-development age.

 

 

 

[PeterPan]

Jenn, the easiest thing is to get the full regular hearing eval and the screening (SCAN3, the screening portion of it) done.  No, you don't have to have the psych eval first.  You'll get into the audiologist sooner than a psych anyway, and you want to get started with things.  There's sort of an elimination process to evals too.  

 

You can talk with the audiologist about the language acquisition.  Since it's a university, you'll be seeing students and have a supervising professor.  They like seeing these more unusual cases and scenarios.  The professor will be there to make sure you get the right answer, but it's a good learning experience for the students, meaning you shouldn't feel bad about taking the time to ask your questions.  

[merry gardens]

...The substitution of the word "fish" for "shrimp" sounds like issues with memory and how words are stored and retrieved. Shrimp is a more specific type of fish. She was close but not quite right. It likely wasn't a hearing/auditory processing problem, but something else with language. (My son with a dyslexia dx makeremediation mnds of mistakes, but my son with an APD dx doesn't.) There can be evaluation. overlap in these language processing disorders, so there could be more than one thing going on.

 

Two interesting books you might like reading: "When the Brain Can't Hear" is about APD. "It's on the Tip of My Tongue" is about word retrieval.

Thinking about this fish/shrimp thing more and my response. That's an auditory memory, so it might fall into the auditory processing camp while also falling into the memory camp. I read somewhere that an APD dx vs a dyslexia dx sometimes just comes down to who's making the dx--that may not be true for all aspects of apd but many people with dyslexia present with auditory processing problems. My son with a dyslexia dx has not been through full audiologist work - up for apd, he was too young at the time and at this point in his remediation, (all 10 levels of Barton, portions of LiPS and more) the original phonological problems don't show. They're gone.) Also, by the later levels of Barton, he made far, far fewer of those word substitutions. His auditory memory improved, and while we did memory exercises and while his getting older may account for some of that, I suspect that Barton contributed to that improvement in not just phonological processing but auditory memory too because of the way it builds words to phrases to sentences repeatedly over the levels.

 

If you can do both the audiologist apd evaluation and the neuro psych eval, do both. Audiologist is more affordable and quicker--plus it's already scheduled, so that's a great place to start. A good neuro psych can be harder to find and harder to schedule. And lots of times professionals will refer a client to other professionals to rule out suspected problems in those areas of expertise, so bringing an audiology evaluation would help with that aspect of the evaluation. My kids have never yet had a full nuero psych evaluation.

[Storygirl]

merry gardens, I 'm interested in what you are saying about APD and dyslexia. I've been wondering whether to have DD10 tested by an audiologist, so I have asked about this specifically.

 

The neuropsych's response -- Because he sees ADHD with DD10 (though not officially diagnosed), he thought the audiologist may not be able to get accurate responses from her. She may not be able to pay enough attention during the testing. He didn't think it was necessary.

 

The OG tutor's response -- What seems to be audiological (not hearing all of the sounds in the words) is due to the dyslexia. Dyslexia remediation will help, and so an audiological screening is not really needed.

 

I'm considering doing it anyway. Not decided yet.

[merry gardens]

Storygirl--it's interesting to read what your DD's nuero psych said about apd and adhd. I really wish we'd found a good nuero psych earlier in our journey, but I asked and asked and no one could refer me to someone they considered "good." Maybe there's professional bias. ??? Maybe.

 

Maybe adhd could affect apd testing and the results, but being able to pay attention to what one is hearing is also part of auditory processing and could be affected by audiotory skills. For example, my son with the apd dx tested above normal in regard to his ability to hear background noise. He's more easily distracted by background noise because he hears it better--and perhaps vice versa. He hasn't been tested for adhd or ADD but I have my suspicions if we had tested for those first he might have that dx. Doctors who diagnose these things have to carefully parse through all of what's going on and may not be very familiar with what's outside their specialty. I spoke to a nuero psych several months ago who would have referred us to someone else because it gets more complicated. (We didn't go, mostly due to cost. Also after speaking to the nuero psych, I felt reassured about how we're doing.) APD can look like adhd (or add) and/or dyslexia--again, there's a lot of similarities and people can have more than one thing going on. Sometimes what looks like an attention problem may improve dramatically if the student is placed closer to the speaker and away from auditory distractions and then given written instructions in addition to verbal instructions.

[PeterPan]

Storygirl, I agree there doesn't need to be some blanket thought of all kids need $350 evals audiology evals, kwim?  You have to look at the mix of what you have going on.  My dd was born at home and had never actually had the tympanymetry (sp) thing they do, just a normal hearing exam that they run on babies at the hospital.  I think a county health dept will do that on babies for free?  Anyway, she hadn't had that.  She was having issues with background noise, which is an APD symptom.  So when I took her to the uni, I was dealing with two very specific questions that both specifically needed an audiologist to answer.  (one, was there anything we didn't know about, and two was the background noise issue enough that it needed to be investigated further)  

 

My ds had an APD screening tool with the SLP, and the tool was half phonemic awareness.  I saw her give it and thought what a crock, of course he's going to fail all the sections a dyslexic would fail.  That's NOT a reason to go get an $$$ audiology eval, just because they have phonological symptoms.  I took him because he had those AND he was not responding to people who talked to him (especially if they were behind him).  Again, he was born at home, meaning he had not had that hearing test.  So in his case I was checking really basic things like could hearing loss explain his symptom of not answering people.  And not to restate what people already know, but it CAN happen.  Crimson had it happen.  He did the not responding thing at the audiologist, and it DID catch their eyes.  It's something that needed an explanation, but in his case it was not an audiological explanation.  It's just that we had to eliminate that from the list of options.

 

Around here, anyone can get a basic hearing eval for $35 at the univ.  If their dc has never had a hearing eval EVER or has symptoms that could be explained by hearing loss, then it's a really doggone good idea to get it done, kwim?  But for the APD screening, if you're going to ask someone to do that, it would make sense to have some indications of it.  A private audiologist is making more $$ off you, and personally I think it's a little disturbing that an audiologist is like oh yeah, come in and I'll run $$$ tests on you without first meeting you to see if those $$$ tests are even necessary.  I think it's smart to screen and make sure you even NEED the $$$ tests.  

 

The SCAN3, a test commonly used for this, can be done just to first page (as a screening tool) or completely for the full APD eval.  Our uni will run, if there's indication of need, that screening portion as part of the $35 normal eval.  That's a tremendous deal.  But they have a year waiting list and charge significantly more if you want the full test completely run.  There's no WARRANT to do that if the dc has no APD indications and is not flagging on the screening, kwim?

 

I know there are some APD vs. ADHD symptom lists that make it look like they overlap a lot.  Really, the audiologists are mainly looking for issues with background noise.  It's the most common symptom.  Look at the audiological symptoms, not the more general ways they affect the person.  Just like when people say but my kid can't tell l/r, etc. etc., is he dyslexic.  No, these things go back pretty tightly, with dyslexia to phonological processing and comprehension and APD back to audiology.  

 

Which is all to say, if your dc is having symptoms that you think relate directly back to how he's processing sound, obviously get on the list and get a screening done.  If the dc is just generically ADHD, I don't see the issue.  Both my dc were able to sit fine for the audiologist without meds, but I agree that's not going to fit everyone's situation.  It would just vary with the dc.  If your psych thinks your particular dc would have trouble completing the eval without meds, that's pretty telling.