Neurophysc eval, OT, primitive reflex integration, LiPS, or other first?

[Bookworm4]

After reading a lot on here and other linked websites from here and google searches, I feel like I have a better idea struggles that DD8 may be dealing with, but feel a bit conflicted on the best way to turn first.  First for background, DD did vision therapy when she was 6.  She has also been in speech therapy through the schools for articulation for 3 years and will start up again soon now that the local school is back in session (I don't know if it was more than articulation as the school never mentioned differently and didn't have an eval for speech outside of the school).

 

After reading a lot here, I started to suspect dyslexia.  She had many items on the dyslexia symptoms list that I got from the Barton website.  She also has a lot of items on the list for ADHD that Barton sent me.  Last night after reading about APD, I wondered if maybe that is part of her struggles.  I know she also has some retained primitive reflexes (we worked on some in VT, but I think she has more retained reflexes than what was worked on and I don't think the ones we worked on were fully integrated when we finished VT).  I told DH that I thought I needed to seek out an OT to help with her handwriting, and after I watched a video on the Palmer reflex this week, I wonder if that is part of her problem.  I know she has STNR and maybe ATNR impacting her posture/head/stamina while writing as well.  I've suspected dysgraphia, but I'm not sure that it's true dysgraphia or something else causing the handwriting struggles (visual/muscle memory, retained reflexes impacting grip, and/or something else?).

 

Yesterday I was reminded that an online class I took on primitive reflex integration and rhythmic movements made the video demonstrations on exercises available again to those of us who had taken the Brain and Sensory Foundations class in the past.  I have been watching those to refresh my memory and am certain the exercises would help her, but question if I will be able to do them in the best order for her (I need to go back over my notes and class manual) and may try to see if I can find an OT that understands them to give me advice and direction as well as help on her handwriting/hand grip.

 

DD passed the Barton screening, but when we practice reading she often confuses the short /o/ and short /u/ sounds, short /i/ and short /e/, and sometimes the short /a/ and short /o/ in words.  The o/u and i/e confusion and remembering which is which is more common.  She has been out of the public school classroom for 2 years so doesn't realize how far behind she is in reading.  She wants her writing to be neat, but still has MANY reversals.  She talks a lot...so much it exhausts me...more than any other kid we are around.  Even though she talks a lot, we are still working on her learning to stop and ask people questions about themselves and not always talk about her interests.  She's good at being quiet in a group setting when kids are supposed to be quiet though.  She told me she wants to try the lazy 8 writing exercise that Dianne Craft teaches this year.  She liked the idea of Apples & Pears when she saw a couple of activities that were similar to vision therapy exercises, but yesterday complained that writing and spelling at the same time were hard (it was our first day and did page 1 of book A).

 

I'm not sure where I should start first at this point.  I think I found someone who can do a neurophysc eval that is 2 hours from here.  I am need to contact them more about their testing though.  I'm not sure if I should start with OT to work on retained reflexes and handwriting first.  I also am not sure if something like LiPS is needed hear the difference in the short vowel sounds (in speech thereapy we are mostly working on /r/ sound production at this point) or if that would be a waste since she passed the Barton screening.  I've spent so much time and money over the last 2.5 years trying to figure out how to best help her and trying different things, I don't want to continue to waste time and money on the wrong things or doing them in the wrong order. 

 

All that to say, should I start with a neurophyc eval?  Once I know the cost and waiting period, should I just work on integrating reflexes while we wait, seek an OT (which I don't know if any local ones know much about retained reflexes), or start somewhere else?

[PeterPan]

Start the reflex exercises now.  No, I don't think the OT will be whizbang better.  If you have the videos, that's good enough.  Just get going.  Is it RMT?  Basically do them all.  The exercises you do for each reflex overlap, so if you do them all, you're nailing all the reflexes, even without identifying all of them, kwim? 

 

No, you don't need LIPS.  Barton will work on the vowel issue, no problem.  You can play some additional games or something, but as far as the instruction Barton will take care of it.

 

I would work on your reflexes now, while you're waiting for the OT appt.  Take your time and find an OT you like.  I'm surprised you can't get the school to do the OT.  You could get them to eval and add it, or do it privately, whichever.  

 

Psych will take longer to get into, so that's what you work on while you're working on the rest.  Doing Barton will not blow the validity of the psych eval.  Since your OT issues are a bigger deal right now, I would get those going and work on the psych eval as you can.  Often there will be a wait of 1-3, even 6+ months to get in, so the psych will just take time.  The reflexes I would get going on now.

[Bookworm4]

Start the reflex exercises now.  No, I don't think the OT will be whizbang better.  If you have the videos, that's good enough.  Just get going.  Is it RMT?  Basically do them all.  The exercises you do for each reflex overlap, so if you do them all, you're nailing all the reflexes, even without identifying all of them, kwim? 

 

No, you don't need LIPS.  Barton will work on the vowel issue, no problem.  You can play some additional games or something, but as far as the instruction Barton will take care of it.

 

I would work on your reflexes now, while you're waiting for the OT appt.  Take your time and find an OT you like.  I'm surprised you can't get the school to do the OT.  You could get them to eval and add it, or do it privately, whichever.  

 

Psych will take longer to get into, so that's what you work on while you're working on the rest.  Doing Barton will not blow the validity of the psych eval.  Since your OT issues are a bigger deal right now, I would get those going and work on the psych eval as you can.  Often there will be a wait of 1-3, even 6+ months to get in, so the psych will just take time.  The reflexes I would get going on now.

 

Thanks for your advice.  The exercises taught in the class are both RMT and primitive reflex integration (how to test, how to activate the reflex before integration, and how to integrate different ways).  I'll finish going through those the next few days and get started on them quickly.  I know DD4 needs them as much as DD8.  I want to make sure I find that right balance of working on the integration without overwhelming her (them) at the same time.

 

I tried to get an OT eval last year at the school (we were with their virtual academy the last two years and in the classroom the year prior, but homeschooling this year).  I never got anywhere.  Our local school doesn't have an OT on site and they skype with an OT from a bigger city 4 hours away (with an assistant on site).  I have no idea how effective that is.  I can try again, but given last year's frustrations, I am tempted to talk to our pediatrician's office and not bother with the school (but have no idea what costs I would be looking at either).  For an OT, when you mention finding one you like, do you meet with them before an eval to ask questions, or base your decision to use them after an initial eval?

 

As for Barton, I haven't ordered it yet.  I didn't know if I should wait until after a neuropsych eval to order it.  We did AAR 1 two years ago and finished it last fall.  At that point I had switched to LOE Foundations and did A through 1/2 of C (but we progressed too quickly through C that she stopped retaining the information well).  I ordered Dancing Bears A (she couldn't read the sentence for fast track) to try for this year and she balked at it this week when I pulled it out and said she wished she could go back to AAR.  I've thought about doing level 2 with DB A (just 10 min a day for DB), but still have concerns and question if that is the right move.  I'm willing to try Barton and convince DH it will be worth the cost if we need to, but honestly didn't know if I should spend the $ on it before an eval.  I have been impressed with various things I've heard about Barton though.

 

Thanks for the advice about the eval.  I'll take the time to get an OT figured out while also getting started on reflexes and RMT, and then figure out who to have perform an eval.

 

[PeterPan]

Yes, definitely, definitely get going on the RMT!!  Sounds like the ps is a bust for OT and you're going privately.  That's awesome you were able to do the RMT training.  I'm jealous.   :)

 

You know, it's a toss-up.  Our ps had no trouble seeing ds' SLD reading, in spite of him being in Barton 3 at age 6.  Seriously.  But then our jerk, stupid expensive private psych 6 months earlier had blown off everything I said (that the ps later gave me as SLDs), citing the then in-range tests.  6 months later it was again obvious how out of range his scores were.  Sigh.  I'm saying I totally get your reasoning there, and yes I'd be wanting that psych eval too.  Maybe just get started seeing what you can find?  Like if the psych eval is 1 month out, that's different from 6-9 months out, kwim?   Then you can go with your gut.  

[Bookworm4]

Yes, definitely, definitely get going on the RMT!!  Sounds like the ps is a bust for OT and you're going privately.  That's awesome you were able to do the RMT training.  I'm jealous.   :)

 

You know, it's a toss-up.  Our ps had no trouble seeing ds' SLD reading, in spite of him being in Barton 3 at age 6.  Seriously.  But then our jerk, stupid expensive private psych 6 months earlier had blown off everything I said (that the ps later gave me as SLDs), citing the then in-range tests.  6 months later it was again obvious how out of range his scores were.  Sigh.  I'm saying I totally get your reasoning there, and yes I'd be wanting that psych eval too.  Maybe just get started seeing what you can find?  Like if the psych eval is 1 month out, that's different from 6-9 months out, kwim?   Then you can go with your gut.  

 

The RMT training was part of a basic class designed for parents, therapists, and educators.  The formal RMT training to become certified is more extensive than what was taught in the class I took.  I took the class from Sonia Story at http://moveplaythrive.com/.  I think she still offers it 2-3 times a year as an online options.  I know she teaches classes live at various places in the country too.  She just wrote a second level to the class I took (I took Brain and Sensory Foundations), but it's not an online option right now and don't know if it ever will be or not.  I'd love to take something in person sometime, but it's not feasible at this point in time.  The nice thing about the online though is that she makes the videos showing the demonstrations available for review and you can re-listen to the entire class recorded for a certain length of time.  She has been very nice and helpful when I have emailed her in the past as well. 

 

That makes sense about Barton.  I will read more about the list of people that can do evals that Barton's office sent me and find out what kind of time frame and cost I am looking at. 

[geodob]

The Palmar Reflex shares a connection with the 'oro-facial muscles'.

So that a retained palmar reflex will have an effect on speech.

If she has a retained palmar reflex, then addressing this could also help with her speech issues?

 

A simply exercise for this, involves touching finger to thumb, going from finger to finger.

To promote a free flexion and extension of the muscles controlling the fingers.

[Bookworm4]

Thank you both for your suggestions.  I appreciate it and it is helpful as I work with DD.