Test Scores: NVLD? Something Else? Help With Next Steps

[PeterPan]

Every doc has how they do things.  Did the doc check for retained reflexes?  You know the #1 thing I would do along with that VT?  OT.  He ASSUREDLY has OT issues, and OT plus VT, for that amount of time, would put you in a strong place for fall.  If you start now, by fall you have a new kid.  Maybe not new, but at least surprising, with more tools, more skills.

 

Did they decide ADHD as well?  Is he going on meds?  If he is, I think you could add social stories onto that.  It would pair well with the new meds.  Anything for theory of mind and perspective taking.  Socialthinking.com has good stuff.  Teaching Theory of Mind: A Curriculum for Children with High Functioning Autism, Asperger's Syndrome, and Related...  I just got the younger kid version of this.  

 

If he doesn't type yet (and proficiently), then I would work on typing.  

 

I know that 7 months sounds like a long time, but it's really about typical.  My dd finally hit a wall where she couldn't go farther, but it was because they were doing a ton of visual processing stuff that required working memory, etc.  It turned out she had at least one mildly retained reflex that had gotten missed.  So if your doc does something like that, where he treats the convergence, depth perception, etc., for part of the time and then moves his attention to visual processing, then you'll probably find your school work upticking in the 3-4 months, like he says.  That was definitely our experience.

 

Ok, I said this in my original reply and deleted it because I didn't feel like I had said it politely enough.  Are you new to homeschooling?  Will he remain in school during this?  Barton has a pre-test and placement tests.  It's *very possible* that he doesn't even need Barton.  And *if* he needs it, I really think your own confidence in your relationship and your ability to teach him will improve as you do the VT.  VT will be your foray into teaching him, and you'll build that relationship and go *Oh, I CAN do this!*  So that would be a really, really good reason to wait.  

 

Did you say you're getting psych testing?  Try to get it done in the middle of your VT.  Like schedule it for that 3-4 month mark.  There's usually a wait for good neuropsychs anyway.  Try to get someone who will slow down and do pragmatics testing (BEFORE you do the theory of mind materials I linked you!), an ASD tool (ADI-R for instance), a CTOPP (to sort out the dyslexia question) and the CELF or CASL (for language processing).  When kids are presenting with language disabilities and developmental disabilities, there are very detailed tests that can sort out what's going on.  My ds' CELF testing, for instance, explained why he was having trouble comprehending what he was reading.  They can do that even with a pre-reader.  

 

So as a consumer trying to decide what intervention he needs, testing like that would allow you to target.  In my ds' case he is dyslexic, yes, but he also has severe EF (executive function) issues that affect his comprehension.  So for him Barton alone CANNOT give complete improvement.  That detailed testing allowed me to say ok, what he is going to need is speech therapy materials that improve his meta-linguistics (what the low CELF scores indicated for him), his noticing of the bits of english.  So, ironically, for him part of improving his *reading* was using *speech therapy* materials to improve his language comprehension.

 

I'm saying you could totally waste your money on that Barton tutor.  She will have the lowest training/qualifications (typically) of ANY of your options. The requirement to get Barton certified is that you've taken, I think, 2 students through level 2, and then they complete additional training with Barton for a number of days.  Around here it takes a month of full time training PLUS numerous hours on the job to get OG certified.  Barton is fully scripted, and I LOVE it.  But I cannot just do Barton straight, nor alone, with my very complex SN dc. He may need modifications to integrate other disciplines like speech therapy.  He may not even NEED Barton. He might have a great CTOPP score. 

 

Which is all to say, most people new to these situations don't feel confident.  It doesn't matter if you're a new homeschooler, veteran homeschooler but new to SN, or even an intervention specialist from your former life.  All kinds of people feel overwhelmed when they hit this.  You don't have to pretend things aren't happening or that one thing will simplistically solve EVERYTHING.  It's ok to fight against that.  We here KNOW VT does not solve EVERYTHING.  But it's going to help what was affected by the vision.  It's going to bump his EF a bit because they usually bring in some EF work.  It's going to build his confidence.  My dd was like a new child after VT, totally, totally different.  This is NOT uncommon.

 

The best way to avoid mistakes is to do evals before you do expensive interventions.  The hardest thing is getting the autism question sorted out, since NVLD is no longer in DSM5.  It's gone, poof.  So you want a clinic or psych who really spends time slowing down on that, because that's actually an ever harder/more important question than the SLDs, even though those are super, super important.  That's the one that gets really frustrating when it's left hanging out there. 

 

Deleted some comments here.  I just got the GARS3 (new version of the Gilliam) and I like it!  So I no longer need to spit nails about the Gilliam.  The new one is dramatically more thorough, more clear.  

 

You mentioned you want to fix things.  Of course you do!  As you have him home (are you going to be homeschooling?) and you do these things together, that question is going to transfer to *How do I make him blossom?*  I promise you that will happen.  Some of this stuff you really can "fix."  Like vision, you'll probably get some improvement.  Depending on the extent of his OT issues, he may have some limits.  Like he could have mild OT issues or severe.  It's a good reason to get that eval'd.  But yeah, some things you can fix.  But that *overall* what's going on?  He is who he is.  You can give him some tools, but all the therapy in the world will still leave him who he is.  He'll have more tools, but at some point it changes to ok, how do I help him blossom, what can we do with him that lets him be his best version of himself?  And that's where your peace will come, when you realize you've done all these things and it's ok.  I'm mama bear too, and you wouldn't stop me from doing the interventions I do.  But there's also that realization that he is who he is and it's not going away.  So like, last night I was telling my ds, who has an obsession going back all his years with (item that shall remain nameless) and I told him *Wow ds, when you grow up you should work for Nerf making those!*  And he didn't quite get it.  And I said yes, you could help them design them.  He's like, if I help design them, do I get to bring them home and play with him?  

 

Because, after all the therapies, he still is who he is.

Edited February 11, 2016 by OhElizabeth

[Lecka]

I don't have a strong opinion, but another reason you might consider waiting is that the VT appointment and homework may be hard on your son. You might let him get started with the VT and the new activity, and then add the spelling once you see he has the energy.

 

It may be easy on him, too, but it might be an adjustment to have the new things and the homework.

 

You don't want to make it like you are adding a bunch of stuff to his free time all at once, if he might be prone to having an attitude like "why do I have to do all these things all of a sudden, I don't want to do all of it."

 

I have one I have found that out about the hard way.

 

But if that is not his personality or he is very motivated to improve his spelling, then that is not an issue.

[Tiramisu]

I don't have a strong opinion, but another reason you might consider waiting is that the VT appointment and homework may be hard on your son. You might let him get started with the VT and the new activity, and then add the spelling once you see he has the energy.

 

It may be easy on him, too, but it might be an adjustment to have the new things and the homework.

 

You don't want to make it like you are adding a bunch of stuff to his free time all at once, if he might be prone to having an attitude like "why do I have to do all these things all of a sudden, I don't want to do all of it."

 

I have one I have found that out about the hard way.

 

But if that is not his personality or he is very motivated to improve his spelling, then that is not an issue.

 

I agree with this. We held off on everything else when we did VT. She was in a bad place emotionally when we started VT, very argumentative. I really doubted we would be able to manage even that. But something miraculously kicked in and she put more effort into VT than I would have believed possible and we saw results in a very short time. I'm glad I went slowly with other stuff.

 

Also, it's unusual that kids will know when their processing is off. It's just their normal. So not realizing he is seeing double doesn't surprise me. Dd started seeing double during some VT exercises and it went on a while before the therapist caught it because dd never mentioned it.

[kbutton]

Honestly, I am in the do one thing at a time camp when there is something that influences the other problems. I don't think it's overkill to do Barton if you have a nagging sense of something else going on, but if it's really expensive, i would wait and do VT first. I would not add a bunch of stuff like OT right in the middle. In fact, our VT place asks people not to do too much. Our speech person did not want to do things until VT was over, etc. There are some therapies that need to go together, but that's not that typical. My kids WOULD NOT be able to handle a lot of different therapies at once. VT was emotional difficult for my older son, sometimes gave him headaches, etc. For my younger son, it actually toned down the emotionality, but we would not have been able to do it and something with a lot of commitment at the same time.

 

I would not add OT to VT unless I had a conversation with both places about retained reflexes. Around here, they just do NOT do OT for retained reflexes. It's hard to find therapy for reflexes here--we just recently referred a professional therapist (not OT or PT) to the VT place because she needs somewhere to send clients who need reflex work! She said there are other places who do some reflex work (mostly chains that are for brain-therapy), but it's formulaic and doesn't always work for individual kids. My son that did OT after VT had amazing results with VT first, and then good results with OT. If we had done the OT first, it would have flopped. Younger one did not need VT yet, and the OT didn't do reflexes (wish we had known--I think we were told that if they found evidence, they would do them, but they didn't really look that close). OT had much more limited success for him. And this is a very reputable OT place. It's just not their niche (and that is the problem with finding therapies--they all have a niche). 

 

But then again, our VT is literally billed partially as OT and partially as VT, so it depends on how they approach the whole thing.

 

[PeterPan]

I would also note that Kbutton's VT doc brings in quite a bit of OT type exercises.  Ours didn't, so they wanted us getting OT as well. It's really just going to vary.

 

And yes, I totally agree it's possible to do too much.  Someone gave me the advice, when I started, to do 2 therapies at a time, no more.  Right now we get speech therapy, music therapy, and OT.  We sort of push that, but the music therapy is fun, not wearying like the others.  Lecka also pointed out the idea of ramping up slowly.  That can be really good advice.