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School eval frustration - Who can do a CTOPP? update 6/14


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I just left my daughter's IEP meeting and I'm pretty frustrated that they did not do a CTOPP which I specifically asked for. She score below average on the WJ-IV in broad reading, basic skills, fluency and comprehension but since she did ok on the word attack, the psych felt it wasn't necessary to do more. I'm shocked, honestly, as nonsense words were super hard for her when I tasted at home, and her working memory then wasn't assessed at all? Can an SLP or any other reading specialist give this test (I've suspected dyslexia btw) or do you think that this pysch's gut is right? I have a kid that only barely passed the Barton pretest, on her second attempt, and who thinks apple is spelled "alpl"because she hears an l sound at the beginning. I knew, she would likely squeak by, not being severe enough to get an SLD label, but still, I just don't know where to go right now. TIA. She also did a WISC on her and I just realized they didn't give me those scores, but verbally they said there was a significant gap in her IQ and her other scores.

Edited by Joyful Journeys
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I'm getting old now, but I could swear our SLP did the CTOPP.  There might be a minimum age involved.  We were referred to the SLP by our ed psych.

 

I'd ask for the WISC scores, including the subtest scores.  One of the four main categories is Working Memory.  FWIW, it's also possible to take the school's scores to a private psych for analysis/opinion.  IME, many school psychs typically do not go to the same depth in the analysis as a good private psych might, for reasons of both time and level of expertise.

 

Edited by wapiti
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In our state every test that will be run is agreed to, even if just tacitly, as part of the consent to eval form.  So if you got the evaluation report and all the evaluations were done, that ship sailed.  Your only recourse then is to use the legal process in your state to file a dispute and force them to pay for independent 3rd party evals.  Or you be really nice about and you get back with them and say hey I think we missed something, this doesn't jive.  

 

The psych could be right, dunno.  The WISC should have given you working memory.  

 

Did they do ADHD screenings?  APD screening? 

 

So yes, you're going to need more.  Just falls to deciding how to get it done.  You can dispute the results, but I think you're going to need more evidence to go that route.  If your dd did ok on the decoding and reading portions of the WJ, then maybe it's an explanation they didn't screen for.  

 

Sometimes an SLP will run the CTOPP, yes.  You might prefer just to call around and find a psych who will do a 2nd opinion, maybe running just a couple additional things.

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Who knows, maybe the results will surprise you!  :)  And it's true, just because they HAVE the tests doesn't mean they bother to RUN them.  Sigh.

 

So yes, if you're going for private evals now, take your time, find a psych with a good reputation for SLDs, somebody who takes the time to tell you what to do with the results, someone who is easy to talk with.  Actually, just *not arrogant* would do.

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SLP's can run a CTOPP and diagnose difficulties with phonological processing but depending on your state's licensing rules, they may not be allowed to give a dyslexia diagnosis. You may need a psychologist for that.

 

Yes. Teachers, social workers, occupational therapists, and mental health therapists can also run also run a CTOPP provided they have a master's degree and specific coursework in tests and measurements.

 

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In theory, the DAS-II should cover a lot of things, but I don't think it is as in-depth as the WISC.  (My ds had a private WISC in 1st grade.  In 4th grade, the school psych did a DAS II.  I had another child to retest with our private psych and when I mentioned ds and the DAS-II, she was negative about it, strongly preferring the WISC.)

Edited by wapiti
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In theory, the DAS-II should cover a lot of things, but I don't think it is as in-depth as the WISC. (My ds had a private WISC in 1st grade. In 4th grade, the school psych did a DAS II. I had another child to retest with our private psych and when I mentioned ds and the DAS-II, she was negative about it, strongly preferring the WISC.)

I have a message in to be sure, but it appears that she was not given any of the subtests that cover working memory and processing. I have scores for Verbal Reasoning, Nonverbal reasoning, spatial skills and then a general cognitive score. Reading up on the tests there are a lot more subtests that do rapid naming and such and I don't see that on my score sheet at all :(

Edited by Joyful Journeys
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I don't know. I've signed the forms in the meeting stating I agree with what was done and decided upon. My husband now says he'll just pay for whatever. Maybe he is finally coming around, though he still just thinks they should be in school, the very place that didn't bother to test her for what her actual issues are.

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http://www.wrightslaw.com/info/tests.evals.crabtree.htm  Also read about evaluations and testing on Wright's law.

 

Were you given a copy of the reports prior to meeting? Please read the above. What State are you in and please check your own state education laws? You may have even more protection. I believe you have every right to get an independent evaluation through the school district.

Edited by VinNY
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Yes. Teachers, social workers, occupational therapists, and mental health therapists can also run also run a CTOPP provided they have a master's degree and specific coursework in tests and measurements.

 

SLP's complete coursework in phonological disorders (I'm in the intro-level one this summer and will take an advanced one in grad school assuming I get accepted) so I think that one would be more qualified to interpret the results of a CTOPP than an OT, MSW, MFT, etc. even if those individuals can legally administer it. A SLP can also administer a language test like the CELF or CASL that might give useful information about the child's reading comprehension. Oral comprehension precedes reading comprehension and a child who appears to speak fine might still have issues with more advanced language skills.

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I do think the OP would benefit from her child seeing a neuropsych or ed psych, but it will almost certainly be cheaper and less of a wait to have some testing done by a SLP. If the OP can find a SLP who can also do the Auditory Processing Disorder screening, I would recommend going with that one. Full CAPD testing requires an audiologist, but it is within the scope of practice of a SLP to do the basic screening tests.

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SLP's complete coursework in phonological disorders (I'm in the intro-level one this summer and will take an advanced one in grad school assuming I get accepted) so I think that one would be more qualified to interpret the results of a CTOPP than an OT, MSW, MFT, etc. even if those individuals can legally administer it. A SLP can also administer a language test like the CELF or CASL that might give useful information about the child's reading comprehension. Oral comprehension precedes reading comprehension and a child who appears to speak fine might still have issues with more advanced language skills.

 

Sure, if you can find and SLP who offers it. I'm biased because I'm about to start privately offering educational testing and assessments, but I've also done phonological coursework, special ed coursework, and educational psychology coursework in addition to my classroom teaching certification and experience. There are some incredibly qualified teachers and private educators around who can administer, interpret results, and write reports as well. That might be an option for OP too.

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http://www.wrightslaw.com/info/tests.evals.crabtree.htm Also read about evaluations and testing on Wright's law.

 

Were you given a copy of the reports prior to meeting? Please read the above. What State are you in and please check your own state education laws? You may have even more protection. I believe you have every right to get an independent evaluation through the school district.

No I was not. Apparently she showed no signs at all of phonemic awareness or working memory issues. No signs of dyslexia present. I'm at a loss. She's been doing all those things for months. Maybe a break in reading and she has improved? I just don't know, it's like she evaluated a different child. The only issue she saw was her

choosing the wrong vowel sound in some cases.

 

 

Just to make sure I'm not crazy, I had her read a chapter in a book that I know in his her reading level. She skipped a word, started to decode sq as sp, subbed words like this for those and do for did and on and on. Yes it could be vision related, but I cannot understand how she made zero errors like this with a total stranger 3 weeks ago. She has done the same with two other evaluators. I'm just baffled at all of this.

Edited by Joyful Journeys
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Just to make sure I'm not crazy, I had her read a chapter in a book that I know in his her reading level. She skipped a word, started to decode sq as sp, subbed words like this for those and do for did and on and on. Yes it could be vision related, but I cannot understand how she made zero errors like this with a total stranger 3 weeks ago. She has done the same with two other evaluators. I'm just baffled at all of this.

My youngest which has mild tracking issues had a ruler and a pointer as aids he could use while doing his reading test. When they test him on nonsense words, the print was very big, close to 36pt font size, about 8 words per letter size page.

 

At first my hubby thought he was playing a fool when reading because he is mischievous. However when my hubby point at each word at a moderate pace, he read correctly.

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That sounds so frustrating! When the evaluation results are so far off of what you see with her, I would go ahead and seek another opinion through private evaluations.

 

Two years ago, after years of having DD10 struggle with reading, I took DD10 to a dyslexia school for a free little screening. I was positive that she had dyslexia and was hoping for some validation of my concerns. But she came out of that mini session with a report that indicated she was doing well enough that there were no warning signs of a reading disability. I politely argued with the evaluator, and he stood behind the test, saying it only had something like a 4% failure rate in detecting reading issues.

 

A year later, we had her evaluated by a neuropsychologist, and she was diagnosed with a severe phonological impairment. Yep. Dyslexia.

 

Now that little school screening was not the CTOPP. Whatever test they did was just worthless for finding her problem. So I agree with your instincts to keep looking for answers. Maybe your daughter's troubles are more vision and less phonological, but I would want to have that CTOPP to know for sure.

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So you're getting VT?  Honestly, I would do the VT *then* psych evals.

 

She will start soon. Appointment this week for a final diagnostic to customize her plan of care. It may very well look at her working memory too and give me some insight I couldn't get from the schools. I initially thought it was purely vision, but after her Barton screening, which requires no actual reading, being such a flop, I thought something else must be going on too. I'll get on a waitlist somewhere, and likely we'll be done with VT and see where she is.

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That sounds so frustrating! When the evaluation results are so far off of what you see with her, I would go ahead and seek another opinion through private evaluations.

 

Two years ago, after years of having DD10 struggle with reading, I took DD10 to a dyslexia school for a free little screening. I was positive that she had dyslexia and was hoping for some validation of my concerns. But she came out of that mini session with a report that indicated she was doing well enough that there were no warning signs of a reading disability. I politely argued with the evaluator, and he stood behind the test, saying it only had something like a 4% failure rate in detecting reading issues.

 

A year later, we had her evaluated by a neuropsychologist, and she was diagnosed with a severe phonological impairment. Yep. Dyslexia.

 

Now that little school screening was not the CTOPP. Whatever test they did was just worthless for finding her problem. So I agree with your instincts to keep looking for answers. Maybe your daughter's troubles are more vision and less phonological, but I would want to have that CTOPP to know for sure.

Yeah, we had a similar situation.  The first evaluations the kids got were not in depth enough or detailed enough, or done by someone with enough knowledge and experience to actually give us any real answers, although I didn't know enough to recognize that at the time.  They sent us in the wrong direction and didn't address any of the actual underlying issues at all.  We were told those issues didn't exist.  Uh, yeah, they do.  Getting a private evaluation through someone with extensive training and background knowledge helped tremendously.

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That sounds so frustrating! When the evaluation results are so far off of what you see with her, I would go ahead and seek another opinion through private evaluations.

 

Two years ago, after years of having DD10 struggle with reading, I took DD10 to a dyslexia school for a free little screening. I was positive that she had dyslexia and was hoping for some validation of my concerns. But she came out of that mini session with a report that indicated she was doing well enough that there were no warning signs of a reading disability. I politely argued with the evaluator, and he stood behind the test, saying it only had something like a 4% failure rate in detecting reading issues.

 

A year later, we had her evaluated by a neuropsychologist, and she was diagnosed with a severe phonological impairment. Yep. Dyslexia.

 

Now that little school screening was not the CTOPP. Whatever test they did was just worthless for finding her problem. So I agree with your instincts to keep looking for answers. Maybe your daughter's troubles are more vision and less phonological, but I would want to have that CTOPP to know for sure.

Oh my goodness, I'm sorry that something similar happened to you and OneStep, but it is a comfort at least that it just depends on the test and the evaluator. I did have her read with me more and she is certainly doing better overall, which is nice, but I can't believe all the signs have disappeared and she is fine. I just dropped her off at her VT appointment and they said it would take 1.5 hrs! I'm hopeful something will come to light, they told me it will help them see just how much her vision is effecting her processing.

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The vision piece will be a big part, but also, if she was taught with sight words, the guessing and problems with nonsense words can be because of that, but amplified because of the vision issues. How and where did she learn to read and with what method or methods?

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  • 3 weeks later...

The vision piece will be a big part, but also, if she was taught with sight words, the guessing and problems with nonsense words can be because of that, but amplified because of the vision issues. How and where did she learn to read and with what method or methods?

 

I'm so sorry, I'm just now seeing this question! She was taught to read mostly with Reading Lessons Through Literature. She was blending CVC in public K, and with some AAR the second half of kindy. She responded well to the OG style, get er done approach with RLTL and she is up to level 3 now and suddenly all sorts of issues are coming out of the woodwork. 

 

 

 

 

 

I wrote back to the school psych and she said that she didn't test DD's working memory or do a CTOPP because DD showed *zero* signs of dyslexia. She decoded slowly, but accurately, just mixing up the front and back of a word a couple times and choosing the wrong sound for vowels. I still can't figure this out, when she has never read anything totally accurately with me. I now have the results from her testing with the VT to throw in the mix. 

 

During her testing, she was unable to recognize when a letter was reversed or not in proper orientation 14 times! Whoa. She made 4 errors writing them, putting her at a 5-6 year old level, well below expectations. The doc said her reversal issue could be even worse then she lets on. She is compensating really well, likely guessing what word should come next. 

 

Here is where things get interesting? In one subtest of Visual Perceptions Skills, specifically Visual Sequential memory, she did great, well above average. She has always done well with things like patterns in math and this was all done with pictures. Yet her auditory perception, tested with the Auditory-Visual Integration test, she tested quite low, 10-25%ile. This test involved listening to a sequence of numbers, then reproducing it either by saying it or writing it down. She did better with things that she heard and had to reproduce, versus things she read which isn't surprising, but both were low.

 

This shows an overall issue with working memory..the very thing I wanted tested from the school for crying out loud! She was again placed at a 1st grade reading level, and she is heading into 3rd.

 

The doc suggest 7-9 months of therapy... :scared: She said the three months I was told before would only touch the convergence issue and not the visual processing. They will integrate metronome work. I'm dismayed over the cost, but with DS3's issues, I know there is no way I can do enough at home, I have to outsource this. 

 

I have an appointment scheduled with a private psych to test for LDs. They say it's about 3 hours of testing and it's 3 visits. The gal on the phone couldn't tell me the exact test names that will be run, given my history before, I'm going to be really pushy about knowing what I'm paying for :laugh: Is there any reason at all I should wait until we have some VT before this appointment? 7-9 months is a ton of time and I think it would skew the results if I've remediated issues? The auditory piece is really interesting to me, she's had no speech issues.  

Edited by Joyful Journeys
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Don't do an evaluation for LDs without doing VT first. SO MANY of my son's frustrations evaporated after VT. It felt like such a waste to have done testing when we did, and VT was less expensive than the neuropsych testing.

 

Have you looked into CAPD? Auditory processing is a huge issue. That is one of our labels here. If Barton's pre-test is all verbal directions, a poor performance on that test could be because of auditory processing and/or having to process auditory and visual information simultaneously--my child with vision issues and auditory processing has trouble doing visual and listening tasks simultaneously. In fact, some kids with auditory processing have trouble doing ANYTHING and listening at the same time.

 

 

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Well how long is the wait for the psych?  If the psych has a long wait, that might sort of answer this for you.  If the psych has a 3-6 month wait and the VT needs 3-4 months to get through convergence, well you'd have a LOT of improvement by the time you got to your psych eval.  What they're describing is how it rolled with my dd.  The first three months of her VT were for convergence, depth perception, etc., and the rest of the months were for visual processing.  

 

I don't know what your dd's actual diagnosis will be.  VT will not remove dyslexia.  *More* common would be VT and then end up with an ADHD diagnosis.  That's just super common.  But if it is dyslexia, I'm feeling with you that waiting months upon months is delaying intervention.  On the other hand, you're DOING a really ESSENTIAL intervention that is foundational to dyslexia intervention.  (If your eyes aren't working, how do you expect OG to work??)  So to me, I think you could AT LEAST in good conscience delay the psych eval a bit and let this work out, get some VT under your belt.  You're not going to start aggressive OG during VT.  It would be fatiguing and hard to afford.  You're just not likely to.  And if that's the case, then you go ok, what's a really sensible timeline, considering the wait for the psych, etc.

Edited by OhElizabeth
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The place I called that can test for LDs is just a psychology practice, not nueropsychologist and will be cheaper than VT by about half just paying the cash rate. There's no wait, I chose next month to give me time to save. And yes, I just have no idea what to do with her instruction wise right now.

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And I have thought about CAPD but she doesn't have a lot of symptoms? She's kind of unsteady with mulitstep directions, but she follows conversation fine, doesnt complain in noisy places etc. So for her auditory recall to be so low, I kind of want to chalk that up to attention/memory etc?! I could get an eval done at a university not too far away, though, so I'll look into that later.

 

And she also had an ADHD screening through our ped. We'll find out those results next week. A mix of a computer test, questionairre and bloodwork to check for any other deficiencies.

Edited by Joyful Journeys
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And I have thought about CAPD but she doesn't have a lot of symptoms? She's kind of unsteady with mulitstep directions, but she follows conversation fine, doesnt complain in noisy places etc. So for her auditory recall to be so low, I kind of want to chalk that up to attention/memory etc?! I could get an eval done at a university not too far away, though, so I'll look into that later.

 

And she also had an ADHD screening through our ped. We'll find out those results next week. A mix of a computer test, questionairre and bloodwork to check for any other deficiencies.

 

There seem to be (from presentations I've read, etc.) that there are profiles with CAPD. With things like ADHD, more symptoms=greater likelihood. With CAPD, you can have just one problematic area and have it bad enough to get a diagnosis.

 

It's entirely possible that what looks like attention/memory could be a function of how "quickly" she takes in speech. My son's rate at which he can take in speech is in the single digit percentiles. We don't know if we sound like Alvin and the Chipmunks to him, sound garbled, or sound like we're skipping words (I think we sound to him like we are skipping words based on little things here and there). 

 

The test they run for the rate of speech thing is called Time Compressed Sentences on the SCAN 3. My son scored in the 2nd percentile. He follows conversations pretty well, though he can come across as ditzy. Basically, when you read about dyslexic kids skipping/not comprehending or not decoding every word and still getting the gist of a passage because they have context, that is how a CAPD kid who has trouble with time compressed sentences would deal with the auditory input--they would piece a conversation together by getting the overall context. Unfortunately, it doesn't always work!

 

The fatigue of listening so closely can cause some memory glitches too. It just depends.

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There seem to be (from presentations I've read, etc.) that there are profiles with CAPD. With things like ADHD, more symptoms=greater likelihood. With CAPD, you can have just one problematic area and have it bad enough to get a diagnosis.

 

It's entirely possible that what looks like attention/memory could be a function of how "quickly" she takes in speech. My son's rate at which he can take in speech is in the single digit percentiles. We don't know if we sound like Alvin and the Chipmunks to him, sound garbled, or sound like we're skipping words (I think we sound to him like we are skipping words based on little things here and there).

 

The test they run for the rate of speech thing is called Time Compressed Sentences on the SCAN 3. My son scored in the 2nd percentile. He follows conversations pretty well, though he can come across as ditzy. Basically, when you read about dyslexic kids skipping/not comprehending or not decoding every word and still getting the gist of a passage because they have context, that is how a CAPD kid who has trouble with time compressed sentences would deal with the auditory input--they would piece a conversation together by getting the overall context. Unfortunately, it doesn't always work!

 

The fatigue of listening so closely can cause some memory glitches too. It just depends.

Well this is fascinating, thank you! I would actually love my 6 yr old to do it, but I want to wait til she is 7. She very much presents with ADHD symptoms but she has had speech trouble in the past and still does, though it is subtle. DD8 definitely is not hearing sounds properly sometimes as I've realized with her spelling "alpl" (Apple) and "hultel" for hotel etc. so if that is enough in itself to get it checked out, we will.

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