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Help with CTOPP, WISC and where to go from here (dyslexia, dysgraphia)


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DS6 was just diagnosed with moderate dyslexia. I'm relieved to finally have it diagnosed, and I have a bit of a plan from reading these boards, but I would love any help you can give me with these test results.

 

 

----------------------------------------------*Deleted detailed testing info for privacy reasons. Thank you SO much for your help!---------------------------------------------------

 

I'd appreciate any specific recommendations for the dyslexia, as well as help prioritizing where to start. What stands out to you as the most pressing need?

 

 

 

Edited by Faithful_Steward
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I don't know enough about test scores to be helpful in that area.  We never tested that extensively.   Other moms on here are way more knowledgeable with that and I am sure that they will weigh in.

 

I just wanted to say hello and hope you get everything figured out.  :grouphug:

 

The one area that I can speak to with confidence is that of morale/confidence in your son.  My son was diagnosed with dyslexia when he was 9 after a few failed years of trying to teach him reading as a home schooler.  He has 2 older siblings, both early, avid readers.  He was constantly comparing himself with them unfavorably.  The dyslexia diagnosis was actually a blessing.  We read and studied and talked together about how dyslexic minds are different, not worse or bad.  We researched all the advantages (and there are many) of being dyslexic to the point that his older sister said that it wasn't fair that she didn't have those same advantages.   :lol:  

 

Your son might be a bit young for all that yet, but it is never too early to start talking about the uniqueness of how he thinks and pointing out the things that he is good at.  And, yes, tons of hands on stuff that encourages and plays to his strengths.  

 

Another thing that helped (and caused some envy among his siblings :tongue_smilie: ) was that he got a dedicated device to listen to audio books - with his own set of headphones.  That was huge.

 

One question - you said that the doctor said that you couldn't teach him at home?  Am I understanding that right?  Why would that be?

 

 

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Ok, there is a lot going on here.

 

I think you've gotten some good advice, but some seems off too. The working memory seems to be addressed by ADHD meds. There is not much you can do to improve processing speed other than accommodate.

 

He is beyond AAR. IMHO, the advice to start with LIPS is sound. Those CTOPP results are very weak and that is one area you can gain a lot of improvement in with some targeted work. I'm not sure why he would think you can't teach him yourself. That may just be a professional bias.

 

What other issues you feel should be addressed right away? Maybe the dyspraxia? Has he seen an SLP?

 

ETA: Wait, did he get an official dyslexia diagnosis? I'm seeing NVLD, not dyslexia.

Edited by FairProspects
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One question - you said that the doctor said that you couldn't teach him at home?  Am I understanding that right?  Why would that be?

 

Personally, I think this doctor is just a super high achiever and is of the mindset that we have to outsource to the best of the best. He wanted me to send our older son to one of several elite private schools, all of which are so out of our reach financially that it is laughable. There is just a disconnect between the ideal and reality. Either that or he's not accustomed to dealing with many parents who are willing and able to put in the work to learn to DIY. I don't know.

 

Thank you so much for your suggestions regarding his self-confidence. I could get him a Kindle for audiobooks, and I'm sure he would love to have more access to that. I almost feel relief now that I know that I can go way out of the box with this kid. My mind is racing with ideas. :)

Edited by Faithful_Steward
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Ok, there is a lot going on here.

 

I think you've gotten some good advice, but some seems off too. The working memory seems to be addressed by ADHD meds. There is not much you can do to improve processing speed other than accommodate.

 

He is beyond AAR. IMHO, the advice to start with LIPS is sound. Those CTOPP results are very weak and that is one area you can gain a lot of improvement in with some targeted work. I'm not sure why he would think you can't teach him yourself. That may just be a professional bias.

 

What other issues you feel should be addressed right away? Maybe the dyspraxia? Has he seen an SLP?

 

I think the dyspraxia might be a typo now that I look at it. He only has articulation issues, no apraxia. And now that I think about it, the medical dyslexia might qualify him for private speech therapy through our insurance, so that's good.

 

I don't know what to address first. LIPS? What is the accommodation for processing speed? More time?

 

I thought the CTOPP results were pretty bad, too, so I was surprised by that the SLD reading was only considered moderate. Maybe because of his age? It might be because his IQ is average so there isn't as big a discrepancy as there would be if he was above average in that area.

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LiPS, and you can do that yourself. I found a new-but-shelfworn copy of the manual relatively inexpensively at Gander Publishing's Amazon store.

 

Hearbuilders has a free iPad app for Phonological Awareness and if you like that, you might consider trying the full computer version.

 

Rapid Naming you can work on with dots. OhElizabeth has talked about working with her DS on this using home-made cards. Interactive Metronome may also be helpful.

 

Jungle Memory might be a good thing to try for the working memory. If he responds to that, consider CogMed if you can find the budget for it.

 

Processing speed is one of those things that sometimes people see a bump as a welcome side effect of other therapies like IM, VT, OT, etc. I'm not sure whether there's anything that targets it directly and certainly VT & OT can be very pricey if you don't have insurance coverage.

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Jumping to the end here, but is that NVLD new?  That's DSM4, not DSM5.  I understand why they're doing it, but you should ask them when they'll run pragmatics on him for social thinking, theory of mind, etc.  There's usually that along with NVLD, and some kids with NVLD under DSM4 will cross over to ASD under DSM5.  ASD gets you more funding, so it's a question to ask.  And some people really don't cross over or come close and walk right up to it.  I'm just saying it's something you could ask and watch.

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Ok, Jumping down again!  One, our psych gave me the same ABSOLUTE POSITIVE BALONEY about not teaching my dyslexic son.  ;)  Here's what I say.  

 

You're going to have to be willing to make him do things that aren't fun.  

You're going to have to be diligent.  

There's going to be a LOT more that needs to be done than you even begin to realize.  

You're going to have to be of an intellectual bent that you can learn multiple new materials and therapy techniques and teach them well.

You're going to have to have enough time, strength, energy, freedom from distraction, that you can do these things.

 

If all those pieces aren't there, then hire people, yes.  It matters more THAT it gets done than who does it.  

 

I teach my ds because *I* know his speech issues more than anyone else and was better positioned to learn the Barton and LIPS materials and blend them with his speech therapy techniques.  For our situation, absolutely I was the best one, our psych's arrogance notwithstanding.  I also have a background in linguistics and enough hutspah that most things don't fluster me once I decide I'm doing them.  Usually, lol.  

 

That said, now that I'm past the most particular things that *had* to be done by me because I was blending in his speech therapy, I'm bringing in more people and would bring in more if I had the funding.  I mentioned the NVLD and theory of mind.  Did your psych do language testing?  I haven't finished reading your post yet.  Are those IQ scores what you were expecting?  NVLD will bring theory of mind issues and social thinking issues that are going to require additional work.  The dysgraphia requires additional work.  If he has language issues, those require additional work.  If that IQ is a challenge (I was just glancing), then he's going to be working ADDITIONALLY hard to do all that additional work.  

 

Does that make any sense?  You didn't just get mild dyslexia.  You just got 5-6 things that ALL are going to happen, ALL at therapy level.  And all those things impact the REST of the things.  At least that's how it feels with my ds.  It literally ends up feeling like almost nothing we do is not therapy.  It's exhausting, because everything is that very detailed, very intentional, methodical material and methodology.  Everything.  

 

That's why the psych is saying to bring in help, because he has seen the train wrecks.  You're not guaranteed school would do better.  In fact I can guarantee school would *not* for my ds, because he's extremely complex.  But I can tell you by myself it's exhausting.  We've brought in an ABA tutor who works on the social thinking and behavior and sensory regulation and some academics.  I have a whole TEAM of people I'm collecting who help me.  It's not like it's JUST ME.  I like doing all these things, but it's just a lot.  

 

I think you can take some time to assess all your options, all your paths, to get assessment of what types of help you need and what those scenarios would look like.  If he were in school, who would the team be?  If he were at home, who would your team be?  Think of it that way.  

 

Also, I would not assume the dyslexia school will take him.  Our large, super-fab dyslexia school near us cannot handle any behavioral problems and only wants the mildest of ASD.  Like basically their clients are the happy cheerful face dyslexia.  They aren't set up to handle theory of mind and perspective taking issues, nothing.  When you're more complex, you go to one of the more niched charters that is smaller and able to handle more complex situations.  What you're talking about is a very complex situation.  But go on their sites, talk it through with them, see.  At least you've got really good evals now, so you know what you're dealing with and can see your options, frame it into scenarios, and then decide.  

 

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That said, now that I'm past the most particular things that *had* to be done by me because I was blending in his speech therapy, I'm bringing in more people and would bring in more if I had the funding.  I mentioned the NVLD and theory of mind.  Did your psych do language testing?  I haven't finished reading your post yet.  Are those IQ scores what you were expecting?  NVLD will bring theory of mind issues and social thinking issues that are going to require additional work.  The dysgraphia requires additional work.  If he has language issues, those require additional work.  If that IQ is a challenge (I was just glancing), then he's going to be working ADDITIONALLY hard to do all that additional work.  

 

Does that make any sense?  You didn't just get mild dyslexia.  You just got 5-6 things that ALL are going to happen, ALL at therapy level.  And all those things impact the REST of the things.  At least that's how it feels with my ds.  It literally ends up feeling like almost nothing we do is not therapy.  It's exhausting, because everything is that very detailed, very intentional, methodical material and methodology.  Everything.  

 

 

Also, I would not assume the dyslexia school will take him.  Our large, super-fab dyslexia school near us cannot handle any behavioral problems and only wants the mildest of ASD.  Like basically their clients are the happy cheerful face dyslexia.  They aren't set up to handle theory of mind and perspective taking issues, nothing.  When you're more complex, you go to one of the more niched charters that is smaller and able to handle more complex situations.  What you're talking about is a very complex situation.  But go on their sites, talk it through with them, see.  At least you've got really good evals now, so you know what you're dealing with and can see your options, frame it into scenarios, and then decide.  

 

I snipped this response but this is exactly what I was thinking too. This is not a simple dyslexia diagnosis. There are many things going on here. Yes, pursue LiPS, but the NVLD is no small matter either.

 

Do you have a children's therapy unit or center anywhere near you? Our local one has OTs, SLPs, a psych, and I think ABA specialists. Because it is a cohesive unit, the therapists are able to recognize and work simultaneously on interrelated issues, sometimes with multiple different types of specialists. If something like that is an option for you, I would strongly consider it even if it is a drive.

 

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Jumping to the end here, but is that NVLD new?  That's DSM4, not DSM5.  I understand why they're doing it, but you should ask them when they'll run pragmatics on him for social thinking, theory of mind, etc.  There's usually that along with NVLD, and some kids with NVLD under DSM4 will cross over to ASD under DSM5.  ASD gets you more funding, so it's a question to ask.  And some people really don't cross over or come close and walk right up to it.  I'm just saying it's something you could ask and watch.

 

I'm wondering if this is another typo. The doctor didn't say anything about NVLD and I didn't notice it until I got home. I'm pretty sure they use old profiles and copy/paste these reports, so it is possible that it is a mistake. They also call my son "her" throughout the report, and there was one line in my older son's report saying he has autism when it clearly says in 5 other places that it was definitively ruled out. So maybe I need to call the office and check on that. His pragmatics are fine. My older son is communicatively disordered and may eventually be diagnosed with social communication disorder. I'm definitely familiar with those struggles with pragmatics, and this little guy doesn't have them. Maybe there is another component to NVLD?

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Adding: Are you feeling overwhelmed?  How do you feel about this?  Were you surprised?

 

A little overwhelmed but not surprised. I actually feel a bit relieved to have the diagnosis and a clear picture of what is going on. They saw exactly what I was seeing in pretty much every area. The report says  that his results might be affected by the impulsivity and behavior issues when things got hard, but he didn't feel like it was worth the expense of doing it again.

 

Mostly I feel like I don't want to deal with it right now. My son is happier than ever since being on his meds and things have really been stabilizing around here. We're enjoying the pool and the beach and camping, and I really really really don't want to deal with it yet.

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I snipped this response but this is exactly what I was thinking too. This is not a simple dyslexia diagnosis. There are many things going on here. Yes, pursue LiPS, but the NVLD is no small matter either.

 

Do you have a children's therapy unit or center anywhere near you? Our local one has OTs, SLPs, a psych, and I think ABA specialists. Because it is a cohesive unit, the therapists are able to recognize and work simultaneously on interrelated issues, sometimes with multiple different types of specialists. If something like that is an option for you, I would strongly consider it even if it is a drive.

 

 

Maybe the office where I had him evaluated? I'll ask around.

Edited by Faithful_Steward
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Ok, Jumping down again!  One, our psych gave me the same ABSOLUTE POSITIVE BALONEY about not teaching my dyslexic son.   ;)  Here's what I say.  

 

You're going to have to be willing to make him do things that aren't fun.  

You're going to have to be diligent.  

There's going to be a LOT more that needs to be done than you even begin to realize.  

You're going to have to be of an intellectual bent that you can learn multiple new materials and therapy techniques and teach them well.

You're going to have to have enough time, strength, energy, freedom from distraction, that you can do these things.

 

If all those pieces aren't there, then hire people, yes.  It matters more THAT it gets done than who does it.  

 

I teach my ds because *I* know his speech issues more than anyone else and was better positioned to learn the Barton and LIPS materials and blend them with his speech therapy techniques.  For our situation, absolutely I was the best one, our psych's arrogance notwithstanding.  I also have a background in linguistics and enough hutspah that most things don't fluster me once I decide I'm doing them.  Usually, lol.  

 

That said, now that I'm past the most particular things that *had* to be done by me because I was blending in his speech therapy, I'm bringing in more people and would bring in more if I had the funding.  I mentioned the NVLD and theory of mind.  Did your psych do language testing?  I haven't finished reading your post yet.  Are those IQ scores what you were expecting?  NVLD will bring theory of mind issues and social thinking issues that are going to require additional work.  The dysgraphia requires additional work.  If he has language issues, those require additional work.  If that IQ is a challenge (I was just glancing), then he's going to be working ADDITIONALLY hard to do all that additional work.  

 

Does that make any sense?  You didn't just get mild dyslexia.  You just got 5-6 things that ALL are going to happen, ALL at therapy level.  And all those things impact the REST of the things.  At least that's how it feels with my ds.  It literally ends up feeling like almost nothing we do is not therapy.  It's exhausting, because everything is that very detailed, very intentional, methodical material and methodology.  Everything.  

 

That's why the psych is saying to bring in help, because he has seen the train wrecks.  You're not guaranteed school would do better.  In fact I can guarantee school would *not* for my ds, because he's extremely complex.  But I can tell you by myself it's exhausting.  We've brought in an ABA tutor who works on the social thinking and behavior and sensory regulation and some academics.  I have a whole TEAM of people I'm collecting who help me.  It's not like it's JUST ME.  I like doing all these things, but it's just a lot.  

 

I think you can take some time to assess all your options, all your paths, to get assessment of what types of help you need and what those scenarios would look like.  If he were in school, who would the team be?  If he were at home, who would your team be?  Think of it that way.  

 

Also, I would not assume the dyslexia school will take him.  Our large, super-fab dyslexia school near us cannot handle any behavioral problems and only wants the mildest of ASD.  Like basically their clients are the happy cheerful face dyslexia.  They aren't set up to handle theory of mind and perspective taking issues, nothing.  When you're more complex, you go to one of the more niched charters that is smaller and able to handle more complex situations.  What you're talking about is a very complex situation.  But go on their sites, talk it through with them, see.  At least you've got really good evals now, so you know what you're dealing with and can see your options, frame it into scenarios, and then decide.  

 

Honestly, my plan is to pursue private tutoring if I can. I just don't want to be the one provoking his frustration if I don't have to. I want to be his cheerleader and his soft place to land. My dad has offered to help pay for tutoring, and I might actually allow him to help for the first time in my married life. If tutoring doesn't end up being an option, then I'll do it and I'll rock it. And I know that either way I'm going to have to learn how to teach him and help him every day. I just think it is best if I don't run point on this one. ;)

 

The local ps would not be good. The doctor pretty much ruled that out for us. The dyslexia school is an hour away, so that is four hours of driving a day. Plus they don't accept students until mid elementary.

 

I walked out of the consult thinking this was pretty straightforward dyslexia/dysgraphia. lol

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I'm re-reading your post and realizing I'm a goober.  His IQ is high!  I saw that 81 and I was like wow, that's going to make everything a little extra challenging.  But pay no attention to me.  That was just the percent!   :)

Edited by OhElizabeth
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The answer to your question about AAR is no, no, no, no, no.  Please do not do that.  I really don't know where you got the "moderate dyslexia" going.  I guess as opposed to not or severe?  Whatever.  My ds' scores weren't that low and Barton was ESSENTIAL for him.  AAR is fine for what it is, but you're just going to frustrate the bejeebies out of him using things that aren't appropriate for dyslexia.

 

Next, another grain of salt for you on what the psych is saying.  This psych is saying oh don't teach your kid AND we're the best choice?  Nothing like prescribing the thing they sell, lol.  OF COURSE you can teach him Barton yourself.  Do you WANT to?  Dunno.  Is he compliant, able to work through hard things, etc.?  Dunno.  That whole interpersonal dynamic is real!  If it's not getting done with you, then someone needs to do it, yes.  But if you can sit down with him and work and he's compliant and you're understanding the material, there really isn't an issue.  And if he said do LIPS first, then yes do LIPS.  It's VERY worth doing.

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Oh what a sweet but sad thought of him lugging around books!  Well does he have a kindle?  I got my ds a kindle HDX a year or two ago.  See what the current models are.  Best purchase ever.  So much function for so little money.  You will qualify for National Library Service (BARD), Learning Ally, anything you want.  Also of course Audible is forever running deals.  I use audible, even though it costs money, because everything autoloads onto my ds' kindle, making it easy for me.  But I suppose BARD does to.  Once you get your written report, take it to your ped and have the ped sign the forms for BARD/NLS and then you'll have that.  That's what I'm doing on our next visit.  

 

Ben Foss has an article and books where he talks about ear reading and creating a culture that legitimizes ear reading AS reading instead of like only eye reading being good enough.  It's something you can think about.  We have the unique ability, when our kids are this young, to put healthy ideas into their head, framing how they see their disability.  Sure my ds has a disability, but he also has Abilities!  He goes through TONS of audiobooks, way more than most kids his age would even eye read if they had the reading level.  

 

If your psych did any language testing (CELF, CASL), you could share if you wanted.  That language comprehension stuff was so pivotal for my ds to enable him to read anything with comprehension.  Your battle is not going to be just the decoding, most likely.  You're also going to have comprehension issues, so you want to see where those other weaknesses are and start having someone on your team be working on them.  Could be you, could be an SLP, could be anyone.  Social thinking *and* language issues will both affect reading comprehension when his decoding comes in.  Both are things that take time and can be started now if the testing identified them.

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I think the dyspraxia might be a typo now that I look at it. He only has articulation issues, no apraxia. And now that I think about it, the medical dyslexia might qualify him for private speech therapy through our insurance, so that's good.

 

I don't know what to address first. LIPS? What is the accommodation for processing speed? More time?

 

I thought the CTOPP results were pretty bad, too, so I was surprised by that the SLD reading was only considered moderate. Maybe because of his age? It might be because his IQ is average so there isn't as big a discrepancy as there would be if he was above average in that area.

 

Just pulling this down.  Dyspraxia and apraxia, in the US, are different things.  You're in the US?  Here dyspraxia is overall motor planning, where apraxia is usually referring to praxis of speech.  There's also oral praxis, so verbal or oral apraxia or both.  Kids with apraxia are usually going to have *some* praxis in the rest of their motor planning but maybe not enough to move all the way over to that DCD/global dyspraxia label.  Kids with dyspraxia have it overall and may, therefore, have it show up in their speech.

 

So actually I personally would question an "articulation" diagnosis of any kind of a child is diagnosed with dyspraxia/DCD overall.  I'd get him into a PROMPT therapist and get a proper speech eval for praxis of speech to make sure it's not apraxia causing the articulation problems.  And THEN I would want the best speech therapy method COMBINED with the LIPS so he gets all the modalities coming together.  That way he sees it, feels it, gets the motor planning input.  DON'T trust your SLP.  They are NOT trained to do an in-depth praxis of speech eval and it gets missed, missed, missed.  Look for a PROMPT therapist, someone who can run the VMPAC.  

 

How severe are his articulation issues?  Your articulation and phonological processing are linked.  I think you're really going to want some help to sort this out, depending on how many sounds he's missing, etc.  Given that extremely poor phonological processing and the mix, I'm just really curious about his speech now.  Does he talk really fast?

 

Yes, those CTOPP numbers are very low.  I just don't think calling it "moderate" is helping you at all.  My ds' apraxia was called moderate when he was first eval'd, and over time he slid to severe.  These are labels that change.  I think your mix is very, very serious and that it's significant that he wants to do these things (bright IQ!) and can't.  I would get him the audiobooks and let him start satisfying that IQ drive to learn.  You can get a kindle in a day with prime.  Order tonight and you'll have it by Friday I'll bet.   :)

 

Edited by OhElizabeth
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Oh what a sweet but sad thought of him lugging around books!  Well does he have a kindle?  I got my ds a kindle HDX a year or two ago.  See what the current models are.  Best purchase ever.  So much function for so little money.  You will qualify for National Library Service (BARD), Learning Ally, anything you want.  Also of course Audible is forever running deals.  I use audible, even though it costs money, because everything autoloads onto my ds' kindle, making it easy for me.  But I suppose BARD does to.  Once you get your written report, take it to your ped and have the ped sign the forms for BARD/NLS and then you'll have that.  That's what I'm doing on our next visit.  

 

Ben Foss has an article and books where he talks about ear reading and creating a culture that legitimizes ear reading AS reading instead of like only eye reading being good enough.  It's something you can think about.  We have the unique ability, when our kids are this young, to put healthy ideas into their head, framing how they see their disability.  Sure my ds has a disability, but he also has Abilities!  He goes through TONS of audiobooks, way more than most kids his age would even eye read if they had the reading level.  

 

If your psych did any language testing (CELF, CASL), you could share if you wanted.  That language comprehension stuff was so pivotal for my ds to enable him to read anything with comprehension.  Your battle is not going to be just the decoding, most likely.  You're also going to have comprehension issues, so you want to see where those other weaknesses are and start having someone on your team be working on them.  Could be you, could be an SLP, could be anyone.  Social thinking *and* language issues will both affect reading comprehension when his decoding comes in.  Both are things that take time and can be started now if the testing identified them.

We do have a Kindle Fire! He tends to ruin things, but we'll give it a shot.

 

The ear reading thing is exactly what the NDVP said and he stressed that there isn't anything more valuable about reading with the eyes vs the ears (except that if he isn't reading by age eight then it lowers IQ). No CELF or CASL. He is strong in verbal comprehension.

Just pulling this down.  Dyspraxia and apraxia, in the US, are different things.  You're in the US?  Here dyspraxia is overall motor planning, where apraxia is usually referring to praxis of speech.  There's also oral praxis, so verbal or oral apraxia or both.  Kids with apraxia are usually going to have *some* praxis in the rest of their motor planning but maybe not enough to move all the way over to that DCD/global dyspraxia label.  Kids with dyspraxia have it overall and may, therefore, have it show up in their speech.

 

So actually I personally would question an "articulation" diagnosis of any kind of a child is diagnosed with dyspraxia/DCD overall.  I'd get him into a PROMPT therapist and get a proper speech eval for praxis of speech to make sure it's not apraxia causing the articulation problems.  And THEN I would want the best speech therapy method COMBINED with the LIPS so he gets all the modalities coming together.  That way he sees it, feels it, gets the motor planning input.  DON'T trust your SLP.  They are NOT trained to do an in-depth praxis of speech eval and it gets missed, missed, missed.  Look for a PROMPT therapist, someone who can run the VMPAC.  

 

How severe are his articulation issues?  Your articulation and phonological processing are linked.  I think you're really going to want some help to sort this out, depending on how many sounds he's missing, etc.  Given that extremely poor phonological processing and the mix, I'm just really curious about his speech now.  Does he talk really fast?

 

Yes, those CTOPP numbers are very low.  I just don't think calling it "moderate" is helping you at all.  My ds' apraxia was called moderate when he was first eval'd, and over time he slid to severe.  These are labels that change.  I think your mix is very, very serious and that it's significant that he wants to do these things (bright IQ!) and can't.  I would get him the audiobooks and let him start satisfying that IQ drive to learn.  You can get a kindle in a day with prime.  Order tonight and you'll have it by Friday I'll bet.   :)

 

They did say that his issues will become more severe with age. Sorry about he confusion with dyspraxia/apraxia. I feel like I'm speaking a foreign language. :) The report says Expressive Language Assessment: mild dysarthria, no dyspraxia noted. He doesn't talk really fast; he actually stutters sometimes because his brain works faster than he can get the words out. You can literally see the entire thought pass through his mind and then the frustration before he slows down and very carefully tries again.

 

I also see a few of the social things in the report now, like the loud speech and dominating a conversation. His ADOS score was only a 1, but I think some targeted work could be beneficial.

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Well he's so young, the social thinking deficits are really hard to tease apart.  On a test the ps did on my ds at that age, he could literally pass with a raw score of *2*.  I kid you not.  A year later he totally bombed a different pragmatics test because with the passing of a year the scores they expected were higher. That's really good that they did an ADOS!  It's subjective, but still that's really good.  Sort of clears the air.  So then what you could do, given he's 6, is Incredible Flexible You.  If you're busy, then that's where you expand your team and you look for someone who has that in their skill set.  That's where he'll start in the Social Thinking materials.  It can be an SLP, a behaviorist, an OT, anyone who has been trained (or can read) who picks up the materials and uses them with him.  Social skills are the #1 determiner of employability, NOT his reading, NOT his writing, not his math.  Social skills and grit/tenacity will be what limit his future success.  So yes, if you're seeing the social skills issues now (which you are), then that's money and time well spent to work on them.  A ps will put social skills and behavioral goals in an IEP without an ASD diagnosis.  It's just pretty common now to go ahead and put them in, because they know how important they are.  So as you build your team, that's something to look for.

 

Oh don't apologize on the labels, mercy!  I was just clarifying so you could sort it out.  So did the report say dyspraxia?  You put that in your first post, so I was confused.  The talking fast thing is just something that some kids do to compensate motor planning issues.  It would be one of those glaring red flags.  

 

Hmm, tends to ruin things?  Is your kindle in a case?  Ours is in a leather one, just a cheapie from ebay, and that has been good enough with ds.  However I hear you on the need to protect things.  Are you going to be able to get him OT?  

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Honestly, my plan is to pursue private tutoring if I can. I just don't want to be the one provoking his frustration if I don't have to. I want to be his cheerleader and his soft place to land. My dad has offered to help pay for tutoring, and I might actually allow him to help for the first time in my married life. If tutoring doesn't end up being an option, then I'll do it and I'll rock it. And I know that either way I'm going to have to learn how to teach him and help him every day. I just think it is best if I don't run point on this one. ;)

 

The local ps would not be good. The doctor pretty much ruled that out for us. The dyslexia school is an hour away, so that is four hours of driving a day. Plus they don't accept students until mid elementary.

 

I walked out of the consult thinking this was pretty straightforward dyslexia/dysgraphia. lol

 

Well then you have your answer!  And that's exactly why that psych was saying not to teach him, because it *does* skew that dynamic and make a situation that doesn't work for a lot of people.  Your dad is SO sweet to offer to pay!  You might check, before you start, to see if there are tax-free ways to do this.  For instance, the tutoring would be a valid educational expense, therefore you could pay for it from a child's education IRA.  So if your father is planning to gift him $10K, then he could do that to the education IRA for the tax benefit and then you draw from that account to pay the tutoring bills.  Something like that.  See about the laws in your state and what your options would be.  Our state has accounts like that that are supposed to be for college.  I'm not sure if you can use them for earlier.  

 

Will your insurance cover any of this?  They won't cover tutoring, obviously, but they could cover social skills with an SLP.  So they could cover more hours of speech therapy and the therapist could do both articulation *and* social thinking.  You could have two different therapists if you wanted.  Whatever, just thinking out loud.  The problem is not what could you do.  The problem is how do you afford it.  :)

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A little overwhelmed but not surprised. I actually feel a bit relieved to have the diagnosis and a clear picture of what is going on. They saw exactly what I was seeing in pretty much every area. The report says  that his results might be affected by the impulsivity and behavior issues when things got hard, but he didn't feel like it was worth the expense of doing it again.

 

Mostly I feel like I don't want to deal with it right now. My son is happier than ever since being on his meds and things have really been stabilizing around here. We're enjoying the pool and the beach and camping, and I really really really don't want to deal with it yet.

 

The psych says don't bother to eval again???  That would be unusual not to eval again.  You'll update the evals for accommodations, for testing, because your understanding of things changes, etc.  If he's college bound (which he might be with that IQ!), he'll certainly need updates.  But that's years from now.  

 

That's so exciting that the meds are making a big difference!  I hear you on just wanting a lovely, normal summer.  You could do LIPS yourself or hire it done and it wouldn't ruin your summer.  How far away is this psych?  A reason to do LIPS now would be to give yourself a place to start from in the fall.  You're catching this so early that if you get him OG in the fall, you're really in a good position to be on track.  Getting LIPS over the summer, just LIPS, puts him in a better position for that.

 

Ok, I'll say this and be rude.  I think it's odd that a psych would have and endorse a Barton tutor.  Barton is fine, I use it, I like it.  However OG has certification and is much more flexible.  You're talking about a young child with social thinking materials, etc., and Barton isn't really on-level for that.  That's why your *gut* was thinking AAR, because it's target is a younger audience.  So what you might consider doing is shopping around, seeing the dollar amounts, seeing what these tutors charge.  

 

Around here, I can get an SLP who is certified in OG who also has an ASD certificate (I kid you not), for $65 an hour.  For $35 an hour you can get straight OG tutors.  I haven't seen prices on Barton tutors around here.  I can't imagine it's less than $20-25, and it may be all the way up in that $35-50 range.  In other words, you might be able to find somebody who brings multiple skills to the table, someone who could blend the articulation work and LIPS (which would be FABULOUS), etc.  

 

Your ds is bright and wants to read.  I don't think doing LIPS would be as unpleasant as you think.  My ds really enjoyed our time doing it.  

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According to my articulation disorders textbook, Developmental Dysarthia is different from Childhood Apraxia of Speech because CAS results from problems with the language motor planning in the cortex (higher brain) while Developmental Dysarthia has to do with damage to the nerves in the central and/or peripheral nervous system (it's typically associated with Cerebral Palsy). I haven't gotten to the lecture that covers this particular chapter yet so that's the extent of my knowledge on the subject.

 

Has your child ever been evaluated by a pediatric neurologist? If the psych is saying dysarthia and dysgraphia, then I would personally recommend seeing a neurologist. I've heard of mild CP being missed until a child was older.

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PROMPT works for CP too.  So we're right back to suggesting you get a 2nd opinion on the speech and not assume traditional articulation therapy will do the job.  Then merge the more effective (lightning bolt more effective!) speech therapy and the LIPS.  Powerful, super powerful.  

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