Testing today for DD6.5

[Changed]

I've worried for a year that DD might have dyslexia, but I figured I was doing everything I could to teach her properly so I decided I didn't need a diagnosis. Especially since I haven't heard good things about our school district. However, dh thinks dd should be reading by now since we've started "first grade". He was mentioning putting the kids in school, assuming I'm not doing enough. 

 

So, I made an appointment with a psychologist for testing. We go in just a couple hours and it will be $600! The fear that we will go through testing and they'll find nothing terrifies me. lol. Do I assume the psychologist knows what he's doing, or are there specific tests I should ask for? Any questions I need to ask? 

 

Thank you!

[OneStepAtATime]

Hopefully they won't just be doing a dyslexia screening. Many kids with dyslexia have other areas of weakness as well as areas of strength. You need the big picture, not just a small piece, TBH.

Also, there are other issues that can kind of mimic signs of dyslexia. If the screening comes back negative but your child is still having some issues you might look into a developmental vision exam with a developmental optometrist (you can have 20/20 vision and still have developmental vision issues), plus possibly a screening for auditory processing issues through an audiologist if that seems warranted (you can have perfect hearing and still have auditory processing issues).

Even if your child is not dyslexic theoretically the tests being run will give you a fuller picture of your child.

Have you done any research? Read anything? I realize you can't do much before the appointment but you might read The Mislabeled Child and The Dyslexic Advantage by Brock and Fernette Eide to start.

Good luck.

Edited July 19, 2016 by OneStepAtATime

[PeterPan]

As long as they do the CTOPP, you're fine.  CTOPP plus achievement and IQ will be more than enough info to diagnose dyslexia.  There's other stuff you get in longer evals (language testing, visual-motor integration testing, etc.), but that can be done later.  

 

So how did it go?  If this is the intake appt, ask what they'll be doing.  Hopefully it will be enough!  There are many clinical psychs who do a fine job!  Think positive.  :)

 

And yes, if your dh is so concerned that he's saying school, then it's time for evals.  When you say you've done everything you need to to teach her properly, what are you doing?  If you've been doing Barton, you may have pushed up the CTOPP scores, making it harder to diagnose.  I guess just see how it goes!

[Changed]

Hopefully they won't just be doing a dyslexia screening. Many kids with dyslexia have other areas of weakness as well as areas of strength. You need the big picture, not just a small piece, TBH.

 

Also, there are other issues that can kind of mimic signs of dyslexia. If the screening comes back negative but your child is still having some issues you might look into a developmental vision exam with a developmental optometrist (you can have 20/20 vision and still have developmental vision issues), plus possibly a screening for auditory processing issues through an audiologist if that seems warranted (you can have perfect hearing and still have auditory processing issues).

 

Even if your child is not dyslexic theoretically the tests being run will give you a fuller picture of your child.

 

Have you done any research? Read anything? I realize you can't do much before the appointment but you might read The Mislabeled Child and The Dyslexic Advantage by Brock and Fernette Wide to start.

 

Good luck.

 

I will check out those books. Thank you!

 

As long as they do the CTOPP, you're fine.  CTOPP plus achievement and IQ will be more than enough info to diagnose dyslexia.  There's other stuff you get in longer evals (language testing, visual-motor integration testing, etc.), but that can be done later.  

 

So how did it go?  If this is the intake appt, ask what they'll be doing.  Hopefully it will be enough!  There are many clinical psychs who do a fine job!  Think positive.   :)

 

And yes, if your dh is so concerned that he's saying school, then it's time for evals.  When you say you've done everything you need to to teach her properly, what are you doing?  If you've been doing Barton, you may have pushed up the CTOPP scores, making it harder to diagnose.  I guess just see how it goes!

 

Today was the initial appt as well as the testing. They were very friendly and afterwards he said DD was very sweet and very smart.  :D He gave me a quick rundown and then we made an appt for next week when he'll go over the results thoroughly. 

 

He said she has ADD and dyslexia, the auditory kind. He also said she has dysgraphia. I am completely overwhelmed. I knew in my heart she had dyslexia, and possibly dysgraphia, but for some reason hearing it makes it...real. And I had NO CLUE about the ADD. I almost find it hard to believe even. I have always said she gets very distracted and can't concentrate with ANYTHING going on around us, but I just never thought about it anymore. 

 

Then he pretty much told me the only effective treatment for ADD is medication. And said that fixing the ADD will sometimes fix the other problems.  :sad:  Is this true? There HAS to be a way to treat/fix/help the ADD without medicine?! 

[OneStepAtATime]

Glad the evaluation experience was a positive one even if the results were not necessarily as expected.  Give yourself time to process this before making any decisions, buying any curriculum, jumping into anything really.  Just breathe and give yourself time to process.  It might help to read some books on dyslexia and ADD and dysgraphia, especially if you need to feel like you are doing something, but I would still wait and process for a bit while you do.  

 

Is medication the only option for ADD?  This is not something with a yes or no answer.  This really will depend on the child, how profound the ADD, their learning environment and any comorbid issues.  Medication may be a great solution (although it may take quite a bit of time to tweak out the right med or meds and the right dosage), and nothing to fear.  Seriously.  There are many who were very opposed to meds and fearful of that option but in the end found out it was a life saver.  Early days medications got a bad rap for a whole host of reasons, some warranted, some not.  Scientific studies have come a long way since those early days.  There are more/better options out there.  

 

That is not to say that meds are your only choice.  It may not really be necessary if you can help her function at home in an effective way.  Again, that will depend on so many factors that there really is not a definitive yes or no answer.  Sometimes lots of structure/scaffolding/proper diet/exercise/etc. can help without meds.   It will take time to tweak it all out and find a productive course.  Plan for the long haul.  

 

:grouphug:  :grouphug:  :grouphug:

 

Hang in there.  You are not alone.  Many of us have been where you are (and many are still on that journey :) ).  FWIW, at the intake interview for DD just a few weeks ago the neuropsychologist indicated to me that she feels DD and DS are probably ADD/ADHD.  I strongly suspected DS was ADHD but really had not processed that DD might be ADD.  It was a bit of a shock.  We will see once evaluations start (end of August).

[PeterPan]

Then he pretty much told me the only effective treatment for ADD is medication. And said that fixing the ADD will sometimes fix the other problems.  :sad:  Is this true? There HAS to be a way to treat/fix/help the ADD without medicine?! 

 

You're making me smile on the not catching the ADHD thing.  Yeah, it's just so ubiquitous and normal sometimes in our families.   :)  It's 60% comorbid so it's common to get both labels.  I'm sorry it's hard and a shock.  It probably feels very overwhelming.  Remind us, is she your oldest?

 

In a way he's being straight with you.  There's a lot you can do, and some of the things will actually give you some improvement, just depending on your mix of what's going on.  Like you can get an OT eval and for some kids there will be things going on where you realize *some* of the ADHD symptoms were from OT stuff (retained reflexes, etc.).  Totally agree.  And you can read books on food reactions and for some kids there will be food issues going on.  We can run down the whole list.  

 

But does any of that stuff like 100% super duper done deal REMOVE the ADHD?  Nope, fat chance.  We're talking percentage improvements. I think it's good to get all those percentages, but at some point you need a whole, or relatively whole, functional child, kwim?

 

The research right now is showing that BEHAVIORAL interventions before medication actually gets better outcomes and parent satisfaction than either alone or in the reverse order.  So my two cents is get an OT eval to check for OT issues, get a vision eval to see what's going on there (COVD doc, just an annual visit thing, a screening), and think through if there's anything glaring with like food allergies, congestion, sleep apnea, etc.  When you've done that physical stuff or while you're doing it, work on the behavioral side.  We're actually using a behaviorist, but my ds pushes over to ABA.  I'm just saying the research supports getting behavioral work FIRST.  

 

Then, we've you've put in 6-9 months into that, I think you'll know whether you want the meds or not.  I don't think there's a compulsion to use them, because some kids are more functional than others.  It's a continuum.  If her function, with those other supports, is to where she's learning and things are working, then maybe you're cool.  My ds, honestly, in spite of ALL those interventions, is really pushing the limits on that.  

 

I'm really not in the must medicate camp, because my dd was very happy for a lot of years sans meds.  She functioned well, had great test scores, was able to work so long as she had lots of breaks.  It just wasn't make/break at that age, only a pain in the butt and inconvenient.  But you know what's going on and how much it's affecting her.  I think when you have a new diagnosis it's good to take your time.  You can google that research and think through things for yourself.  I'm just saying that's the flowchart I'm using with my ds.  He'll be 8 this fall, and that window is really closing on how long we let this go on.  Everyone will have an opinion on what you should do. I think you can flowchart it, work through the steps, know you've done what you can, and decide whether what remains, at this time, necessitates that kind of intervention.  The intervention is good when it's time.  I just can't say it's timely for EVERY 6 yo to have the meds.  For some maybe then, for others maybe later.  You won't know what percentage improvement the other things will get you till you've tried them.

Edited July 20, 2016 by OhElizabeth

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First of all, I just realized I put this under Special Needs!  :huh: Sorry about that.

 

Thank you both for your responses. This dd, Olivia, is my second oldest (and I have a 5yo and 3yo). My oldest is ten years older and about to graduate.  :crying: But she went to school in Kindy and First, so Olivia is my first kiddo that I'm teaching to read. I have been using Logic of English with her. We are on Foundations B, lesson 62, if you're familiar with it. I never did bite the bullet and buy Barton.  :sad:  So, I need you to tell me where to go from here.  :tongue_smilie: I'm going to buy or borrow the dyslexia books that are always mentioned. But do I just continue with LoE like I've been doing? Does she still need Barton? Does she need tutoring? And how about the dysgraphia? Do I still make her write everyday? Expect perfection? Forget about it and teach her to type? lol. 

 

I've tried researching online, but it's mainly what to look for if you suspect dyslexia, or how to get teachers at school to accommodate. I AM the teacher, yk? 

[OneStepAtATime]

I have never used Logic of English so I can't speak to that. I wish I could. How does it work?

 

Barton is great but whether your child needs Barton I don't know. DD didn't start Barton until she was in 6th grade, having been in a brick and mortar school with lots and lots of English/Reading/Writing instruction through 5th grade. She still needed Barton to finally unlock reading, writing, and spelling. Doesn't mean that your child would need that level of intervention, but with a dyslexia diagnosis at least Barton is targeted specifically to dyslexics and is waaaaaay cheaper than hiring a trained dyslexia tutor.

 

Personally? I think I would do the following:

 

1. I think I would work on getting the ADD/ADHD thing tackled first by looking at behavior therapy and seeing how that goes. Lack of ability to stay focused is going to affect everything.

 

2. You might go ahead and give yourself the Barton tutor screening, then give your child the student screening to see if an OG based system would work or if your child might need something like LiPS first. Knowing that will help you with what to do about reading specifically. (Screenings are fairly short but make sure you are both rested, won't be interrupted, are doing it in a quiet part of the house and don't have anything else scheduled so there is no time pressure).

 

3. Maybe go ahead and do Level 1 and 2 of Barton (if you and your daughter pass the screenings) while you are tweaking out everything else. You might even return to your other program later but Barton Level 1 and 2 may be a huge help. Why? Because frequently it is the first two levels that fill in the missing pieces a dyslexic is unable to pick up on their own or with normal reading instruction. Most reading programs skip over what is covered in Level 1 completely. And it seems sooooo simple. Yet that is EXACTLY what many dyslexics needed and never got. Just be aware that these levels are very short and are not representative of the program as a whole. The other levels increase in depth and length and intensity and take longer to complete but can be huge.

 

If she burns through Level 1 super fast then you can exchange it for Level 2 instead of having to buy Level 2.

Edited July 20, 2016 by OneStepAtATime

[OneStepAtATime]

Oh, as for the dysgraphia you can work on it every day but don't expect perfection.  That may not even be possible...ever.  If writing is frustrating her then keep practice short and don't tie it to output of other subjects.  Keep it as something to be worked on separately.  Scribe for her in other subjects so that she is not having to deal with the dysgraphia AND the dyslexia AND the ADHD issues.  Give her brain a chance to focus on learning the content material without being so overwhelmed with everything else.

 

Yes, plan on incorporating typing but I would probably wait until she is a bit older, her dexterity is more developed, etc.  And be prepared for typing to take a loooooong time to get to automaticity and to a wpm speed that makes it feasible to use for her primary output with academics.  It could take years.  Maybe not.  Maybe she will pick it up really quickly.  Just be aware that lots of different processes go into writing and many of those processes tie in to typing for output as well.  If someone has dysgraphia the same breakdown in processes for handwriting can trip them up learning to type for output.  When you do finally get her typing try to use a program that you can control the wpm and accuracy requirements.  Make sure that the focus is on finger placement accuracy and DON'T push speed at all while she is still learning where to put her fingers and how hard to push down on the keys.  Speed will improve once finger placement accuracy has become automatic.

 

I would also do a lot of read alouds and audio books.  Give her exposure to more advanced vocabulary/grammar/concepts/stories while her reading skills are worked on separately.

[PeterPan]

First of all, I just realized I put this under Special Needs!  :huh: Sorry about that.

 

Thank you both for your responses. This dd, Olivia, is my second oldest (and I have a 5yo and 3yo). My oldest is ten years older and about to graduate.  :crying: But she went to school in Kindy and First, so Olivia is my first kiddo that I'm teaching to read. I have been using Logic of English with her. We are on Foundations B, lesson 62, if you're familiar with it. I never did bite the bullet and buy Barton.  :sad:  So, I need you to tell me where to go from here.  :tongue_smilie: I'm going to buy or borrow the dyslexia books that are always mentioned. But do I just continue with LoE like I've been doing? Does she still need Barton? Does she need tutoring? And how about the dysgraphia? Do I still make her write everyday? Expect perfection? Forget about it and teach her to type? lol. 

 

I've tried researching online, but it's mainly what to look for if you suspect dyslexia, or how to get teachers at school to accommodate. I AM the teacher, yk? 

 

Hmm...  I can tell you what you must NOT do is eat bags of chocolate to solve your problems.  That I'm sure of.  :D

 

Really though, you're listing several good paths.  Barton can be a good path, so can a tutor.  Waiting on some things and focusing on foundations can be good.  Hiring help can be good and doing it yourself can be good.  ADHD meds can be good, and sometimes NOT using meds turns out to be good.  

 

It's not like you're LOCKED IN on whatever you decide.

 

Some things to help you decide?  

 

You could do the Barton pre-test.  It's free and would give you helpful information.  It tells you how to score and what to do with the results, so definitely do that and report back.  I would do that because it's free.  

 

The other thing you could do is go visit a REALLY GOOD reading tutor.  Someone who is OG-certified or maybe Barton certified.  This is just run of the mill dyslexia, yes?  You don't have any speech problems or autism or anything that would require outlandish extra skills, yes?  So probably a Barton tutor or you with Barton or an OG certified teacher, ANY of those options could work.

 

I think since you were not making progress with LOE (in spite of it being a generally good program) that it's your big clue phone that your dd needs more help.  Barton is terrific.  Reading tutors can be terrific.  It's not really right or wrong either way, just more a question of money, time, who is going to get it done.  You have littles.  Is it realistic for you to work an hour a day on it?  Is it possible the others will be dyslexic too and you'd like the training Barton would give you to help them also?  There would be some logic to that.

 

The $$$ reading tutor place in town here integrates writing instruction into their reading sessions, but it goes very slowly and gradually as the kids progress.  So it's just sort of assumed, like we get some fledgling skills and then we begin writing.  Barton does something similar.  I think it's ok to back off, get some seeds going, let your reading instruction get some writing going, then go back to regular writing.  I think it's ok to work on typing at some point if you want.  I like the Talking Fingers with my ds.  I think it's AWESOME to do paired writing and writing by dictation to Mom or with dictation software.  Knock yourselves out with that, mercy.  It's not like writing is only valid if she pushes a pencil and spells it. So Bravewriter's Jot it Down, narrations, whatever you want will be fine, just done by dictation instead.  

 

No one can tell you what to decide on the meds.  I can tell you that whether you go with them or not you're going to need to work on working memory (which the Barton pre-test checks), executive function, structure, behavior, etc.  A lot of people have unmedicated ADHD.  It's not a crime to use the meds and it's not a crime not to.  You might see how she does with changes (environment, structure, curriculum, etc.) and whether she learns fine once you're able to step up the curriculum.  People then will debate potential.  Fine.  I'm just saying that's how our ped encouraged me to think through it with ds, asking how much it's ACTUALLY affecting his ability to access his education.  My ds has been able to learn to read IN SPITE of some really extensive ADHD and ASD symptoms.  That's not true for everyone, but it can happen.  

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I have the test results now. I don't know if you want the long story or the short story. Lol. Short story is this: "there was a significant difference when comparing verbal comprehension and perceptual reasoning to both working memory and processing speed.....she is a bright child, but at times is literally in a world of her own...showing all the signs of inattentive ADHD. Also showing a secondary auditory memory impairment affiliated with auditory dyslexia...which is creating a phonetic sequencing and sound blending level of deficiency. Aka impaired automatic naming."

Edited July 27, 2016 by vcoots

[Changed]

So, what now? Barton level 1 and working in a quiet environment?

[kbutton]

I have the test results now. I don't know if you want the long story or the short story. Lol. Short story is this: "there was a significant difference when comparing verbal comprehension and perceptual reasoning to both working memory and processing speed.....she is a bright child, but at times is literally in a world of her own...showing all the signs of inattentive ADHD.

 

 

 

Also showing a secondary auditory memory impairment affiliated with auditory dyslexia...which is creating a phonetic sequencing and sound blending level of deficiency. Aka impaired automatic naming."

 

I broke up the statements for clarity. The first one means what it says--processing speed and working memory are lagging behind her overall intelligence, and it is consistent with ADHD. If you aren't sure what WM and processing speed are, WM is being able to hold information in your mind so that you can manipulate it. Processing speed is somewhat a pen and pencil task that is influenced by dexterity, but I think they revamped the WISC V so that it didn't rely so much on dexterity. Anyway, it's basically about efficiency--how fast is stuff firing mentally. 

 

The last statement is a mishmash of terms I've not seen put together that way, but dyslexia is not one of the things we are dealing with. Someone else might be able to answer you, though it would probably help to know what test results pointed to that terminology--what was the tested basis for that statement, in other words.

[Changed]

I had the same confusion about that last part. Is he trying to say APD? Idk. He said she's a very visual learner.

 

Would it help if I put the raw numbers of the subtests on here??

[kbutton]

Some of it sounds like APD, but not all of it. It could be phrased from the point of view of someone who doesn't believe in APD, but sees the symptoms of it? IDK.

 

Since I can't comment much on dyslexia outright, and I'm not sure what automatic naming has to do with an auditory memory weakness, it's more about knowing which tests/subtests point to that particular finding. I hate to have you post scores when I don't know for sure what it correlates to. He mentions the automatic naming, but that's output, not input, and I would think auditory memory would be input. 

 

It's also possible that some of this is copy and paste error! It happens in reports because clinicians tend to state findings in a generic way (like Lego pieces) and then customize as necessary as they polish up the report. It's not laziness--it's just that when you have finding x, there are only so many ways to state what x means, so they keep ready made parts and pieces, and then they modify from there.

[PeterPan]

Sorry, just found this.  The TAPS (test of auditory processing) that our SLP ran is 1/2 phonological processing, but an audiologist will use the SCAN3 screening portion.  I don't think it necessarily follows to say someone with dyslexia has APD.  You can also have mild APD symptoms connected with the ADHD and just the overall mix and not push over to APD.  But it might in some kids, yes.  

 

I'm concerned about his observation that she seems in her own world.  Of all the things in there, that's the one that's a little *whoa*.  Did he run any behavioral forms on her?  

 

To me, I would begin the interventions for the dyslexia and ADHD.  I would schedule an audiologist and put that for when she's newly 7 or whatever cutoff the audiologist wants to run the SCAN3 screening tool for APD.  That way you're saying ok, is there a physical explanation for why she seems in her own world?  And I would keep watching that behavioral stuff.  Sometimes explanations evolve over time, and when you re-eval in say 3 years, maybe there will be some more explanations for that.  My dd is only ADHD-inattentive and although a brief fading out is normal for that, just gone in her own world isn't.  To me that's not a very complete explanation.

 

Did he run any language testing?  CELF or CASL?  Might be worth a trip to the SLP to get that run, just to make sure there's nothing language wise going on to explain that seeming like she's in her own world thing.  

 

You've gotten a lot of good information to start with, and what you've got so far will keep you busy for a while!  I would just add the audiologist and SLP as you can, just to eliminate those questions.  :)

Edited July 28, 2016 by OhElizabeth

[geodob]

With the 'Rapid Automatic Naming' test?  RAN. 

Visual images are stored in our brain's Visual Cortex.

Auditory such as words, are stored in our Auditory Cortex.

 

So that what automatic naming tests? Is how fluent the connection between the Auditory and Visual Cortexes is?

This connection develops through practice, which builds the neural wiring that connects them.

So that their is an instant connection between an image and its name.

 

But when their is a delay in automatic naming of objects?  This will of course, cause a delay in naming written letters/ words.

Though research has shown that, by directly practicing naming things?

This will build the neural wiring, and increase the fluency.  Which will carry over to written letters and words.

 

Here's a link to an article that explains it and provides some exercises to practice.

Where you will be able to observe an increase in speed and fluency, from practicing.

 

http://dyslexiahelp.umich.edu/professionals/dyslexia-school/word-retrieval-fluency-and-ran

 

[PeterPan]

Ironically, we worked on rapid naming with numbers (check), colors (check), and not letters (oops).  Turns out letters were also on the CTOPP, so that score was still low!  Can't win, lol.