Thoughts on these test results?

[Pawz4me]

DS17 was evaluated due to suspected ASD. These are some of the results of his psychoeducational testing. I'd appreciate hearing any thoughts anyone may have. Obviously it's a very spikey profile.

 

WAIS-IV

 

Scale Composite Score/Percentile

 

VCI 138/99

PRI 79/8

WMI 148/99.9

PSI 76/5

FSIQ 110/75*

GAI 107/68*

 

Subtest Scaled score/percentile

Similarities 14/91

Vocabulary 16/98

Information 19/99.9

 

Block design 5/5

Matrix reasoning 8/25

Visual puzzles 6/9

 

Digit span 19/99.9

Arithmetic 18/99.6

 

Symbol search 5/5

Coding 6/9

 

*The psychologist says his FSIQ and GAI really can't be calculated with any degree of accuracy due to the extreme spikiness of his results.

 

 

WIAT-III

 

Composite Score/Percentile

Total Reading 119/90

Basic Reading 127/96

Reading Comp and Fluency 107/68

Written Expression 133/99

Mathematics 109/73

Math Fluency 99/47

 

I've got the subtest scores for the WIAT-III. I'm not going to type those out but can provide any additional info.

 

She's diagnosing him with an "atypical learning disorder."  She explained it as a definite learning disorder due to the huge discrepancies in his scores, but nothing that there's a DSM code for. And I didn't think to ask, but . . . doesn't his profile pretty much exactly fit NVLD?

 

She also did/had us and him do questionnaires and scales (Brown ADD Scale, ADHD Rating Scale IV, Child Behavior Checklist, Youth Self-Report Form, SRS-2, GADS, CARS2-HF and ADOS) and diagnosed him with ASD Level 1.

 

Her recommendations include extended time on tests and large projects, a quiet space for testing, being provided lecture notes and slides, being allowed to record lectures and use a Smart Pen/Livescribe.

Edited September 23, 2016 by Pawz4me

[kbutton]

She's diagnosing him with an "atypical learning disorder."  She explained it as a definite learning disorder due to the huge discrepancies in his scores, but nothing that there's a DSM code for. And I didn't think to ask, but . . . doesn't his profile pretty much exactly fit NVLD?

 

She also did/had us and him do questionnaires and scales (Brown ADD Scale, ADHD Rating Scale IV, Child Behavior Checklist, Youth Self-Report Form, SRS-2, GADS, CARS2-HF and ADOS) and diagnosed him with ASD Level 1.

 

Her recommendations include extended time on tests and large projects, a quiet space for testing, being provided lecture notes and slides, being allowed to record lectures and use a Smart Pen/Livescribe.

 

That sounds like a solid evaluation, and yes, it does fit NVLD. NVLD is not in the new DSM, but strategies for that would be helpful.

 

My guess is that he is going to be fantastic in classes where discussion is a very big component and reading is secondary to that. He will retain and learn more by discussion and writing out his thoughts than reading alone--the lower reading comprehension compared to the other scores is probably due to pragmatic language and social/abstract stuff being a bit behind his intellectual level. 

 

His processing is slow, but his working memory is AMAZING. That is a huge gift--seriously! That's a big help in lectures, discussions, and written expression. 

 

As for the visual processing, that might not ever be a great area for him. If you have not had a COVD evaluation, you might consider it. That can contribute to or even cause major issues with the perceptual reasoning. But, some kids have fine vision and have this profile, so it may or may not be something that's going on with him.

[Storygirl]

I agree, it is a NVLD profile (DS12 has NVLD). Some psychs won't diagnose it, since it is not in the DSM5, but you can dig in and do your own research. I've learned a lot online. Your son is also 2e with those high scores.

 

Does he struggle with math (I see his math fluency is lower)? geodob has posted a couple of interesting things recently about how visual spatial affects the ability to see and understand patterns, which explains why NVLD students commonly struggle with math and reading comprehension. kbutton is right that pragmatic language can really affect the reading comprehension.

 

Pragmatics and social skills typically become the most debilitating aspect, because those areas affect the ability to perform in a job and have positive personal relationships. Unfortunately, the statistics for people with NVLD succeeding in the workplace are depressing. Did they do pragmatic testing? If his pragmatics are lower, that's an area to target with therapy.

 

Does he have an IEP or will you get one? If so, make sure the school tests for pragmatics, so he can get social goals in his IEP. They likely won't test unless you make a point of asking. Social skills/ pragmatics are tested by a SLP, so you have to request a speech evaluation.

 

Does he have a career goal? College plans?

[PeterPan]

Language testing?  Social skills testing?  Either or both of those could be behind the reading discrepancies.  Did she run a CTOPP?  Do you think it's phonological or comprehension?  I haven't dug in on the WIAT to know what those sections are showing you.  Same gig with the math. He's basically functioning like he has SLD math.  You *can* be very math gifted and have a math disability.

 

He has a lot of contradictions, and I think it's BECAUSE he's clearly gifted with disabilities.  Congrats on the thorough evals.  What do you feel is holding him back the most?  Social is your biggest determiner of employability.  What are you wanting to solve?  The list you're saying the psych said probably isn't as much as could be done.  I'd encourage you to definitely treat him as GIFTED along with the disabilities.  Like don't look at that 110 and stop there, because that 138 is in him.

[Pawz4me]

Thanks for all the input! I'm going to take a stab at responding to some things (and asking a few more questions), but please keep in mind that I have a decent big picture understanding of some of these issues but am probably woefully ignorant about a lot of the specifics. I may need some hand holding/directing.

 

 

That sounds like a solid evaluation, and yes, it does fit NVLD. NVLD is not in the new DSM, but strategies for that would be helpful.

 

My guess is that he is going to be fantastic in classes where discussion is a very big component and reading is secondary to that. He will retain and learn more by discussion and writing out his thoughts than reading alone--the lower reading comprehension compared to the other scores is probably due to pragmatic language and social/abstract stuff being a bit behind his intellectual level. 

 

His processing is slow, but his working memory is AMAZING. That is a huge gift--seriously! That's a big help in lectures, discussions, and written expression. 

 

As for the visual processing, that might not ever be a great area for him. If you have not had a COVD evaluation, you might consider it. That can contribute to or even cause major issues with the perceptual reasoning. But, some kids have fine vision and have this profile, so it may or may not be something that's going on with him.

 

Yes, I definitely thought about vision therapy. He was evaluated by a developmental ophthalmologist when he was around 2.5 or 3 and at that time he wasn't found to have any issues. But I assume that could change over time? Is a developmental ophthalmologist assessment different than what would be done for vision therapy? And that was 14 or 15 years ago, so I'm guessing the knowledge about issues has progressed a lot in that time?

 

 

I agree, it is a NVLD profile (DS12 has NVLD). Some psychs won't diagnose it, since it is not in the DSM5, but you can dig in and do your own research. I've learned a lot online. Your son is also 2e with those high scores.

 

Does he struggle with math (I see his math fluency is lower)? geodob has posted a couple of interesting things recently about how visual spatial affects the ability to see and understand patterns, which explains why NVLD students commonly struggle with math and reading comprehension. kbutton is right that pragmatic language can really affect the reading comprehension.

 

Pragmatics and social skills typically become the most debilitating aspect, because those areas affect the ability to perform in a job and have positive personal relationships. Unfortunately, the statistics for people with NVLD succeeding in the workplace are depressing. Did they do pragmatic testing? If his pragmatics are lower, that's an area to target with therapy.

 

Does he have an IEP or will you get one? If so, make sure the school tests for pragmatics, so he can get social goals in his IEP. They likely won't test unless you make a point of asking. Social skills/ pragmatics are tested by a SLP, so you have to request a speech evaluation.

 

Does he have a career goal? College plans?

 

I guess "does he struggle with math" would depend on how "struggle" is defined. He's in an early college high school program at our local CC. Last year he took MAT171 and 172 with final averages of 84 and 85. Decent scores, but significantly lower than his scores in other classes. He's never made less than an A in a non-math class. This semester he's in MAT271 (the highest math offered at his CC) and yes--he's definitely struggling. He made 43 on the first test. But from what he says the entire class is struggling and the highest score anyone made on that test he knows of was a 50. He blames the teacher for a lot of the problem and says if he had the same teacher he had for MAT171 and 172 he'd be doing much better.

 

Pragmatic testing -- My big picture understanding is that pragmatics is the give and take of conversation? If that's what you mean, then the only testing that was really done was her informal observations during the entire testing process and the part of the ADOS that involves assessing that.

 

One of her recommendations was for a social skills class and we're definitely going to look into that.

 

He does not have an IEP. The psychologist recommended approaching the school about a 504 plan. At this point in his academic career . . . I don't know? As I said, he's in an early college program and as of the end of last semester his GPA was somewhere in the 3.7 to 3.8 range. So academically he's doing okay without any accommodations. My initial thought is that I would like to at least discuss these test results with someone at the school. If nothing else I'd like to get permission for him to start using a smart pen. I think that has the potential to help him immensely when he transitions to a four year school and it would be nice for him to really learn how to use it effectively now. And there are probably other things he could really benefit from now that I just don't know. I don't know how much red tape or time is involved in implementing a 504? His school is small, very supportive and geared toward first time college students or students who struggle with a variety of issues/just don't fit well in a typical high school setting. I think they will bend over backward to do whatever they can.

 

Career goals/college plans -- Definitely college. If all continues to go as planned he'll get his AS degree a week before he graduates high school. Then the plan is to transfer to a four year school. Career goals -- totally up in the air. His interests are history, political science, sociology and similar areas. The psychologist suggested that he would likely do well working as a professor, researcher or at a think tank.

 

That really is an interesting profile of strengths vs weaknesses. I always thought processing speed and working memory most often varied together (both high or both low), but maybe that's only because they do in my own dc, so that's especially interesting to me. I don't have anything to offer as far as interpretation, but have a question for you, if you don't mind. Is this your ds's first eval, and do you anticipate being able to get testing accommodations for him for SAT/ACT? I have a junior we're contemplating evals for, but trying to weigh the costs/benefits, and have been thinking it would be too late for test accommodations since she's already taken some tests without (PSAT and likely a subject test before we would get an appointment for an eval).

 

This is his first evaluation since he was preschool aged. Back then he was evaluated by a children's hospital and our school system and was found by the hospital ealuation to have some slight developmental delays in speech and motor skills and possible vision issues (thus the follow up mentioned above with the developmental ophthalmologist). He had private speech and OT for several years. The school system evaluation was done when he was around four (I think) and they said he wasn't qualified for any services. I've always believed he was on the spectrum, but it was only in the last year when anxiety became an issue and we sought help for that that a professional (his psychiatrist) finally agreed with me. That lead to our scheduling psycho-educational testing.

 

DS has taken the PSAT (twice), the PLAN and the ACT with no accommodation. He didn't report having any time problems on any of them, and he scored a 28 on the ACT with absolutely no prep (believe me, I tried).

 

Language testing?  Social skills testing?  Either or both of those could be behind the reading discrepancies.  Did she run a CTOPP?  Do you think it's phonological or comprehension?  I haven't dug in on the WIAT to know what those sections are showing you.  Same gig with the math. He's basically functioning like he has SLD math.  You *can* be very math gifted and have a math disability.

 

He has a lot of contradictions, and I think it's BECAUSE he's clearly gifted with disabilities.  Congrats on the thorough evals.  What do you feel is holding him back the most?  Social is your biggest determiner of employability.  What are you wanting to solve?  The list you're saying the psych said probably isn't as much as could be done.  I'd encourage you to definitely treat him as GIFTED along with the disabilities.  Like don't look at that 110 and stop there, because that 138 is in him.

 

Talk to me in simple terms about language testing -- as I said, he was in speech therapy (apraxia) as a preschooler but hasn't had anything since he was discharged (at which point he was said to be within the normal range). That's the only testing/therapy he's had in the speech/language realm.

 

Social skills testing -- No. Who would we see for that?

 

Phonological or comprehension -- I have no idea. I wouldn't have guessed there was a problem with either.

 

I think social skills are definitely his biggest hindrance. I'm guessing some (most?) of it is the lag in the social/emotional area that comes with ASD? The psychologist said (and I already knew) that kids on the spectrum are typically three to four years behind NT kids in those areas. She suggested therapy/a social skills class and we're definitely going to look into both of those.

 

Anyone have thoughts on sending a kid like this off to college versus encouraging him to live at home and commute? DH and I are torn on how to approach that. We don't want to hold him back any, but we feel like the safest approach would be for him to commute (there's a decent-to-good regional state uni within commutable distance). Finances are another issue -- obviously he's good in the classroom but may not be so good at employment. To better his long term chances of successful employment we want to give him plenty of time to find his niche and to catch up as much as possible in the social skills area. And with the low processing speed and anxiety issues we want to make sure he doesn't overload his schedule. Living at home and commuting would definitely make our funds go a lot longer. His psychiatrist (who he sees for GAD) is encouraging him to stay home and commute. But if he wants to go away (likely no more than a couple of hours) . . .??? We just don't know how to advise him or what to subtly push for in that area.

Edited September 23, 2016 by Pawz4me

[PeterPan]

No, pragmatics is social thinking and a very involved topic.  There are simpler assessments (like the pragmatics portion of the CASL) and very detailed ones like the Social Language Development test that have a bunch of subsections.  This social skills thing is not a small deal.  It's the single biggest determiner of his future employability, but it's also directly affecting his reading comprehension, etc.  If he were in school with low scores in pragmatics, they would put it in his IEP and intervene.  Even that blame shifting in his math class is a social thinking issue and something they work on.  

 

It does sound like he should have been given a math SLD.  He has significant discrepancy between IQ and achievement.  And again, rather than blaming or blowing it off, he should be told the truth, that he's gifted with disabilities.  Fwiw, my ds is in that position.

 

Personally, I like social skills instruction done by a behaviorist, because they're extremely good at getting in their real lives and helping it to connect.  You'll also find social skills groups run by SLPs, etc.  You can go to SocialThinking.com and see the types of materials and what they can do.  You could even go to their workshops.  Really though, I'd encourage you to find a behaviorist (BCBA).

 

No, an opthamologist is a surgeon.  Sometimes they even poo-poo VT.  Some do it, but it's not typically their gig.  If you're wanting to check vision, look at COVD for a developmental optometrist.  

 

Has he had an OT eval?  Even if you don't do OT sessions beyond that, it could turn out to be very informative.  He probably has self-regulation issues an OT could help with, and he may have retained reflexes, sensory issues, etc.

 

An SLP can run the Social Language Development Test.  But like I said, me I'm not super keen on SLPs doing it.  They do it, and that's just my OPINION.  I like the BCBA/behaviorist doing it.  The behaviorist is used to going in the home, getting in their head, and working one on one.  You're running low on time and you don't need to sit around in a group.  SLPs doing it are branching out.  They went to the same workshop I went to.  I'm super impressed with the way our behaviorist works with my ds using the Social Thinking materials.  It will take some calling around to land on a behaviorist you feel really confident in.  It's a really important question, so call around, talk with them about what they're trained in, whether they work with teens, etc. etc.  Ours is a LSW (licensed social worker) who has the additional training and has been doing it a long time.  She's qualified to work with adults as well as kids, and she's easy for me to talk with.  Be super picky on this choice and you'll be most happy with the outcome.

 

Is he on meds for the anxiety?  And he gets counseling?  Again, see what the BCBA can do for him.  So it's definite he's graduating this spring?  Then yes, commute.  Suggest he commute for a year while he works with the BCBA, then with a year of aggressive social skills under his belt make the next choice or transfer.  Or, you know, is there something he's passionate about?  If his social skills are holding him back (which they will, anything little now is going to magnify), then would he consider a gap year, maybe interning or volunteering in his passion or to find a passion, doing aggressive social skills work during that (1-2 times a week with the BCBA) and the following year enrolling?  That's something the BCBA could definitely guide you on.  

 

Does he really have a sense of what he wants, or is he drifting?  How imperative is it to make this choice?  Like, I know he's a senior, but he's got a lot going on.  Is he very directioned, knowing what he wants, or not really?

Edited September 23, 2016 by OhElizabeth

[PeterPan]

Ok, you can get an SLP to do the Social Language Development Test and maybe even a CTOPP.  Some have the CTOPP, some don't.  It's kind of irksome that your psych didn't run it.  Honestly, I'd give her a call and ask whether she had those two and whether she'd run them for an extra $$ and be done with it.  It might be she just ran out of hours under a pat billing price.  So if she has them, ask her to run them.  If she doesn't, you're going to end up calling tons of SLPs trying to get it done.  

 

The CELF is a common language test.  It doesn't take as many hours to administer, and it does have a (not well-respected) pragmatics subtest.  Our neuropsych did this and the ps SLP here uses it.  The CASL has tons of subtests and takes lots of hours to administer.  If you want useable information, something you can translate into oh that's what I need to do, the CASL kicks butt.  You can google the subtests for them and compare.  See what you can get.  Our SLPs specialize in apraxia (which my ds has too, sigh), so this is sort of normal testing.  Even if he had it a long time ago, it would be nice to update.  Or he aged out.  Or just assume there are problems and let the BCBA work on it.  He may be too old for some of the language testing.  You could google 

 

In reality, the BCBA can be your point person for these things.  Around here my behaviorist is less than half the price of the SLP.  I kid you not.  And she picks up speech therapy materials and uses them or has the ABA tutor implement them, just like an SLP. So call around, see what your options are, put together a plan.  The BCBA might have someone they really like that they would refer you to.  But I wouldn't do (exclusively) groups.  I think one-on-one work with a behaviorist would get you there faster. But, see what your insurance will cover.  As much as they'll cover, do, mercy.

 

Just keep talking it through.  It's confusing at first, but I think it's because your mix isn't going to look like anyone else's.  It depends on what you have access to, etc.  So see what you can make happen, make calls, come back and talk it out on the boards.   :)

Edited September 23, 2016 by OhElizabeth

[Pawz4me]

No, pragmatics is social thinking and a very involved topic.  There are simpler assessments (like the pragmatics portion of the CASL) and very detailed ones like the Social Language Development test that have a bunch of subsections.  This social skills thing is not a small deal.  It's the single biggest determiner of his future employability, but it's also directly affecting his reading comprehension, etc.  If he were in school with low scores in pragmatics, they would put it in his IEP and intervene.  Even that blame shifting in his math class is a social thinking issue and something they work on.  

 

It does sound like he should have been given a math SLD.  He has significant discrepancy between IQ and achievement.  And again, rather than blaming or blowing it off, he should be told the truth, that he's gifted with disabilities.  Fwiw, my ds is in that position.

 

Personally, I like social skills instruction done by a behaviorist, because they're extremely good at getting in their real lives and helping it to connect.  You'll also find social skills groups run by SLPs, etc.  You can go to SocialThinking.com and see the types of materials and what they can do.  You could even go to their workshops.  Really though, I'd encourage you to find a behaviorist (BCBA).

 

No, an opthamologist is a surgeon.  Sometimes they even poo-poo VT.  Some do it, but it's not typically their gig.  If you're wanting to check vision, look at COVD for a developmental optometrist.  

 

Has he had an OT eval?  Even if you don't do OT sessions beyond that, it could turn out to be very informative.  He probably has self-regulation issues an OT could help with, and he may have retained reflexes, sensory issues, etc.

 

An SLP can run the Social Language Development Test.  But like I said, me I'm not super keen on SLPs doing it.  They do it, and that's just my OPINION.  I like the BCBA/behaviorist doing it.  The behaviorist is used to going in the home, getting in their head, and working one on one.  You're running low on time and you don't need to sit around in a group.  SLPs doing it are branching out.  They went to the same workshop I went to.  I'm super impressed with the way our behaviorist works with my ds using the Social Thinking materials.  It will take some calling around to land on a behaviorist you feel really confident in.  It's a really important question, so call around, talk with them about what they're trained in, whether they work with teens, etc. etc.  Ours is a LSW (licensed social worker) who has the additional training and has been doing it a long time.  She's qualified to work with adults as well as kids, and she's easy for me to talk with.  Be super picky on this choice and you'll be most happy with the outcome.

 

Is he on meds for the anxiety?  And he gets counseling?  Again, see what the BCBA can do for him.  So it's definite he's graduating this spring?  Then yes, commute.  Suggest he commute for a year while he works with the BCBA, then with a year of aggressive social skills under his belt make the next choice or transfer.  Or, you know, is there something he's passionate about?  If his social skills are holding him back (which they will, anything little now is going to magnify), then would he consider a gap year, maybe interning or volunteering in his passion or to find a passion, doing aggressive social skills work during that (1-2 times a week with the BCBA) and the following year enrolling?  That's something the BCBA could definitely guide you on.  

 

Does he really have a sense of what he wants, or is he drifting?  How imperative is it to make this choice?  Like, I know he's a senior, but he's got a lot going on.  Is he very directioned, knowing what he wants, or not really?

 

It's going to take me a bit to wrap my mind around the pragmatics stuff!

 

He had OT as a preschooler for motor and sensory issues. Was discharged prior to kindergarten and said to be in the normal range then. He didn't seem normal to me, but we were private pay so she had no reason to discharge him if there was still room for improvement.

 

He's been on fluoxetine for anxiety since July 2015. Sees a psychiatrist every three months for managing that. He has an appointment coming up on Wednesday, so I'm trying to figure out what topics I need to pursue with her at that appointment. He's not in counseling but we're open to anything that will be helpful to him. He's very cooperative so I think would be willing to try anything. She may be able to point us in the right direction for that (there are some social workers/therapists in the same office). We also have an appointment on October 14 for the psychologist to explain all this to him and I'll have the opportunity to ask her more questions then, too. Or I can schedule another appointment with her just for me to go in and discuss . . whatever.

 

He's drifting with no clear plan. DH and I are treading carefully because it would be *very* easy for us to influence/manipulate him--he would likely do whatever we suggest in terms of schooling, career plan, etc. At this point DH and I are open to anything (gap year, etc.) that will improve his long term chances of success. I would want him to do something productive during a gap year besides therapy, though. Continuing to take a few classes at the CC would perhaps be an option. I guess that would destroy any chances of him qualifying for any freshman scholarships if/when he transferred to a four year school, but I don't think that would be a huge issue. We're planning on being full pay anyway.

 

I have lots of research to do. I'm really not getting how all these areas tie together!

[PeterPan]

I'm sorry it's overwhelming!  You've gotten a lot at once!  That's 3 weeks till the psych appt.  Since she already told you he needs social skills intervention, that's what I would put your emphasis on.  It's the single thing most likely to get you BIG REWARDS right now.  

 

BCBA=Board Certified Behavioral Analyst.  As a matter of practice, it means they have training in lots of areas affected by autism.  Autism is an umbrella problem and they're the umbrella person for it.  So getting a BCBA is saying we know it's autism and we want someone who specializes in autism.  That's what I'm suggesting you find.  My ds has apraxia, SLDs, and ASD1, and that's what we're using.  You don't really want a social worker or counseling per se.  You want a behaviorist, someone who exclusively works with autism.  They're pretty magical, honestly.  

 

See what you can find for a behaviorist/BCBA in your area.  There is a directory for BCBA.  To get one, I'd have to go into the big city.  That's fine and works too, but some behaviorists were doing this before BCBA.  So that's why you just see what you can find.  He's most likely to be *himself* in his own environment.  So if you'll let someone come into the home and work with him, they're most likely to gather enough information to actually help him.  Like really open up with it, kwim?  And maybe they'll say no, don't need that, meet at Panera or whatever.  Just talk with them.  

Edited September 23, 2016 by OhElizabeth

[Crimson Wife]

 

Talk to me in simple terms about language testing -- as I said, he was in speech therapy (apraxia) as a preschooler but hasn't had anything since he was discharged (at which point he was said to be within the normal range). That's the only testing/therapy he's had in the speech/language realm.

 

You would want to see a speech & language pathologist familiar with testing adolescents since the typical SLP deals mostly with the toddler to early elementary range. Any SLP can run the various tests but for useful interpretation of the results & not just boilerplate from the scoring manual, you need someone with experience.

 

Some tests that might give useful information are the CELF-Metalinguistics, the Test of Language Competence-Expanded, the Test of Problem Solving 2-Adolescent, and the Test of Social Language Development-Adolescent. I'm sure he'd score fine on the basic language tests so what you would want to find out is how he compares to his peers on more advanced language skills.

[Crimson Wife]

 

The CELF is a common language test.  It doesn't take as many hours to administer, and it does have a (not well-respected) pragmatics subtest.  Our neuropsych did this and the ps SLP here uses it.  The CASL has tons of subtests and takes lots of hours to administer.  If you want useable information, something you can translate into oh that's what I need to do, the CASL kicks butt.  You can google the subtests for them and compare. 

 

You keep saying this, but I'm thinking what your DS got was the screening version of the CELF rather than the full version. My Language Disorders textbook says the screening version is 20-45 minutes while the full version is 1-2 hours, the same as listed for the CASL.

 

I've seen my daughter's reports for the CELF and the CASL and based on that plus the information in my Language Disorders textbook, I would NOT agree that the CASL gives superior information to the CELF. They each have their strengths.

[Terabith]

I don't know. I have slightly different thoughts.

 

I would definitely want a developmental optometrist eval and a more in depth pragmatics test. But the Information subtest on the WAIS is very dependent on social judgment, so I doubt it can be that bad. By all means, do remediation you can. And maybe a gap year with therapy and volunteer work. But I don't think I would lean towards commuting. I would be looking for the college that is the best fit, looking particularly at small liberal arts colleges, with small classes taught by professors and a support network on campus. He's gifted, and I would want to push for him to shine in his areas of strength and find his niche and tribe. Now, if he can't maintain friendships or cope socially, it would be different.

[Pawz4me]

I don't know. I have slightly different thoughts.

 

I would definitely want a developmental optometrist eval and a more in depth pragmatics test. But the Information subtest on the WAIS is very dependent on social judgment, so I doubt it can be that bad. By all means, do remediation you can. And maybe a gap year with therapy and volunteer work. But I don't think I would lean towards commuting. I would be looking for the college that is the best fit, looking particularly at small liberal arts colleges, with small classes taught by professors and a support network on campus. He's gifted, and I would want to push for him to shine in his areas of strength and find his niche and tribe. Now, if he can't maintain friendships or cope socially, it would be different.

 

We're scheduled to attend an open house at a small local LAC on the 1st. It's one of the colleges that change lives. I think in many ways it could be a great fit for him.

 

In other news -- I have a meeting scheduled for Thursday morning with his school guidance counselor and principal. I emailed his evaluation to the guidance counselor and she emailed me back in less than an hour to set up the appointment.

[PeterPan]

If this is a ps, then IDEA kicks in and they can be compelled to provide services too!  They can run the pragmatics testing, language testing, etc.  Sounds like a good plan!

[Storygirl]

I don't know what to say about commuting to college versus going to a residential campus. There are pros and cons to each. I know that many on the spectrum have trouble when going away to school, even if they are strong academically. I think I would tend to consider living at home, so that you can offer support that he might lack if he lives away. Is it possible for him to commute to the LAC? I think a LAC that has a good reputation for dealing with disabilities could be a good choice.

 

I know the autism diagnosis is new and that you will want to read up about that, but I think researching NVLD will give you some additional insight that will be helpful. There are definite NVLD characteristics that are not always found with autism, so you want to be well versed in both areas.

 

Because he has been doing well with CC, I imagine he will handle the academics of the remainder of college well. I think considering the life skills aspect and what he needs to be prepared in the workforce is the really important piece to address. Has he ever had a part time job? I think getting some work skills under his belt before college graduation would be a great plan. If he could use a gap year to have therapy, work at a part time job, do a little volunteering (also will build job and people skills), and maybe take one CC course to keep the academics from going rusty, you may then have a much better idea about whether he will be in a good place to go to a residential college. Better for him to have that year at home now and solidify those skills than to have to return home after college because he can't gain employment. Having an associate's degree hopefully would open some doors for getting a job.

 

I think with the kind of career choices he is interested in, he is going to have to consider graduate school. Beware of a possible tendency to continue in school with no practical and possible end goal in mind. Going from college to grad school and then hoping that employment will happen without a strong previous work history would not be a great idea.

 

Even if he took two years or more to work after graduating with his associate's degree and high school degree, it would not be a bad idea. It would allow him time to mature and give him good solid work skills, which may then give him a better idea about what he would like to pursue as a career.

[Storygirl]

I just wanted to add or emphasize that at his age, it's really important to have WORK as the end goal. Some kids go off to college not knowing what to pursue for a career, and it all works out, because they figure it out as they go along. So at age 17 or 18, the emphasis of thought is on what college to go to and what major to study. That's all well and good and works out for most people. But for someone with autism and an NVLD profile, being successfully employed in any job is the big hurdle. It's common to be under employed, in a job that one would not expect for someone so smart.

 

So being a college professor, etc. might be a good fit for his mind and personality, but he's probably going to have a longer road than normal to get there. Being able to make a living in the meantime, while he climbs the ladder to his ultimate career goals, is going to be really important, unless you have the resources to support him over a long haul. So you might want to help him develop a two-level goal -- first what he needs to do to be employable in any job and what low level job he will aim for (because everyone starts with a low level job) that can support him at least at a basic level over time, and second, what he will need to do to get through graduate school and into the higher level jobs that he wants to aim for.

 

You may want to consider whether he can double major in something very practical PLUS history/poli sci. That approach would hit both goals -- shorter term employability and long-term career preparation -- simultaneously.

 

DS12 is likely not college bound. He has some significant LDs, which are going to make even high school level work difficult for him. Even now, I ponder what we should do to prepare him for the workplace, because he has to be able to be employed, doing something. And I'm wrapping my mind around the idea that he may not live independently until much older than the norm.

 

These are not fun thoughts, but I'm striving to be realistic.

 

(This is coming from a person who was an English major who went directly to grad school without a career plan and who thinks being in college indefinitely would be fun).

[Tokyomarie]

These results definitely confirm that your son is 2E! Definitely some pretty wild discrepancies...

 

I think I've missed the reason why you sought an evaluation at this time. What are the functional challenges your son is experiencing? What do you think he needs most in the way of support or accommodations to transition into adult life? Often for these kids, it's not so much academic as it is learning social and work skills.

 

If he is in early college and maintaining a 3.7 or 3.8 GPA without accommodations, he's not showing that he needs them to succeed academically. OTOH, if something like a LiveScribe pen or being allowed to record lectures would be a big help, you would seek those accommodations under a 504 Plan.

 

In the early college program my son attended, we went through the regular process for determining eligibility for an IEP or 504 through the high school arm of the program. Once he was determined eligible for 504 accommodations, an accommodation plan was developed. The CC disability office then listed him as an eligible student and he was to deal with that office to actually be granted accommodations in his college classes. Once students are attending college classes, supports for those classes are covered under ADA law, not IDEA. If the high school arm of the program sees a need to provide extra instruction, they can develop an IEP, but for a student who is succeeding in the college classroom, it's not likely that they would.  

[Pawz4me]

Is it possible for him to commute to the LAC? I think a LAC that has a good reputation for dealing with disabilities could be a good choice.

 

I know the autism diagnosis is new and that you will want to read up about that, but I think researching NVLD will give you some additional insight that will be helpful. There are definite NVLD characteristics that are not always found with autism, so you want to be well versed in both areas.

 

Because he has been doing well with CC, I imagine he will handle the academics of the remainder of college well. I think considering the life skills aspect and what he needs to be prepared in the workforce is the really important piece to address. Has he ever had a part time job? I think getting some work skills under his belt before college graduation would be a great plan. If he could use a gap year to have therapy, work at a part time job, do a little volunteering (also will build job and people skills), and maybe take one CC course to keep the academics from going rusty, you may then have a much better idea about whether he will be in a good place to go to a residential college. Better for him to have that year at home now and solidify those skills than to have to return home after college because he can't gain employment. Having an associate's degree hopefully would open some doors for getting a job.

 

I think with the kind of career choices he is interested in, he is going to have to consider graduate school. Beware of a possible tendency to continue in school with no practical and possible end goal in mind. Going from college to grad school and then hoping that employment will happen without a strong previous work history would not be a great idea.

 

Even if he took two years or more to work after graduating with his associate's degree and high school degree, it would not be a bad idea. It would allow him time to mature and give him good solid work skills, which may then give him a better idea about what he would like to pursue as a career.

 

Yes, the LAC is only 30 minutes away, so commutable (DS is a very good driver) They do have a requirement to live on campus for four years, but that appears to be a very loose requirement. He can apply for an exemption due to his disabilities and because he would be living with his parents within a certain radius of the campus.

 

I am going to read up more on NVLD. As I said, I've strongly suspected for years that DS was on the spectrum so I'd done quite a bit of reading and educating myself about that. And in the course of that I came across NVLD quite regularly. That's why once I had just a few minutes to process things I realized that by "atypical learning disability" the psychologist almost certainly meant NVLD. When I was reading about it I would go back and forth in my mind--does he have NVLD? Or autism? Autism was the better fit to my way of thinking. It never occurred to me that he could have both. Most of what I've read seemed to lean toward NVLD, although being able to stand on its own as a diagnosis, also likely being a subset of autism, and that to a certain extent all people with autism would qualify for a NVLD diagnosis. Or maybe not the Temple Grandin highly visual type of autism, but the people on the spectrum who more closely fit DS's profile. I could be wrong but it seems to me a lot of this boils down to our ability to accurately and meaningfully label things, and the areas labels apply (medical, academic, etc.).

 

Yes, we understand some of his choices would require graduate work. Which is why commuting to the local state uni is so appealing. We do have a good pool of money earmarked for his college expenses. It would very likely go much farther at the local state uni than at the private LAC. I think academically both of them can be considered safety schools for him.

 

He's never had a job. He's an ambassador at his school which is I guess technically a job but it's so nominal and the "work" is so sporadic there's no way I'd really consider it a job. He has done a bit of volunteer work, although a lot of that has been at the school (tutoring) and at random community events. Nothing sustained. It's a challenge around here to find volunteer work or job opportunities for teens. But yes--I get what you're saying about some work experience being critical.

 

 

I just wanted to add or emphasize that at his age, it's really important to have WORK as the end goal. Some kids go off to college not knowing what to pursue for a career, and it all works out, because they figure it out as they go along. So at age 17 or 18, the emphasis of thought is on what college to go to and what major to study. That's all well and good and works out for most people. But for someone with autism and an NVLD profile, being successfully employed in any job is the big hurdle. It's common to be under employed, in a job that one would not expect for someone so smart.

 

So being a college professor, etc. might be a good fit for his mind and personality, but he's probably going to have a longer road than normal to get there. Being able to make a living in the meantime, while he climbs the ladder to his ultimate career goals, is going to be really important, unless you have the resources to support him over a long haul. So you might want to help him develop a two-level goal -- first what he needs to do to be employable in any job and what low level job he will aim for (because everyone starts with a low level job) that can support him at least at a basic level over time, and second, what he will need to do to get through graduate school and into the higher level jobs that he wants to aim for.

 

You may want to consider whether he can double major in something very practical PLUS history/poli sci. That approach would hit both goals -- shorter term employability and long-term career preparation -- simultaneously.

 

DS12 is likely not college bound. He has some significant LDs, which are going to make even high school level work difficult for him. Even now, I ponder what we should do to prepare him for the workplace, because he has to be able to be employed, doing something. And I'm wrapping my mind around the idea that he may not live independently until much older than the norm.

 

These are not fun thoughts, but I'm striving to be realistic.

 

(This is coming from a person who was an English major who went directly to grad school without a career plan and who thinks being in college indefinitely would be fun).

 

I totally get what you're saying. I've been trying to make DH understand the rather bleak statistics on long term employment at a level DS is academically/intellectually capable of. We'd love to come up with some more practical ideas (open to suggestions!), but we're pretty short on those. DH has said for years that DS would make an excellent mailman, and I agree. With his working memory he'd have names and addresses memorized in no time. And truthfully although he would be underemployed--I think that's the type of job he would thrive in. Repetitive and relatively low stress. But we're not coming up with much more than that. It seems like most practical jobs require the skills that DS is weakest in. We've always said that all we want is for our boys to be happy and we didn't care if they chose to be garbage collectors or whatever. And that's true. We're not emotionally invested in any grand career plans, just trying to choose the best route for him right now so that he can continue to have something productive to do. And we do value education for its own sake.

 

I'm sorry about your DS, and I hope you can find the perfect niche job for him. I was at the grocery store yesterday and noticed the stockers and I thought that DS wouldn't hate a job like that. He might be a bit embarrassed by it being beneath him intellectually, but I think he could be fairly content doing just about anything and that he could meet his intellectual needs elsewhere. Of course the downside of that is that a minimum wage job, even a full time one, isn't going to provide a very adequate income. I hope both of us can manage to help our boys find a good place in the world for them.

 

 

These results definitely confirm that your son is 2E! Definitely some pretty wild discrepancies...

 

I think I've missed the reason why you sought an evaluation at this time. What are the functional challenges your son is experiencing? What do you think he needs most in the way of support or accommodations to transition into adult life? Often for these kids, it's not so much academic as it is learning social and work skills.

 

If he is in early college and maintaining a 3.7 or 3.8 GPA without accommodations, he's not showing that he needs them to succeed academically. OTOH, if something like a LiveScribe pen or being allowed to record lectures would be a big help, you would seek those accommodations under a 504 Plan.

 

In the early college program my son attended, we went through the regular process for determining eligibility for an IEP or 504 through the high school arm of the program. Once he was determined eligible for 504 accommodations, an accommodation plan was developed. The CC disability office then listed him as an eligible student and he was to deal with that office to actually be granted accommodations in his college classes. Once students are attending college classes, supports for those classes are covered under ADA law, not IDEA. If the high school arm of the program sees a need to provide extra instruction, they can develop an IEP, but for a student who is succeeding in the college classroom, it's not likely that they would.  

 

He started having issues with anxiety a couple of years ago and started losing weight. His pediatrician diagnosed the anxiety but didn't feel comfortable prescribing medication and referred DS to an adolescent psychiatrist. We had to wait over five months to get an appointment with her (his ped did prescribe medication in the meantime), and then it took her a few times of seeing him before she told me she suspected he was on the spectrum. And I was almost giddy that after all these years a professional was finally agreeing with me! Which led to the evaluation. My guess is that it's the lack of social skills that are at the root of his anxiety and what he needs to work on most.

 

It might be interesting to note that as far as the psychiatrist is telling me the reason she believed DS might be on the spectrum was because it is so incredibly hard to pull information out of him. He doesn't "get" things like when your psychiatrist asks you "How are things going?" that she's expecting more than "Fine" as an answer. So .  . social skills/communication. Other than not being talkative and being a bit awkward, when he sets his mind to it he can come across as very typical. Which is why I suspect his pediatrician and the therapists he had when he was younger all thought there was no way he was autistic. And why I doubted my own intuition enough that I didn't really push hard for an evaluation sooner (even the psychiatrist was wishy washy about the need to seek a full evaluation!). But as he's gotten older and closer to being a full time adult and his world has gotten more complex to navigate it's been getting harder and harder for him to fake normal. At least that's my admittedly simplistic take on things.

 

That's great info about 504 versus IEP. His psychologist mentioned 504, not IEP. The only high school level class he takes is a once a week seminar. All his other classes (this year and last year) are/have been college level. My guess is that his principal and guidance counselor will bend over backwards to do everything they can to assist him. We can buy a LiveScribe or voice recorder or whatever. We'd want him to have those anyway if they'll be helpful, so asking the school system to provide him with those isn't something we'll do, We just need their help to get him permission to use them. And I'd be thrilled if we can get them to do some more assessments.

 

And FWIW -- Some of you have mentioned that blaming his math teacher for his lack of performance is a social skills issue. I'm not convinced that's correct. From what I know of her and her reputation I tend to think DS is making an accurate and honest assessment. She's not particularly well regarded by the high school teachers and staff (to put it mildly), but she's the only person at the CC who teaches that class.

Edited September 24, 2016 by Pawz4me

[PeterPan]

Or think of it as autism, subtype NVLD.  Because really what happens for people who got the NVLD question is they have to go back and figure out whether they also fit the criteria for ASD.  The research now is showing lots of subtypes of autism, so it's ok to go yes autism, but subtype, variety.  The research just hasn't filtered down to the DSM.

 

[Storygirl]

Yes. Autism with NVLD. Some people with ASD don't have NVLD, and some people with NVLD do not have ASD.

 

Personally, I think of it as two spectrums that overlap. NVLD can range from mild to severe. The more severe the impact of NVLD, the more likely that there will also be an ASD diagnosis.

 

But there are plenty of people with ASD who don't have the NVLD profile. Many people with autism are good at seeing patterns and good at math, for example, which is why they end up in tech industries. But those careers are a poor fit for NVLD kids. So it's harder to find a career that will fit. Going with a humanities focus is an obvious choice for someone like your son, who is 2e, but the question is how that parlays into a job.

 

Mail carrier sounds good! He might make more money with a parcel package company. My cousin's husband worked as a UPS driver for over 30 years and supported his family on his income. My cousin stayed home with her kids when they were little, then worked only very part time once they were in school, so she wasn't bringing in much dough. Her husband's job supported them.

[Storygirl]

double post

Edited September 24, 2016 by Storygirl

[Storygirl]

Having the ASD diagnosis instead of just the NVLD diagnosis is a good thing, by the way. DS does not have an ASD diagnosis at this point, and we are always going around in our minds about whether we should pursue that further.

 

I think he is probably high functioning ASD, but many people do not see it, mainly because he makes eye contact.

 

You might contact your county board of disabilities to see if there are services available to help him transition into adult life. There also may be a state medical fund for people with disabilities that is like secondary insurance that will pay for things regular insurance does not. Our state has this (we are not part of it, but it was mentioned by a social worker when we were having some screenings done for another child).

 

Because he has the ASD diagnosis, it may allow him to get these services that might not be available to someone with just an NVLD diagnosis.

[kbutton]

I haven't had a chance to read the latest replies, but I forgot to mention a book. Dry as dust, but it's great. Different Minds by Dierdre Lovecky talks about 2e ASD, ADHD, LD, NVLD and various combos of some of those. Different profiles and needs are compared and contrasted very well to show the nuances of what kids struggle with. It's a wonderful resource.

[kbutton]

I want to piggyback on what Storygirl said about transitioning stuff. The local board of DD or even some parent advocate groups often have transition seminars. You might have to extrapolate a bit (they are not usually thinking about 2e kids), but you can still find valuable information there. 

 

I also heartily agree that looking into UPS and other parcel carriers is a great idea. We know a UPS carrier that does very well, and with it being a lower stress job, he dabbles in some stuff on the side. The post office is not super stable right now, but it's certainly also a possibility. My dad was a carrier for the USPS for a long time. We lived in a pretty rural area, and the technical jobs available at the time all kept moving away, and he did not want to move. He loved his job (though not the management, lol!). If they were not closing/consolidating so many little post offices, I would suggest having your son consider starting at any level in the USPS and then taking tests for supervisor or postmaster positions in small offices (after getting social/anxiety under control). But those tiny and really small post offices are going away, unfortunately. The USPS also  offers jobs that are in processing centers. 

[Terabith]

I would really encourage you to think about him living on campus at a LAC. Especially if it's primarily residential, it would be harder to make friends and find his niche as a commuter. I'd consider letting him try it, at least for a year. It sounds like he has the skills to cope with living independently, and a residential college is perfect training in independence.