When to get assessed?

[silver]

My son has always had some difficulties with language. He was a late talker. We got him assessed for speech delays when he was 2, but the testing lady was satisfied with his receptive language (since he could follow instructions) and his expressive language (since he would imitate sound effects and animal sounds). Learning to read was slower for him than other skills. He recently bombed the spelling portion of his standardized tests (13th percentile, compared to being over 85th percentile for everything else). I don't think the testing was a fluke or bad day, as he also struggles with spelling during school. He does not seem to pick up vocabulary for reading/read alouds. He stutters, but not so badly that it interferes with communication. 

 

Other than spelling, he does well in school. His writing isn't where I want it to be, but I have seen improvement this last school year, so I'm happy with his progress. We've done many OG based programs (he learned to read with LOE Foundations A-C, has done levels 1-3 of AAS, and levels 1-4 of RLTL). This year we have done my own version of Spelling You See where he highlights chunks, copies, studies, and writes from dictation. 

 

I don't know if I should get him assessed, and if I do, what kind of tests would we even need him to do? Is there a different spelling program that would work? It seems he learns well enough to just remember for the lesson and then immediately forgets (for example, he really does know that /shun/ is typically spelled 'tion', but he spelled 'information' as 'informashen' during his testing). AAS was a flop with him because he would see the pattern of the lesson, apply it to the lesson, and then forget about it. 

[PeterPan]

What's your insurance coverage and what can you make happen? You would have some different options, depending on pricepoint. If you were in our ps district, you'd make your written request and try to compel them to run SLP eval, including artic, the CELF, etc. You'd get a psych eval, and hopefully they'd run a CTOPP. That would be a nice list. They'd do a crap job at it, but they'd do it.

 

If you're able to fund privately, I would look for a PROMPT therapist who specializes in apraxia to figure out if that "stuttering" is actually remnants of a motor planning problem. I'd have them run the VMPAC and then the CELF or CASL. And then, yes, you'd like a psych/neuropsych eval to look for discrepancy, run IQ, run a CTOPP, etc. You're trying to sort out what is dyslexia, what is motor planning, etc. 

 

Because that list starts to get long and expensive, that's where you go back to budget and how you're funding the testing. The SLP eval will be less expensive than psych, and doing the CELF with an SLP is dramatically cheaper than the same test with a psych. Sometimes you can find a reading tutor to do the CTOPP. So then, you could take all that info and go ok, this is where it's pointing, do we NEED to go to the psych. If you need to stagger your spending, that would be a way to do it. If your insurance will cover one type of practitioner over another, obviously lean that way. Sometimes they'll cover tons if the label comes out ADHD/ASD and diddley if it's SLDs, sigh. So just see. 

[PeterPan]

Eventually you'd like his eyes screened, but that's not really your starting point. But it's one of those things to do eventually.

[silver]

There certainly could be vision issues. He wears glasses, but has only ever gone to a normal eye doctor for those. They've had a hard time pinpointing his prescription the past two years. 

 

I want to clarify about the stuttering. He doesn't do it all the time. He does it when he's excited or when he's thinking hard about what to say (like when giving an oral narration). It pops up sometimes during normal conversation, but it isn't very noticeable then. 

Edited March 27, 2017 by silver

[PeterPan]

That's a little odd. Our developmental optometrist practice locally seems to have exceptional eye docs. Like the scrips I've gotten from them are WAY better than from the regular doc I went to before. You might look for a developmental optometrist, see what you can find. And that's a really good way to do it, starting with just a regular exam for scrip and asking them to *screen* for the developmental problems. That way you don't have a lot out if you don't even like the doc, kwim? And they can tell a lot with a screening.

[PeterPan]

So then what about the other tests? I don't think vision is going to explain what you've got going on here.

[silver]

So then what about the other tests? I don't think vision is going to explain what you've got going on here.

 

 

There's certainly more than vision, because that wouldn't explain speech issues. For a developmental optometrist, does eye insurance typically cover that? If so, it may need to wait a year, as we've used the annual exam benefit already this year. 

 

 

He's a bright kid, especially in math. I've always wondered if maybe he's able to compensate for some learning disability (such as dyslexia) and thus makes it less obvious.

 

I have an older version of the Brigance CIBS ( http://www.curriculumassociates.com/products/detail.aspx?title=BrigCIBSII ). Would any of those tests be something that could give helpful information while we figure out insurance/evaluations?  (ETA: here's the table of contents of the version I have: https://www.curriculumassociates.com/professional-development/ca101/downloads/bricomp.pdf )

Edited March 27, 2017 by silver

[Crimson Wife]

Ugh, that first speech evaluation you described sounds totally wrong to me after having done the language assessment and intervention from birth to 5 course last semester. Imitation can be appropriate as part of an articulation assessment but there should have been a more comprehensive expressive language assessment done as well.

 

I would start with the school under the Child Find program since that is free. Then depending on the results, you might want to seek a private evaluation. Anything you can get run by a SLP will be significantly cheaper than seeing a psychologist.

 

 

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