APD - how can I help her?

[Southern Ivy]

My daughter is only 5, so it's going to be awhile before we have an official diagnosis; but she's been recently diagnosed with ADHD and a processing disorder. All signs I'm seeing are pointing to an auditory processing disorder (it's also been heavily hinted at by some professionals). 

She graduated speech this past December; we originally went for initial g/k sounds. The rest of the sounds seem to be developmentally appropriate. However, I'm going to call and set up another evaluation to see if there are other issues they can help with - for one, the neuropsych, a family friend, my sister and my mom have all mentioned she can be hard to understand sometimes. 
It was also suggested that we see an OT for potential retained reflexes, so I'll be looking into an eval for that too. 

So, all that stated (and I'm sure I've left holes, so please ask!), I kind of feel like I'm in no-man's land since she's too young to get diagnosed with APD or dyslexia (or both). I don't want to sit here and do nothing for the next 2-3 years, but I'm not sure how best to help her. 

At this point, I know we need to tackle the alphabet (she can only readily identify A and X). She can't remember any of the sounds of the letters either. This is after having been in preschool for 2 years.  So, I know that's kind of a crucial piece we need to address first. But, after that, I don't know where to go to help her overcome the hurdles of this processing disorder. 

What have you done with your kids? What programs have you found to be beneficial for your child? (At this point, Barton is not an option. I would love to do it, but it's just not financially feasible right now.)  

And to quote Oh Elizabeth 

So I'm saying ask the right questions, like what would prevent the train wreck? Start a thread here on the board about APD and ask what aspects are involved or could be involved and what you can do to avoid train wrecks with them.

 

Anything that I wouldn't expect to be a problem with APD, but actually is? Anything I should expect to occur when teaching her? Basically, what can you tell me that I haven't yet read in regards to APD?

Edited June 21, 2017 by Southern Ivy

[Lecka]

Look at the Barton reading program's pre-test. There is a section where -- if it is failed, she recommends a program called LIPS.

 

That is something you can look at, maybe it is a possibility.

 

Look at phonological awareness, and phonological processing. That has to do with hearing letter sounds.

 

Look for stuff (aka google) about multisensory ways to work on things.

 

There is a lot for phonemic awareness now -- ideas on the Internet. A lot may be hard now, but look for the simplest stuff and see if any of it is an option.

 

Also keep in mind for speech therapy through school -- you can ask to have her re-evaluated every so often. It is common for kids to exit speech and then 6 months later maybe they qualify again. Say what you are seeing when you request it. It will depend on where you live maybe -- but maybe worth a shot. Or maybe you can ask questions about how close she is to qualifying or whatever. Speech therapists do work on this stuff too but I don't really know how they qualify kids. And both my boys were/are qualifying for articulation and then also have goals related to "phonological processes."

 

Good luck! I think this is something that often does get better.

 

And both my sons have/have had OT so I agree with people saying OT type stuff (like the retained reflexes) can often go along with it. It is also something that often improves.

 

There is a lot of reason to be positive :)

[Southern Ivy]

Thank you so much, Lecka! 
I will look at the pretest and we'll see how she does. 
I am going to have her take the CTOPP to see where we stand on the phonological side. The local dylexia learning center administers the test, so we'll be scheduling that soon. 

Did you use Bartons with your kids? Or did you use another program to teach reading? 

[Lecka]

Well.... to be honest my oldest son ended up having an articulation score of 63 (ouch) at the end of Kindergarten and so he qualified for a lot of speech therapy. He qualified for private speech therapy 2 days a week for an hour each (we ended up cutting it to 45 minutes instead of an hour).

 

Insurance covered it but we would have qualified for a sliding scale at the university speech clinic where we lived.

 

I worked with him a lot and everything -- I did -- but speech therapy went a long way for him.

 

I did a lot with him on phonemic awareness activities. There is something called Elkonin boxes that are one thing that was helpful -- basically it is a way to teach segmenting using a penny or something. But a lot of phonemic awareness activities -- there is a lot out there.

 

Then I also spent a lot of time with him on learning to blend. Using letter tiles (or blank tiles -- but I used letter tiles). Learning to blend was about the hardest part of learning to read for him. It took a lot for him. Learning letter sounds and associating them with letters was also very hard. And then he had a long fluency stage, too.

 

I did piecemeal but I think I should have done Barton. This son also went to public school and he got extra practice at school and what they did for fluency was good for him. I don't think they did much for teaching him to blend though. It is not easy.

 

Then my younger son is a different situation, but he has some overlapping issues. He qualifies for a lot of speech therapy, and he still has a lot of articulation goals. He can blend CVC and CVCC and CCVC (he makes a lot of mistakes with CCVC). He can't blend more than 4 sounds right now. We also just had some new testing and he got a scaled score of 4 on auditory blending.

 

My older son also did better when he could see the letters (once he knew them) than just from listening.

 

My older son reads very well now and he can even spell! His handwriting is a bit better but he types almost everything now. He is 12. The whole speech therapy thing just set him back, he had to take time at every step. We couldn't just skip him having time at a level just because he was older. And when he was in pre-school he probably wasn't hearing a lot of things correctly. Like -- I think he heard words like "frog" with an r blend just as "wog." Or maybe "fog." Maybe "wog." He improved in speech therapy but it took time. Like 18 months with the private speech therapy.

 

But at the end of 3rd grade he started reading Harry Potter even though I was sure it was too hard for him. He did it! He liked books where he already had seen the movie and knew the story, or had already heard it. At the end of 4th grade he was doing well.

 

My younger son has overall language issues because he has autism; so this is kind-of just one thing to work on. He has other goals that are more important right now. Being able to blend goes a long way, too!!!!!!! It is very good for him.

[Lecka]

Advice I have on the whole APD thing -- if you are seeing phonological issues --- then focus on that.

 

When you read about other things -- keep in mind it may only be phonological issues for you.

 

Phonological issues can be remediated a lot of the time. Most of the time.

 

So some other things of APD where you read it is long-lasting, it really may not apply to your child so much.

 

My older son had a private eval towards the end of 4th grade..... this is after he had exited speech therapy at the end of second grade with an articulation score of 101 :) And he had done a lot of OT (and here too -- well, he had low enough scores to qualify at school and for private OT, which insurance paid). It is often really hard to qualify for OT through school, he had just some very low scores though.

 

Well -- all his OT scores improved. Some stayed on the lower side -- but a little improvement can really go a long way.

 

Anyway -- on the whole phonological issue ------ when he did this testing at the end of 4th grade, he scored 90-91 on all of the sub-scores related to this. It wasn't directly a category but there were related categories.

 

Now -- on one hand, after all this work, and so much work, I was disappointed it was still a lower score for him. He had other scores more like 100 and up (except for written expression).

 

But on the other hand -- this score is high enough to support him being a good reader and a good speller!

 

Not everybody gets the same result but my point is more -- in 5 years the whole APD/phonological processing thing may be a complete non-issue for you.

 

So I think if you aren't seeing more than this with auditory processing, then don't read things about APD and assume it will apply to you.

 

My impression is this is the "best" kind of auditory processing issue to have because it can often be very well remediated.

 

Or maybe my son is just in the category where -- this is why they don't want to diagnose kids under 8. Because he was much improved when he was 8. And then he did keep improving through 4th-5th grade with just seeming to have an easier time.

 

Where with my younger son who has autism -- this is just one thing of auditory processing he has trouble with. And he is 8 1/2 and he has intelligibility issues from his articulation. The more "this is longer-term" type of info applies more to him, but he does also improve with therapy and with age.

Edited June 22, 2017 by Lecka

[Lecka]

Also for an interesting video -- Google "reading and the brain reading rockets" and there is a PBS special about this. And the exciting part was the kids learned to read! I used to watch it a lot :)

[Lecka]

Also -- this is just ime.... but with my older son in public school..... I think he could do better one-on-one with a speech therapist sometimes, and they wouldn't see what he might be like day-to-day.

 

But with him in public school -- there is the teacher saying "look I have a hard time understanding him, other kids have a hard time understanding him."

 

So if you see that -- you need to communicate that to the speech therapist, because they do take that into account (my impression at least).

[Southern Ivy]

Thank you! Yes, I will definitely relay the lack of understanding for others when they listen to her. Sometimes, if I'm not paying close attention or not watching her, I have issues too. I thought it was just my ears, but having other people say they had issues was eye opening. 

Thank you so much for all the advice! I'm going to read it again to make sure I get everything. 

[Lecka]

Can you tell speech therapy is a theme for me?

 

I think -- if it is an option, great.

 

If it seems like it isn't an option ------ her speech is likely already good enough that you can work with her. She may not need speech therapy.

 

My son still stumbles over words here and there, but it is overall that his speech is good now.

 

I don't think you get "never a stumble, never a mispronunciation" but you get "overall this kid is doing well" as the best outcome.

 

So I think... you just have to ask sometimes to find out if people think her speech is fine or if she should see a speech therapist.

 

And if it is fine -- then there is still a lot you can do with pre-reading skills and stuff.

 

If you can do the "phonemic awareness for young children" (a book on Amazon; one of a lot of books on Amazon with similar content) stuff with her --- that is a good sign.

 

I couldn't really do the "phonemic awareness for young children" stuff, it was too hard.... he worked up to being able to do it. He didn't start out being able to just start at the beginning of it.

 

And then -- if you feel like "hmmmm I am not seeing hoped-for progress" then a next step is something like Barton or whatever that is more for dyslexia than for just average kids who pick things like this up more easily.

[Lecka]

Phonemic Awareness in Young Children by Marilyn Adams ---- a book like this is great if your daughter can do it. Even slow would be pretty good.

 

If you are beating your head against the wall, then you look for something for dyslexia or "struggling readers."

 

Or -- something else.

Edited June 22, 2017 by Lecka

[Lecka]

If she is in anything like pre-school where her teacher could compare her to other kids -- that can help. Because it can be hard to tell when you aren't around other kids her age.

 

I don't have a good idea because both my boys were/are in speech therapy, and then my daughter was much more advanced. And then in K her teacher recommended her for a screening and she qualified for speech therapy, too. But she only did it for a year or so, just with the school speech therapist, no big deal.

 

But then for my older son -- I got a screening sheet back for him in pre-K and his teacher had circled "often" for how often she had a hard time understanding him. And I had no idea! I thought he sounded just fine.

[Lecka]

I was just browsing.... there is a new-to-me book on Amazon called The Intensive Phonological Awareness Program. It says it is "RTI Tier 2."

 

Now -- Barton is RTI Tier 3.

 

The way RTI tiers work is ---- general instruction is Tier 1. Usually programs that aren't specifically for "struggling" "remedial" "dyslexic" "at risk" etc are Tier 1.

 

Then Tier 2 is extra help for kids who are having a hard time with just Tier 1. They need some extra help, they need some tutoring. But when they get the help/tutoring, then they can keep up pretty well with the Tier 1.

 

Tier 3 is more like ---- a lot of extra help, kids are pretty lost with Tier 1 materials (but may go back to Tier 1 later), they are getting some intensive tutoring and not "extra help" tutoring.

 

So you can try Tier 1, then add Tier 2, then go to Tier 3 if it is needed. Or you can just go straight to Tier 3. You can adjust.

[kbutton]

It was also suggested that we see an OT for potential retained reflexes, so I'll be looking into an eval for that too. I have no research to point to, but it is possible that retained reflexes can interfere with auditory processing (retained reflexes interfere with lots of things). The connections are sketchy but potential, but we've had good things happen from integrating reflexes. Specifically, my son's trouble hearing in noise got MUCH better.

 

Anything that I wouldn't expect to be a problem with APD, but actually is? Anything I should expect to occur when teaching her? Basically, what can you tell me that I haven't yet read in regards to APD?

• There are subtypes of APD that can be teased out sometimes with testing. You might want to read about those and see if you see patterns. That might give you a better direction to target therapy.
• My son's APD doesn't come with serious phonological deficits, but he did have some soft signs of dyslexia. Turned out to be an eye issue mostly. 
• Regarding subtypes, you can have very specific trouble with auditory processing in just one or two domains and have tons of intact auditory processing skills. It's not as straightforward as some diagnoses this way. For instance, my son has trouble taking in speech at a normal rate, but that's not true of everyone with APD.
• I would look at accommodation lists and see what seems to help her (you might have to try new things to know). Some of the accommodations for one auditory issue are exactly OPPOSITE the recommendations for another type. It's really frustrating in that sense. Just be aware that it's not one size fits all.

Best wishes!

 

I think the biggest thing for me is realizing HOW MANY AREAS of life APD interferes with. I know, that's not cheery. 

 

Make listening fun and worthwhile as much as you can and work on listening behaviors as much as you can. We really had no idea how much my son was missing, and missing stuff has led to him having less than appropriate behaviors in some ways. For instance, he seems to not prioritize listening in socially appropriate ways, so he is often not paying attention when he should be. Reward her attention-related behaviors if they are not inherently rewarding themselves since kids with APD might not get a lot out of listening. My son is very irritating about listening, to be frank. I am not entirely sure how to explain it, but it's real, and an audiologist friend and our family counselor both see the behavior as being consistent with his APD.

 

Also, be prepared that as her brain matures, a couple of things can happen:

• Hearing "more" can equal overwhelm that needs to be coped with. Her brain might not necessarily know what to do with additional input as it matures.
• Expect her to go through specific stages of brain or auditory development later that she has skipped or is skipping now--for instance, my son is having sensory issues and behaviors related to his auditory system maturing, and those issues and behaviors are more what you would expect from a toddler or preschooler (covering ears, etc.). Previously, I think his brain just totally missed the discomfort in the past, and now he's really bothered.
• My son has a bit of a victim thing going on. It's not an entitlement thing--it's more of a "everyone is out to get me thing." It's in keeping (as my audiology friend and our counselor suggest) with his specific APD profile. As his brain catches more than it used to (but still not what other people catch), it's like he's been in a coma, waking up, and then lamenting that it's not what he expected, and it's somehow our fault. It's really annoying, unpleasant, etc. It's causing him to get flack from people, and we're all getting flack from him. I think this is compounded by executive functioning issues, being touchy-feely in general, and also by the fact that he's going on 10. My older son was very unpleasant from ages 9-11.5 or so as well.  

Sorry to be the bearer of bad news. But, I am telling you so that you can work on things that might be relevant later, such as the listening behavior. Behavior is so much easier to train at her age. Also, if you can't directly remediate the APD right now, but you see that she has anxious tendencies or something like that, you can work on those issues before her brain has to multi-task some of that development that can occur later.

 

To be clear, my son still has APD issues, but there is a big jump in auditory development between ages 8 and 10, APD or no APD. If your kid goes from seriously affected to gaining new brain maturation and doesn't know what to do with it, it's really frustrating. That is my son right now. He needs help managing those changes big time.

 

Terri Bellis (I think) wrote a book on APD that covers subtypes, presentations, etc. She has some information on the potential for some interpersonal issues that stem from APD. I need to re-read that stuff, lol! 

[kbutton]

P.S. Some speech therapy tests do help distinguish between auditory issues and phonological issues. I can't remember the name of that one right off the top of my head. 

 

Also, sometimes SLPs work on auditory skills as well. My son's is starting to do this, and it's been...interesting. Let's just say that sometimes the speech therapy session becomes impromptu counseling session! It's a tricky thing to get the difficulty level just right for therapy purposes because it's so individual. 

[prairiewindmomma]

There are different sub-types of APD. Figuring out where those specific skill gaps are is going to help you be able to target remediation. 

 

One of the specific things I did with ds when I was first teaching him letters and sounds was to teach two at a time.  I put two letter tiles in front of him--simple ones, with only one sound, and with VERY different sounds.  As an example---"m" and "p".

I would say "M says 'mmmm'.  When you see this letter, you should think 'mmmmm'.  Let's make that sound together. 'Mmmmmmm.'" He would repeat the sound with me.

"P says 'pppppppp'. ...." 

 

Ok, here are the two tiles. M says 'mmm' and P says 'ppp'.  I'm going to make a sound. You point to which letter makes that sound.

 

He would look at me like I was insane, because it was way too easy.  

Until it wasn't.

B/V M/N D/T.....there were a number of sounds he couldn't hear.....and there are some he still doesn't distinguish between. He reads fluently, though. I just have to give spelling words in a sentence for context.

[Southern Ivy]

There are different sub-types of APD. Figuring out where those specific skill gaps are is going to help you be able to target remediation. 

 

One of the specific things I did with ds when I was first teaching him letters and sounds was to teach two at a time.  I put two letter tiles in front of him--simple ones, with only one sound, and with VERY different sounds.  As an example---"m" and "p".

I would say "M says 'mmmm'.  When you see this letter, you should think 'mmmmm'.  Let's make that sound together. 'Mmmmmmm.'" He would repeat the sound with me.

"P says 'pppppppp'. ...." 

 

Ok, here are the two tiles. M says 'mmm' and P says 'ppp'.  I'm going to make a sound. You point to which letter makes that sound.

 

He would look at me like I was insane, because it was way too easy.  

Until it wasn't.

B/V M/N D/T.....there were a number of sounds he couldn't hear.....and there are some he still doesn't distinguish between. He reads fluently, though. I just have to give spelling words in a sentence for context.

Good to know. 

 

Earlier, before we had her tested with the neuropsych, I had a page with pictures. She was supposed to find the ones that started with the W sound. I did the W sound multiple times and then went through the pictures. I made it, or so I assumed, very obvious which were W words and which weren't. Like, well and cat. She chose cat, bird, etc. Absolutely no idea. 

 

At this point, she can't even remember the actual letters. I may just start 2 at a time, like you did. 

 

Did you use a specific program? I was thinking of AAR, but I just don't know what would be best. 

[prairiewindmomma]

Ds had WAY more going on than just APD, so I did a mix of things. I tweaked K12's K phonics program.  It spends a LOT of time working on hearing sounds and reading nonsense words and uses a ton of tiles.  Even still, because of his severe dysgraphia and visual processing difficulties, I probably tweaked 2/3 of the material to suit him.  I think we clapped every cvc and cvcc word he read for the first 2-3years to distinguish between sounds and syllables.  We later moved into a hyper-tweaked form of OPGTR.  He reads well above level now, but it's because we solved a long list of other problems.

 

If I had to just buy something off the shelf, I'd look seriously into Barton.  

 

FWIW, the decoding was just one of his APD issues.  Processing speed, sequencing directions, distinguishing from other background noise, ALL of that had to be taken into account. I still can't give him complex three step directions.  I can say "pjs/teeth/bed"--and he knows that stands for the three main points of his bedtime ritual, but I can't say, "Please put away these shoes on your way to put on your pjs.  Also, when you're in the bathroom, rinse out the sink.  No reading in bed tonight!"  

[PeterPan]

AAR pre won't be strong enough to help her. If her issues were mild, you could use Earobics, which is sort of general purpose software. It's adorable and would be a fine supplement. LIPS kicks butt honestly, and you might decide it's worth the effort and expense. It's the only thing out there I've seen that really solidly makes a STRONG CONNECTION between how the sound is produced and how it sounds and how it's written. So you're going to have pictures of faces, look in the mirror and realize how your mouth looks and feels, match it to a face, build words with faces, etc. Then you transfer from faces to blank holder tiles, then from blank holder tiles to letters. And I brought in the whole multi-sensory gig for teaching the writing along with it.

 

I think I've shared the file on how I did it. If it's not on dropbox, I can send it to you. I wrote it up when it was fresh in my mind. It might be what you're really wanting. I would wait and do it AFTER the CTOPP.

 

I like AAR pre btw, just as a product. It's adorable, with only minor flaws. It's truly a delightful product. I'm just saying when you've got serious issues, go straight to therapy materials and don't screw around. You are going to have so much to blow your money on without buying products that aren't destined to work. No commercial product aimed at the homeschool market is going to be the therapy level that you need. I buy almost NOTHING aimed at homeschoolers anymore. NOTHING. We've got serious issues, and I look for things that are either therapy materials or really targeted intervention materials, things, the reviews typically say an Intervention Specialist or OT or SLP is using in schools. Regular hs stuff, stuff at conventions, nope, just keep right on walking.

[Southern Ivy]

AAR pre won't be strong enough to help her. If her issues were mild, you could use Earobics, which is sort of general purpose software. It's adorable and would be a fine supplement. LIPS kicks butt honestly, and you might decide it's worth the effort and expense. It's the only thing out there I've seen that really solidly makes a STRONG CONNECTION between how the sound is produced and how it sounds and how it's written. So you're going to have pictures of faces, look in the mirror and realize how your mouth looks and feels, match it to a face, build words with faces, etc. Then you transfer from faces to blank holder tiles, then from blank holder tiles to letters. And I brought in the whole multi-sensory gig for teaching the writing along with it.

 

I think I've shared the file on how I did it. If it's not on dropbox, I can send it to you. I wrote it up when it was fresh in my mind. It might be what you're really wanting. I would wait and do it AFTER the CTOPP.

 

I like AAR pre btw, just as a product. It's adorable, with only minor flaws. It's truly a delightful product. I'm just saying when you've got serious issues, go straight to therapy materials and don't screw around. You are going to have so much to blow your money on without buying products that aren't destined to work. No commercial product aimed at the homeschool market is going to be the therapy level that you need. I buy almost NOTHING aimed at homeschoolers anymore. NOTHING. We've got serious issues, and I look for things that are either therapy materials or really targeted intervention materials, things, the reviews typically say an Intervention Specialist or OT or SLP is using in schools. Regular hs stuff, stuff at conventions, nope, just keep right on walking.

Ok, choking on the price, but if it works... 

 

 

kbutton and Lecka, I haven't forgotten you both. I've read, but have not had the brain space to form a coherent thought! ha I have appreciated the input and I will respond soon!

[PeterPan]

You won't be doing anything therapy level like that for phonological processing till you do the CTOPP. Once you have that, if you decide you need LIPS, write me. I ought to get around to selling mine. I have no intention of tutoring anyone ever, and we're past the stage of using it. I'm sort of wistful about it, sentimental, because it was a really amazing stage and experience for us. I just don't know if I'd have the heart to do it again. It was so all-consuming and took so much brain power. It really was rocket science for him. But I suppose life moves on and I have to sell. 

 

I swear though, seems like when I sell I end up rebuying stuff, lol.

[Southern Ivy]

You won't be doing anything therapy level like that for phonological processing till you do the CTOPP. Once you have that, if you decide you need LIPS, write me. I ought to get around to selling mine. I have no intention of tutoring anyone ever, and we're past the stage of using it. I'm sort of wistful about it, sentimental, because it was a really amazing stage and experience for us. I just don't know if I'd have the heart to do it again. It was so all-consuming and took so much brain power. It really was rocket science for him. But I suppose life moves on and I have to sell. 

 

I swear though, seems like when I sell I end up rebuying stuff, lol.

Thank you. I definitely will. 

[Lecka]

Yes -- you are probably not looking for any usual thing.

 

You are looking for items/activities that say things like: for a reading intervention specialist, for a speech therapist, Tier 2 or Tier 3, etc.

 

Then it is hard to say in advance..... but moving forward in the future, you might have a mix of -- more things like this, plus maybe regular stuff for a younger age than you really want to be doing.

 

Like -- maybe in a year from now you are considering regular things as an option.

 

I have had quite a few times when I order something optimistically, think it will work, it doesn't, it sits on the shelf a year, and a year later it works out.

 

So it isn't like it is useless to look now and see what you might like to use, time goes by and it can get to be an option!

 

But the problem is -- the kids who are appropriate for the regular programs have been hearing well all this time, and have been learning about beginning sounds and rhyming and things somewhat naturally through exposure and being read to, etc.

 

But they didn't make huge leaps -- they spent time, too, maybe years, of making these language connections between what they are saying and how it sounds.

 

It didn't happen overnight for them, either, it is just a process that takes time. And then it is harder anyway for our kids, and we know they haven't had a "stable neural representation" of the sounds. This means like -- they don't hear k and automatically know it is k, it might be k or it might be t, or it might be g, or d.

 

So then it is going to be very hard to tell if two words both start with the same letter or a different letter, and very hard to tell if two words end in the same sound or different sounds.

 

And hard to match the sound t with the letter t. When it seems random what sound you are hearing at different times.

 

So it is just time-consuming, and then you have to add in the time to have it gel and to have lots of exposure.

 

But what is good is older kids can be a lot easier to work with and they can work harder and have a longer attention span and stuff. That was a positive for my older son to be in speech therapy when he was 6-7, because he could get a lot more done than would be appropriate to do with a littler kid. (None of my kids have ADHD, though.). That is looking on the bright side, but I think it is a real thing, too. As much as earlier is better, sometimes older kids can plow things that would not be appropriate for a younger kid, and with being older they can catch on faster than a younger kid. I would definitely not wait or anything, but at the same time, what might be 1-5 minutes of going over something now might be able to be 15-20 minutes in a year. And it does go a long way.

 

But just in general, there is a progression:

 

1. Phonological awareness. Telling if two similar words are the same or different. (I think)

 

2. Phonemic awareness. You can find a ton of info on phonemic awareness. There is a hierarchy of skills and it is things like counting syllables, separating a compound word into the two words, beginning letter sounds, segmenting, blending, rhyming.

 

In theory -- for regular stuff they are very big on doing this all orally, and definitely not using any letters.

 

For stuff you are likely to use -- they almost always have some visual like a picture card or blank tiles (or small movable objects of some kind) because our kids tend to *need* that for extra support since they tend to be weaker at just holding the word they heard orally in their head while analyzing it.

 

I did use letters too because I thought teaching the letters helped to teach the sounds, but "they" make a big point that kids need to do this stuff, in general, by listening and not by looking at words and looking at letters to get the answers.

 

So this is all stuff that you might be working on before/while doing other "usual" things.

 

Some things are things where you can be working at different skills at the same time. Other things you may need to work on foundational skills first and go in order.

 

But in general -- that is kind-of what you are looking at, and you have options for how you work on it, what materials you choose, etc.

 

In general -- LIPS is going to work on phonological awareness. But there is other stuff out there for it, too, if you don't want to start out spending so much. Or maybe speech therapy turns out to be an option.

 

In general -- Barton Level 1 and Level 2 are going to work on phonemic awareness at a "Tier 3" level. There is a ton out there for phonemic awareness. A lot is for general kids where they don't need visual supports (usually picture cards or counters). Stuff with the supports are going to be more appropriate in general -- maybe over time you can do things without visual supports, too. But in general -- expect to start a skill using the supports and then use them less with that skill, but then expect to use them again for a newer/harder skill (and then maybe use them less over time).

 

There are a lot of books and Pinterest stuff for phonemic awareness.

[Southern Ivy]

In general -- Barton Level 1 and Level 2 are going to work on phonemic awareness at a "Tier 3" level. There is a ton out there for phonemic awareness. A lot is for general kids where they don't need visual supports (usually picture cards or counters). Stuff with the supports are going to be more appropriate in general -- maybe over time you can do things without visual supports, too. But in general -- expect to start a skill using the supports and then use them less with that skill, but then expect to use them again for a newer/harder skill (and then maybe use them less over time).

Oh - btw, I did the Barton prescreening. Poor thing BOMBED it. So, definitely need to start with the phonological awareness. 

[Guest]

You can also try music lessons.  There's a whole mess of research showing how actual lessons (not just fiddling around on an instrument) can help APD.

 

My son has mild hearing loss and was diagnosed with APD two years ago.  We did the speech therapy and learned how to accomodate on our own.  Right about the same time, he added violin lessons to his regular piano lessons.  Last month, when he went in again to get re-checked for both hearing and APD, his APD test came back perfectly normal and the audiologist said that the music lessons were likely the reason for that.  I'm NOT saying that music lessons can cure APD, but that they can certainly help to varying degrees depending on the child and severity of APD.

[PeterPan]

Oh - btw, I did the Barton prescreening. Poor thing BOMBED it. So, definitely need to start with the phonological awareness. 

 

Remember, that's what the CTOPP is looking at. Without that baseline, you're messing with the data to get things diagnosed. It's always a catch-22. I did *some* LIPS with my ds before his psych eval, and he was still diagnosable. However he had tremendous discrepancy, meaning the psych considered discrepancy. In general for SLD reading they're looking for an absolute low. So waiting a month or two to get that CTOPP done could be worth it.

 

Given the amount of instruction she has had so far, I agree that's pretty significant that she failed the Barton pre-test. It's a screening a typical newly 5 yo should pass easily. 

 

I would be looking at LIPS or FIS (Foundations in Sound). FIS is new and there's really not a lot out there on it. It's not going to be LIPS, so if your dc needs a really multi-sensory method of getting things to connect, my guess is LIPS is still the better tool. I had someone write me back channel saying oh don't slam FIS. I haven't seen FIS. I'm just saying look for what's different. The content of both will be fine. LIPS is loosely scripted where FIS is completely scripted, like Barton. My ds is a rare bird, the hardest of the hard. Well maybe not THE hardest, but a pretty nasty case. Apraxia plus autism plus SLDs? That's nasty. Even Barton straight doesn't work for him. He's just all over the place and needs lots of extra steps to get the multi-sensory. His need is way beyond that of a typical dyslexic.

 

So yeah, just look at it, gauge for yourself. But I'd be wanting that CTOPP first. You could call that psych who specializes in SLDs and talk with him straight. What is his minimum age for diagnosing SLD Reading? Can he discriminate APD and SLD Reading? When? Would the baseline CTOPP and then running it again a year later be enough info that he could diagnose SLDs at that later time if he can't do it now? 

 

Lecka mentioned minimal differences. My ds has sort of ping-ponged with that. LIke we do it and think oh got that, then boom we need to do it again. They get more *complex* and more subtle. Today my ds was mixing up court/quart. When you google minimal differences, that's not a particularly common set of letters to be struggling with, kwim? Like maybe it is and I just missed it. You can go to SuperDuper and see. They sell cute Super Decks for minimal difference pairs and might have apps.

 

Any time you're having to google, use therapy papers you find online, buy therapy materials, etc., that tells you you're moving the bar on stuff that was diagnosable and maybe could have had a baseline first. Stuff that is in the normal range of intervention is like sound games you find in walmart, cute workbooks you find at the grocery, puzzles from ToysRUs, etc. It's pretty normal to work on phonemic awareness and phonological processing at a basic level. Then, when you see it's not working, you start stepping up.

 

I would look for multi-sensory tools. Because she's already had a lot of instruction at a typical level (written plus sounds, maybe some games, etc.), you really want to move up to a tool that's using LOTS of senses. You're going to want to see it, touch it, feel it, move it, look at it in a mirror, match it to how it looks on a picture of the mouth, move those mouths around while you say it and feel it on your mom's face, trace it in the sand while saying the sound and looking at the mouth picture, etc. LIPS does all that. You mentioned AAR pre. It's super adorable, a really nice standard tool, but it's not meant to do all that. It's like asking your dentist to do brain surgery. There's a lot farther this can go.

Edited June 23, 2017 by OhElizabeth

[PeterPan]

You can also try music lessons.  There's a whole mess of research showing how actual lessons (not just fiddling around on an instrument) can help APD.

 

My son has mild hearing loss and was diagnosed with APD two years ago.  We did the speech therapy and learned how to accomodate on our own.  Right about the same time, he added violin lessons to his regular piano lessons.  Last month, when he went in again to get re-checked for both hearing and APD, his APD test came back perfectly normal and the audiologist said that the music lessons were likely the reason for that.  I'm NOT saying that music lessons can cure APD, but that they can certainly help to varying degrees depending on the child and severity of APD.

 

My ds has done music therapy. He was completely monotone before, so we were trying to get his voice to be able to go up and down. The challenge with actual music lessons is you need behavior, fine motor, everything to be there. My ds is super there cognitively, but for the fine motor, self-regulation, etc., he needs adaptation. So it's kind of a challenge. But yeah, the music therapy was brilliant for us. It got his voice able to go up and down. It's still *hard* for him and he isn't good at singing. We could go back. He'll try to sing, but it's just a slog, sigh. 

 

Whatever is causing it for him, it's severe enough that it wasn't a fast fix. Then they thought they would be smart and bring in more things, so they started working on social thinking, etc., idiots. Then it was stressful and he was having behaviors. But that's a total rabbit trail. Just saying it wasn't fast for us. We did a full year and another semester. If the op's dc has behaviors, fine motor issues, etc., it might be hard to bring within reach. But it's good stuff if you get the right person. That's interesting too, because it sounds like you're saying the violin specifically was helpful. That is really a lot of effort, matching tones and figuring out where to place the fingers, right?

[Guest]

My ds has done music therapy. He was completely monotone before, so we were trying to get his voice to be able to go up and down. The challenge with actual music lessons is you need behavior, fine motor, everything to be there. My ds is super there cognitively, but for the fine motor, self-regulation, etc., he needs adaptation. So it's kind of a challenge. But yeah, the music therapy was brilliant for us. It got his voice able to go up and down. It's still *hard* for him and he isn't good at singing. We could go back. He'll try to sing, but it's just a slog, sigh. 

 

Whatever is causing it for him, it's severe enough that it wasn't a fast fix. Then they thought they would be smart and bring in more things, so they started working on social thinking, etc., idiots. Then it was stressful and he was having behaviors. But that's a total rabbit trail. Just saying it wasn't fast for us. We did a full year and another semester. If the op's dc has behaviors, fine motor issues, etc., it might be hard to bring within reach. But it's good stuff if you get the right person. That's interesting too, because it sounds like you're saying the violin specifically was helpful. That is really a lot of effort, matching tones and figuring out where to place the fingers, right?

 

Did you go to just a general music teacher or did you specifically go to a music therapy teacher/clinic?

 

I don't think I can say beyond a doubt that it was the violin, but I can say that it was the music lessons.  The research I read suggested that:

1. Neural connections are stimulated simply because there are so many things going on: differentiating notes/tones at high speed, processing mutliple sounds at once at the same time picking out the melody.

2. A trained musician's brain picked out essential sounds from background sounds far easier than an untrained brain, helping people with APD focus better on the relevant sounds of speech.  This is why simple music therapy can only go so far; lessons as if you are training a musician are far better.

 

3. The physical structure of the brain is changed with musical training (any instrument): gray matter is increased and the connections between the hemispheres are strengthened (helping memory and executive function). 

So the violin works the exact same part of the brain as the piano, but on the other side (so mirror image).  For our situation, the combo of violin and piano might have put extra emphasis on making those hemisphere connections or something, but I can see where any actual music training would help in some way with APD.

Edited June 23, 2017 by WendyAndMilo

[Southern Ivy]

never mind - misread something lol  

 

Edited June 23, 2017 by Southern Ivy

[Lecka]

I'm just going to be blunt.

 

I think it is strange to bomb the whole thing. If she bombed the whole thing, not just the section that refers you to do LIPS.

 

It makes me think it is something about the test-taking process and not necessarily her knowledge/ability.

 

Bc I saw your post on the other thread -- I think you might want to re-test after she has ADHD medication or something. Her test score from the other thread -- that is just a score that is way off, it is very artificially lowered -- that is how I read the comments.

 

So this might be artificially lowered too.

 

Or maybe start with stuff it is obvious she needs instead of going too much from the pre-test when it really might not be accurate.

 

Good luck!!!!

 

My kids don't have ADHD but I have seen many kids who just have an easier time and pick things up faster after starting medication.

 

And then there are other choices, too, if you want to try other things and wait for medication.

 

But it is just a thought!

[Lecka]

Also -- working on this stuff -- I wish I thought it were fun and easy, just do some cute activities and kids will just pick it up. Okay, it is like that for a lot of kids.

 

But if she is struggling it is possibly going to be hard work for her.

 

I think you can look at doing anything you can to lighten the burden on her shoulders.

 

And if it were just reading -- okay. But if she is having trouble with this then it is impacting her in daily life and she needs to have what improvement she can.

[Southern Ivy]

I'm just going to be blunt.

 

I think it is strange to bomb the whole thing. If she bombed the whole thing, not just the section that refers you to do LIPS.

 

It makes me think it is something about the test-taking process and not necessarily her knowledge/ability.

 

Bc I saw your post on the other thread -- I think you might want to re-test after she has ADHD medication or something. Her test score from the other thread -- that is just a score that is way off, it is very artificially lowered -- that is how I read the comments.

 

So this might be artificially lowered too.

 

Or maybe start with stuff it is obvious she needs instead of going too much from the pre-test when it really might not be accurate.

 

Good luck!!!!

 

My kids don't have ADHD but I have seen many kids who just have an easier time and pick things up faster after starting medication.

 

And then there are other choices, too, if you want to try other things and wait for medication.

 

But it is just a thought!

That's how I read it too. I think it's just mommy pride distorting how I see things and making me want a 2nd opinion. But, Elizabeth and storygirl have been great about making me step back and really think about this and realize that there's no straightforward answer. 

 

As for the test, she could do about half on each activity. So, I'm not sure what to think. I do think a lot of it was inability to focus. 

I'm not going to be basing anything off the pretest. I just did it to see if she could. I know there's a LOT more that she needs. I'm hesitant to do anything until we get her on medication, though.

My whole "let's try it naturally first" lasted a whole 3? weeks. lol I won't be able to work part time, homeschool her AND keep the house clean if she's not on meds and destroying the house while I'm working. lol This week with her dad gone was rough - the house looks like a bomb went off. 

[Lecka]

I think that is a good idea!!!!!

 

I think it is pretty natural to not see things at first and think "no, I don't see those things."

 

And then when it is pointed out -- all of a sudden -- start to see the things here and there.

 

It has happened to me a few times!!!!!

[PeterPan]

You can call Barton and talk with her about the pretest.

 

You could do GPP, reflexes, meds, then CTOPP, then redo Barton pretest and decide.

 

She may be a full time job for a while. Any flex on the part time work? Your time with her is very valuable.

[Lecka]

This is the most "random thing a parent thinks" kind of thing, but I have heard of anything from: kids making just rapid, rapid progress when they start medication, to kids not making rapid amazing progress, but finally making some kind of progress such that you can see how they are doing when they can pay attention.

 

That is when it is working. Since one of my kids has autism, I also hear of kids where trying ADHD medication was more random and "hey let's see what happens" and they don't have much difference and then quit taking it. But if can be worth it sometimes for people to try it to see if it will work even if it isn't recommended like "we are very confident this is something to try."

 

I also think you need to question if it is keeping her from soaking up learning throughout the day. Kids her age we hope are picking up lots of learning from exposure. If her ability to soak up learning by exposure is effected -- I don't think it is the same situation as for kids where they are doing just fine during informal or child-led or active learning times that come up throughout the day ------ and then it can make sense to think of medication as more for he formal learning times.

 

Really we want kids to be learning from their environment throughout the day. That is the ideal. And we want to remove any barriers to this kind of learning. Because really this is how most of younger kids' learning is happening!

 

On the other hand this might not be something you see with her.

 

I think it is something to consider, though. I think it is a mistake to get an attitude like "well these things are only a problem in formal learning environments." Plenty of things are problems when kids are playing at the park on the weekend and want to play with some other kids. Plenty of things are problems during those times when kids learn throughout the day or from informal learning times or from hands-on learning times you might tend to try if they are what she connects with better.

 

I think you just keep it in mind and watch to see what your actual situation is. But when the word severe has been used I think you may not be in a "oh this only matters when we are sitting at a table doing a formal school subject" kind of situation.

[Lecka]

There is also a concept like "is the child benefiting from instruction."

 

However much instruction she may have had *in theory* at pre-school, because she was physically sitting there, she may have only benefited from portions of the instruction. Like what if they had a 5 minute activity they thought was very appropriate to kids her age, but she only paid attention to the first minute.

 

Well -- she hasn't actually received the amount of instruction that *in theory* you might think she has received.

 

She might make more gains when she is really receiving instruction in a way that works for her.

 

This could be the same situation if she needs some kind of scaffolding. If she isn't getting the scaffolding, she is sitting there (or physically present) but isn't benefiting from the instruction.

 

This is one of the most vexing things. Because it is like -- the learning opportunity is there, the child is there, but there is a missed connection of some kind and the child and the learning opportunity don't quite connect. And it can happen with the natural daily-life informal learning opportunities, too. They might all take some extra effort, support, scaffolding, whatever, for the child to be able to connect with the learning.

 

Hopefully this is less of an issue! But it is a blind spot I see people get when they get very into "school is so artificial, kids sit at desks too much," and just assume that they don't need to worry about any other situations. Plenty of people are correct in this assessment for their child, but what matters is what you are seeing. Not that it is true for other people and so you assume it is always that way (or whatever).

Edited June 24, 2017 by Lecka

[Lecka]

And it is the same situation where -- if she didn't have the foundational knowledge for learning letters, necessarily, then a lot of that instruction was just not instruction she was in a situation to benefit from.

 

If she is in a school-type situation where they assume she can blend CVC words and she can't -- there is just a ton of wasted, wasted instruction.

 

Or everything is presented auditorily with no multisensory supports for kids who may be much weaker auditorily ---- it is just wasted as far as what your daughter may be able to connect with.

 

The bright side is you see what you can do to make it so your daughter can connect, and there is a lot out there whether it is multisensory teaching, quieter environments, going over things an extra time, waiting to move on or starting with a smaller amount of things to learn (like maybe only work with 5 letters at a time instead of always moving onto the next letter after a week), etc, and then also you have options like medication, structuring the day (whatever is most helpful for active time, or providing more structure, or providing more free time, whatever), OT activities, etc.

 

All these things add up to more connecting, and more benefiting from learning opportunities.

 

And a lot of time -- connecting with learning opportunities goes a long way for making progress.

Edited June 24, 2017 by Lecka

[PeterPan]

This is the most "random thing a parent thinks" kind of thing, but I have heard of anything from: kids making just rapid, rapid progress when they start medication, to kids not making rapid amazing progress, but finally making some kind of progress such that you can see how they are doing when they can pay attention.

 

That is when it is working. Since one of my kids has autism, I also hear of kids where trying ADHD medication was more random and "hey let's see what happens" and they don't have much difference and then quit taking it. But if can be worth it sometimes for people to try it to see if it will work even if it isn't recommended like "we are very confident this is something to try."

 

I also think you need to question if it is keeping her from soaking up learning throughout the day. 

...

I think it is something to consider, though. I think it is a mistake to get an attitude like "well these things are only a problem in formal learning environments." ...

 

I just wanted to pull down these thoughts. If you have retained reflexes and begin working on them, you'll typically see changes in a month. It usually only takes 1-2 months to integrate them, so we're talking a very fast thing here. I get being skeptical of a trial of meds and wanting to do other things first. Some of that stuff with diet can help, but it's percentage. My concern is the *significance* of the symptoms and that the meds would improve more than behavior. Bumping that processing speed could help APD dramatically. Lecka's point about the cumulative effect of decreased input over time is really significant.

 

I've had my kids to multiple psychs (4+) and I can tell you that NONE of them were oh yeah gung ho about meds, suggesting them like candy. That might be the reputation among peds, but it ISN'T for psychs, at least not in my experience. I think it's highly significant when a psych is saying put a 5 yo on meds. To me that's your red alert, your warning that this is really significant.

Edited June 24, 2017 by OhElizabeth

[Lecka]

I am seeing kids in maybe a different situation than what a lot of people see, but I talk to people where it is more like -- they are able to actually do/participate in OT after starting medication; and then they are able to realize gains from OT.

 

I would say I have been quite a few younger kids where their biggest problem was something holding them back from being able to actually do/participate in the therapies/activities/experiences that they actually needed to be doing.

 

My perspective on OT is that it takes an incredible amount of compliance, focus, frustration tolerance, etc.

 

And yes some OTs are directly working on those things.

 

But if you are saying "well what I actually want is to do these exercises" then doing some of these exercises take an incredible amount of compliance, focus, frustration tolerance, etc.

 

It can be a waste of time to try to do all these things but the child isn't able to get the full benefit from doing them. They don't get the same gains.

 

I think it makes more sense sometimes; to use the medication to get to where kids can do the certain activities, see some gains from *actually doing them,* maybe some more skills are built up, then ---- when the skills are in place sometimes people can reduce the medications because some skills have really gotten a chance to develop.

 

This is a more.... severe kind of scenario, but it is a real thing for some kids I think.

 

If you think she had a good experience in speech therapy, she wasn't held back in her progress, etc, then it probably doesn't apply.

 

I have seen little kids where their on-task behavior is just so low they just can't even do the things that would help them.

 

But all the kids I saw go from pre-school through 2nd grade (with my younger son) made major gains and major progress! It didn't stay that way for any of them.

 

It is just a different perspective; though.

[Lecka]

I don't take it for granted at all that my 8 1/2 year old can go into a therapy center, go for speech therapy for 30 minutes, and really be able to benefit from that 30 minutes.

 

It is new in the past year to see this -- before always there have been things where I know he isn't able to spend the same amount of time/effort on purely speech and not these associated things that are also very good and worthwhile but *aren't the same as being able to go through a certain amount of speech stuff.*

 

It is a big bugaboo of mine; and then I have heard horror stories where a child wasn't recognized as having _____ until after ______ was in place, and if only ______ had been able to be recognized earlier they could have worked on it earlier.

 

And I have heard this with stuff that should have been identified through OT evals, sometimes, but the OT couldn't get a solid eval done and so they have to kind-of guess based on observation..... I have also heard it for even things like getting glasses!

 

But sometimes it can seem like the skills you are trying to gain from therapy (or equivalent) are the skills needed to be successful in doing therapy at all. And then it is like -- you have to start somewhere.

[PeterPan]

Well it's definitely going to be good information if she *tries* the reflex tests and *tries* the exercises. I went through 5 OTs before I ended up with a PT who was half-way good for reflexes. It's not like even getting in the door guarantees you're getting them nailed. 

 

With my ds, he was not compliant in a lot of things, like non-compliant in the way Lecka's ds is non-compliant. Getting him to DO the reflex exercises, or at least allow them passively, was an issue. Once we got over that and got his body calming down, his compliance went up. So... to me... I think you just have to try and see what happens. You won't know till you try. 

 

Let me put it another way. Having a lot of water under the bridge, reflexes are the only thing *I* would wait around very long on, and then only one month. Food? I can bring ADHD kids into my home, feed them what we eat, and watch them calm down in one week. You don't need 6 months for that. 

 

That's just opinion, but I'm saying it's *my* opinion. I like diet changes, reflex work, etc., but my point is that none of these things are long leash. We're talking one month, and either you're seeing changes that let you know it's going to be enough or you're not.

 

Next word to the wise. It can take a while to get the appointment, do the follow-up appts, and actually get meds. There are some peds who just write the scrip and there are some who want to do other things first and create paper trail. So you can have a 1-3 month wait from when you decide you want meds till when you actually get the scrip in-hand. That's also something to consider. Like it can be a sensible plan to make the appt to have the ADHD med discussion, know it's a month out, and go ok while we wait for that we're going to do these other things. 

 

That 6 month out thing really rattles me. That's head in the sand. Just mho there, but I'm just saying. Either they're missing the severity of what you're saying or you're not communicating it there like you are here or they just don't get it or something. Six months, in the life of a 5 yo, is HUGE. That's tons of language development time, tons of behavior. That's HUGE. And it's basically saying start K5 with a dc who is basically non-functional and go through half the school year. That doesn't seem absurd to you? SOMETHING needs to change.

 

That was why I got evals before we started K5, because I told my dh I absolutely could not teach him without better help and information. So what is changing between now and fall, realistically, so you will be able to work with her?

 

Ok, I'll back up and ask, where is she actually at behavior wise? If you are flexible on location/position (standing, sitting, while on a ball, etc.), what is her ability to work with you on highly engaging, preferred materials for 5 to 10 minutes? Is she SAFE in an age-appropriate setting? Does she have a sense of body in the group if you're walking as a family, working with her, etc., or is she disappearing and unsafe? It's one thing to be in motion, it's another thing to be unsafe and not have a sense of body in the group.

 

If you work with her with highly preferred materials in 5-7 minute segments using rewards, lots of praise, and breaks in-between the segments, how does she do? 

 

See these are things you're looking for to go ok, I can work with her, someone can work with her. Therapy sessions are usually 30-50 minutes. They can provide lots of supports, sure, but they're expecting at least to have 5-7 minute chunks with breaks and a sense of body in the group. It's what Lecka is saying, that at some point you have to be really honest about what is going on. 

 

Meds *can* bump auditory processing for some kids by improving processing speed. Definitely, definitely. It would be a pro in the meds sooner rather than later category. When kids are developing fine with language, able to work with their workers a reasonable amount of time with reasonable supports (short segments, breaks, motivators, lots and lots of praise), then that's workable. That's the kind of ADHD where people go yeah we changed the environment, provided supports, we made it work. That can happen with some kids! And that can be an ok stage for a long time for some kids WHEN IT'S WORKING. 

 

So it's just about being really honest. Like sit down with a timer, say we're going to work three times today and then we're going to go to the park. And each time we work we're going to work for 5 minutes with a timer, and when the timer goes off we're going to do this activity you pick or eat a snack. Then lay out the three tasks and the three reward breaks, get your timer, and do it. Kwim? Like that would be super bare minimum functional. And the work you pick could be really flexible! Like it could be playing with a playmobil barn set. Anything you choose that maybe requires some language or interaction. Could be coloring or a puzzle or puppets or a farm sound toy. Anything that takes a little effort on her part to choose to interact with you and use her language. 

 

You could try it and see what happens. Then you're removing "the school work was the problem" or "Mom was the problem" or whatever and it's down to who she really is and where she really functions. You're seeing whether she can put her body in the group, choose to use her language, choose to attend, for even a short amount of time, when it's highly preferred.

 

Was your dd in the room during that ped appt? I was just wondering, lol. Then I was wondering what she was doing and what her waiting behaviors are, like what behaviors she had there. Did she engage? Was the appt very long? With my dd, just run of the mill ADHD-inattentive, you would have thought very little at that age. She just came across as fidgety, active, but she was totally compliant and interactive. My ds is different. He would be totally in his own world and then, when he was DONE he would start jumping on you and having behaviors. So I'm just wondering what she was doing in that appt. Like if someone (a doctor) is trapped in a small room with my ds for 45 minutes, they're usually like, well they don't curse but they just get this horrible look like they GET it and they pity you and to make an appt so they can start working through the steps to help you...  :lol:

 

To follow up Lecka's comments on diagnoses and late diagnoses. I knew a girl with severe APD when she was the age of the op's dd and younger. It was a hard, hard situation. They just don't diagnose APD at that age. The dc was diagnosed APD later, more the typical time (7+). I think she had already been on ADHD meds a couple years at that point. She was really astonishing, like a feral cat, running around the room... But she didn't have ASD. I think it was just that the decreased input of the APD and the severe ADHD was really delaying her on every level. So take in less, process less, understand less, no sense of body in the group at all. It was an awful stage. 

 

So it may be something you roll into, that you take what you can get now and you add each diagnosis and intervention as you can. Nobody does this perfectly. Do what you can now with the information you have, then do more as you get more info.

[PeterPan]

I missed it, was the dc in speech therapy? Did you observe to see how the SLP was working with her? That would be really useful information to have. When one provider is having good success, you want to learn from them and carry methodologies over. It can tell you a lot about how you can work with her better.

 

Providers all vary and their skill sets vary. It's just something to watch for, like who is really good with her and how do they do it? If you see a routine they use (work, breaks, motivators, structure, etc.), you want to learn from them!

[PeterPan]

SLP evals don't tend to be too expensive. If you find the audiologist you want to use for the APD eval later (or a screening now), you could ask them if they have SLPs they know do a good job...

[Southern Ivy]

If she is in anything like pre-school where her teacher could compare her to other kids -- that can help. Because it can be hard to tell when you aren't around other kids her age.

She was in preschool, but a very small one (we live in a small town). Only 6 kids in her class and one other student had speech issues, so I think her teacher just got used to it. I think that's why it was surprising to me 

 

I'm just going to be blunt.

I think it is strange to bomb the whole thing. If she bombed the whole thing, not just the section that refers you to do LIPS.

 

I will add, she totally sucked at the syllable thing if it had more than 2 syllables. She could also count the words in the sentences, but she did count syllables a few times, so she failed that part too. The last part was the worst - pulling down different color for the different sounds, same colors for the same sounds - she could NOT do that. She could repeat the sounds and she could tell me if the sounds were the same/different, but the she kept getting confused on same colors/different colors/2 same colors-1different color - it was just beyond her understanding, I think. 

 

Please be blunt. :) 

 

She may be a full time job for a while. Any flex on the part time work? Your time with her is very valuable.

The pt job is VERY flexible. I actually have two pt jobs. One, I teach English to Chinese students from about 4am-7:30am; the other job is 20 hours whenever I can do it. It's pretty easy to do and if I can get a good 5-6 hours in on Sunday when dh is here, the rest of the week isn't hard. I can do an hour of the morning, an hour of the afternoon, then an hour of the evening. (It's just hard to do when dh is gone, like he was this past week.) 

 

I also think you need to question if it is keeping her from soaking up learning throughout the day. Kids her age we hope are picking up lots of learning from exposure. If her ability to soak up learning by exposure is effected -- I don't think it is the same situation as for kids where they are doing just fine during informal or child-led or active learning times that come up throughout the day ------ and then it can make sense to think of medication as more for he formal learning times.

 

Really we want kids to be learning from their environment throughout the day. That is the ideal. And we want to remove any barriers to this kind of learning. Because really this is how most of younger kids' learning is happening!

It's such a hard thing to figure out right now. lol 

On one hand - she loves Magic Schoolbus and learns so much from it (or so I perceive anyway). She's very inquisitive and I can see her trying to figure things out or making observations. (She saw some bug with green eyes the other day and wanted to look it up and find out what it was.) So, I see her learning things and exploring. She does fairly well with Math U See. We're going through Primer, but right now, it's easy review. We'll see how she does when it gets to new content.

 

I do think it's something that is going to affect her in all areas though - social and academic. 

 

There is also a concept like "is the child benefiting from instruction."

 

However much instruction she may have had *in theory* at pre-school, because she was physically sitting there, she may have only benefited from portions of the instruction. Like what if they had a 5 minute activity they thought was very appropriate to kids her age, but she only paid attention to the first minute.

 

Well -- she hasn't actually received the amount of instruction that *in theory* you might think she has received.

 

She might make more gains when she is really receiving instruction in a way that works for her.

 

And it is the same situation where -- if she didn't have the foundational knowledge for learning letters, necessarily, then a lot of that instruction was just not instruction she was in a situation to benefit from.

 

If she is in a school-type situation where they assume she can blend CVC words and she can't -- there is just a ton of wasted, wasted instruction.

 

Or everything is presented auditorily with no multisensory supports for kids who may be much weaker auditorily ---- it is just wasted as far as what your daughter may be able to connect with.

 

The bright side is you see what you can do to make it so your daughter can connect, and there is a lot out there whether it is multisensory teaching, quieter environments, going over things an extra time, waiting to move on or starting with a smaller amount of things to learn (like maybe only work with 5 letters at a time instead of always moving onto the next letter after a week), etc, and then also you have options like medication, structuring the day (whatever is most helpful for active time, or providing more structure, or providing more free time, whatever), OT activities, etc.

 

All these things add up to more connecting, and more benefiting from learning opportunities.

 

And a lot of time -- connecting with learning opportunities goes a long way for making progress.

You are so right. I was furious when I first discovered that she didn't know her alphabet. Like, we've paid all this money and she doesn't know a freaking thing? What the heck?! 

I never really worked with her because of pushback from her, but now I"m seeing that it was frustration over it being too hard. I realized soon that it was her and not the school, but still. So hard to realize that at first. 

(May I just add that A Beka is NOT an appropriate curriculum for kids like her? Yeah - kids like her who are so out of the box don't do well with such a 1 formula for every kid type of program. So thankful the preschool is doing away with it next year.) 

 

Rabbit trail. Sorry. haha 

 

Anyway, you're right - I hadn't thought about it in regards to her being there but not. So, she really probably hasn't had decent instruction because she was zoned most of the time.  I'm really hoping that I can incorporate enough multisensory activities to help her with this. 

Edited June 24, 2017 by Southern Ivy

[Southern Ivy]

I just wanted to pull down these thoughts. If you have retained reflexes and begin working on them, you'll typically see changes in a month. It usually only takes 1-2 months to integrate them, so we're talking a very fast thing here. I get being skeptical of a trial of meds and wanting to do other things first. Some of that stuff with diet can help, but it's percentage. My concern is the *significance* of the symptoms and that the meds would improve more than behavior. Bumping that processing speed could help APD dramatically. Lecka's point about the cumulative effect of decreased input over time is really significant.

 

I've had my kids to multiple psychs (4+) and I can tell you that NONE of them were oh yeah gung ho about meds, suggesting them like candy. That might be the reputation among peds, but it ISN'T for psychs, at least not in my experience. I think it's highly significant when a psych is saying put a 5 yo on meds. To me that's your red alert, your warning that this is really significant.

Good to know about the psych/red flag. I honestly didn't think it was as severe as she said, but this month has been very eye opening. I'm sitting here thinking "How did I not see this right in front of me?!"

I do think I'm going to go the whole "her processing speed is low and the medication will help with that" route. I do think that if I go in again, say what I've been doing with her and that it's not working (even though it's only been a month), I think she will be agreeable to the medication. 

 

 

 

I missed it, was the dc in speech therapy? Did you observe to see how the SLP was working with her? That would be really useful information to have. When one provider is having good success, you want to learn from them and carry methodologies over. It can tell you a lot about how you can work with her better.

 

Providers all vary and their skill sets vary. It's just something to watch for, like who is really good with her and how do they do it? If you see a routine they use (work, breaks, motivators, structure, etc.), you want to learn from them!

She did. She went for a year for initial g/k sounds. She did well. When she graduated, she had some articulation issues, but they were developmentally appropriate at the time. 

Unfortunately, her SLP has moved to St. Louis so we'd be starting over (relationally) with a new SLP. 

[Lecka]

Not that it is the most conclusive thing in the world ---- but it is good she could tell what sounds were the same and what sounds were different!

[PeterPan]

The Barton pretest intentionally uses multiple skills. It's goal is to make sure the dc has ALL the skills together, at an adequate level, to begin Barton. So when she was struggling to pull down the tiles, that could be working memory as well. That's where you combine your info from sources and figure out what aspects are the issue. LIPS works on all of them together. And remember, you can call Barton and talk with her about the pretest, the other scores you have, etc.

 

Did your psych do any phonological processing? Was there a component in that readiness test she ran? What was that? It would give you some data to compare to the working memory from the IQ and the Barton pretest.

[PeterPan]

That's exciting that she's doing well in MUS Primer! That's really good, like one thing to check off the list! :)

 

[kbutton]

The last part was the worst - pulling down different color for the different sounds, same colors for the same sounds - she could NOT do that. She could repeat the sounds and she could tell me if the sounds were the same/different, but the she kept getting confused on same colors/different colors/2 same colors-1different color - it was just beyond her understanding, I think. 

 

I never really worked with her because of pushback from her, but now I"m seeing that it was frustration over it being too hard. I realized soon that it was her and not the school, but still. So hard to realize that at first. 

(May I just add that A Beka is NOT an appropriate curriculum for kids like her? Yeah - kids like her who are so out of the box don't do well with such a 1 formula for every kid type of program. So thankful the preschool is doing away with it next year.) 

 

Multi-tasking is really hard with auditory directions. That's pretty much an across the board APD problem. It overlaps with ADHD too, but it's definitely something that is an issue with APD too. 

 

Lots of us have learned (and re-learned, lol!) the hard way that pushback often = area of disability. Not always, but often. I am still seeing this in 7th grade with my older one.

We followed up MUS Primer with Miquon, and now we're doing Singapore for my kiddo with APD. Not that it's a magic bullet, but it was a very good fit in case that helps you.

 

I hadn't really thought of this as possibly being an aspect of that need for things to be low-key, not multi-tasking, etc. due to APD, but my son LOVED anything self-correcting at your DD's age. I think it really had to do with doing it at his own pace and without a lot of extra stimulation. Anyway, he would teach himself things on the down-low when we had enough pieces to practice it alone. For instance, I had a pocket calendar to do months of the year and such. He knew how to count to 100 at that point, but he didn't know his numerals. However, he made the connection that the numerals in the calendar were the written version of counting, and he would touch them one by one when no one was looking and count until he could recognize the numerals. I did have to show him that you go L to R, and then you start on the next line. After that, he just took over. Then, I put ABCs in the pocket chart. He knew the alphabet song...same story. Now, obviously, this is going to look different for your daughter if she's not able to distinguish sounds and things, but you might try to find other self-correcting materials if you think that she's in a situation where "too much" stimulation makes her get confused, learn wrong, etc. Too much is very subjective, which doesn't help define things, but it's something you could watch for.

[Southern Ivy]

The Barton pretest intentionally uses multiple skills. It's goal is to make sure the dc has ALL the skills together, at an adequate level, to begin Barton. So when she was struggling to pull down the tiles, that could be working memory as well. That's where you combine your info from sources and figure out what aspects are the issue. LIPS works on all of them together. And remember, you can call Barton and talk with her about the pretest, the other scores you have, etc.

 

Did your psych do any phonological processing? Was there a component in that readiness test she ran? What was that? It would give you some data to compare to the working memory from the IQ and the Barton pretest.

I don't think there was a phonological processing component. 

The Bracken School Readiness Assessment that she did covered: 

Colors (11/11)

Letters (2/16) (Shocker. *sarcasm*)

Numbers/Counting (11/19)

Sizes (10/12)

Comparisons (4/11) - this was verbal, so understandable, I think

Shapes (23/20)

 

Score: 94

Percentile: 34

 

She was within the average range. "It is also above what would be predicted by either her verbal IQ or her Full Scale IQ". 

 

So, yeah, putting all the pieces together now, I can really see why you and Lecka are pushing speech and the languages tests. 

 

Multi-tasking is really hard with auditory directions. That's pretty much an across the board APD problem. It overlaps with ADHD too, but it's definitely something that is an issue with APD too. 

 

Lots of us have learned (and re-learned, lol!) the hard way that pushback often = area of disability. Not always, but often. I am still seeing this in 7th grade with my older one.

We followed up MUS Primer with Miquon, and now we're doing Singapore for my kiddo with APD. Not that it's a magic bullet, but it was a very good fit in case that helps you.

 

I hadn't really thought of this as possibly being an aspect of that need for things to be low-key, not multi-tasking, etc. due to APD, but my son LOVED anything self-correcting at your DD's age. I think it really had to do with doing it at his own pace and without a lot of extra stimulation. Anyway, he would teach himself things on the down-low when we had enough pieces to practice it alone. For instance, I had a pocket calendar to do months of the year and such. He knew how to count to 100 at that point, but he didn't know his numerals. However, he made the connection that the numerals in the calendar were the written version of counting, and he would touch them one by one when no one was looking and count until he could recognize the numerals. I did have to show him that you go L to R, and then you start on the next line. After that, he just took over. Then, I put ABCs in the pocket chart. He knew the alphabet song...same story. Now, obviously, this is going to look different for your daughter if she's not able to distinguish sounds and things, but you might try to find other self-correcting materials if you think that she's in a situation where "too much" stimulation makes her get confused, learn wrong, etc. Too much is very subjective, which doesn't help define things, but it's something you could watch for.

She is so bad with multitasking! 

I really wanted to do Singapore. But, I wasn't sure if it would be hard for her with whatever is going on. I knew MUS was hands-on, so we went with that. 

 

Your son! All the feels.  :blush:  :blush: 

We were given an alphabet banner by the optometrist when we went and discussed possible dyslexia/APD and vision therapy. He showed her what to do and how to figure it out. He said, "She's very smart. She just doesn't know how to make it come out right now. But, just watch her. She'll figure it out and she'll do great." 

I need to get it hung up so she can go over it.