beishan
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Posts posted by beishan
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They recommended Wilson 2 times per week and 1hr each time but can be break down to 30 minutes each and 4 times per week. He is still at school and has IEP. He is supposed to meet reading specialist 3 times per week last school year and I know reading specialist is Wilson trained. However, I just knew that they were working on comprehension, not Wilson reading. This school year, he is placed in inclusive class that has special Ed teacher in class support his reading and language arts. From what I know, she will use direct phonic instructions while reading with him but not specified if it will be OG. I need to find out more. Speech therapy goals were achieved last school year but SLP will continue working on his Pragmatic Language part which is not set in his IEP.
We have an tutor at home. She is OG trained but not Wilson. She does guided reading and writing with my son since 2nd grade. This school year, tutor will use megaword, vocabulary workshop and writing with skills along with four square writing framework with him. I will ensure he does reading assistant at least 3 times per week. I mentioned that to our private evaluator, and she thinks the home plan is solid.
I will provided the report to our case manager and see what she says. Our IEP is due to renewal in January.
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Ladies
Thanks for the great advise at the beginning of year when we started our IEP process. During passed summer, I finally took DS to do private dyslexis evaluation. Below is the score.
CTOPP-2
Phonological Awareness = SS 88 (Average = 100), 21%
Elision 50%
Blending Words 5%
Phoneme Isolation 37%
Phonological Memory = SS 92, 30%
Rapid Digit Naming 25%
Rapid Letter Naming 37%
Rapid Symbolic Naming = SS 92, 30%
Memory for Digits 16%
Nonword Retition 50%
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He got diagnosed with a Oral and Written Language disability consisting of dyslexia, dysgraphia, syntactical issues and poor working memory. Wilson reading, reading assistance are two things recommended for decoding and fluency. In addition to that, he also needs to work on retelling and sequencing. Is there any suggestion?
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Our district sent us whole report 10 days before IEP meeting. Do you only get the score or you have the whole report? My son had WISC-V for his IQ and woodcock johnson for achievement test. His IQ is not able to interpret due to variance of index scores on different categories (high VCI and PSI but very low WMI). The psych suggested to use his VCI as IQ index. In his woodcock johnson score, the comparison base is the score of majority children at his age can perform and then you can compare your DC's score from there.
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We use MM review book in the past two years. It has 2-3 review pages for each topic and then follow with one page test for the topic. At the end of each review book, it has year end assessment which contains several pages of mixed questions belong to the content of the year. I use it as refreshment during summer and prepare for next school year. So far it works well.
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Social skills group may be reimbursed under SLP coverage depending on how the clinic bills. I just got a call that there may be an opening for DD at a clinic where she's been on the waitlist for ages. They are not in-network for our insurance but they do bill in such a way that we might get 70% of the cost reimbursed. I don't know how it'll work given that the insurance is already paying for private speech and ABA (insurance might claim it isn't medically necessary for that reason).
Our social skills group runs by clinic that is out of network. We pay them first and they provide us receipt with code so we can submit it to insurance. We got 70% reimbursement back for out of network. We have United Healthcare. We just submit receipts online and the check will be mailed to us.
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I also got email from school psychologist as I mentioned that we want to know if DS has any change after we stopped fish oil two weeks ago. She checked with classroom teacher and reports no significant change after he stopped taking fish oil. At home, I continue noticing handwriting improvement, better attitude and better tolerance of frustration. His tutor and ice skating coach both reported better attitude and cooperation during session. Now all he takes in the morning is multivitamin (with 37.5mg b6, 15mg zinc), opc3 (Pycnogenol), and 200mg magnesium.
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Alternatives include flaxseed oil or EPO. FWIW, some kids have a similar reaction to flaxseed oil as others do to fish oil; it's all so individual. And I've been intrigued about krill in the past but it's been so long I can't remember why :tongue_smilie:
How about borage oil? I just ordered a bottle of GLA from Nordic Naturals and my Dad gave me a small bottle of cold press flaxseed oil. I think I will start to give him GLA over the long weekend and see if it makes any difference. So far DS has been reacted nicely after we stopped fish oil. Two emotion incidents reported after we stopped fish oil but school psychologist told me that he handled fairly well. Calm down faster with adult and was able to come up with solution for problem solving.
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The only thing I've ever heard is that people with pyrrole disorders don't tolerate fish oil well. I can't find information about it and know even less about it firsthand.
DS has slightly smaller than regular red blood cell (68/72) and slightly lower hemoglobin level (10.6/12). It's not due to lacking iron intake. Let me research more on this.. Thanks.
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Recently my son told me that taking fish oil seems make him cranky. I asked how? He said when other kids are joking, he will be more emotional if he takes fish oil that day. If he does not take it, he will just join them and laugh. So I stopped his fish oil last week. The first thing I notice is that his hand writing becomes neat. Everything stays on the line. Second thing I notice this week is that he can take correction much better and does not argue too much now. While showing improvement on some areas, he was more forgetful after we stopped fish oil. He forgot to bring back some homework twice since last week and forgot to turn in his reading log last Friday.
Has anyone experience this? He is taking Nordic Natural Pro EPA fish oil.
Background:
DS is 10 and in public school. ADHD PI, Mild Specific learning disability in reading and writing
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I just signed up summer camp yesterday. We will do the same camp like other summers in the past. It's half academic and half fun activities. This summer my mom will take my niece here so we have Mandarin immersion environment at home this summer. I am planning to do more Chinese lessons through this summer. I also think about signing him up for Mathnasium summer session to see if it will help more than just doing MM workbook in summer. Swimming lesson and ice skating (he wants to switch to hockey track) will continue through summer. We also need to prepare his violin audition for Youth Symphony this summer. I hope he can get in and get some different experience playing in orchestra setting. By the end of summer, we will go on road trip to Boston and Acadia National Park.
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I guess it will depend on school district. We just went through the process from district and child study team in our district has been very helpful. In addition to run tests in school, we were also referred to psychiatrist outside for psychiatric evaluation which was paid by district. Each professional shared and reviewed all information. Each of them provided us individual report from their perspectives. My son ended up getting more help than I expected. But educational psychologist will mainly focus only on improving his function in educational setting. I did ask them if I should go to audiologist to sort out APD possibility and they said it will be our choice as it will not change whatever they have in IEP for him. In addition, they do not diagnose nor give out label. However, the psychiatrist we were referred to is able to give us diagnosis (ADHD combined, mild dyslexia, mild dysgraphia, adjustment disorder) on his report after he interviewed us and reviewed all results from school evaluation. If you have concern outside of academic area, neuropsychologist may be better choice to go to.
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Thanks all for commenting above. We went to IEP eligible meeting today and DS did qualify for IEP under ADHD. During meeting, they mainly focus on his working memory and ADHD. But they did put down he has reading difficulties so it's addressed in his IEP. His Wilson reading with reading specialist will continue 30min x 2 times per week to work on his reading skills. They will have special ed teacher push in his class twice per week to support his language arts (both reading and writing) for the rest of his 4th grade and extend to 45min x 5 times per week each for reading and writing on 5th grade. He also gets speech therapy twice per week, classroom aide for science and social study next year when he is on 5th grade, both individual and group psychological consulting with psychologist once per month, enabling text to speak feature during state test for math and tons of classroom modification. I have not done reading the whole IEP draft yet but those are pretty much on top of my head after meeting.
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I agree. Given his language instruction/exposure history, something is off. A child is likely to lose the reading and writing ability for chinese with reduced exposure time but verbal ability stays (stagnate but not regress) if the child gets to use the language daily in conversation.
Given that his first 18months is in chinese only, long term memory should be there for verbal for whatever vocabulary he was exposed to.
Within 1st year of switching to all English at home, his oral Chinese regressed from 90% to 10% even he still went to Chinese school every Saturday. Now I asked him if he remembers certain words that he used to know when he was 5, he said no. This year, I quit Chinese school and started to homeschool his Chinese. We focus only on speaking and listening. I use only oral instruction and do not force him to look at the textbook. He retained what I taught him after lessons and is able to apply it in conversation immediately. And his oral Chinese is progressing after we quit Chinese school.
ETA:
If he can remember the complex chinese words easier than the simpler ones, attention could be the issue. As in there is more to see and absorb in complex words (more strokes) than simple ones.
Same might go for math. The harder ones might have less careless errors.
That's interesting point and I think it may be true.
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I think doing something to improve his working memory would be a big help. The language testing area you highlighted also seems to be related to working memory and I notice in the reasoning his figure weights is higher then the matrix reasoning scale score which also could be a working memory thing. If you can't hold multiple pieces of info in your head at the same time then the matrix reasoning area can end up lower.
I also notice his processing speed is higher then other areas which probably means he rushes through things without stopping to think.
What you said above is very true. Psych put the similar comments in the report. He observed that his WMI score got impacted by his ability of attention and impulsiveness (choose answer without finish looking all options).
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geodob
English is his dominant language. He is basically using English to learn Chinese now. Here is his bilingual exposure history:
birth - 14mo
All Mandarin 24*7
14mo-4yo
M-F attending full time daycare center
8am-6pm English
6pm-8pm Mandarin
WEEKEND - All Mandarin
5yo-8yo
M-F attending public school + after school
8am-6pm English at school
6pm-9pm English at home
Saturday 12:30-3:00pm Chinese school
8yo-10yo (present)
M-F attending public school + after school
8am-6pm English at school
6pm-9pm English/Mandarin at home
He has very limited oral Mandarin now but is able to understand 50-60% of daily conversation in Mandarin. It took him 2-3 times longer to retrieve Mandarin words than English. When learning to read and write in Chinese, his retention is very minimum. He tends to remember more complex words than simple words. Generally he speaks English smoothly and has great vocabulary. Occasionally we observe that he has difficulty to retrieve words and end up he needs to repeat part of sentence few times before he can grab the word and continue with the sentence. But it does not happen all the time.
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Ok, I think it's bizarre that a clinic would give therapy for social skills for several years and never look at whether this is ADHD with social delay or ASD. That's a pretty serious question.
The more bizarre thing is our insurance paid for it. It was actually first billed under adjustment anxiety and later switched to be billed under ADHD diagnose code after we got the label from neurologist.
You're saying he complains about noisy environments, but *that* can be sensory. Has he had an OT eval? What we're specifically saying is can he *understand* you talking to him when he's in a noisy environment... So if you go in Chipotle (which is famously noisy) and you try to talk about what you're ordering and the guy says what kind of beans, can he hear and respond? Me, I hear fine. The noise bothers me and I get headaches from it, might have avoidance symptoms, etc, but I can hear you just fine. My ability to discriminate figure/ground and separate out the voice of the person speaking from all the rowdy noise in the background is fine. My dd, is right on the line, where she *struggles* to understand what you're saying. She might or might not get it. She avoids those situations, because it's so hard for her to hear the voice and distinguish it from the noise. The strain of her trying to distinguish like that gives her horrible headaches. She's borderline on the APD screening. Then you get people who actually are functionally deaf in that situation. They literally can't distinguish the voice from the background.
He complaint about loud noise which made him exhausted. When I brought him to see circus show (with loud music), he wanted to get out in the half time and appeared to be very tired. But sometimes he wants me to turn on high volume of his audio books while we are in the car ride because he claims that he cannot hear. He can hear and understand both languages (mainly speak to him in Mandarin when not doing school works) fine in noisy environment.
I asked for OT/PT evaluation but school denied it as they claimed that they did not see issue with motor skills. I may need to go private route.
My ds was not responding to people, and one of the questions they ask you in an ASD screening is whether you've ever wondered if the dc was deaf. That's why we took my ds to the audiologist, because we felt like we really needed to get sorted out *why* he wasn't responding. The audiologists saw it happening too, but in his case it's not a hearing loss, not a background issue, just the ASD. He just goes into his own world.
Takes a while to get into a good ASD clinic. The Baker place ought to be able to help you, mercy. I don't know what they do. At least a referral or something. I know I've got two of his books in my house right now, one on meltdowns and another on social skills. He's not looking at the camera in the picture of him in the social skills book. Is Baker himself NT? His picture was pretty bad in that book. I don't think a NT person would have let a picture like that get published. They would have had a nicer picture made. Of course I just wrote the Cruz campaign asking them why they don't bother to hire a good photographer and control his imagery. The shots, the lighting, the editing on his images are HORRIBLE. Images matter. Trump controls his imagery very carefully. People who feel well and who are in control handle these things. To me it was like a little hmm, that's odd, when I saw the poor image in the Baker book. Yup, just checked. It's on the back cover. It's underexposed, no eye contact, basically just a cropped snapshot.
Well...we don't see him directly. We are just in the group that using his way to run social skills group. If I get to see him, I will let him know. :laugh:
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And has someone actually addressed the ASD question?? If he's having issues with WH question words, that's a marker of ASD.
No. We started Social Skills Group when he was in K. His K teacher recommended us to try because he was lacking social emotional control in K (threw tantrum when he did not get his way). She said that one of her students in other class got improved after trying the social skills group. He was paired with other two boys that also have ADHD labels. Therapist mentioned that he shows frustration on word retrieval especially when the conversation speed starts to pick up. It will take him 2-3 tries to get the words that he wants and some kids may lose patience for that. She was afraid it will hurt his social situation. As of WH question, I did mention it to his ESL teacher but she did not observe the same issue when he was in her class. He got referred to ESL service when he was 6 but discontinued when he went to 2nd grade because they see no benefit. He speaks English fluently. What therapist observed is that he answered WHAT question with WHERE or WHY answer. Example like when therapist asked him "What will you normally have for Thanksgiving" and he answered "We are going to Edward's house". I bought some DVD from Super Duper and practiced with him. He is able to answer WH question in the activities without any issue so I was not sure if he has issue with WH question or more culture background knowledge issue as we do not normally celebrate Thanksgiving in the family....Now at 10 years old, if you ask the same question again, he can answer perfectly fine.
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You can ask your school whether he qualifies for in-school help. DS11's scores were particularly low, so it was obvious that he had a need. If you need to get it from an outside provider, you would look for a speech language pathologist who does social skills training. Sometimes this is in the form of a social skills group instead of individual therapy.
Story, I was just reading in Teaching Social Skills to People with Autism that group social skills work does not tend to generalize over and is not individualized enough. The article in the book indicates the paired social skills work, like what Kbutton's dc gets, is more effective. In that situation they're doing customized work that is actually using things in the dc's life and doing it with the dc's friends.
DS has been in private social skills group since first grade. He is now 10yo in 4th grade. He was paired with other two boys in the group and developed good friendship. The group runs under Dr Jed Baker's social skills training project. I have already notified his social skills therapist about the finding of poor pragmatic language. She was the one who found that he has issue responding WH questions and wants me to look into language evaluation to sort out.
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There are different subtypes of CAPD and my oldest has the audio sequencing one. She has a really good ear for learning the viola according to hear teacher and did well at the tones in Mandarin when she took a class when she was little (we weren't able to continue after we moved since all the Chinese schools here teach the Cantonese dialect). She mixes up syllables in multisyllabic words, transposes digits in numbers, does multistep directions out of order, and also really complains about noisy environments.
That sounds very much like DS. He mixes up syllables in multisyllabic words, transposes digits in numbers, does multistep directions out of order, and also really complains about noisy environments. However, it does not happen every time though... I think I will have to look into this more.
The challenge is that a ps diagnosis of ASD and private are not one in the same. For the ps to put ASD in the IEP, they're saying that it is his disabling condition and the condition which best describes what adversely affects his ability to receive an education. The school can acknowledge social/pragmatics problems and put goals for that under the ADHD (a lower disabling condition) and NOT label him as ASD, EVEN IF he has a medical diagnosis of ADHD.
In our state, this is actually a fight people have, because there's big money associated with each diagnosis. In other words, if you actually want the question answered thoroughly, without bias, you may need to go private. It depends on the school and what they're seeing. If they're seeing (in the classroom, in the school) the social but *not* anything due to self-regulation, repetitive behaviors, etc., they may just put in goals for the social using ADHD or the SLDs as the disabling condition and not bother to go deeper on the ASD question. They're not there to give you a medical diagnosis, only to say if the symptoms are affecting his ability to receive an education.
So if you want the ADHD vs. ASD question addressed, you would look for a psych or clinic specializing in autism. One interesting way is to look for a BCBA (a behaviorist that treats ASD) and see if they practice under a psych or refer to a particular psych. Or you can get an eval through a clinic that specializes in ASD. That will typically be a multi-factor eval, which can be helpful as it catches things that aren't yet on your radar like OT and speech.
Thanks for great information. From the report I received, I can see school thinks that his ADHD (inattentiveness, impulsiveness and self regulation on his emotion) impacts more on his social and education situation. We don't mind to go private to sort it out if we need to. We have pretty good insurance coverage.
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Are they testing social pragmatics as well as whatever is on the CASL for pragmatics? The returning to topics of his interest can be a spectrum thing. But a lot of this is also related to CAPD. I would get a screening with an audiologist.
While CAPD is not considered an education issue, it sometimes can be a qualifying condition for an IEP--they can count it under SLP, but they can count it as it's own thing under other health impairment, but it's tricky to do. You can also get IEP goals for CAPD, but that's also kind of iffy and may be done under speech or something.
Will he be able to get speech therapy from school for Pragmatic Language? Or is there any help we can get outside of school? I was googling Pragmatic Language Disorder last night and found it does fit DS. Now we are not sure if it's part of his ADHD or something (CAPD, AS) more. I checked symptoms of CAPD but he does not fit completely. He has good ear while learning violin (play by ear) and good audio memory. He often follows along the storyline well when he listens to audio books. He memorizes whole paragraph from the book and is able to repeat it without a book. He has no issue identifying 4 different tones while learning Mandarin and some other dialect (has 8 tones) from my home country. However, he does fit description of some CAPD subtypes. I will need to get it sort out from audiologist.
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A standard deviation is 10 for many tests, so yes on the reading recall you have 2 standard deviations (what the ps is looking for) between the score and IQ. The word fluency however is on track for IQ. That could mean anything. It could be with a CTOPP the evidence of dyslexia would be there. It could be he has executive function issues from his ADHD giving him comprehension problems. They might even go to SLD reading based on that, dunno. You just have to talk with them. I think it's totally fair to want weaknesses to be addressed.
His WJ IV Achievement Form A also indicates issue with reading:
Cluster/Test RPI SS (68% Band)
READING 37/90 81 (79-84)
BROAD READING 37/90 86 (83-88)
BASIC READING SKILLS 48/90 85 (82-87)
READING COMP 53/90 79 (75-83)
READING FLUENCY 44/90 87 (83-91)
READING RATE 89/90 100 (96-103)
BROAD WRITTEN LANG 57/90 86 (83-89)
WRITTEN EXPRESSION 79/90 92 (88-96)
MATHEMATICS 94/90 105 (102-109)
MATH PROBLEM SOLVING 95/90 108 (104-112)
MATH CALCULATION 92/90 102 (98-106)
BROAD MATH 93/90 104 (100-107)
Letter-Word Identification 30/90 84 (81-87)
Applied Problem 95/90 107 (102-112)
Spelling 68/90 91 (81-94)
Passage Comp 45/90 82 (77-86)
Writing Sample 46/90 85 (81-89)
Oral Reading 51-90 84 (80-87)
Sentence Reading 37/90 90 (86-95)
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The reading support at school is using Wilson reading Foundation as curriculum. It's a gentle version of Wilson Reading but it's taught by certified reading specialist in small group setting. He used to get 5 days of reading support (30 minutes each) but reduce to 2 days (30 minutes each) this year.
No, SLP did not run CTOPP and we did not have previous psych evaluation. We only had neurologist evaluation for ADHD previously. He got reading support through school intervention due to not meeting benchmark on his reading assessment each year. The school psych did run TOWRE-2 and he scored lowest end of average on Sight words and below average on Phonemic Decoding Efficiency. In WJ IV ACH, he scores low average on Phoneme/Grapheme Knowledgement and Word Attack subtest. They did not give us GAI.
I am seeking answer of what issue we are actually facing and why he is so struggling in language learning (reading and writing). I have utilized all resources to help his reading in the past 2 years and he worked pretty hard as well. However, the improvement is limited and we are still not able to fully close the gap after working hard with OG for 2 years. I want to find out if he is qualified for more support resource at school or any other issue we can help to address out side of school.
The term of pragmatics language is new to me. After looking the definition up from internet, we did observe the situation in the past. When he spoke, he liked to talk about his own topic. He responded people's question with irrelevant answer. He does not fully understand the meaning of certain words and misused it in wrong setting/people...etc. We did not red flag those earlier as we are bilingual family. Most of people kept telling us that's due to bilingual situation and he would outgrow eventually. His pragmatic language has improved over time when he gets older and gains some social skills. He will respond question to the topic now but still consistently redirect conversation to topic (topic he likes) that is irrelevant to previous one. I was thinking about expressive language (trouble describing events in clear sequence) at the time we requested SLP evaluation as I did not know which term will be properly described the situation.
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DS is currently enrolling PS. He has been Intervention program for two years and reading support (Wilson Reading Foundation) for 3 years. However, his achievement test on reading still scores poorly on the lowest end of average range. We reviewed his progress last September and agreed that there must be something more going on so we requested the evaluation. The purpose of evaluation is to find out what else school and we as parents can do to help him in the educational setting and daily life. So what you see is that there is no SLD sign showing on the testing result? How about his low average working memory?
The note in speech report indicates that he was found relative weakness in the area of awareness of the setting and the audience, topic management, purpose of conversation, visual-gestural cues and abstractions.
In CASL, here are breakdowns:
Antonyms 105 (Average)
Syntax Construction 81 (Below Average)
Paragraph Comprehension 95 (Average)
NonLiteral Language 89 (Low end of Average)
Pragmatic Judgment 74 (Below Average)
Total Test 86 (Average)
OWLS II
Listening Comprehension 99 (Average)
Oral Expression 98 (Average)
Oral language Composite 97 (Average)
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I would recommend having a Central Auditory Processing Disorder evaluation by an audiologist experienced with CAPD testing. The low pragmatic language score could be an indication of Autistic Spectrum Disorder but CAPD also can cause pragmatic language difficulties. The low sentence repeat score would be consistent with CAPD. So I would definitely go for the CAPD testing.
Thanks. Which professional we should seek for CAPD testing? I forgot to add that he has ADHD PI diagnose from pediatric neurologist last year. Not sure if this will impact the score as well.
Tutoring for Dyslexia
in Special Needs Board
Posted
Does anyone have suggestion for dropping ending sound of a word while reading? DS can decode the word correctly but often drops ending sound like -s, -es, -ed. He does OK with -ing ending though. His OG tutor has been working with him for word list with -ed ending and plan to start nonsense word list with him soon to see if it will help. We have been trying to correct this habit for a long time but seems not able to eliminate it completely. Few years back, he had same issue with his oral language but now he rarely has this issue when he talks. The issue mostly shows on his reading and writing only now.