Testing: Neuropsych or SLP?

[AHASRADA]

**UPDATE ON POST 6**

 

A brief background: My dd was given a psychoeducational assessment at our local university 2 years ago. She was diagnosed with a "specific learning disorder in the area of reading and writing", which means she's dyslexic. I knew that.

 

After receiving the diagnosis and expressing my desire to know the root cause of and appropriate interventions for her receptive and expressive language difficulties (LPD maybe?), I was told this was beyond the scope of the psycho-ed assessment, and referred us to a SLP for further testing.

 

Her name has finally come up on the waiting list for a reading and language assessment with the SLP, and now I'm getting cold feet. I am afraid of a repeat of the last eval. which, although shedding some valuable insight, basically told us what we already knew. Most importantly, they were not able to give us any specific curriculum recommendations for us to implement at home, since they are accustomed to working with PS kids. I have already been told by the SLP office that they will provide a diagnosis and recommend the types of therapies she needs, but will not be able to name specific programs I can use at home since, again, they are making a referral for outside services, not for HSing moms. However, she may be severe enough that she needs outside therapy anyway, and I can always ask you guys for curriculum recommendations based on the therapies they suggest.

 

There is a local psychologist who is HSing-friendly and in fact highly recommends HSing for LD kids. She could do a full neuropsych. eval. and then help me to implement interventions for dd at home. She would conduct a quantitative electroencephalogram and neurodevelopment testing in addition to the routine language tests.

 

So where is the dilemma?

 

The SLP office comes highly recommended by many parents of dyslexic kids. I also know that they specialize in reading and language issues, whereas the psych. addresses attention and behavior issues as well, so her expertise isn't quite as focused. The cost for the SLP eval. is $800.

 

The psych., being homeschool-friendly, is in the best position to guide me through interventions to use at home, which is what I really want to come out of this (the SLP office doesn't seem to know what to do with a mom who wants to do the therapy herself!), assuming she has knowledge of the full spectrum of programs and approaches for dd's language issues. The cost of a full neuropsych. eval. is $1200.

 

So, what do I do? I have to put a deposit down on the SLP eval. by next week if I want to keep the appt., so I have to make a decision.

 

Thanks in advance for your advice!

Edited October 7, 2011 by AHASRADA

[wapiti]

My question would be whether the new psych is going to be able to tell you anything different than the old psych - there are those two tests you mentioned, but where are they going to get you in terms of dealing with the issues? I'd ask - maybe they have a good answer. Generally speaking, psychs are great issue-spotters, but often refer to other professionals for further evals and treatments in various areas. The SLP is one such professional.

 

FWIW, 1200 seems more like a price for a regular ed psych assessment rather than a neuropsych assessment, which I thought was more in the range of double.

 

On the other hand, the 800 for the SLP sounds overly expensive. Our last big eval with an SLP office was around 450, which included some auditory reasoning tests (though we were dealing with language processing but not with dyslexia specifically). Maybe the 800 includes more.

 

If you are facing additional issues (the attention and so forth) outside of the language issues, then by all means I'd investigate that, but regardless I'd be afraid that you'd still end up going to the SLP for the language issues. I don't see what the neuropsych is going to do for you for further identifying the language issues. As for home programs, I'd come here :), particularly once you've done the language assessment and have more specific identification of the language issues.

 

that's my two cents

[rafiki]

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[PeterPan]

Just to ditto what Wapiti said, around here that SLP price would be way high and the psych price not fitting a neuropsych eval. I'd definitely ask what you'd be getting in that SLP eval, as that's an insane amount of money. That would have to be a LOT of hours or something, choke. I pay $100 an hour and get the only SLP certified in this technique for a multi-state drive. So I would expect *8 hours* of services for that $800. I would have expected more like $250, which is what I paid for my ds' eval. That was 2 1/2 hours btw. For a write up it would have been another $100, the cost of her time.

 

The point of stepping up to the neuropsych, from what I've been told, is to get the diagnosis for ADD, ADHD, that type thing, and get meds. They're looking at specific portions of the brain and how they work, etc. If you don't have any issues with working memory, executive function, ADD, etc. but you are having a lot of issues with language, then it seems like the SLP might be a good way to go. But I'd still have a lot of questions about that price tag. I'd do some calling around. I also haven't had to pay a deposit for ANY of the evals we've done. That would be hugely concerning to me. Do they take your insurance??? Insurance doesn't pay deposits like that. Insurance gets the bill, says they charged you too much, and changes the amount. Something just doesn't add up. Have you called other SLP's to see what the going rate is in your area? Have you tried looking at lists for Interactive Metronome or other therapies, just to find some more (possibly also good) SLP options?

 

Just to talk in circles a minute, have you pondered working memory and *why* she has the language problems? They seem to be saying that part of the reason our kids have issues with the language expression is BECAUSE of the working memory. That points you back to the neuropsych (just in case you wanted to go in circles!). Then you find SLP's like Yllek's who are uncommonly good at working on working memory as it relates to expressive language.

 

All I know is I'd do more inquiring about going rates for SLP's and look for options. That just seems high to me, and I wouldn't want to have to pay a deposit like that.

Edited October 7, 2011 by OhElizabeth

[wapiti]

Just to talk in circles a minute, have you pondered working memory and *why* she has the language problems? They seem to be saying that part of the reason our kids have issues with the language expression is BECAUSE of the working memory. That points you back to the neuropsych (just in case you wanted to go in circles!). Then you find SLP's like Yllek's who are uncommonly good at working on working memory as it relates to expressive language.

 

Just to add to this little bite of food for thought, my kids have language processing issues but none of them has a problem with working memory (even ds, who sometimes/often appears to have some sort of attention issue - WM was his highest section on the WISC - a good three or four standard deviations higher than processing speed; his issue is more in the area of auditory reasoning, whatever that is lol). Maybe that's what keeps them from being dyslexic, not having the WM issue?

Edited October 7, 2011 by wapiti

[AHASRADA]

Thanks for the replies.

 

I just spoke with the psychologist on the phone, and she has explained what she does more clearly. Basically, I am comparing apples to oranges. She focuses on testing the child's neurological development. If everything is fine at the brain stem and mid-brain level, she would refer me to the SLP for language testing and therapy at the "cortex level." If she finds an underlying neurological development issue that could be at the heart of dd's difficulties, she would work on those first. So, her recommendation would be to do her testing first to rule out any lower-level brain function issues before moving on to the SLP to treat the symptoms. Based on our previous psycho-ed. testing, she would only do the neurological component, which would cost $500 (2 hours of testing plus eval.)

 

Yes, the SLP testing does sound like a lot of $, but this is THE place to go for language issues, very well-known, the 1st place anyone would recommend for SLP services. We have been on a waiting list since May, so they need a small deposit ($50) to be fair to the others on the waiting list. FWIW, they are doing both a reading and a language assessment (4 hours), since her reading testing is 2 years old. I really wanted them to base their evaluation on current data, and I personally wanted to see what progress has been made, particularly since we have completed an OG-based program in the interim. The psycho-educational evaluation we did 2 years ago, which included IQ, working memory, etc. plus reading was only $400 because it was done by PhD students in training (which is why we went with the psycho-ed. rather than neuro-psych. at the time).

 

So, I have the option now to do both. I would have to lose my current SLP appointment at the end of Oct., and have the neurological testing done in November. If she finds any neurological development issues, we will address those first, and move on to the SLP once they have been remedied. If nothing is found, we take the next SLP appt. in Dec. or Jan. Doing both test would cost about $1300. Either that, or I stick with the SLP and forget the psych. with her "brain stem, middle-brain" development theory (although I find a lot of truth in it).

 

NOW what do I do??? Thanks, everyone, for your helpful comments. Keep 'em comin'!

[PeterPan]

Just to add to this little bite of food for thought, my kids have language processing issues but none of them has a problem with working memory (even ds, who sometimes/often appears to have some sort of attention issue - WM was his highest section on the WISC - a good three or four standard deviations higher than processing speed; his issue is more in the area of auditory reasoning, whatever that is lol). Maybe that's what keeps them from being dyslexic, not having the WM issue?

 

Hey wapiti, you ask good questions. You said language processing, but I think I'm thinking language *expression* as in output, getting it out. With so many terms, I'm curious now to go back and reread those paragraphs in DA and see exactly what they said. Indeed, they do walk up to a line with the idea that dyslexia creates a functional working memory deficit simply because the different processing eats up so much. It was an interesting concept to ponder. So I don't know how that relates to what you said, because you came at the same thing from a different angle, hehe. Like you, I've been surprised to see people getting dyslexia labels, losing dyslexia labels, getting told the child is not dyslexic but has a reading disorder or now has nothing because you've remediated, blah blah. I mean it's just so stinkin' convoluted the way they're handling it. IF the Eides are right and IF dyslexia is in fact connected to specific structures in the brain (the actual way the mini-columns and wires are laid out, etc. etc.), then there's no way for it to go away and no way for it no longer to be a diagnosis just because they remediated. So the whole set of contradictions I see going on between practitioners makes NO SENSE to me. Either you have a dyslexic brain or you don't. What seems to vary is what the practitioners decide to label you with, and it seems to be changing with the wind. I don't know how a person going in with their kid to the neuropsych is even supposed to feel confident that the "not dyslexic" diagnosis is even correct. There's no discussion of it beyond "reading disorder" level from what I'm seeing, no looking at it the way the Eides do. So either the Eides are out in left field or the rest of the profession is blathering stupidity or something.

 

Rant #892, sorry. I just haven't figured that out.

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[rafiki]

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[wapiti]

Hey wapiti, you ask good questions. You said language processing, but I think I'm thinking language *expression* as in output, getting it out. With so many terms, I'm curious now to go back and reread those paragraphs in DA and see exactly what they said. Indeed, they do walk up to a line with the idea that dyslexia creates a functional working memory deficit simply because the different processing eats up so much. It was an interesting concept to ponder. So I don't know how that relates to what you said, because you came at the same thing from a different angle, hehe.

 

I don't even know what the Eides say about it (duh!) - I'm sure I'll end up getting their new book at some point, but I'll have to check the Mislabeled Child when I get home. I can imagine that the processing could take up the whole working memory (I'm thinking, like a computer), but in my ds's case it's just so hard to say, with that gigantic disparity between processing speed and working memory. But my dd's disparity is smaller (though similar), and her language processing issues are equal or worse than his. I wonder whether we'll ever know.

 

I have asked here before and have yet to get a straight answer as to who diagnosis dyslexia/reading disorders and what the criteria is for that diagnosis. I haven't been able to dig it up by googling either, which makes me wonder . . .

 

I do know that in 2004 IDEA/NCLB laws changed and affected who gets help and a LD label. Potential (IQ) is no longer taken into consideration. You may want to read about those changes more.

 

Many "symptoms" overlap with each other. Could it be that the "decline" in dyslexia diagnosis and rise in ASD and ADHD is a response to the 2004 changes? There is a DSM IV code for Reading Disorder but I'm not seeing criteria that must be met and how that is document. It makes is seem so subjective.

 

Anyway, these are just my thoughts. I would love for someone here to be able to educate me on who diagnosis dyslexia and what the standard criteria are for such a diagnosis.

 

:bigear:

 

I always thought it had to be a psych or neuropsych - I know a psych at the local university diagnosed a friend's dc. But I also thought I read that weird things are happening with the Reading Disorders section in the DSM V, whenever that finally gets adopted. Maybe there's a good reason that the Reading Disorders section isn't called Dyslexia? I want to double-check that but I can't even seem to find the link to the CDC website for that section right now, though I thought I had looked at it once upon a time.

 

At one point, I got a letter in the mail from some researchers about a reading disorder study at a local university; when I called them (because there's the potential for free IQ/achievement testing) I asked about vision, and on the one hand kids with vision issues were being excluded from the study, but on the other hand I don't think they were ruling out such things in the study participants. Anyway, I recall thinking that there was something odd about the definition of reading disorders that they were using.

 

That's all I got :tongue_smilie:

Edited October 8, 2011 by wapiti

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[PeterPan]

Yllek--I have a fundamental problem with this whole "reading disorder" label, both because it's a loaded term and because it's not particularly reflective of the ENTIRETY of the problem. So IF the DSM or whatever is going to that label, then where's the label for the *rest* of the dyslexia symptoms? Is dyslexia still in that DSM book? Didn't LizzyBee a while back say in her area they were giving both labels but that the dyslexia one required more steps to get? Clearly I'm not up on all this.

 

I'm saying my kid doesn't need a "reading disorder" label. She tested 30+ on the WJIII last year. She can "read," because I've taught her from the beginning like she was likely to be dyslexic (long before I knew there was a term for what I was seeing in her and my dh). This whole thing of diagnostically cherry-picking out *one* aspect makes no sense to me. It explains why the Eides are holding onto the term dyslexia and pursuing it as an overall diagnosis that allows people to see the bigger picture of what is going on with their brains.

 

I mean thinking about it, what use is it if I pay for a neuropsych locally, only to told my remediated 2E dd doesn't meet the guidelines for the label? Does that do me a hill's bean of good when it's CLEAR she responds overall as what the Eides label "dyslexia"??? The phonologic and reading issues are there (my meteor/metro park story from a couple days ago), but they're harder to tease out because of her overall strengths. I'm also mystified by the idea that *politicians* are deciding the DSM standards. Wowsers.

 

So yes, I really dislike the term "reading disorder." To me it's not communicating or addressing the larger picture, and it's a loaded term. :(

[rafiki]

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[AHASRADA]

Does this SLP office only do evaluations without providing any of the therapy themselves? So do they only make recommendations to school districts for services? Who is performing the therapies that they recommend? Another SLP? Wouldn't that person want to do their own evals?

 

Sorry I didn't make that clear. Yes, the SLP office does provide therapy following the evaluation, although they have made it clear that my dd, at age 11.5, might be too old for the services they provide (they mostly work with younger kids), so if her abilities are beyond what they can address, they will give an outside referral. Personally, I want to avoid outside therapy unless it is absolutely essential, mainly due to the cost (nothing is covered by insurance), the inconvenience of travel and the disruption to our homeschooling. I mainly want a diagnosis that I can bring here and get specific program recommendations (IdeaChain, Dianne Craft, whatever) that I can do myself at home.

 

And I'm struck by what the psychologist is telling you. Our neuropsychological eval included both cognitive and achievement testing (presumably "brain stem, middle-brain and cortex" level issues). The brain development language that this psychologist is using sounds like he is coming from a neurodevelopmentalist angle. I don't know much about the folks who do neurodevelopmental therapies, but it's not the neuropsychological evaluation that most folks on this board are talking about. Also, I don't think most neuropsychologists treat any of the disorders that they diagnose. What is the psychologist's background?

 

If we were to do a full neuropsych. eval., she would include the typical cognitive and achievement testing, in addition to the neurodevelopmental aspects. Since dd had the psycho-ed. eval. done 2 years ago, the neuropsych. said we didn't need to redo that portion, she would only evaluate her neurological development to see if dd has issues that need to be addressed at the brain-stem or mid-brain level, or if she should move on to the SLP for cortex-level therapy. The neuropsych. does the cognitive training herself, and would teach me what to do at home to address dd's issues. She has told me that she is somewhat unique in her field, and that while there are SLPs who work from her neurodevelopmental approach, they are swamped and can't possibly take new patients.

 

It makes sense to me that sometimes kids are displaying symptoms of something wrong at a more basic level, and that years of remediating the symptoms won't fix the problem. I like the idea of trying to "treat her brain" at a basic level, progressing to higher functioning levels over time, so she is better prepared to accept the "cortex-level" therapy at that point. The only problem is, I don't know if this is really necessary, and at her age, I don't want to wait another year or two to address her specific learning issues.

 

The safest thing is probably to do both testing, to get recommendations from SLP to treat her symptoms, and if the neuropsych. says she needs more basic cognitive training, we can do that first. I just hate to spend more $$ on evals. that could be used to purchase these training programs!!

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[rafiki]

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[PeterPan]

His general reading achievement is very, very high, but he still has a disability that was determined by his neuropsych eval. This is why I'm a little confused by the idea that somehow a dyslexic who is reading well is not going to get diagnosed.

 

So Yllek, how did they parse that out? I guess that's nitpicking, but it's really an issue to me. See Michele here took her boys to the neuropsych and it seemed to go the other way, that they *didn't* give the dyslexia or even reading disorder label to one, even though he might have seemed to her to have had as many issues as the older, only more easily remediated. I pretty much threw my hands up in disgust when I heard that, kwim?

 

And yes, the Eides take the position that dyslexics have an entirely different brain format (not right word) and that the entirety of the differences is why you see such a BROAD range of effects (both positive and negative, across the entirety of the person's being), rather than it being just reading. See my quandry?? To me that's a HUGE contradiction. What the Eides are saying fits with what I *SEE*. What Michele experienced doesn't fit with what she SEES. And the two approaches contradict each other. But I can't tell where the Eides are making up their own thing or who is changing or what. And it seems like every neuropsych place I call is different. I mean it honestly is like they're all making up whatever they wanting and feeling privileged cuz they have some stupid (expensive) letters after their name.

 

(Kinda get the sense I have decreasing respect for this profession??)

 

So what VALUE is there if I take my dd to the Eides (which I've honestly considered saving my pennies to do) if I get a diagnosis that is way off-stream from what ANYONE else is doing? And conversely what value is there if I take her to a local neuropsych and get told there's nothing to diagnose because she's remediated above the point of their ability to discriminate and test?? $2500 down the drain locally, even more if we went to Seattle.

 

Yes, I think too hard. You know, I think these are questions that the Eides themselves could best answer. Maybe they have in one of their books and I don't realize it? Maybe they would answer it if we posted on their forum or blog or emailed them or something? Maybe it's time for me to do something intelligent about my quandry. :)

[PeterPan]

I don't know for sure, but it looks to me that there's now the following:

 

Learning Disorders

315.00 Reading Disorder

315.1 Mathematics disorder

315.2 Disorder of written expression

315.9 Learning disorder NOS

 

Communication Disorders

315.31 Expressive language disorder

315.32 Mixed receptive-expressive language disorder

315.39 Phonological disorder

307.9 Communication disorder NOS

 

Attention-deficit Disorders

314.01 Combined subtype

314.01 Predominantly hyperactive-impulsive subtype

314.00 Predominantly inattentive subtype

314.9 Attention-Deficit Hyperactivity Disorder NOS

 

(taken from Wikipedia. Not sure what the missing items are on the actual DSM).

 

Hmm, this is interesting. I love how some of y'all know this stuff. So you're pointing out that *everything* gets a "disorder" label? I hate that term. But it looks to me like they've taken "dyslexia" (which of course was a huge term that communicated little specifics) and they're breaking it down into the subcomponents. So then did your dh come out with like 13 labels, one for each aspect of his issues? I don't know if that makes sense, but you kwim? I could live with that. So is the term dyslexia GONE from that diagnostic thing you were looking at? So is it that they are now going to diagnose all the component symptoms and entirely DROP dyslexia as a label??

 

Just trying to get in the flow here. See the next question to me is wondering what the Eides put on their diagnostic forms. It's not like they can go making up codes. They're going to be putting the same codes as every other doc using these guides, right? So maybe they're using dyslexia in their book but putting all these subcomponent labels as the diagnostic codes??

[rafiki]

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[PeterPan]

So what did Yllek's neuropsych run that showed the problems in her dh that Michele's neuropsych didn't? Or is this actually all subjective? See it seems like where this is going is that there are more tests that ylleks np did that *could* have shown the ld in michele's kids if michele's np had done those tests. Or am I reading this wrong?

[PeterPan]

Ok Yllek, what can you make of this? It's from the Eides website and tells what they look at and how they diagnose with codes.

 

http://neurolearning.com/clinic.htm

Referring physicians may use a wide variety of appropriate diagnosis codes, including, but not limited to: learning disability (315.2), encephalopathy (348.30), attention deficit disorder (314.00), academic underachievement (313.83), developmental delay (315.90), or spells (780.39).

 

Neurology Consultation includes a survey of all major nervous system functions including vision, hearing, gross language, fine & gross motor coordination, strength, sensation, and general outline of medical and developmental history, and review of symptoms. Based on the Neurology Consultation, referrals to appropriate therapists and other professionals are made.

The Neuropsychological Assessment includes examination for major cognitive areas, including hemispheric dominance, pencil control, fine motor control & speed, phonology, speed of word retrieval, and language skills (receptive, expressive, figurative, semantic, syntactical). Selection of tests may vary, but usually ability-achievement discrepancies are determined by IQ testing (WISC-IV, WAIS-IV), achievement tests (WIAT-III) and with selected subtests from the Woodcock Johnson Cognitive Abilities Test III, Nelson-Denny Reading testing, PEEX2, PEERAMID, etc. as appropriate. Our reports will also include practical advice regarding learning differences or preferences, and specific curricular or resources recommendations. We will review school reports, written and creative work of students, and results of previous IQ or cognitive assessments. At times, families have invited children's teachers or tutors to the follow-up visit, and this can be very helpful for coordinating the student's plan.

 

It also says the Eides are MDs, and that they're doing a neuropsych eval. That's just interesting, because I've wondered if maybe some of the people doing these neuropsych evals are actually phds, not mds...

 

So it *looks* like they're using the same diagnostic codes you found, even though they're using the term dyslexia in their books (a term not found in the codes anymore??). Do the tests they list address the auditory issues you were talking about? And do they reflect what your dh's np tested to identify his issues? Ok, I reread your post and think I'm getting what you're saying about the auditory. You're saying the np screens and you'd need a more thorough eval elsewhere if they saw any signs. That makes sense.

 

See now all I need is a version of the Eides on the east coast...

Edited October 9, 2011 by OhElizabeth

[rafiki]

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[PeterPan]

Hehehe, when you go to bed early, you can get up early and post more! :)

 

So I'll flip this on you. What if your ds *is* dyslexic, remediated enough that it's not showing up well on the tests?

 

Therapy is a funny thing. Sometimes they're making new pathways in the brain that DO affect future acquisition and development. However sometimes what they're doing is bringing the child up to the point he can be at that age. For instance my ds has a motor planning problem in his brain. We can work hard and make him sound very good, look normal, get him almost age-appropriate. But the fact is, if we stop now, his progress STOPS. He doesn't have the brain structures to keep going forward on his own.

 

And what I'm seeing is that it's this long slog. My dd always spelled above grade level till this past year. Oh yeah, we worked a LOT on it, sometimes doing 2-3 programs at a time, but who's counting? LOL When we stopped, she stopped. Oh she would say she's progressing and learns from reading, but the reality is her scores don't show it. And there's so much more to learn at this age. It almost feels exponential.

 

I hate when people play the age card, so I'm not wanting to do that. And I *do* believe you can do therapy that fundamentally impacts the way their brain processing information and allows them to build and go forward. VT is a great example of that, but even then I've suspected for a while now that kids who do it very young would need to re-do it to learn how to do the higher cognitive level stuff. But I also think sometimes we're fighting a losing battle. The minute you stop, they are gonna go from 60 to 10. That's why some articles call it "stealth" dyslexia, because some of these kids *can* mask it when they're younger. It comes out stronger later, when you realize you don't WANT to spend so much time working on stuff that is hard, hard, hard, when you want your day to be a bit positive, when you realize your dc may not be best served psychologically by 18 years of therapy and therapeutic teaching in your home.

 

Mercy, that was too rough. Your dh ran into that though, that idea that just because you *could* try to remediate some of the weaknesses (his IM experience) doesn't mean you don't have consequences. And at this age, in junior high and looking at high school, we're asking serious questions about where to give, where to keep working, where to wait. So when the NP isolates each facet and gives you a snapshot of where she is functionally, that's not as helpful as someone grasping where she's been and where she's GOING. I don't need a present snapshot; I already know that. I need someone who can offer guidance for the *future*.

 

So if you do therapy now and achieve the goals of a 7 (or 8 or 9 yo, build a little cushion), that *doesn't* mean he's going to continue to build skill on his own and hit adult-level skills later. It might mean you have to go back again and again and keep working on it. Maybe in some areas he would and in some he wouldn't?

 

Well at least the NP diagnosis thing is making more sense to me. Somehow I thought they were gonna rub her head and magically infer the structure of her brain to read her future. All they're doing is taking a statistical snapshot of the present for purposes of legal coding. I need a head-rubber, someone who can give me more. I mean is your dh's reality changed by having those codes? No. He already knows who he is and what he is. It gets him accommodations if needed. But if they aren't needed, did it allow him to make better decisions or come to grips with himself? Probably not, lol.

 

For the record, I do still want a NP eval for her. But I want a head-rubber, not just a snapshot. And I understand they could show up more. But my guess is, based on everything I've read, they aren't going to show up that much more than what I already suspect. That's why I want a head-rubber. :)

 

I spent a while last night reading on a forum for med students, and when I searched it for dyslexia it turned out this issue of dyslexic doctors (and wanna bes) is pretty common. It was pretty interesting to see the same things we wrangle with on this board (are accommodations legit and fair, at what point do you decide you're just plain on the wrong path, etc. etc.). And it was interesting to see the FRUSTRATION of the posters who wanted to pursue a path and were finding it closed to them due to their dyslexia and ability to get over the hump. One had been told to pursue dentistry instead. He said he'd rather be a poor (hopefully he meant $$?) doctor than a rich dentist. Whew.

 

So it's not like these questions get any easier. They actually get harder, because you're determining the course of someone's life, how they feel about themselves, what doors are open to them.

Edited October 9, 2011 by OhElizabeth

[rafiki]

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[PeterPan]

Hey Michele, did you notice Yllek's dh has both the ADD label *and* the dyslexia label? I thought that would interest you, since that's what you were asking. I'm not sure why the EF thing was never on your radar. It wasn't on mine till the OT screened and pointed it out.

 

While I find the Eides explanation of working memory getting sucked up by the struggling processing of the dyslexic brain, I ALSO think you can have the SPD eating up working memory and just plain ADD/ADHD eating up working memory. It's not like you can't have one, two, or all three. Just because they overlap doesn't mean they explain it away. It's not like the working memory issues of a dyslexic are *only* from the dyslexia. It would depend on the dc. And conversely you could be dyslexic but NOT ADD/ADHD.

[Osmosis Mom]

Ahasrada, I have no clue what you should do, but wish you the best. I would sort of lean towards doing the SLP at the hospital and take things from there, bypassing the psychologist. I am sure you could get specific curriculum recommendations here plus it would save you some energy.

 

Wish I knew more what to suggest, though.

 

On a side-note, most of this thread has been imcomprehensive to me and I am in awe of what homeschooling moms do for their kids.

[PeterPan]

Michele, if you really want to rattle your chain, look up chapter 8 in DA, pg. 69. They give a story of a dc originally diagnosed ADHD and aspie by another doc that they later concluded was dyslexic as well. I'm trying to reread this section. I wonder if they're being much more specific than we realize. They list all these categories of what they found (writing fluency, spelling, syntax, rote and working memory, focused attention for auditory-verbal material, processing speed, sequencing, organizing), ie. all the things you guys have been talking about with coding and specific aspects. Then they went on to say "but we also found many of the wonderful strengths that individuals with dyslexia often show."

 

So at one age he didn't get certain codes, at another age he did, and they looked at the bigger picture and said that he had what they view as dyslexia processing going on the whole time.

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[rafiki]

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[PeterPan]

Well that's the irony, that it seems like the NP is only looking at things you can see and test. I wanted more--I wanted them to read minds. ;)

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[PeterPan]

Ok, here's something nifty. http://www.ua-kid.com/2011_09_01_archive.html Scan through this and you find the Yllek mentioned with Response to Intervention. There's also a discussion of "dyslexia" as the recognized term for the ps and govt. Kinda interesting.

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[AHASRADA]

Asmaa, are you still following this thread? I'm sorry that we've taken it in such a different direction.

 

As I said, a neurodevelopmentalist and a neuropsych aren't the same things, and the neurodevelopmentalist approach is pretty controversial. I've just seen you use the terms interchangeably and wanted to be sure that you knew what you were getting into. :001_smile:

 

Thanks so much for helping me out. I have really appreciated your feedback. Yes, I do believe this NP is an NP working from a neurodevelopmentalist approach.

 

Here are her credentials:

 

Neuropsychophysiologist, Psychoeducational and Neurodevelopmental Consultant, Certified in Neurofeedback Training, Trained in the use of neurodevelopmental intervention, Trained in dyslexia testing and teaching, Certified with the Ontario Association of Consultants, Counsellors, Psychometrists and Psychotherapists (OACCPP), experience as a teacher, principal and school psychologist.

 

In any case, I think I have decided to just stick with the SLP for the time being. If $$ and time were no options, I would probably want to exhaust all avenues and do both testing. However, I only have 2 1/2 more years to prepare her for high school-level work, we have a long way to go, and I can't afford to spend time and money on unconventional therapies that may or may not get us anywhere.

 

Any opinions on this decision would be appreciated!

[PeterPan]

I think the issue with the neurodevelopmentalist thing is that it's a self-described title, not something through a regular medical board with standards, etc. At least that's how it is in the US. And in the US a neurodevelopmentalist doesn't necessarily have any medical background or a degree in psychology. What that means is that *some* of their stuff is good and some is incomplete. I mean I had one telling me if I just had my dd crawl 5 minutes a day (at age 11 mind you) her eye problems would improve and she wouldn't need VT.

 

So if your practitioner you've found has a PhD in neuropsychology *and* has studied the theories of the neurodevelopmentalists, there's no issue there. They would be in a good position to take the best of both, kwim? But if someone is saying they're a neuropsychologist and DON'T have the degrees, don't have the qualifications *and* the way they got into the neurodevelopmental stuff was via apprenticing (which is what some do in the States), then I personally would have some questions. I don't think it's an issue of their advice being bad. It's the issue of it being incomplete.