Evaluations by OTs and SLPs

[laundrycrisis]

I have a question about how much and what kind of evaluations can be done by an OT and an SLP, and would this cost less than having a psychologist do testing. We do not have coverage for neuropsych testing - none. My concerns are in the area of working memory and executive function, and perhaps language processing.

 

This child has already been through two years of VT and a good chunk of that was for visual processing issues, and all things visual are pretty much taken care of. He has begun seeing an OT for fine motor/coordination/muscle tone issues. I've had these other concerns for a while, but not had them addressed (because we were very busy with learning to read and write). I asked at the therapy facility who would do an evaluation for these other areas. The OT is suggesting that I should have a full language evaluation done by the SLP, because if there is a language processing issue that would affect everything else. I guess I really don't know much about what SLPs do - I thought they just worked on speech, and he does not have any speech issues. But I guess can they also look into receptive verbal problems and memory issues ? I am curious about how this compares to having testing done by a psychologist and if it will be a lot more affordable. I would love to have full psycho/educational testing done for him but with no coverage for it that is a lot to think about. What we have been doing instead is tackling one area of concern at a time, starting with what seems most critical.

Edited April 10, 2012 by Laundrycrisis2

[Gisele Marie]

Our daughter has had OT evaluations and the following areas were tested:

What can I expect during the evaluation? (Copied from another site)

 

• Sensory processing skills

– The way the body takes in and processes information, which includes the five sensory systems:

 Visual—how your child processes what he sees

 Auditory—-how your child processes what he hears

 Tactile—how your child processes what he touches

 Vestibular—how your child processes himself in motion

 Proprioceptive—how your child processes his actual movement

– Motor planning—the way your child can plan and make movements

– Self regulation—the way your child calms himself

 

• Visual-motor and visual-perceptual skills – Handwriting

– Cutting with scissors

• Upper extremity use – Strength

– Range of motion

– Using both hands together (bilateral skills)

Gross motor control

– Motor control—how well your child moves

– Coordination

– Strength

Activities of daily living

– Dressing

– Grooming

– Feeding—feeding self and the ability to eat a variety of foods

 

I know this doesn't answer all your questions but hope it helps!

 

Gisele

[PeterPan]

If that's all you need, you could go through the ps. No, the OT and SLP wouldn't replace a psych eval. Our OT did the behavioral screening for EF, but that's really subjective. If you want actual numbers for processing speed, working memory, etc., the ps should be able to do it for you.

[peacefully]

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[laundrycrisis]

If that's all you need, you could go through the ps. No, the OT and SLP wouldn't replace a psych eval. Our OT did the behavioral screening for EF, but that's really subjective. If you want actual numbers for processing speed, working memory, etc., the ps should be able to do it for you.

 

I don't want the actual numbers - just to know if there is a problem we should consider therapy for. We do not have any coverage at all for any of this therapy so having the numbers wouldn't have any financial benefit, which is part of why I don't want to spend thousands just to get those numbers. I also do not want to go to our school district for anything. I would probably not accept any of their services because I have not heard good things at all about how they are offered, and I think it is unlikely they would offer much (or anything at all) anyway. And in this state, as a homeschooler, being off their radar is the way to go. We have a huge amount of freedom and privacy here, as long as we don't get involved with the public schools or get anyone too curious about our homeschool. Some homeschoolers here have had a hard time extracting themselves from the public schools' "help" once they decided it was not worth having. If they would just do what I want without any "hidden cost", I would absolutely take advantage of it, but that's just not the case here.

[laundrycrisis]

This thread caught my eye, but I can't write now. I'm posting this so I can sub and come back to this. Just quickly, our SLP helped my ds with working memory, executive function issues, and language processing. Our therapy took just over a year, and the difference in the way that ds functions is dramatic. HUGE.

 

I completely had no idea that a SLP could do this. I knew they could help with language and conversation issues - but I had no idea they could get into working memory and executive function problems.

[peacefully]

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[Lecka]

My son had a language evaluation when he started private speech.

 

It was to see if there were any underlying issues affecting his speech.

 

He turned out not to have underlying issues.

 

He had a hearing test, they looked inside his mouth, they tested articulation, vocabulary, listening comprehension, and oral expression.

 

They only tested things that might be underlying causes of the known problem. If one of those tests had come back low, that would have led to more tests.

 

He went to a university clinic and the SLP students give the tests and write up the assessments as part of their course work. So -- you just get it done if you have services there.

 

My son had some evaluation for OT at school, also, just for handwriting. In this case -- the evaluation was ONLY to see if scores were low enough to qualify him for services. She got a little information from them, but mostly she will just work with him and figure out from working with him what he needs. He got 50th percentile on some tests that would have given her some direction in working with him, if the scores had been lower.

 

I think about a full evaluation for my son. With the testing he has had -- I don't think it is anything like we would get from a neuropsychologist.

[PeterPan]

I don't want the actual numbers - just to know if there is a problem we should consider therapy for. We do not have any coverage at all for any of this therapy so having the numbers wouldn't have any financial benefit, which is part of why I don't want to spend thousands just to get those numbers. I also do not want to go to our school district for anything. I would probably not accept any of their services because I have not heard good things at all about how they are offered, and I think it is unlikely they would offer much (or anything at all) anyway. And in this state, as a homeschooler, being off their radar is the way to go. We have a huge amount of freedom and privacy here, as long as we don't get involved with the public schools or get anyone too curious about our homeschool. Some homeschoolers here have had a hard time extracting themselves from the public schools' "help" once they decided it was not worth having. If they would just do what I want without any "hidden cost", I would absolutely take advantage of it, but that's just not the case here.

 

You don't need expensive therapies if it's EF and working memory (without the expressive language stuff Yllek is talking about). If it's only processing speed, EF, and working memory, then with the scores from the psych testing you'll come to the boards and figure out what to do. We've had threads on working memory, EF stuff, etc. It's all stuff you do at home.

 

You might not need the numbers now, but I can tell you after years of teaching my dd, I was GRATEFUL, like bow down and kiss the man's FEET grateful, to get the numbers. They'll totally change how you teach your child. Just sayin'. I hear you on not wanting to go through the ps. I have no help there, sorry. I'm just telling you that at some point that actual psych eval will be helpful to you. If the ps isn't your path, then start saving your pennies now, shop around, and try to save to do it in say 2 years. That would be my advice.

[merry gardens]

Speech and language pathologists (slp) are trained in both speech and language processing. Just as in any other profession, their abilities vary. A good slp can tell you more about language processing than a bad neuro-psych, but a good neuro-psych would tell you more than a bad slp. If your ot can give you the name of an slp with strong experience and a high success rate, I'd start with that before a neuro-psych evaluation. (If you had the name of a great neuro-psych instead of a great slp, I'd probably tell you to start there.) An slp will be less expensive than a neuro-psych exam and it may tell you exactly what you are wanting to know.

 

 

(Both Kelly and Elizabeth seem to have found professionals who were extraordinarily talented. If they lived near you, take your child to both Kelly's slp and Elizabeth's neuro-psych. :D That's what I'd do if they lived near me. )

[laundrycrisis]

Thank you all ! Okay, I found some of the working memory threads. I will likely order the Achieve Publications workbook because it is really affordable. They did so much work with him for visual memory in VT and it helped a lot with written work. If I can work on the auditory memory issues at home and get him going in that direction, why not ? He may actually have a language processing problem - this may explain why we have to tell him things eight times, and it may be part of his dysgraphia too. The more I read about it, the more I am thinking this may be there. He also just gets lost in the middle of a task and forgets what he is doing and why. I'm not sure what problem causes that. I am going to ask the psychology practice how much their LD testing costs so I will have a number to work with, and if all that was done, would a separate language evaluation by an SLP still be recommended.

[PeterPan]

Thank you all ! Okay, I found some of the working memory threads. I will likely order the Achieve Publications workbook because it is really affordable. They did so much work with him for visual memory in VT and it helped a lot with written work. If I can work on the auditory memory issues at home and get him going in that direction, why not ? He may actually have a language processing problem - this may explain why we have to tell him things eight times, and it may be part of his dysgraphia too. The more I read about it, the more I am thinking this may be there. He also just gets lost in the middle of a task and forgets what he is doing and why. I'm not sure what problem causes that. I am going to ask the psychology practice how much their LD testing costs so I will have a number to work with, and if all that was done, would a separate language evaluation by an SLP still be recommended.

 

What you've described can be attention, as in ADHD. You need the psychologist for that. An OT can only screen for it, can't do the full, proper eval and give you the numbers on processing speed, working memory, and actual attention compared to his peers. It's the simplest answer. Doesn't mean it's definitely what's going on, but it's the simplest way to explain what you've described. For attention, I didn't know this going in, but they actually have tests where they put them in front of a task on the computer where only a simple response is required (click mouse if you see a dash, whatever). But they have to do this sustained task for quite a while. My dd thought it was interminable. :lol: Anyways, it means there are ways they can QUANTIFY attention to tell you if that's the issue or something else. That means you can talk with the places (ps, private, whatever), ask them specifically what tests they'll run (write them down fast, it will be an alphabet soup!) and whether they'll be doing tests for sustained attention.

 

I hope you're able to get the eval. It would be nice to have those answers.

[Crimson Wife]

You might want to give Earobics a try because that is relatively inexpensive (this site sells the Foundations & Connections as a bundle for $99) and is supposed to help with auditory processing.