DD's psychoeducational eval results are in

[Ravin]

We finally got the testing results, and they weren't especially helpful. While she tests low-average in several areas, overall she came out average in intelligence and learning, so no LD diagnosis. The psychologist thinks it's her mood and behavior issues getting in the way of learning, not the other way around.

 

DH's rather succinct summary was, "the parents are overreacting, they should put her in school."

 

One of the things we went in asking was, if we place her in school next year, should we hold her back a year from her current official grade level? The psychologist thinks if we did that, she'd be bored and not appropriately challenged.

 

My gut still tells me giving her an extra year isn't such a bad idea. She's got an October birthday, so at the age cut off for a grade lower. But, the school we're seriously looking at for her next year starts with 6th grade. It's a small school with an arts focus, 6th - 12th, with only 86 students in the middle school. The atmosphere is laid back without sacrificing academic rigor and expectations. Art is integrated into the main curriculum, along with electives. I think it will be a good fit for her.

 

For reasons to do with my education and work path, it's not looking like we'll be able to homeschool next year even if we want to.

[OneStepAtATime]

What are the qualifications of the evaluator? Did they assess any strengths?  Any real concrete specifics?  Why did you seek evaluation in the first place?  Sorry to ask so many questions.  

 

Our evaluation didn't catch everything that I now suspect may be happening, but at least the second evaluation really did give us some concrete answers,  Our first one was useless.  

 

With our second one we found out that my son does phenomenally better when presented with something in color and an auditory component.  My daughter did not have this need.  My daughter has an incredible grasp of 3D spatial relations so if she constructs something she remembers the information far better than just filling out a worksheet.  My son does not have this strength.  I could go on.  Did you get any answers like this that might help determine how they learn best?

 

With our first evaluation neither child was diagnosed as dyslexic.  They both are.  Neither child was determined to be dysgraphic.  My son is.  Neither child had an auditory processing issue.  They both have certain glitches, although different ones.  If we hadn't finally gotten a second opinion we would still be spinning our wheels and heading in the wrong direction.  NOt saying that is what happened in your situation, but are you certain the evaluator was qualified to really dig out all the nuances of what might be happening?  How much experience do they have with the specific issues you have been seeing?

 

Sorry you didn't get better answers.  The school you are looking at sounds like it might be a good option, since homeschooling may be off the table.  Have you talked to them?

[kbutton]

Is there a big spread in points (not percentiles) on the various subtests (assuming WISC or something like that was used)? A spread of 20 points or so between subtest scores is considered something worth teasing out.

[Tiramisu]

The school you describe sounds nice. :)

 

Generally, at least where we live and in typical schools, school is much more demanding than it used to be. The kids are under so much stress. It may be different in other parts of the country, but if things are the same as where we are, I don't think it's a bad idea at all to give her an extra year. 

 

I have my own dd in college and other young family members in college, and everyone agrees, even colleges ask a lot more of students than they did when we were younger. Thinking of the future, another year of maturity could never hurt.

[Ravin]

On the WISC-IV, her subtest scores ranged from 9's to 12's, so within a standard deviation of each other and of the mean.

 

On the WJ-3, her weakest scores were in reading fluency (86), math fluency (80), calculation, (89), and spelling (89). Her strongest areas were story recall-delayed (120), and story recall (119).

 

Her weakest area on the supplemental scales was handwriting, at 68.

 

None of the strengths and weaknesses were surprising, but the psychologist didn't see any alarm bells, which was. Several areas of borderline low-average scores, all clustered around her ability to put pencil to paper for output, are the common weak point.

 

I do plan on taking it to our GP to find out if we can get an OT evaluation referral.

 

The evaluator has her PhD, and was in the process of completing clinicals for licensure, at the university clinic here which has a very good reputation. She was supervised as well, of course.

 

She downplayed our reporting on the parent report form of problems, relying more on our interview, interviews with teachers at her enrichment program and her psychologist, and her observations.

 

She made suggestions like making our homeschool day look more like a typical classroom school day to help her manage her emotions and behavior. Others reflected similar things to what we already do under guidance of her counselor.

 

Most of the academic area recommendations fall into the "no sh%? Sherlock" category, or things I've avoided because she falls apart when we do them--like timed math drills.

 

It just feels like something is being missed here, and the more I ponder it, the less I think the psych knew at all how to take DD's educational setting (one on one, intensive, tailored instruction) into account. Knowing she's where she's at with that, I still doubt she'll perform on the same range in a traditional classroom setting. It's incredibly frustrating.

[kbutton]

I think the WISC 9's to 12's on each section are combined into categories. For instance, coding may be a 10, but it's combined with cancellation and something else to give a subtest score, which is 100 or 120 or whatever. I am pretty sure it's those numbers that are used to see whether there is a 20 or more point discrepancy.

 

Sorry the recommendations are not at all helpful.

[Tiramisu]

I think the WISC 9's to 12's on each section are combined into categories. For instance, coding may be a 10, but it's combined with cancellation and something else to give a subtest score, which is 100 or 120 or whatever. I am pretty sure it's those numbers that are used to see whether there is a 20 or more point discrepancy.

 

Sorry the recommendations are not at all helpful.

 

kbutton, I think what you're referring to is when the subtests are grouped into a verbal, perceptual, working memory, and processing speeds, so that you see a gap of twenty points or more between the verbal and the perceptional, it's something to pay attention to. Or, if you see a gap with the verbal and perceptual being much higher than the working memory and processing speeds. 

[Ravin]

Her index composite scores are all fairly close together

Verbal Comprehension 100

Perceptual Reasoning 100

Working Memory  107

Processing Speed 103.

[OneStepAtATime]

i just have no faith in evaluations or recommendations from people who say "Do it more like a classroom setting."  Really?  What exactly do they mean by that?  Sitting upright at a desk for hours on end?  Is there something else they were referring to as beneficial?  My kids had some great teachers when they were still in a b&m but there was almost NO time in class for ANY one on one instruction and if you didn't understand what was happening, too bad, they had to move on.  Half the class period was wasted on discipline issues, or administrative issues or passing out papers, or changing classes, etc.  If you needed to spend more time on something, you couldn't. Class was over and you had to go to the next thing.  If you finished what you needed to do and would like to get going on the next subject, or delve deeper into the current subject, it wasn't an option.  Not at all.  Can't do that either.  Sit there while the others finish up and waste time waiting until you can go to the next class.  The actual time they were learning was minimal.   What, specifically, do they mean by that recommendation?  Did they give any specifics?  I am genuinely curious.  

 

To be honest, it sounds like the people telling you this have been brainwashed to believe that only classroom structure has validity and I know that isn't true.  It can work great for some, but not for all, and is actually pretty inefficient.  I have taught in a classroom setting.  Nearly half my family, including my mother and grandmother, were or are teachers.  A classroom setting treats kids more like they are in an assembly line factory than as individuals.  This does not mean that I don't think we need a public school system and the option for private schools.  I think we do.  I am grateful we have one.  I just wish the educational system would move away from the factory mentality....

 

My first evaluator and of course the school tutor and the school administration and even our pediatrician had that attitude of the classroom setting being the very best for our kids, and if we were to homeschool (a really frowned upon endeavor) we would need to structure our day as they have it at school for the kids to maintain a high level of learning.  That ended up not being the best option at ALL.  Thankfully, the second evaluator had recommendations for what to do if they remained in a standard classroom, but was very positive on the possibility of homeschooling, with one on one instruction, if we wanted to pursue that course, and had some really good suggestions for how to make that work within our specific situation.

 

Anyway, I'm getting off my soap box now.  Sorry.  I know that isn't really helping you.  I wish I had something more productive to say....

[Ravin]

Mostly she said to structure it time-wise. Such as, not spend longer on a subject at a time than a classroom would, and no more than 20 minutes on a task. But I already tailor lessons to make it easier for DD to focus. I can tell when she isn't focused and shift gears or give her a break.

 

She didn't do a full ADHD work because we didn't go in specifically looking for that.

 

I was hoping for concrete help, some problem that, knowing what it was, we could deal with. That's not what we got. That every inch of "low average" achievement is gotten with hard work and tears and frustration seems to not be acknowledged. The notion that her mood issues are making it difficult for her to learn doesn't explain why it's only in certain areas she struggles and has such anxiety. Her behavior problems are centered around the learning process. She doesn't butt heads with me over everything. Overall she's eager to please and helpful and considerate and patient. It just doesn't add up.

[VinNY]

I think an OT eval would be helpful. Sounds like some VMI issues. Does she exhibit praxis issues?

[Tokyomarie]

Can you remind us of these things? Functionally, what are the tasks your daughter has the most difficulty with? What tasks are areas of strength?

 

What was her lowest subtest on the WISC-IV? What was her highest subtest?

[Ravin]

I think an OT eval would be helpful. Sounds like some VMI issues. Does she exhibit praxis issues?

 

I don't know what praxis issues are.

 

Can you remind us of these things? Functionally, what are the tasks your daughter has the most difficulty with? What tasks are areas of strength?

 

What was her lowest subtest on the WISC-IV? What was her highest subtest?

 

Her lowest subtests on WISC-IV were 9's in "Similarities," "Coding," and "Matrix reasoning." The highest were in Digit Span and Symbol Search, which were both 12's.

 

Functionally, she has the most trouble with math calculations and fluency. Applied problem solving she can do, but writing it down in "math" terms, completely and clearly, is difficult for her, as are multi-step math processes such as long division. She has a dreadful time with place value--not as a concept, but in applying it by lining up numbers correctly. Outside of math, her handwriting is pretty bad generally. It's legible, but she has difficulty with spacing, consistent size of letters, etc. Her spelling is poor and while she has good editing skills looking at something on a worksheet, she doesn't see her own mistakes and remember to correct them.

 

I've had to break down and separate and teach her various parts of the writing process separately, and she still hasn't built up to consistently integrating them,. She is very verbal, and can narrate well, and answer questions about what she has read or had read to her, but in translating what she has to say into writing on paper it turns into a mess. If she doesn't verbalize and plan what she's going to write ahead, it's worse. She doesn't write "automatically" at all.

 

She reads slowly and not fluently. She can decode individual words well (thanks to phonics instruction), but tends to skip words or parts of words. She can get the overall meaning of something, but misses detail often.

 

I guess the thing I really worry about is that when we go ahead and send her to school, her barely treading water academically will turn into drowning. And that that together with the social pressures of the school environment will be disastrous. 

[Tiramisu]

I think an OT eval would be helpful. Sounds like some VMI issues. Does she exhibit praxis issues?

 

I think you are on to something.

 

Can you remind us of these things? Functionally, what are the tasks your daughter has the most difficulty with? What tasks are areas of strength?

 

What was her lowest subtest on the WISC-IV? What was her highest subtest?

 

I'm grabbing Ravin's quote below about her low scores to show that VinNY might be right.

 

On the WJ-3, her weakest scores were in reading fluency (86), math fluency (80), calculation, (89), and spelling (89). Her strongest areas were story recall-delayed (120), and story recall (119).

 

Her weakest area on the supplemental scales was handwriting, at 68.

 

None of the strengths and weaknesses were surprising, but the psychologist didn't see any alarm bells, (Perhaps she should have!) which was. Several areas of borderline low-average scores, all clustered around her ability to put pencil to paper for output, are the common weak point.  (Yup!)

I do plan on taking it to our GP to find out if we can get an OT evaluation referral. (Good idea!)

 

 

It may be worthwhile to get more testing of the visual-motor and fine motor issues. 

[Tiramisu]

I don't know what praxis issues are.

 

 

Her lowest subtests on WISC-IV were 9's in "Similarities," "Coding," and "Matrix reasoning." The highest were in Digit Span and Symbol Search, which were both 12's.

 

Functionally, she has the most trouble with math calculations and fluency. Applied problem solving she can do, but writing it down in "math" terms, completely and clearly, is difficult for her, as are multi-step math processes such as long division. She has a dreadful time with place value--not as a concept, but in applying it by lining up numbers correctly. Outside of math, her handwriting is pretty bad generally. It's legible, but she has difficulty with spacing, consistent size of letters, etc. Her spelling is poor and while she has good editing skills looking at something on a worksheet, she doesn't see her own mistakes and remember to correct them.

 

I've had to break down and separate and teach her various parts of the writing process separately, and she still hasn't built up to consistently integrating them,. She is very verbal, and can narrate well, and answer questions about what she has read or had read to her, but in translating what she has to say into writing on paper it turns into a mess. If she doesn't verbalize and plan what she's going to write ahead, it's worse. She doesn't write "automatically" at all.

 

She reads slowly and not fluently. She can decode individual words well (thanks to phonics instruction), but tends to skip words or parts of words. She can get the overall meaning of something, but misses detail often.

 

I guess the thing I really worry about is that when we go ahead and send her to school, her barely treading water academically will turn into drowning. And that that together with the social pressures of the school environment will be disastrous. 

 

Praxis has to do with motor control. Google dyspraxia. Dysgraphia is one manifestation of dyspraxia.

 

The two weak scores are either visual or visual-motor dependent; you see the same problem in real life. You may see higher scores in subtests that measure similar things, but I think you should still pay attention to it. My dd had that issue.

 

See the bolded part above. This type of reading issue may also be a visual problem that could possibly be tied into the praxis question, i.e. motor control of eye movement. In addition to the OT eval, you may want to get an evaluation from a covd optometrist. There is effective therapy that can help with things like this.

 

I don't think the psychologist is right. I think you're right. It doesn't mean mood issues aren't playing into it. The mood issues could even be exacerbated by something else and vice versa.

 

ETA: If you read about dyspraxia, you will find that the effects are far-reaching in terms of academics and stretch into emotions. It's good that you're looking into this now before school next year. Things will get harder, so it's wise to be prepared so you can employ strategies to keep her learning experiences positive.

[Ottakee]

If you do decide to send her to school I would put her back a grade. If she started K at 4, turning 5 in Oct. she would be VERY yyoung for her grade here. In fact, most kids with birthdays after May/June wait to start K until they are 6 and go to Young 5s first. If she is already struggling then the extra year might really help her academic and emotionally wise.

[Tokyomarie]

I agree with the others that an OT and a developmental vision eval with a COVD optometrist is warranted. With a handwriting score down at 68 and functional difficulty with tasks that are handwriting dependent, I'd want to find out what I could about what is holding back handwriting development. In looking for an OT, I'd want to know the OT's experience with testing various components of physical function that contribute to handwriting ability- including but not limited to coordination and strength in the hands, postural tone and core muscle strength, etc. Also, I'd want my OT to be familiar with how visual function can contribute to handwriting difficulties. I wouldn't want an eval that only looked at handwriting itself. Sometime an OT will do a cursory look at handwriting, then just start right out teaching Handwriting Without Tears (the most common program for handwriting taught by OT's). The OT should also be familiar with tools that are helpful, such as different styles of paper and writing implements.

 

Have you experimented with speech-to-text software yet? With good oral story recall and narration skills, I'm wondering if she would be able to translate that oral narration to computer via Dragon and get a product that's closer to what she can conceive of cognitively.

[OneStepAtATime]

I agree, too.  Your mommy instincts seem a LOT more intelligent and accurate and observant than the psychologist's.  Have you read the Mislabeled Child by Brock and Fernette Eide?  You might look through it to gain some perspective, along with the resources already recommended for specific possible issues.  Tons of kids are misdiagnosed on a regular basis.  There are lots and lots of professionals out there that don't seem to have any real background knowledge or experience with tweaking out all the various individual issues that can trip a child up, yet they charge a bundle for their limited experience and knowledge.  I wish there were some sort of systematic, thorough training they ALL had to go through that covered how to look at all these different possible issues so they could at least attempt to point parents in the right direction with some modicum of real expertise.

 

Our second evaluator DID take into account how much additional work I was having to put in just to help our daughter get decent grades.  Our first one did not.  Our second evaluator DID indicate that my personal observations as a parent held a lot of weight with her since I was so directly involved in her daily education, even though she was in a brick and mortar school.  She did not dismiss my concerns at all, but pursued them.

 

I hope with all my heart that you can do additional research and evals on your own in time to find the best path for your child, hopefully to help for the remainder of this year, but especially before start of school next year.  If homeschooling next year is really out, that may be a  difficult situation.  6th grade is a tough year.  She is supposed to start 6th grade next year, right?  If she is already struggling, and you were considering having her repeat a year, would that mess her up for going to that really small school if it starts with 6th?  

 

I really do think that repeating a year may be the better choice, after everything you have said.  It really helped my daughter.  She repeated 4k before we even knew specifically what was going on.  She was the youngest in her class and just didn't seem ready (we didn't know why so we attributed it to age).  We moved her to a different school and had her do 4k again.  She did much better the second time.  When we started homeschooling, and finally had a diagnosis that made sense, we started over with reading, spelling and now, just recently, math, taking things back to the most basic levels to fill in the gaps she was struggling with.  We started over with a completely different approach than what the school was using for reading, spelling, grammar, math, while allowing her to move forward in other areas of interest like science (with accommodations).  Not being at grade level yet in some core subjects (she should be in 8th if you go by age or 7th if you go by where she was when she left school) is irrelevant.  Her finally learning things in a way that makes sense to her and giving her a chance to thrive is what matters.  Grade levels are arbitrarily assigned numbers created to make it easier to function in a factory mentality.  They have very little to do with an individual's abilities and mental development.  Honestly, repeating 4k and then starting over in 6th was the best decision for our daughter, both times.   I have several friends that went that route, too.  None of them regrets the choice.

 

Wish there were a quick, easy answer.  Hugs and best wishes, to all of you.

[PeterPan]

I'm pretty much with the others, wondering how she looks if you put her back a grade.  My ds has an October b-day, so I sympathize.  Especially given that her IQ is plumb average, right in the middle, I would put her back.  

 

I agree with the suggestion to do the vision check, partly because I think it's good for anyone, but more so because it does seem like some of your complaints could be explained by that.  It's an easy thing for a developmental optometrist to screen for during a regular exam.  You go to COVD to find a developmental optometrist.  

 

Then I had one question that you don't have to answer if you don't want to, but is she on any meds that could be causing the symptoms?  

 

Sorry your psych experience was less than stellar.  It seems like they ran basic stuff and then just stopped.  

 

Oh, I'm with you on the school issues.  If you put her in still bumped up a grade and she's struggling with the basics, I don't see how that works out.  If you keep her at home another year, repeat the grade, keep working on that foundation, the arts school will be here a year from now, and she'll be stronger for the extra year to mature.

 

As far as the structure thing, you're understanding it correctly.  It's not about school bias.  It's just the idea of consistency, predictability, routines, STRUCTURE, things that keep people at an even, predictable keel.  She's totally right and our psych said it too.  Our psych ALSO said that keeping my dd in small group situations was ESSENTIAL and was the reason she was succeeding and doing so well.  Since your budding psych didn't have the courtesy to say that, I will: She's doing well BECAUSE you've kept her in small group situations.  School might work, but only to the degree it replicates the parts of homeschooling that have been working for her.  Proceed with caution.

[Ravin]

Thanks for the feedback everyone. It's reassuring to know I'm not the only one who's run into debatable diagnoses.

Not sure where we're going to come up with money for a developmental optometrist. Medicaid doesn't cover that, I'm pretty sure.

[PeterPan]

You never know.  Don't go in for the full developmental vision eval.  All you're wanting is a regular vision eval but to do it with a developmental optometrist.  If you do that (and get a good one) you can talk with them about the developmental stuff and have them screen.  So if medicaid covers vision and that doc, then you should be able to get it to work.  

[Ravin]

Medicaid only covers a regular vision screen by a regular optometrist. Which we did last spring.

[Lecka]

My son has had an OT eval and services at public school. We have been able to have a private OT eval and services, and I am not dissatisfied with the public school. The private means he gets more time, which he needs, and some things school is not doing.

 

But school will work on handwriting, since it is so educational.

 

I don't think that is the whole answer, but maybe something.

 

If you are looking for info about scribing for her or doing software -- the dyslexia books are a good source of information.

 

The Mislabeled Child also has a section with handwriting.

 

I think on the bright side -- maybe some things are ruled out.

 

But it sounds disappointing otherwise. It doesn't sound like the person really considers reading and handwriting.

[PeterPan]

Medicaid only covers a regular vision screen by a regular optometrist. Which we did last spring.

Makes sense.  What I'm saying is the dev. optometrist is a regular optom with extra training.  Ours is one of many in a whole office.  It should read just like a regular doc for insurance purposes.  And the screening I'm talking about would be part of a regular exam, regular appt, nothing extra that would change the coding or insurance.  So if they cover a regular annual eye exam, just try to get that done with the better doc.  You could at least call.  They'll know whether they usually get med. to cover it or not.