Auditory memory, phonemic awareness.... (**Updated with New Results on 4/9/16**)

[ssavings]

It's been about a year since I first posted about DD#2 (my third child), who was having extreme trouble remembering her letters names/letter sounds.

To update: since August, she's been enrolled in a "natural structure" school, which is supposed to work very well with children who have learning issues. Now, she's nearly 6, and finally just now starting to recall letter names and letter sounds. She knows 5 sight words (hard earned!), but is still having trouble with basic things - she's not able to distinguish middle and ending sounds of CVC words, has a hard time with one-to-one correspondence when counting, etc.

We took her for an SLP evaluation (since it was covered by our insurance). While we're still awaiting the full report, two of the things they immediately focused on were poor auditory memory, and poor phonemic awareness. She suspects visual memory issues, and there might be other issues (she recommended a neuropsych eval and an OT eval). 

While we're awaiting insurance approval for the OT eval, and awaiting getting into the neuropsych (the only one within 200 miles covered by our insurance has a very long wait), I'm wanting to help her with her auditory memory and phonemic awareness.

I know we're not homeschooling anymore, but this board has been the most knowledgeable, understanding, compassionate source of information I have had for any learning issues, and I really didn't know where to start. 

Please, treat me like I know NOTHING about these issues because, honestly, I don't.

Where do I start? What do I do? I know LindaMoodBell is sometimes recommended, but we can't afford the 30K the center wanted.... 

Added 4/9/16:

I feel like I pop in here semi-annually with test results now. I lurk all the time, but I feel pretty lost mostly, so I don't have much to contribute. 

In the good news.. she's incredibly happy and well-adjusted. Her therapists/ESE teachers/etc. all adore working with her!  She is learning to roller-skate, and we're talking about day camp for a few weeks this summer close to home! 

More testing, completed in January. Done by the school. It seems complete enough, but I have no idea how to interpret/proceed. The school isn't interested in actually HELPING her, it seems (they gave her the IEP, but aren't actually doing it). 

Suggestions/ideas/thoughts?

WISC-IV

 

FSIQ: 83 (13th percentile) 

 

Verbal Comprehension: Standard Score 96 (39th percentile)

• Similarities: 9
• Vocabulary: 9
• Comprehension: 10 

 

Perceptual Reasoning: Standard Score 75 (5th percentile) 

• Block Design: 7
• Picture Concepts: 4
• Matrix Reasoning: 7

 

Working Memory: Standard Score 91 (27th percentile) 

• Digit Span: 7
• Letter-Number Sequencing: 10

 

Processing Speed: Standard Score 83 (13th percentile)

• Coding: 5
• Symbol Search: 9

 

Woodcock Johnson III Test of Cognitive Abilities 

 

Long-Term Retrieval: Standard Score 70 (2nd percentile)

• Visual-Auditory Learning: Standard Score 75 (4th percentile)
• Retrieval Fluency: Standard Score 78 (7th percentile)

 

Short-Term Memory: Standard Score 93 (32nd percentile)

• Numbers Reversed: Standard Score 86 (17th percentile)
• Memory for Words 105 (64th percentile)

 

Working Memory: Standard Score 88 (17th percentile)

• Numbers Reversed: Standard Score 86 (17th percentile)
• Auditory Working Memory: Standard Score 98 (45th percentile)

 

Young Children’s Achievement Test (YCAT)

Early Achievement Composite: Standard Score 78 (7th Percentile)

• General Information: Standard Score 89 (24th percentile)
• Reading: Standard Score 90 (9th percentile)
• Mathematics: Standard Score 85 (16th percentile)
• Writings: Standard Score 87 (19th percentile)
• Spoken Language: Standard Score 78 (7th percentile)

 

 

Clinical Evaluation of Language Fundamentals

• Core Language: Standard Score 81 (10th percentile)

 

Test of Auditory Reasoning and Processing Skills

• Standard Score 86 (17th percentile)

 

Goldman-Fristoe Test of Articulation

• Standard Score 59 (.1th percentile)

 

Edited April 10, 2016 by ssavings

[PeterPan]

Do the Barton pretest and follow the instructions from those results. If it indicated LIPS you can do it at home. It's dyslexia.

 

Ps I have pneumonia and am being brief

[OneStepAtATime]

Agree with OhE. while you are waiting on further info, you could do the free pre-screening on the Barton site.  Fairly quick and easy to administer.  It is not a content based assessment, by the way.  It assesses whether there are potential issues that might make an OG based system problematic for your child to start until those other issues are addressed.  It may give you some additional answers for free.  

 

OhE is right.  You very well may be facing what was once called dyslexia.   If the pre-screening indicates LiPS is needed before an Orton-Gillingham based program can be used (and I recommend you try an OG based program, not a sight word based program) then you could do LiPS at home for a great deal less money than going to their center (like thousands and thousands of dollars less).  Will you have extensive training?  No.  But the system does have supports for home tutors.  Not as good as the ones for Barton but if you take the time to really look through the material, ask questions when you hit areas you don't understand, and are patient with yourself and your child, I think you could absolutely do it successfully at home.  

 

And if your child passes the Barton screening with no issues then you would probably not even need LiPS.  You could move straight into a solid OG system like Barton or Wilson or something along those lines.

 

http://www.bartonreading.com/students_long.html#screen

 

Best wishes and good luck, whatever you decide.

[merry gardens]

Oh E--I'm sorry to learn about your pneumonia. :( Hope you get well soon.

 

As Oh E wrote, Barton Reading and Spelling has a student screen. The first level of Barton covers phonemic awareness exclusively and the program continues to develop those skills; however, some children don't have enough to even get started. That's where LiPS comes in. Lindamood-Bell centers are expensive and not always close by, so some have turned to doing LiPS at home--or finding a speech therapist who can administer it and/or teach those skills.  LiPS was developed by a speech therapist, Phyllis Lindamood, and some speech therapists incorporate similar things into speech therapy.  You don't yet have the slp evaluation, so perhaps you are one of the lucky ones whose speech therapist plans to cover this in speech therapy. I'd suggest you consider taking the Barton tutor screen and then administer the student screen, which could give you idea of where Barton would tell you to start.  Then, once you have the slp report with the therapist's recommendations, you can better evaluate what your options are on how to proceed with remediating the phonemic awareness challenges.

 

Also, in the mean time, you can try playing some auditory memory games with your daughter. A number of traditional children's games and songs help build auditory memory skills. Things like "Old MacDonald" require the children to repeat the animal names and sounds in the order work to build these skills. The game "Going on a Bear Hunt" fits in actions too, but it's primarily an auditory memory game too.  There are lots and lots of them.  Look into playing games with your child that involve saying words and remembering what's been said.   

[OneStepAtATime]

Also linking your previous post on the LC board to provide some continuity...

 

http://forums.welltrainedmind.com/topic/507281-xpost-ddalmost-5-struggling-with-her-letter-sounds/

 

I noticed you did not respond to OhE's question last year regarding whether the audiologist tested for auditory processing, not just straight "hearing" IYKWIM?  I realize the test was quite a while ago but I was curious if they had actually tested for auditory processing?

[ssavings]

No, I can't get an auditory processing screening done for another year at our local hospital. Our insurance will cover it, but the only place near us that does it won't screen until the child is 7. No idea why, but they are extremely firm on that policy.  

I did the Barton screen with her, since she had just woken up from a nap and was pretty refreshed. She failed the first two sections... miserably. Not a surprise, because the compound word section of the SLP testing was also way beyond her (the SLP didn't finish that test, because it was so confusing and frustrating for my girl).

I'm confused as to how to rate her performance on the third section. She did wonderfully on the "repeat these sounds, build them with squares". Missed one, but got it right on repeat. But then she'd forget the sounds when it came time to "touch and say". It's not like she was making sounds and guessing, she was just like, "I forget what the sounds were that I just build..". It's like the process of building then with the squares distracted her enough that she forgot them (her auditory memory is very, very poor). However, she WAS able to repeat the sounds, clearly, and distinguish between them enough to build them with squares (we actually built them with Blokus playing pieces, but...).  So, with that... needs LIPS? Doesn't need LIPS? 

[OneStepAtATime]

You might call Susan Barton, or email her, to ask what she would recommend.   She usually responds within a few hours to a couple of days and has been quite helpful to many on this board.

[PeterPan]

What the SLP did may very well have been an APD screening.  Half is phonemic awareness (I don't have it in front of me, just generalizing) and the other is I forget what, something that requires auditory reasoning.  Anyway, my ds, dyslexic, was very low on the phonemic awareness half and more typical on the other part.  It specifically said APD across the top and my *guess* is it's what your SLP ran.  

 

The reason I'm being so direct is because dyslexia identification has gotten a LOT more aggressive in the last few years.  They now have CTOPP normed to age 4.  Our neuropsych, highly regarded in our area, wanted us to be AGGRESSIVE on intervention.  Not just oh yeah, might be, but AGGRESSIVE.  At this point TIME IS WASTING.  

 

Personally what I'd do is get some practitioner, any psych, ANYONE who will run SOME kind of testing that includes a CTOPP and get it run before you do LIPS.  It's going to be your most clear diagnosis point.  That way you don't have any disputes.  What you're looking for now are all the benefits that come with your paper trail.  You want access to Learning Ally, Bookshare, etc. etc. The more interventions you do before the evals, the more you muddy that.

 

I'm not saying dawdle.  I'm saying be less picky and more concrete.  Find SOMEONE at some distance who will run that CTOPP and diagnose the dyslexia and give you a baseline.  Use that month or two while you're getting those evals done to start reading LIPS to learn how to implement it.  Then, when the evals are done, begin aggressive intervention.  

 

If you can, that's what I would do.  Beating around the bush or pretending it will change with age won't help.  Wait, continue on the natural path, and you'll be at the same place a year from now.  Or you can intervene aggressively and appropriately and have a reader.  The research shows whether they read late or early they STILL have to go through the stages of errors of new readers.  In other words, the sooner your dc actually begins reading the better.  Early intervention gives better results.  

 

I don't recall where you are.  I'd find a psych highly respected for dyslexia (since you're going to drive no matter what), someone who says on the phone that they will do the CTOPP and diagnose at this age. If they pussyfoot around, keep looking.  That psych will read the tea leaves on the APD anyway.  Most obvious sign is a discrepancy between verbal and performance IQs.  I actually took ds for a full hearing eval (just regular) at a university that does top notch APD evals.  They ran some of the extra stuff and confirmed he's probably ok but said they'd still do the full APD eval when he hits 7 if the psych wants it.  There's that back and forth.  It's not like a proper hearing eval would accomplish NOTHING.  They might even be able to largely eliminate it as a concern, as ours did.

[geodob]

Memory of the written letter, is stored in the Visual Cortex.

Memory of the letter sound, is stored in the Auditory Cortex.

 

As separate Cortexes, a fluent connection needs to be developed between.

So that when we see a Letter, it instantly connects to its sound.

 

From what you wrote, she knows the sounds of all letters.

Also knows what each letter looks like.

So that she can remember what they look and sound like.

 

But what she has a difficulty with, is the connection between them?

 

The main test for this, is the Rapid Naming Test.  

Which involves naming 'things' pointed at.

Where difficulties with this, carry over to letter naming.

 

But importantly, some research was published. That showed that practicing naming things pointed at in pictures.

Developed a stronger and quicker connection between the Auditory and Visual Cortex. 

Which carried over into a more instant connection between written letters and their sounds.

So that it can be developed through practice.

[merry gardens]

No, I can't get an auditory processing screening done for another year at our local hospital. Our insurance will cover it, but the only place near us that does it won't screen until the child is 7. No idea why, but they are extremely firm on that policy.  

 

I did the Barton screen with her, since she had just woken up from a nap and was pretty refreshed. She failed the first two sections... miserably. Not a surprise, because the compound word section of the SLP testing was also way beyond her (the SLP didn't finish that test, because it was so confusing and frustrating for my girl).

 

I'm confused as to how to rate her performance on the third section. She did wonderfully on the "repeat these sounds, build them with squares". Missed one, but got it right on repeat. But then she'd forget the sounds when it came time to "touch and say". It's not like she was making sounds and guessing, she was just like, "I forget what the sounds were that I just build..". It's like the process of building then with the squares distracted her enough that she forgot them (her auditory memory is very, very poor). However, she WAS able to repeat the sounds, clearly, and distinguish between them enough to build them with squares (we actually built them with Blokus playing pieces, but...).  So, with that... needs LIPS? Doesn't need LIPS? 

I think you need professional help in selecting the right programs for your daughter. Susan Barton is the one who directed my son to LiPS when he passed parts A and B but failed part C. While my son has memory struggles, it wasn't his memory per se that caused him to fail part C.  He was unable to distinguish between several similar sounds, (particularly vowels) and it took a great deal of time and effort before he could. I'm not sure what she'd suggest given how the OP's daughter did on the Barton Student Screen.  To my recollection, she recommends something besides LiPS if the child fails section A and B.

[OneStepAtATime]

I agree with merry gardens, your child may need something other than LiPS based on her pre-screening results but Susan Barton would be the best one to ask.  She is usually quite approachable.  Email her and share the results with her.  Hopefully she can make a recommendation.

[Lecka]

I am sorry I don't know how to link for some reason.... but on the Barton site, if you go to "students" and then to "Student Screening" and then to "Student did NOT pass" it looks to me like she recommends Lips.  It gives her e-mail and phone number also. But you really can call or e-mail her.  I e-mailed her wrt my son, and got back a response.  It is really something you can do!  You can also ask the speech therapist, and see what the speech therapist thinks.  Is it the same thing the speech therapist sees, or something different, how does it fit together -- this is something you can ask the speech therapist. 

 

My son's auditory memory was fine, as far as I know.  His auditory discrimination was poor and his phonemic awareness was VERY poor. 

 

My son was able to make improvement in auditory discrimination in speech therapy.  However -- he spent two years in speech therapy not making progress, he made progress when he went to private speech therapy.  I saw other kids improving in speech therapy (he was there primarily for articulation at the beginning) but my son didn't.  So -- whatever speech therapy you have, you DO want to see improvement.  If after a couple of months you do not see improvement, then you need to ask about it and maybe look for something that will be more effective.  But at the same time -- hopefully the speech therapist you are already with will be very effective!  Probably she will be -- I am just saying, don't wait around for 2 years (like I did) when there is not progress. 

 

What helped my son with phonemic awareness, was dyslexia materials.  I used a hodge podge, but dyslexia materials, imo, are the best for phonemic awareness.  I have been through with my daughter now ---- she has learned phonemic awareness just fine with pre-school materials.  She has needed some extra work, but not much extra work at all, and she did not need any materials beyond the usual pre-school stuff.  But -- for my older son, pre-school stuff never worked with him, and there is something for kids who are not helped with pre-school materials ------- and it is dyslexia materials. 

 

It is nothing to be afraid of, it is just the materials that will help your daughter develop phonemic awareness skills.  It is not scary like I thought. 

 

I think it is great you are looking into OT so early, too.  My son was also in OT and visual memory was one of his low scores.  It seems that for some kids it can just go along with the phonemic awareness, for whatever reason. 

 

It was a lot of hard work, but my son is reading on grade level now in 4th grade, he is a fluent reader and enjoys reading, he is reading on grade level.  He does still have problems with his handwriting, but it has improved.

 

But I agree -- it is a good time to get started. 

 

For me personally -- I did not wait around for an eval to get started, but my son was recommended to repeat Kindergarten, and scored very low on the Dibels screening.  I did not need more information than that, in his case.  Now he has had speech and OT evals and speech therapy and OT, but for the past year he has not had any therapy (yay!). 

 

It is a lot of work -- but I think, you will need to do what you can at home, and you may need to supplement the speech therapist.  I would take your information to the speech therapist and see what your speech therapist says.  There are things besides Lips, that exist, that can target auditory memory.  Maybe the speech therapist is using those materials.  Maybe they will be effective, maybe they won't be ---- but I do think, you need to be looking for progress, not just hoping whatever the speech therapist does is working, if that makes sense.  I think you need to be active and keep track of her progress.  When she is through auditory memory and ready for phonemic awareness, you need to be working with her, or somebody needs to be working with her, as she gets through phonemic awareness (probably with a dyslexia program or a special program through school ----- probably not the same stuff they use with pre-school or Kindergarten, unless you see that she makes progress that way). 

 

You might want to read Overcoming Dyslexia, the beginning of that book explains phonemic awareness and how it is related to learning to read.  Or -- you might be able to find that same information on the Barton website and not need to read the long version, whatever your preference is. 

 

I also looked at Lindamood Bell, as something that exists, but for us -- I would have to move into an apartment for the summer, b/c we do not live near a center.  But -- for my son, local speech therapy and OT options, and dyslexia (or "struggling reader" -- one I used marketed itself more as for a "struggling reader" instead of using the word "dyslexia") programs that I could use at home, have gotten a good result.  So -- I think, it is nice that those centers exist for the children who make progress there, but my son has not suffered by not going there. 

 

At school -- I would ask what "Tier" her reading program is right now.  For a lot of reading programs in public school, not all -- but it is how it is locally -- they use RTI.  In RTI, a reading program used in general classroom instruction is "Tier 1."  If they notice someone is having a little trouble, they add "Tier 2."  Tier 2 is 15-20 minutes extra per day of instruction, and it is built in with the Tier 1 program, so that it is connected to the Tier 1 program.  Ideally -- kids who do the extra few minutes of Tier 2, it is enough for them to stay caught up with the Tier 1 program.  They are not falling behind. 

 

Then there is Tier 3.  Tier 3 is basically ----- the kid needs one-on-one instruction and it needs to be pretty different from the Tier 1 stuff of regular classroom instruction.  B/c -- the kid needs it slower, with more practice, and does not need to move on to the next thing just b/c the Tier 1 program is moving on to the next thing.  Some Tier 3 programs are computer-based instruction but imo often these are garbage.  I think Tier 3 should be one-on-one with something like Barton or Wilson or a teacher experienced with Orton Gillingham or something like that.  Something where kids do make progress. 

 

I think you need to find this out at school, if possible.

 

It is very, very easy for a kid in school to go to get identified for Tier 2, then fall behind with Tier 2, then go to Tier 3, but the Tier 3 the school does might not be very good.  In the meantime -- they are falling farther and farther behind the other kids, who got appropriate help and caught up earlier.  At my kids' school, which is so lovely in so many ways, I have seen that they seem to (imo) screw around until 3rd grade, although of course there are kids who do good with the Tier 2 intervention.  But then in 3rd grade they do more, and they have a summer program between 3rd and 4th grade that seems like it is very good and kids (finally) really get some one-on-one tutoring.  But -- I know this from other kids.  My son was able to join a regular classroom reading group part-way through 1st grade b/c of his speech therapy and me working with him at home.  He had seemed to be the worst in his group with the reading specialist.  He was the only one (out of parents I knew) who was recommended to repeat K (we declined b/c my husband refused to allow it, he had been retained in K and did not like it).  But -- he is not behind, and he has not had to do these things. 

 

So anyway -- I have thought since he was recommended to repeat K, that I want Tier 1 for him and that he needs Tier 1.  I have not felt like I need to let the school tell me "oh, let's let him be in Tier 2 some more and see what happens."  I have felt fine to use scripted programs with him at home. 

 

I do not think I could have done what he did in speech therapy, but he also had pretty severe articulation issues, he had fallen down to below the 10th percentile after his 2 years with no progress, and that is when the school speech therapist told me I should take him to a private speech clinic.  I did not think of it myself, I thought -- I am doing what I should, I am taking him to speech therapy (he went in pre-school and Kindergarten through the school district) and I didn't know I should question his lack of progress. 

 

So overall -- I think, don't worry and think it is the end of the world, it is just something where she will probably need to work harder and longer, maybe/probably with a different curriculum than is usual, but expect her to succeed in going this route.  But at the same time -- without trying to make this happen, she is at risk of languishing and just not making much progress. 

 

 

[Lecka]

I would also ask -- is there something they are doing at school, that has led to her recent skill acquisition of many letters and letter sounds? 

 

B/c, my son also learned his letters and sounds, finally, after working one-on-one with a para when he was in Kindergarten (and at about this time of year or a little later in the school year). 

 

I promise -- he had tons of exposure and he went to a good part-time pre-school.  He did not pick it up from the same things where my daughter has picked up a lot of letters and letter sounds, and then she got really solid in the first 2 months of Kindergarten, just from the same activities my older son did without picking up so much. 

 

So -- go ahead and ask.  Was it multisensory?  Was she tracing things?  Using a material like sand or dough?  Was it Handwriting Without Tears?  Was it b/c of a song?  Was it b/c she jumped or bounced on a ball? 

 

Maybe, it was just -- she finally had enough exposure.  But maybe, there was something that clicked with her a little better. 

 

If there is something that is clicking with her a little better, to help her remember, then you want to know what it is, and try to harness that in the future.

 

I think for my son -- I know some things that help him, but also, there is not any one thing, he does well with practicing in a variety of ways -- it helps to build it up so that he can remember.  But I think for some kids, there is one way where they do much better if they are practicing with that way.   

 

If you have an idea, or think someone at school may have figured out something that works for her, find out what it is, and think about ways to use it. 

 

Doing things an effective way goes so much farther than doing things an ineffective way.  So -- maybe this can be a way to find out something that is effective for her. 

 

I hope so!  It is really a good sign that she has made this recent progress!  Good luck :) 

[MistyMountain]

Personally what I'd do is get some practitioner, any psych, ANYONE who will run SOME kind of testing that includes a CTOPP and get it run before you do LIPS.  It's going to be your most clear diagnosis point.  That way you don't have any disputes.  What you're looking for now are all the benefits that come with your paper trail.  You want access to Learning Ally, Bookshare, etc. etc. The more interventions you do before the evals, the more you muddy that.

 

I'm not saying dawdle.  I'm saying be less picky and more concrete.  Find SOMEONE at some distance who will run that CTOPP and diagnose the dyslexia and give you a baseline.  Use that month or two while you're getting those evals done to start reading LIPS to learn how to implement it.  Then, when the evals are done, begin aggressive intervention. 

 

If you can, that's what I would do.  Beating around the bush or pretending it will change with age won't help.  Wait, continue on the natural path, and you'll be at the same place a year from now.  Or you can intervene aggressively and appropriately and have a reader.  The research shows whether they read late or early they STILL have to go through the stages of errors of new readers.  In other words, the sooner your dc actually begins reading the better.  Early intervention gives better results. 

 

I don't recall where you are.  I'd find a psych highly respected for dyslexia (since you're going to drive no matter what), someone who says on the phone that they will do the CTOPP and diagnose at this age. If they pussyfoot around, keep looking.  That psych will read the tea leaves on the APD anyway.  Most obvious sign is a discrepancy between verbal and performance IQs.  I actually took ds for a full hearing eval (just regular) at a university that does top notch APD evals.  They ran some of the extra stuff and confirmed he's probably ok but said they'd still do the full APD eval when he hits 7 if the psych wants it.  There's that back and forth.  It's not like a proper hearing eval would accomplish NOTHING.  They might even be able to largely eliminate it as a concern, as ours did.

 

 

How do you find a CTOPP practitioner? I have never heard of one before. Is getting that done more affordable then a neuropsych exam? 

[NYmomof4]

We did Earobics when DD was in 1st grade and had lots of difficulties. It's a computer based program with several games. There is auditory memory game, blending, chunking, breaking up a word into sounds, differentiating between similar sounds. All in all, I found this program to be very easy to implement - no time from you, DD playing 20 min every day, and helpful. DD had auditory processing eval prior to the game, and 12 months later. The doctor doing the eval noted that she rarely saw gains as huge as she saw in my DD. To me all games looked super simple, but I think it was exactly what my DD needed.

[Lecka]

A CTOPP may be one of the tests given by a neuropsych. 

 

It is just a test of phonemic awareness. 

 

This is just me -- but I read a description of the CTOPP, and I already knew my son did not have those skills.  I already knew he had poor phonemic awareness.  Partly b/c he was having Dibels screening at school -- this is how I found out. 

 

But I was already kind-of far into knowing my son had poor phonemic awareness and trying to get him these skills, before I ever heard of the CTOPP.

 

Otoh -- if you go to a neuropsych and your child has the CTOPP, and then you find out "your child scored low on the CTOPP so you need to do x and y" ----- then it is really informative. 

 

Reasons to make sure you get the CTOPP:  1) it is considered to be very good 2) you can have an age level and it may help you get school services that your child needs 3) it can measure progress or lack of progress 4) you have a record for a diagnosis that may help you get school services or school accommodations or accommodations on standardized testing. 

 

But you don't have to wait if you don't want to, if you already know your child has poor phonemic awareness and you want to start trying to take steps to improve it.  If you don't think any of these reasons really apply to you.  That is how I felt.  Also -- I had no clear path to getting the testing done.  Etc. 

 

But -- if you are getting a neuropsych, you can ask them, "do you administer the CTOPP" ahead of time and they might say yes or no.  They might have a different test the prefer to use for some reason.  Or -- this is my impression, at least. 

 

Susan Barton talks about it on her website.  If you google "Barton CTOPP" you can see the pages where she mentions it.  If you want to take a quick peek. 

 

I read a book or something that gave an overview of the sections, and by the time I read it, I already knew all the information about phonemic awareness and where my son was at the time.  He might have already remediated a lot of it by then, I am not sure. 

 

It is a test where you will expect scores to go up with remediation.  You will want to take it again later and see that the scores have gone up and the percentiles have gone up.  Or -- this is my understanding. 

 

As someone who has no first-hand experience, just summarizing what I have read about it. 

 

Edit:  You might be able to find a speech therapist or other person who can give the CTOPP.  But I don't think it would replace neuropsych testing.  Depending on what you hope to learn from neuropshych testing.  Like -- if they are giving 12 screenings or tests at a neuropsych, and this is just one, you miss out on the other tests.  You miss out on a diagnosis and recommendations from the neuropsych. 

 

But if you (and this is how I felt at the time) already know "OH NO my child has very poor phonemic awareness and I have go to try to remediate it" and want to move forward from there -- then you don't need a neuropsych test to tell you that.  At the time -- I would have found out about my son's issues that he needed OT for about 2 years earlier than I did -- which would have been worthwhile.  So -- to discover additional things you have not thought of yet, in case they are present, is another reason for a neuropsych exam. 

 

But I don't think it has hurt him not to have it.  We found out about the OT things at an appropriate time, I think.  But I think it is a good point people make in favor of getting a neuropsych exam. 

 

But at the same time, if you can tell your child needs something like Barton, you do not have to go and get a CTOPP just to have a piece of paper in hand saying your child has poor phonemic awareness skills. 

 

If you just google "CTOPP" you can see a link to a description of the test, too.  It looks like it is phonemic awareness plus rapid naming.   (And, I realize I am using phonemic awareness and phonological awareness interchangeably -- oops.) 

 

But -- it is nothing magical, but it is good.  I think if you have a chance to get it, it is good to get.  If you don't have a chance to get it, I would not sweat it too much.  That is my opinion overall.  But -- I do think it is worth making some effort to get it if it is possible.  I just would describe myself as really not having the opportunity to have this for my son at the time.  But, if I had gone a period of time and not seen him make progress, I think I would have had to figure out a way to make it happen, though it would have been extremely difficult for a number of reasons, and so I am glad that things worked out.  He also had a pretty thorough speech and language eval through speech therapy at the time, though it did not include the CTOPP or any of the other tests that are listed when talking about dyslexia. 

[PeterPan]

Yes, the CTOPP is one of the tests a psych will run.  It has age-norms down to 4 now and includes RAN/RAS scores that geodob mentioned.  You can work specifically on RAN/RAS and I've discussed this in other threads.  I'll send you the files or may have posted the links to download them.  That way you can work on it for free.  Just don't do it BEFORE evals for pity's sake.  These are primary markers to get your diagnosis, and you WANT the paper trail to get interventions, funding, accommodations, etc. Learn all this stuff while you work on getting evals and begin after you get the testing.

 

Earobics, I don't know. We have it, used it, and it's generally good for the kids in our SLP's practice where they all have apraxia but don't all necessarily have dyslexia.  Ds hit constant walls with it, where things were incredibly frustrating.  LIPS broke through all that.

 

 

[Lecka]

I think, if you are going to get evals, then it does make sense to wait for the evals. 

 

But I don't think you have to do evals to do intervention/remediation. 

 

For my son, he is not going to need accommodations for reading (it really looks this way at this point). 

 

For handwriting -- well, he would qualify today as much as he would have qualified back when he was 5. 

 

For some other things like Earobics, I tried a similar program but it did not work well here.  But, it has worked for other people. 

 

I think this is just something where things are good and you can try them, but you have to look and see if your child is making progress or not.  Maybe your child is a little more or less severe than another child, or has slightly different issues, so that different things work better. 

 

If it is frustrating and there is not progress, that is a sign -- either look at changing programs, or look hard at changing how you implement (how much time, rewards, positive attitude, not allowing frustration, making it easier, scaffolding more, etc).  Or both. 

 

I think Lips is more intensive than Earobics, and many kids need that.  Many other kids will be well served by Earobics. 

 

From things people say, about how long certain things have taken their kids, I think my son had a particularly hard time with learning to blend and segment (phonemic awareness) and with fluency, but for some things he did not have as hard of a time as other kids seem to have.  I think it is just how it goes. 

[ssavings]

Well, nothing will really be done anyway for a few months, which will give time for evals.  I am on the wait list for speech therapy, likely I won't get into actual appointments until after the neuropsych. 

So, for now, I learn as much as I can and wait on evals?

 

[Lecka]

I don't think you have to wait on evals.  (My personal opinion -- there are valid reasons to wait.) 

 

I think -- if you have not read a lot on the Barton website, maybe the Reading Rockets website, maybe read Overcoming Dyslexia, maybe read Parenting a Struggling Reader by Susan Hall and Louisa Moats -- then it is good to read those. 

 

But -- I think when you are reading, you may see that there are things you can go ahead and try.  You can also talk to her school and ask at her school.  Can you make an appointment with a speech therapist or reading specialist through school?  Maybe, maybe not -- it is worth a shot.  It is worth a shot, asking about her reading instruction at school.  You can google "auditory memory" on amazon and see if you want to spend $10-$15 to try a book.  You can google "phonemic awareness" on google and see if you want to try any of those books -- I just bought two for my younger son, and one I am using, one it turns out is still too advanced for him.  They were $10 each.  I am happy with "Picture Sorting for Phonemic Awareness" for him, though (it is matching rhyming pictures and matching pictures that start with the same letter). 

 

I have not done anything for RAN/RAS, but I think those are possible to do at home -- google or go to a link.  Geodob's post says you can practice pointing at things and naming them, for example.  It is something where -- you can give it a try and see how it goes.

 

I think you need to do your reading and learn as much as you can, and then you are prepared for the evals. 

 

If, in the course of your reading, you feel some confidence that you want to try some things that seem simple and cheap, to see how they go, I think that is good.  I think if you are looking at making a more expensive purchase that is going to be kind-of difficult to implement, you might wait on that until after the eval, depending on how long you would have to wait.  I would not wait 6 months, but I would wait 2 months.  I would probably wait 3 months.  I don't think I would sit, having done research, feeling like I had a good idea of what to try ---- should that happen to occur while doing research -- and just wait 6 months.  

 

But -- I definitely don't think that you need to go out and by Lips tomorrow.  Or Earobics.  Or anything that might be hit or miss.  It can't be helped, I think, that it takes time to read and wade through information and try to start to figure out what applies to your daughter.  I don't think it is a good time to stress out or try to do something that might be a little random.  But -- if you are researching and you get this feeling like "this is exactly what I am seeing" then I think it is fine to start.  I feel like -- if your daughter was getting a little extra reading instruction at school, would you go to school, and say "I would like my daughter taken out of her extra reading instruction, b/c I want to wait until I can get her into the neuropsych eval, and I don't want her to get any instruction before that" b/c it just does not make sense to me. 

 

I also do not know if you can request an OT eval at school -- here, it is hard to get OT at school (my son qualified, and it is surprising to people, b/c many kids need OT but can only get private OT and not through school).  But -- sometimes you can talk to the OT and the OT has an idea.  Or -- maybe there is not as long as a wait for an OT eval.  I don't really know if that will be included in a neuropsych eval -- I would ask the secretary, and get on a list for an OT eval if I needed to (if through school was not an option, or you basically know she would not qualify at school). 

 

But -- I think you will get an idea, as you do your research.  If you do your research, and you are familiar with the terminology, but you are not seeing anything obvious to do, then I think it is setting you up for success with the neuropsych eval. 

 

But I don't think it is like, you can't do anything if you come across small things you can do, that might be like a game, or just a new little routine, and that will not be stressful or too difficult.  I think that is fine.  And -- maybe you get convicted that you need to go in a certain direction, and if that happens, I think that is fine, too. 

 

But I would feel very comfortable to say you are going to get on your waiting list (or are on it) and you are going to spend some time just researching, so that you don't just randomly try things or try the first thing someone mentions. 

 

I think it is up to you, you are definitely doing well to be planning on the eval.  Whatever you are comfortable with.  You can definitely take your time to make a decision and wait for the information from the eval -- that is a good way to go.   

[PeterPan]

I'm with Lecka.  How long until the neuropsych eval?  I would be willing to wait 2 months but not 6.  If you're going to wait for evals, make sure you expedite getting those evals done.

[Soror]

I'm just doing a quick post, hoping to come later. Ds' CTOPP scores were bad but we didn't get the dyslexia diagnosis. We weren't able to start any reading until 6, nothing with letters would stick at all. He still cannot say the alphabet. We finally started with I See Sam books as what he had to remember was so little we could get going and he could get some encouragement, it was so incremental and repetitive it really helped him. Ds fails the Barton screening as well, so I have it on my list to have him evaluated for speech and hearing issues to rule out CAPD.  My son cannot distinguish vowels very well either and m/n's. I also called and talk to Susan Barton and I would whole-heartedly agree with the recommendation of calling her, she is very friendly and loves to help, you have nothing to lose.

 

There is just so much info out there and it can be overwhelming. One thing I remember I believe from FairProspects is just picking one thing to focus on at a time, that is what I'm doing here. I have 3 other kids and the rest of life, people spend many years getting degrees, so it is ok if it is confusing. Sandy, who posts here sometimes has a book that is a good primer on various issues and evaluations and it is only $3.50 on kindle:

http://www.amazon.com/How--Homeschool-Your-Learning-Abled-ebook/dp/B00GG0HX44/ref=sr_1_3?ie=UTF8&qid=1423063414&sr=8-3&keywords=learning+abled+kids

 

The Eides have a nice primer as well, the Mislabled Child:

http://www.amazon.com/Mislabeled-Child-Solutions-Childrens-Challenges/dp/1401308996/ref=sr_1_1?ie=UTF8&qid=1423063525&sr=8-1&keywords=the+mislabled+child

 

Anyway, I like both of those books as they are a good overview of various things, I started with Mislabled Child years ago and found it helpful. I'm since read various specific books on dyslexia and ADHD but I was happy to have that background, especially as often these things go together.

[PeterPan]

I'm just doing a quick post, hoping to come later. Ds' CTOPP scores were bad but we didn't get the dyslexia diagnosis. We weren't able to start any reading until 6, nothing with letters would stick at all. He still cannot say the alphabet. 

I'm just curious, how bad?  My dd didn't know the alphabet until we did VT at age, oy, 11?  They had a peripheral vision exercise where you had to touch each letter while focused on a bee in the middle of the page.  I think she had never actually connected the sound names of the letters with the written in her mind so the alphabet song might as well have been in some other language, just a string of sounds that didn't mean anything.  That exercise of slowly saying them and touching them using her peripheral vision got everything to connect.  

 

Is your ds failing the pretest because of the sound discrimination or the working memory or both?  That would be really whack not to be able to discriminate those sounds now at age 10.  How old was that CTOPP?  Did the psych screen you for APD?  Half the APD screening tool is phonemic awareness stuff, at least on the test our SLP did.  If you get a normal hearing eval you could do it with someone who is an expert in APD and they could do the screening tool.  That would be more efficient than screwing around with an SLP, unless of course you also need a language eval.

[Soror]

I'm just curious, how bad? The range was pretty vaste from 2% to 60s IIRC  My dd didn't know the alphabet until we did VT at age, oy, 11?  They had a peripheral vision exercise where you had to touch each letter while focused on a bee in the middle of the page.  I think she had never actually connected the sound names of the letters with the written in her mind so the alphabet song might as well have been in some other language, just a string of sounds that didn't mean anything.  That exercise of slowly saying them and touching them using her peripheral vision got everything to connect.  He's been twice to a COVD dr, just recently in Jan. This last test she did say he had a minor issue with tracking but she said it didn't need any kind of therapy but we could do it at home. Tracking was one thing that came up from the NP.

 

Is your ds failing the pretest because of the sound discrimination or the working memory or both?  He cannot discriminate the sounds of some, like vowels and m and n. That would be really whack not to be able to discriminate those sounds now at age 10.  How old was that CTOPP? It was from Nov 13 Did the psych screen you for APD? No, no screening for APD, it didn't even come up. It wasn't even on my radar until I redid the Barton screening and seen what he failed- as before when we did it he failed it all.  Half the APD screening tool is phonemic awareness stuff, at least on the test our SLP did.  If you get a normal hearing eval you could do it with someone who is an expert in APD and they could do the screening tool. That would be more efficient than screwing around with an SLP, unless of course you also need a language eval.

 He's had a regular hearing test but not APD. He was recommended to get a speech eval anyway, so I was planning on going to an integrated place. I called one but never received word back and then we got busy. 

 

I just looked it up:

ctopp2

phonological memory-2%

memory for digits 9%

nonword repetition 2%

 

rapid symbolic naming 37%

rapid digit naming 63%

rapid letter naming 16%

 

alternate phonological awareness 37%

blending nonwords 37

segmenting nonwords 37

 

ctopp

alternate rapid naming 35%

rapid color naming 50%

rapid object naming 25%

[ssavings]

They did the "Clinical Evaluation of Language Fundamentals for Preschool 2", the "Comprehensive Test of Phonological Processing", and the "Structured Photographic Articulation Test". 

Diagnoses:

Articulation disorder (315.39) characterized by:
-Overall deficit: mild
- Substitution errors
- Distortion errors
- Intelligibility rating 85% to unfamiliar listener

Language based reading disorder (315.00) characterized by 
- impairments in most/all areas of reading including basic language skills,, phonological awareness, spelling, and reading comprehension, 
-Overall deficit: moderate, ICD-9-CM 315.00
- difficulty with retention for print awareness, rapid naming, phonological memory for blending and segmenting at the phonemic level

Receptive Language Disorder (315.32) characterized by:
- language processing difficulty
- Overall deficit: mild
- Reduced understanding of age level concepts
- Reduced understanding/processing of age level instructions
- Reduced auditory memory

Notes:

Associated with a medical diagnosis of prematurity
Responds to therapeutic techniques (stimulable for error sounds, improved performance with models/prompts/cues). 
Test for auditory processing at 7
OT evaluation recommended


I'll copy the test results to the next post. 

[ssavings]

Test 1:
Clinical Evaluation of Language Fundamentals Preschool -2 (CELF-P2)
Subtest Score:
Sentence Structure (SS):
- Raw Score: 16
- Standard Score: 8
- Precentile Rank 25
Word Structure (WS):
- Raw Score: 20
- Standard Score: 10
- Percentile Rank: 50
Expressive Vocabulary (EV):
- Raw Score: 26
- Standard Score: 9
- Percentile Rank: 37
Concepts and Following Directions (C&FD):
- Raw Score: 12
- Standard Score: 6
- Percentile Rank: 9
Recalling Sentences (RS):

- Raw Score: 18
- Standard Score: 7
- Percentile Rank: 9
Word Classes - Receptive (ages 4-6) (WC-R):
- Raw Score: 9
- Standard Score: 7
- Percentile Rank: 16
Word Classes - Expressive (ages 4-6) (WC-R):
- Raw Score: 9
- Standard Score: 7
- Percentile Rank: 16

Core Language Scores and Indexes
Subtest of Scaled Score:
- Core Language: 27
- Receptive Language: 21
- Expressive Language: 26
Standard Score:
- Core Language: 94
- Receptive Language: 81
- Expressive Language: 92
Standard Score Points +/-
- Core Language: 7
- Receptive Language: 7
- Expressive Language: 6
Confidence Interval (90% Level):
- Core Language: 87-101
- Receptive Language: 74-88
- Expressive Language: 86-98
Percentile Rank:
-Core Language: 34
- Receptive Language: 10
- Expressive Language: 30

Notes: "DD#3's receptive language scores fell below that of her expressive language scores with only milk overlap. She had relative difficult with recalling sentences following directions, and comprehension of complex sentences. This could be related to possible reduced auditory memory or language processing difficulties.

Test #2
Comprehensive Test of Phonological Processing (CTOPP) Ages 5-6
Elision (EL):
- Raw Score: 0
- Grade Equivalent: (below K)
- Percentile: 9
- Standard Score: 6

Rapid Color Naming (RC):
- Raw Score: 334
- Grade Equivalent: (below K)
- Percentile: 2
- Standard Score: 4

Blending Words (BW):
- Raw Score: 4

- Grade Equivalent: k.7
- Percentile: 50
- Standard Score: 10

Sound Matching (SM):

- Raw Score: 6

- Grade Equivalent: K.2
- Percentile: 37
- Standard Score: 9

Rapid Object Naming (RO):

- Raw Score: 262

- Grade Equivalent: (below Kindergarten)
- Percentile: 5
- Standard Score: 4

Memory for Digits (MD):

- Raw Score: 7

- Grade Equivalent: K.0
- Percentile: 16
- Standard Score: 7

NonWord Repetition (NR):

- Raw Score: 5

- Grade Equivalent: K.0
- Percentile: 5
- Standard Score: 4

 

Composites:
Phonological Awareness (EL+BW+SM)
- Sums of SS: 25
- Percentile: 23
- Composite Score: 89

Phonological Memory: (MD+NR)
- Sums of SS: 15
- Percentile: 16
- Composite Score: 85
Rapid Naming (RD+RL) (**noted as most significant score from this test**)
- Sums of SS: 9
- Percentile: 1
- Composite Score: 67

Test #3
Structured Photographic Articulation Test (SPAT)

- Raw Score: 59
- Percentile Rank: 9
- Standard Score: 72
Notes: Error sounds consistent. Phonemes in error: th, r, and medial v. Stimulable for v and th, but not [r]

[ssavings]

315.00 is dyslexia, right?

This is the "paper trail" that we want, that was talked about above... to qualify us for bookshare/learning ally/IEP or 504 plan/ etc?

 

[Tokyomarie]

This information will qualify your daughter for Learning Ally and Bookshare. It is important data that will help her qualify for an IEP- and she should get an IEP, not just a 504 if she is in school. However, the school team needs to do its own eval, which will include reviewing this document. 315.00 is now formally referred to as "specific learning disorder with impairment in reading." There is a statement in the DSM that it is also known as dyslexia.

[PeterPan]

Yes, you just got handed a bunch of LD diagnoses.  You're just not recognizing them because they're using the new DSM names (reading disorder, etc.) instead of what you're used to seeing (dyslexia).  Is that SLP going to follow up with therapy?  That's some pretty serious articulation issues.  Did they discuss the possibility of apraxia?  If it's apraxia, you want to see if you can get PROMPT.  And you've got receptive language issues.  And you've got dyslexia.  You should be focused on serious intervention with those scores.  Dyslexia tutor, lots of speech therapy.  Did they run a WISC or that's why you want the psych eval?  Keep digging, definitely, and get your interventions lined up.  

[Lecka]

"Responds to therapeutic techniques (stimulable for error sounds, improved performance with models/prompts/cues)"

 

This is very promising, though :) 

[ssavings]

Yes, you just got handed a bunch of LD diagnoses.  You're just not recognizing them because they're using the new DSM names (reading disorder, etc.) instead of what you're used to seeing (dyslexia).  

Is that SLP going to follow up with therapy?  No, the eval was done though the Children's Hospital, and they have a year wait for therapy. I took the eval to another therapy group in the area, who is writing a treatment plan to submit for insurance approval. It'll take about 3 weeks to get all the approvals, and we should be able to start private speech therapy there. 

That's some pretty serious articulation issues.  Did they discuss the possibility of apraxia?  If it's apraxia, you want to see if you can get PROMPT.  No, she didn't mention it, either in person or in the report. I don't even know what that is. She did mention safety/socialization concerns because of the articulation issues.

I feel massively unqualified to deal with this. I spent almost two hours starting at the results. Just staring. It's like... you know you're taking them in because there's something wrong, but I didn't anticipate so many diagnoses. You hear about people fighting to get one diagnosis. I got a plethora. 

And you've got receptive language issues.  Which is what indicated the need for follow up for auditory processing after she turns 7, right? I googled "receptive language disorder" and got a bunch of "auditory processing" results. 

And you've got dyslexia.  I didn't expect to actually get this diagnosis.. thought she was too young? I'm guessing the scores are pretty bad that I got handed the dyslexia diagnosis, right? I know it sounds like a stupid question, but I have 0 baseline for this. I talked to, like, 6 people in the last few weeks who had evals at the same place and were frustrated that they didn't get the dyslexia diagnosis.  

You should be focused on serious intervention with those scores.

Did they run a WISC or that's why you want the psych eval?  Nope, just the three tests I mentioned. I am still waiting to hear about whether we're going to get into the neuropsych, and I also have an appointment with an educational lawyer to try to force the district to do edu-psych evals (which sould, I hope, include the WISC).

Keep digging, definitely, and get your interventions lined up.  

 

I felt like an idiot tonight. I brought the results to DD's (former) school, and the teacher and dean of students were both like... "Oh, she doesn't need interventions, this is just stuff that she'll outgrow." I'm not sure what it says for the school that I got handed these test results, and the school (both teacher and dean of students) swears that she's fine and has no learning issues.  If I was seeing it with homework, they should have been seeing it, right? (it's a tiny class - 5 students, and a tiny school - less than 100 students.). Now my mom (who works at the school) thinks I'm overreacting and the results "weren't really bad". This is just one of the reasons why we're transferring her to a Charter School near us mid-year; because at least they'll be aware of a serious problem when they see it. The school treated me like an absolute moron,. 

[Lecka]

My mom was in denial for a while, too.  It is too bad, but I hope she will get on your side down the road. 

 

My son had lower intelligibility than your daughter at the same age, and he did quite a bit of speech therapy.  He talks fine now, and he has been out of speech therapy for about 2 years now.  He is 9.  He was doing a lot of speech therapy his 1st grade year, and then did not need as much in 2nd grade, and then was able to exit services in 3rd grade.  If you want to look at apraxia, just google it.  My son did not have apraxia, but it is worth a quick google for sure.

 

Don't be too worried about some of the other low scores and the dyslexia.  It just means you do a different reading curriculum.  There are scripted programs available, with DVD videos to show you how to do it.  You do not have to re-invent the wheel.  It is a lot of work, but there are things you can use. 

 

You are catching this at a really good age. 

 

Today is probably the worst day -- it probably goes uphill from here. 

 

For a lot of these scores, you will expect them to go up.  It is not like an IQ score where you think it is going to be the same over time.  There are scores where you do speech therapy and your scores go up, you do a phonemic awareness program and your CTOPP scores go up, I don't know first-hand but my understanding is that the RAN/RAS scores can also improve. 

 

They are not disasters, it is more like -- "oh great, we will have to do speech therapy and a certain reading program."  You would be doing a reading program anyway, it will just be a dyslexia program.  Maybe you do a foundational program before Barton (or another program).  But -- this could mean, you spend 3 months, you could spend 6 months, you could spend 9 months (or she spends that time working with speech therapists).  It does not mean "she will never learn."  It is very far from meaning that.  It is still a downer to have to do this extra work, pay extra money, and have to deal with it.  But it is not a downer like it means these scores are permanent or like they are hugely meaningful about your daughter.  It doesn't mean your daughter has something really wrong with her. 

 

The school is probably not bad people, just not familiar with this.  It is not always widespread knowledge.  It should be, but it is not.  I am glad you have another option, I hope it is better.  Even if you get disappointment from the charter school, too, you can still work with her at home and work with the speech therapist.  It is doable.  Hopefully it will be a better situation, but even if it is not -- it is not your only option, b/c there are quality programs available for parents to use, and I am hopeful that there is a good speech therapist in your area. 

 

A lot of charter schools have a really bad reputation for special needs students, so I hope that is not the case in your area.  I get Facebook posts that the charter schools in Wisconsin are not helpful for students with more severe (more severe than your daughter) special needs, and that upsets me, but it is the nature of the Facebook page I am subscribed to to see reports of this kind of thing.  But just to say -- I hope your school will be a lot better, but just in case, you do still have options to teach your daughter, and a lot of these things are things that absolutely can be taught, it is just harder, it is not impossible. 

 

 

 

 

[PeterPan]

Well then don't show them to relatives.  Anybody who tells you she's going to outgrow this is a blathering idiot.  Or maybe, like Lecka said, it's some kind of denial.  You got a firm diagnosis from a place not inclined to hand them out like candy.  It IS true the school will play games with you and say you can't diagnose dyslexia/reading disorder in a child of that age.  You CAN and your SLP did and our extremely well-respected np did.

 

I really don't know anything about receptive language delays.  I don't think they *have* to be caused by CAPD.  I think it could also be connected to developmental delays, which the psych will look for.  You are RIGHT to fight for these evals.

 

That is extremely low intelligibility.  Read about verbal apraxia (childhood apraxia of speech).  It's a motor planning difficulty that can underlie articulation issues of that severity.  You'll find symptom lists online so you can probably eliminate it from your mind or else notice flags for it.  They would be things like issues with chewing, motor planning, sticking out tongue, blowing bubbles, etc.  And it could just be receptive and expressive delays, not a motor planning thing at all.  I'm just suggesting you spend 30 minutes and google it and decide for yourself.  If you think there are flags for it, you would look at the PROMPT Institute website and find a therapist and give them a buzz to talk it through.

 

I'm sorry it's overwhelming.  You've gotten a big list and it's normal to feel grief, like you're in a fog, like you're constantly crying, overwhelmed, guilty, etc.  It's ok to feel all those things, and as you cry and get them out of your system the fog will clear and you'll transition to action.  But I'm sorry it's hard and know it's not fun.  Main thing is you got these diagnoses NOW.  That's the awesome part.  The hard part is realizing you have to figure out what to do with it and that things won't be like you thought they would be.  And there's a lot of grief with that.  But then there's good when you find the joy of the new journey.  Sounds like you're surrounding yourself with people who are trying to help you, and that's good.

[Lecka]

I think I remember that "errors are consistent" means it is less likely to be apraxia.  It is still worth googling, but just sharing what I remember.  My son's errors were consistent, too.  That means -- every time they say the sound, they say it the same (wrong) way.  With apraxia, I think errors are less likely to be consistent.  

 

His articulation score was 63 when he was 6, then about a year or a little over a year later, he scored 93.  Then after two years, he scored 108.  So it can go up!  

 

I also found this:  http://www.readingrockets.org/article/top-10-things-you-should-know-about-reading it says towards the bottom that 2/3 of children with reading disabilities can learn to read at an average or above-average level, if they get good intervention.  So -- it does not make a lot of sense to me, why a "reading disability" is something where 2/3 of children can learn to read at an average level or higher -- but it is.  That is something that worried me a lot, I did not know that for a while.  (I also liked to read the testimonials on the Barton reading website, and watch the struggling reader video on the readingrockets.org website, showing befores and afters of kids who needed extra help -- it was really encouraging to me.)

 

I do really hope you hit it off with the speech therapist when the time comes, and that the new school is better, too!  

 

And, I agree with OhElizabeth, too.   

 

 

[ssavings]

I'm thinking likely not on apraxia. Her errors are consistent, she's responsive to correction on them (mostly), and, as bad as her expressive language is, it's significantly better than her receptive language.

I kind of feel like we're just waiting around... I don't want to start something until I get the SLP's treatment plan and see what they're providing. **shrug**

[PeterPan]

Since the SLPs ran a CTOPP, do they do something like LIPS for phonemic awareness?  You could ask them.  If they do, then after a month of that maybe she'd be ready to start with a dyslexia tutor or ready for you to come in with your materials.  Who are you planning on having do the reading tutoring?  Private, you, or the school?  Unless the school has a certified OG tutor, they're your least qualified option.  

[ssavings]

I'm not sure what they're going to offer. They might. We also have a local LindaMood Bell center, though, so I wonder whether they refer there instead of doing it themselves? I will find out, probably this week, what their plan is for the next 6 months. Once I get that, I'll know better where to go.

I plan to either hire a private tutor or tutor her myself. School is the last (worst) option. 

[PeterPan]

LMB will be very expensive.  Most important thing is that it gets done.  If you feel comfortable buying LIPS and doing it with her yourself, you certainly can.  In fact, the cost of LMB centers is so high, you could get a good private eval and do LIPS yourself and still be ahead.

 

If you plan to hire a private tutor, then find out who is OG-certified near you (or Wilson or...) and see what they recommend.  They may have the ability to do LIPS or something equivalent for you.  

 

If you plan to do the tutoring yourself, might as well pick up LIPS and get going.  That way you'll be able to carry the LIPS methodology into your Barton (or whatever) tutoring time.  I found Barton 1 and LIPS blended exceptionally well.  It's a chunk of change upfront, but for us it was pretty golden.

[ssavings]

I think we're going to have to do it ourselves. I can't find a Barton tutor near us, either. She's sweet and compliant, though, very eager to please, so I think it'll be okay. Plus, she's still young enough that we're not having to undo a ton of past damage (I hope). 

I'm a bit concerned about how the program they use to teach reading at school is going to go along with Barton - I thought I'd heard that you aren't supposed to do anything else while you're using Barton. 
 

[PeterPan]

Is pulling her out to teach her an option?  Dyslexics often have problems with math too.  By the time you afterschool math and reading she might as well be at home.  I'm working with my *very* ADHD dyslexic 6 yo boy an hour a day.  If he can hit an hour a day, well I definitely think it's worth shooting for.  Want the progress, put in the work.  Get pneumonia, get no work done.  (me)  Anyways, seriously, I can't imagine afterschooling an hour a day AND then being worried about her math.  Easier just to pull her for a season and decide the school question later, when her reading is on-track.

[Lecka]

I was able to work with my son's 1st grade teacher.  He did not have to do any reading homework from school, though I did some reading comprehension activities with him from school, I just did the reading and talked about it with him.  

 

It will depend on what the school is doing.  I bet they might be really happy to go along with you.  Or, it is possible.

 

My son's 1st grade teacher saw that he had made progress over the summer, based on his Dibels score and newfound ability to blend, and she was like "I will support what you are doing, please keep doing it."  Then with the reading specialist, he was playing phonemic awareness games that I did not think were getting him really far, but I did think it was nice practice, and not hurting him in any way.  

Once he was at a certain point in decoding, but struggling with fluency -- I found his school to be doing good things with him in fluency.  I still needed to work with him, but I did not feel like I was doing it all anymore.  

 

OhE makes a good point about math.  My son has always done well with school math, except for math facts.  They have a really good math program, they have specialized training for the teachers, they use a ton of manipulatives, they separate out conceptual math  and math facts to a large degree, etc.  I am really not sure how he would do with math at home.  B/c he does good with math at school, and I only worry about math facts and the occasional help with homework he doesn't understand, I have found that a reason to stay in school.  This way -- I can just focus on reading types of things.  

 

If we had the situation of not benefiting from the instruction in math, as we had in reading ----- well, I would be in complete agreement with OhE.  

 

If you conclude you need to work with her in math as well as reading, then I would worry about fitting that in after school.  

 

It can definitely be hard to fit things in after school, too.  

 

If you think about what your days are like, and think about what you want her to have, you can think, "how much of this does she get from school, how much will I provide after school?"  If you find that she is not getting much from school, you will be squeezing more and more in.  

 

For me -- I liked my son's school for social things, for electives, for the math, and I really have felt he benefits in every way, except he would not learn to read there.  Which, on one hand, is a huge problem and I hate it.  On the other hand, it is only one thing, and I do like everything else.  

 

The way it worked out for us, I was also able to get a lot done in the summer.  

 

A key thing you want to ask -- is your daughter happy in school?  Do they care about her and will they be flexible?  If this is a no -- that is a major reason to think it may not work out.

 

But -- you can talk to them, and see what they say.  

 

What I have found -- once you are with a speech therapist or OT, then it changes from "random thing parent thinks is a good idea" to "oh, the SLP thinks this is a good technique."  This has gone a long way for me with both school SLP/OT and with saying to the teacher "the private OT says x is a good idea for x reason."  The private OT was willing to come to school with me to talk to the teacher/IEP team -- but it turned out I didn't need her to do that.  His private SLP did not do that, but his school SLP did say things at his IEP a few times that his teacher would really listen to.  In a way where - -if I said the same thing, I would not be really listened to.  

 

But I think this is b/c there is a school culture in place that values listening to the school speech therapist!  I don't think this is a guarantee at all.  But it has been something helpful to me a couple of times.  

 

But really -- find out what she is currently doing.  Are they doing things that are counter to Barton?  Or, are they doing things that are fine with Barton, but just not intense enough for your daughter to learn?  It makes a difference.  Like -- the things the reading specialist were doing were good and went along with what he needed.  It was just *laughable* that, after I had worked with him, and knew he was taking hours to learn certain concepts, and more hours to learn things to the point he could do them without taking a very long time, that he was going to get very far with 45 minutes a day of playing games in a small group.  But the games themselves I think were good!  I think games people might pick to go along with Barton!  (Or another reading program.)  It is just -- some kids are not going to pick it up with mostly games and only a little of the serious instruction, and I believe my son was in that category.  

 

I think I have got one of the most flexible, willing-to-cooperate schools of people posting here.  Part of that, I do think I have worked to make that happen by talking to teachers, and following up when sometimes I walk away and then do not know what was really said, I have requested a meeting in writing (a big step for me at the time), and a few other things.  

 

But most important -- he has had teachers who have been flexible.  Mainly his 1st-grade teacher, b/c that was the year that I was doing a lot (a lot!!!) with him, and he could also have been crushed by not being at the right level in school -- but his teacher was extremely supportive.  She is someone who loves underdogs, and also saw that he had a supportive parent.  She did not write him off, she really saw him as a great kid.  I think his K teacher got frustrated with his lack of progress and did kind-of write him off, thinking it was his fault or my fault, and not her fault as a teacher.  

 

With a less flexible teacher, maybe it would not have worked.  There is no way he could have done the expected homework.  If we had a situation where I had to make him do inappropriate (and it is damaging to make kids do homework they don't really understand, imo, I was doing that in K and didn't understand why it wasn't working) homework, or else he was going to miss recess, or where the teacher put him on the spot to do things he couldn't do, that would all have been different.  

 

But really -- I totally agree with OhE.  Afterschooling reading is a big commitment, and your ability to do it does depend on things that happen at school -- you just have to see what is happening at school for her, though.  But -- if there is a need to afterschool both reading and math -- I think that would be very difficult to do after school.  

 

But, they also might be willing to use some math activities you bring in.  Or -- what they are doing in math might be good, she might just be picking it up more slowly.  My 6-year-olds are in Kindergarten -- and there are a few months left of Kindergarten -- maybe she is getting enough practice at school.   I honestly don't know.  

 

With my younger son, I showed his K teacher a Social Thinking program I bought to use at home, and I asked if she would consider borrowing it to use in class, I told her it would really be helpful b/c he likes things more he has done in school sometimes.  She looked at it, and said she liked it so much she was going to buy her own copy with some funds she gets from the PTA to buy classroom materials.  So -- she is using it in her class, now!  For this -- it is a set of story books and she reads them the story books once in a while.  

 

But anyway -- if I hadn't asked, she wouldn't have done it.  I could have asked, and she could have said no.  But, I did ask, and she is doing it.  

 

So -- I think it is worth a try.

 

But my mom was a K teacher, and she had a deep belief that 6-year-olds are not able to be behind, she had an old Piaget (?) idea that it was just maturity, and it is still a useful idea, but it is not such a useful idea when it comes to reading.  But still -- I think if a parent came in and had some Scholastic book or something, and said, "could you add this in?  it would really help my daughter." And it seemed good to her, and appropriate.  Honestly -- I think she would do it.  So -- maybe if you are looking at doing some math things, maybe they would do them at school.

 

Developing number sense is part of Common Core and done at my kids' school -- so they might be doing *something* for number sense.  Or, maybe they don't do much.  Or, maybe they do it, but it is not the right level.  But it should not be a crazy idea to them that you want her to work on it.  

[Lecka]

I want to add -- how do I know it was the work we did at home, and not just his time with the reading specialist?  A) that was feedback I got from his 1st grade teacher, who telling me they did not normally see this progress with kids who had his Kindergarten Dibels scores.  B) my son able to move from the reading specialist group, to the lowest reading group with the classroom teacher, and then (the next year, not the same year) to the regular reading group.  No other kids from his reading specialist reading group moved out of that group.  From talking to another mom, the reading specialist is very nice and good with her son.  But -- her son did not move up from the reading specialist group.  I do think that now (4th grade) he is reading well, and I think he made a lot of progress in summer ESY for reading last summer (my younger son was in pre-school ESY at the same time at the same school).

 

But I would not choose to let my son spend a couple of years behind, when he could catch up sooner.  

 

I also know that there are different issues and not everyone will learn at the same pace.  But -- I asked around, and my son was the only that was recommended to be retained in Kindergarten.  

 

Even if there is not always the same end result of "oh, now my son is in the regular reading group" or "now my son reads at x level," ------ even though that happens very often after dyslexia remediation ------ I think it is also enough to know, the child is farther ahead than they would be without it, even if you cannot directly compare two kids, and maybe some kids reach a place in one year that other kids reach in 3 years.  It does not matter too much.  But -- the progress does matter!  

[ssavings]

updated the first post

[PeterPan]

It looks like they did some very thorough testing!  That's a good thing, yay!!

 

Did they do an OT eval?  If they didn't, you want one.  What diagnoses did they give her and what interventions is she getting now through the school?  And what is your ability to do private services?  Did they by chance calculate a GAI for that IQ?  Seems like they should have.  Her GAI would be higher than her full scale score, much closer to average.  Remember, discrepancy and reasonable sense of what can be expected is partly how you gauge whether you've got complete, effective intervention.  So for them the lower IQ score is more convenient.  

So I'm assuming they diagnosed SLD Reading (dyslexia), language delay, and maybe ADHD?  Did they run some kind of EF screening or ADHD computer test?  And what therapies is she giving her now?  What do you want to do?

 

The first thing is to make sure that you understand all the things they diagnosed and that you know what they SHOULD have diagnosed that they didn't.  With those scores, they may have also diagnosed SLD math and SLD writing.

 

So I'm going to suggest that if, after a year in that school, her scores were that low, she's probably going to need some serious tutoring.  And with the significant speech and language problems (you have BOTH) and the SLDs, you're going to need to balance serious, effective, targeted intervention with time that also allows her to explore her strengths and passions.  

 

So tutors for math, reading, writing.  Speech therapy for the articulation AND additional speech therapy for expressive language.  Do NOT let them pull some junk about just one session.  And probably needs an OT eval to check for retained primitive reflexes.  And I would do an eye exam with a developmental optometrist to see what's going on there.

 

If you're wondering whether the vision would impact reading, sure that's a good question.  I'm scrolling back through the thread and found your CTOPP scores.  I'm sure any vision problems would make it *worse*, but reality is she has dyslexia.

 

So, to use common language, she has dyslexia, dyscalculia, probably dysgraphia, articulation problems and severe language delay, and my guess is also ADHD.  Probably will end up with an average IQ when you get a GAI.  She's going to need serious intervention.  Have you done the Barton screening?  I would do that and see what you get.  My guess is you need LIPS.

 

The more interesting question is what's behind this continued articulation delay.  You might do some reading on apraxia, just to make sure you don't have a missed diagnosis there.

 

Any behavior challenges?  Quirks?  Things she gets stuck on or does repetitively?  (just asking)

 

Now that you have this list, what do you want us to help you do?  You want her to stay in school, or do you plan to pull her out?  Are private services an option?  You mentioned LMB.  No I would not do that.  You can do LIPS yourself, or get an SLP to do it.  My ds has apraxia *and* the dyslexia, so I combined his speech therapy and LIPS work.

Edited April 10, 2016 by OhElizabeth

[ssavings]

I so always appreciate your replies/insights. You're truly amazing, and have been a blessing for me/us! Thank you! 

It looks like they did some very thorough testing!  That's a good thing, yay!!

 

Did they do an OT eval?  If they didn't, you want one.  What diagnoses did they give her and what interventions is she getting now through the school?  And what is your ability to do private services?  Did they by chance calculate a GAI for that IQ?  Seems like they should have.  Her GAI would be higher than her full scale score, much closer to average.  Remember, discrepancy and reasonable sense of what can be expected is partly how you gauge whether you've got complete, effective intervention.  So for them the lower IQ score is more convenient.  

Her GAI is just a few points above her FSIQ, because it's pulled down so far by per Perceptual Reasoning subscores, which are dramatically low.

Per the school psychologist, perceptual reasoning isn't something that can EVER be remediated - "you either have it, or you don't". Not sure where to go with that?

We are pending an OT eval at All Children's. Their waiting list is approximately forever, but we'll get it soon, I hope! Once we get it, we'll ask it to be considered by the county and added to the IEP. In the meantime, we did create the IEP based on what we had - better to get started on something than not at all. 
 

So I'm assuming they diagnosed SLD Reading (dyslexia), language delay, and maybe ADHD?  Did they run some kind of EF screening or ADHD computer test?  And what therapies is she giving her now?  What do you want to do?

 

SLD Reading, SLD Math, Mixed Expressive-Receptive Language Disorder, Articulation Disorder, Long Term Memory Encoding and Retrieval Deficits Not-Otherwise-Specified... 

They balked when I suggested ADD/ADHD testing, because "she's just so sweet. And she doesn't act out. She'll just sit in class and wait patiently - not hyper at all." I still feel like ADD (not hyper, but ADD) is a possibility, so I have an appointment for a private eval. Does ADD/ADHD have an impact on learning, though? 

 

The first thing is to make sure that you understand all the things they diagnosed and that you know what they SHOULD have diagnosed that they didn't.  With those scores, they may have also diagnosed SLD math and SLD writing.

To some degree, they seemed to say that some things are "fine" that clearly aren't. Writing, for example - her writing's fine, except that she can't write... o.O

 

So I'm going to suggest that if, after a year in that school, her scores were that low, she's probably going to need some serious tutoring.  And with the significant speech and language problems (you have BOTH) and the SLDs, you're going to need to balance serious, effective, targeted intervention with time that also allows her to explore her strengths and passions.  

 

So tutors for math, reading, writing.  Speech therapy for the articulation AND additional speech therapy for expressive language.  Do NOT let them pull some junk about just one session.  And probably needs an OT eval to check for retained primitive reflexes.  And I would do an eye exam with a developmental optometrist to see what's going on there.

They're doing two hours/day of one-on-one with the school's special ed teacher (an hour for reading/writing in the morning, then an hour in the afternoon for math/general information). 240 hours/month of speech for articulation, 240 hours/month of speech for language (Florida is one of the view states that views speech and language as two entirely separate categories on the IEP, and because she meets the criteria for both, they have to offer separate time for both). 
 

If you're wondering whether the vision would impact reading, sure that's a good question.  I'm scrolling back through the thread and found your CTOPP scores.  I'm sure any vision problems would make it *worse*, but reality is she has dyslexia.

 

So, to use common language, she has dyslexia, dyscalculia, probably dysgraphia, articulation problems and severe language delay, and my guess is also ADHD.  Probably will end up with an average IQ when you get a GAI.  She's going to need serious intervention.  Have you done the Barton screening?  I would do that and see what you get.  My guess is you need LIPS.

We're on.. almost a year... of LIPS. I think 10 months or so. And, it was an arduous process! We're finally, slowly, at the point where she is barely able to pass the Barton screening, so proceeding to that is an option, if that's the best idea? 
 

The more interesting question is what's behind this continued articulation delay.  You might do some reading on apraxia, just to make sure you don't have a missed diagnosis there.

Who would be the private sector person to evaluate for apraxia?  SLP? The articulation delay seems to have gotten worse - well, it's stayed fairly consistent, rather than her articulation improving with age, I suppose. We did have a rule-out of disarthria, which is a good step, I think. 
 

Any behavior challenges?  Quirks?  Things she gets stuck on or does repetitively?  (just asking)

The behavior thing is a particular challenge. She's incredibly sweet, honestly. She's very mellow and mild. She'll sit for hours upon hours, no complaints. She's not, at all, hyper. She's the type of child who is perfect for school, because she just sits there. They feel that her behavior is perfect (and, from their perspective, it is). I think that she is, to a large degree, disengaged? I wonder if it's some sort of ADD, that she just sits unfocused, even when she's not understanding something? 

I guess, what I'm asking is, is the lack of behavioral challenges, given the fact that she's had a 7 hour school day where she's literally not comprehending a single thing for the entire school year and all of last year, until a few weeks ago, odd? It seems to me, if she was engaged and if her behavior was "normal", we would have seen, at the least, some frustration or irritation? Something? 
 

Now that you have this list, what do you want us to help you do?  You want her to stay in school, or do you plan to pull her out?  Are private services an option?  You mentioned LMB.  No I would not do that.  You can do LIPS yourself, or get an SLP to do it.  My ds has apraxia *and* the dyslexia, so I combined his speech therapy and LIPS work.

I'm debating pulling her out. I have to talk to my boss and see about work. The reality is, though, that after almost two years of working within the school system to try to get her help, it's clear that she's simply not going to get everything she needs there. They might do some, but not nearly what she needs to be able to function. 
Private services are an option.. as are things I can do at home. My issue is that, honestly, I look at the scores, and it all looks very, very overwhelming! I'm not sure WHERE to start, what to do. 
We got the first Ronit Bird book for math (dot patterns), because she still, really, is struggling with things like counting.
For the reading, should I be looking at Barton, now that she's gotten to the point in LiPS where we can do that? Is there something else/something better? I'm concerned that Barton isn't going to help with comprehension the way she needs - but maybe I need to take one step at a time and take comprehension challenges later?

Perceptual Reasoning? Long-term memory encoding and retrieval? Working memory? Processing Speed? I have absolutely NO idea where to start with any of those!

 

[PeterPan]

That's a long time to be working on LIPS without progress.  PROMPT is the therapy we get for apraxia, and it is extremely powerful paired with LIPS.  The PROMPT Institute has a provider locator page with maps, so you can see your options.  The other thing I would be wanting (just me) is a hearing eval.  I took my ds to a university that has an audiology program specializing in APD.  Your dd is old enough to have an audiology eval and the SCAN3 screening portion.  Then they can decide if she needs the full APD eval.  It requires a booth and is very specialized to get done right.  At our uni that eval and screening was only $35.  I would be getting that audiology eval.  You've got both speech and phonological processing resisting intervention.  So you've got hearing or motor planning or something deeper causing it.

 

I know it's overwhelming.  Focus on the basics, the most foundational things.  Behavior is first.  She's probably withdrawn because of her speech.  Any repetitive behaviors, escape behaviors, quirks, unusual sensory issues, reactions to noise or touch, getting stuck/fixated on things?  

 

Sometimes kids are like onions and it takes time to unwrap what's going on.  My ds has been eval'd by multiple, multiple people in the last year and a half.  Every time we learn something more.  

 

If your insurance is giving you funding or insurance to make therapies happen, that's going to be a hard decision.  I think you could get some more evals done (audiology, PROMPT SLP, etc.), see what your resources are, see what your insurance will cover, see what interventions you would want to use if you pull her out, etc., then decide.  It sounds like school has helped her some socially and emotionally, and that's important.  That's something you'd want to replace.  You've got sort of a full picture question, not something that you can decide with snippets.  You could see how the whole picture would look, then decide.

 

Yes, I'd prioritize behavior, social skills, and speech/language.  I'd prioritize evals for audiology (and speech, if she seems to fit any symptoms of oral or verbal apraxia).  Your school seems to be giving you a terrific list of interventions, btw.  Love, love that.  Do they have a person trained in OG or some other dyslexia-appropriate methodology?  What would their SLP be doing for the articulation?  That's a process you could work through to make your decision.

[kbutton]

Did they by chance calculate a GAI for that IQ?  Seems like they should have.  Her GAI would be higher than her full scale score, much closer to average.  Remember, discrepancy and reasonable sense of what can be expected is partly how you gauge whether you've got complete, effective intervention.  So for them the lower IQ score is more convenient.  

 

These two links describe when to use a GAI:

 

http://images.pearsonclinical.com/images/assets/WISC-IV/80720_WISCIV_Hr_r4.pdf

http://mcandrewslaw.com/publications-and-presentations/articles/when-to-use-the-general-ability-index-in-assessing-eligibility-of-special-education-students/

 

Basically, they both say that you should use the GAI when one of these situations apply to your student:

• a significant discrepancy between the student’s VCI and WMI;
• a significant discrepancy between the student’s PRI and PSI;
• a significant discrepancy between the student’s WMI and PSI; or
• significant intersubtest scatter exists within the WMI and/or PSI.

In your list of scores, those subtest abbreviations are what you have listed for Verbal Comprehension (VCI), Perceptual Reasoning (PRI), Working Memory (WMI), and Processing Speed (PSI). 

I am not positive what is considered a significant discrepancy, but I believe it's based on the actual score, not the percentile rank. This is probably why they didn't really emphasize the GAI score. It's just not that helpful in this case. 

 

I am not really hearing ADHD in your description. She seems like a child that is not one to make waves, and that includes when she's not understanding what's going on in class around her. I would also suggest that be used as a reason to continue advocating for her--they must understand that she is not going to be a difficult student behaviorally, and that lack of difficultly actually makes it harder for someone to use behavior to gauge comprehension, engagement with tasks, need to ask questions, etc. They need to not pass her over simply because she's not bothering anyone. And that will happen. Easygoing kids get passed over. Squeaky wheel and all.

 

Her best scores on the IQ test are not reflected in the achievement test. So basically, you are probably needing to find out how to remediate/accommodate her language difficulties so that she has some hope of meeting her potential in those areas. You have a big difference in the VCI and PRI scores--that may not buy you a GAI according to the recommendations above, but it used to buy a non-verbal learning disorder label. If she's having visual perceptual problems or visual motor troubles, that could be totally behind the lower PRI scores, or they might be something that is weak, and the visual motor scores push them over to significantly different than the verbal IQ. So, while the school might be right that you have it or you don't, make sure the don't have it part is true and not just something that's gone wonky because her eyes aren't teaming, etc. 

 

If she does fit the profile for what used to be called non-verbal learning disorder, you are really, really going to need to push for language remediation because language is the way she's going to process things the best--via discussion and things like that. She's going to learn best in dialog with someone else, not listening to dialog around her (though small group dialog might be fine, and if there is hearing or auditory processing stuff in the way, accommodating that might make a lecture scenario more productive as well). Remind them until the cows come home that she's basically average in this area. She has the potential to use this area very well if you can access it!!!

 

So, definitely consider hearing and COVD evaluations to rule out hearing loss, auditory processing, or visual motor problems. 

 

I have not used LIPS. It's very visual, correct? Pictures of sounds and mouths together? I may be mixing it up with something else. I wonder if a pictoral representation of sound is going to get through to someone with a deficit in perceptual reasoning. 

 

Fairly or unfairly, you might have to use some strategies that work for kids with borderline cognitive delays. I would not let on about that to the school because you want to push for remediation, and she's already going to be easy to sideline because she's not having bad behavior or asking a lot of questions that take up the teacher's time. She's compliant and sweet.. The reason I think those strategies might be useful is that you have a significant deficit in one kind of processing, and LDs in the area of her cognition that works the best. That's not a fun/easy situation. She can make progress and learn, but it's going to take work.

 

I see she has some significant issues with long-term memorization from the diagnoses you got, but her working memory that allows her to hold things in her brain and manipulate it at the same time is good. I mean, it's not stellar, but my kids whose IQs are in the gifted range have working memory comparable to what your daughter has, so it's doable when language is not getting in the way. So, she can at least hold her own in real time, but she needs help getting things into long-term memory with repetition, spiral review, etc. Again, resources and strategies that help kids who have borderline issues might help you with this. 

 

:grouphug:  :grouphug:  :grouphug: 

[PeterPan]

The social withdrawal can be because of the language problems.  My guess is you get more effective language interventions and that will improve. However it's a really good question as to why the language isn't improving with the current interventions and whether there's some social delay, motor planning, or auditory issues going on there as well.  

 

Yes her discrepancy is 21 between verbal and non-verbal, which is significant.  However NVLD is out as a diagnosis.  From what I'm being told, they're going neurodevelopmental disorder or spectrum, depending on the mix.  Given the social withdrawal, it seems like an important question to ask.  Did they run the pragmatics component of the CELF?  It's not very good.  There's an additional pragmatics test the ps SLP can run.  

 

Well keep getting back to us as you gather more data.  

Edited April 10, 2016 by OhElizabeth

[ssavings]

We met with an O-G specialist today to look at Barton tutoring starting fairly soon. She recommended S.P.I.R.E. instead - her reason being, while still multi-sensory, SPIRE is a very auditory program, and that's our area of relative strength? She noted that when DD was trying to remember the names of letters, she would use the sound as a "trigger" to help her remember the word (i.e., she'd look at a C, say /k/, which would jog her memory for the actual name of the letter).