Please help me understand CTOPP

Bookworm4 · February 2, 2016

Please help me understand the CTOPP more. We are currently undergoing an eval with the local school psychologist and are nearing the end of the eval. The SLP we see at the school told me today that the school does have the CTOPP-2 (she didn't know until recently that the school had it as the SLP that works with the older kids is normally the one to administer the test). She finished a different phonological processing test today that is not as comprehensive as the CTOPP. She is going to read through the CTOPP tomorrow and get back to me later in the week about scheduling a time to do the CTOPP (assuming it covers more than the phonological processing she already did). I've read the basic description of the CTOPP 2 on Pro-ed and another website that sells it and read various threads about it on here in relation to dyslexia testing. I've also read various comments on here about remediating to the point of the results not showing on the CTOPP. I am trying to wrap my head around this before I meet with the school psych to go over testing (most likely next week since we will finish the rest of the testing by next Monday).

How do you know if a child has had enough remediation or intervention to test okay on the CTOPP or not but still struggle with phonological processing? For example, DD8 has had speech therapy for 3.5 years at the PS. I know that during that time, there were a couple sounds that she had a hard time hearing the difference. We have spent countless hours between school ST and home practice with hearing the sounds (and syllables) in words correctly and articulating correctly. On top of that, she spent one year in PS in a reading class that worked intensively on phonological and phonemic awareness (the lowest reading level class for K) and was also pulled out of class for extra practice on rapid naming and DIBLES nonsense words practice, the following start of the school year did AAR Pre-level and the fall after that we ran through LOE Foundations A after we had done AAR 1 to make sure her phonemic awareness was good. Granted the last two years, we did very little with nonsense words which I know can impact it for some kids. I guess what my question boils down to, can a child who has gone through all that work on phonological and phonemic awareness test in an average range on the CTOPP 2 but still have struggles with phonological processing?

MistyMountain · February 2, 2016

I have wondered that. I did a lot of phonemic awareness stuff with ds plus he has had speech therapy that worked on the things you mentioned. Then I did AAR with him. The school he goes does rapid naming of letter sounds. It took him the longest to pass the the timed test they did but he worked on it a lot and he eventually did. The school he goes to also uses a phonics based method and the kindergarten teacher had a lot of experience. I do think all that helped his scores which turned out average on the CTOPP but I do not think it would be enough for some kids even with all that. My younger child seems to struggle with phonemic awareness but she does not have a speech delay. I sometimes wonder if the speech therapy helped ds with his. I I thought he was ok with his phonemic awareness but he made more mistakes and was slower with the straight phonics based words so he does have to work at it but that was not picked up by the CTOPP. I think it can still be caught though in a lot of kids even if they have gotten remediation.

Edited February 2, 2016 by MistyMountain

Lecka · February 2, 2016

This is a short answer, but my understanding is that even when phonological processing is remediated, in the sense that there is no need to keep working on it specifically, test scores may still be lower in phonological processing when compared to someone who has never had any kind of struggle.

But, that other reading scores could be the same between these two groups.

My older son sounds similar, and he had some testing last year that showed he is weaker in.... I can't remember exactly, but the decoding-ish areas.

For me this is something I accept and I don't think it is something where I need to try to being this score up for him. He is really doing well with his reading, and this score is in the average range now -- it is just lower than his other areas in reading.

I don't know what your purpose is. Is it to see if he will get a diagnosis? Is it to see if you still need to work on this area in order to bring his score up?

My son did not get diagnosed with reading disorder last year, and that makes sense to me. For another situation I can see that it would not make sense. He is diagnosed with dysgraphia now, which he really needs.

As far as when it is okay to stop trying to bring up these scores, I think -- look at how he is doing, not at this score, to some extent. At a certain point, there is still improvement to be made. At a certain point there is still a need for improvement to support reading. Then, at a certain point the scores may be lower but it is okay.

I can't remember where I have read that scores in phonemic awareness are often lower even after successful remediation, but I do think I have read it.

I hope the people doing the testing are helpful and that you can ask them some more questions about it, too.

Lecka · February 2, 2016

double post

Edited February 2, 2016 by Lecka

PeterPan · February 2, 2016

As hard as it is, I would wait and see the results before you worry too much. If she's at a 1st grade reading level with an average IQ and 3rd grade instruction, she's probably still going to have 2 standard deviations SOMEWHERE and get the diagnosis.

Obviously if they were drilling RAN/RAS (one of the latent markers of dyslexia), that probably bumped that score. But that's a GOOD thing, kwim? And you've done plenty of intervention. The school wants to see RTI (response to intervention), and you've demonstrated that. So if she's multiple grades behind in spite of increased intervention, you're there. My ds was in Barton 3 as a K5er when the ps confirmed his diagnosis. Seriously. They used his CTOPP score from before Barton (with some LIPS under his belt) and then paired that with what they SAW IN FRONT OF THEM. The discrepancy was glaring.

That extent of her difficulty is pretty telling, when she's had so much really diligent intervention (working on RAN/RAS, working on phonological processing, etc.) and she's still struggling.

Remember too, the school is legally required to identify dc with disabilities, but their goal in this eval is not the SAME as yours. Their goal is to identify whom they are legally required to provide with intervention. They're typically looking for 2 standard deviations of discrepancy. So a gifted child with 2SD of discrepancy between IQ and achievement, in spite of stepped up intervention (RTI), that get a diagnosis. Sometimes they'll jiggle that to 1.5SD, but that's how they get there. So someone can HAVE a disability but not qualify if they do not have the discrepancy on something. It's just the challenge of the system.

So to me, it's like let's get the info, let's see what it says, let's interpret it in that context, but the school is only saying whether there's enough discrepancy that they would be legally required to provide services, not whether he's actually dyslexic or not. With what you're describing, I don't think that's going to be an issue. I think it will be there and be obvious. Remember, that dc's peers keep going, acquiring skills, as the disabled child fell behind. So it's not like intervention in K5 makes all signs of disability disappear in 3rd grade. It will probably show up other ways you're not expecting, like in the writing or in reading comprehension. And if it's not, you say Thank God! I mean, that's a good thing, eh? But just the fact that the psych was *willing* to run the more detailed test is a sign that she thinks it will show up something worthwhile. If the other test had been flagging nothing and those scores were stellar, she wouldn't have bothered.

Edited February 2, 2016 by OhElizabeth

Bookworm4 · February 2, 2016

I don't know what your purpose is. Is it to see if he will get a diagnosis? Is it to see if you still need to work on this area in order to bring his score up?

My concern is not so much that DD gets a diagnosis, but that I get the right information to make a correct decision about what she needs next with reading curriculum or what areas are weak to focus on before moving forward with reading. I was wondering if someone could need more work in phonological processing or phonemic awareness (like with Barton 1 for example), but it now show up on the CTOPP if they actually need that extra work.

I want to be informed and understand enough in the different areas they are testing to be able to ask the right questions when the psych goes over the results with me. I may be over analyzing and borrowing trouble while waiting for all results and need to stop thinking about it. Often I don't have a lot of time to read and research until my kids are in bed and know that researching late at night when tired it takes me more time to wrap my head around different areas than it does if I read about it during the day.

Edited February 2, 2016 by Bookworm4

PeterPan · February 2, 2016

Phonological processing is sort of an endless pit with dyslexia. We did rhyming with my ds in Barton, but is it easy and something we do now? Nope, because it's just horrible for him. My goal with the phonological processing is to get *just enough* to get the reading going. But as far as saying oh go back and do more? No, because at some point, if it's a disability, you just move on.

I think you're right to ask what the next step is. How is her reading instruction going? Are you wanting to *change* her reading instruction based on this diagnosis? If her current reading instruction is working and she just needs to continue, you continue. However if her current instruction is inadequate, you'll move over to Barton or get OG or whatever your plan is. And to do that, really the CTOPP doesn't decide. You'll do the Barton pre-test (which you can do now!), and then maybe the end of level tests for placement. So really, the placement tests could answer that question. Barton is pretty particular with those tests, because the goal is to make sure all the skills are there to let them go forward. The skills build, so they have to be there.

You could go ahead and do the Barton pre-test and see what happens. If she passes that, you could call/email Barton and ask her for the placement tests to see if she'd go into a higher level or if she'd go into Barton 1.

Here's the link for the pre-test. That's where you start. And don't be afraid to call Barton and discuss it. She's a really lovely person.

Students | Barton

Lecka · February 2, 2016

If you think she may need Barton, she will start in Barton Level 1. I think you should read on the Barton website to think about that.

It is just how Barton is, and if she needs Barton or would benefit from Barton, you start in Level 1, so her CTOPP score is a bit of a non-issue there.

But I agree, you do want to know if she is doing well enough in phonemic awareness, in general, to quit specifically focusing on it, or if she is ready to move on.

I think this is what you want to ask: regardless of her percentage score on the phonemic awareness tests, is her score showing that she has the foundation she needs, or is it showing she doesn't have the foundation she needs.

B/c.... I have a 10-year-old son, who has a similar background, with very low scores on the Dibels etc. in K, pull-out in K, speech therapy, etc. ----- and I have done a lot to work with him. And, now (and for the past 2 years or so) he has been reading fluently at grade level, based on looking at "oral reading fluency" (aka listening to him read out loud) and based on his comprehension.

I did a TON with him wrt phonemic awareness and decoding.

Now he is in 5th grade, and he reads well in his grade.

He would still have a low-average phonemic awareness score, I believe. (Based on some things....) But I believe it is high enough that it is good enough to support his reading. It is just not as high as for kids who have never struggled. I also believe (based on things.....) that he has gotten as high as he can get with intervention on phonemic awareness. He has come a LONG way. He plateaued. He plateaued at a place that is still low-average, and a lower score for him, but that truly seems to be high enough to support him in reading fluently and with good comprehension.

When he had the testing, the report says that the score reflects "residual weakness that is now largely resolved." For our situation, that makes sense. He does not need a diagnosis, he does not need an accommodation for reading..... he does have that residual weakness, but I really don't think it is holding him back.

For our situation, his handwriting is a problem, and totally related to the earlier signs of dyslexia..... but now, I have peace about his reading level, even though his phonemic awareness/decoding scores are on the lower side (but within average! just low average).

I think if you are thinking of Barton ----- think of Barton! You may need it or not, regardless of current scores.

I do think readingrockets.org is a good website, it can talk about the learning-to-read process, that is often going to be: phonemic awareness, then decoding, then fluency.... and in the meantime, vocabulary and comprehension.

You also might read Overcoming Dyslexia.

I hope you can get some good answers when you talk to the school psychologist!

You definitely want to have an idea of vocabulary words like: decoding, and fluency, too.

My son did have to work on fluency, too, in addition to decoding and phonemic awareness. He had to work a lot at every level. But vocabulary and comprehension have always come easily to him. But fluency did not come easily to him. So I do think, if it is time to say "there is a solid foundation" in some areas, then, it is time to move on to the next (whether it is decoding or fluency), and you need to know if the foundation is there or not.

I did not use Barton, and I did not do fluency along with decoding (not knowing it would be an issue the way it turned out to be). Barton does teach fluency and decoding both, and phonemic awareness. But I say this as someone who has looked into it ---- not someone who has used it. (I got Barton Level 1 and loved the dvds, but decided not to use it for a few reasons, mainly that my son would continue in public school, b/c of various personal reasons.)

Edit: What I mean is, my understanding is that Barton teaches decoding and fluency in an integrated way. I think I focused on decoding without adequate fluency focus for my son, so I had a situation where we did decoding and then we did fluency. I hope that makes sense.

Edited February 2, 2016 by Lecka

PeterPan · February 2, 2016

Technically she might not just start in Barton 1. She might actually need to do LIPS or something else first, which is what Barton's *free* pretest will show you. And, if she's had a lot of instruction, maybe she'd do well on the placement test for Barton 1 or 2. This is definitely stuff you can sort out. She's *probably* going to start with Barton 1, but it's a question you can sort out now, while you're waiting for your results to come in.

Since they've already done the testing, you could go ahead and do LIPS if it turns out she needs it. That would be a great way to take advantage of this time. Some kids can go through LIPS in just a matter of weeks. The pretest will tell you if you need that. Or have you already done it and you know what the results were?

Adding: I keep saying Barton, and I have no clue if that's what the op is thinking. However the pre-test and placement tests would be free, easy ways to answer her question. :)

Edited February 2, 2016 by OhElizabeth

Lecka · February 2, 2016

The CTOPP will be good information, but it will be one piece of information, I think. I don't think you will be able to make a lot of decisions with only that piece of information, when she is her age and with already receiving (what sounds like) quality remediation.

If she were younger and/or had not received quality remediation, it would say "work on this area."

But when she has worked on it ----- I think it is something to ask, for sure, but a lower score (especially with no baseline score from before she had any remediation) may not be an "answer" the way it would be if she were younger or if you knew she had not had any remediation wrt phonemic awareness.

Her (previous) Dibels score might give an idea of the progress she has made, though. I have hopes the speech therapist will be helpful on this!

But I agree -- it is good to be prepared going in, so you know what they are talking about!

Edit: Good point, OhE. I had not thought of that.

Edited February 2, 2016 by Lecka

Bookworm4 · February 2, 2016

Thank you. I'll reply more later today when I have a chance. To answer a few questions though, yes, DD did pass the Barton screening last fall. We had done the level 1 post test as well, but after talking with Susan Barton about it, she had recommended holding off purchasing Barton until we could get an evaluation and make sure it was the right fit for DD. I'll try to add/explain more later today.

Crimson Wife · February 2, 2016

One thing I didn't see mentioned in this thread (forgive me if it was & I just missed it) is that Barton Reading is not recommended for kids who have receptive and/or expressive language issues. See #2 here: https://bartonreading.com/students/

You mentioned speech therapy but you didn't say whether it was for speech (like articulation), language, or both.

Bookworm4 · February 2, 2016

One thing I didn't see mentioned in this thread (forgive me if it was & I just missed it) is that Barton Reading is not recommended for kids who have receptive and/or expressive language issues. See #2 here: https://bartonreading.com/students/

You mentioned speech therapy but you didn't say whether it was for speech (like articulation), language, or both.

You didn't miss it. I didn't think to mention it. She has been in speech for articulation. I specifically asked the SLP about receptive and expressive language because I saw that on the Barton website and didn't fully understand what they were to know for certain if we were dealing with either language issue. She explained them some and what I would be seeing if they were problems and also said that she is certain without even needing to test that DD does not have expressive or receptive language delays (she has been working with DD for 3.5 years). She ran through one area of the language test for the sake of the school psych, but didn't do all of it. If the school psych needs more than that test and her explanation of how DD is with language, then she'll run more of the test.

Edited February 2, 2016 by Bookworm4

Bookworm4 · February 3, 2016

Phonological processing is sort of an endless pit with dyslexia. We did rhyming with my ds in Barton, but is it easy and something we do now? Nope, because it's just horrible for him. My goal with the phonological processing is to get *just enough* to get the reading going. But as far as saying oh go back and do more? No, because at some point, if it's a disability, you just move on.

I think you're right to ask what the next step is. How is her reading instruction going? Are you wanting to *change* her reading instruction based on this diagnosis? If her current reading instruction is working and she just needs to continue, you continue. However if her current instruction is inadequate, you'll move over to Barton or get OG or whatever your plan is. And to do that, really the CTOPP doesn't decide. You'll do the Barton pre-test (which you can do now!), and then maybe the end of level tests for placement. So really, the placement tests could answer that question. Barton is pretty particular with those tests, because the goal is to make sure all the skills are there to let them go forward. The skills build, so they have to be there.

You could go ahead and do the Barton pre-test and see what happens. If she passes that, you could call/email Barton and ask her for the placement tests to see if she'd go into a higher level or if she'd go into Barton 1.

Here's the link for the pre-test. That's where you start. And don't be afraid to call Barton and discuss it. She's a really lovely person.

Students | Barton

Thanks. Her reading curriculum in in need of change or more review before moving forward. While I think AAR is a great program, DD is struggling through level 2 right now. This is with having done LOE A, B, and 1/2 of C between AAR 1 and AAR 2. I have read how great Barton is for so many and the cost of that sounds more appealing than a tutor cost for our budget at the moment. DD needs something different than what we are currently doing. I know I can come up with more review or similar type words to practice where she needs it, but frankly, I am tired and would do better not having to come up with all of that right now. It sounds like Barton has all the extras already done on their tutor website if you need them. I know that Pen had good results with High Noon, but I don't know if that would be the right fit for DD or not and am scared of wasting more time if I head in the wrong direction. I should keep in mind that I could contact Susan Barton after the testing to find out if Barton is indeed a good fit for DD.

Bookworm4 · February 3, 2016

If you think she may need Barton, she will start in Barton Level 1. I think you should read on the Barton website to think about that.

It is just how Barton is, and if she needs Barton or would benefit from Barton, you start in Level 1, so her CTOPP score is a bit of a non-issue there.

But I agree, you do want to know if she is doing well enough in phonemic awareness, in general, to quit specifically focusing on it, or if she is ready to move on.

I think this is what you want to ask: regardless of her percentage score on the phonemic awareness tests, is her score showing that she has the foundation she needs, or is it showing she doesn't have the foundation she needs.

B/c.... I have a 10-year-old son, who has a similar background, with very low scores on the Dibels etc. in K, pull-out in K, speech therapy, etc. ----- and I have done a lot to work with him. And, now (and for the past 2 years or so) he has been reading fluently at grade level, based on looking at "oral reading fluency" (aka listening to him read out loud) and based on his comprehension.

I did a TON with him wrt phonemic awareness and decoding.

Now he is in 5th grade, and he reads well in his grade.

He would still have a low-average phonemic awareness score, I believe. (Based on some things....) But I believe it is high enough that it is good enough to support his reading. It is just not as high as for kids who have never struggled. I also believe (based on things.....) that he has gotten as high as he can get with intervention on phonemic awareness. He has come a LONG way. He plateaued. He plateaued at a place that is still low-average, and a lower score for him, but that truly seems to be high enough to support him in reading fluently and with good comprehension.

When he had the testing, the report says that the score reflects "residual weakness that is now largely resolved." For our situation, that makes sense. He does not need a diagnosis, he does not need an accommodation for reading..... he does have that residual weakness, but I really don't think it is holding him back.

For our situation, his handwriting is a problem, and totally related to the earlier signs of dyslexia..... but now, I have peace about his reading level, even though his phonemic awareness/decoding scores are on the lower side (but within average! just low average).

I think if you are thinking of Barton ----- think of Barton! You may need it or not, regardless of current scores.

I do think readingrockets.org is a good website, it can talk about the learning-to-read process, that is often going to be: phonemic awareness, then decoding, then fluency.... and in the meantime, vocabulary and comprehension.

You also might read Overcoming Dyslexia.

I hope you can get some good answers when you talk to the school psychologist!

You definitely want to have an idea of vocabulary words like: decoding, and fluency, too.

My son did have to work on fluency, too, in addition to decoding and phonemic awareness. He had to work a lot at every level. But vocabulary and comprehension have always come easily to him. But fluency did not come easily to him. So I do think, if it is time to say "there is a solid foundation" in some areas, then, it is time to move on to the next (whether it is decoding or fluency), and you need to know if the foundation is there or not.

I did not use Barton, and I did not do fluency along with decoding (not knowing it would be an issue the way it turned out to be). Barton does teach fluency and decoding both, and phonemic awareness. But I say this as someone who has looked into it ---- not someone who has used it. (I got Barton Level 1 and loved the dvds, but decided not to use it for a few reasons, mainly that my son would continue in public school, b/c of various personal reasons.)

Edit: What I mean is, my understanding is that Barton teaches decoding and fluency in an integrated way. I think I focused on decoding without adequate fluency focus for my son, so I had a situation where we did decoding and then we did fluency. I hope that makes sense.

Thank you. Explaining your son's working and testing in phonemic awareness helps me understand better as well as something OhE said about her son's struggle after all the Barton work as well.

I have Overcoming Dyslexia on my bookshelf. I started it this fall and don't remember why I didn't get it finished. November and December were crazy months and then in January I started working my way through The Mislabeled Child and The Dyslexic Advantage. I am almost done with those and should go back to Overcoming Dyslexia again (unless the psych results how something very different than I am anticipating).

I don't think that DD's DIBLES scores were saved from K, but I could be wrong. They were given in the classroom and not in speech therapy. I know that the teacher from last year had them from May and the psych at least had that for reference as well as some other comparisons.

Thanks for the tips. I am familiar with decoding and fluency and know DD is way below where she should be in both areas. The initial reading test the psych did, she only tested in the 15th percentile in the oral reading. I don't know the result on all other areas tested yet.

PeterPan · February 3, 2016

Bookworm, if she has a 15th percentile score like that, she's probably going to get the diagnosis.

I guess I'm trying to figure out what was going through Barton's mind on the not needing it? If you're stalled out in AAR 2 with an 8 yo and have all these problems, clearly you need better tools. I think your logic is correct that Barton will be a stronger tool than what you've used so far and less expensive than hiring a tutor. Yes, it has the online resources as well as what is in the lessons.

In our case when Barton said get evals, I think it was because her experience was that evals would show us more was going on, that she didn't want us to stop with simplistic explanations. Are they running the CELF5 or some other detailed language processing test? That would be useful to you, so I hope they do. Oh, you said they started too and the SLP stopped. Was it the CELF or something else? In my ds' case, he had very low scores and very high scores in the same test. I've seen in happen with us that SLPs can be incorrect about things when they generalize and don't really slow down and run the tests.

I'm glad you're getting thorough evals. It does sound like she's going to have some scores low enough to get to a diagnosis. Did they run a WISC for IQ? They usually run something, because you want to be able to put these scores in context. That WISC will also give you processing speed and working memory. You're going to have a lot of useful bits buried in the reports, and you'll be able to use those bits to apply how you teach. It won't really be just about the diagnosis, if that makes sense. And that's something where it's just going to take time.

Shhh, but I didn't really find Overcoming Dyslexia that helpful. Maybe it wasn't answering questions I had at the time or maybe it was too introductory? I don't remember. Dyslexic Advantage by the Eides is interesting, because it changes how you view your kids. The youtube videos of Ben Foss demonstrating ear reading and using technology, WOW those are well worth watching! If you're moving on to *what do I DO*, then those are places to look.

How is your dd's speech at this time? Have they ever given you a diagnosis? My ds has apraxia, and it just makes everything a little more complicated. Like, when we started Barton, we realized that he was getting fatigued partly because the SPEECH of reading aloud was so hard! And it wasn't hard to sort out. What we did there is we made videos of him reading material that was familiar (from several lessons back in Barton) vs. material that was more at instructional level and then material that was what he was just learning that week. So then you could see in the video where his speech was affecting his ability even to read material that was very familiar. And we didn't use something novel for that. We used his Quizlet lists of Barton words/phrases/sentences, so we knew where it was for him, so the only variable was his speech.

I think the thing to remember is that you DO NOT HAVE TO SIGN anything that day. They will give you their spiel with their reports, and you can say thanks, I need to think about this. You DO NOT have to sign. That gives you the ability to slow down and think about things and then come back with more questions. If you're feeling uncomfortable or rushed, that's your tool. So it's not so much that I was blowing you off earlier, because I've done the IEP process myself and know how it feels. I'm just saying you can't know and that it IS hard to react that quickly and know. So then you say wow, I need to look this over and talk with my dh before I sign. It's the law and it's ok to do that if it makes it more comfortable for you.

Bookworm4 · February 4, 2016

Bookworm, if she has a 15th percentile score like that, she's probably going to get the diagnosis.

I guess I'm trying to figure out what was going through Barton's mind on the not needing it? If you're stalled out in AAR 2 with an 8 yo and have all these problems, clearly you need better tools. I think your logic is correct that Barton will be a stronger tool than what you've used so far and less expensive than hiring a tutor. Yes, it has the online resources as well as what is in the lessons.

I think that Barton was concerned that ADHD may have been impacting the lessons too much. I don't know if she was concerned about other areas too. ADHD was a big concern though. While I don't doubt that there probably is some level of ADHD, I don't know how much I may have given the wrong impression or not. I know that areas of reading and writing are so stinking exhausting for her though that she gets so fatigued that she doesn't last long in lessons in those areas.

In our case when Barton said get evals, I think it was because her experience was that evals would show us more was going on, that she didn't want us to stop with simplistic explanations. Are they running the CELF5 or some other detailed language processing test? That would be useful to you, so I hope they do. Oh, you said they started too and the SLP stopped. Was it the CELF or something else? In my ds' case, he had very low scores and very high scores in the same test. I've seen in happen with us that SLPs can be incorrect about things when they generalize and don't really slow down and run the tests.

I am not sure which language test the SLP used. I forgot to ask and didn't look closely enough at the cover. I know that only vocab was tested (and she did great which didn't surprise either the SLP or myself), but she didn't do the other areas at all. I got the impression that she didn't see the need for the other areas with her knowledge of DD unless the psych ends up needing that portion of testing done.

I'm glad you're getting thorough evals. It does sound like she's going to have some scores low enough to get to a diagnosis. Did they run a WISC for IQ? They usually run something, because you want to be able to put these scores in context. That WISC will also give you processing speed and working memory. You're going to have a lot of useful bits buried in the reports, and you'll be able to use those bits to apply how you teach. It won't really be just about the diagnosis, if that makes sense. And that's something where it's just going to take time.

I don't know yet if it was WISC or something similar. I know they looked at IQ and some areas of executive functioning along with testing in spelling, writing, and math. Yes, it makes sense about the useful information in the reports. I need something useful. I know that it may take time to wrap my mind around all areas and figure out how to implement the changes that DD needs.

Shhh, but I didn't really find Overcoming Dyslexia that helpful. Maybe it wasn't answering questions I had at the time or maybe it was too introductory? I don't remember. Dyslexic Advantage by the Eides is interesting, because it changes how you view your kids. The youtube videos of Ben Foss demonstrating ear reading and using technology, WOW those are well worth watching! If you're moving on to *what do I DO*, then those are places to look.

I haven't heard of Ben Foss youtube videos. I will have to look at them. I've read a little bit about ear reading, but not a lot. It sounds like something DD would like.

How is your dd's speech at this time? Have they ever given you a diagnosis? My ds has apraxia, and it just makes everything a little more complicated. Like, when we started Barton, we realized that he was getting fatigued partly because the SPEECH of reading aloud was so hard! And it wasn't hard to sort out. What we did there is we made videos of him reading material that was familiar (from several lessons back in Barton) vs. material that was more at instructional level and then material that was what he was just learning that week. So then you could see in the video where his speech was affecting his ability even to read material that was very familiar. And we didn't use something novel for that. We used his Quizlet lists of Barton words/phrases/sentences, so we knew where it was for him, so the only variable was his speech.

DD's speech has improved a lot. We are down to just working on R and R-blends and a little bit left on ending voiceless th sounds. She is making progress. She now tried to correct her younger sister when she says the words incorrectly. She never got a diagnosis of apraxia, but her speech has never been tested outside of the school if that makes a difference. I have no idea if there is a correlation to her speech, but the post level 1 tests in Barton just wiped out DD to the point that I broke up the testing into more than one session.

I think the thing to remember is that you DO NOT HAVE TO SIGN anything that day. They will give you their spiel with their reports, and you can say thanks, I need to think about this. You DO NOT have to sign. That gives you the ability to slow down and think about things and then come back with more questions. If you're feeling uncomfortable or rushed, that's your tool. So it's not so much that I was blowing you off earlier, because I've done the IEP process myself and know how it feels. I'm just saying you can't know and that it IS hard to react that quickly and know. So then you say wow, I need to look this over and talk with my dh before I sign. It's the law and it's ok to do that if it makes it more comfortable for you.

In addition to the red comments above, thank you also for the reminder that when they review the findings that I don't have to sign or agree to anything that day. I am sure I will need time to process everything. We have the speech IEP, but that is pretty straight forward. I don't know what recommendations to expect after their testing.

PeterPan · February 4, 2016

Ok, I'm just jumping down here. If she has reading comprehension issues, don't settle for only vocab being tested. The SLP can run the CELF or a similar language processing test to make sure she's actually COMPREHENDING on each level. You know she's comprehending on the word level, but what about the sentence and paragraph?!?! My ds had 99th percentile vocabulary, 28th percentile single sentence comprehension. We started Barton and he couldn't UNDERSTAND anything he was decoding. It was basically hyperlexia at that point. We've had to do extensive, extensive work on his grammar processing. The SLP never ran that testing either, never suspected it. He was memorizing large amounts of info, which enabled him to repeat whole phrases and sentences (scripting) and even paragraphs, without understanding. By the time you go to the paragraph level in the testing, he was understanding better (85th percentile) because he was getting more info and piecing together. But at the single sentence level, toast.

The other thing is that ADHD, though extremely common (60% comorbid with dyslexia?) is also not a complete explanation. Like they'll say that, but the most disabling portion of the ADHD can be EF (executive function) issues. Well that single sentence comprehension is considered a meta-linguistics issue, that they're not noticing the bits. And meta-anything is EF. So they'll say oh but we already have an explanation, her reading comprehension problems are the ADHD!! But without that detailed testing, YOU can't see that and understand what to DO about it.

For me, once I knew ok meta-linguistics, I brought in programs that work on that, that force him to notice details. Same gig, we do Hidden Pictures, working on noticing details. And I read the speech therapy materials FAST, so he has to notice the details.

So yeah, without that detailed testing, you don't know. Could be an issue. Otherwise they're just gonna say her reading comprehension issues are the ADHD and not give you the breakdowns on why. But you can press for that. Don't just believe them. The school is motivated to save money and do as little as is necessary to satisfy the law. YOU are advocating on her and have to ask these questions.

PeterPan · February 4, 2016

I had forgotten how hard a time she had with that placement test! I remember, now that you mention it. I can see why Barton was concerned. Yeah, I'd push for that language testing. There's just no reason not to get a complete picture. High vocabulary does NOT mean there's nothing further going on. It's ok for you to ask for that and just ask the question. How do we *know* she has appropriate comprehension at the single sentence level if she's having comprehension problems? Did they run an APD screening? That's another thing the SLP can run.

If they didn't run that APD screening, you might see if you can get it done affordably. She's old enough now to have the proper screening, in a booth with an audiologist. At our univ we can get it done for $35. Sometimes situations are complex, and APD and just hearing issues in general are one of those things that sort of lurk. They can cause the speech and phonological processing problems. They can cause fatigue. There's a lot of overlap and interplay with the ADHD, and some degree of problems is probably much more common than we realize. My dd was 1 point away from failing the screening. For her, with only a formal ADHD diagnosis. it's considered a relative weakness, something she has to compensate for but not enough to get her a diagnosis. But we learned good strategies in the eval, so it's not like it was a waste, kwim?

I think you have to run more evals, because they help you *eliminate* things.

Crimson Wife · February 4, 2016

Ok, I'm just jumping down here. If she has reading comprehension issues, don't settle for only vocab being tested. The SLP can run the CELF or a similar language processing test to make sure she's actually COMPREHENDING on each level. You know she's comprehending on the word level, but what about the sentence and paragraph?!?! My ds had 99th percentile vocabulary, 28th percentile single sentence comprehension. We started Barton and he couldn't UNDERSTAND anything he was decoding. It was basically hyperlexia at that point. We've had to do extensive, extensive work on his grammar processing. The SLP never ran that testing either, never suspected it. He was memorizing large amounts of info, which enabled him to repeat whole phrases and sentences (scripting) and even paragraphs, without understanding. By the time you go to the paragraph level in the testing, he was understanding better (85th percentile) because he was getting more info and piecing together. But at the single sentence level, toast.

I don't have the results of the CELF-4 testing that my DD did on Monday yet, but the previous testing she did last June with the CELF-5 and in December 2014 with the CELF-4 showed similar discrepancies. We were seeing much lower percentages than OhE's DS but the same general pattern. Vocabulary was the highest (and the only score on the entire language test that was within the average range) and single sentence comprehension being the lowest, with paragraph comprehension somewhat better than the single sentence.

In my DD's case, she's got multiple things dragging down the listening comprehension scores. A child with typical hearing is going to have an easier time but there still could be things at the brain level tripping up the comprehension.

Bookworm4 · February 4, 2016

I had forgotten how hard a time she had with that placement test! I remember, now that you mention it. I can see why Barton was concerned. Yeah, I'd push for that language testing. There's just no reason not to get a complete picture. High vocabulary does NOT mean there's nothing further going on. It's ok for you to ask for that and just ask the question. How do we *know* she has appropriate comprehension at the single sentence level if she's having comprehension problems? Did they run an APD screening? That's another thing the SLP can run.

If they didn't run that APD screening, you might see if you can get it done affordably. She's old enough now to have the proper screening, in a booth with an audiologist. At our univ we can get it done for $35. Sometimes situations are complex, and APD and just hearing issues in general are one of those things that sort of lurk. They can cause the speech and phonological processing problems. They can cause fatigue. There's a lot of overlap and interplay with the ADHD, and some degree of problems is probably much more common than we realize. My dd was 1 point away from failing the screening. For her, with only a formal ADHD diagnosis. it's considered a relative weakness, something she has to compensate for but not enough to get her a diagnosis. But we learned good strategies in the eval, so it's not like it was a waste, kwim?

I think you have to run more evals, because they help you *eliminate* things.

I don't have the results of the CELF-4 testing that my DD did on Monday yet, but the previous testing she did last June with the CELF-5 and in December 2014 with the CELF-4 showed similar discrepancies. We were seeing much lower percentages than OhE's DS but the same general pattern. Vocabulary was the highest (and the only score on the entire language test that was within the average range) and single sentence comprehension being the lowest, with paragraph comprehension somewhat better than the single sentence.

In my DD's case, she's got multiple things dragging down the listening comprehension scores. A child with typical hearing is going to have an easier time but there still could be things at the brain level tripping up the comprehension.

Does the CELF deal with auditory processing? I know I'm going to get push back from the SLP if I request more from her and may need to address it with the psych when we do the next portion of IQ testing next week. The SLP may not know about the comprehension problems. The psych suspected that her comprehension problems were because of the difficulty she had even reading that portion of the exam. Is there something I can do at home related to this that may show more why they should test more that I can discuss with them when I see them next week? Can the school come back and just refuse to do additional testing with a reason why?

The fatigue is huge and I know we need to get to the bottom of why. I checked with our state universities and it doesn't appear that they offer discounted services. I know there is a local place that can run the hearing and APD scan, but have to find out if we need a referral and if our insurance will cover any. I've heard about some pretty large bills from that place (and yes, it is associated with a hospital).

Bookworm4 · February 4, 2016

Ok, I'm just jumping down here. If she has reading comprehension issues, don't settle for only vocab being tested. The SLP can run the CELF or a similar language processing test to make sure she's actually COMPREHENDING on each level. You know she's comprehending on the word level, but what about the sentence and paragraph?!?! My ds had 99th percentile vocabulary, 28th percentile single sentence comprehension. We started Barton and he couldn't UNDERSTAND anything he was decoding. It was basically hyperlexia at that point. We've had to do extensive, extensive work on his grammar processing. The SLP never ran that testing either, never suspected it. He was memorizing large amounts of info, which enabled him to repeat whole phrases and sentences (scripting) and even paragraphs, without understanding. By the time you go to the paragraph level in the testing, he was understanding better (85th percentile) because he was getting more info and piecing together. But at the single sentence level, toast.

This is interesting. I have never thought about the difference between a sentence and paragraph level comprehension before.

The other thing is that ADHD, though extremely common (60% comorbid with dyslexia?) is also not a complete explanation. Like they'll say that, but the most disabling portion of the ADHD can be EF (executive function) issues. Well that single sentence comprehension is considered a meta-linguistics issue, that they're not noticing the bits. And meta-anything is EF. So they'll say oh but we already have an explanation, her reading comprehension problems are the ADHD!! But without that detailed testing, YOU can't see that and understand what to DO about it.

I know the psych is looking at EF. I don't have any idea about processing speed. The digit memory I heard her mess up on 6 digits, but was able to get up to 7 digits but was way off once they hit 8 digits. When they listed numbers and letters and she had to put them in numerical and then alphabetical order, she struggled a whole lot. I have no idea what is "normal" for her age though with that. I don't know if she could do more than 4 combined number/letter digits and get them in the right order.

For me, once I knew ok meta-linguistics, I brought in programs that work on that, that force him to notice details. Same gig, we do Hidden Pictures, working on noticing details. And I read the speech therapy materials FAST, so he has to notice the details.

Do you have a recommendation on a good place to read up on this more? I know for me, the more informed I am on a topic, the better the questions I can ask or explain why I want certain tests run.

So yeah, without that detailed testing, you don't know. Could be an issue. Otherwise they're just gonna say her reading comprehension issues are the ADHD and not give you the breakdowns on why. But you can press for that. Don't just believe them. The school is motivated to save money and do as little as is necessary to satisfy the law. YOU are advocating on her and have to ask these questions.

Are there any other areas I should bring up if the psych does bring them up related to comprehension and language? Comprehension was in the 5th percentile.

Crimson Wife · February 4, 2016

Here is an excerpt from my DD's CELF-5 report last summer when she was 6 1/2:

Subtest
Sentence Comprehension (Receptive)

This subtest assesses the child's ability to interpret sentences of increasing length and complexity and then to select the pictures that illustrate referential meaning of the sentences. (e.g. The child is shown four pictures and has to identify which one shows, "The boy has a ball.")

Following Directions (Receptive)

This subtest assesses the child's ability to follow directions of increasing length and complexity. (e.g. The child is shown a picture with various shapes in black and white and is asked to, "Point to the black circle and the white square.")

Recalling Sentences (Expressive)

This subtest assesses the child's ability to recall and imitate increasingly complex sentences. (e.g. The child has to repeat, "My sister is in the sixth grade.")

Paragraph Comprehension (Expressive)

This subtest assesses the child's ability to answer questions about paragraphs of increasing length and complexity.

HTH!

Bookworm4 · February 4, 2016

Here is an excerpt from my DD's CELF-5 report last summer when she was 6 1/2:

HTH!

Thank you! Yes, that helps.

Crimson Wife · February 4, 2016

The CELF-5 also has a reading comprehension subtest but my DD is only in 1st grade so even if she were typically developing, that particular subtest wouldn't be appropriate.

PeterPan · February 4, 2016

If you wait until the SLP has written her report, I don't see how you get more done, at least not politely. That's why you would ask now. If the psych is your case coor, then you talk with him/her and you mention you were concerned about comprehension and wondered if they were running tests for actual language comprehension at the sentence level. Me, I just act dumb. I'm not dumb, but when I want something done like that I just kinda play dumb. They don't really want you walking in and telling them what to do, but you can also show that you won't consider the eval complete if it doesn't answer basic, reasonable questions. So then you just state your basic reasonable questions and your reasons (evidence) why they ought to be asked.

Yup, the bills will be astonishing for audiology or any service through a hospital. Like 2-3X private. You would never ever ever want to do that if you're paying the bill yourself. PLEASE dn't think we're saying to do that. Drive a bit further, call around, find a private audiologist or a different university. If you have to drive an hour but you save a ton, that can be worth it. Privately, a basic audiology exam with the SCAN3 screening portion (NOT a full APD eval), will be $380. And at the uni here it's $35. That's only the screening portion of the SCAN3, the first page basically. If you need the entire book, that's more. So it would never make sense, unless you had clear, clear symptoms of obvious, glaring APD, to go straight into a $1500 APD eval, kwim? You just wouldn't do that. You'd start with the audiology exam and the screening.

People do get answers they weren't expecting when they get evals. I expect you'll get some kind of answers you weren't expecting. The only question is from whom.

Crimson Wife · February 4, 2016

Yup, the bills will be astonishing for audiology or any service through a hospital. Like 2-3X private. You would never ever ever want to do that if you're paying the bill yourself. PLEASE dn't think we're saying to do that. Drive a bit further, call around, find a private audiologist or a different university. If you have to drive an hour but you save a ton, that can be worth it.

With a complex child, there may be benefits to going to an experienced children's hospital audiology clinic. I paid out-of-pocket $$$ for Stanford Children's to run a 2nd opinion test when Kaiser (the HMO insurance we had at the time) discovered the hearing loss last February. I felt a bit guilty about taking the Stanford results back to the Kaiser audiologist but she was actually glad that we'd had the second opinion done. With my DD's ASD diagnosis, there was always the concern about cooperation & reliability.

When I had my older kids get updated audiology exams, I did it through Kaiser because testing them is straightforward. They understand and will cooperate with the testing procedure. They're not going to indicate hearing a tone that they actually didn't (causing a false negative) nor fail to indicate a tone that they did hear (false positive).

Bookworm4 · February 4, 2016

This is all interesting with the audiologists testing as well. Could some of the testing by an audiologist explain why DD mishears the phonemes in some words? Like hearing backing instead of batting or beeth instead of beef?

I told DH yesterday that I was going to bring up auditory processing concerns for my 5 year old at her well child check this month. I wondered about it for DD8 before, but then thought maybe it was other things that I was seeing.

I have to say that the more I learn about child development and it's impact on learning, the more complex I realize it is, and the more I realize how little I really know.

PeterPan · February 4, 2016

The more common explanation will be dyslexia. The audiology eval is more about ruling out things. You want to rule out hearing loss. APD you would have symptoms of, but an audiologist will not typically eval for it, like a complete eval, until the dc is 7. I took my ds in to the uni audiology at newly 6 because I wanted that done before his psych eval. He had never had a hearing eval, save the quickie screening at the ped, and I just really felt it was reasonable, with the amount of symptoms we were having (not responding, speech problems, phonological processing problems, etc.) to make sure hearing was not part of it. But he still has not had a full APD screening like the SCAN3. His SLP did another APD screening and he did poorly on half of it. Thing is, that half also seemed to be material you would fail if dyslexic. So it's definitely on my radar, now that he's 7. However the *most common* symptom of APD is issues with background noise. Some kids will lip read and fool you, but just in general we don't think ds is having troubles in background noise. They did run a bit of the screening on him, even though he was 6, just to be thorough. They saw the not responding (because he did it with them), so they were trying to be extra thorough.

So anyways, really, the simplest solution usually is the solution. I took my dd to the uni and had them run the SCAN3, because she was still complaining of issues hearing in background noise. She in fact is right on the line. It wasn't her imagination. It's just not quite to the point where she gets a diagnosis. Such is life.

Me, I hate to send people on wild goose chases. But it's also possible to miss things. So I think just use your common sense. If she has had hearing evals and they were fine AND there's no complaint about hearing in noisy places (homeschool convention, Chipotle, gym classes, in the car, when the kitchen vent/hood is on, whatever), then that's a good sign. I personally am not worried that my ds has it. You can have just plain old, run of the mill, boring dyslexia. You can have dyslexia and apraxia. You can have all sorts of mixes. Maybe it's just a simple solution. You want to exclude problems, and you want to do screenings if you have symptoms. My dd was complaining of the symptoms, and it was time to get it sorted out. But if you aren't even seeing the main marker symptoms (trouble in background noise is the most common), and you've excluded hearing loss, I think it's ok to use your sense on that. You may just have some really good dyslexia genes in your family. :)

PeterPan · February 4, 2016

Ok, I'm going to say this another way, and sorry if I'm rambling. *I* wouldn't pay $400 for a hearing eval + APD screening if there are NO indications. I would get their hearing checked, but in our area the county health department even can do that. Find someone with the equipment to do it correctly, and sure have that done. But when push comes to shove, paying $400 for a screening (if there are NO symptoms) would make no sense. That money would be better spent on Barton.

Also, I keep saying this, but if you have symptoms of APD, the ps is responsible to screen for that. That SLP *should have* the SCAN3 or something comparable. They CAN run that for you for free. That is within the province of an SLP or psych. So you don't even have to spend money on this technically.

Crimson Wife · February 5, 2016

This is all interesting with the audiologists testing as well. Could some of the testing by an audiologist explain why DD mishears the phonemes in some words? Like hearing backing instead of batting or beeth instead of beef?

.

In my DD's case, she was mixing consonants up because she cannot physically hear the difference, especially with the quieter ones. /k/, /t/, /f/, /sh/, and /th/ are all pronounced without vibrating the vocal chords so they're softer than vowels and voiced consonants.

So I would definitely mention the difficulties to the audiologist. It may not be a hearing issue, but better to get it checked and ruled out than missed.

Bookworm4 · February 5, 2016

In my DD's case, she was mixing consonants up because she cannot physically hear the difference, especially with the quieter ones. /k/, /t/, /f/, /sh/, and /th/ are all pronounced without vibrating the vocal chords so they're softer than vowels and voiced consonants.

So I would definitely mention the difficulties to the audiologist. It may not be a hearing issue, but better to get it checked and ruled out than missed.

When DD started learning the difference between /f/ and voiceless /th/ in speech last year, she could not hear the difference between the two. She only could tell the difference by watching someone's mouth. She can often tell the difference now. I thought she could always tell the difference after the speech work, but last month learned that she never knew that "both" ended in a /th/ and not /f/ and couldn't hear the difference. After grocery shopping, she asked me if it was "beef" or "beeth" and said she wasn't sure if she was hearing it right. I never thought about the possibility of that being related to a potential hearing loss before. Her mishearing the /k/ sound for /t/ recently too is something I never thought about actual hearing loss potential either.

As for testing hearing, I may need to get a referral from our pediatrician. I can see them offering to run their in clinic hearing screening that they do with some well-child checks. Does that screening actually catch all hearing issues? Is it good to try that, or just say, "thanks, but I'd rather just check it at an audiologist's office"?

Crimson Wife · February 5, 2016

As for testing hearing, I may need to get a referral from our pediatrician. I can see them offering to run their in clinic hearing screening that they do with some well-child checks. Does that screening actually catch all hearing issues? Is it good to try that, or just say, "thanks, but I'd rather just check it at an audiologist's office"?

The hearing screening at the pediatrician won't catch a mild hearing loss or one that affects just certain frequencies. It didn't catch my daughter's but the pediatrician still made the referral for full testing because the school district IEP team was insisting on it. It's actually a really good thing they did insist because who knows how much longer the loss would've gone undetected.

Later-onset childhood hearing loss isn't super-common, but it isn't super-rare either. About 0.5% of babies are born deaf but by age 18, the incidence is 1.7%.

PeterPan · February 5, 2016

Yes, full booth, with an audiologist. Not the ped/nurse screening thing. And to me, I'd use the audiologist that would be the one you'd want for the APD eval. That way they can do the screening and do a really good job of the screening. Then, if you need the full eval, you've already got that relationship and can get it scheduled.

Bookworm4 · February 5, 2016

Thanks. I plan to call the peds office this afternoon about a referral. I appreciate all the help and tips.

Edited February 6, 2016 by Bookworm4

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