How to work on inferential comprehension?

[Kathryn]

I just received results from my 8yo's first standardized testing. Honestly, I was shocked at how well he did. He was above the 90th percentile for everything but one category. But, apparently this one category is really holding him back not just in schoolwork but in life. It's labeled inferential comprehension and includes:
inferential meaning
concept development
predicting outcomes
sequential relationships
He did very poorly on this whole section (as in his percentage correct in every subcategory would be a failing grade). Looking up inferential comprehension, I see that other types of information under this category would be things such as generalizations, cause and effect relationships, future predictions, and unstated main ideas. These are all things he struggles with and always has. And like I said, this is not just in his schoolwork, but in all areas of his life (leading to my shock at his overall high scores). Full disclosure of his challenges in case anything is relevant: he was diagnosed with ADHD several years ago and he started stuttering a year ago.

Is there is anything in particular that I can do to help him learn these skills?

[underthebridge]

We have been using three approaches for this with DD9, who is neurotypical and a fairly good reader.

1) Discussion while reading aloud - I pause during reading and we speculate why someone says/does something, what we think will happen next, what is a character feeling, etc. 

2) Sentence composition - DD9 is practicing forming sentences with clauses, appositives, etc. Using words such as although, since, before as part of her writing helps her reading comprehension. 

3) Reading Detective - this doesn’t provide much direct instruction, but it has been valuable in reinforcing the idea of identifying evidence in the text. There are passages followed by multiple choice questions. Each answer can be pinpointed to a sentence or paragraph number, and the student must cite the correct one. After using this resource, DD9 is now accustomed to supporting her ideas with specific examples from the text. 

There are other resources such as inference jones that perhaps other posters can tell you about. I have found that discussion and sentence composition are the most helpful in obtaining the skills, but Reading Detective is terrific for cementing the idea that there has to be a citable justification for each answer. 

[PeterPan]

What scoring results did the test give you? Looking at percent correct is not a valid way to interpret a test. You want to look at the standard scores or or standard deviations. The test should have kicked you out some other kinds of scores, so definitely look at that. I'm all for intervention, sure, and do a ton with my ds, but first interpret the test correctly.

So as far as intervention, the test is pointing out to you some helpful things. A lot of times people think of inferences as only predicting, but actually they're much more extensive. If he's having issues with inferences AND sequencing, that's pretty significant. Depending on the degree of what is going on and the overall picture, I'd be wanting to know why. That's a pattern that can be associated with some other problems (ADHD, ASD), so you're going to want to be looking at the whole picture.

As far as levels of intervention, you have something like the Spotlight on Reading series from Carson-Dellosa. I've been using it with my ds, and it's good stuff. https://www.carsondellosa.com/search-catalog?q=spotlight &fq=showonly_string_mv-AND|bookmediatype-ebook;agegrades_string_mv-AND|Grade 2 %2F Ages 7–8 It has grade leveled books and approaches things sequentially and carefully. That will be a mid-level of intervention. Intervention in the ps will have tiers (1-3), so I'm not saying it's labeled for that. It's just more of an affordable, pick this up, it's organized intervention. There are published programs that will be labeled by tiers (tier 2, tier 3, etc.) that will be even slower-paced and take more time with scripted models where they underline their evidence, etc. 

Then you can step over to SLP materials, which are NOT hard to pick up and implement. The reason I'm showing you them is because they tend to hit across a variety of categories and not get stuck in just one. http://www.linguisystems.com/products/product/display?itemid=10518 Here's an example. Might give you just enough of a jump start that then you'd realize all the ways they should be applied across the curriculum, and then you'll be able to work on them in your lit, etc. Linguisystems also has a Spotlight series (NOT the same as the CD one) that works on inferences. http://www.linguisystems.com/products/product/search And if you go to Super Duper Inc, they have games, etc.

Sequencing is a bigger issue. It is connected to inferencing, but it will affect narratives. How are his narratives? Can he tell you about his day? Can he retell a story?

Sometimes, when a dc has one set of test scores that is low, sometimes it's that he had a bad day, his blood sugar was low, his pencil was in the wrong column the whole way, the paper was turned the wrong way, something was distracting him, he wasn't feeling well, whatever, kwim? You said it's in all his life. Is he seeing an SLP for the stuttering? They'll be the natural ones to talk this over with. There's a Test of Narrative Language they can run that might show a lot. It will hit inferencing, sequencing, expressive and receptive language. It's just super duper. Like if they don't have it, compel them to buy it. It's not that expensive, and once they run it they'll be ecstatic. Now not every SLP is into expressive language. You may need another SLP if the one you're using isn't. They're actually not that common and you may need to look around. But that's what you're looking for.

Come hang on LC. I've got a motherload narrative language thread going. Ignore the autism label on it. :)

 

[Kathryn]

20 minutes ago, PeterPan said:

What scoring results did the test give you? Looking at percent correct is not a valid way to interpret a test. You want to look at the standard scores or or standard deviations. The test should have kicked you out some other kinds of scores, so definitely look at that. I'm all for intervention, sure, and do a ton with my ds, but first interpret the test correctly.

So as far as intervention, the test is pointing out to you some helpful things. A lot of times people think of inferences as only predicting, but actually they're much more extensive. If he's having issues with inferences AND sequencing, that's pretty significant. Depending on the degree of what is going on and the overall picture, I'd be wanting to know why. That's a pattern that can be associated with some other problems (ADHD, ASD), so you're going to want to be looking at the whole picture.

As far as levels of intervention, you have something like the Spotlight on Reading series from Carson-Dellosa. I've been using it with my ds, and it's good stuff. https://www.carsondellosa.com/search-catalog?q=spotlight &fq=showonly_string_mv-AND|bookmediatype-ebook;agegrades_string_mv-AND|Grade 2 %2F Ages 7–8 It has grade leveled books and approaches things sequentially and carefully. That will be a mid-level of intervention. Intervention in the ps will have tiers (1-3), so I'm not saying it's labeled for that. It's just more of an affordable, pick this up, it's organized intervention. There are published programs that will be labeled by tiers (tier 2, tier 3, etc.) that will be even slower-paced and take more time with scripted models where they underline their evidence, etc. 

Then you can step over to SLP materials, which are NOT hard to pick up and implement. The reason I'm showing you them is because they tend to hit across a variety of categories and not get stuck in just one. http://www.linguisystems.com/products/product/display?itemid=10518 Here's an example. Might give you just enough of a jump start that then you'd realize all the ways they should be applied across the curriculum, and then you'll be able to work on them in your lit, etc. Linguisystems also has a Spotlight series (NOT the same as the CD one) that works on inferences. http://www.linguisystems.com/products/product/search And if you go to Super Duper Inc, they have games, etc.

Sequencing is a bigger issue. It is connected to inferencing, but it will affect narratives. How are his narratives? Can he tell you about his day? Can he retell a story?

Sometimes, when a dc has one set of test scores that is low, sometimes it's that he had a bad day, his blood sugar was low, his pencil was in the wrong column the whole way, the paper was turned the wrong way, something was distracting him, he wasn't feeling well, whatever, kwim? You said it's in all his life. Is he seeing an SLP for the stuttering? They'll be the natural ones to talk this over with. There's a Test of Narrative Language they can run that might show a lot. It will hit inferencing, sequencing, expressive and receptive language. It's just super duper. Like if they don't have it, compel them to buy it. It's not that expensive, and once they run it they'll be ecstatic. Now not every SLP is into expressive language. You may need another SLP if the one you're using isn't. They're actually not that common and you may need to look around. But that's what you're looking for.

Come hang on LC. I've got a motherload narrative language thread going. Ignore the autism label on it. ?

 

 

I appreciate the suggestions. Will come back and read in more depth later as I'm out right now, just wanted to address a few comments. 

I did ITBS Complete Battery and CogAT  

I do know how to interpret the results, I was just pointing out his own percent correct to demonstrate the issue. For the difference between student and nation he's well off the charts on the positive side for everything but these categories (and sustained listening). For these, he's well on the negative side for most and off the chart for the negative on predicting outcomes. 

He did great on all the rest of the test, even parts taken at the same time  I administered and was watching, so I know that these were things that he specifically had difficulty with  

My older son has autism. I've never noticed anything in this child that makes me suspect autism. 

We just did an evaluation for the stuttering last week with someone who specializes in stuttering, but she doesn't take insurance, so I'm on the lookout for someone else. Apparently, most SLPs around me only see preschoolers. 

Telling back a story is EXTREMELY difficult and frustrating for him. We just finished WWE3 and we aren't going on because it was just tear-inducing every narration day. 

Will come back to this later. Thank you so much!

[PeterPan]

So then yes, you want an SLP who works a lot with expressive language, and you want them to run more detailed language testing. There's also the CASL. I'm not a huge fan of the CELF and we can go in circles about that with people saying how great it is. The CELF Metalinguistics is ok. You could run the Social Language Development Test. You really, really want the Test of Narrative Language.

And yeah, with a sibling history of autism and these issues showing up, probably are going to want psych evals on the table and an ADOS. Kids can present very differently. If it would improve your insurance coverage or access to services, it would be worth doing. This 8-10 range is pretty common for diagnosis in higher functioning kids. 

Have you looked into something like Verbalizing and Visualizing? 

There are theories that stuttering connects to processing speed. The psych evals would give you data on that. So it's not like oh it has to be this or that, just connecting dots that more evals at this point would give you a more complete picture to work from. The SLP can assume, but the psych testing would help.

[ElizabethB]

CAPs Reasoning and Reading series explicitly and incrementally teaches inferential comprehension.

https://classicalacademicpress.com/subject/reasoning-reading/

[PeterPan]

For the narratives, an SLP is going to recommend Story Grammar Marker. Mindwings (the publisher) has a sale through the end of the month, fwiw. I think it's 15% off with a code on their FB page. It's not really going to go back and remediate language issues or anything else, but it's a tool they recommend. Also you can look at V/V, which is a bit earlier in the process, focusing on visualization and expansion of language. Super common thing to recommend.

I went to a training for Social Thinking where they demonstrated their dynamic assessment, then I had it done on my ds before we got the TNL a year later. Narrative language is SO foundational to everything he needs going forward, and what's astonishing is that by 5 basically kids are already telling complete narratives. So when our kids are 8-10 and struggling, they're really VERY behind on the scores. Like when you dig in on this inferences may become the least of your concerns. Get the scores and see obviously.

I went through a series of sequencing workbooks with my ds this past year, and you can find them just by searching on amazon. 

When the testing says concept development, that term concepts can be pretty loaded. For instance, look at the toc for this and see if it's things your ds would struggle with either receptively or expressively http://www.linguisystems.com/products/product/display?itemid=10047

When they look at sequencing, there are routines, but they also look at things like the social thinking required (why did he do it, what was he thinking, what would he say there) and the connector words (first, next, last, etc.). So if you administered the test yourself, you might have gotten to notice what aspects of the sequencing he was struggling with and what they were testing. They were probably looking at a variety of things. The TNL will kick you out scores there.

[kbutton]

23 hours ago, Kathryn said:

My older son has autism. I've never noticed anything in this child that makes me suspect autism. 

We just did an evaluation for the stuttering last week with someone who specializes in stuttering, but she doesn't take insurance, so I'm on the lookout for someone else. Apparently, most SLPs around me only see preschoolers. 

Telling back a story is EXTREMELY difficult and frustrating for him. We just finished WWE3 and we aren't going on because it was just tear-inducing every narration day. 

Will come back to this later. Thank you so much!

 

The language issues you are describing are very, very tied to autism. My son is cognitively gifted and has ASD, and he was diagnosed at almost age 9. His language issues like this didn't come out of the woodwork until later than that, but they are exactly what you are describing, honestly. 

22 hours ago, PeterPan said:

The CELF Metalinguistics is ok. You could run the Social Language Development Test. You really, really want the Test of Narrative Language.

And yeah, with a sibling history of autism and these issues showing up, probably are going to want psych evals on the table and an ADOS. Kids can present very differently. If it would improve your insurance coverage or access to services, it would be worth doing. This 8-10 range is pretty common for diagnosis in higher functioning kids. 

1

Besides the social language test and Test of Narrative Language, I strongly, strongly recommend the TOPS testing also. You need to be sure you can find someone that can run newer versions of the test or at least the right test for the age range. I can almost guarantee with what you are writing, the Test of Narrative Language is going to give jaw-dropping results. The other tests might find stuff, or they might not show anything until he hits the age 12-14 range where the developmental demands are higher, and concepts tested become more abstract.

I strongly recommend looking into a psychologist who specializes in 2e kids because they are used to having to look a little deeper to see issues that aren't always evident. I am leery of the ADOS unless it's given by someone who has a reputation for doing a good job with trickier kids--where I live, anecdotal evidence suggests that high-functioning kids are routinely missed with ADOS testing at the facilities most often recommended by pediatricians in our area. If you cannot find an SLP that works with kids older than preschool, you might be able to find some kind psychologist (ed psych, neuropsychologist, etc.) who will run the language testing. Not all do, but if they have a compelling reason to, sometimes they will. Our psych ordered the tests on trial basis, and then found them extremely insightful and helpful.

I would not fool around with materials meant to remediate typical kids--I would look at things from speech therapy publishers. 

[PeterPan]

Yeah, I've got someone doing the ADOS who is training post-doctoral students on it. Definitely not run of the mill. And yes the ADOS can get the higher functioning and 2E kids. And, for the op, I'll tell you a narrative exercise is part of the ADOS. So when we're saying it's significant, it's significant because it's in the ADOS.

Just realized op's ds is probably too young for the Metalinguistics. And I'm with Kbutton that doing it too early means the cutoff will be low and make it easy to miss them. So that's one where waiting a few years would be better. We were told it was good at catching language issues in kids where they weren't showing up other ways. Our school liked the TNL, and when I realized narrative language is also on the ADOS it was this big lightbulb moment for me.

Kbutton, in our big LC thread, has been talking about the difference between a retelling of facts and a narrative with cohesion. My dd somehow said the same thing a different way and it finally clicked for me. It's like this triple hurdle when we realize some of our kids aren't necessarily even getting out the facts, let alone getting any cohesion or plot or conflict or resolution to it. I'm really liking how Talkies (the primer level of V/V) is connecting language and play. I'm finally seeing why ds wasn't using narrative language in his play either. 

[PeterPan]

For the op, did your ds do any form of complex echolalia or scripting? My ds, as his speech came in, was quoting long passages from audiobooks, tv, etc., basically memorizing them. For him, the SPELT (structured photographic expressive language test) was enlightening, because what looked like a lot of language on him was actually this memorized level (the whole) without ANY understanding of the parts or how to rearrange them. So even though he could tell us all these things, he failed the SPELT, utterly and disastrously. 

Sometimes it can be really contradictory like that where they have strengths masking weaknesses.

[kbutton]

5 minutes ago, PeterPan said:

For the op, did your ds do any form of complex echolalia or scripting? My ds, as his speech came in, was quoting long passages from audiobooks, tv, etc., basically memorizing them. For him, the SPELT (structured photographic expressive language test) was enlightening, because what looked like a lot of language on him was actually this memorized level (the whole) without ANY understanding of the parts or how to rearrange them. So even though he could tell us all these things, he failed the SPELT, utterly and disastrously. 

Sometimes it can be really contradictory like that where they have strengths masking weaknesses.

We also had echolalia that was more disguised too, but he doesn't do it a lot. Just when he's learning something kind of new. It was super functional and appropriate to the situation. For my son, he could understand what he was saying and why, but it stuck in his brain exactly as he heard it, and he had trouble "forgetting" it enough to rephrase. For him, it's a multi-step process. He just has trouble overriding what he hears AND coming up with novel language to say something similar, so he just uses what he's already heard. 

OP, how does your son do with answering open-ended questions? Things I would look for are whether he includes the right level of detail, the right categories of facts, if he strings them together cohesively, if he can state things by positively and negatively with some flexibility (for instance, can say both what something IS and what it IS NOT). Can he create a definition for something (even if it's not structured like a dictionary definition) that contains category words, or does he have to do a lot of talking to get to the point? For instance, if you ask what a car is, would he be able to say something like "A car is a vehicle that people ride in or drive from one place to another place" and include maybe some key descriptive things like having four wheels, etc.? Vehicle would be a specific noun (category word), but some kids would miss the opportunity to put a label on that concept and have to use several descriptors instead--"box thingy that you sit in," and other phrases. 

I know that one issue we are pinpointing with my son is that coming up with categories inside of categories is very hard. For him, it's like there is one category and many details, and he can't sort and re-sort those details conceptually. But he can do sorting exercises with those same words and pre-made labels and tell you what the rationale is for the label. It's crazy! But it really affects language tasks.

[PeterPan]

I got a kit of cards from ProEd/Linguisystems to work on categorizing. It has leveled deck starting with large categories and then going to subcategories. The Cusimano workbook hits paraphrasing. I've been working on synonyms with him, and I'm sort of hoping that the skills will merge as we push forward. (exercises where he's stretched to paraphrase, the idea of synonyms clicking so he CAN restate it, etc.)

 

[PeterPan]

This might interest the op. It's a 30 minute webinar from Story Grammar Marker where they explain the Critical Thinking Triangle and how it underlies inferencing and problem solving.

 

[kbutton]

I will cross-post in the LC thread about narrative language, but I called Mindwings to ask about some of the components of the SGM (overlap of products, etc.), and the author spent some significant time talking to me about my son's issues and about the parts of the program. I highly encourage anyone looking at the program to gather up questions and give her a call!

[Kathryn]

7 hours ago, PeterPan said:

For the op, did your ds do any form of complex echolalia or scripting? My ds, as his speech came in, was quoting long passages from audiobooks, tv, etc., basically memorizing them. For him, the SPELT (structured photographic expressive language test) was enlightening, because what looked like a lot of language on him was actually this memorized level (the whole) without ANY understanding of the parts or how to rearrange them. So even though he could tell us all these things, he failed the SPELT, utterly and disastrously. 

Sometimes it can be really contradictory like that where they have strengths masking weaknesses.

Hmm, I suppose he does have some issues with this, but I honestly thought of it more as mimicking his brother's behavior (my older son is high-functioning--most people have no idea). Both of them constantly repeat phrases. He also (and this is different than his brother) has a few stock questions that he uses to start conversations constantly (the same few questions over and over).

[Kathryn]

7 hours ago, kbutton said:

We also had echolalia that was more disguised too, but he doesn't do it a lot. Just when he's learning something kind of new. It was super functional and appropriate to the situation. For my son, he could understand what he was saying and why, but it stuck in his brain exactly as he heard it, and he had trouble "forgetting" it enough to rephrase. For him, it's a multi-step process. He just has trouble overriding what he hears AND coming up with novel language to say something similar, so he just uses what he's already heard. 

OP, how does your son do with answering open-ended questions? Things I would look for are whether he includes the right level of detail, the right categories of facts, if he strings them together cohesively, if he can state things by positively and negatively with some flexibility (for instance, can say both what something IS and what it IS NOT). Can he create a definition for something (even if it's not structured like a dictionary definition) that contains category words, or does he have to do a lot of talking to get to the point? For instance, if you ask what a car is, would he be able to say something like "A car is a vehicle that people ride in or drive from one place to another place" and include maybe some key descriptive things like having four wheels, etc.? Vehicle would be a specific noun (category word), but some kids would miss the opportunity to put a label on that concept and have to use several descriptors instead--"box thingy that you sit in," and other phrases. 

I know that one issue we are pinpointing with my son is that coming up with categories inside of categories is very hard. For him, it's like there is one category and many details, and he can't sort and re-sort those details conceptually. But he can do sorting exercises with those same words and pre-made labels and tell you what the rationale is for the label. It's crazy! But it really affects language tasks.

He has a very hard time answering questions like that or expressing his thoughts. We actually just had a question like this about an hour ago. My husband asked what the difference was between an android and a robot. I was about to answer when he said that he wanted to. So, he went on and on for a couple of minutes about it, all dancing around the concept that it's a robot in the shape/form of a human but never just explicitly saying that. 

He often asks questions in really odd ways that I just can't figure out what he's trying to ask. 

[PeterPan]

Sounds like you've got some good reasons to pursue evals.

[Kathryn]

3 minutes ago, PeterPan said:

Sounds like you've got some good reasons to pursue evals.

 We go in to my older son's autism specialist in a little over a month. I'll talk to her about it. I do appreciate the resources and thoughts. Thank you. 

[Kathryn]

14 minutes ago, PeterPan said:

Sounds like you've got some good reasons to pursue evals.

One more example that just now happened. We are watching Paddington 2. Paddington has been arrested and is in court. He's verbally reminding himself that Mr. Brown said he'd be fine as long as he gets a fair-minded judge. Cut to the judge walking in. Paddington sees his face and it cuts to an earlier scene of Paddington having a mishap in a barber shop and shaving off a huge chunk of this same guy's hair.

Everyone in the room watching the movie moans "oh no!" and DS8 says "what? Why'd you say that? What's wrong?" These are the kinds of things that always go right over his head and I've never understood how. 

[PeterPan]

Lots of dots are connecting for you, sounds like. I think it's ok to be aggressive about evals. You could go ahead and do the ADOS or other ASD testing, do speech, go multi-factored, get it sorted out.

Don't be bashful about coming over to LC. It's clearly time, and no matter what you find he's probably going to need some intervention. You definitely want to know why this is happening. There's this idea of "central coherence" or that he's seeing lots of parts but not realizing how they fit together into a whole. So it can be processing speed, hearing loss, social thinking, whatever, but it can also be that in a dynamic situation he's not able to process everything and build it into a whole. My ds is that way with sports. He can do a single task pretty well (he's rather athletic), but when you put him in a GAME he's toast, utterly toast. Gifted IQ, but he can't follow which way the ball is supposed to go, whose team is doing what, etc. So he can do soccer drills in a soccer camp, but he can't PLAY soccer. 

So yeah, definitely start evaling. I've gotten so much bad advice over the years with people blowing off this or that, I wouldn't accept any blow-offs. I know you won't, but I'm just saying you've got enough data points that that isn't acceptable. Is the autism specialist a BCBA or a psych or an SLP? Would they be the one doing the testing if you proceed? I just hate the wait, sigh. That's going to be the hard part, now that you're noticing things and connecting things. 

[Kathryn]

5 minutes ago, PeterPan said:

Lots of dots are connecting for you, sounds like. I think it's ok to be aggressive about evals. You could go ahead and do the ADOS or other ASD testing, do speech, go multi-factored, get it sorted out.

Don't be bashful about coming over to LC. It's clearly time, and no matter what you find he's probably going to need some intervention. You definitely want to know why this is happening. There's this idea of "central coherence" or that he's seeing lots of parts but not realizing how they fit together into a whole. So it can be processing speed, hearing loss, social thinking, whatever, but it can also be that in a dynamic situation he's not able to process everything and build it into a whole. My ds is that way with sports. He can do a single task pretty well (he's rather athletic), but when you put him in a GAME he's toast, utterly toast. Gifted IQ, but he can't follow which way the ball is supposed to go, whose team is doing what, etc. So he can do soccer drills in a soccer camp, but he can't PLAY soccer. 

So yeah, definitely start evaling. I've gotten so much bad advice over the years with people blowing off this or that, I wouldn't accept any blow-offs. I know you won't, but I'm just saying you've got enough data points that that isn't acceptable. Is the autism specialist a BCBA or a psych or an SLP? Would they be the one doing the testing if you proceed? I just hate the wait, sigh. That's going to be the hard part, now that you're noticing things and connecting things. 

 

I'm just so tired of life being so damn difficult. And feeling awful that this kid has never gotten the attention he needed because all eyes were on his brother. 

It took over a year to get into an evaluation for my oldest. We have to drive two hours to get to his appointments because though we were on waitlists for all three developmental/behavioral peds places in our state that do evals, after a year of waiting, the first one to call was two hours away and not the one in our city. When the one here finally did call, they literally hung up on me when I said he'd had the evaluation at the other place. The place he goes to offers us nothing besides testing and meds. They know nothing about services in my city. I was told to get in contact with the support group for special needs kids here, but they never responded to my calls. 

There's currently a lawsuit against my state by autism moms for how impossible the state makes getting ABA therapy. We are the lowest-paid state in the country for therapists (far less than half the national average) and that's reflected in the fact that they are extremely poor quality. When we actually made it to the top of the waiting list for therapy, we gave up our spot after four months because it was making him worse. The "therapists" had two hours of training. They were college grads but in completely unrelated fields. They had no idea what they were doing and were making things horribly worse--when they even showed up. 

Sorry for my tangential griping. I'll stop now. Sometimes I'm just plain done with life. So, anyway, it seems the fastest route would be to talk to my oldest's doctor at the developmental/behavioral pediatrician's office we go to. 

[PeterPan]

Oh dear, it makes sense you're frustrated! Well come hang on LC. We're kicking butt over there IN SPITE of the system. Little secret, but it's not like providers are omniscient even when there's tons of funding for hours with them. In our state we have an exceptionally generous disability scholarship program. We finally, finally got my ds moved over. I give up my FAPE and can take that money to any state listed provider to service his IEP. Can I find an SLP to do the stuff with my ds that I'm doing now? Nope. Totally trail-blazing. I'm doing hours a day of speech/language materials with him right now, because we're off from his regular apraxia therapy (maternity leave for SLP). We're doing really well, maybe making some progress. But I've been to scads of SLPs hoping someone could help me. Some are better than others, but some things just really benefit from the hours we can give them by working with our kids at home.

So at some point, *you* are the magic and *you* are the one to put the training and materials into.

And yeah, I hear you on it sucking sometimes. Sigh. If it makes you feel any better, we drive over 2 hours each way for our weekly speech therapy (the one on break right now, yay!) and have for, um, almost 8 years. There were breaks in there, but you get the drift. 

On the evals, maybe take a little trip? You could fly on Southwest to a major city, do the evals, go home. 

Keep whining away. It's not offending anybody.

[kbutton]

Kathryn, that's a very frustrating experience! I hope it goes better this time. I would be pretty persistent with the developmental ped--don't take no for an answer.

Travelling for an evaluation definitely sounds like it could be helpful to you if it doesn't totally mess up something with insurance or your finances. Are you in a rural area, or mostly just a clueless and not well-reimbursed area?

[PeterPan]

Some places are just deserts for services and evals. Where I am, in the midwest, I can get an autism eval in 2 weeks, and I can have my choice of plenty of BCBAs, a large practice with 5 educational therapists, blah blah. Where my dd is going to college in the south, there is ONE BCBA for an entire county. For real. A total desert, a wasteland. I don't know how people get services and survive. They don't. They put the kids in the ps and hope for the best.

So literally just traveling could put you somewhere where it's a lot easier to get services. A dc with that level of language issues will be easily diagnosable. I wouldn't go hospital, personally, but that's because around here the hospitals are teaching schools. I didn't want my very complex situation being handled by some med student. I wanted someone with some EXPERIENCE. And people around here do have screwy experiences with the children's hospitals. And they have long waits and are expensive. 

You could move. If you're that frustrated, maybe it's something to put on the table. 

[Kathryn]

We're in the capital city in a Southern state. Moving is not an option nor is traveling long distance for services or evaluations--we just don't have the money.  The economy/politics here makes it so that getting services is extremely difficult. And being from the place that everyone moves to because it's cheaper means we don't have the ability to leave the place. We live on one income because we did t want our kids falling through the cracks in the system, but it also makes other things more difficult. 

[drjuliadc]

Some schools of thought associate stuttering with “mixed dominance.” That is where a child has handedness in one side but a dominant foot, eye, ear on another.

it is not to hard to test and remediate this yourself if it becomes obvious which side “should” be dominant. You just roll a ball to them repeatedly and see what foot they kick with, give them a play “spyglass” and see what eye it repeatedly goes to, and show them how to listen though a door to see if they can hear what is on the other side and see what ear they use.

If the child or adult predominantly uses the right or left, but not ALL right or left, that is mixed dominance and should be corrected. Stuttering improves when mixed dominance is remediated.

[PeterPan]

And you'll find professionals who DON'T intervene on mixed dominance and who think that being ALL one dominance or another is actually a problem. Go figure.

[HS Mom in NC]

Making an inference requires having had relevant past experiences.  If they're asking him to infer things outside of his personal experience, then it's just another stupid test question.  If he is being asked to make an inference about something he's had experience in, then maybe there's a cognitive issue, or you just need to wait for him to mature a little more.  Kids don't all develop at exactly the same pace and the pacing of each individual child's development isn't always consistent.

[Kathryn]

Quick update: after talking with DH, we made a list of our concerns and I took DS to the pediatrician this week. She agreed that an evaluation was in order and her office is starting the paperwork process for that. Apparently, waiting times are no better than they were when our oldest was diagnosed, though. But, at least we got the ball moving. 

[PeterPan]

Well keep us posted and feel free to come hang on LC... So it's gonna be a 6 months wait? 9? Worse?

[Kathryn]

15 hours ago, PeterPan said:

Well keep us posted and feel free to come hang on LC... So it's gonna be a 6 months wait? 9? Worse?

I won't know until they contact me. It was just at a year for my older son. The doctor told me that the place in our city that does evaluations is around two years right now. 

[PeterPan]

Oh dear. Well you can come here and get one a LOT faster. Given that you're seeing issues and want to intervene, it would be good to get SOMETHING going. What about SLP testing? Could you get into that sooner? That's what you're really dealing with right now. There's tons an SLP who specializes in autism and expressive language could start working on and get identified for you. If they got it identified, you could work on it. 

[kbutton]

On 6/1/2018 at 6:42 PM, Kathryn said:

Quick update: after talking with DH, we made a list of our concerns and I took DS to the pediatrician this week. She agreed that an evaluation was in order and her office is starting the paperwork process for that. Apparently, waiting times are no better than they were when our oldest was diagnosed, though. But, at least we got the ball moving. 

As not awesome as the wait is, this gives you some time to start some record-keeping, tracking issues, etc. and see how some of the issues play out over time. It should give you a lot of good data about school, life skills, etc. Hang in there!