Resources or advice for teaching child with dyslexia and speech issues

[mickeysfavorite]

Hello All! I am getting ready to tutor a student (7 years old) who has dyslexia, mild processing issues, and a speech problem. The child is receiving speech services from the school and has made progress, unfortunately summer is here so the services will end and pick up in the next school year. Meanwhile, I will be tutoring using the Orton-gillingham method. He currently has trouble with pronouncing the sounds G, D, L, N, Q, U. I am looking for resources or advice :) on how to handle this while tutoring with him. TIA!

[PeterPan]

That's a rather unusual list of sounds not to have for that age. So he has his Rs and th/TH but not /g/, /d/ and even all his vowels??? The Q sound is technically a devoiced /g/ with rounding added (/kw/ if you will), so it's no shock that he's missing both. That is odd if he has /k/ but not the /kw/. 

The reason I'm nitpicking there is incorrect diagnosis would be an explanation for ineffective therapy. Has he had his hearing tested? By an audiologist? Has anyone screened him for apraxia (motor planning of speech)? 

https://academictherapy.com/detailATP.tpl?eqskudatarq=DDD-1009  This was one of my favorite things with my ds. It uses minimal differences pairs to improve phonological processing, and they don't have to be able to say the words to benefit. I was given instructions that had us using each page lots of ways. We did rapid naming, working memory exercises (touch the 2 I say, touch the 3 I say, etc.), etc. etc. Just a terrific book for an affordable price.

Are you looking for help with speech or phonological processing work or what? On the speech, well like I said I'd want a hearing eval pronto and I'd be making sure there's not another explanation. The list of what is not clicking there is just appalling. It's lots of positions and could reflect undiagnosed problems which would explain why the speech therapy for a whole school year has been so ineffective.

[mickeysfavorite]

17 hours ago, PeterPan said:

The reason I'm nitpicking there is incorrect diagnosis would be an explanation for ineffective therapy. Has he had his hearing tested? By an audiologist? Has anyone screened him for apraxia (motor planning of speech)?

He just started speech in November of last year. I know that it is an unusual list of letters sounds that he has difficulty with. As far as hearing, mom says the hearing has been tested as he went to an ENT. He has really bad seasonal allergies. I too question the dx of the speech. He was a late talker and he experienced regression at ages 3-4. His mom reports that his tongue can not position correctly to make the sounds. I am not here to judge, I just want to help if I can.  I have recommended an evaluation beyond the school for speech. 

17 hours ago, PeterPan said:

Are you looking for help with speech or phonological processing work or what?

I am looking for ways to help him with reading and spelling. I am not a speech pathologist (obviously) so I need help with ways for the sounds to make sense to him. I thought about ASL for individual letters. Ways he can determine that the letter is different then the sounds he can produce. (Does this make sense?) I am also looking for ways to get his self esteem up. 

 

17 hours ago, PeterPan said:

This was one of my favorite things with my ds. It uses minimal differences pairs to improve phonological processing, and they don't have to be able to say the words to benefit. I was given instructions that had us using each page lots of ways. We did rapid naming, working memory exercises (touch the 2 I say, touch the 3 I say, etc.), etc. etc.

This is a great resource! Thanks! 

I understand this situation is a hot mess, as he has parents fighting over him and what not. So it will be a challenge but both parents seem to be on board. So..

[PeterPan]

Yeah, that's screaming autism and apraxia. See if there's someone with reasonable training in PROMPT (the best therapy for apraxia) within a sane drive so that you can give her a referral. The PROMPT institute keeps a provider list, but so see what's on there. You want someone who has done level 2 training AT LEAST or is working on certification (Bridging) or is certified. Avoid a person with only level 1 training if possible. It's not enough to do it correctly and it can reflect a lack of commitment to learn the methodology.

Not to point out the obvious, but if it's autism with language delays, then teaching him reading is only one piece. In fact, it's very possible the language is why he's not reading, not just the phonological processing. You could work on OG and just produce a hyperlexic reader with squat comprehension. Without proper SLP services and testing (or testing and amazing kick butt intervention by someone doing what the SLPs should have been doing), he won't comprehend what he's reading.

See what language testing they've done so far. They may have done the CELF. If they haven't done any language testing, one the mother can push through the ps or two she can try to make it happen privately. You'd like to see:

-CELF or CASL (they're just overall language tests, I like the CASL better)

-TNL=Test of Narrative Language--push, push, push to get this done. 

-SPELT=structured photographic expressive language test. This caught my ds' grammar/morphological issues that I kept telling people were there that they couldn't quantify. He bombed it, because he had done so much scripting (memorized language) and knew everything in chunks (whole to parts) rather than understanding the meanings of individual components (part to whole).

So what happened with my ds with apraxia, SLDs, and ASD2, is that I got him reading with Barton but he couldn't understand what he was reading. So he'd read "A frog sat on a log" in a little booklet I wrote and he couldn't draw a picture for it. No comprehension. Zilch. No pronoun referrants (huge autism issue) either. He's still funky on pronouns btw, so we're working on them again now.

34 minutes ago, mickeysfavorite said:

this situation is a hot mess, as he has parents fighting over him and what not. So it will be a challenge but both parents seem to be on board. So..

So you've got custody/divorce issues? Here's your problem. The needs are more significant than they are acknowledging, and your sticky point is what is good for him. It's easy to find poor intervention for speech and hard to find good intervention, yes. So I'm not gonna say oh getting this vs. that is a moral issue. However, there are things that need to happen that you don't want to enable them to pat themselves and not do. He needs his autism diagnosis, and he needs access to SLP year-round. If he gets the autism diagnosis, he can get on medicaid, get the waiver, get services year round. 

So it's not just a question of what you can do but what you're enabling them NOT to do if you do it. Reading is not his biggest problem right now. Language issues and a potential autism diagnosis are. 

Has he had IQ testing? Unfortunately, IQ enters the discussion. Verbal scores enter the discussion. Have you done the Barton screening? I'm just asking about that because it's a little baseline for whether he is ready to go forward with an OG program or whether he needs significant work to be ready.

LIPS and that Attention Good Listeners book are both great things for this dc. I think if a 7 yo is needing ASL to do basic work it's again time to back up and force the parents' hand and say he MUST have evals. He just must. It is not in the child's best interest not to be diagnosed and not to have access to interventions. The private evals can drive the school IEP process, helping him get better interventions in school too. 

For language, I'm going through the SPARC books with my ds right now. They're simple to implement. http://www.linguisystems.com/products/product/search?series=13  The SPARC for apraxia is crap, so don't do that. You want PROMPT. But the SPARC for Attributes, Grammar, etc. are terrific, terrific. I did the Grammar Processing Program (Super Duper Inc) with my ds years ago and it helped him move from hyperlexic to comprehending text. Thing is, there's just so much going on with this kid. With my ds, all doing the intervention did was allow the school system to blow us off. 

That's why I'm saying you can actually do more harm than good. You won't, but I'm saying once they realize they have to fight for interventions and funding and placements, they're going to wish they had baseline data. And anything you do for language just makes that harder. 

But maybe the ps already did language evals. Just dig in and see. Ask to see his IEP, kwim? He has one if he's getting services. See what testing was done and wasn't done and what the scores were and what you can tease out of that. You don't know what his starting point is for language and what he comprehends. With some kids you have to back up a bit more. It's a really uncool position to get in where they're reading but not comprehending. Then you're looking at doing language work or some of your Lindamood Bell stuff (Talkies, Seeing Stars). I'm not saying teach whole word, but it's just not necessarily the most important thing. You want some comprehension to come with it.

Kids who are non-verbal can read. There's plenty of room to work around that with pointing, choice cards etc. So the not being able to say the sounds isn't the dealbreaker. It's an issue because he needs optimal, year-round SLP services. He really, really needs that. The AGL book can be done with pointing. 

You know, maybe he'd make good progress with a good PROMPT therapist. Things can turn around quickly sometimes. And if they find someone and he's a drive and they do it and it WORKS, they can sue their school district to require them to get a person trained in PROMPT. For real you can do this. If the school SLP had him a year and his speech is still THAT BAD, then that's when you step in and you sue to get better therapy provided. That takes time, but I've talked with someone who did it. It's not as crazy as it sounds, and since we're talking a problem that is going to need years of intervention frankly, they might as well think in terms of suing and what they can do to make it happen. Or they can move. There are people who move to be nearer to a really good PROMPT therapist.

Keep asking questions. I'm not sure if I'm even answering yours, lol. With my ds, we focused so much on just getting the speech out that we didn't have funding for expressive language. Well language glitches up EVERYTHING. It's gonna glitch this kid's reading, writing, math, social, everything. And for my ds, language had to go way back. Like we've been going through workbooks on attributes. In the autism community they call it FFC (feature, function, class), but in the SLP world they call it attributes, categories, etc. There are words and you'll see those key words used across products. So you can go to Linguisystems and type in "attributes" into the search box and pop up stuff. How is a kid supposed to TALK about the book he just read if he can't describe? And if he has autism and has issues with attributes (very common), then that's what is going to happen. So even if you get him reading and even if he comprehends (all big IFs), then he still needs to have the understanding at the bit level, the word level, the smallest parts details, to be able to get out the responses. And where it will show up is he'll do great on multiple choice and struggle at the open-ended questions. Then they'll be like see he comprehends, and you're like but he can't get it out and is struggling to write and is getting more discouraged each year.

And the school system is awesome, because if they don't test for it then the problem doesn't exist.