Processing disorder?

[Rachel]

My 6 year old started speech this summer for a couple reasons including a possible stutter. His SLP is stumped and now thinks what we call his stutter is actually more of a processing disorder. I don’t really know what that means or where to learn more about it.  She is beginning some testing to help her figure out more and has been consulting with coworkers while she tries to figure out how to proceed.

Could you point me toward some resources for learning more about processing disorders? It’s a term that I have only recently heard. 

[PeterPan]

A psych might be better to sort it out. Sometimes what they're saying with stuttering is that it's the processing speed. The IQ testing a psych does will quantify that.

[kbutton]

We were told my son's speech issues at that age were slow processing, but he has motor planning issues with speech. Being told it was processing and that it would get better meant two lost years of therapy. It was an SLP that told us it was a processing problem. Grrr.

[Rachel]

3 hours ago, PeterPan said:

A psych might be better to sort it out. Sometimes what they're saying with stuttering is that it's the processing speed. The IQ testing a psych does will quantify that.

There is a psychologist in the same office and I know they work together. I don’t even know what processing disorder means. Like does it mean his brain moves faster (or slower) than his mouth?  Is there a checklist of symptoms somewhere?  Is this something that just affects speech? Or does it affect ability to follow instructions?  

He doesn’t have a diagnosis or anything, the SLP is still brainstorming ideas, what’s going on isn’t straightforward.  She was thinking breath support for awhile but has decided it’s ok. She was hoping to have another SLP sit in on a session soon but hasn’t been able to work that out yet. Today was the first she brought up processing disorder.  I’m just kind of wanting to gather some information and see if it sounds like him. 

[PeterPan]

1 hour ago, kbutton said:

We were told my son's speech issues at that age were slow processing, but he has motor planning issues with speech. Being told it was processing and that it would get better meant two lost years of therapy. It was an SLP that told us it was a processing problem. Grrr.

Yes, I agree that your SLP is over her head and has no clue. If you have the option, you'd do well to look for a different SLP. I'm not a fan of being a $$$ therapist's learning experience. The person down the road who has the experience is going to be the same cost and they'll actually know what to do. What you're describing is MUCH more common than you think. They're called to deal with so many things and they're often dealing with stuff they have no clue about.

What's actually going on? 

[Storygirl]

I am going to go out on a limb here. I know nothing about stuttering and very little about other speech issues. But one of my sons has low processing speed and sensory processing disorder, and we investigated auditory processing when trying to figure out the other son's issues. So I know a little bit about some processing disorders.

It sounds to me as if your therapist threw out the words "processing disorder" to indicate that she really doesn't know what is going on and how to treat it.

Because "a processing disorder" is a comment that is really generic and does not have a diagnostic meaning, as far as I am aware. I suspect she means that the speech issue does not seem to be due to motor planning.

Consulting with colleagues can be a good thing, of course, but if it seems to you that she has exhausted her own knowledge and is mining for ideas from others....it might be wise to seek a second opinion from a different therapist.

In the meantime, you can ask her what she means by "processing disorder," and she may be able to explain better.

Edited October 11, 2018 by Storygirl

[lewelma]

My younger son had a severe stutter at age 6. Our Speech Language Therapist worked with us for a year to correct it.  I'm not sure it is super important *what* has caused it when treating a stutter.  In my reading from that time, I did not run across different ways to treat a stutter depending on cause. You simple treat the symptoms.

Ruth in NZ 

[Rachel]

10 hours ago, Storygirl said:

I am going to go out on a limb here. I know nothing about stuttering and very little about other speech issues. But one of my sons has low processing speed and sensory processing disorder, and we investigated auditory processing when trying to figure out the other son's issues. So I know a little bit about some processing disorders.

It sounds to me as if your therapist threw out the words "processing disorder" to indicate that she really doesn't know what is going on and how to treat it.

Because "a processing disorder" is a comment that is really generic and does not have a diagnostic meaning, as far as I am aware. I suspect she means that the speech issue does not seem to be due to motor planning.

Consulting with colleagues can be a good thing, of course, but if it seems to you that she has exhausted her own knowledge and is mining for ideas from others....it might be wise to seek a second opinion from a different therapist.

In the meantime, you can ask her what she means by "processing disorder," and she may be able to explain better.

I think you have it exactly correct, thank you. 

[Rachel]

12 hours ago, PeterPan said:

Yes, I agree that your SLP is over her head and has no clue. If you have the option, you'd do well to look for a different SLP. I'm not a fan of being a $$$ therapist's learning experience. The person down the road who has the experience is going to be the same cost and they'll actually know what to do. What you're describing is MUCH more common than you think. They're called to deal with so many things and they're often dealing with stuff they have no clue about.

What's actually going on? 

It’s hard to describe. We initially sought out speech therapy due to trouble with vowel r sounds and while we were at it I asked about the “stutter”. While difficulty pronouncing r’s is common at his age, he was compensating in a weird way. Initially she said the “stutter” alone wouldn’t justify speech therapy but since we were already there it didn’t hurt to work on it. 

It’s not a true stutter. A common example would be while he’s explaining something and then mid-sentence, almost like he’s searching for a word, he would say something like “the dog-og-og.”  Sometimes he can go on with what he’s saying and others he has to start over. With awareness about bumpy talking he has almost completely stopped repeating syllables. But he does frequently run out of breath mid sentence and now will repeat entire words when that happens. He also has started using filler words like um and uh a lot. So it’s like he substituted one habit for a new one.

At home he will get frustrated that he forgets what he wanted to say but that doesn’t happen at therapy. The frequency has decreased and it isn’t when he’s talking one on one, it’s more likely to occur when the whole family is together (so the environment is noisy) or he gets interrupted.

I don’t think he has serious issues, but would like to keep it from becoming serious.

 

Edited October 11, 2018 by Rachel

[PeterPan]

1 hour ago, Rachel said:

and then mid-sentence, almost like he’s searching for a word

There's actually a whole area they can look at of word retrieval, and there are lots of things that impact it. https://www.smartspeechtherapy.com/category/word-finding/  Here's a blog post with tons of info for you and here's a book your library might have It's on the Tip of My Tongue: Word-Finding Strategies to Remember Names and Words You Often Forget

1 hour ago, Rachel said:

he does frequently run out of breath mid sentence

That's an issue. Is the SLP aware of this? Honestly, you need to move on and get a more experienced SLP. You have a more complex situation than this SLP is ready to handle. 

1 hour ago, Rachel said:

At home he will get frustrated that he forgets what he wanted to say

That can be your EF (executive function) and working memory. It can also be that something else is hard (motor planning, word retrieval, dealing with distractions like background noise, etc.) that it's making it harder. So it would be harder to hold his thoughts in a noisy house with cartoons and the dishwasher on and siblings running around than it would be to do the same tasks in a quiet therapy office with just one person and the door shut. That therapy office is not real life, and unfortunately he's having problems in real life.

1 hour ago, Rachel said:

it’s more likely to occur when the whole family is together (so the environment is noisy) or he gets interrupted.

There you go. So then you want someone ready to think through how much of this is ADHD (distractability, attention, executive function, low processing speed), how much is how he's filtering background noise (dichotic listening, APD), how much is word retrieval (an SLP issue), etc. So then to really sort through this, what you actually need are evals by a psych, an SLP, an audiologist, and an OT. And the better the practitioners the better the evals. You've got some kind of SLP novice (turnover is 2-3 years, she's a novice), and you need someone much more experienced with word retrieval, expressive language, etc. On the psych, you want someone with experience with retained reflexes and APD or sensory issues and ADHD. With the psych, someone with ADHD will do unless you suspect SLDs as well.

My dd has ADHD has her official psych diagnosis and she has issues with background noise and word retrieval. I used a neuropsych with her, and he had word retrieval testing. I forget the age we're talking here, but I'm surprised your SLP isn't offering it. See that link above and see options for testing. SLP testing is usually $100 an hour where a neuropsych is $250+ an hour. So depending on how your insurance works and what you're paying for, the SLP can be cheaper. But if you can't get a better SLP, then sure someone else will do it. But if the SLP practice doesn't even OWN the tests (don't be shocked but they probably don't), then they can't run them. Best way to get better testing then is to call a big practice with lots of SLPs (meaning they own a lot of tests) and ask if they have anyone who specializes in word retrieval and APD issues and see what they say. You don't have to end up with an APD diagnosis for that person to be helpful. You're just trying to look for someone with more experience.

When we did the psych testing on my dd, we found severely discrepant processing speed. So it was objectively low, but it was terribly low compared to IQ. That's stuff the psych can sort out for you. So that low processing speed PLUS the word retrieval issues PLUS the ADHD PLUS the difficulty with background noise was just a combo hit. For her, we ended up with ADHD meds, some OT for retained reflexes and other issues, and a filter from Able Kids. She now loses her speech if she's very tired, because she's in college and using her language so hard all day long. But with all her accommodations and supports (meds, filter, etc.), she's fine and functional and has great grades and keeps her scholarship.

So it's sort of a big deal and sort of not. Like we could have looked at how well my dd did WITHOUT all those things and say oh it's not a big deal, stop whining, just answer, blah blah. But reality was, how bright she was was covering up for what a hard time she was having. The brightest kids DESERVE to have these evaluations and accommodations and interventions. It's very possible that it's much harder for him than he's letting on or that it could be much better with some intervention. None of these things we did for my dd were horrific. One trip to Able Kids, a few psych evals, a visit to a university audiologist, etc. But none of it was on the wow that was huge kind of level like I do for my ds with autism (8 years of speech therapy, on and on). But little things, getting the right therapist who actually has a clue and doing the right things for a bit, can make a BIG DIFFERENCE.

Edited October 11, 2018 by PeterPan