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Runningmom80

Choosing a tester for dyslexia

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Is an SLP + Psychologist preferable to a neuropsychologist or vice versa? 

 

We have it narrowed down to these two options, and the SLP + Psych is $600 more than the neuro. We will gladly pay the money if it's important to have the SLP involved. 

SLP + Psych does 2 days of testing, (SLP one day, the psych is the second day.) neuro does it all herself over 3 days. Both do the various language tests along with IQ and achievement. Both will screen for attention issues as well.

 

Any insight? Does it even matter? I'm a professional over-thinker. 

Edited by Runningmom80

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DD13 was diagnosed by a neuropsych. Others may chime in, but from our experience, a NP is all that is needed. All of the schools we have dealt with (private, public, and a private dyslexia school) have  accepted the NP report, and none requested a report from an SLP.

If there are areas that a SLP can help for therapy to address issues that are identified, the neuropsych should recommend that in her report.

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I don’t think it will matter which one you choose.  

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FWIW, our neuropsych wouldn't do dyslexia testing, despite that being one of two primary reasons we sought an eval (the other being anxiety/emotional issues). And he never even told me straight up he wasn't going to test for dyslexia, so I was super ticked when I got our results back, and all he had done was a basic reading test - I think one of the Woodcock Johnson III subtests. No looking at RAN, no phonological processing / phonemic awareness, no other language skills at all, nothing. He said that they can't test for actual dyslexia because insurance wouldn't cover it (and since dd was reading "at grade level, she was obviously not dyslexic anyway"...). I countered that I would've paid it out of pocket if he had just *told* me he wasn't going to test for it for this reason! It was hugely disappointing.

When we finally settled on an SLP, she did all that was needed and we didn't even need the psych involved. So it would've saved us a *tremendous* amount of money to just do the SLP to begin with over the neuropsych...

Edited by 4KookieKids
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We were told by a neuropsych that insurance would not cover the dyslexia testing, because it was considered educational testing, not medical. But the NP still would run the tests; we just had to pay out of pocket for DD's dyslexia testing. (My two sons also had NP testing, and theirs was covered by insurance, but it was not for dyslexia).

It's definitely something to discuss with the practitioners.

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In our case the SLP works with an Ed psych and that team costs more than the NP. The NP assured us she would do the phonological testing required to diagnose. (We’ve asked her 100 questions at this point!) 

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On 2/4/2019 at 11:44 AM, Runningmom80 said:

Is an SLP + Psychologist preferable to a neuropsychologist or vice versa? 

 

We have it narrowed down to these two options, and the SLP + Psych is $600 more than the neuro. We will gladly pay the money if it's important to have the SLP involved. 

SLP + Psych does 2 days of testing, (SLP one day, the psych is the second day.) neuro does it all herself over 3 days. Both do the various language tests along with IQ and achievement. Both will screen for attention issues as well.

 

Any insight? Does it even matter? I'm a professional over-thinker. 


When we had our twin boys tested, we went with a local psychologist who is a dyslexia specialist. She was recommended to us by a close friend, and was also highly recommended by one of our local dyslexia schools. Our workup included -- 1 hour intake interview; 2 days of testing, and 1 hour followup, to go over the results. Our test result packet was 30+ pages. 

I would recommend checking out the Bright Solutions (Susan Barton) page on testing -- they'll give you practitioners in  your area. 

In your situation, it sounds like your neuropsych person is who I'd go with. But --- email her. Ask her questions -- what kind of tests, what do you do with results, etc, etc. 

 

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38 minutes ago, DiannaKennedy said:


When we had our twin boys tested, we went with a local psychologist who is a dyslexia specialist. She was recommended to us by a close friend, and was also highly recommended by one of our local dyslexia schools. Our workup included -- 1 hour intake interview; 2 days of testing, and 1 hour followup, to go over the results. Our test result packet was 30+ pages. 

I would recommend checking out the Bright Solutions (Susan Barton) page on testing -- they'll give you practitioners in  your area. 

In your situation, it sounds like your neuropsych person is who I'd go with. But --- email her. Ask her questions -- what kind of tests, what do you do with results, etc, etc. 

 

 

Unfortunately there are no Barton testers local to us. 

Our workup is the same as yours, but she’s not considered a “dyslexia specialist.” The SLP + Ed Psych are both members of the IDA. Now I’m second guessing our choice...

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What exactly do you need?  

If what you need is an official diagnosis and not much else, then I don’t see any reason to spend extra.

But that is just me.  

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13 hours ago, Lecka said:

What exactly do you need?  

If what you need is an official diagnosis and not much else, then I don’t see any reason to spend extra.

But that is just me.  

 

I need someone who can tease out stealth dyslexia and probably not so stealth dysgraphia.  I’m spending over $2,000 either way, so it’s not like one is way cheaper. 

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Yeah, that is different from just needing documentation. 

Definitely ask about stealth dyslexia.  And definitely clarify what you mean by stealth dyslexia.  I think it’s a term where you might have one thing in mind, and then another person has a different thing in mind.  

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Well I just got a response back that I’m not sure I feel confident about...

She said she uses CTOPP-2 only if “she thinks she needs to” after doing some other testing. She doesn’t use RAN/RAS.

 

 

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5 hours ago, Runningmom80 said:

Well I just got a response back that I’m not sure I feel confident about...

She said she uses CTOPP-2 only if “she thinks she needs to” after doing some other testing. She doesn’t use RAN/RAS.

 

 

 

I would absolutely run and not use her then!! Especially given your other thread on the AL board -- this is EXACTLY the problem we had with my dd! People spent almost a full year telling me she was not dyslexic because of (insert comment about her reading be "about right" or "at or above grade level" or "on par for age, since she's still young" here), before I found someone willing actually do the phonemic/phonological testing!!

Edited by 4KookieKids
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27 minutes ago, 4KookieKids said:

 

I would absolutely run and not use her then!! Especially given your other thread on the AL board -- this is EXACTLY the problem we had with my dd! People spent almost a full year telling me she was not dyslexic because of (insert comment about her reading be "about right" or "at or above grade level" or "on par for age, since she's still young" here), before I found someone willing actually do the phonemic/phonological testing!!

 

 

Thank you for this, I appreciate the insight! That was my gut reaction. 

We canceled with the NP and are going with the SLP + Ed psych. 🙂

 

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12 hours ago, Runningmom80 said:

Well I just got a response back that I’m not sure I feel confident about...

She said she uses CTOPP-2 only if “she thinks she needs to” after doing some other testing. She doesn’t use RAN/RAS.

 

 

The RAN/RAS s in the CTOPP, so that part doesn't make sense. The real question is what tests the np would run. If the np is doing zero language screening on a person with a suspected language disability (dyslexia) then that's absurd. Now the (remove not nice word) np who first eval'd ds used the CELF as a language screener, and the CELF has known issues with under-identifying kids with language disabilities. (sensitivity, specificity,blah blah) It also doesn't have a narrative language component. So then what you're really saying is how significant are the language issues on the person and how thoroughly do you want them explored. If the psych is doing the tests you want done, there's no issue. It sounds in your case like you're going with the SLP + psych combo. The nice thing about this is it sounds like they're used to working together. It's probably going to be a good experience. The perpetual problem with psych evals is getting actionable info. If there are language disabilities involved, then having that more detailed testing is what you need to get beyond the DSM diagnosis and get actionable.

I forget your whole situation, but I hope the evals are very informative!

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Yes that is my fear because she is reading above grade level, and third grade has such a wide range of normal, she’s not going to present easily as dyslexic. It’s in her spelling and writing that it’s most obvious to me. I gave her that online Z screener and she got a 61% on the first part which they flagged, and did fine on the second part (read words like a 5th grader, whatever that means to them) 

 

If there is just a screener given there’s a good chance she'll sail past it even though she clearly has an issue.

Edited by Runningmom80
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There's a test some SLPs are using now, the TILLS, that is hitting a lot of areas for language and doing better than CTOPP plus CELF. Since you're getting this SLP + psych approach, I think you're going to stand a much better chance of making a full picture of her needs.

As you say, the SLD Reading diagnosis can come and go and will be based on current needs, not genetics or reality. (The DSM is idiotic.) So yesterday your kid is dyslexic, today they are not. Or maybe they'll get there. But they really might not. What you want is the full picture and a current description and a game plan. If your SLP part of the team is going to do narrative language testing, something to dig in on syntax and morphology, etc. then really that's the best you can hope for. 

When I had my dd eval'd years ago, she was in that strong reader, struggling speller category. She didn't go dyslexic but she had this funky strange, crazy low word retrieval score that is typical of apraxia and dyslexia. Then ds was born with his apraxia and it became obvious why she was having troubles. As the spelling became less of an issue with tech those other language scores (word retrieval, processing, etc.) held and became much more significant issues. So that's why I'm saying focus on getting the range of testing and less on the changeable DSM terms.

Oh, and fwiw when we did genetics my dd was heterozygous for one of the dyslexia genes. So that's REALITY, like concrete reality that she's carrying something. But it's not showing up enough to go boom, call her dyslexia. I've seen studies showing at least 12 known genes that affect different aspects of dyslexia (phonological processing, word reading, etc.). So when there are severities and differences, that's why. The DSM recognizes none of it and doesn't care. It's just a current description of need for support, not this personal identifier of reality.

They can also go SLD Reading for some other things like comprehension, etc. If your SLP is thorough, hopefully they'll sort this out. Also run genetics if you want. It's kinda cool.

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