Menu
Jump to content

What's with the ads?

displace

Neuropsych reading testing question

Recommended Posts

I have a specific question regarding testing reading during Neuropsych evals.  DS is reading ok, on grade level but not IQ level (probably), with only fatigue.  He does still skip articles, read words out of order, and skip suffixes.  During all prior Neuropsych reading tests, it’s usually a comprehension and vocab test, where a student reading silently and mixing up articles or suffixes may go unnoticed, especially in a high background knowledge/IQ. 

Are there Neuropsych tests that will pick up these small reading concerns?  Also, if he is trying hard he could probably make no mistakes for a bit, though it will slow him down.

Share this post


Link to post
Share on other sites

I don’t know what tests they used for this, but our neuropsych picked up these issues in dd who scores very high in reading comprehension. She ended up with a dyslexic/highly gifted diagnosis, among others. 

  • Like 1
  • Thanks 1

Share this post


Link to post
Share on other sites
1 hour ago, kand said:

I don’t know what tests they used for this, but our neuropsych picked up these issues in dd who scores very high in reading comprehension. She ended up with a dyslexic/highly gifted diagnosis, among others. 

Ok, so at least theoretically it’s possible.  Thanks!  I have always mentioned this and I know they do visual perception type tests, but at least two people have said there was no evidence of dyslexia.  And I think the definition has changed for diagnosis purposes (where we met criteria long ago of IQ/skill discrepancy, but may not anymore).

Share this post


Link to post
Share on other sites

She was only 7.5 when she had the neuropsych eval, but they did pretty limited/ basic achievement testing, so no, it probably wouldn't have picked up subtle reading problems.  But it's possible they do more in depth testing of academic skills with older kids.  The speech therapist actually did more in depth reading testing, including a CTOPP, which was very helpful.  

  • Thanks 1

Share this post


Link to post
Share on other sites

My then 18yo DS was retested one year ago for uni accommodations, and the SLD for reading was affirmed.  He scored a 34 on the reading ACT subtest.  Listening to him read, one would never suspect dyslexia.  I don't know what test the np used, but she determined the dysgraphia and dyslexia were both still present.

  • Like 1
  • Thanks 1

Share this post


Link to post
Share on other sites

Yes, though we have much better luck with an educational psychologist that understands 2e kids than a neuropsych who will be really black and white about every test and explain away every discrepancy (I think the quote was, "I don't really read into the numbers"). 

CTOPP is one test they use. Lots of observational data can help--you could bring in current and old samples of work. My second kiddo is 2e with a big mish-mash of auditory processing, dyslexia, dysgraphia, and dyscalculia (which stunned me). I think he was harder to diagnose because it's not just one thing, and sometimes there has to be enough little things going wrong all at once for the wheels to fall off the bus.

I think one thing that helped push us to the diagnosis is that at some point, my son got on ADHD meds, and it helped show a bigger discrepancy between IQ and achievement in areas that would be expected for dyslexia. Basically mitigating the ADHD helped demonstrate a really high verbal IQ with significantly lower WJ scores and some marginal CTOPP scores. Adding in older data and anecdotal reports of his struggles finally pushed things over to a dyslexia diagnosis.

I kind of wondered if I was making a mountain out of a molehill, but the harder the work has gotten, the more he gets gummed up on little things that shouldn't be problem. When I told someone who has worked with him that he got a diagnosis, she said, "Well, it's about time." Then, I saw some video footage (not something I can link to--sorry, it's from an online conference) that was like watching my son's own reading from a few years ago (and how he reads on a "bad day" now). I feel more justified in having been a squeaky wheel every day, lol! 

I also have the ability to (sort of) compare my kids to cousins who have similar ability levels but not as many struggles (even if they are also quirky). It's very enlightening. Those cousins haven't been tested, but everyone knows they are clearly gifted, and so many things are effortless for them that my kids have some kind of hang up about. Interestingly, when you find an area where there is more level playing field (meaning not an area of disability), my kids still give the cousins a run for their money. It's not a competition, and it's not something I talk about with the relatives, but the comparison also makes me feel more confident in my own observations. 

It's also possible to have both dyslexia and developmental vision issues. If you have a good developmental optometrist, you can rule out any concerns you might have or help you figure out where one issues stops and another begins (if applicable).

 

  • Thanks 1

Share this post


Link to post
Share on other sites
3 hours ago, displace said:

Ok, so at least theoretically it’s possible.  Thanks!  I have always mentioned this and I know they do visual perception type tests, but at least two people have said there was no evidence of dyslexia.  And I think the definition has changed for diagnosis purposes (where we met criteria long ago of IQ/skill discrepancy, but may not anymore).

P.S. This is why I mentioned the developmental vision issues--if those tests showed something, you can follow up on that as well as on the dyslexia question.

  • Thanks 1

Share this post


Link to post
Share on other sites

Well the other issue is that the psych is not asking what your genetic status is, only what is currently evident. Did he remediate well? Last psych who saw ds did the same thing, saying they didn't want to put SLD Reading or SLD math, which is obviously poppycock. 

So if the dc needs the accommodations or services that having that label would provide, then he needs the label. But having those labels change (which they do whimsically like that, we've been through scads of psychs now) means nothing about what is absolutely, actually happening. It doesn't mean his genes changed (I've seen studies listing at least 12 for dyslexia and have posted links in the past) or that the earlier diagnosis was incorrect or that your instruction was unnecessary. It just means that right now, with the way it's presenting, the psych doesn't see the need to use that label and assign those accommodations. That's all.

Personally, the more I use psychs, the less impressed I am with them. It's a really limited, pigeon-holed, expensive field. We let hugely important issues ride on what they see, and they have these stupid limited tests and snippets of time with the kid and make sweeping, sometimes idiotic conclusions. No offense to psychs reading the board. 

Advocate for what needs to happen. If he needs accommodations or access and this eval was to make that happen, then obviously you're gonna have to have a sit down and talk that through. Why were you paying to update evals at this time?

Also, fwiw, is he on ADHD meds? If he's not, that would be a logical question with all that word-skipping and impulsivity (or at least what sounds like it). You already did VT, yes?

  • Thanks 1

Share this post


Link to post
Share on other sites

In all seriousness, I don't know if you know our saga enough to know, but my ds literally saw *3* psychs in one year and ALL THREE SAID SOMETHING DIFFERENT!! I kid you not. It was surreal. 

Psych evals are snapshots, how it looks at the time, and the DSM is reflecting what needs to happen for service/support, not what is medical or genetic. Labels come, they go. They're not personal. And it really can be that whimsical and fallible. Think about it. *We* know our kids' weaknesses because we teach them and are in their minds. We know how to elicit them. But the psych just has this standardized tool and has to hope the 2E kid can't fake it out. So kids with high IQ can fake out a language test when it's heavy on multiple choice or provide models. My ds, at least so far, has been like 80-90-something percentile on math achievement testing, even though the kid can't tell you how many months from March to June (like no sense of it at all) and is only just beginning to learn multiplication. But oh yeah, he can pass the tests and look good, don't ask me how, lol. 

So how would the psych, with only standardized tools, sift through that? It's not personal, it just is what it is. And you'll find psychs who spend time and dig in and get to know the kid. But that's why I'm back to my point on advocating for what needs to happen. That's the most telling thing.

  • Thanks 1

Share this post


Link to post
Share on other sites

Thanks for the replies.  DS did have VT, and we “mostly” finished but may still go back for a follow up.  OT does still do some VT focus with DS.  The last Neuropsych testing was bungled, and I was trying to get diagnoses updated (if there’s dyscalculia, EF concerns, etc).  I’m pretty sure now he’ll meet criteria for ADHD (he’s always had the symptoms but the impact on learning and doing is now present), so I just want to be thorough.  I can’t treat ADHD with meds at the moment, but I want DS to know and me help him work on EF/memory stuff/etc.  Not that I like labels and diagnoses, but it’s much easier to explain that his brain functions this way because of X and that’s why we do Y, versus him realizing he’s different and it’s not just how he reads and writes.  Idk, kind of hard for me to pinpoint.  I tend to agree that that a lot of this testing isn’t objective enough and there’s not enough tools to help with diagnosis or treatments.

Share this post


Link to post
Share on other sites
39 minutes ago, displace said:

 I can’t treat ADHD with meds at the moment,

Ok, I'll bite or not be nice and ask or whatever. Why not? Money? Disagreement between parties? We had that issue in our house, where one was reluctant and the other uncertain. You seem to have had so many issues over the last few years that were directly related to the ADHD that it seems like doing something evidence-based that gets major improvement would be a goal. Of those, the only things I can think of would be:

-cognitive behavioral therapy 

-l-tyrosine

-meds

And then there's my ds, whose profile makes it unsafe to give him the meds, which is like extra nasty to work with, sigh. So I get if that happens. Beyond that, I don't know, just saying if you're having trouble, then prioritize bringing in a solution known to make a difference.

  • Like 1

Share this post


Link to post
Share on other sites
5 hours ago, PeterPan said:

Ok, I'll bite or not be nice and ask or whatever. Why not? Money? Disagreement between parties? We had that issue in our house, where one was reluctant and the other uncertain. You seem to have had so many issues over the last few years that were directly related to the ADHD that it seems like doing something evidence-based that gets major improvement would be a goal. Of those, the only things I can think of would be:

-cognitive behavioral therapy 

-l-tyrosine

-meds

And then there's my ds, whose profile makes it unsafe to give him the meds, which is like extra nasty to work with, sigh. So I get if that happens. Beyond that, I don't know, just saying if you're having trouble, then prioritize bringing in a solution known to make a difference.

A combo of medical contraindications and personal desire.  I can speak only for myself in that I definitely don’t want to withhold something necessary, but OTOH, I will be super cautious about side effects and potential side effects of meds.  We have mutiple concerns for contraindications.

  • Like 1

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×
×
  • Create New...