UPDATE!! “Screening” mtg w/public school

[PeterPan]

34 minutes ago, mmasc said:

By far on the SLP’s test, the Understanding Spoken Paragraphs was the lowest. 

Check but it sounds like they administered the CELF. In testing we talk about sensitivity and specificity, one meaning how often they get it right and the other meaning how many people with issues the test misses. The CELF is commonly used as a language screener in the ps because it's one hour, lots of things done, boom. However it has serious sensitivity issues and *under identifies* kids with language disabilities, especially in kids with a higher IQ. It's a known issue and some test publishers have started issuing cutoffs to guide interpretation for better sensitivity. Also, the CELF entirely uses *multiple choice*. Think about this, a language test puts the answer in front of them and then says can you identify it. Kids like mine can easily bluff their way through that, hence the sensitivity issues. Life is not multiple choice.

37 minutes ago, mmasc said:

he had a full audiologist exam for APD when he was 8. Presumably it was done correctly and he hasn’t developed that since then. Surely...

There are a few different systems or approaches so a different audiologist might test differently. No I would not say it's universal like oh just run the SCAN and you know it got done right. My kids have been two three different audiologists (one private, one in CO at a big name clinic, one at a well known university program) and the evals totally varied. 

40 minutes ago, mmasc said:

the psychologist noted that “phonological memory” was an area of difficulty.

That screams APD or some kind of larger language based disability. Remember, APD is *not* some mysterious auditory processing problem but a LANGUAGE problem. So an SLP who has thorough language testing can diagnose and treat that APD just as well. It's auditory processing of LANGUAGE, not blips and beeps. And that's why it's not a path thing to diagnose, because you're asking what nuanced areas of language a particular individual has difficulty with. They might have difficulty in one subset and be fine in others, which means they "test" fine overall but are having great difficulty in real life!! It's why the answer is detailed, super detailed SLP testing, which you have not had yet. Your kid is flagging on the CELF, which is an overall screener that many would have passed even with language problems. So it is NOT crazy to be beating this language drum and asking for more detailed evals. Everything you're saying goes back to language.

42 minutes ago, mmasc said:

She also noted on rapid naming skills, he was above average.

Because rapid naming is typically not worked on directly and because it is commonly low in dyslexia it's considered a lagging indicator even when there has been intervention. Did you work on it directly? If you did, then that's not a solid way to make a decision on dyslexia. If you did not, then yes that's a really good sign that the issues you're seeing are probably not due to dyslexia. It's hard to believe, but there's actually a movement saying not to bother with rapid naming, which is total hogwash. Strong rapid naming scores are highly correlated with strong readers and it's just logical. (soap box and all that)

44 minutes ago, mmasc said:

Working memory was his best score.

That's really good!! Was it something you worked on or built through your teaching style? Working memory is the scratch board of the brain, allowing info to go from short term to long term memory. It's excellent that it was a strength for him.

46 minutes ago, mmasc said:

the SLP said he “was all over the place”. And she did say distracted.

The first ps SLP we had on our IEP team *knew* ds was on the spectrum, knew what was going on, but it was very clear what the coor was telling them for what his disabling condition was to be and how he was to be profiled. There is a silencing, a stifling, and you'll see a lot of turnover in the ps I think because of this (and many other reasons). 

Attention and distraction are such a funny thing. If he's struggling to understand spoken paragraphs, that's GOING to show up in life, in academics, etc. Have you compared lexiles for what he can read with engagement (comprehension, attention, ability to narrate and talk about) vs. what he can listen to for a read aloud with engagement? Now narrative language is technically separate, but that behavior piece is very telling for when the comprehension breakdown is occurring. If you had to sit in a room where everyone was speaking Russian, how long would you pay attention? Would that change if you knew Russian? Exactly. 

[PeterPan]

To offer SLP services, they would want to see *significance* in the scores. So them not offering SLP services does NOT mean he would not benefit. It means that he's skating by and averaging out. He could have subtle challenges in a bunch of language areas that together make him struggle but aren't showing up on any one test that *they* are administering to make it obvious that he needs intervention. And if his scores are fine overall and he's accessing his education, you won't likely get service. 

For him to reach his POTENTIAL, you have to go private. It's just how the system is. You should be very concerned if he has significant discrepancy on a section like understanding spoken paragraphs, mercy. The school not offering services does NOT mean he does not need intervention. 

What happens is that eventually a bright dc's ability to mask and ability to compensate gets maxed out. It's only a matter of when.

[PeterPan]

55 minutes ago, mmasc said:

What can I do *today*? Not totally sure, but 1) keep using the whiteboard and maybe Math U see (again) for math to give that highly needed white space. 2) no more reading science out loud without him having something to follow along with. I’ll provide the text so he can engage with it more. 

That's really smart to go more visual! Is there a difference between how he does with computation vs. word problems? Just wondering how that paragraph comprehension score is showing up in real life.

If I could suggest, I would look at the lexiles on your read materials and look through what is working, what is not, and see if there is a pattern. Lexile considers syntactical complexity, which is definitely part of that "understanding spoken paragraphs" score. So if there's a pattern where higher lexile is connecting to behaviors, pushback, or struggles, then dropping the lexile to get him into material that is better fit could bring immediate change.

https://hub.lexile.com  This is a website I use ALL THE TIME to get materials that will work for my ds. I find things that are working, look at the lexile, then do a search and limit it by topic/genre. So say you want to study art this summer and want a book series. You can look for art books at the target lexile. It can be really humbling, but it works!! Then you might get back some of that engagement, attention, and narration but dropping the language level to fit where he's definitely comprehending. 

Teachers do this all the time using reading groups by level in their classrooms, using differentiated instruction materials (same workbook with 3 levels of pages), etc. We're just doing it 1:1 so it's trickier. With my ds, I also notice what level of language the materials can be for *independent* work vs. instructional level *together* work. If I want the work to be INDEPENDENT, then it CANNOT be at instructional level. In this case, that means it is going to need to be at/below his language comprehension so he can do it independently without comprehension being a factor. If you're wanting independent work, that's something to look for is ways to drop the language level. Be humble on this and get your peace back.

Fwiw, I've talked about this and people are like oh that's awful. Fine, whatever, but one of the phrases I'll use is "like a rock star." What would I have to do to the material (dropping the grade level, changing the language level, increasing EF supports, adding structure, adding tech, whatever) to get him able to do it LIKE A ROCK STAR? That will tell you a lot. Reality is you know the gap between what he could do like a rock star and what he's doing with lots of support.

I'm all for supported instruction! There was this educator dude Vygotsky and you can read about him and his theories. There's lots of room for mentored instruction, doing things with them that they aren't yet ready to do independently. That's GREAT!! But if you want independent work, ,that's totally different. And when you as the teacher think through this honestly, that's where some of the breakthrough comes. What math could he do completely independently and what would it look like done together? What LA could he do independently and what could be done together?

That way I can say what my goal is. If my goal is independent, I have to drop the language level and instructional level to meet my goal. If my goal is at instructional level or higher (mentored, like Vygotsky) fine too. I just recognize what I'm doing and differentiate the levels of those materials to fit the type of work I'm trying to accomplish. Not one level of interaction but varied. 

I'm just saying that's how I get peace with my ds. I'll make another post on something positive. 🙂

[PeterPan]

You said working memory was a strength in his scores, so good harness that!! That working memory would let him play board games. Does he enjoy them? Then build that into your day! Do more of what is going well. The evals found you something that is going WELL and you want to lean in on that. Use that for breaks, build it in. 

When things are hard, one of thing best things you can do to turn things around is find something that is going well and lean in on it. If you only work on areas of disability, life looks really down. Make space in your day for something that goes well.

[mmasc]

I’m not seeing the CELF listed, so I’m not quite sure where she got that, especially since it was on the psychologist’s report and the SLP report. 
 

Ok, so I live in the BIG CITY. There are no less than twenty gajillion SLPs within 20-30 minutes of me. How do I find one that HAS and CAN DO the detailed language testing?? Do I find out names of tests and specifically ask if they do them? Because if I just call places, I feel certain that they ALL will tell me they can do whatever I need done, kwim?

[PeterPan]

Ticket to Ride comes in several levels and versions. Ditto Catan. Both should be great for someone with strong working memory. Strategy games, anything where he holds his thought. We really like Rivals for Catan. There are cooperative games like Forbidden Island. 

I forget what your dynamic is like and why you're pursuing evals now. If things are not positive, then that's what you're looking for, something that goes well to lean in on and do more of.

[PeterPan]

Just now, mmasc said:

I feel certain that they ALL will tell me they can do whatever I need done, kwim?

LOL yup. Did they list the tests they used anywhere? Maybe it was so obvious to them they didn't bother, sigh. Nothing like making it so a parent can't trust but verify. No test name so you can't google and question their interpretation. 

Here is a link with the CELF 5 cutoff scores for sensitivity. https://www.leadersproject.org/2014/02/17/test-review-celf-5/#:~:text=The%20CELF%2D5%20reports%20sensitivity,Plante%20and%20Vance%20(1994).

 

[PeterPan]

Wow, I hadn't looked at the scores lately. Looks like as minimal as only 1 SD of discrepancy could be necessary on the CELF5 to have decent sensitivity. Most schools are looking for 1.5-2 SD and will say that for all tests. It's only in the last few years that we've started getting these cutoff scores. 

If you're not enrolling him, doesn't seem like a fight worth having. Is there something on the line here with eligibility or services you want access to? It's not like the school would provide amazing service even if they qualified him. Like his IEP might say something like 15 minutes a week or 2 hours a quarter or some such thing. It would blow your mind. Might even just say push-in services or consultative instead of direct.

Privately, I have my ds working with 4 SLPs every week. No kidding. Hours and hours. And have for years. Now it shows, because his articulation is perfect, he can chew and eat, he is improving in conversation, he can go in noisy places, on and on. But you'd be horrified if you saw his IEP. It seriously has always said something like 20 minutes a week, 2-4 hours a quarter, something like that. For severe apraxia, autism, on and on. For real. 

So only fight the fight that is necessary. I qualify him and then use our state funding to make things happen that need to happen. If you're enrolling him, you have a different ballgame. If you're enrolling him, then you have the challenge of deciding how much to fight, what to do privately, etc. If you're enrolling him, you may need to do some private evals to update the IEP or even file an IEE. If you're not enrolling him, doesn't matter.

Don't make this personal or about who was nice. They're nice people and they did what the system told them to do. It has limits. YOUR job is to make happen what your ds needs. 

[mmasc]

Yes, he does like board games! We don’t play them nearly enough so that’s a good reminder to add them back in. Thanks!

Re: did I specifically teach working memory or work it into my teaching style? Ummm, I guess not.🤷🏼‍♀️ If I did, I didn’t know it lol. Now reading, yes, we worked *a lot* on phonological stuff, remediation, High Noon, etc etc etc. So I guess we did hone in on that for sure. (I’ve got old posts on here for that too)

[mmasc]

12 minutes ago, PeterPan said:

Ticket to Ride comes in several levels and versions. Ditto Catan. Both should be great for someone with strong working memory. Strategy games, anything where he holds his thought. We really like Rivals for Catan. There are cooperative games like Forbidden Island. 

I forget what your dynamic is like and why you're pursuing evals now. If things are not positive, then that's what you're looking for, something that goes well to lean in on and do more of.

We have Ticket to Ride! It’s not one of ds’s favorites, but when we do play, he usually beats us all with his very strange to us/unconventional methods 😂

(He really likes Monopoly and Uno, and sometimes Labyrinth)

I did look at getting some tangrams since I saw those were good for visual spacial struggles  

I’ll look into the others you mentioned. Thank you! 

Edited May 20, 2022 by mmasc

[PeterPan]

9 minutes ago, mmasc said:

Ok, so I live in the BIG CITY. There are no less than twenty gajillion SLPs within 20-30 minutes of me. How do I find one that HAS and CAN DO the detailed language testing??

To learn more about the tests that might help him, go to major vendors like Super Duper Inc or ProEd Inc and look at their testing sections. It's all there, nothing mysterious, and then you'll know. They're going to flat say yes we own the tests you listed or no we do not. You're going to ask them what tool they run for pragmatics and they're going to say. You're going to ask them what tests they own for expressive language and they're going to say. You're going to ask them how they handle APD and what tests they have and they're going to say. 

I suggest googling

state name + SLP + literacy

state name + SLP + expressive language

state name + SLP + autism

state name + SLP + APD

state name + SLP + apraxia

state name + SLP + dyslexia

You're not looking for popularity but more who seems really into it. Network a bit, kwim? Like our apraxia SLP is *not* the person to see for expressive language! She has the tests, but really you don't do motor planning AND language well, because motor planning is such a specialty. So what you want is the person who's doing crap on apraxia even though they claim to and is banging it out on expressive language, snort. Or someone into literacy who got crazy into language and has all those tests. (In our Big City it's a professor.) Or find an APD clinic and ask what SLP they refer people to for evals.

The SLP we're using right now for auditory processing worked at a school for the deaf before. She just has a much better sense of how language is acquired. Someone else here said the same thing that their deaf/hoh SLP specialist was awesome for language. 

When you call and talk with the SLPs, right down the jibberish and acronyms and then google them. It's just a learning curve, sigh. You can also network and find a FB group in your area for autism or SN and see who people are using. One of the amazing people in our area does a lot of the IEE testing and it's what she is known for. That reputation for doing crazy thorough evals gets around, kwim? 

[PeterPan]

16 minutes ago, mmasc said:

Re: did I specifically teach working memory or work it into my teaching style? Ummm, I guess not.🤷🏼‍♀️ If I did, I didn’t know it lol. Now reading, yes, we worked *a lot* on phonological stuff, remediation, High Noon, etc etc etc. So I guess we did hone in on that for sure. (I’ve got old posts on here for that too)

High Noon doesn't weave in rapid naming. The fact that that is strong is, like the psych says, really interesting. It would typically remain low unless worked on directly if it's dyslexia. But the fact that you had to go to such lengths is significant. So call it APD, call it whatever. The SLPs will have some testing when you find the right person and you can update the APD testing with a different audiologist.

I'll go into the weeds here. We acquire language naturally parts to whole (prosody, babbling, limited then more complex language). Some kids' brains are acquiring language whole to parts and there's even a (ridiculous) theory that we should embrace this and that it all works out, which is of course hogwash. My ds has a gifted IQ and his brain was TRYING so hard, memorizing massive amounts, trying to get down to the parts. Well he couldn't get there. The answer was to build up from parts to whole, like what should have occurred.

So with APD what they're talking about is that the auditory processing of language is not going well. Dyslexia is focused on phonological processing and the written language, and my ds is diagnosed with that. But we did so much visual and *didn't* get all the auditory processing of the bits of language. So you can get dichotic listening issues (difficulty with background noise), issues with morphology and spelling, all sorts of things. And the exact mix is just the kid. But it's essentially LANGUAGE. 

Which is to say that's why you could swear it's dyslexia and it's not. And it's why an SLP eval or more nuanced audiology eval (for the language processing=auditory processing) could turn up things. Everyone's pockets will vary. Like my dd could fly through things, almost anything, and yet she had such nasty issues with dichotic listening, word retrieval. You almost couldn't find the holes. On some kids they're more obvious. 

The answer is not to say his scores average out, move on, because the effects of the subtle holes don't go away. It's fine to do an OT eval and get really good screening for retained reflexes, because those DO affect language. And my dd had reflexes that just did not want to integrate and stay integrated. Definitely connected with her funky, hard to diagnose, never any big thing but definitely lots of funky things situation. 

Edited May 20, 2022 by PeterPan

[Kanin]

2 hours ago, PeterPan said:

I've used umpteen SLPs, OTs, psychs, you name it. It's *very hard* to get anyone to dig in and find the subtle issues. Those people are special. 

 

Very, and soooooooo overloaded that they probably don't have time to dig as much as they might want. 

[mmasc]

16 minutes ago, PeterPan said:

LOL yup. Did they list the tests they used anywhere? Maybe it was so obvious to them they didn't bother, sigh. Nothing like making it so a parent can't trust but verify. No test name so you can't google and question their interpretation. 

 

Psych listed these:

Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI 6)

Comprehensive Test of Phonological Processing (CTOPP-2)

Wechsler Intelligence Scale for Children (WISC-5)

SLP listed:

CELF-5

[PeterPan]

Just now, Kanin said:

Very, and soooooooo overloaded that they probably don't have time to dig as much as they might want. 

Our school district finally got to hire more people with COVID. It was unbelievably hard before that and the staff were so stressed.

[PeterPan]

Just now, mmasc said:

Psych listed these:

Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI 6)

Comprehensive Test of Phonological Processing (CTOPP-2)

Wechsler Intelligence Scale for Children (WISC-5)

SLP listed:

CELF-5

Did the psych or someone do achievement testing??

[PeterPan]

18 minutes ago, mmasc said:

Yes, he does like board games! We don’t play them nearly enough so that’s a good reminder to add them back in. Thanks!

Sometimes we had something that was working and we didn't realize *why*. 🙂

[PeterPan]

The biggest thing private evals did for me was to say it's OK to do things differently. I'm a slow learner, haha, and I would ask about a subject and the psych is like yeah do that one out of the box too. Over and over.

It's ok to get data about your kids, see them as they really are, and make a positive path. There's some work to be done and that part is a little ouchy (finding the right people, getting the materials to do it yourself, whatever). But it's OK to have a very sticky situation that doesn't look like some of the people here on the boards and go BUT WE'RE OK. Do what fits him and do it fearlessly. 🙂

[mmasc]

9 minutes ago, PeterPan said:

Did the psych or someone do achievement testing??

The special Ed teacher administered that. 

[PeterPan]

2 hours ago, mmasc said:

I did look at getting some tangrams since I saw those were good for visual spacial struggles

Is he having issues with visualization or geometry or visual/spatial tasks? 

[Terabith]

I have a 2e kid who is very crunchy and has incredibly disparate scores.  Even though she’s not really ADHD, they suggested meds to bump processing speed.  That didn’t really work for us, but it might be something to ask about. When she was young, we honestly weren’t sure if she’d be able to live independently, let alone go to college, but she’s actually fantastic now at 17.  Still crunchy…can’t spell, has loads of issues with certain kinds of memory tasks, struggles with algebra, but she’s doing fine.  We put massive efforts into getting her to be a fluent reader.  

[mmasc]

I’m so glad to hear all of your success stories! Your dc are lucky to have you on their side😊

[mmasc]

2 hours ago, PeterPan said:

Is he having issues with visualization or geometry or visual/spatial tasks? 

Ummmm...yes, for sure. Anything geometry is his nemesis 😂 We’ve been working on perimeter and area for.ev.er. Forget any other age appropriate geometry stuff—not there at all. Lining up numbers vertically to add/subtract, especially with decimals is tough. 
 

When he was little, he never liked pattern things or sequencing things. He never liked building legos, but loved playing with them, so he’d have his siblings build them. He never liked puzzles much either. 
 So yeah, all of the math stuff regarding visual spacing is there for sure—shapes, geometry, patterns, measuring, etc  

The only thing that’s a bit of an anomaly is that he IS very good at sports.

[PeterPan]

1 minute ago, mmasc said:

Lining up numbers vertically to add/subtract, especially with decimals is tough. 
 

When he was little, he never liked pattern things or sequencing things. He never liked building legos, but loved playing with them, so he’d have his siblings build them. He never liked puzzles much either. 

You're listing a lot of things there that could be impacted by vision. Have you looked into a developmental vision eval? Our place will *screen* for the developmental issues and then do a longer eval if warranted. Might be worth it at least to have a screening. 

[mmasc]

57 minutes ago, PeterPan said:

You're listing a lot of things there that could be impacted by vision. Have you looked into a developmental vision eval? Our place will *screen* for the developmental issues and then do a longer eval if warranted. Might be worth it at least to have a screening. 

We did a full, 9 month in-person VT stint about 3 years ago. Helped TREMENDOUSLY on skipping lines while reading and words “jumping around”. I didn’t notice much math benefit, but the reading for sure. 
 

Also, I’d like to put in a HUGE thank you here to you guys because if I hadn’t been an avid reader and researcher on this forum, I would’ve never known to seek out a developmental optometrist. 

[kbutton]

22 hours ago, mmasc said:

Yes, he did have vision therapy in-person for 9 months about 3 years ago. I should probably pull out some of the materials they used just to have him double-check that he can still do it all. (They said we could do that, but expected him to not have any more problems). I shudder to think what the visual special scores would’ve been before therapy. 

Maybe I won’t have to fight for *something* to be provided. I will go off the angle that those accommodations are what is providing those “average” scores. I’ll have to look and see about the difference between visual spacial and verbal. I don’t remember. Thanks for that tip though. I’ll definitely look at it. 

from what I can tell, they did not do those other iq tests that you mentioned. She did say that his working memory was good (average).

Yes, before VT, things probably would've been worse! Sometimes kids need a little push when they grow a bunch, but yes, VT gains should be permanent unless something else is going on. For instance, one of my kids has some visual accommodation issues that VT will not fix because he has defective connective tissue in the structures that hold the eye lens in place. 

One of the principles in special education law is that supports that are working should not be removed. If what you are doing rises to the level of intervention vs. accommodation, then it should be acknowledged in the IEP.

So, FSIQ and GAI are just variations in the way that an IQ is reported. FSIQ is full scale IQ, and it's how they report all the tests they do as one overall score. If your kid has a lot of variations on the individual parts of the test, the FSIQ doesn't capture that very well because a kid with even scores across the board and a kid with highs and lows across the board may very well not really have the same IQ at all. Generally for a spiky profile, the higher scores are going to show actual potential, and the lower scores are going to show areas where they likely have a disability influencing the outcome. 

The GAI is another way of reporting scores. General Abilities Index--because a lot of kids have pretty consistent scores across the board but show deficits in processing speed and/or working memory, GAI calculates a score that leaves processing and working memory out. It's a pretty typical way of showing how a student will likely do if they have their processing and working memory accommodated. 

Some kids have really similar FSIQ and GAI, and some have really different scores when reported both ways. Other kids (like one of mine, lol!) is super spiky no matter how it's reported, but the spikes are even around the subtests--for instance, my kid will have both high and low scores on the language part of the WISC (ranging from average to extended norms), and all of his test groupings are like that vs. having high language index but a low VSL index. Some kids have one index a lot higher or lower than the others. 

It's all just a way to try to capture different aspects of what testing shows beyond an overall single number. 

Good working memory is a huge help! 

9 hours ago, PeterPan said:

You're going to have to dig in on what you've got. They did good tests, but they did not exhaust the testing it could take to sort this question out. Personally, I would be heading to an SLP who specializes in literacy at this point.

You gotta love ps evals. Bless their hearts, throwing out "poor verbal comprehension" and then not doing the evals to explain it. So APD, SLP issues, what is at the bottom of that? That's outrageous not to get that sorted out but it's how the system works. If his scores are fine, treat it as EF and move on. You SHOULD do all the things they're saying *and* you should get further evals to see if there are treatable issues explaining the "poor verbal comprehension". That's eyebrow raising and something to look into. You want to know if ADHD meds solve it (it's only attention) or if there's APD or some subtle language issues going on or what. That takes more detailed testing and specialists.

Sure and why is vocabulary low? Time for SLP evals. Private, someone specializing in it, someone who will spend 6-8 hours just on language and dig in and sort it out. 

I agree. 

9 hours ago, PeterPan said:

The psych looks at my kid and goes doesn't fit in. ED classroom is closer. Gen ed with resource room. They have these options and they're profiling the kids and going ok this kid with this mix *tends* to do well here. They know how that mix rolls.

Another profile that doesn't tend to get served well is kids who have borderline IQs. Kids whose IQs are in the 70s and low 80s (or spiky but averages to this). They usually do too well to be in the special ed classes, but they are shoved through the lower "normal" classes that might have an interventionist there "for anyone." If they have a lot of help at home, they get even less at school. 

1 hour ago, mmasc said:

Ummmm...yes, for sure. Anything geometry is his nemesis 😂 We’ve been working on perimeter and area for.ev.er. Forget any other age appropriate geometry stuff—not there at all. Lining up numbers vertically to add/subtract, especially with decimals is tough. 

When he was little, he never liked pattern things or sequencing things. He never liked building legos, but loved playing with them, so he’d have his siblings build them. He never liked puzzles much either. 
 So yeah, all of the math stuff regarding visual spacing is there for sure—shapes, geometry, patterns, measuring, etc  

This really makes me think NVLD is definitely an area to look into. 

[PeterPan]

2 hours ago, mmasc said:

We did a full, 9 month in-person VT stint about 3 years ago.

Did the VT doc check for retained reflexes? If not, you should get his vision rechecked. Developmental vision can change with growth spurts, etc. and if the reflexes were not integrated the problems are likely to remerge. I'm not meaning to discourage you, just saying it happens. It may be they didn't get everything done and it may be that he needs the OT/reflex work to get the rest of the way. He should not be having trouble lining up columns of numbers to do his math.

[kbutton]

2 hours ago, kbutton said:

Generally for a spiky profile, the higher scores are going to show actual potential, and the lower scores are going to show areas where they likely have a disability influencing the outcome. 

Quoting myself to add that a child with relatively even scores across parts of the WISC is likely to have the easiest score to interpret and most accurate score to interpret. So, spiky may mean less accurate (or not), point to a disability (or not), or simply be difficult to interpret when you look at the full score vs. the parts and pieces, if that makes sense. 

[Storygirl]

I agree with the idea of you reading about nonverbal learning disorder. You are hitting on the main criteria: Verbal scores much higher than visual spatial on the WISC, low processing speed, trouble with reading comprehension, mathematical concepts (specifically geometry, but can be trouble with higher mathematics in general), and social/pragmatic language difficulties.

You didn't mention the social/pragmatics specifically from what I can remember, but it is suggested by having lower vocabulary and background knowledge, and the comprehension of paragraphs.

DS18 has the NVLD profile.

NVLD kind of merges into the autism spectrum. Some kids with the profile do not have ASD, while others cross over into a autism diagnosis. My son was diagnosed with NVLD at age 10 by a neuropsychologist and was diagnosed as autistic at age 15 by a psychologist who specializes in testing for autism. Many/most professionals don't use the NVLD diagnosis, since it's not in the DSM, but you can still read about it, and I've found it EXTREMELY helpful to understand more about the profile when helping my son.

I think you should keep your appointment for the private evaluations that you are on the waiting list for. And I agree with pursuing private SLP testing, as well. The school testing gave you some valuable information but didn't uncover enough to answer all of your questions.

[PeterPan]

9 hours ago, Storygirl said:

NVLD kind of merges into the autism spectrum. Some kids with the profile do not have ASD, while others cross over into a autism diagnosis.

Because this is the case, op needs to gather data and consider her psych choice. If she does the SLP evals and gets pragmatics testing and is flagging there, then she'd be wise to make sure the psych she's using has significant experience with autism. Psychs have a range of tools for examining that question, from a simple form like the GARS (spit spit) to the ADI-R (better) to detailed "gold standard" intake evaluations like the ADOS. So when that is the question, getting someone who works with it a LOT is sometimes the best way to get it answered. The psych who is good with ADHD and SLDs might not be the person to sort out the ASD question, even though in theory they should be. When psychs specialize in autism, then tend to spend more hours on that question and run more tools (paper tools *plus* the ADOS *plus* lots of their own observations) to make sure they address it thoroughly. 

Also @mmasc might be wondering why the school psych didn't address this if it was so obvious or potentially on the table. It's just the limitations of how their evals roll. They're not open ended. If she didn't say something that compelled them to consider it when they sign the consent to eval forms, then then don't. And any tools they would have run on the ASD would have been (generally) limited anyway, like maybe just a GARS (spit spit). Now there *are* school districts that have teams that are ADOS-trained, and this is SO AMAZING. I love that this is happening. You get some serious conversations there when the entire IEP team has been trained on the ADOS and knows what they're seeing. But just to go in and come up with answers, that's not how school evals roll. They limit themselves to what was initially agreed to on the forms. 

I'm sorry this is not fun and has to be on the table. However it's just how some kids are, needing to see multiple psychs to get the layers of challenges addressed. There's a lot of peace to be had on the other side, as you get answers that make sense and explain the *gamut* of what you're dealing with. In a school setting they would start with the evals they did, see if those accommodations were enough, and then reconvene the team as more became obvious. They only do what is necessary for the dc to access their education. It's not medical evals meant to explain every component of what is going on or indeed to OPTIMIZE his ability to succeed in school and life. 

In reality, our questions are different from what the school was asking. The school process is helpful and it got you a start to know what to be asking next. 

https://www.socialthinking.com/Articles?name=social-thinking-social-communication-profile  You might find this article interesting.

[prairiewindmomma]

Beery is the one of the main screeners all of the vision therapy places we've gone to. It does pick up quite a bit. 

I kinda agree with the NVLD profile idea also. School districts generally don't mention it because it's not in the DSM, so if they can't differentiate out specific issues, and there aren't some clear discrepancies going on they will either say "doesn't qualify" or they will try to qualify under a broader diagnosis like anxiety or something. 

In terms of lining up numbers, try using grid paper, and try using highlighters for each place value setting. I would use orange through all of the thousands, red through all of the hundreds, yellow through all of the tens, and green through all of the ones.  As he is writing out the numbers, it will be easier to line up visually. You'll also understand pretty quickly whether he is comprehending place value in numbers...ie that in 743.69 that 4 represents 4 tens or 40.

I'm totally curious, big picture, what your plan and goal is.  If he is finishing up 7th now, he has a year until high school starts. Are you thinking you want to take him all of the way through high school? If he isn't capable of college level work, are you ok with an unaccredited diploma? I hate to ask the hard and awkward question, but I think it's one you'll need to reckon with. I ask only because in looking at trade skills job placements here, the accredited versus unaccredited diploma is a very big issue. It may not be where you are.....but the next few years will pass very quickly and it is easy to forget that when you're still working on basic fundamental skills. 

[PeterPan]

On 5/20/2022 at 6:06 PM, mmasc said:

I’m so glad to hear all of your success stories!

I was watching this video and thought it's kinda like raising our kids. You can watch his story, but basically he visualizes the end, decides he can, and then does what he doesn't know how to do, lol.