Not satisfied with Nero-psych response

[Wishes]

Crossposting to Learning Challenges Board

In September I posted about my son’s neuropsych report and a few qualms that I had with it. I recently contacted the neuropych in regards to my son’s math skills and the likelihood of dyscalculia. My response is italicized.

I was also hoping to speak to you about his mathematics. As I continue work with him, I am becoming more concerned about math. I know you didn’t find dyscalculia in your testing, but here is what I am seeing. He has trouble determining the difference between 2 and 3 and between 4 and 5 amounts (on an abacus and also in items). He has issues with more and less. When we use a math balance, he would find that 2+2=4 for example. However, if the next one was something like 4+4, he would start with less numbers (4 again or even lower). Subitizing 5 has been challenging. I have been using Right Start A with him which is a strong visual/active learning base, however, I am at the point that I felt like I needed to stop. I am using some materials by a woman in the UK who specializes in dyscalculia, Ronit Bird. We are focusing on using the dot patterns in dominoes and dice and he seems to have a better discernment. So here is my dilemma; I am having a hard time deciding how much is processing and if there is something dyscalculia at work. He learned (through the program) to identify numbers on a two-colored abacus). He has trouble with 2/3 sometimes like I said earlier. If the number is seven, he will sometimes call out 2. I see this as his processing, because he sees the one color and is not processing the other. But other times, there seems to be a real disconnect in his understanding. It confuses me how he has such strong scores in the visual part of the WISC but struggles between 2 and 3 items. I had him work through an online assessment through DynamoMaths, an online program for dyscalculia, and he scored low. Do you have a specific program you used to measure his math or was it a discrepancy between the IQ and academic assessment. Do you have an alternative assessment you use to go further into the dyscalculia?

His response is bolded:

Regarding math, his basic calculations are intact, but the word-based problems are being impacted by his reading scores - we need to keep an eye on this though as he progresses through school as I could be consistent with Dyscalculia at some point. The inconsistency you are seeing might be due to his low automaticity skills (Rapid Naming) which can impact reading fluency, spelling, and math fluency. Regarding math programs, I like the Math-U-See Program and Singapore Math programs.

First of all, I don’t believe my concerns were addressed. In the testing, my son used marks to add up the simple addition problems he completed. I didn’t mention word based problems and that isn’t even something we are working on. I understand automaticity. How does that address his confusion in amounts? What about his seeming confusion about less and more? 
I’m feeling frustrated and a bit concerned. I want to make sure I’m on the right track with my son. I am still working on the medication end to help his focus and short term memory, but I want to address the LDs as well. Am I missing something in the response? 

[Rosie_0801]

Your system may differ from mine, but if you were here, I'd say:

Dyscalculia isn't in the DSM, I don't think, so they can't diagnose it.

You probably need an educational psychologist to answer your questions, rather than a neuropsychologist.

If I were you, I'd just assume the kiddo has dyscalculia and get on with teaching as though he did.

My dyscalculic kid wouldn't have learned maths at all without CSMP.

[PeterPan]

SLD Math is in the DSM and there are probably subtypes. I haven't looked at it in a while. They'll probably acknowledge SLD math on this dc at some point. It's just right now the test scores don't get him there even though the reality of it is obvious. There will come a point where he won't be able to cover it anymore. The bummer will be the psych could then blame it on your instruction. Unless testing again GETS you something, I wouldn't bother. Assume it is. And maybe do your next round of evals with a psych from the Hoagies Gifted list, someone who specializes in 2E kids or sees complex kids more. 

There *are* legitimately different ways to do things. For instance some psychs will just say "autism" covers everything and that separate SLD labels are not needed for those kids. It's just *helpful* to have them and I think it's important to clarify because not all kids with autism have the degree of challenges that come with the SLD. 

But yeah, he's complex, you're right, psych is underwhelming. It happens. It's why I'm not a nice person anymore. I've fought the system so long that I'm just done. 

[SFisher]

First off, Im not going to claim to have any advanced knowledge of dyscalculia.

but, I have read just an enormous amount of information on learning disabilities in the last year. My son is 2e and has mismatched skills… for example, his math ability outpaces his writing ability and depending on how he would’ve been assessed in the past, it could’ve been very confusing.

I think what the psych is trying to say is the testing is pointing to adequate math skills, but problems with output (saying/writing) the numbers. Rapid naming is being able to think of and use the right word.

One of my sons has a mild issue with rapid naming and he’ll forget the word for common things like a spoon and it is not predictable/consistent (he’ll not be able to think of a word one day, but remember it most of the time.) If I were to ask him to get a spoon he would be able to do it. And if I were to ask him if we use a spoon or fork for ice cream, he’d know the answer. If I asked him which is round, a fork or spoon? He’d know the answer. 

If rapid naming is the case, your child may be able to show math skills without verbal output. For example, if you gave him a sheet with a number line on it, and you gave him objects to count, could he point to the correct number? If you wrote on an index card “more” and on another “less” could he match them to two comparable lego towers? Or if he isn’t reading yet, you could say “point to the tower with more blocks”. If you remove verbal responses like saying numbers  or math terms and replace them with visual responses (pointing, matching, number stickers) do his abilities seem different?

If this was my kid, I would experiment a little with doing math that doesn’t require him to say his answers. And I would read more about rapid naming - how it presents and how you can support a kid who struggles with rapid naming.

There are probably lots of layers going on here and you’re starting to put it together. I’m almost a year out from my child’s neuro psych report… after carefully considering each piece and reading in more depth and seeing how accommodations worked, it ended up pointing me to a auditory testing and a diagnosis that no one saw coming.

 

 

Edited March 25 by SFisher

[Rosie_0801]

1 hour ago, SFisher said:

If rapid naming is the case, your child may be able to show math skills without verbal output.

That's why CSMP worked so well for my kid. When she was small, her non verbal intelligence was 6 years higher than her verbal.

We followed the CSMP curriculum (along with other stuff) but did a lot of work translating the CSMP diagrams into standard notation or vice versa, when her brain was too tired to actually calculate answers.

[kbutton]

Some kids guess more with time pressure too. I would imagine having RAN/RAS issues can make you feel like you are being pressured even when you are not.