understanding learning differences
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| Tue, 09-19-2006 - 1:30pm |
All right I'm still trying to figure out how to decipher my daughter's recent tests and assessments so I can figure out how to help her. To say I don't trust other people ("experts") to do the helping is an understatement. Now I need help.
Yesterday while she was passed out in an undersized stroller in a book store I went browsing the education section and read a couple chapters on NLD and realized I misunderstood a few things about strengths and weaknesses in NLD and AS kids (my life is set up for the possiblity of occassional low reading retention at the moment).
So, I want to solicit some help/opinion/corrections/elucidation on my thinking here...
Based on the assessments my daughter seems to have average language skills for verbal reception, but a very high level of expressive language skills. She has low average skills for fine motor, and very low skills in the area of visual spacial understanding/organization. She also has sensory integration problems, social delays, ritualistic behaviors, scripted play and anxiety problems. All of these were observed by the assessment team and documented in the report.
They sent us to speech therapy for articulation problems and to help understand the reason for the gap between the receptive and expressive language (tested as a 17month gap in a 47 month old child). However, the speech therapist said she can't help with articulation until Kiv stops sucking her thumb (working on it) and that Kiv isn't eligible for language stuff because she didn't test below average on any of it. So, is language average, even with such a differenciation? When I was teaching and took a seminar in understanding standardized testing scores I was told that even if a child had all average and above average scores we should be concerned if we saw a range of scores of certain size accross certain skill sets as it was indicative of learning disorder. I thought that was the sort of thing you wanted to pick up, understand and address early? Of course this is a private place and what they can do is dictated strictly by my insurance company.
Anyway the original report went on to say that the results did not indicate a spectrum disorder. However, doesn't AS specifically require that the child have no language delay and that they have this sort of visual reception/organization problem? From my reading yesterday (and last night because I bought the book) I also gather NLD has the same criterion, although I'm less familiar with that. I have to read more about NLD.
So, what I'm getting from the report, scores, and my outside reading is that although none of these professionals will say more than "social developmental delay with pragmatic language concerns" is that I need to be advocating for a child that has AS or NLD or another serious processing disorder. I mean from lowest to highest score in one of these tests Kivrin actually showed a developmental gap of 33 months. That seems significant to me at least.
And why is it so hard to get and OT evaluation? Kivrin is seeing her 3rd speech/language pathologist this morning at school. For some reason they're all lining up to chat with her. ~~I'm aware she has a huge vocabulary. Yes, it's real cool that she can use "slippery" and "stegosaurus" in the same sentence. Now, ask her something real hard like why she wears socks. If you get her thumb back out of her mouth without a bribe I'll give your 10 bucks.~~ I really want an OT to work with her, because that's where I really see a need. Even if they don't have a lot of time to meet with her, I'd just like to have the eval done and a home regimine in hand.
Sorry this is so long.
Mary

ok, first I would get an independent assessment. Whether that means you want to request one from the district, get one through your insurance or pay for a private one, then definitely I would go that route. This is her first set of tests in the schools and you really want it well done and you want to be comfortable with it so you have a good baseline to start from.
Second, on the speech. I think I can explain it. It has more to do with what the law says they have to treat then what on paper is a red flag. First, It is REALLY hard to evaluate pragmatics and social language in young children with high functioning autism spectrum disorders. There just aren't the tests for them. It takes a talented, experienced ST who will do lots of observations and language samples. It is not uncommon for HFA/AS kids to do fairly well on standardized language evaluations. And your right, the scatter typically is a sign that there are challenges and is a red flag that needs to be addressed. However, and here is where what the ST said came in, according to at least our state law and likely IDEA they go by standardized tests to qualify a kid for services. A kid must actually score in California 10th%ile or below on 2 subtests in language to qualify at school age. That is darnnnnnnn low. In preschool typically they have to score at either 25% below thier age in 2 areas or 50% below in one area. So that means a child who is 4 would have to score 1 year below age level in say speech and cognition or 2 years below in speech.
So while I would be concerned at the split in her language scores, they may take the exact legal road and say, well she is average or isn't significantly below grade level so there for she doesn't qualify for help in that area.
Now, if you have a really great ST who has observed that though she can test well she isn't able to communicate effectively near her age level then they will approve it anyway despite the scores. That is how Cait is currently getting ST. Her scores this last time were all great but the ST still recomended speech services weekly based on Cait's conversational skills and I gotta say they are getting wayyyyy better.
Is that all really confusing or what? I am really pooped and I wasn't going to yet reply to this as my head is going to explode but I didn't want to let it drop off the board without you getting a response. I will try to look over it again tomorrow and see if there is anything I missed. In the mean time I have to meet with the school psych tomorrow to go over Mike's testing. Whoopie. I hear he is trying his best but getting dang frustrated. Bit of a meltdown at school today about it. Bummer.
Renee