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Post by momfromma on Mar 31, 2011 16:19:43 GMT -5
I think it is good to start the speech therapy as soon as possible, assuming the services are fine. However, I would want to dig deeper concerning the reading. The program they are proposing www.amazon.com/Bringing-Words-Life-Vocabulary-Instruction/dp/1572307536 seems based only on learning new vocabulary. This is fine if your son has real problems and his only problems stem from his low vocabulary level. However, it will do little to help his decoding skills and fluency, if he needs any help. I would also want to dig deeper with the writing problems. Yes, it may come from his language issues, but it is not clear they have eliminated other possibilities.
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Post by chiaroscuro on Mar 31, 2011 16:32:57 GMT -5
Thanks,
I agree momfromma, and hopefully they will stand by their word. They did seem sincere. If not ,I will seek evaluations on my own. I will post my son's most recent assessment when I receive them from the reading specialist.
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Post by chiaroscuro on Apr 12, 2011 16:53:42 GMT -5
Hi everyone,
I just wanted to give an update. My sons CAPD eval. was rescheduled because my son had a cold and was scoring in the low average range on just the general hearing part of the test they believe due to negative pressure in his ears. So it is set for 2 weeks from now.
I did get his latest reading assessment for CAS.(reading support) Mid-Year level E
WCPM-11 (Proficiency 23-47)
Accuracy 85% (Proficiency 93% and above)
Dictation 94% (Proficiency -86% and above)
RBI-Pseudo Words-10 (Proficient: 11 and above)
Sight Words-16 (EOY proficiency:30)
Comprehension-1 (0-4 below benchmarks)
3rd nine weeks *new* level-G
WCPM-29 (Proficiency 53-82)
Accuracy-89% (Proficiency 93% and above)
Comprehension-4.5 4 limited, 5-Satisfactory
It says he met proficient levels in dictation and RBI sights words but remains not proficient in all other areas measured.
I will post back when I get the CAPD/Language results.
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Post by healthy11 on Apr 12, 2011 18:37:50 GMT -5
I'm not familiar with CAS testing...can you explain what it is? Shouldn't there be Level F results somewhere?
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Post by chiaroscuro on Apr 12, 2011 20:22:49 GMT -5
Hi healthy, CAS stands for Communication Arts Support. It is the specialized reading support group that he has been in since kindergarten. At the beginning of first grade he started on what they call levelAB, at the end of first 9 weeks was level CD,mid-year E(should say EF ), 3rd 9 weeks G, and the end of the year will be level I. Why they did not put the "F & H" in, I couldn't say. From what I can gather, as he moves through each level the passages get a little more difficult, longer and with more sight words. By the end of the year they would want him to have a Word Count Per Minute of 53-82 words, Accuracy of 93%+, Dictation 95%+,RBI Pseudo-words 16+, Dibels NWF 50, Sight words 30, and Comprehension of "level I" material at a 5 (which would be satisfactory). So in order to be considered proficient he will need to double his current speed in two months, increase his accuracy and comprehension on harder material. He is making gains,is working so hard and I am very proud of him. He went from reading 7 words per minute at the beginning of the year to 29 wpm. I am worried though because these are his scores after three years of specialized reading instruction, his valiant effort and lots of reading at home. I hope that kind of explains it.
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Post by healthy11 on Apr 12, 2011 21:51:27 GMT -5
I was wondering if it was some standardized test that I just hadn't heard of before. Unfortunately, I don't know how many other Millermom members are familiar with CAS, either, so it's hard to comment about it...As you point out, your son certainly seems to be making progress, but it's hard to tell what rate is enough to get him up to grade level expectations. At least he's moving in the right direction.
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Post by chiaroscuro on Apr 14, 2011 10:01:05 GMT -5
Sorry about that. It is his scores from the assessment using the First Grade 2005 Hasbrouck & Tindal Oral Reading Fluency Data .
It looks like he jumped up from the 10%ile(7 WCPM) in reading at the beginning of the year to the 25%ile(29 WCPM) now, according to their chart. So he is making gains and his comprehension has improved too going from a 1 which is below benchmarks to 4.5 which is between limited and satisfactory.
I am not sure but I think by using this chart, they claim they can give a projected trajectory of where a particular child should rank in reading through Grades 1-8. Is anyone familiar with this?
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Post by healthy11 on Apr 14, 2011 16:03:33 GMT -5
What state do you live in? Sometimes, curriculum choices differ depending on what part of the country you're located in.
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Post by chiaroscuro on Apr 14, 2011 16:20:21 GMT -5
I live in PA
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Post by healthy11 on Apr 14, 2011 16:30:18 GMT -5
There are a couple of other Millermom members from PA who post fairly regularly. I'm going to suggest that you start a new post, with reference to your CAS testing in the title, because not everyone is familiar with deciphering WISC testing, so they may not be reading this discussion thread.
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Post by chiaroscuro on Apr 14, 2011 16:49:15 GMT -5
Thanks healthy,
I think that is a good idea. I will post back on this post when I get the results from his CAPD/Language evaluation (which is coming in about two weeks) or anything related to his IEP.
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Post by chiaroscuro on Apr 29, 2011 10:24:27 GMT -5
Hi everyone, My son finished his CAPD/Language evaluations yesterday and they said it will be another 2 weeks before I receive the report. The Audiologist was concerned because during a part of the test my son became inattentive, stared off blankly and picked up right where he had left off, completely unaware that the test had moved on. She said that he did miss a lot of questions but is concerned that it could possibly be due to seizures. The Language Pathologist also noted that he did this on a portion of her testing and was unable to answer any of the questions from that section. She said that he showed the most difficulty with word retrieval and believes that is what is causing the lower VCI scores(written expression,speech problems and reading difficulties). My son also did poorly on the visual part of her test (which is not in line with his higher PRI scores on the WISC-IV or CoGat). She told me that this indicates he does not learn better through visual channels but rather through Auditory ones. Does anyone have any ideas on why this would be different? While I was observing I did hear him ask her for clarification of what she wanted him to do halfway through this section. She said as he went along he got better. When I brought this to her attention and asked if it was because he wasn't understanding the task (possibly over thinking) she said she was unsure but was kind of pushing toward nvld which I don't see. Any insights here would be appreciated (maybe I'm missing something.) They both recommended that he see a Neurologist to rule out Seizure disorder/other medical concerns. I am very worried right know and the more I read about it leads into other things like brain tumors, strokes, Autism etc. What if his language delay was related to this and I missed it? Any advice would be helpful. I'll post the results when I receive them.
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Post by healthy11 on Apr 29, 2011 10:45:30 GMT -5
((HUGS)) Don't beat yourself up; Your son is the same child you loved 2 days ago, before the testing, and what's most important is that you care enough to continue to support him, while trying to get to the bottom of his struggles. I believe Michellea uses the term "peeling an onion" when trying to get a proper diagnosis for students with learning difficulties, because there are often numerous layers which one has to explore, and the task is not always pleasant. At this point, I think it's natural to fear the unknown, but remember your son does have many strengths, too, and so just take things one day at a time. I suspect that even if you try to make a neurologist appointment now, the doctor wouldn't be able to see you for quite a while, and by then you should have the CAPD/language report, which may help explain things better. Hang in there!
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Post by bros on Apr 29, 2011 11:56:04 GMT -5
Neurologists can very in how long it takes to get an appointment
For some neurologists, like mine, you need to schedule ~4 months in advance to get a good appointment
And for others, like the one I had when i was younger, he always had a few appointments deliberately kept open in case of emergency/new patient/emergency appointment needed
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Post by chiaroscuro on Apr 29, 2011 12:14:25 GMT -5
Thank you healthy,
We have a lot of stress going on right now which is I think is heightening my fears for my son. My husband was recently hospitalized for multiple pulmonary embolisms(thankfully he is o.k he's on blood thinners and is therapeutic) but has since been diagnosed with a C and S blood deficiency. Because it can be genetic I am afraid that my son could be at a greater risk for strokes etc.
I am trying to stay positive and remember I have much to be thankful for. I have four wonderful kids and our family has overcome many things even though at the time they felt hopeless. Our daughter was diagnosed as a newborn with a malrotated small intestine and had surgery at two weeks old. Today, she is a healthy and happy nine year old and by looking at her now you would never know the odds that she overcame as an infant.
My son does have a lot of strengths and I wouldn't change him for the world. I just want to make sure he is healthy and be able to give him the strategies to be able to express his wonderful talents, ideas and strength of character.
Michelea's analogy definitely fits this process to a tee. Thank you for helping me regain my focus and muster the courage I need to do so.
You all have been invaluable and I have a great respect for all of you.
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Post by SharonF on Apr 29, 2011 12:22:20 GMT -5
You're at a really difficult stage. You're getting additional eval results and they aren't lining up easily. Experts are suggesting various other possibilities, from absence seizures to who knows what. You'll just have to take this one step at a time. Don't try to jump ahead too far. And despite the temptation, don't play "what if?" This takes time. It's confusing. And it can be exhausting.
Auditory vs. visual learner...not always easy to diagnose with one eval. Which test did the audiologist use to conclude he is not a visual learner?
Remember, any eval outcomes can be influenced by fatigue, anxiety, time of day, comfort level with the test-administrator, amount of eye-hand coordination used in the test, etc.
Typically, visual-spatial learners have higher PRI scores on the WISC and do better with visual information. Typically, auditory learners have higher VCI scores on the WISC and do better with information presented in words.
HOWEVER--that is not always true. For example, my dd is a visual learner. She thinks in pictures and remembers information in pictures. When she was 12, she was diagnosed with severe Central Auditory Processing Disorder. She had trouble hearing individual sounds within words and had trouble with converting words to meaning.
BUT--her WISC Verbal Comprehension Index was 34 points higher than her Perceptual Reasoning Index. Her IQ test indicated she learned by best by words, not pictures. But that was not true in the classroom!
It took a lot more testing (as well as years of trial and error) to figure out WHEN words are best for her and WHEN pictures are best. She is now in college and the skills that showed up as strengths on her VCI can definitely be an asset. But her innate way of thinking, recalling and learning is still visual.
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Post by chiaroscuro on Apr 29, 2011 12:42:19 GMT -5
Thanks bros,
I am going to make some calls today and tomorrow(4 months seems like a long time to wait, I hope they will see him sooner) and I will in the mean time schedule an appointment with his pediatrician to discuss all of this and see what he thinks (see if it is warranted to get him seen by a hematologist considering my husband)
Also bros can you give me any advice on what to expect at the neurologist evaluation? The SLP was briefly touching upon the different methods they do during the eval to try and trigger a response, like sleep and food deprivation techniques, having him hyperventilate etc. Is there anything else you can add or anything I can do to make the experience better or more comfortable for him?
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Post by chiaroscuro on Apr 29, 2011 13:25:55 GMT -5
Sharon,
The Speech Pathologist on the second day of the eval is the one who concluded he was not a visual learner by her testing. I am not sure what the name of the test that she used but will email her and try to get that info while I am waiting for the report.
I do think something skewed the results on this portion and if he was possibly having absence seizures (ADD, fatigue, etc.)maybe this added to his confusion on what he was supposed to do. After she clarified the directions he did score a lot better. Still it is confusing to get such contrasting results. I am a little nervous about this because she will be making recommendations from her findings for accommodations at school and if he is a visual learner those accommodations may not be well suited for him.
The Audiologist on the other hand told me that he did show signs for auditory processing deficits and if he scored the same way in two years from now he would definitely be considered for CAPD. She also said that he was looking at her for visual cues. She said it is difficult to diagnose CAPD at his age because the auditory system is not yet completely developed and she wanted him to be evaluated by the neurologist to rule out other medical concerns that could be causing similar symptoms first.
I think I'll have a better picture once I have the report. It has been really confusing so far.
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Post by momfromma on Apr 29, 2011 13:44:10 GMT -5
Did your son have a visual processing and memory test to see how he learns better, particularly academically.
My son has a deep language impairment. In 6th grade, his vocabulary standardized test, both expressive and visual, were lower than 70. Everybody was saying he needed things to be presented visually, until he got those tests, and it showed that, as impaired as his language was, his visual memory and reasoning was even lower. He cant visualize anything he has not seen before, for example, and cannot match the simplest drawing with a word if he is not described the drawing. This said, he is a kid that has other perceptual skills that are high. He is very good at remembering how to go to a place he has visited once. He is great at visual games like crossword puzzles, mazes, connect the dots, (well, he is older now, so he does less), and video games. But he cannot learn from just a drawing.
In addition to the neurologist (you should do it, if anything to rule out this issue), you may want to check how he learns best by a WRAML test (memory and learning), and a visual processing test.
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Post by SharonF on Apr 29, 2011 20:12:12 GMT -5
chiaro--
Seizures, including absence seizures, are usually diagnosed by an EEG. But some types of seizures can be elusive to diagnose, even with an EEG.
The triggers you mentioned are often used when doing an EEG, but not always effective. I have had epilepsy since I was 9, take meds daily and have had many EEGs over the years. Depriving me of sleep or food will make me irritable but will not trigger a seizure. However, hormones and stress can trigger my seizures. Even "good" stress like a vacation or Christmas often means I have to increase my epilepsy meds for a few days.
My 10-year old nephew has seizures that almost always happen when he is falling asleep. His EEGs were normal--except if they gave him a sleeping pill first. It took several EEGs before they figured it out.
In high school, my dd had a classmate who had absence seizures that were nearly impossible to catch on an EEG. For years, everything just thought she was a space cadet.
A pediatric neurologist should check more than the possibility of seizures. But it's worth ruling out.
Remember that if someone is overwhelmed by a task, they can have a "brain freeze." It's like all the wheels upstairs stop turning for a few minutes.
And if someone has a very strong learning profile (for example, the test involves complex language processing and the kid is NOT good at language processing), they are more likely to space out or freeze up. It may not be a seizure. It may just be brain overload. Especially if stress or anxiety are also factored in.
And complicating things, your son could be an auditory learner who has trouble with language processing. Or he may have had trouble with the type of visual processing on the test administered by the audiologist, but do fine when he processes other types of visual information. It may take more tests and more time, but you will eventually figure out a pattern. And you and your son will make this work!
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Post by bros on Apr 30, 2011 1:04:57 GMT -5
I also have epilepsy (had it since age six). No known trigger. When I was younger, it was easy to see the epilepsy on the EEG (My readings when I was younger made the neurologist wonder why I wasn't having a seizure while getting the EEG) but now my EEG readings are rather elusive, with 0-5 1-2 second spikes a day. A sleep dep EEG might be good to check for epilepsy, but you may want an ambulatory EEG done if they offer it (An EEG you bring home and that gets brought back to the doctor after 48 or 72 hours, it constantly monitors for that time period).
Epilepsy that starts when getting sleepy is rather common, I believe. Some of my more severe spikes recorded have happened while transitioning between the second and third stage of sleep (It's probably why I have never remembered a dream).
EEGs can also show other things than epilepsy, for example, one of my recent EEGs showed epileptic activity in the frontal and occipital lobes in addition to a right sided dysfunction, which was figured out last year when I had my first neuropsych evaluation.
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Post by chiaroscuro on Apr 30, 2011 7:58:15 GMT -5
momfromma,
The test the SLP gave looked similar to the wraml but I am not sure. She would read him stories and ask him to recount them in his own words. Then she would give him a string of words(like 20) and see how many he could remember immediately.
Then she would show him a picture of a crowd of people doing certain things, then she would take it away, make him wait a minute, and then on a new picture x out anything that had moved, appeared or changed.
Then she would show him shapes in a certain configurations, again take it away for a minute, and ask him to draw them accurately in the same squares they were in.
She would alternate between these tests and go back and ask him to recount the stories he heard at the beginning, how many words could he still remember, what objects and shapes had he seen in the pictures. The funny thing was he did better and remembered more than when he was first given the information.
The last part of the test was like a picture vocabulary test. She would point to something and ask him what it was and on others she would ask him to find a object.
One mistake that I think she made, was that she showed him the observation room where we would be before the test. When he entered the testing room he immediately said "hey, in there I could see in here but now it is just a mirror." He began telling her how he thought it was made and that there must be a layer of something on it. He was so intrigued by this. Throughout the test he kept looking at it, trying to see if he could see us. He said he felt nervous about it.
I'm wondering if this had a little to do with his performance. Also Does anyone know if block design, or matrix reasoning has to do with visual memory or are they tasks that he completes while actively looking at a picture? All of her visual tests seemed more about memory.
Also does anyone know what the CoGat nonverbal measures? Maybe he is good with manipulate visual tasks but not good with visual memory. Does this make sense?
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Post by michellea on Apr 30, 2011 8:41:06 GMT -5
chiaroscuro - while I've never administered or taken the WISC, based on my many exposures to descriptions of the test, I believe that the pictures remain in front of the student while testing - no visual memory. With block design, my son's visual tracking proved to be a bit of a problem. He could not look back and forth to "check his work", without touching the picture and design to be sure he was tracing the right picture / part of the picture and design. The evaluator said that this slowed him down considerably, and while he had a pretty strong score (13 or 14 - I can't remember), he missed some of the time bonus. So, there are factors that can interfere with performance - but I don't think visual memory is one.
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Post by healthy11 on Apr 30, 2011 8:43:59 GMT -5
The PRI's subtests are as follows: • Block Design - children put together red-and-white blocks in a pattern according to a displayed model. This is timed, and some of the more difficult puzzles award bonuses for speed. • Picture Concepts - children are shown rows of pictures, and are asked to find a common bond with one picture in each row. • Matrix Reasoning - children are shown an array of pictures with one missing square, and select the picture that fits the array from five options. • Picture Completion (supplemental) - children are shown artwork of common objects with a missing part, and asked to identify the missing part by pointing and/or naming.
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Post by chiaroscuro on Apr 30, 2011 9:18:11 GMT -5
Thank you, My son scored 16 on BD, 16 MR, and only 12 on picture concepts. I wonder if there is a connection there. Are either of you familiar with the CoGat NV section-what they actually have to do. He scored a 40/40 on this It is very confusing that he could do so well on these but not the other. Michellea it is very much like "peeling an onion" and I appreciate the analogy. The SLP suggested I also have him go to an OT for vision therapy/NVLD but with all of the other tests he's recently been through and now the neurologist, I really want to make sure he is getting the appropriate tests in the right order so that as someone said before "not to make him feel like a science project that needs to be fixed". He does have a lazy eye at times but she told me that also could be part of the seizures. Does a neurologist usually make recommendations for neuropsychologist depending on their findings?
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Post by healthy11 on Apr 30, 2011 9:24:03 GMT -5
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Post by chiaroscuro on Apr 30, 2011 9:43:46 GMT -5
Thanks healthy,
Again it looks like is does not require visual memory but more pattern finding and shape manipulations which he is very good at. Also they are using geometrical shapes as opposed to pictures of people preforming tasks and objects changing position.
I noticed they said that The tests in the nonverbal battery are between fifteen and twenty-five questions each and students are given ten minutes for each test. I am looking at his test right now and his test said he was given 44 items, attempted 44, and got 44 correct giving him a National stanine(NV) of 9 and 99%. It says he was given 44 questions on each section. I wonder if it is a mistake?
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Post by chiaroscuro on Apr 30, 2011 9:52:19 GMT -5
Sorry, I missed the word "each" in the sections of the NV battery. I thought it meant each section in -V,Q,NV.
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Post by chiaroscuro on Apr 30, 2011 22:50:26 GMT -5
Sharon and bros,
Thank you for sharing your own experiences with epilepsy, the tests and what they measure. Looking back at my posts, It definitely was the fear of the "unknown" talking. It just has been a lot of information to take in, digest and try to make connections when things are not lining up. I know many of you have been there and your sound, steady wisdom helps a great deal.
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Post by empeg1 on May 1, 2011 0:31:54 GMT -5
I caution you about accepting a statement that your child is not a visual learner based on results from one test. One can gain an impression from the above, but not anything definitive.
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