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Post by laural840 on Apr 5, 2005 12:52:29 GMT -5
I called Ryan's school today and spoke with the lady in charge of learning differences and testing. She will be screening Ryan this week or next and setting up screening with an audiologist and speech person. It's all preliminary testing and if that warrants further testing, the school system's audiologist will set up more. I think, if the results are inconclusive, that we will then get a referral to a specialist for his CAPD testing. Until that time, all this is free of charge! <vbg>
I should know something in the next couple of weeks. If it's what we suspect, Ryan will then have added to his ADHD - Inattentive diagnosis, CAPD... if I had to guess, I would say Tolerance-Fading Memory.
Laura
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Post by Mayleng on Apr 5, 2005 12:57:54 GMT -5
laura, the school SLP person, is probably not familiar with CAPD or Tolerance Fading Memory subtype and does not have the equipment to test it. Most will just test hearing and CAPD is not about how good the hearing is. My son has Super hearing, he hears things you and I cannot (which is actually a curse for an ADD inattentive guy) and was tested by the school's SLP. She was raving about how good his hearing was and how it will help when he has to write down Oral instructions - WRONG! I had to get him tested by an Audiologist who is familiar with CAPD/APD. So if they tell you that his hearing is OK, they did not do the right test for CAPD.
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Post by Mayleng on Apr 5, 2005 13:04:02 GMT -5
some of the tests that should be included are:
Staggered Spondaic Word (SSW) Phonemic Synthesis (PS) speech-in-noise test.
Plus Immittance measures
For TFM type, the Staggered Spondaic Word test is key.
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Post by laural840 on Apr 5, 2005 13:08:30 GMT -5
I had to get him tested by an Audiologist who is familiar with CAPD/APD. So if they tell you that his hearing is OK, they did not do the right test for CAPD. Yeah, that's mostly what I was concerned about too! I actually talked to that person today. SHE doesn't do the testing, but they do use an audiologist. I mentioned a family Hx of CAPD (my brother has it as well). That's when she said they would do the initial screening and then refer him if needed. It 'sounded' to me like they may not 'diagnose' CAPD, but that they would include some kind of screening that might let them know if further testing was needed? Does this sound 'right' ? I felt better after talking with her directly, but if I get the kind of answer that you get, I am calling my insurance to see which of the three audiologists they cover that test for it near us! I went to one of the MANY links under LD's that you have listed and one site lists audiologists who are in our state that can screen for CAPD - there are only 3 near me, between 30 mins and an hours drive away! Thanks for your input!
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Post by Mayleng on Apr 5, 2005 13:12:21 GMT -5
So, the school is going to refer your child to an actual audiologist for testing now or after the SLP has screened him first? I am confused.
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Post by Mayleng on Apr 5, 2005 13:13:07 GMT -5
If they are using an audiologist, you can always ask them who it is, it could very well be one of the 3 on your list.
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Post by laural840 on Apr 5, 2005 13:21:48 GMT -5
So, the school is going to refer your child to an actual audiologist for testing now or after the SLP has screened him first? I am confused. LOL - now I think I am confused <shrug> OK, she said that she does some of the testing ALONG with an audiologist and speech person. So, an audiologist will screen him during the initial testing. NOW, what tests they will run....? I don't know. THANKS for the names of specific ones, I will print them off and when she calls, I will ask SPECIFICALLY what was done. I don't know the name of the audiologist, but Ryan's teacher is really GREAT to give me additional information, I bet if I asked, she would tell me who it is! This is all so new to us, so I don't know if it's all in the write 'language' or if it's making sense to you... but when I called his school I asked for the person in charge of learning disabilities/differences. She was familiar with Ryan because I had mentioned the possibility of CAPD to HER and she said that the school could test him. From what I read about the actual tests, can't they just do a SCAN-C test to determine if he has CAPD, and THEN do more specific tests to determine which sub-type?
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Post by Mayleng on Apr 5, 2005 13:31:20 GMT -5
My son's neuropsych used the SCAN and ACPT (Auditory continuous performance test) plus others to dx ADD/Inattentive. These tests are attention sustaining tests and may not go into it deep enough to dx TFM or other subtypes of APD. However, they could use this to see if more tests are needed.
See what tests they did when you get the results and you should ask them to show you the results of each test. If the SSW was not included, then you should either ask them to do it or have it done privately.
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Post by laural840 on Apr 5, 2005 13:37:16 GMT -5
THANKS!!! ;D Can you hear my printer fervently printing these posts? LOL
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Post by Mayleng on Apr 5, 2005 13:39:57 GMT -5
Glad to be of help. SharonF is actually the expert on CAPD. Hopefully, she will have more to add.
But good luck with the testing, and let us know how it goes.
If he does have TFM, my audiologist has made some recommendations for my son and I can type it out for you if you like, so you can add it to his 504 or IEP if necessary.
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Post by laural840 on Apr 5, 2005 13:45:51 GMT -5
Glad to be of help. SharonF is actually the expert on CAPD. Hopefully, she will have more to add. But good luck with the testing, and let us know how it goes. If he does have TFM, my audiologist has made some recommendations for my son and I can type it out for you if you like, so you can add it to his 504 or IEP if necessary. Actually I would LOVE that information! If you don't mind, can you send it to me as a message or email me at laural840@aol.com? Ryan doesn't have an iep or 504 yet. Haven't needed it with just the ADHD diagnosis, as his teacher has accomodated EVERY need without needing it in writing! SHARONF - when and IF (lol) you get to reading this, I would also appreciate any other thoughts you might have! Thanks for all that you've already sent me, it's helped a GREAT deal in 'educating' me beforehand! I much rather go in with knowledge in hand, than get knocked upside the head when I am not looking! I LOVE THIS PLACE! BTW - I recommend this site to every ADHD'r and parent of an ADHD'r that I meet! It's been a great place to learn and share! I only hope that someday our experience will help someone else!
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Post by Mayleng on Apr 5, 2005 13:51:30 GMT -5
Laura, another good site for education etc. LDs is www.schwablearning.orgI will post the info here, so that others may benefit from it too. I am glad you like the site. It is just a group of moms getting together to help each other go through this journey.
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Post by Mayleng on Apr 5, 2005 14:32:13 GMT -5
Laura here are the recomendations:
SUMMARY & RECOMMENDATIONS
Hearing testing reveals better than normal hearing, bilaterally. Results from the CAP test battery revealed significant quantitative failures on the SSW test, indicating that "M" exhibits APD in the area of Tolerance Fading Memory (TFM). Individuals with a TFM type of APD may exhibit frustration with lengthy auditory information (eg. instructions), difficulty in understanding speech in noise, poor expressive language ability, weak reading comprehension, display spontaneous spelling errors with previously learned spelling words, and exhibit more difficulty with initial information than the final presented auditory information.
Imagine a situation in which the teacher presents a question to the students. The individual with an APD is trying to process the question, while those without an APD have procesed the question and the answer. Another example of frustration for he individual with APD may be when a teacher tells the class lengthy directions in a rapid manner. This person is unable to retain all of the information when lengthy information is presented. The individual may look as if he is not paying attention, but in realty, he is paying attention and exerts a high level of concentration in order to receive the message. Add a few other factors, such as hunger, allergies, emotional problems, stress, anxiety, poor attention, illness and he will definitely struggle with processing the information. The following are standard and specific recommendations:
Specific to "M's" Case
1. M may require more time to complete tests, including standardized state exams.
2. M would benefit from learning in small chunks. He must study in small increments and should be provided ample notice of scheduled test dates.
3. M should receive a re-evaluation in 2 yrs to ascertain the effect of maturation and therapy.
4. M may benefit from the use of chunking material to assist him with his weak short-term memory struggle. M may also benefit from the use of an index card studying system to aid with his weak short-term memory skill. Such a system entails writing one question on one side of the card, and then simple answer on the opposite side of the card. For advanced academic grades, M should study the cards 10 minutes every day. Therefore, the information is repeated on a continuous basis and the evening before the test he will only have to review the information.
5. M will benefit from the placement with structured teachers who maintain a consistent daily routine. If a portion of his concentration is directed to anticipation of frequent change in the daily routine, in an unstructured class, then he may become more frustrated and exhausted throughout the school day. A teacher who "sticks" to the normal routine of math at 9.05 and spelling tests on one specific day, will provide the structure that the requires. His family will need to consult with the teacher and principal for such placements.
6. Therapies that address the TFM type of APD include note taking, comprehension or auditory information, chunking, sequencing of directions, mnemonic strategies and organization skills.
Standard recommendations for M's type of APD:
1. Preferential seating is important for M, so that he can benefit from both acoustic and visual cues in class. He should be seated away from fan, hall and other environmental noises to reduce the detrimental effects that background noise has on his listening ability. A distance of 6 to 10 feet from the teacher/speaker is considered most beneficial. A common recommendation is to have him sit in the second row to enhance visual cues from other strong students seated in front and beside him. When the teacher gives rapid directions, such as "Take our your math book, turn to page ten, do problems one through six, but skip seven, eight and nine and then do the rest of the problems", M may have more success in responding to these lengthy directions, if he is able to look at the student in front of him or beside him for visual cues. A child who sits in the front of the row, may turn around for visual cues fromt he child seated behind him. The teacher may regard this as a child who is not paying attention, when in fact it is a child who needs to compensate for a CAP problem. To alleviate a misunderstanding of the child's action of turning to the child seated behind him for visual cues, and to enhance M's auditory processing abilities, it is imperative for him to sit in the 2nd or 3rd row.
2. M's teachers/counselors should be aware that he might have difficulty in understanding what is asked or said to him, and he may forget lengthy information presentated to him, especially if the auditory message is rapid. This problem could cause him to miss important verbal information and become frustrated. Directions should be provided in short, direct sentences. He should be encouraged to ask for repeated directions, when necessary and be provided extra time to respond, if necessary.
The use of overheads or information written on the chalkboard will assist M in understanding large amounts of auditory information, especially if the speaker utilizes a fast rate of speech. Also he may either exhibit fatigue or hyperactivity towards the afternoon, due to his high concentration level that he must exert in order to understand the auditory information.
Hope this helps Laura.
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Post by SharonF on Apr 5, 2005 15:08:19 GMT -5
Hi Laura! In addition to the SSW, the SCAN-C and the ACPT, I recommend the TAPS (Test of Auditory Perceptual Skills-Revised.) If CAPD is diagnosed, ask the assessor to explain, in writing, what each of the various tests measures and what the scores mean in real-life terms. Ask them to explain how his particular type(s) of CAPD are likely to affect various aspects of language processing. Have them provide a list of classroom, homework and large-setting recommendations and accommodations (like what they provided for Mayleng's son.) Find out if copies of the CAPD assessment will be provided to the IEP team at the next meeting. If not, make copies for EVERYONE. You may want to also copy a couple of pages of the book "When the Brain Can't Hear" and highlight a few lines--explaining what CAPD is or what your son needs to succeed. We found that our kids' teachers were clueless about CAPD or how it can wreak havoc on reading comprehension, written expression, oral expression, note-taking, etc. Even with the very clear CAPD diagnosis (son in the 2nd percentile on SCAN, daughter in 1st percentile, both in the "severely disordered range" on SSW and TAPS) some teachers didn't get it. They kept believing that our kids' higher-order language difficulties were still due to them "not trying hard enough." Some teachers still hear "auditory processing" and think "hearing acuity." And keep your copy of "When the Brain Can't Hear" handy. After you get the scores back and digest the new info, re-read the chapters that pertain to your son's situation. Dr. Belis' information and recommendations may spark new ideas to strengthen his IEP. Let us know how it goes! to Ryan!
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Post by laural840 on Apr 5, 2005 15:18:03 GMT -5
::BIG SIGH::
I can see now that I need to go back to 'school' again to learn what is necessary to help Ryan to succeed....
Thanks so much for both of your input into what we need to consider. It is a LOT to process for this ADHD mom, and I am printing copies for Ryan's file so that I will have the information for future reference.
I thought we had bitten off a lot with just the ADHD, but throw in the possibility of CAPD and I see that I am back in the learning curve!
Thanks again! I will post when I know more from the initial testing, I am sure that will produce a gazillion questions! L
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Post by SharonF on Apr 5, 2005 15:59:42 GMT -5
Laura--
The good news is that many of the accoms and mods for CAPD (especially TFM) are much the same as those for ADHD-in. Extra time, preferential seating, breaking information and oral instructions into smaller chunks, etc. There is so much overlap between CAPD and ADHD-in. So you may not have as much "new information" to learn as you think!
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Post by Mayleng on Apr 5, 2005 16:12:32 GMT -5
Laura, take a deep breath and relax. This is not a sprint, it is going to be a marathon. We are learning all the time. It is alot to digest but like Sharon said, TFM and ADD/IN faces the same issues.
I will tell you though, that Dr. Tillery (My son's Audiologist) did tell me that for some kids, the TFM do get better in their later teens. She does not know why, or which kid but she did tell me some kids do get better. She is doing a followup study on kids that were dxed with CAPD, and how they are doing in later years. Unfortunately, it will be a while before her study will be completed because she is collecting alot of data on a few hundred kids.
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