My 8 year old, second grade nephew in the Seattle area has received a multitude of possible dxes—SID, possible Aspergers, possible APD, possible visual processing disorder, possible ADD. His parochial school told his mother they did not have the resources to deal with him, so he’s just transferred to the p.s.. He does not yet have an IEP. His mother is off to a high-powered pediatric neurologist (or at least one it takes ten months to see) this week and wants to make the most of the appointment, particularly in terms of getting an effective IEP. His WISC scores are much lower than WJIII. He can read, write, and do arithmetic, but has many sensory problems—can’t stand loud noises, gets carsick, and has frequent meltdowns. He also has problems following any multistep directions. I would appreciate any other views on issues or further testing she can bring up with the doctor while she’s there, as well as any insights as to what might be going on.
His WISC III scores:
VIQ 91
Information 6
Similarities 9
Arithmetic 9
Vocabulary 11
Comprehension 7
Digit Span 11
PIQ 96
Picture completion 11
Coding 13
Picture Arrangement 7
Block design 5
Object Assembly 11
Symbol search 8
Mazes 4
FSIQ 93
Verbal comprehension 91
Perceptual organization 91
Freedom from distractibility 101
Processing speed 101
WJIII
Broad reading 111
Broad math 118
Broad writing 113
He has had some language testing, but not the CELF-3. He did have the TAPS—I didn’t note the exact scores but they fell within the 35 to 50%ile range except auditory processing which was 25%ile. He apparently totally refused to cooperate on the DTLA2—oral directions and the Test of Problem Solving 2.
I have told his mother that the higher achievement than IQ would be a problem in terms of an IEP. And yet he clearly needs help. I have suggested that he get a CELF-3 (required where I live for qualifying under speech-language, don’t now about Washington), as well as a test for auditory processing (he had many ear infections in first year of life). She says the doctor is open to alternative approaches—but she has had a bad experience already with a developmental optometrist. He is receiving some type of therapy that seems aimed at attention with elements of language therapy but I don’t think it is an SLP. She also has him doing Kumon for math facts—he seems to pretty much have them down—I think it probably is dispensible and the time would be better spent on other more basic work. Possibilities that come to my mind are the Listening Program, Interactive Metronome, and FFW (if indicated by CAPD and language tests), as well as OT. I think at this point she would be more open to dealing with vision issues through Audiblox than vision therapy.
Any help would be appreciated.
Re: Help with scores needed (long)
I would question the validity of the the IQ test because a person should not be able to achieve at a higher rate overall then their IQ. Since the IQ test is a verbal test and if the child has APD then this could be producing a lower IQ.
The two sets of scores do not jive.
Helen
Agree with APD possibility
My son also had much higher achievement scores than IQ. He had CAPD—underwent a lot of remediation including FFW 1 and 2. At next testing, IQ scores were much higher while achievement scores declined (sigh—you can’t have everything).
Re: Help with scores needed (long)
I’ll second what Beth said. The GOOD information we’ve gotten for both of our sons in terms of writing an IEP has come from our Neuropsychologist.
Karen
Re: Help with scores needed (long)
Hi Marie,
I think his mother is making a good chiose in setting him up for a neuropsych evaluation. That should help pinpoint what’s going on. In the meantime, if his mother will do Audiblox, that might be helpful for now (it certainly won’t hurt!). With the low auditory processing scores, she might want to consider Earobics, or just having him listen to books on tape every night as he’s going to sleep. Both of my children (LD and non-LD) have tape recorders by their beds and they listen to stories after I read with them or they read on their own.
What other emotional dx is present?
You can go Other Health Impaired with Aspergers; however, not a diagnosis of possible Aspergers. Someone needs to say that it is that.
There are other behavioral assessment ways to go that might get a B.D. label or Emotional Disorder label—depends on what your state calls it. Kids who really need this kind of help, often don’t get it because parents don’t want the label. Then the kid is 16 and in trouble for real.
Seeking the truth is always, IMO, the best thing.
Susan
Just wanted to say that my son saw a pediatric neurologist this summer and it would be a real stretch to say that he would be helpful with an IEP. The one we saw eliminated Asberger’s as a possibility and diagnosed ADD-inattentive and right brain dysfunction. He made some suggestions like books on tape.
I thought he heavily discounted other paradigms like OT. My son has sensory integration issues and has improved markedly but the neurologist almost made fun of OT approaches.
I have heard nothing but great things about him from other physicians and parents so I think it is more the physician mindset. A neurospychologist would be far more likely to put the pieces together in my book.
Beth