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Feeling overwhelmed

Submitted by an LD OnLine user on

I just got reassessment results for my 10 year old son, showing improved reading and spelling, strong verbal reasoning/knowledge, very superior reading compreheension at the isolated word level.

Shows average overall WISC with 28 points between verbal and the lower performance. Verbal comprehension score is high avg. and the entire verbal is probably higher than reflected due to timing difficulties. Weaknesses in active working memory, rapid retrival for phonological info. from long-term memory, visual processing speed (1st %ile), visual discrimination/perceptions (visual closure, form constancy, position in space). Math fluency: well below avg., calculation: below avg. applied problems: avg., quantitative concepts: low avg., writing fluency: below/low avg. and writing samples: low avg.

Rapid Naming: low average, with weaker scores for material (colours, objects) that has not been overlearned, suggesting a truer reflection of natural ability.

It was recommended I get an ADD screening (Freedom from Distractibility: 8th %ile) to rule that out. (An appointment with the preferred expert will take months.) And that I get an updated developmental optometric assessment (last one showed no VT need) and visual tracking exercises (no sources mentioned).

We’ve done FFWD (for CAPD), PG (but need to finish later multisyllable), Interactive Metronome (since the assessment). Am considering PACE/Audiblox.

The immediate problem: to get visual-perceptual stuff. I’ve ordered Integrating Mind, Brain & Body Through Movement (Etta Rowley) on Linda F’s recommendation. I am wondering about Eyes on Track.

A slightly longer term problem: He was demitted from SLD support for language on basis of average reading. (Still in for math.) Oddly, he gets accommodations for his content-area subjects but not for language. The current assessment suggests reverting to language SLD placement /or after school tutoring. (We already have math tutoring in place. Kumon was also suggested.) The assessor recomends a return to half-time SLD but acknowledges there’s a judgment call for me to make.

He would consider going back to full am SLD a huge retrograde step and a blow to his self-esteem, which has grown this year.

But how much after school tutoring can a kid take? How many programs can a working mum do? (I know the answer the the latter is: as many as it takes, but it seems like a long road just now!)

Can anyone help me see the forest for the trees?

Maybe I was deluding myself into hoping that some of the LDs would just go away??

Thanks, and sorry this is so long.

JanL.

Submitted by Anonymous on Thu, 11/27/2003 - 7:13 AM

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I recently finished PACE with a student who is older than your son and has much more severe problems (IQ 70 and severe SID). Even with these problems, we got a 2-1/2 year gain in working memory and a 1 year gain in visual processing. Although there are never any guarantees, I think that PACE would likely be very helpful for your son in these areas.

The gains my 14yo student got from PACE have allowed her to finally forge ahead in reading, what her mother calls “a breakthrough”. We have started her on the Etta Rowley exercises now. She has had difficulty mastering the first group, so I am hopeful that these exercises will provide additional gains, especially in the area of visual processing. I really like the Etta Rowley exercises (although not her explanations of the theory), and highly recommend it. I think it is well worth the money. My student’s mother reports that the 14yo likes it, and that the exercises seem to help “center” her.

I have Eyes on Track but have not used it. My impression is that it would be more suitable for younger children.

With a 10yo, you still have a lot of time for remediation. It’s important to allow for relaxation — for both the child and you — in between therapies. From what I have seen, these children can and do catch up with their peers. You don’t have to do everything at once. You just have to be persistent and observant.

Meanwhile, you might want to consider getting Dance Dance Revolution for Christmas (see thread on Reading bulletin board). I really think that movement therapies are the only ones that address rapid naming deficits, and any sensory therapies you can get out of the way before starting PACE would be helpful (and I think DDR probably qualifies as a sensory therapy, in addition to being fun).

I would leave PACE until the summer months and make it the only therapy done over the summer.

Nancy

Submitted by Anonymous on Thu, 11/27/2003 - 7:21 AM

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I would just ignore the suggestion about full-time SLD or after-school tutoring. Neither option looks like a good one. I would remediate on a schedule that suits the child — which includes supporting gains in self-esteem, and not overloading the child with work. The alternative is increased stress levels for the child, and stress interferes with learning.

Nancy

Submitted by Anonymous on Thu, 11/27/2003 - 6:04 PM

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As an SLP I have seen kids who are smart but they are slow processors because they are easily distracted either by their imagination or external forces.

If you did IM and that didn’t help his focusing then I wonder if it is more of an Attention issue. We had to wait about 5 months before we could get our kiddo in for and ADD assessment. She too had a huge gap in her verbal and non verbal IQ’s and over time as she got older her processing speed dropped further and further. Eventually she was diagnosed as ADD-Inattentive, she too has CAPD and visual issues, and we got her glasses for Astigmatism. That helped a bunch with her reading speed too..

We have done PACE too and our kiddo didn’t like as she found the metronome more irritating and distracting than anything else.

Submitted by Anonymous on Fri, 11/28/2003 - 12:27 AM

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Nancy,
Thank you for your message about the need to relax and slow down. Part of my anxiety comes from something the assessor said, which I question, and that is that after about age 11 it become more difficult to remediate visual-perceptual deficits.

I think I would enjoy DDR but I doubt my son would go for anything with the word “dance” in the title, unfortunately. However we will try it at one of the local kid-fun joints. Given that I am paying for US programs in Canadian funds, however, I think I’ll probably return to IM once I’m teaching part-time in the spring and partial home-school. It’s already paid for, and we just have 8-9 sessions to go to finish the pgm.(quit due to burn-out after 41 sessions), so I think we will do PACE right after.

Your results with PACE are encouraging. My son’s frustration with IM (partly related to the fact we couldn’t get to it before 7:00 pm with me full-time) has led my husband to mutter a lot about “snake-oil” type programs. We haven’t yet seen solid gains from IM (scores on quitting were in superior range for hands and average for feet).

I hope we see gains from PACE.

Thanks.

Jan L.

Submitted by Anonymous on Fri, 11/28/2003 - 12:31 AM

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Is it you who posted the stat onetime about comorbidity for CAPD and ADD being 30% or am I pulling that out of a hat?

Did you see gains from PACE at all? What else have you used for visual-perceptual issues?

It sounds as though our children are somewhat similar profile-wise. Is your child’s ADD the non-hyperactive, hard to pinpoint type?

Jan L.

Submitted by Anonymous on Fri, 11/28/2003 - 11:52 PM

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I didn’t post statistics about CAPD and ADD being co-morbid. I feel they are co-morbid due to personal experience and I have read about it and attended a lecture at the IDA by some researchers that did a study on it.

In regards to PACE she made some gains but she hated it. In regards to visual perceptual issues I had years of eye therapy as a child myself. It really works. Our daughter has astigmatism and she had some tracking problems we did some circle exercises in PACE which helped for that discrimination. She is doing much better now with her glasses and contacts.

Our daughter had years of therapy, LiPS, Seeing Stars, VV, PACE, Somonas, the Listening Program. We spent $1,000’s of dollars on this with minimal progress and it wasn’t until we tried meds for ADD that things really started to come together. When she finally went on meds, she said, “Mom, is this what it feels like when you can focus??…things are making a lot more sense now for me.”

She was diagnosed Inattentive but she also has some hyperactivity. When she is on her meds she is very organized and together, off them she is a virtual chatterbox and ditzy and she will bug people. She is also 14 years old which is probably normal for a teenager. She was diagnosed with ADD at 10 years of age and has been on meds since then. She is a great swimmer and has now discovered Water Polo, it uses up a lot of her extra energy and she can multitask on what she has to do when playing water polo, keeping afloat, passing the ball, swimming, blocking, etc…She loves it..

Submitted by Anonymous on Sun, 11/30/2003 - 9:41 PM

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The testing was done during the summer and towards the end of Sept., before we had started to see significant gains on IM. He had pretty well lost most of his math fluency over the summer. However, I think that if there are any gains from IM, they’re pretty subtle.

I wonder if scores need to be uniformly low to see progress. As I said, we may return to it.

IM is supposed to assist with processing speed (where there are motor planning and sequencing issues) and with attention and math fluency. The lack of dramatic results may reflect a) that motor planning and sequencing are not the underlying “processing speed” factors, or b) that gains in attention (if that’s the culprit) were minor for my son for IM or c) there is some other factor or co-factor (such as cognitive deficiencies) that can be partially/fully trained through PACE/Audiblox). It would be nice to know before shelling out more $ for expensive programs.

The assessor wants us to return for some retesting after we see the ADD expert and try Ritalin. It will be hard to know whether Ritalin or IM or both are responsible for changes, but, Patti, if your daughter’s experience is like my son’s, Ritalin may do the trick (Though he does not present as an ADD kid, these kiddoes are trickier to isolate. Hence the problem of ranking this assessment lower on the list after 1st shelling out for lots of expensive programs).

Thanks for sharing your story, Patti. Oddly, I would welcome ADD as an “explanation” in this case because the alternative explanations will entail lots of expense and lots more “work”—not that remediation for deficiencies caused by lack of Ritalin during critical learning periods won’t be work.

I have two options—to wait for the highly recommended, highly respected pediatric ADD specialist to see my son (a few months) or to just get my son’s family doctor to prescribe a trial dose and experiment with it for a few months. The first course is obviously the better one, but if I’m going to do PACE, I’ll have to order and get going on it before I am likely to have an interview with the big gun who does the thorough and exhaustive investigation. Any thoughts?

Thanks.

Jan L.

Submitted by Anonymous on Mon, 12/01/2003 - 1:46 AM

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I have been working with a child who may be somewhat similar. IM did not have much discernible effect, even though the child has attention and motor sequencing problems (and SID).

We did PACE and saw improvements in working memory and visual processing — not dramatic gains, but significant. It did seem to me while working on PACE that this child might have ADD-inattentive per patti’s descriptions.

As it happened, about the time we ended PACE the mother started a trial of ADD medication (concerta, I think) with her pediatrician. Subsequently I have noticed that this child’s ability to pay attention seems to be much better. Although some of the improvement is attributable to PACE (the child insists PACE helped), I think the medication is helping also.

I almost think it’s worth a trial of medication just to see what happens. Maybe I’m prejudiced, but I’d go with one of the newer medications rather than Ritalin. This family had tried another medication years ago with no good effect, and I suppose it was Ritalin.

Nancy

Submitted by Janis on Mon, 12/01/2003 - 7:52 PM

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Nancy,

Just a FYI, but I am pretty sure that Concerta is just extended release Ritalin. My son tried it for awhile.

Janis

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