Hi, I'm new here...

Tomatis would be useful only if she has a serious auditory processing disorder. I would set Tomatis aside unless you get a diagnosis of severe APD.

The issue of evaluations is a huge one. Some people find a good pediatric neurologist (has to be one who specializes in development, not in brain injuries). Others get a neuropsychological evaluation from a children’s hospital, usually by a team that specializes in these evaluations. Unfortunately, even these evaluations are usually not all-inclusive, they are expensive, and sometimes they are not very helpful.

Physicians and pediatricians do not get training in developmental issues, so usually they are not of much use.

What I would suggest, based on what you have posted, is starting with some basic evaluations that will either rule out or identify underlying problems.

You could start with an occupational therapy evaluation. Private is almost always more thorough and comprehensive than the ones they can give in schools. Usually medical insurance will cover a private OT eval with a referral from your physician. The best thing to do is first find a good clinic and then call them to ask about your insurance. They can usually tell you exactly how the doctor needs to phrase or code the referral to ensure coverage. What you want is an occupational therapy evaluation that includes assessment of sensory integration.

I would also arrange for a developmental vision evaluation. Regular eye exams do not include tests of visual efficiency skills (convergence, accommodation, saccades, etc.). These are a very common undiagnosed problem in children having difficulties in school. For more information, see http://www.childrensvision.com . If you are on a tight budget, go to http://www.homevisiontherapy.com to find developmental optometrists licensed to dispense computer software for vision therapy. My advice is to compare optometrists on this list with those at http://www.covd.org and see if you have one who is listed on both sites. In any case, before making an appointment, ask if the optometrist is willing to design a primarily home-based program of vision therapy if it is needed. This is much less expensive than all in-office therapy.

For the auditory system, an audiologist with specialized training in auditory processing disorders provides the most thorough and comprehensive evaluation. Just as with vision, regular hearing exams do not test for auditory processing disorders and regular audiologists do not have the necessary training. APD audiologists can be very hard to find. Usually your best bet is a university hospital. If you can’t find an APD audiologist, then the next best evaluation is provided by a speech/language pathologist with a special interest in auditory processing. You may be able to find a clinic like this by calling around or asking friends. Most speech clinics offer only cursory testing for APD, but some provide more extensive APD testing that can be helpful in either ruling out or identifying an APD problem.

Once the above evaluations are done, you will have a good idea of what you are dealing with on the sensory level. If sensory integration disorder is diagnosed by the OT, then you know to look at SID therapies first. If visual efficiency skills are lagging, vision therapy is in order. If APD is found, you want to look into sound therapies (possibly Tomatis, but there are many newer sound therapies available that you should investigate).

In short, you want to remediate any problems on the sensory level of development first — motor issues, vision issues, and auditory issues.

Once sensory level issues are taken care of or ruled out, you really want to start your daughter on a good cognitive skills training program. PACE is excellent and fast (http://www.processingskills.com ) but expensive. Two good home-based programs are Audiblox (http://www.audiblox2000.com ) and BrainSkills (home version of PACE, http://www.brainskills.com ). These programs can provide very significant boosts to learning, but they require training hours. Usually you start seeing gains after 40 to 60 hours of training. These programs optimize many skills that make academic learning easier — things such as visual and auditory sequencing, visual and auditory short-term memory, working memory, attention skills, logic and reasoning. The only thing is, you want to make sure the sensory foundation for these skills is sound. Any deficits on the sensory level will limit the gains possible from cognitive skills training.

The final step is academic remediation, which involves finding truly effective programs that are a good match for your specific child. Most people start here, but academic remediation tends to go *much* faster if you first take care of sensory issues and cognitive skills issues. When you follow this order, you optimize the gains that are possible and minimize frustration.

Your daughter is very fortunate to have a parent like you who will look after her interests! Be aware that you are in a better position than professionals to make decisions regarding your daughter. Professionals usually wear blinders — seeing only that part of the child they are trained to look at. You see the whole child. By all means, gather information from professionals but weigh their information against your own research. The internet makes research in these areas fairly easy!

Also, you may want to join the dyslexiasupport2 list at http://groups.yahoo.com . What you described is very typical of dyslexics.

Nancy

I am a speech pathologist and I think if you wait until the speech evaluation comes back it may give you more solutions as to what is holding her back. But you don’t need to jump onto everything at once because it can be overwhelming and each child’s needs are so different.

Also do you have the scores of the psyche test? Can you tell me what you have noticed about your daughter’s learning style at home? Does she stick to things, or does she start things and doesn’t finish. Does she like the TV loud? Does she ask you to repeat things? Does she follow directions? Does she like music? Can she sing along with you and follow hand motions to songs like fingerplays that kind of thing?

WISC-IV

Area and scaled scores
[b]Verbal comprehension[/b]
Similiarities 8
Vocabulary 8
Comprehension 10
[b]Perceptual reasoning[/b]
Block design 10
Picture concepts 8
Matrix reading 10
[b]Working Memory[/b]
Digit span 8
letter-number seq. 6 W
[b]Processiong speed[/b]
Coding 6 W
Symbol search 11

Composite scores
composite score /%ile rank/ 95% Confidence interval/ Qualitative Description

Verbal Comprehension 93 /32 /87-100/Average
Percetual reasoning 96 / 39/ 89-104 /Average
Working memory 83 /13/ 77-92 / low average
processing speed 91/ 27 /83-101 / Average

Full Scale 88 / 21 /83-93/low aver/average

WJ-III

%ile / Standard score/ classification

Broad reading 3 /71 / low
word identification 3/ 73
passage compreshension 9 / 80
reading fluency 7 / 77

Broad math low average
calculation 8 / 79
applied problems 18 / 86

Broad written lang. low
spelling 4 / 73
writing samples 9 / 80

academic skills 1 / 67 very low
academic applications 10 / 81 low/low average

Beery DVMI

she scored in the 10th % which is low average range

she is in grade 4 and 9 years 7 months when these tests were done

Her previous school did in June 2004 a PPVT-III ss91 low end average
Ravens CPM 25-33% average
KTEA reading composite ss78 low
math composite ss78 low
spelling ss83 low average

Feb 2001 she had a speach assessment in which she had age appropriate articulation however her language skills were all below average. Delays in listening, vocab, grammer and higher level language skills

These are the scores that were part of the 5 page report I received from the school. I have to run and get Noelani from school. I’ll answer the rest of the questions when I get back. Thank you both for your responses. I am very grateful for any suggestions. We live in British Columbia, Canada so we do have MSP that will cover certain things here, Tomatis isn’t one of them, but pediactrics, etc would probably be covered. I know my son’s speach therapy is.

Hi. I’m in Montreal, other side of the contintent.

Nancy’s advice is all good — do follow it. Piece by piece, bit by bit. You don’t have to do everything at once.

If a child’s hearing and vision test out normal and intelligence is in the normal range, you can start right in with one-to-one reading tutoring. Many kids just get off on the wrong foot, maybe a small difficulty combined with a poorly-articulated curriculum (are you by chance another victim of “whole-language”?) and the small difficulty grows and grows and balloons out of control. Often good one-to-one tutoring with a tutor who finds your child’s specific needs can make a lot of difference.

If you want my ever-growing reading outlines, email me at [email protected]
Also feel free to ask me any other questions and I’ll try to help or diorect you to someone who can.

Can you tell me what you have noticed about your daughter’s learning style at home?
[color=green]she is highly visual and tactile. the pych report stated that she was a visual learner as well[/color]
Does she stick to things, or does she start things and doesn’t finish.
[color=green]it depends on what it is. she’ll draw for hours. the other day she couldn’t draw a reindeer so she went to the library to get a book on how to draw horses and I have seen numerous sketches of horses done. however other tasks such as cleaning her room doesn’t happen unless I’m there giving specific instructions and watching her the whole time[/color]
Does she like the TV loud?
[color=green]not particularly[/color]
Does she ask you to repeat things?
[color=green]sometimes, however I will have to repeat instructions to her quite often. Used to think that it was because she wasn’t listening however it looks like she just isn’t remembering[/color]
Does she follow directions?
[color=green]most of the time, as long as it isn’t too complicated or involving a task she doesn’t like. often I’ll send her to get me something and she’ll go to the room I said the item was in but it will seem as though she didn’t hear the specifics of where (ie your brush is in my room on my end table, she’ll go to my room but not find the item[/color]
Does she like music?
[color=green]she loves music[/color]
Can she sing along with you and follow hand motions to songs like fingerplays that kind of thing?
[color=green] she has a hard time singing a melody or staying on key, something that didn’t used to be to a problem, and actions to songs don’t seem to be a problem

Victoria, Rachel isn’t a victim of whole language. She has received both phonics and whole language. The reading LA did work on sight words for 100 of the most commonly used words to help with her reading fluency. It is interesting to note however the her friend Marcy who spend 3 years together with Rachel in the same classes is also being tested and is also 2 years behind. Leads both moms to believe that there is something with they way these kids were taught and the disorganization of the the LA and school based teams at the old school. Both Rachel and Marcy are at new schools this year. Rachel in the same city, Marcy in the US.

My mom also reminded me today that back in kindergarten I had mentioned to her that it seems as though Rachel was getting mixed up with the transition from montessori preschool to public school kindergarten. Rachel was adding and subtracting in preschool, but had difficulty even counting in kindergarten. [/color]

Do consider an ADHD evaluation. Your last message describes behavior that is extremely suggestive of that diagnosis. ADHD often looks quite different in girls. They tend to be more inattentive and less hyperactive. They can stick a long time with things that are fun or interesting to them, but can’t handle stuff that is hard or boring. Memory issues are common, as if difficulty with following multi-sequence tasks.

Hi again. I have a daughter who is a weird mixture of very gifted and missing a couple of odd things. My daughter could do calculus before she could read an ordinary clock. She could speak and read two languages before she could write a readable sentence, and she could speak three languages before she could follow a three-step direction. Actually, she never did really manage three-step directions, but she learned to cope by either breaking them down for herself or telling people flat out to tell her one thing at a time.
What I’m saying here is that in many cases, you can (have to) work around the problem, develop coping skills, and develop the child’s strengths to work around the weaknesses. Don’t get bogged down in focusing only on the weaknesses.

Your description of being able to add and subtract when being taught in a logical pattern (Montessori) and then losing it in the school, and also having “both phonics and whole language” and being years behind, is very, very common in the kids I work with. Basically the teachers in the school are well-meaning and hard-working, and it is a pity because you hate to be negative to such dedicated and concerned people, but the programs they are using and their methods of presentation could hardly be worse if they planned for failure. A mixture of phonics and whole language could hardly be better designed to cause massive confusion. And in my experience the phonics in such mixed programs is minimal and insufficient to actually read, so both the teachers and the students treat it as a time-wasting chore. The math programs are probably equally unfocused, many good ideas and worthwhile skills but all presented together in a way that leads to frustration and fear rather than mastery.

Good direct teaching can often help a lot with a student like this. Whether or not you decide she needs medication or other interventions, she wll still need to be taught reading and math skills.

I believe that it would be highly unlikely that she has ADHD. She focuses well on the task at hand when she is doing it. All children will put off doing what they don’t like or find hard. She loves math and reading eventhough she is struggling. She also tries very hard. Her room scenario is another story. The mess tends to get out of hand and she can’t figure out where to start. Once it is clean and managable she’ll keep it that way for a few weeks until she has a friend over and forgets the rules about putting things away before taking something out. I did a 20 page report on ADD/ADHD as part of my special education course during my BA and am 99% sure that it isn’t ADHD. Her track record at school for the past 2 years was one of being on task all the time, it has slipped a bit with moving to a new school and having a male teacher for the first time (not to mention the stresses we have had as a family this fall with having our vehicle stolen and burned the week before school started).

Victoria, the whole language aspect was minimal compared to the phonic end of things. The pych report does mentions that she had mastered several of the basic phonetic rules and attempst ot apply these while reading. However I do agree with the teaching issue. In one of my previous posts I mentioned Rachel’s friend Marcy. They had the same teachers for 3 years and they both are in similar boats right now. I am so very, very thankful that we are at this new school, that they picked up on her needs immediately, started support even before they identified her and truly care about her and want to see her succeed. The main difference and the area that I think the change lies between Rachel’s transition from preschool to kindergarten is the teaching in concrete tactile ways of the Montessori method to the abstract version of the public school.

Yes I know that a lot of what is going to be done in the future will rest on my shoulders and I am preparing myself for that. I am tired and very sad that she is having these kind of struggles, but truly thankful that we are starting to know what is going on. My husband thought Rachel knew how to read better than she was showing and thought she wasn’t trying. And really when he helped her read she would struggle with a word in a paragraph or chapter and then she couldn’t read it the next time she saw it just minutes later, it did look like she wasn’t trying. He honestly doesn’t have the patience to work with her in this manner so it will rest 100% on my shoulders.

[quote:6daa5a35eb=”trikki”] I did a 20 page report on ADD/ADHD as part of my special education course during my BA and am 99% sure that it isn’t ADHD. Her track record at school for the past 2 years was one of being on task all the time, it has slipped a bit with moving to a new school and having a male teacher for the first time (not to mention the stresses we have had as a family this fall with having our vehicle stolen and burned the week before school started).

[/quote]

Do you think she might be depressed? That can produce the symptoms of inattention that your daughter seems to be showing. The main thing is, don’t try to guess at what might be the cause. Get her looked at by an expert and don’t be afraid to hear whatever might be the issue.

She may be, however she is really happy at the new school. It was partically her choice, after dad and I did the research. The school speach pathologist is going to test her for auditory possibilities. I think that I’m going to take her into our doctor to see what he thinks. However I need to get a moment to talk to her about the test (which of course she knows about) and what it means. I wasn’t sure at first if I was going to talk to her about about it at this point or wait, but in talking with a friend how has a son with 3 LDs that was diagnosed in Gr 1, now in gr. 8 she gave me some great insight on how to approach the subject.

Your daughter sounds a lot like my son. The main difference is that my son has been receiving services since 3/4’s of the way through Kindergarten. However, since he started 5th grade I’ve realized that he hasn’t been getting the right kind of services because he just isn’t getting it.

In the last 2 months I’ve uncovered vision problems, DS doesn’t track well and never learned to use his eyes together for binocular vision. So we’re starting vision therapy. He appears to lack visual closure but that may resolve itself with the vision therapy.

DS has sensory integration issues, I’m sure that ties in directly to his deficits. He’s doing sensory integration therapy twice a week.

DS also has an auditory processing disorder. He was tested 1-1/2 weeks ago and I don’t expect the final report for another 1-1/2 weeks. The audiologist wouldn’t say but he didn’t do too well during the testing.

Next week he goes to a psych to start the process for a neuro-psych workup. He had some testing almost 3 years ago that indicated a learning disability probably auditory. I can’t put my hands on the report or I’d post the scores.

My health insurance pays for nothing related to learning disabilities or developmental disabilities.

My current plan is put DS into an LD school next year when he would be sceduled to go to middle school. I’m also considering holding him back in 5th grade at his elementary school to give him time to develop some of the skills he lacks.

My advice is to start a notebook and document *everything*. After stuffing reports in various places I read to put it in a notebook. I’m also including copies of online articles so I have them at my fingertips.

Regarding therapies, it’s never *too* late but from what I understand older children have to work harder to remediate their problems.

especially when they see their peers getting it and they aren’t. It also is comforting for them to hear a parent validate what they already suspect that they are having difficulty but that you are doing what you can to help them get through this. I am sure you already validate the strengths that she has and help her celebrate them.

That part about reading something and net not recognizing it a few seconds later was my son as well. Also, the part about thinking he knew something only to realize he didn’t know what I thought he knew. For instance I have his day care eval from when he was 2 and he could count very well very young. He too could add and subtract very young. Then I realized he was just saying the numbers but he really couldn’t count by rout.
I suppose he has some strengths that hid the deficits. I must have read that day care report 100 times trying to figure out what they saw that was so spectacular in this kid who later struggled so much with basic skills in kindergarten.

Long story short, we did a bunch of interventions most of which helped. Try to understand what is wrong but don’t get on the diagnosis treadmill trying to put a name to it when sometimes for an older child it is best to spend your resources working on those cognitive deficits using some of the therapies and programs discussed frequently on this site.

I found interactive metronome very helpful. We also did vision therapy with great results. My health insurance (Cigna PPO)did cover most of vision therapy but not IM. My son is finished with most of the problems you mentioned. He can read very well now and his writing has recently taken off with some extra tutoring. He is an average math student.

I recently had my son retested (schools expense) and he was found to be above average in everything except processing speed which is still a problem. I haven’t heard about the academic portion yet, I have only received the psychologists report. I would love to do PACE with my son which is processing and cognitive enhancement but he is just burnt out. Since he is doing well in school it is hard to find the motivation in him to do it.
For your child I would consider interventions in the following order interactive metronome, ?The listening program, Vision therapy and then lastly PACE.

This kid sounds so much like my son, whose first diagnosis was LD of written expression. We did lots to work on the LD but got nowhere. He just kept getting frustrated and hated school so much. Then his ADHD got noticed and we tried the medication. It worked and he was finally able to benefit from all the help. We did not think he was ADHD because he wasnt hyper, but it turned out that was his biggest problem.