CAPD Eval vs. Assessments and other IEP stuff...need help

The CAPD eval does not sound right to me. Have you been to http://pages.cthome.net/cbristol/? See if this audiologist is listed with their search engine.

Has your sister checked to find out if her medical insurance will cover a private CAPD eval? I used the website above to find CAPD audiologists in our area, then gave my neighbor the name of one who works at a large university medical center. My neighbor called the audiologist’s office, and they told her her medical insurance would cover the eval if she got a referral from her GP. This she did. Because she had to wait so long for an appointment (9 months or so), my neighbor asked to be placed on the audiologist’s cancellation list. About two weeks later they called, and she pulled her son out of school to spend two days at the university.

My understanding of a CAPD eval is this. First, a standard set of tests is given. If the child passes all of these tests, the evaluation is over and no CAPD is diagnosed. If a child fails one or more tests, additional testing is done to start pinpointing the areas of deficit. This approach is used because the auditory system is the most complex system in the body, and it narrows down the testing required to determine the exact nature and severity of a problem.

A child with a hearing problem isn’t a candidate for CAPD testing, because all of the CAPD tests are normed to a normal-hearing population. I don’t think that speech problems or speech patterns at all preclude CAPD testing.

Did your sister get a written report from the audiologist? I would think that you could post the tests and test results here, and someone would be able to comment on their adequacy.

Mary

Audiologists start out in a bachelors program with similar programs as speech pathologists but where they really separate is in the master’s program. Does she have a Certificate of Clinical Competency (CCC) from ASHA? She is correct in telling your sister that she does not have the speech and language background. Technically as a speech path we are not allowed to diagnose CAPD. We can describe behaviors but an Audiologist who has specialized training can diagnose CAPD after a series of tests involving diachotic listening and language processing are done. I would look into an evaluation by a licensed audiologist with their CCC’s with NO AFFILIATION with the school district who is QUALIFIED to diagnose CAPD.

however, an SLP can test for langauge processing and can use some of the following batteries…
Illinois Test of Psycholinguistic Abilities (ITPA)
the following subtests of the ITPA used are for auditory closure,auditory blending and auditory sequential memory. These subtests look at phonemic awareness and auditory memory length. The results can asssist an SLP to determine if the problem is in the auditory processing or language processing.
The Peabody Picture Vocabulary Test-III
Language processing test (LPT)
The Word Test-Revised looks at memory, categorization, why (similiarities and differences.
The Test of Problem solving (TOPS)
TheListening Test
The CELF
The Test of Word finding (TWF)

I think the recommendations that you have made are good. I would like to see the use of a program like Read Naturally that uses tapes with diction that she can read along with to strengthen her auditory processing, visual memory and sound symbol relationship. What about FFW or Earobics or a sensory integration program with music therapy?

First of all, I would hesitate to do an IEP at all for this child without further testing. I am not sure I understand the IQ results. Are you giving WISC verbal/performance? If her IQ, verbal or nonverbal is between 50 and 75, she certainly needs considerable special ed. services. Is she repeating kindergarten (you said almost 7) and still cannot count to five? I would think that there must be a cognitive delay in that case.

My child had CAPD testing by a specialist in CAPD at the U of FL in November. They do a full battery of age-appropriate tests, beginning with a regular audiological eval to be sure the hearing is normal. The only thing is, though, if your niece is mentally disabled/delayed, I am pretty sure that her processing would be slow due to cognitive issues and I’m not exactly sure how much the CAPD testing would show. They wanted my daughter to have an IQ test before coming so that normal cognitive functioning could be established. You can go to the CAPD site www.ncapd.org and find the CAPD listserve or even email Dr. Jay Lucker whose address is probably accessible on the site and ask him if they do CAPD testing on children with that cognitive functioning level. Dr. Lucker is such an expert in the field, he might be able to do it, but I’d bet most audiologists could not.

In any event, remediation or equipment for CAPD is inappropriate until a child has been through complete APD testing. And as Mary or Patti suggested, it needs to be done by an audiologist that specializes in APD to get any kind of meaningful test results. We paid for all outside testing ourselves, as we knew the school testing would only give us a general idea of our child’s problems. It is well known that having the teacher’s voice amplified is of benefit to most children, however. Another suggestion is to request that she be seated near the front of the room so that she can clearly see and hear the teacher.

One thing you may encounter: when a child’s speech/language scores correspond with the IQ scores (as in their language is up to their ability level), they sometimes will not qualify for S/L therapy. Also, has an OT eval been done? None of these things can be put into an IEP without evals for each one. Also, did you mean one-on-one instruction for language arts and math with an aide? It would be virtually unheard of for one child to have one-on-one instruction with a special ed. teacher for a half day. Most educable mentally disabled children in our system do go to a resouce room for part of the day for language arts and math instruction.

Janis

I wanted to answer your question regarding an IEE. An Independent Educational Evaluation is just that. Independent evaluation would be any other qualified evaluator of your choosing. If you question is an IEE at the district expense,than once the districts eval is done,you disagree with their findings or feel they have not reached the right conclusions, then you may request an Independent evaluation. You can request a listing of independent evaluators from the school,or find your own. The only requirements that can be imposed is:
they must meet at least the same qualifications of the district evaluator( doesn’t seemed to be a problem in this case) And here lately districts have been imposing a cost, being that the eval must meet costumary costs for the area. The issue of whether they can impose this is still up for debate. But as long as your eval meets what they feel is reasonable costs,and this person is qualified then they either MUST allow you to obtain an eval at district expense,or file due process to prove their eval was sufficient,period.

This means ANY evaluation done on the child for educational planning purposes.

IQ testing like WISC are not reliable with CAPD and auditory kids. The TONI or a similar non language IQ test would be a better starting point before some school IEP stereotypes the kid as a IQ/EMI issue and forces a resource room down your throat.

“IQ testing like WISC are not reliable with CAPD and auditory kids. The TONI or a similar non language IQ test would be a better starting point”

Mary, she indicated that there was a nonverbal IQ of 68/75. I still do not understand that score as my own child just had the TONI in Nov. and there was one score for that test. My child also had the WISC-III, and her performance score was only three points less on the WISC than the TONI, so one could not totally dismiss the WISC score on a CAPD child. I do agree with you that both should be done, however. The WISC can give valuable information.

I do think in this case since the child is almost 7 and cannot yet count to five or tie shoes, one can safely propose that there is a cognitive delay and not just CAPD.

Janis

Just to clarify, the counting to 5 was part of the goals in the IEP by the K teacher who can’t understand her speech…I’ve heard her count to nineteen. Her severe ear infections to age 4 and longer had quite an impact too on her language development. And yes, she has some OT issues that impact her fine motor skills like shoe tying. However, my “superior range” intelligence dyslexic son couldn’t tie his shoes until almost 7. So, cognitive delays may or may not be an issue. From my observations however, she seems pretty bright and she seems to have trouble processing what you say, not not comprehending what is being said.

I certainly agree that shoe tying alone can’t indicate a child’s cognitive level. It sounds like they don’t have a good evaluation if the teacher is suggesting inappropriate goals for the IEP. I teach hearing impaired children and I certainly concur that long term conductive hearing loss due to repeated ear infections can cause language delay and problems with auditory processing. My best guess now that I have this new info is that she has a combination of issues. For hearing impaired children, we mainly look at the performance part of the WISC since it is usually higher than the verbal for obvious reasons. But if she was given a non-verbal IQ test, that should be fairly accurate. She will probably need a lot of systematic multi-sensory language instruction to enable her to read. I am going to soon begin using some Phono-Graphix with my milder hearing impaired children. One little girl is 7 and is not really reading yet. I suspect a mild cognitive delay there, too, but she has not had IQ testing. I’ll try to remember to let you know if we have any success with PG.

Janis