Independent Eval.results! (Extra Long)

First of all, most of the dialog you read was about the one IQ test given. All those Verbal Comprehension Scores and Perceptual Organization scores are groups of test scores from the one IQ test. Lots of the dialog refered to one single test.

What were the individual subtest scores on the WISC (or WAIS, if over 16.5 years of age)? I’d like to see how we got to the Verbal Comprehension index and to the Perceptual Organization Index (or factor load as you’ll sometimes here them called.)

Your brother has some very, very significant learning problems going on. He is definitely a slow, but apparently accurate, visual processor. Very slow.

The visual continuous performance test is probably a computerized deal wherein a person watches a screen and pushes a button when a certain image appears. It is pretty mindless and goes on for like 8-10 minutes. It is *one* of the possible pointers for an evaluation for ADD.

There are too many variables to cite only one reason for low Digit Span (or any other test on the WISC or WAIS). Digit span could be concentration, attention, anxiety, poor short term or working memory. See?

Putting things in order are sequencing deficits.

Boston naming test results probably indicate Rapid Automatic Naming Deficit. With the other problems, this would make reading instruction very, very tough. I’m not even sure I could do it in reasonable time…Not that I’m the world’s measuring stick, but I don’t fail often.

You need all the standard scores for these tests. Just average, low average isn’t good when services are generally determined based on points. You need to keep records of this stuff and it should be specific.

Before you load up both barrels and verbally shoot buckshot at the teaching staff, you have a very complex brother. Even if he does connect sound/symbol and phonemic awareness develops, we have a speed issue in just verbally naming things and a visual processing issue, too.

That’s all I have time for now. I’ll repost tomorrow. I’m sure others will post, too.

If you paid for this eval. go back to the eval. person and ask for standard scores, and an interpretation. There is a school of thought that all the APD and slow processing problems are part of executive functioning problems consistent with ADHD. What’s missing is a description of the behavioral(home, work and school) piece…if his behaviors are consistent with ADHD, I’d try treatment for that problem, it certainly may have a quicker payoff than intensive reading instruction in a teenager.

These are the verbal subtests:

Information: 10
Similarities: 10
Arithmetic: 6
Vocab: 9
Comprehension: 9
(Digit Span: 7)

Performance subtests:

Picture Completion: 9
Coding: 1
Picture Arrangement: 6
Block Design: 7 (untimed: 8)
Object Assembly: 9
(Symbol Search: 8)
(Mazes: 11)

Verbal Comprehension: 98
Perceptual Organization: 87
Freedom from Distractibility: 81
Processing Speed: 72

It also say 95% confidence interval, next to the last four subtests.

How can I increase processing speed?

The visual continuous performance test he had to push the space bar every time he saw and A. He remember this test because when I asked him what he had done he said he took a test on a really old computer!

IF a Rapid Automatic Naming Deficit will make reading instruction very, very tough. What program should he be given? He was using Wilson, he had it for 3 years and it doesn’t appear he made any gains.

K.

Unfortunately, this eval was an independent eval which was paid for by the schoool. I asked the Dr. twice for scores to be included and well, they weren’t. It took 3 months to get this report, I am afraid to know how long it will take to get the standard scores.

You said “There is a school of thought that all the APD and slow processing problems are part of executive functioning problems consistent with ADHD. ” What exactly doe that mean?

She did have us fill out some family history, symptoms checklist and a child neuropsychological history. He definitely doesn’t display the ADHD symptoms. So far, when the school teaches him based on his APD, he does really well. My feeling is if they started working with him on his APD problems the symptoms of ADD that the Dr. saw would disappear. Most of his issues are anxiety, which she noted. He is afraid of peer humiliation and failing. He is not a daydreamer, fidgeter, behavior problem, it is all anxiety and frustration with not getting what he needs.

Also, I am confused, his verbal IQ went up but performance stayed the same. Working with his hands is where he is strongest. Putting things together and drawing are really strong for him! I am confused!!

K.

This outside eval. concluded severe ADHD, but it sounds like you disagree…with what diagnosis would you agree(and your brother)? Yes, he functions far below his cognitive potential, but what to do? Your IEP meeting with the school will be key, certainly your brother at 14 deserves to attend and have a say; if he really is super motivated to learn to read and write, you can make a big point at the meeting; are you close to the Landmark School? Go to their website(on the yellow pages on ldonline) and take a look at their programs. They specialize in bright, severely LD but motivated students. At his age, I would say what your brother wants is very important, without lots of hard work on his part intensive reading instruction won’t work. For the ADHD piece, search on Russell Barkley Phd for more info. on excutive function problems. Finally, ask the school for help getting all the scores before your meeting.

He is very motivated but his is very unsure of himself. I definitely disagree with the ADHD diagnosis, it doesn’t fit him at all.

For example, he has a reading class, I asked him last night what they did in class. He said that the first twenty minutes of class they read silently in book and then they are supposed to write in their journals. Then the last twenty minutes she reads out loud to them and they sit and listen. There are many problems with this type of class for him. I said I know he isn’t actually reading during that twenty minutes and he said, he tries to put his head on the desk and take a nap, the school sees this as a sign of ADHD, I see it as a sign of a kid who can’t read! Secondly, when she is reading out loud, it is impossible for him to understand and the testing report says that anything over six words he can not follow.

This time would be better spent with a tutor who can provide actually reading instruction. If the school will let me I will tutor him myself, since I am not working I will go to the school during his two week academic cycle and teach him, unless they have some qualified to teach him with OG, phonographix, or Linda Mood Bell.

The problem with getting scores and assistance is that the independent eval was paid for by the old district. The new district says they want to have a clean slate, but they aren’t even using most of his IEP. The accomodations list is barely being followed, he is supposed to have a 30 minutes session every week with the SLP and this is the seventh week of school and nothing.

I am going to send of a nice but firm letter to the SPED director. We need to have an IEP meeting but I know that it will take another couple of weeks to get that done. I want the IEP followed now!!

K.

We are not near the Landmark School, it is about 2 hours away. If I could get the school to pay for it, I would move there with him so he could go, but he would never leave and go by himself.

He is at a vocational school, which he is really liking a lot. I am not sure how he would handle a change and my family couldn’t afford it otherwise.

K.

My son also does poorly on digit span and repeating back longer sentences but he comprehends well when read to, at least one on one. Im not sure, from my experience of one LD child ;), that those two would go together.

I do understand the reading complaint-this is how my sons regular reading class was run last year in 4th grade and it drove me and the special ed people crazy. This is the age theyre reading primer type stories so I would read the story for the week to him on sunday so he could actually do the independent reading they were supposed to doing on monday and tuesday. Im sure he still misread many words until they actually read aloud on wed(IF he even noticed by then)

We put them in tutoring and special ed to stop the word guessing but no one ever seems to think to teach the teachers to stop encouraging and allowing them to guess in the first place!!!!!!! aaargghhh

Also, have you ever tried adhd medication? I definitely realize you dont want to but slow processing goes hand in hand with adhd and the meds increase processing speed. At his age, and with his current level of frustration, it might be worth a trial period. JMHO

We have not tried medication. It is a very sore subject in our house. The Dr. who did the independent eval said we should consider Concerta, but in the same sentence she also said that he could crush it up or take it in liquid form. Since it is not available that way, it is only available in pill/capsule and he can not take capsule or pills without vomitting.

The real issue, in my house, is that he does not want to take it and my father wants to force him to take it because after all if a DR. says he needs it, he needs it!

I think we can solve the attention issues, which doesn’t really exist anyway, in school, there has never been one “complaint” about him not paying attention. The only trouble with attention is in a class that requires tons of reading, last year it was history , this year it is reading class.

As far as slow processing speed, that is a given considering he is sight reading. He doedn’t know how to decode any words!!If he is taught how to decode, his processing speed with increase.

K.

At 14, your brother should have a say in whether or not to try medication. If he ever does want to try, however, adderall XR comes in a capsule form but can be opened and sprinkled over applesauce, pudding or the like.

Andrea

Thank you Andrea, that is good information to have.
K.

K,

When you met we met with the DR. in August didn’t you say that the Dr. said that your brother had not been taught the way he needed and needed to be taught in a different way.

My question is where are the Dr. list of recommendations?

Helen

There was a list of 20 recommendations at the end of the report. They are very good and will help but there is nothing about a reading program or how he needs to learn how to read.

K.

> Information: 10
> Similarities: 10
These two scores mean that he has average information and ability to use verbal reasoning.

> Arithmetic: 6
This subtest can be low due to math anxiety, or difficulty concentrating (could also be anxiety).

> Vocab: 9
We often see this subtest drop in the teen years in low/no readers.

> Comprehension: 9
Reasonable common sense.

> (Digit Span: 7)
I’d like to know how he fared on forward versus reverse. Did the report indicate?

> Performance subtests:
>
> Picture Completion: 9
> Coding: 1
> Picture Arrangement: 6
> Block Design: 7 (untimed: 8)
> Object Assembly: 9
> (Symbol Search: 8)
> (Mazes: 11)

Symbol search is very motor-free—just requires on to make a slash mark sort of in a box for a response. It is almost pure visual scanning. This is a good sign on reading. But the visual motor and visual memory required to get a good score on Coding seems to be the big culprit here. Low scores may indicate visual-motor coordination difficulties, distractibility, anxiety, visual defects, poor pencil control, poor motivation, excessive concern for detail in reproducing symbols, lethargy, or boredom. It can be any one or more of those—not necessarily all of them. The administrator should have made some observations about performance (e.g. worked slowly w/perfection). If the Symbol Search were also low, I’d be more keyed on the visual part. Visual memory can assist w/a low score but would not bring a score of 1 without something else going on. As a tester, I’d be reviewing this one to see that I did everything right or observed anything.

> Verbal Comprehension: 98
> Perceptual Organization: 87
> Freedom from Distractibility: 81
> Processing Speed: 72
>
> It also say 95% confidence interval, next to the last four
> subtests.

Don’t worry about this confidence interval part.

> How can I increase processing speed?

I think the bigger question is increasing visual memory. I’m not sure that pure visual processing speed is the question. The other question seems to be RAN. I am anxiously awaiting to hear what MaryAnn Wolfe has to say on this topic. We should know something in 3-4 months.

> The visual continuous performance test he had to push the
> space bar every time he saw and A. He remember this test
> because when I asked him what he had done he said he took a
> test on a really old computer!

Yes, that’s the one I was thinking about.
>
> IF a Rapid Automatic Naming Deficit will make reading
> instruction very, very tough. What program should he be
> given? He was using Wilson, he had it for 3 years and it
> doesn’t appear he made any gains.

K., I have to tell you that I don’t have an answer to this right now. I can tell you that PG, OG and LmB will not improve his visual memory nor his visual motor integration (if that is a factor). None of these will help w/RAN either.

I’ve been successful w/mild RAN cases; however, visual memory was a strength. I have not met (that I know of) a kid like your brother.

I like the idea of a vocational program, especially if he likes it, too. There is no disgrace in being trained to do something. Lots of our kids are 18 and not really ready to do anything. That may be the best thing school has done so far.

The report didn’t indicate how he did on forward vs reverse, it just said that it was forward and reverse.

How can I increase visual memory? Also, if he is sight reading, isn’t that showing that he has a strong visual memory?

Also, can I use something like LMB Visualizing and Verbalizing to help with memory??Is it something as simple as having the SLP work on that with him? That also confuses me,the school thinks he needs to work on just understanding that words have different meaning, that sound ridiculous to me and a waste of time with the SLP?!?

Thanks
K.

Go back and ask that Dr for recommdations on a reading program and the type of setting he will need help in. If there are language difficulties then he will need text books and teaching lectures he can understand. How are they going to incease his phonemic awarenes and decoding skills? If the tests that demostrated thise weaknesses, then his IEP should have goals of increasing his levels. Check them quarterly, if there is no progress then you have every right to ask for a private program that can increase his skills. Lindamood bell offers 6 hours per day schools that address a whole slew of issues your brother faces. You should be asking for several grade levels of growth for each year. How will the school accomplish it? Check out the Shannon Carter case.
Your brother is one of the most underserved cases I have heard of. I think that your brother has been the victim of severe and pervasive neglect. Read the Gebser case on either reedmartin.com or wrightslaw.com. You have a civil rights case of denial of FAPE. Have you ever filed a complaint with the Office of Civil Rights?

The question is, how long does it take for something to get stuck well in his visual long-term memory? I think a long time by what you’ve written. Also, if not used, then could have retrieval problems, too.

V & V isn’t a memory tool. The only thing I know to do is a multi-sensory approach to learning. It taps into visual, auditory, and tactile-kinesthetic senses in order to help get a word or pattern into memory to begin with. Has your Wilson tutor been doing tracing or air writing w/your brother? (Some tutors don’t do this…)

I can’t go any farther on line. I’d be doing trial & error things and its the observation piece that would tell me if I was on the right track.

I’m sure others will chime in with their thoughts.

V/V isn’t a memory tool?

Maybe it is a matter of semantics but V/V made a huge difference in my son’s ability to hold on to information, both verbal and visual.

I am confused, someone told me that visualizing is how when you are reading, you comprehend and in turn remember (memory?)

Am I on the right track?

K.

Usually, this is a strength for them and they choose it to enhance their ability. Now, if visual memory is a weakness, one will probably rely more on other modalities to help them get something into long term memory.

I guess I could explain it as, if you are born w/out sight, you learn to use your hearing acuity to gather more & more information. That is a very extreme situation, however, some of our kids have such huge visual perception problems that they would naturally accommodate themselves using another sense. Developing the impaired one will be a good thing, but when the chips are down, we go to the channel on which we can depend.

For some people, V & V helps them the actually understand what they read in a very global sense and down to small detail elements in description. I think it helps people to organize and use the information that they already have in memory—just can’t get it out in a workable fashion for speaking or writing.

To me, it seems more organization of information in speaking and writing output than actually getting it into memory to begin with. Now, there is a little memory component for people who are good visualizers. Not so sure about this in folks w/impaired visualization skills. They may truly need to use other tracks to be effective memorizers of information.

I’ve not read the research on this. Would be interesting to do so, though. Maybe in my spare time…

that is the whole theory behind the program. You are definitly on the right track. As Eistein said, “If I cannot see it, I cannot understand it”.

>They may truly need to use other tracks to be effective memorizers of information.<
I cannot imagine what those tracks would be. Especially if one is already a poor auditory learner.
Every time you think of a persons name for example, their face will always pop up in your imagination. How could any one listen to a description of a story or problem and understand it without visualization skills?

RobinA wrote:
>
> >They may truly need to use other tracks to be effective
> memorizers of information.<
> I cannot imagine what those tracks would be. Especially if one is a poor auditory learner.

I have had many kids (not an above average number but enough to be significant) who must use the tactile or kinesthetic track to input information effectively. Their visualization track (even with V & V) developed so slowly and incompletely that this never became their “go to” strategy. My own child was balanced enough that this wasn’t an issue; he was a good visualizer but auditory track wasn’t very good early on. It developed, but will never be his “go to” strategy.

> Every time you think of a persons name for example, their
> face will always pop up in your imagination.

The key word in that sentence is “you” That might be a favorite visualization skill for some, however, it isn’t global. Everytime I (or lots of folks) think of a person’s face, their name does not pop into my mind. There are some names that I have to do a special trick to remember: Visual the person with something that resembles their name. Ex: If I were trying to remember my own name, I would picture myself holding something long. To remember a colleague’s name—Wollenzein—I had to picture her leaning on a wall holding a mazagine. (Rhymes w/last syllable of name.) Someon w/poor P.A. would not choose this technique if rhyming were a problem. It was a conscious effort, though.

>How could any
> one listen to a description of a story or problem and
> understand it without visualization skills?

People can understand the gestalt without good imaging skills. They can pick out main points and supporting facts. They can pick out vocabulary. There is a fairly high level of understanding without imagery. However, it is void of the essence of literature—emotion and descriptive detail. Writing structures are much affected, too.

All of us (me, too) tend to relate situations w/ourselves or our children to more global application than may truly exist. I keep talking and thinking about the fact that the term LD has over 5,000 different possible types. It is very difficult to globalize anything in this field.

Here’s that individual case globalization thing again. (See response to your post below.) Einstein had a hugely developed visual-spatial and logical-mathematic brain gift. Probably had the P.A. of an ant—don’t know, just a guess because language was so hard early on and reading was difficult in early years. So, he went to his “go to” strategy—visual combined w/logical.

We cannot, though, take this fact about Einstein and globally apply it to other brain types without knowing their strengths and weaknesses.

I have many kids who score great on auditory (Have terrific Digit Spans and Arithmetic on the WISC/WAIS) but have the visual logic skills of an ant. I help them develop strategies bases on strengths while developing the weakness areas to the best of their ability.

I keep returning to Larry Silver’s neurological model after twenty years of it rattling about my brain w/other theories. It is looking more & more like he had a brilliant vision of what is LD.

If folks are interested, I’ll post to Jessica an old pamphlet Dr. Silver wrote for Ciba-Geigy. She can check w/him to see if it can be posted. It was the first thing I read about LD in 1989. It has continued to work over this long span of time.

He really did not have much of a visual memory at all until after V/V. The skill of a teacher in applying any program should also be counted in this whole process. The program was very well monitored and implemented at this particular clinic. I have seen a great difference in how sucessful the LB programs are depending on the instructors skill. The successsul seesions have the child feeling energized even at the end of a long day after school and afterschool care.

I a glad you perceive a positive difference in verbal memory for your son.

I wasn’t discounted nor padding the effect “good teaching practices.” I was discussing more in the reliability and validity arena. Sorry if I misunderstood your direction.

One of the biggest changes was in the pre and post tests on the test of verbal absurdities. Before V/V , he really couldn’t even score high enough to register anything. After the program was completed, he scored a mental age of 13. He was 10 years old at the time.