question re idea

Since the problems with the hand are related to his injury, why won’t your medical insurance cover PT and OT privately for him? That would likely be better than what the school would provide anyway.

If your son is performing at or above grade level, I would think a 504 would be more appropriate to get modifications for the writing issues. NVLD would not be an appropriate term for a child with an arm injury.

Janis

Thanks for your advise Janice but I am running out of benefits for therapy under our insurance due to the pt he has been having. As far as the NLVD my reason for requesting that is not related to his arm, but instead due to his mixed test scores on the GT test. My understanding that a discrepancy of more than 45 points would be indicative of a learning difficulty. As I stated before, it may have been due to the medication he was taken, but it does seem strange that he scored so high elsewhere if this was the sole cause. Also he does seem to exhibit some of the indicators of NLVD, though mildly so, and perhaps could be attributed to his adhd. My research had indicated that children with NLVD were frequently misdianosed as adhd.

I’d get the testing — and get it done under valid conditions. Whatever the spread — if he was in pain and on meds that affectedhis thinking… the scores weren’t valid.
However, it sounds like it is going to be *tough* to make the case that he needs the OT to receive an appropriate education… I’d look at all other possible routes, too. Keep plugging :)

The performance part of an IQ test involves using hands and some subtests assess visual-motor skills. If he was having to use his left hand, his performance scores would be affected. And with taking pain meds, there is no telling how inaccurate this score is. But that still is not NVLD, unless he would have scored that way with his good right hand before it was injured.

I hope you can get him the help he needs, though.

Janis

A couple of thoughts:

First, I would think that your son’s injury and its lasting effects would qualify him as other health impaired and eligible for PT or OT. He has a physical disability, just as a child with cerebral palsy or muscular dystrophy does. Those children are eligible for services regardless of the presence or absence of LD.

Second, it may be important for you to know that NLD is not a recognized LD “label.” Thus, that diagnosis alone will not guarantee you services.

Third, your son is gifted. Discrepancies between verbal and performance IQ are much more common in gifted children and, while they may indicate a relative learning weakness or even a relative LD, you would need a lot more than that to diagnose NLD.

Fourth, as you note, the medication certainly could have artifically lowered your son’s performance IQ. Performance IQ is greatly affected by slow processing speed and by motor skills difficulties. Heavy duty pain killers could influence both of these areas.

I think you certainly should follow through on further testing. It is always better to know what you are dealing with.I hope this helps.

Andrea

Andrea,

But doesn’t there have to be academic delay to justify placement as OHI?

Janis

I don’t understand. JUST a significant descrepancy between verbal and performance IQ indicates giftedness? I thought you still had to meet the “magic number” at one end or the other?

Leah,

He apparently did not qualify because of the lower performance score. But you couldn’t possibly consider that score valid because he was doing the tasks with his left hand because his right hand/arm is injured. The school should have stated this and disregarded the performance score.

I think he needs a private evaluation. If they can establish that he is gifted, it is possible that his school performance is delayed in comparison to his ability. In unusual cases like this, schools don’t know how to handle the scores or placement. So I’d take him for a private eval and get an accurate assessment.

Janis

Janis,

Right I understand, but in a “overall” situation, a large discrepancy between verbal & Perf. does not indicate giftedness, right?

Also, wouldn’t you have to know his actual scores to determine if he was, in fact, gifted?

To the original poster: on this site in LD in Depth under Legal and Legislative, click on comparison of ADA, IDEA and 504…if you are looking for an eval. and think you child meets the definition of NVLD(again read on this site under LD in Depth), write a letter and ask for an eval, but know that it is NOT a category in the federal regs under IDEA; you ask several questions about eligibility under special ed.-a temporary disability like a fracture, even if the recovery is long is not an orthopedic handicapping condition like cp, and schools might make temporary accomodations for a student with a fracture, but would expect health insurance to provide PT or OT.

To Leah: evals for “giftedness” are not standardized and vary from system to system; the standard def. of IQ of 130 and above may also include in some areas evidence of special talent, etc. as well as academic skills far above grade level.

Gifted programs are NOT an entitlement(our district does not have them at all), and entrance to them varies also.

Perhaps I’ve got this wrong, but didn’t the original poster say that her son was in a gifted program? A discrepancy alone is not an indicator of giftedness. You still need either a verbal or performance IQ in the gifted range, which is generally 130+. My point was that discrepancies in children who are known to be gifted may not be an indicator of a serious problem.

Andrea

The factor that we are not addressing that the poster is asking is whether her son would qualify for special education services for either OHI or LD. In both cases there would need to be documentation that the disability affects the child’s ability to learn.

In the original post it was stated that the child was performing at or above grade level. If this is the case then no the child would not be eligible for services. Having a disability does not automatically qualify a child for sped services. Currently in my school we have children with ADHD and others who are wheelchair bound that do not have these services b/c of the very reason that their disabilities do not affect their educational performance.

A child with a nonverbal learning disability would qualify under the category of LD if the requirement as to a severe discrepancy formula was met.

Thanks all for your replys on this subject. I still feel somewhat confused but the info helps. To any who have knowledge about NLVD I understand that it doesn’t qualify a child for assistance if they are performing at grade level, but isn’t there intervention available outside of the school system for this type of difficulty? Somewhere in my researching on this subject I read that it is not unusaul for a child to perform well up until age 9 or 10 when more complex problem solving skills are required and that some children with NLVD are initially diagnosed with adhd. Beleive me, I am hopeful that the testing was just skewed due to his other problems. How overt are the symptoms? I have seen a few things that make me wonder such as sometimes, he seems “out of sync” with the other children. Especially in sports or in music programs at school, both in coordination and in awareness of what he should be doing. Though he has been better of recent, he frequently put his shoes on the wrong feet and didn’t seem to realize it. He has extreme sensitivity to noise. He will sometimes seem not to hear us then after we have asked him to do something 4 or 5 times and we get frustrated, he doesn’t understand why we are angry. Does any of this fit for NLVD or is this just all part of his ADHD?? Thanks again for your input.

Sounds like auditory processing possibility. Re: the hypersensitivity to noise and repeating, esp. in view of the music problems (sounds like my APD daughter). Have you read the “Out of Sync Child” by Carol Kranowitz?

I can’t diagnose of course.

P.S. I didn’t know that subtest skews were commonplace in gifted children. In our district you have to be 130 period. No variation. (unless of course you’re a friend or relative of a muckity-muckl) Original post said he was tested for GT but didn’t qualify from what I understand.

[quote=”SONOMAVAL”]>> Thanks all for your replys on this subject. I still feel somewhat confused but the info helps. To any who have knowledge about NLVD I understand that it doesn’t qualify a child for assistance if they are performing at grade level, but isn’t there intervention available outside of the school system for this type of difficulty? <<

There are lots of different interventions that parents use for their NLD children. (I have one “typical” NLD’er, and a second child who meets many of the criteria, but at least so far does not have the dx) But besides academic needs, my kids get no help within the school system. The older one did have OT in K & 1st grade, but was released from OT when he could walk through a door without hitting the door frame, and could hold a pencil, though he still had only VERY marginal printing ability. He has always had SI issues, but because they are of the hyposensitive type, and are not considered a problem at school (because they do not lead to disruptive behavior in the classroom) he is seen as ineligible for OT in these areas.

Outside the school system, sure, you can have whatever therapy you can afford. But health insurance doesn’t cover it, we pay out of pocket.

>> Somewhere in my researching on this subject I read that it is not unusaul for a child to perform well up until age 9 or 10 when more complex problem solving skills are required and that some children with NLVD are initially diagnosed with adhd. <<

That is true, but most NLD children show strong signs of difficulty way before that. It’s just that the standard assessment tools used by schools aren’t designed to pick up on the problem areas. The children who are dx’s earlier are those that have severe classroom behavioral issues, (usually SI related) or accadmeic issues due to the visual processing problems. (my older son, with the firm NLD dx, has been on an IEP since Kindergarten)

>> Beleive me, I am hopeful that the testing was just skewed due to his other problems.<<

JUST VIQ/PIQ split, even in a child who did not have an injury and was not on pain meds is really not diagnostic for NLD. (although some evaluators have started using this discrepancy to label children as NLD whether they are or not) While the deficits in some areas may be subtle, my understanding is that a child MUST show at least some signs of deficit in all the areas affected by NLD for the dx to be accurate.

These areas are:

Fine and/or gross motor (again, not due to accident or injury)
Visual/spatial
Part-to-whole problem solving
Pragmatic language

The last 3 of these combine to cause a number of secondary problems:

Inferential comprehension
Social (usually a biggy)
Reading (for some children with particularly bad visual/spatial issues)

Many NLD’ers, particualry those who are dx’d late or not at all, also develop tertiary problems:

Anxiety
Depression
Other emotional problems

While not included in all diagnostic protocols, most of us “NLD parents” and many experts have also seen that most NLD children also have:

Executive function problems (which overlap with ADHD)
Sensory integration problems (can be hyper or hypo, or a combination)

>> How overt are the symptoms? I have seen a few things that make me wonder such as sometimes, he seems “out of sync” with the other children. Especially in sports or in music programs at school, both in coordination and in awareness of what he should be doing. Though he has been better of recent, he frequently put his shoes on the wrong feet and didn’t seem to realize it. He has extreme sensitivity to noise.<<

Those COULD be part of NLD, but as other people mentioned, they are typical SI issues, and many kids have SI problems without having NLD… It’s not part of the “required” list of problems for NLD.

>> He will sometimes seem not to hear us then after we have asked him to do something 4 or 5 times and we get frustrated, he doesn’t understand why we are angry. <<

Again, that’s in the mushy area of XF, where it could be NLD, or it could be ADHD. Or as someone else mentioned, those would also fit with a child who had CAPD issues.

All of which goes to reinforce what others have said, you really need a comprehensive outside eval.

Karen

My friend’s son was initially on an IEP for various difficulties. He took off academically but they kept him on his IEP because he continues to have fine and gross motor issues that affect his writing. He is on the IEP to get OT. (This mom was my inspiration to pursue outside remediation)

He was recently invited into the GT program which really isn’t much of a program. They just identify gifted kids as is required by New Jersey law. It wasn’t based on IQ but rather teacher recommendation. Even while identified as gifted and receiveing no services except OT he remains on an IEP.

Can you believe she didn’t even fight to get this? I know Leah would like this one.

If you child has NVLD type issues with or without an official diagnosis there are specific programs frequently discussed here that can help address the visual/ motor deficits.
A few to look into are interactive metronome, audiblox, PACE, neuronet and vision therapy.

You can spend a lot of money getting a diagnosis. I have chosen to spend the money on remediation. I wouldn’t count on the schools.

[quote=”Leah-FL”]

P.S. I didn’t know that subtest skews were commonplace in gifted children. In our district you have to be 130 period. No variation. (unless of course you’re a friend or relative of a muckity-muckl) Original post said he was tested for GT but didn’t qualify from what I understand.[/quote]

Leah,

Here is a link for you. Linda Silverman is a very highly regarded expert in the field of giftedness testing. http://www.gifteddevelopment.com/Articles/Using%20Test%20Results%20to%20Support%20Clinical%20Judgment.html

Also, doesn’t your child have some motor skills issues? If so, you might point your school in the direction of Kaufman’s book “Intelligent Testing with the WISC-III. He writes that “For children with motor problems, the WISC-III P-IQ and PO index do not adequately reflect intellectual verbal and nonverbal intelligence through the auditory-vocal and visual-motor channels of communication. When one of these
vehicles is damaged, some or most of the battery is no longer measuring intelligence for that individual.…even the higher of the Verbal and Performance IQs, or of the VC and PO Indexes, may be an underestimate of the child’s level of intellectual functioning.” Kaufman is one of the foremost authorities on intelligence testing.

Andrea

sounds like two seperate issues.
First you have the academic needs based on the ADHD,
then you have the occupational therpay needs.
I would focus on the learning to write,due to OT needing to be “educationally necessary” before the school is obligated to provide.
If this injury happened on the school grounds,I would think they are obligated to help out with therapy outside of school. I would look into this. They have insurance also.

I would get a prescription from your orthopedic Doc stating he needs OT to learn to write again. With a script. I would think writing could arguably be educationally necessary.