first school evaluation

Ktllc

New Member
My son is going to have a school evaluation in a couple weeks. My hope is: he will qualify for special pre-kindergarten and have a teacher who actually understand his needs.
It is very likely that he has Central Auditory Processing Disorder (CAPD). Anything that has to do with "hearing", he is lost. He does not like or understand story books, but love picture book (like the pig, the cat, the elephant and the matching picture). He does not do songs. He does not watch TV. He can't memorize single letters but is able to recognize sight words.
My feeling of all this: he needs a very visual and hands on teaching environment. The noise around needs to be minimum and instruction repeated directly to him face to face. The following through is crucial to make sure he did in fact processed the information.
All of those needs are not met or even understood at his regular daycare. Socially and on an education stand point it is a waste of time. He is withdrawn and does not understand what is going on. The only activity he fully particiaptes in is art.
How should I get prepared for the evaluation? Am I even going to have an input?
I'm afraid they are not going to see the magnetude of the problem because he will not be in a regular setting. When he is one on one, he understands a lot better. Not having background noise helps a lot as well.
Any advise would be welcomed.
Thanks!
 
T

TeDo

Guest
There's not much you can do. If they ask you for anything, give it in DETAIL. The meeting when they share the results and try to come up with a plan is when you get to share EVERYTHING you want/need them to know. Classroom observations are usually a part of the assessments they do. If they don't, request that they do. That is something you can ask them about now. Explain your concerns about differences in settings. Depending on their results, it sounds like he could benefit from 1:1 assistance throughout the school day. Someone who is responsible for HIM ony and to make sure HE understands what he's being asked to do and to work with HIM in a quiet setting when necessary or able. A teacher is not going to have the time to do any of this with all the other rugrats he/she is responsible for. Anyway, now you have my two cents. Good luck.
 

keista

New Member
I'd relax a bit. I'm pretty sure they will pick up on at least some of the issues. That will open the door for you to express your concerns and for them to do further evaluations.

Reminded me of my son's pre-k evaluation - just opposite. Since I thought he was a GENIUS, I was concerned that they would not see the FEW areas I was concerned with and wouldn't qualify for pre-k at all. (at the time and at that school, they only accepted the kids that were most behind) To my shock and dismay, they deemed him WAY behind the other kids. I was absolutely floored!

So, I say relax. IF (and that's a really BIG IF) they don't flag anything, THEN get out the Warrior Mom armor and go to task on them.
 

InsaneCdn

Well-Known Member
It is very likely that he has Central Auditory Processing Disorder (CAPD). Anything that has to do with "hearing", he is lost.

Not sure what age they start doing Speech Language Pathologist (SLP) evaluations... but if you're suspecting Central Auditory Processing Disorder (CAPD), the starting point for that evaluation is Speech Language Pathologist (SLP) (speech language pathologist).
Often, schools start this process if they see language processing issues (there are variations on Central Auditory Processing Disorder (CAPD) out there, and not all have language processing problems - but yours sounds more "classic" which is easier to catch).
If they don't start this evaluation, then YOU can try to get it either privately or through the medical system (not sure how that works where you are).

So, like the others said, don't panic yet, but DO start doing research, lining up plan B, etc.

And you might want to start something like a Parent Report (see site resources) to help you collect your thoughts, observations, experiences etc.
It helps to have all that at your fingertips when meeting with schools and other professionals.

Good luck!
 

Ktllc

New Member
Insane: We did see a Speech Language Pathologist (SLP) and she actually is the reason I am worried. She said his language are actually extremely good, way above his age. Tha's why he flies under the radar (had previous school assessment through Head Start). She explained that if they stick to language test, the school will never see/understand the problem. She then recommended to see an audiologist to test for Central Auditory Processing Disorder (CAPD).
That leads to my second issue: no one will test a child under 6 years old. They simply don't have any norm to go by....
The Speech Language Pathologist (SLP)'s advice was treat my difficult child's issues like Central Auditory Processing Disorder (CAPD) even though it is not official yet. She explained that she could not help him without an audiologist report (which would point the area(s) affected by the disorder).
The Speech Language Pathologist (SLP) also warned of school speech therapists: very few are actually familiar with Central Auditory Processing Disorder (CAPD). She said that regular speech therapy would not be of any help for difficult child, although the school might actually suggested.
His language skills and conceptual thinking always make him look within normal or above age level. At least that was the case at Head Start with their screening tools. That's actually one of the reason I don't think he will go back next school year. It was just so frustrating to try to explain and have nobody listen.
Ok, I'll try to relax. I promise! lol
 

JJJ

Active Member
Hi and Welcome.

You are great for going after an evaluation while he is still in preschool!!!

Some things I'd recommend:

1. Complete a "Parent Report" (see the link at the end of my signature). Be sure to include a list of your "Areas of Concern" and make sure they relate to his schooling.
a. DS5 has difficulty understanding spoken languauge when there is background noise.
b. Despite a strong vocabulary, DS5 does not seem to comprehend directions when give to the group.
c. DS5 had instruction at XYZ day care as well as at home on his alphabet but has been unable to learn it but he has learned 9 sight words.
d. DS5 can learn but only when the information is presented visually with 'hands-on' activities.

2. Ask the school to send either their psychiatric or their Speech Language Pathologist (SLP) to observe at the day care.

3. If the day care is also seeing the issues, ask their lead teacher to write a letter detailing some of the areas that he has issues. (You may want to meet with her and talk it through and jot down the areas that you are both worried about so that she has a starting point for the letter.)

4. Have the Speech Language Pathologist (SLP) that you saw write a report with her findings and her recommendation for "early childhood services to address suspected Central Auditory Processing Disorder (CAPD) and for a full Central Auditory Processing Disorder (CAPD) evaluation as soon as he turns 6 and the audiologist is willing to test him."

If the school does not find him eligibile for special pre-k, they may still find him eligible for SL services. Also, if you can, look for a Montessori-style preschool, they are very hands on environment.
 

seriously

New Member
Has his hearing been thoroughly tested?

Has he had hearing problems in the past?

Did the speech person test him for problems with phonemic awareness?
 

Ktllc

New Member
The Speech Language Pathologist (SLP) had one recommendation: test for Central Auditory Processing Disorder (CAPD) as soon as possible. So far, I was told no testing will be done until he turns 6. That is 2 long years.
The Speech Language Pathologist (SLP) also told that she cannot do any therapy without a report from an audiologist...
As far as the daycare, they don't see anything... he does not cause any trouble, therefore there is no problem in their eyes.
His therapist does see quite a few issues though. She has the following diagnosis on him: ODD, disruptive behavior, autistic disorder and pervasive developmental disorder. I kind of trust her and she has seen my son regularly for 3 months now.
His hearing has been testing before and after putting ear tubes about 2 years ago. Everything was fine then. Should we retest?
Should I come to the evaluation with the therapist's report? Or wait and see what the school team comes up with?
 

seriously

New Member
Yes, his hearing should be re-tested. Be sure to tell the audiologist who does the testing about the problems he is having so they do a thorough evaluation of his hearing - both conductive and sensorineural. Here's a link to some info about the four kinds of "hearing loss". You can have more than one kind of hearing loss simultaneously.

http://www.mychildwithoutlimits.org/?page=kinds-of-hearing-loss

I
t is very important to rule out hearing loss when you have a child with these kinds of symptoms. If at all possible, get this done before any further assessments are done by school, etc. as any evidence of significant hearing loss needs to be taken into account and may even qualify him for an IEP as Hearing Impaired.

So did the Speech Language Pathologist (SLP) test his phonemic awareness? That's the ability to "hear" or identify the individual sounds that make up language.

If you're not sure, just ask her if she evaluated this or not.

The school should do this if she did not.

What kind of license does the therapist have? Is she a psychologist or social worker or ??

If she has a Ph.D. or Psy. D. in psychology then I would ask her for a written letter listing your son's diagnoses, accommodations she recommends (like a small classroom) and the behaviors that she sees as likely to prevent him from being able to benefit from the regular school curriculum and setting.

I would ask her to NOT include the ODD diagnoses if she feels comfortable doing so. This "diagnosis" carries a big stigma and can lead to the school defining all his difficult behaviors as ODD and pretty much taking a punitive approach - punishing him instead of helping him.

It is puzzling that you list both autistic and pervasive developmental disorder. Usually a child is autistic which IS a pervasive developmental disorder (Pervasive Developmental Disorder (PDD)) - so you wouldn't say he has both. There are some Pervasive Developmental Disorder (PDD)'s that are not "autism" but if she feels he has one of those then she should be specifically naming that disorder.

Has she suggested you get your son assessed by the local regional center (the federal program to identify and support children with CP, autism and other severe cognitive impairments)? If not, then I would look into this ASAP.
 

Ktllc

New Member
The LSP did not test for phonemic awarness (I was there when she did the test, and it was just about understanding language).

The appointment with the audiologist is AFTER the school evaluation but BEFORE the psychiatric. evaluation. (just made the appointment!)

As far as the therapist: she is a Licensed Professional Counselor at the Masters level. That is all there is in my area, as well as Social Workers (Masters as well).
She has all those diagnosis listed on my difficult child's file, but she was actually kind of upfront with me about it. She said she was not super comfortable with it, it is not a perfect fit but she can't treat him without a diagnosis. My son likes her and he does make progress on what they are working on (identifying his feeling and when he needs to go and use his cool down spot). She also agrees that the ODD is not his primary issue. On his strenght, she listed: sweet and loving and wants to please adults (among other things). To me, that does not describe a typical case of ODD. She said my son was such an interesting and complex case... I'm glad she finds him interesting, but it does not give us the answers we all want.

If the school would just care enough, I know my son could strive and do wonderful things. I feel it's just a matter of finding the right teaching method.
 

seriously

New Member
Well, there are pro's and con's to having someone describe your child as "complex and interesting". One con is that she may not have the depth of experience to be able to accurately diagnose his issues and develop a comprehensive treatment plan. Her lengthy list of diagnosis also suggests this.

If she's helping and it's what you have to work with - then go for it.

You are totally correct. ODD is the diagnosis given to a child who is always oppositional. They say NO every time you say Yes = or anything else for that matter. This is in my humble opinion not a diagnosis that should be given a child who can also be described as "sweet, loving, wants to please adults". ODD kids do NOT want to please adults or anyone else for that matter.

It's good that you are doing a more thorough assessment. On balance I think I would not ask this therapist for any kind of letter/report. It will probably just stir things up without actually helping.

The school may do a screening audiology test that is VERY basic.
 

Ktllc

New Member
husband and I were remembering how the hearing test went 2 years ago. And I remembered that difficult child did not do well when he was in the sound proof chamber. The audiologist just thought he was a little young and shy and that was the reason why he did not answer... Drawing such a conclusion made sense at the time, he was only 2 years old after all. And the test, where he just had to sit quietly while the machine was measuring stuff in his ears, was just fine.
Now I'm wondering if all that time we assumed wrong! What if he really has a hearing probem. I mean a physical problem.
It would explain a lot, almost everything.
My mother met a friend who has a hearing problem (after an accident) and as she was talking to him, she saw him become more and more agitated. He finally turned toward an other person at the dinner table and yelled: "could you please at once stop shouting in my ears!!!". Everyone froze and the poor man had to apologize and explain that his hearing issue makes him feel like he is at a train station and all the sounds get mixed up.
If a grown man who is very well aware of his issue reacts like that, just imagine a 4 year old!! It has to be awfull to suffer from some kind of hearing issue (physical or Central Auditory Processing Disorder (CAPD)) and not even being able to understand or explain it.
All those testing cannot come soon enough.
 

seriously

New Member
Ok. So did the audiologist you went to before use anything especially for kids to help with the testing?

Like, did you hold your son on your lap during the sound booth tests?

Did they have stuffed animals in the corners of the room that moved and made sounds as part of the testing?

Did they put a little ear plug sort of thing in each ear and do a puff of air to measure whether his ear drum was working right?

Does your pediatrician do any basic hearing screening every year? If so has he passed those?

If you can get that hearing test moved up I would do it. Otherwise, all the results could be useless if he turns out to have even a mild hearing loss.

I would also suggest that you specifically ask the audiology office if they do anything special when testing younger children and/or how many children they test in a month (i.e. how much experience do they have testing young children). Then get them to tell you what they do that's different.
 

Ktllc

New Member
They did the "ear plug" thing and everything was ok. He was able to sit quietly.
When he was in the booth, he did not react during most of the test. It has been two years and I don't recall very clearly. She had the little stuff animal but it did not really help. Since everything else was fine, he was young to really be able to participate and V. tends to be mute with stranger anyways... (he got better). Basically we all agree that there were no reason to worry and that he had passed the test.
The clinic deals with children on a daily basis and I think that both the ENT doctor and the audiologist are pretty good with kids. They both have seen all my 3 kids.
At his 4 year check up (a few months back), the pediatrician could not do the hearing test because he had stuffed something in his ear. After a trip to the ENT to extract a green piece of paper, the doctor checked his ear tubes and everytging was ok.
Conclusion: it is possible that we've all missed something.
I'll call tomorow and see if the audiologist could test him before the school evaluation. At least, it is already scheduled before the private psychiatric. evaluation. One out of two.
 

InsaneCdn

Well-Known Member
On audiologists, Central Auditory Processing Disorder (CAPD), and Speech Language Pathologist (SLP)...

Most audiologists do HEARING tests. These do not capture Central Auditory Processing Disorder (CAPD) issues.
Normally, Central Auditory Processing Disorder (CAPD) is a multi-disciplinary diagnosis.
It starts with school or parents flagging "issues", then Speech Language Pathologist (SLP) evaluation - which should include not just language evaluation, but auditory filtering/focus as well (this may be a slightly newer protocol - we didn't get it a few yrs ago, but did get it this year); if the Speech Language Pathologist (SLP) feels there may be Central Auditory Processing Disorder (CAPD) issues, there is a basis to go to highly specialized audiologists specifically to pursue testing for/diagnosis of Central Auditory Processing Disorder (CAPD).

Speech Language Pathologist (SLP) has recommended testing for Central Auditory Processing Disorder (CAPD) - excellent, you're past that hurdle.
BUT... is this audiologist appointment just with an ordinary (or even ordinary pediatric) audiologist? OR, with someone who specializes in Central Auditory Processing Disorder (CAPD) and other such issues?

If its NOT with a Central Auditory Processing Disorder (CAPD) specialist... then you will not get reliable testing for Central Auditory Processing Disorder (CAPD).
Doesn't mean you shouldn't still see this audiologist - really pays to know if the hearing side is working, because if THAT is a problem, they won't diagnosis Central Auditory Processing Disorder (CAPD) at this point (would want to do interventions for hearing first, and see the impact).
 
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Ktllc

New Member
Well, I have tried but the audiologist cannot move our appointment. Although she doe not test Central Auditory Processing Disorder (CAPD), I think it is good to rule out any hearing issue.
The psychiatric. evaluation through private insurance has just been cancel and I have to find a new doctor (the other one is sick and might never come back!)
So now, the school evaluation became all that more important.
I think I'm not going to mention the audiologist otherwise they might account every issues to a physical hearing problem and chances are it's not the case.
This way, in either scenario we can move forward: because of the school findings or because of the findings by the audiologist.
And yes, I understand that the school test would be void if there was to be a hearing loss... But then I feel we would have to treat the physical problem before drawing any other conclusion anyway.
I wil also bring a copy of the Speech Language Pathologist (SLP) report which points out Central Auditory Processing Disorder (CAPD). It will give some to back me up. But thats all I'm going to come with. If a diagnosis of ODD will only stigmatize, than no thank you. Specially since he is such a sweet heart with his teachers anyways. The ODD show at home and yet, I'm not sure the diagnosis is correct. If we were to find the root of the problem, the ODD would likely to disappear.
 

InsaneCdn

Well-Known Member
FWIW - I think you're on the right track - especially with the ODD diagnosis and it not really being applicable at school anyway.

Good luck with the start of the school year.
Keep us posted on how it goes...
 

Ktllc

New Member
Well, we took difficult child to the school evaluation this morning.
In all, we were over there about 1.5 hour.
We talked to the Special Education director quite a bit. She seemed to really listen to us. We mentioned Central Auditory Processing Disorder (CAPD) as we ended out a copy of the speech evaluation previously done by the hospital. We talked about the fact that difficult child might not be behind enough for services. She explained that the guide lines require at least 30% delay in one area.
She also said that we (parents and team of Special Education) will make sure he does not fall through the cracks even if does not qualify this time around. She understood our concerns and said that a Learning Disability (LD) would likely be picked up when he is older. She went on to say that at that age, some kids can fly under the radar but as they grow older the gap becomes bigger, mor obvious and then she can intervein according to the guide lines.
She also smiled and said that we don't seem to be the kind of parents who will accept for our son to fall through the cracks. If he tests "too good" now, then she wants to see him every 6 months and monitor him by retesting.
We spoke with the psychologist and she thing his has excellent cognitive skills. That did not surprise us. So no problem on that end.
The SLT saw a few language concepts issue but nothing real bad. She also noted that transitionning was hard for him and that he was very visual. She does not believe he has Central Auditory Processing Disorder (CAPD). She thinks he understand the questions (therefor "hears" fine) but don't necessarly grasp the whole concept. She gave a few example: "when do you see the stars? When it is dark" "where is the bear? in the back of you" -instead of behind. The environment was quite noisy and his answers although not 100% accurate were never off. She also noted the need to repeat instructions quite a bit. But once he heard it a few times, he could proceed with what was asked.
We will have the meeting next week with the results.
I am not sure what to think of all that... I guess we'll see next week.
The only thing they did not see first hand: how withdrawn he can be around his peers. He is quite a social little fellow with grown ups. The Special Education director agreed that the withdrawn attitude is really not age appropriate.
In all, I felt they were caring and not dismissing anything. Once they understood we were serious, they were ready to do their job. Nothing like a good old certified letter!
 
T

TeDo

Guest
Good for you Ktllc. I am so glad you have staff that are willing to work with you (regardless of the reason). I am hoping to have a similar experience with difficult child when he starts his new school next week.
 
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