first school evaluation

[InsaneCdn]

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.

He can have auditory processing disorders and NOT have classical Central Auditory Processing Disorder (CAPD).
Central Auditory Processing Disorder (CAPD) = difficulty processing spoken language.
Other APDs= difficulty processing sound - for example, can hear and comprehend fine in a quiet environment, but cannot distinguish the "important" sounds from the background and other noises, in a noisy environment (issues with auditory focus, anditory filtering, auditory discrimination).
And neither of these is a "hearing" problem. The ears work just fine, thank you - its what happens when the sound hits the brain.

This whole auditory discrimination suite of disabilities is only recently recognized, and many SLPs may not be aware yet.
There is a whole battery of tests around hearing through background noise.
AND - things like classroom microphone systems or personal FM systems, really help - bring the "important sounds" to the foreground.
He may be spending so much mental energy just trying to catch the words, that he doesn't have the brain power left to really process what he hears, especially in noisy environments like... school!
You might want to raise this specific issue with the Speech Language Pathologist (SLP) for initial screening - usually, it takes an experienced clinical audiologist to do the detailed testing.

The sooner they catch this, the better.
Otherwise, school is going to drive him around the bend. Huge psychological and behavioral issues can come out of this.

 

[Ktllc]

Insane, the Speech Language Pathologist (SLP)'s opinion is just that: her opinion. I agree she is not in the position to diagnosis Auditory processing issues.
difficult child will not be able to be tested by a (C)Auditory Processing Disorders (APD) audiologist until he is at least 6 years old.
At least, the Speech Language Pathologist (SLP) was smart enough to recognize that certain strategies used with Central Auditory Processing Disorder (CAPD) kids would be quite effective for him: talk to him face to face, maybe a little slower with very good articulation, reduce surrounding noise, follow through and repeat as necessary.
I still don't understand why we need to repeat things so many times IF his brain processes the auditory info and his cognitive skills are good.
Basically, I take all that with a grain of salt and don't jump to too many conclusions yet.

 

[InsaneCdn]

If he is in "perfect" conditions, does it reduce your need to repeat? Does it make things worse if conditions are "extreme"?
By "perfect" I mean... absolutely NO background noice at all - no music/tv/dishwasher/other kids playing/dad reading newspaper/etc. - and one-on-one with no visual and other distractions? I suspect even home is much noisier than you realize.
By "extreme" I mean... the state fair, or a noisy birthday party, or a crowded shopping mall...

If there is a large difference in his "hearing" depending on the environment, then what the Speech Language Pathologist (SLP) is saying makes sense - he probably can hear within reasonable ranges, and can process verbal language - but cannot do so if he has to work around background noise. In which case... it would really pay for you to make whatever lifestyle changes it takes to make your home VERY quiet - husband may have to use headphones for TV etc., move dishwashing and clothes washing to after your son is in bed, no background music, etc. If you can do this and his behavior improves at home - then, when school has issues, you have the contrast... you can prove that "noisy" doesn't work for him - diagnosis or not.

They can't test Central Auditory Processing Disorder (CAPD) until age 6 because... they have to rule out so many other things first, including ADHD, which can't really be determined until they are into full-time school at least.

Its tougher when they are this young, because so many of the accommodations rely on reading skills - outline of class at the start of class so they can follow along, note taking services, etc.

by the way - Speech Language Pathologist (SLP)'s "opinion" carries a lot of weight - you won't even get screened for Central Auditory Processing Disorder (CAPD) unless the Speech Language Pathologist (SLP) is of the "opinion" that this might be present. Its not a diagnosis - but its definitely a red flag, and is taken seriously by others.

 

[Ktllc]

Well, well, well... We saw the audiologist and she did the standart testing. She could not perform one about hearing with background noise, she does not have the equipment.
His hearing is excellent! After a few of my questions, she told me that referring for a ore in deph test would be pointless: there is no norm for 4 year old kids. The doctor would not be able to really do anything with the results.
She said to keep an eye on it and that my suspiscions are very reasonable assumptions because of his health history (repeated ear infections and then ear tubes which are still in).
We have a meeting at the school to get the results of last week evaluation. A little nervous, but kind of ready to hear what everyone is saying: "let's monitor it, we are not sure yet".
I guess I'm trying to make peace with the fact that he is so young and there is so little we can do.
If he has Asperger's like I suspect, what can really be done at that age??

 

[InsaneCdn]

If he has Asperger's like I suspect, what can really be done at that age??

If he has anything on the autism spectrum - including Asperger's - then early intervention is absolutely vital.
Its not as though there is a specific treatment for Aspies, or medications or anything... but they DO diagnosis early, and then you need to learn how to work with your kid, and then how to help your kid survive in a non-Aspie world.
In many areas, there are special services for Autism Spectrum Disorders (ASD) kids - things like socialization groups, day camps, etc.

If he IS Aspie, you're going to want to know as early as possible.

If he is NOT Aspie - then the real dxes may have to come later - they don't normally diagnosis ADHD, for example, until grade 1, most Speech Language Pathologist (SLP) issues aren't tested for until grade 1, etc. But at least you would know that its not "Aspie". (or not... at this age, they often get the diagnosis wrong... and it might need to be revisited later...)

The background-noise test was done by the Speech Language Pathologist (SLP), not the standard audiologist... so, keep this in your "future file" for Speech Language Pathologist (SLP). (The secondary testing and diagnosis was done by a highly specialized audiologist in a teaching hospital - 10 miles of red tape to get there, but it starts with Speech Language Pathologist (SLP) tests showing issues)

 

[Liahona]

Our pediatrician saw difficult child 2 was autistic about 8 months old. It took him about a year to convince us to have him tested. At 18 months the autism specialist diagnosis him. We started tons of early intervention. I've done ABA previously and could do it at home. Its been recommended to do 20 - 40 hours of it a week with Autism Spectrum Disorders (ASD) kids. We also did the Play project with Dr. Solomon. We also did Speech Language Pathologist (SLP), Occupational Therapist (OT) and an autism pre-school. Part of the diagnostic criteria for Autism Spectrum Disorders (ASD) is that is shows before age 3. If you suspect autism it would be good to get him tested. You don't want to miss the opportunity when they are young. It gets harder for their brains to learn after about 6 1/2 years old. Its called brain plasticity where if presented with the right opportunity the brain will re-wire itself a little (the autism doesn't go away, but can get better).

 

[ksslp]

have you been to see a developmental pedi? That's where I would go for a diagnosis of any sort. You're in North Carolina? I would think Duke would be the best place to go, but expect the wait time to be loooooong.

The sooner you get interventions the better!

 

[TeDo]

ksslp, welcome to our little corner of the world. This is a very old thread and is likely to get lost quickly. Why don't you start your own thread and introduce yourself, your family and your situation to us. We would love to learn more about what brought you here.

 

[Malika]

If he has Asperger's like I suspect, what can really be done at that age??

Hello Ktllc. I was a little confused by this - I thought you just had an evaluation that ruled out autism - or did I misunderstand?

 

[buddy]

She said to keep an eye on it and that my suspiscions are very reasonable assumptions because of his health history (repeated ear infections and then ear tubes which are still in).

Hi there! (In full disclosure...I am a Speech Language Pathologist (SLP) (have worked birth-3, ECSE, elem, middle thru highschool) so please know I am NOT giving professional advice here, just general info which may or may not apply)

...The impact of this kind of medical history is often underestimated. Ear infections, tubes needed etc. are middle ear issues and not directly going to harm the nerve pathways (which is what is involved in Auditory Processing Problems....) However, any time one of our senses is dulled, or not stimulated normally our nerve pathways including the brain can have difficulty "learning" to interpret the sounds (or sights with vision etc...) so he may need some catch up.

In addition, just the impact of a child being ill repeatedly....especially if he felt pain with the ear infections (amazing but some dont) they are going to miss out and/or not going to want to be engaged fully. Just having hearing that comes and goes with all that fluid and goo...(not that he would be deaf, but certainly would have the symptoms of doing better in a quiet environment etc.) can result in their "learning" to tune out-not on purpose but just because it happens so often.

In any event, it seems like you are saying your gut is telling you there is a chance of Autism Spectrum Disorders (ASD)/Asperger's which can also explain many of the things you are seeing.
Bottom line is to trust your gut and use methods that you find are appropriate to address the symptoms you are seeing. Great that you are not ignoring his challenges. Then, even without a diagnosis, you won't feel he has missed out on time with interventions.

It sounds to me like the second Speech Language Pathologist (SLP) is (if I am reading between her lines correctly) hinting at Autism Spectrum Disorders (ASD) too...

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.

She made points that go along with that diagnostic/educational category: * difficulty with transitions *he seemed to be a visual learner *language concept issues *need to repeat/attentional issues And you said they mentioned that they understood your concerns with his being able to relate to adults better than kids and being "shy".

For many years Speech Language Pathologist (SLP)'s were the only ones catching kids with Autism Spectrum Disorders (ASD) (communication issues are referred to them naturally, so they see them first and many years ago kids were not so readily identified as Autism Spectrum Disorders (ASD)) so she may have the early radar that you have and/or she may have listened to your input she may have looked for those signs...

So, keep not only your report but the notes you have from the meeting for the future (if they are in your head, write them down...you will be surprised what you forget as the years go on, and how helpful that can be).

sounds like your little guy is really lucky to have you!

 

[buddy]

sorry, I see that you have a follow-up thread...got confused becasue this was under the new posts and I didn't notice it was started earlier....my apologies.