Gifted Issues Discussion homepage Forums Twice Exceptional Benefits of getting a neuropsych eval?

Thanks DeeDee and Polarbear. I asked what I should be doing and was told "You're doing it." I asked what I should ask the school to change in light of these new test results and was told "Give them the report - they should know what to do." I heard back from the school and they said once all team members have a chance to review the report we'll meet to discuss any changes to her IEP.

I know she is in a good place with people who are trying their best to meet her needs and we are MILES ahead of where we were this time last year. Any yes, as polarbear says, the neuropsychs tend to forget this is our first time down this path. I just hate feeling so ignorant. Part of me wants to hire an advocate who has been down this road before but I really don't want to risk alienating a district that has been so cooperative. I think I am getting pretty good at asking questions but I'm not there yet in terms of understanding the answers

You can consult with an advocate on the side without bringing him/her to meetings with you. If you want the expertise but not the baggage. Or you could nag the neuropsych some more.

The report should have recommendations, but I have found that if you don't discuss/understand things beforehand they might not fit the school situation/possibilities right. Especially if you have no idea what the possibilities are.

Oh, and I am writing the above as if I knew what I was doing, but we are still flailing here, with a complete failure to get the school to do anything for my son. Who does fine academically, but struggles socially. If there is anything between a 1:1 aide (which we will clearly never get) and keeping him in the office during all recesses and lunch breaks (the latest suggestion from the school), we haven't been able to articulate it.

Pemberley, we never actually hired an advocate, and our school never knew we'd consulted with an advocate. We were able to find a non-profit advocate's group that allowed us to call up and ask specific questions. They also reviewed our private evals and school paperwork etc so they'd understand as much as they could about our ds' needs and abilities etc.

The thing that consulting with an advocate helped us with the absolute most was understanding our local schools - even though Federal Law is the same everywhere in the US, the specific ways in which IDEA and ADA are implemented vary quite a bit, plus there are huge variations even within our school district re how accommodations etc are implemented, how school staff feels about accommodations etc - things like that. Plus the advocate's group was able to give us the language to use when talking to the school staff to give us the best "at bat" chance of getting our ds' needs met.

And I need to give a warning similar to Sia's - we haven't always been terribly successful! It took us 3 years to get an IEP, still had the school trying to tell us "everything is ok", once we had the IEP our ds wasn't given the help he needed and was outlined in the IEP, and ultimately our best successes for ds have come through private therapy that we've had to pay for, and this year we just absolutely bailed on the public schools here and went private because our ds was a mess emotionally both from not being challenged appropriately within the areas of his intellectual strengths and at the same time not being helped in the areas he really needed help. So that's my big disclaimer - and also my sincere wish that the journey is much easier for your family!

Best wishes,

polarbear

Thanks Sia. I was just sitting here thinking of this option. I recently met an advocate who is excellent with the LD stuff but rather confrontational and doesn't seem real strong on the 2E front. It may be worth hiring her to help us understand and prepare even if we keep her in the background and continue working with the school ourselves.

Has your school tried setting up a working group with a couple of highly social, sensitive kids to work with your ds? Maybe lunch once a week with the social worker or school psych to facilitate?

Hmmmm... There have been suggestions along those lines, but they have revolved more around throwing all the problem kids together (with a facilitator, except they can't find one). Thanks for the new idea!

SiaSL,

This might come in handy for the school.

In the light of a new day I am feeling a bit better about all of this. Polarbear I know exactly what you mean about huge variations in implementation. I still can't believe that with all the issues we have discovered and all the services our district is providing that last year I totally hit a brick wall at the regional magnet. If we had lived in the city where that magnet was located DD would still be suffering verbal and emotional abuse while being considered ineligible for even an evaluation. It is SO not a level playing field. My heart breaks for all the kids who find themselves in districts that aren't willing (or able) to meet their needs.

This is the recommendation section from the neuropsych's report. Is this similar to what others have received or should I have expected more detailed input on exactly what to request in terms of interventions? Someone yesterday suggested I look into whether or not "vision training" might be appropriate. Any input?

*******

1) Workup by a pediatric neurologist with appropriate EEG. I made the referral to __________ M.D. at __________.

2) ________ may benefit from a cognitive remedial program with the emphasis on memory, attention including hemiinattention, and visuo-spatial perceptual organization. She is not acquiring reading/writing skills at the rate that would be expected give her verbal IQ and precocious language development, and her educational program should be reviewed in light of these findings


3) Further occupational (OT) evaluation, therapy, and consultation to address fine motor and visuomotor skills. It may be possible to pursue this through school and the OT should provide regular consultation to teacher and parents to help promote generalization of skills.

4) In light of the significant nature of the findings, a repeat neuropsychological evaluation is indicated in 10-12 months to assess any changes in the cognitive status; or sooner if dictated by the changes in the clinical picture.

Although it's not the same set of recommendations, it's similar to what we received (although from things I've heard from other people - I have always felt we didn't receive as much as other people do lol!). We were able to get more specific details verbally from our neuropsych, but this is very similar to the amount/type of info she included in her official report.

If you don't have specific info from her re what type of cognitive remedial program or where to seek that out in your area, I'd ask for the info. Our neuropsych never included those types of specifics in her report but she made very specific recommendations re who/what was the appropriate person or service to seek, or in the case of OT, for instance, she felt any OT would work and recommended we get on every waiting list we could and take the first appointment we could get (waits are very long for OT here).

My older dd has been through vision therapy. It's somewhat controversial, and I can only give you our limited experience but fwiw, for our dd it was *extremely* helpful. It was recommended by a neuropsychologist based on her performance on the WISC and a follow-up visuo-motor test (Beery VMI). She scored extremely low in the one part of the WISC that asks children to find and mark matching characters, and couldn't copy accurately on the Beery VMI. Her scores on the WISC subtest was sooooo so very low it was below the 1st %ile - I'm not sure she actually found even one character, and it was a huge drop from her other WISC scores which were very consistent across the board. On the Beery her low subtest score was also very low, maybe around the 5th percentile. The neuropscyh suspected vision troubles based on that and referred us to a developmental optometrist. I was very skeptical as our dd had just cruised through a regular eye exam with 20/20 vision. We talked to our regular eye dr about it, and she too recommended we give it a try - her take on it was if it was a neurological challenge, vision therapy wouldn't help, but if there was a muscular weakness involved it would help. And yes, it helped *tremendously* - we didn't realize until her vt eval, but she had severe double vision - so severe that much of the time her brain was switching off the vision in one of her eyes. She was 8 years old when we found this out, and she literally had no clue that the rest of us also didn't see two of everything most of the time! Anyway, in addition to the double vision her peripheral vision was very limited and her eyes didn't track. So for her, vision therapy helped tremendously, within just a few months. She went from being a struggling (and perplexing!) reader who hated reading to being a great reader who loves to read and walks around with a book in her nose most of the time.

What I don't know is if what your neuropscyh is referring to as OT for visuomotor is related to the types of things vision therapy would help with. Our ds has a visuomotor challenge, but he's also been screened by the vision therapy folks and came out a-ok with no worries there. I know he scores low on visuomotor type of np tests, but don't remember the specific subtest names at the moment. Our dd, otoh, had an extensive OT eval at 4 but the OT didn't catch any visuomotor issues. So I'm guessing it's two related but different things?

polarbear

Our most recent report not only included referrals for SLP and OT and recommendations for remediation, but numerous specific recommendations for appropriate classroom and testing accommodations and modifications, as well.

My son has/had similar visual challenges, including left-sided visual neglect/hemi-inattention, and that appears to have improved greatly with targeted therapy from an OT specializing in rehabilitating visual issues in addition to "regular" OT.