Gifted Issues Discussion homepage Forums Twice Exceptional Evaluations - am I going about this all wrong?

We had DS6 tested for IQ and achievement by a private LEP when he was 4 and 5 years old. He is more "mathy", but actually is fairly well balanced Verbal and Non-Verbal according to SB5 and WPPSI-IV. Working memory very high, however, processing speed is relatively (although not dismally) low.

Last year I was thinking maybe dysgraphia because he was very avoidant of pencil-to-paper tasks, but his writing has improved a lot and he has never complained about pain when he's writing. Last year we had an OT eval done, but it was not particularly helpful - I filled out a questionnaire and basically the report was a regurgitation of what I had filled out. OT recommended doing listening therapy (haven't actually done this but may do it, although through a different provider) and providing DS with fidget toys.

The biggest issues are inattention, executive skills, and social skills. He's doing fine in terms of academic achievement because he was light years ahead when he started school, but he is getting into trouble every day for making noises, being off task and distracting others in class. We're pretty sure his teacher doesn't understand him, so we'll be meeting with her soon, but that's a different matter...

I would like to get him evaluated by a neuropsych, but DH thinks it's too early. In the meantime, we have scheduled an assessment for CAPD because he really does fit all the "signs". I'm also leaning towards doing another OT assessment for SPD with a provider that was recommended by the LEP.

Are we wasting our time (and money) by looking at things piecemeal and heading down these different roads? Should DS be doing a neuropsych eval before all these other evals, or is it better to wait until he is a little older? (DS turned 6 in July)

Isn't it also too early for a CAPD assessment? I thought they didn't like to do those until kids were 7 or 8 years old.

We did the piecemeal thing with our son and ended up getting lots of diagnoses that held pieces of the truth but didn't shed light on the whole problem in a unified way. We finally got what I consider the real unifying diagnosis when we went to the Eides after several years of mucking about.

I would definitely choose the neuropsych. An OT will undoubtedly identify sensory issues, but will not be able to tell you whether they are themselves a cause or an effect. Even if CAPD is identified, there's no evidence based treatment out there as far as I know. And you may only be working around the edges of a problem, rather than seeing the whole thing.

A neuropsych should be equipped to consider all the various issues and put the puzzle together for you.

I would also recommend the neuropsych first, so that you have some knowledge of what direction you need to be going before rushing into more of these assume-a-diagnosis type of assessments. What looks like a *sign* of CAPD *might* be a symptom of it - or it might be a symptom of something else - if you look around at various challenges you'll see that many symptoms overlap - plus it's difficult sometimes to actually see a symptom that's clear as a bell to a person who isn't spending every day with your child. I really *really* recommend starting with the comprehensive exam first and then branching off with other evaluations based on what the neuropsych recommends.

Best wishes,

polarbear

Comprehensive evaluation is generally the better way to go, as otherwise specialists only see their little part of the elephant.

And while I know some people have anecdotally-positive experiences with listening therapy, I would caution you that there is negligible research supporting its effectiveness, and some potential for damage to hearing. It tends to be recommended by OTs, who are, I have to mention, particularly prone to fad treatments, as a field.

Yes indeed. We were once told by a school OT that DS's behavior problems were not due to his conclusively diagnosed *autism*, they were due to his *sensory issues*. All trees, no forest.

Thanks everyone for your input. Yeah, I wanted the neuropsych first, but branched out more due to DH's reluctance.

So, is there such a thing as too young or not ready for neuropsych eval?

Anyone here have a neuropsych diagnosis (with a neuropsych experienced with gifted) that turned out to be wrong?

With that set of issues, I'd say that 6 is not at all too young.

I definitely got this feeling when I took DS to OTs. One of them put him on a spinning board for a few minutes each week, and then watched his eyes shaking back and forth. She couldn't seem to give me a logical explanation for why she was doing this. Then they wanted me to take him for vision therapy but couldn't really give me good reasons for that either. Metronome therapy was done on both my kids. It might have been somewhat helpful for DD but DS never seemed to improve. I thought that the activities meant to increase his fine motor skills were helpful, like how they made him cut with a scissors, or made him hold a pencil in his fingers rather than his fist, but otherwise I just had to roll my eyes at some of it. PT for gross motor was much more helpful, IMO.

I took DS to one follow up session with the OT that did the eval. It was about 30 minutes of her giving him different fidget toys to try out, a couple of slides down a short ramp on a board with wheels, 10 minutes of him lying on his stomach on a swinging platform throwing beanbags into a bucket, and discussion about whether I wanted to do listening therapy. I didn't get the sense that he got ANYTHING out of it. Admittedly only one session, but I am not inclined to spend $100/hr and take time off work to have him see someone in whom I felt little confidence.

Yay- I brought up the neuropsych again with DH and told him I really wanted to do it. He said "Go ahead". Then said something to the effect of "I guess you're not going give up on that". Perseverance pays off!