Gifted Issues Discussion homepage Forums Twice Exceptional 2e and more

Apologies for posting again but I am rather desperate.
Short version..10 year old twins, 1 PG, 1 HG. PG daughter also has right hand syndactyly and ADHD. Has seen 2 neuropyschs. Had consult last week with Dr. Silverman who advised that both reports were accurate with the ADHD dx but the IQ reporting was inaccurate on both. We have paid out of pocket for all these consults and I just fed up. I would love to be able to see a doc who can dx accurately. Dr. Silverman referred us for a vision assessment with a Dr. here in Washington State. We are also going to Colorado for some testing for some auditory processing problems. I don't understand why the other docs didn't call this out and I feel like we are wasting time and money. Does anyone have a recommendation for a doc that works with 2e kids who can do a comprehensive evaluation? I also think PG daughter has dysgraphia as well. Any guidance would be appreciated.
Laurie

(bump)

As this post has gone unanswered until now, I will just offer a few thoughts - Schools used to perform vision and hearing screening, possibly they no longer do, or not in your area. Schools also used to require a signed form following an annual exam with the child's pediatrician or family doctor (during which vision and hearing screening was ostensibly conducted, with referrals to specialists if needed).

Regarding the piece-meal approach to testing and diagnosis of factors which could impede learning, unfortunately there may be more specialists and less coordination, integration, and oversight of services than there used to be.

If you have a good regional Children's Hospital, that may be one place to start. If they do not offer coordinated, integrated services to screen for learning difficulties, they may be willing to establish such a practice. So much of what we do may not help our children directly, but may help others, raise awareness, and change society for the next generation. In many ways, we are pioneers.

If asked directly, the professionals you are working with may be able to recommend other doctors/specialists/screeners/health care providers they have coordinated with previously for other patients.

It is a tall order for a parent to function as a child's case manager, especially if a parent has limited familiarity with medical and/or educational systems. Wishing you all the best with the ongoing diagnoses and advocacy for your child.

Is this Dr. Silverman at the GDC or a different Dr. Silverman? (Just curious) And was your consult an actual eval of each dd or a parent interview?


It doesn't sound like you have *inaccurate* diagnoses - possibly just not complete diagnoses at this point. Dr. Silverman felt the ADHD dx was correct for each and has recommended some additional follow-up - this isn't unusual for a neuropsychologist or educational psychologist to suggest additional follow-up by other specialists after taking a broad look at a child's functioning (the broad look is the goal of a neuropsych assessment).


I'm guessing the vision assessment is with a developmental optometrist. Re the eval for auditory processing, I would think you could get that in Washington State - but the recommendation from Dr. Silverman is most likely due to Dr. Silverman being in CO and familiar with DOs there (again just a guess... but possibly a place you could save some $ if concerned about that..plus... just a personal opinion - if you're seeing a DO about possible tracking/etc type vision issues, it's possible your dd may need vision therapy to correct them if any are found. You'd want a dr local to where you live for vision therapy).


Just a guess, but one possibility is that your previous evals were looking for specific diagnoses (such as ADHD), or you hadn't seen a neuropsych previously. Re the IQ being inaccurate, that's most likely due to 2e issues, so, for example, if your dd has a vision challenge, the parts of the IQ test that rely on visual analysis will likely be low scores relative to other sections - until the vision challenge is resolved. If your dd has fine motor related dysgraphia, her score on the coding subtest will most likely be low - and might be low forever simply because the brain-hand fine motor link in dysgraphia is not something that is usually correctable with therapy.


I'm going to answer the dysgraphia question in your other post.

Best wishes working your way through the 2e maze - it's a journey.

polarbear

The vision and hearing screenings provided at school are simply that - screens. They aren't the type of evaluation that would look for or uncover a visual processing challenge or an auditory processing challenge.


While we may be pioneers, and the advocacy of one parent may in turn benefit many who follow, this is one small pet peeve of mine. (Please know I'm not picking on you indigo.) Sometimes as parents of children with challenges, there are times we're going to run into a brick wall where it is easy for a bystander looking in from the outside to say - fight this, make a change here, stand up for what's right and make a difference for everyone else who will come after us. If we have the time and energy and passion to do so, that's great, and yes, we can change the world. But for most of us, caught up in the day-to-day challenge of parenting a child with a challenge, we don't have the time and energy left over to make a change for everyone else - we have to focus on meeting the needs of our own children first.

polarbear

A standard hearing test (done either by the school or ped) will not necessarily pick up APD. A kid might hear perfectly well, but can still have APD. I gather the same is true with certain vision problems; they won't be picked up with standard screenings.

Exactly. They *may* help a parent begin with looking at vision/hearing, rather than these items coming up much later.

Agreed. I mentioned this to manage expectations that a coordinated, integrated set of services may not come about right away. There was no suggestion to devote effort or fight for change.

Agreed. I took the OP's statement of "vision assessment" to be exactly that, not a "developmental evaluation".

The in-school vision screenings I'm familiar with are a close match with what's described by Prevent Blindness America - children's vision screenings. While they may not catch every problem, they've helped many students and families by flagging children who needed or would benefit from additional vision assessment.

You may want to try the following professionals:

Dr. Liz Smith
www.kinderminds.com
Neuroeducational evaluations
Bellevue

Dr. Nancy Torgerson
Developmental Optometrist
Alderwood Vision Therapy
Lynnwood & satellite office in Redmond

Dr. Liz Zeitlin
Audiologist
Northwest Auditory Processing Clinic
Issaquah

Northwest Gifted Child Association
nwgca.org
Resources, events, newsletter, etc.

For a truly integrated approach, your best bet may be Seattle Children's Hospital or Dr. Smith although you'll have to pre-screen for relevance to your child's particular situation and LOG.

I know how frustrating it can be in the search for appropriate professional help. Best of luck!

Have you seen a geneticist? There are some rare genetic syndromes that can cause both syndactyly and learning issues, so it might be worth checking that out. Especially if your PG daughter or her sister have any other physical anomalies (some of which could be so minor only a geneticist would notice).

Thanks everyone for the replies. Yes, Dr. Silverman at Gifted Development Center in Colorado. Dr. Silverman recommended we see Dr. Torgerson for a developmental vision assessment and a doctor at the Able Kids Foundation in Colorado for auditory processing assessment while we down there seeing Dr. Silverman for achievement testing. She mentioned the Davidson young scholars program which is how I found this discussion forum.

Thank you again for all the guidance. We really appreciate it!