Gifted Issues Discussion homepage Forums Twice Exceptional evaluation refused

Does this vary from state to state? Our 504 coordinator told me last year 504 can do BIP but this year, at 504 meeting, she said now the district wants that via IEP. I know another student with 504 who has BIP but maybe that was grandfathered.

I think I already know the answer to this, but here goes anyhow: can a child with a high VCI have a receptive or expressive language disorder?
DS' pediatrician said he could make a referral to in-network medical speech/language but it is more for hearing loss issues.

University can do this but will not bill insurance. I am inquiring about financial assistance.

I'm not sure about the accommodations. The biggest problem is that most of the organizational stuff has been left on the plate of one teacher and that teacher is the least experienced and seems to be the most rigid and uncommunicative.

My biggest concern at this point is I could end up spending more money I don't have, as I did for the neuropsych testing, and still spinning wheels, unable to access help, etc.

DS' neuropsychologist has closed shop and moved out of town. If I asked for more EF testing, it would be with someone different. What types of tests would be helpful? Also: DS' WM is good (127,I think) per WISC V. His PSI is lower but still average (109). When you say memory, is that what you mean?

I was just reviewing this post and something struck me. This is funny (but not ha ha funny): they SAW DS last year, all of his struggles, he circled the drain all year. Of course I had to step in, because he was having a psychiatric crisis. The program's answer to DS is: we don't want him here, really, and if he requires extra work that proves he doesn't belong.

The point I tried to make all year last year is that the nature of his problems goes with him wherever. No teacher is going to relish all the 504 accommodations. No teacher is going to enjoy his personality when he is overwhelmed, anxious, depressed. There has never been a single person who stated a single "academic concern" about his ability. Their take is that this is too much rigor for him. My take is that my friends with kids in "regular" programming have just as much, if not more, homework, rote learning, busy work, etc. And neuropsych said we do not want to let him off the hook, challenge wise. I think part of the problem is he's never had to try before, so he never developed good habits.

If it didn't hurt DS emotionally to throw him to the wolves (i.e. stop the scaffolding), I'd do it. I can't do that in good conscience when I'm most concerned about his mental health.

Earlier this year DD with high VCI was diagnosed with both expressive language disorder and CAPD. Both came as a total surprise. (Started with a rule out CAPD eval and then audiologist discussed motor speech concerns with SLP colleague leading to speech eval. No one suspected expressive language disorder.) We did the evals at our state flagship university's speech and hearing clinic and insurance covered both - didn't even charge a co-pay. Other SLP's I spoke with would not accept insurance but would provide paperwork to be submitted to your insurance if needed. One would not accept insurance through her private practice but offered the option to have her students at the private university where she taught do the eval under her supervision and said that would be covered by insurance. So there is no one size fits all answer to insurance coverage. Unfortunately it may be a time consuming process to call all the various possible testers but could be worthwhile if you can get it covered.

Yes, but I don't have a good explaination. This one of my DS16 main problems. He was diagnosed by a neuropsyc a bit over a year ago with an impairment in written expressive language among a few other things. I have found it very difficult to find remediation with this problem, but do have accommodations in his 504. It's hard to explain to teachers because they see him not filling in worksheets or writing nothing for a first draft of an essay as either non-compliance or not understanding the subject matter.

I'm not sure that your average speech/language pathologist would be able to help. Last year I tried finding writing tutors that would be able to help him with little luck.

Not sure I have a lot of good suggestions for you. But I wanted you to know your kid is not the only one struggling with these issues. I seem to have a school district that is being a bit more accommodating and compliant and seems to understand 2E kids a bit better.

This sounds like something I could have written about DS's 6th grade teacher who's entire experience teaching was with gifted and highly motivated students.

Well, no wonder it took so long to get the report. She was probably trying to pack her stuff.
aeh would be better qualified to answer this question but I can tell you what was done with DD. She was given the Rey-Osterreith Complex Figure test, where there was a complicated design (you can google this) and she had to copy it, and then at a later point draw it from memory. I see DD as being fairly good at art, but her drawing was a mess. She did it in a very haphazard way that represented no planning/organizational ability. I think she was at around the 6th percentile for this test, but the 85th percentile for a different test that looked at visual-motor integration (The Bender-Gestalt Visual-Motor Test) which made it clear it's an EF issue, and not a motor or vision issue. He also gave her the Delis-Kaplan Executive Functioning System (D-KEFS) which tests for things like scanning, sequencing, switching, sorting, design fluency, verbal fluency, inhibition, inhibition/switching, etc. Also the California Verbal Learning Test (CVLT-C) which tested short and long term memory (she was in the average range which I don't know if it's "normal" for a gifted child, or not. Her working memory on the WISC was 96th percentile).

I don't know if it's worth shelling out a lot of money to get more testing, in terms of making the school do the right thing, but if nothing else, it may give you more information. I feel like with the BRIEF, all it is is people saying "yes, he's disorganized" "Yes, there is limited planning ability", etc. but there are actual standardized tests that test actual performance from a neuropsychological standpoint.

I'm researching local resources. What I'm thinking is:

There is no question about the EF issues. He is profoundly impaired (I am using "profoundly" loosely). You can look at him straight in the eyes and say something and if he's not engaged, he can't repeat it. He takes 15 minutes per sock when getting dressed. These are just examples; there are many more. Medication helps with these issues.

The bigger question is about language. I don't know if he actually has an LD or if this is also EF.

There is an assessment center here that lists a couple of PsyD/PhDs that do psychoeducational testing. One will do school-based evaluations. One who is listed on Autism Speaks website and is experienced with ASD. None lists all of these specialities.

This center works on sliding scale and is offers services regardless of ability to pay, if insurance won't pay.

The university SLP will do evaluation and offers services--but those are students under supervision.

I think I should call the ASD experienced PhD first, because she lists psychoeducational evaluations. I can ask her if she is qualified to dx language disorders. I could also ask if she can administer other EF tests.

Does that seem reasonable?

I don't think any of this will make any difference to the school peeps. It might help me come up with our own treatment plan.

eco, I am extremely busy this week and haven't had a chance to reply to your thread - and there is so much to reply to!

I did want to jump in quickly on this one question - which as you said, you most likely already know the answer to, but YES, a child can have an extremely high VCI and still have an expressive language disorder - my 2e ds is exactly "that". It might help to understand if you look at the description of the WISC subtests that go into VCI - I won't repeat them here in case I get anything incorrect, but you can find the descriptions easily by googling. Expressive language is made up of *so* much more than what is assessed by VCI, and the VCI calc itself is made up of a combination of three subtests, so it's possible there might be a discrepancy between subtests that is subtle enough it's overshadowed by strong results on the other subtests.

My ds' language deficits show up (in testing) as a discrepancy in relative scores on the CELF, and on a pragmatic language assessment he's had that I can't remember the name of (I can look it up later). Just as significantly, they show up in real life, and paying attention to when/how they occur as they happen is perhaps more helpful in understanding what's up than his testing.

One gotcha is - what is considered a diagnosable disability or condition by a private evaluator is often different than what it considered a qualifying score to prove need of academic services at school.

Best wishes,

polarbear

WISC-V only has two subtests listed, if I understand correctly what a subtest is:

Vocabulary 19
Similarities 15

His VCI is calculated to be 139 (last test). Apparently the high vocabulary score fits Asperger's.

Earlier (age 8) WISC-IV testing doesn't list subtests but VCI is 130. I think WISC V may have eliminated one test that had more social language in it (?)

Testing before that was a lot higher (all I have in front of me is GAI, 146) but he was much younger (6).
You don't say? :P JK. I think I'm tired of dealing with the school. I want to help DS.

I wonder if they'd have to allow a private psychologist observe DS in the classroom, since they aren't willing to take a look?

"I think I already know the answer to this, but here goes anyhow: can a child with a high VCI have a receptive or expressive language disorder?"

This also popped out at me.

Absolutely. However, testing the expressive & receptive speech must be done carefully knowing the child has high verbal abilities. For YEARS, we've had SLPs do the CELF, see ceiling scores, and stop, dust off their hands, and declare "no problem here" (and roll their eyes none-too-subtly at me for even having asked). CELF meta-language subtests are administered separately (CELF-Meta). DS didn't even look all that unusual there, but there were enough oddities in the scores to have the SLP look further. The bottom fell out on the Social Language Development Test in a manner consistent with the CELF-Meta oddities. Looking at just his VIQ scores or the basic CELF test (no subtests in either below 98%ile), no one would have had any idea.

On the EF and expressive/receptive language skills, we're finding that teaching the expressive speech skills and social skills are helping immensely with the EF. I suspect we're giving him the tools to infer what is important to other people as well as picking up on implied speech. A lot of our apparent EF gaps were missing implied meaning in directions given.