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Interesting. I see some of the same issues with DS6, diagnosed with an expressive language disorder last year, raised bilingual French (home) and English (community) and enrolled in a Spanish immersion program since K.

I can go in more details on his history through PM if you are interested, but what I learned is:

1) most ST who are not familiar with multilingual kids try to simplify the problem by asking families to go monolingual. The test instruments are not normed with bilingual kids, monolingual STs can't assess functioning across multiple language, it makes problem much too complicated for lost people. And there is very little litterature on the subject (although the little there is shows benefits to keeping the second language going it is usually in a context where the secondary language is the home language and the primary/target language is the community language).

2) the one ST we have talked with who deals with lots of multilingual kids told me that language disorders are problem with language acquisition mechanisms and not specific to a given language. So the same problem will show across all languages -- you were right about that.

3) there seems (no hard data there I could find) that learning multiple languages could help with some meta-cognition skills that could in turn help with the language issues.

4) kids learn how to compensate. The brighter, the better. There might be a cost (they can spend a lot of energy compensating).

I think it is great that you identified visual support as a potential helping mechanism.

Not bad, but not likely true. IDEA has never been fully funded, which means that special ed is a financial loss for schools-- the federal funding never actually reimburses schools for the services they provide to disabled students.


I think that has become less and less true over time. There is still some gray area, but there are standardized tests that do help to quantify even things like social behavior. The trick now appears to be to find the provider with enough expertise to use the right tests and read them correctly: there are lots of people who are not up to date. Has your child had the ADOS, which really does try to separate out and quantify who has autism and who doesn't? Quite useful.

It is true that someone who shows obviously autistic symptoms at a young age might not later-- often because someone worked really hard teaching them to fit in better. People do change as they grow. If there was an ASD, the typical path would be that the details change over time, but the social differences and difficulties remain, and those usually do include language difficulties.


Yep.

DeeDee

Yes please


This is something that had concerned me - that the testing material would be designed for monolingual kids and his results wouldn't be accurate because of that. In the end the doctor said the results were inaccurate because of his behaviour, which made sense as well.


Yes... I think this makes so much sense. In the info sessions for the program before the kids are in KG, they use this catch phrase: "How goes the first language, so goes the second."

On that note, I thought DS would be ok because... hmmm, where do I start... let's just say I have no experience with "typical" so I had to guess. There are a lot of odd milestones for both my kids, but for brevity's sake, here are just a couple:

DD(now 9) - mastered alphabet at 16 months (would scan and point on request) before she'd say a single word (24 months); was writing letters (26 months) before she was fully potty trained (28 months) ...so she was a little atypical (I stopped referring to the baby books when she was three and reading and writing full sentences)

DS(now 8) - alphabet mastery - not sure, but at 24 months (within a day of his second birthday) he started speaking (not a word before then) by handing me alphabet blocks and naming them. I'm thinking "aw, he does know them. He's a little late, but.." (??). At three he was sounding out three letter words.

He was definitely delayed compared to his sister, but still a bit ahead of the norm, so I felt safe with the language immersion idea.


I've heard this too. In fact our psychologist did her thesis on language immersion, and she mentioned meta-cognition benefits.

You know what's interesting? When he started KG, the teacher said that he seemed more comfortable in the French environment than the other kids. I am now wondering if that's because he was simply used to his brain "scrambling" language and the transition was easier for him than for the typical kids who were taken aback by the new sounds.


Yes He seems to sleep well at night, lol (as opposed to his sister, who is perpetually wired!)


I'm glad to have that ace up my sleeve. It would have been hard to miss, actually... from a very young age he seemed to be able to "think with his eyes" ...advanced puzzles, mazes, etc.

Interesting... there was no ADOS done. The assessment tools used are listed as follows:

Beery VMI-VI
WISC-IV
CLEF4
WJIII-NU
WRAML2
Conner's (version 5)
BASC-2
BRIEF

I'm wondering now... (I'm SO glad I stared this thread - you all are helping me so much, getting the wheels turning, thank you!! )

...I'm wondering if the tests she used were influenced by the anxiety counselor he saw before his assessment. Both at the same firm, so in direct, daily communication with each other.

Background: Our pediatrician (who is controversial but very savvy) originally said "he has no issues other than anxiety - I can't help you any further until he has anxiety counselling." Ohhhkay. So we started with the counselor (who specializes in child anxiety) at the psychologist's firm. She was wonderful (loved her!!) but human, and prone to her own experience colouring her objectivity. She said she saw very little anxiety in DS but that he reminder her very much of her own son, who has ADHD (worth noting is that she spent 4 hours, one on one, with DS). She was involved in setting up the assessment with the psychologist and no doubt shared her opinions, which may have influenced the tests the doc chose for the assessment.


I've often wondered about that - is life therapy? He's never had any ASD-specific treatment, just parenting (positive reinforcement, consequences, structure, etc etc).

He's been difficult to discipline: from a very early age (like, 3) he'd misbehave, laugh and then run to time out on his own, for example (it was a joke to him! He'd finish his time out, come out when it was over and repeat the offense that got him in trouble, laugh again and run back to time out) ...it was always like he was mocking and testing me, rather than not being reachable. (sigh) I tried taking his toys away and got a similar response (he'd bring me stuff).

A friend of mine, a TA, had interesting insight: she told me that he was possibly feeling over stimulated and was clever enough to create a situation where he could be sent to a quiet space to recover. I think this theory makes sense, but if you saw the gleam in his eye... I think it was more that he was making the connection between his behaviour and adult response / manipulation.

Later I had DS's sister's grade 2 teacher tell me that DD had the best adult manipulation skills she's ever seen (brought out in an attempt to control anxiety). I didn't make the connection with DS until he was in the pediatrician's office, where it was clear that he was using manipulative behaviour (which the ped. called right away... light bulb for me - his was so different than his sister's that I missed it).

Anyway, I've often wondered if ASD and ADHD (to name two of many) can actually be outgrown. DS has changed dramatically - even the teachers at school are commenting on this - gushing about how he's come so far - and yet the "language holes" in his brain persist. So now I'm left with the question: is this developmental as well, or an actual cognitive deficit that won't change or improve without targeted intervention?

If you search my back posts, I'm pretty sure I've posted several times the list of tests that was used in diagnosing my DS10. There is some overlap with your list, but significant differences too.


A lot of parenting is meant to modify behavior, as all ASD therapies are. Theoretically the therapies should be more targeted and efficient, but the aim is similar: to get the desired behaviors and eliminate the unwanted ones. Life experience also produces behavior change.

FWIW my DS was very difficult to discipline, too, somewhat in the way you describe. Time outs had no effect. I took a parenting course because I was sure it was my fault. Nothing they suggested worked on him either. Those years were tough. In his case it was definitely not manipulation per se; more like experimenting on his environment (humans included) to figure out what was going on.


ASD is permanent; that's part of its definition, a lifelong impairment. My understanding of ADHD is that that is also a wired-in brain difference with permanent implications. However-- brains do change over time. Human beings, especially young ones but really all of them, have a tendency to grow and learn. People with ASD and ADHD and all manner of other things learn coping strategies and skills for being in the world.

My DS at 10 still has autism and he always will. When he was in kindergarten his problems were freaking out and hiding behind the bookcases or fleeing at school and rambling on about the Latin names of clouds to other kindergartners, those sorts of things. He doesn't do those things any more. The problems look totally different, but they are still real: he has problems identifying when a peer is bullying him or just joking around, he gets anxious if he forgets to turn in his homework (and he often does). When he goes to college, it will look different still. I bet there will still be anxiety and social mistakes in his mix, but he will have grown and gathered some new strategies for managing it all.

At least, I'm counting on that.

ETA: I can't say from my armchair where your DS's language holes come from or how they should be approached, but anyone who knows me knows that I like to use every resource available to identify and work on problems. In your shoes, I'd look for the clearest answers and most appropriate therapies.

DeeDee

I'm back! There's been so much discussion on this post (great discussion!) - I may bounce around a bit to get in every thought that's crossed my mind on this -

First, re my ? about speech therapy:


Speech therapy (once per week, outside of school) has been *the* one therapy that has helped my ds with his expressive language disorder. Most of his therapy has been directed toward just getting his thoughts out (verbally or written), organizing his thoughts, and developing his written expression (adding descriptive detail etc). He is the only kid like him that his speech therapist has ever worked with, and she's basically developed his therapy program as she's worked with him. The differences with him vs her other clients are first, his high IQ - she had never seen a 2e kid before, and second, he doesn't have any kind of apraxia (I think that is the term - for physical challenges with vocalization?). He will tell you that he just doesn't "know what to say" - and it's not like a kid who has ideas but doesn't know exactly how to put it in words or who is afraid they won't say something correctly - it's like he literally is stumped by the request to come up with anything, like there's a huge void in his brain for that particular request. He's a very concrete thinker - his struggles with expression first became apparent to *us* (parents) when he wasn't able to deal with open-ended writing assignments at school (started in 2nd grade). When he had writing assignments at home he would just melt in frustration and not be able to write even a simple sentence. By the time he was in 4th grade he started telling us he had some of the same challenges with getting his thoughts and ideas out even when it was verbal conversation - that's when it finally dawned on me that maybe an SLP could help, and around the same time I read something about speech therapy for gifted kids who had disorder of written expression.

Once we made that connection, it was also easy to look back in hindsight and see some clues from when he was very young. He didn't start to talk until he was three, and he didn't even babble. I can remember every speaking-type-sound he made between 11 months (the first one) to 3 simply because there were so very few of them. At 11 months his dad was walking out of the room in the morning and he said "bye". I thought cool, he's going to start talking... and instead he never said "bye" again. There were one or two other times when he would say a simple word, try it out, then never say it again. I'm sure you're thinking, um, why didn't we take him for speech therapy then, but we had no clue there was any kind of anything going on other than him being a quirky kid who didn't feel like talking. He seemed to be on-track developmentally in all his other areas, his dr was never concerned at well-kid checkups, and his receptive language was a-ok. Once he did start speaking everything was in long, complex sentences so for sure we thought everything was a-ok at that point - but the flip side of it is, he wasn't being asked to do the type of expressive output that he is challenged with until he was in 2nd grade at school - and then we chalked his initial lack of output and classroom behaviors to either being bored or being a perfectionist because by then we knew he was clearly a really high IQ kid.

Our ds started in private speech therapy because he didn't qualify for speech through the schools (he does have an IEP for SLD/written expression, but the school district doesn't consider speech therapy relevant to that SLD). So we've gone with private speech therapy and even though it hasn't been quick (or easy) ds has made tremendous progress. The key has been his SLP - she cared tremendously about helping ds and was challenged (in a good way - she was interested) in finding a program that would help even though she hadn't worked with a child with his set of challenges before.

So that's our ds. The other thing I'd mention about him is that as he's gotten older he's been able to describe in better detail what's challenging re expressive language and that's helped a little bit too.


I wonder if there might be some clues in the testing he's had (WISC etc) that could help understand the sequencing challenge. FWIW, my ds is a different kid with additional diagnoses, but his challenges include mixing up directions and things like that, and the neurospych tests (including the WISC) provided clues - not the complete diagnosis, but clues that pointed to the need for other tests (many of which your ds has had :)), that helped us better understand what his challenges are.


I agree with mgl and DeeDee. I think that diagnosis can be difficult in part due to overlapping symptoms between different types of disorders. Our neuropsych has a chart which I *really* need to find so I can post a link here that shows the overlap in symptoms between ADHD, ASD, and whatever category it is my ds fits into (he is diagnosed with Developmental Coordination Disorder). It's a Venn Diagram that shows each of those three categories and lists the symptoms of each - with each having some unique symptoms but all three have many overlapping symptoms. My ds was seeing a counselor for awhile to help with learning how to deal with anxiety, and she was convinced he was on the autism spectrum because he would seem to blank out sometimes and be totally lost when she asked him a question. Our neuropsych, otoh, felt she could completely rule out autism, and based on what I've seen of autism questionnaires and descriptions of what is required for a diagnosis I think she's correct and what I've seen of ds' social functioning I think she's correct. Back when he was first having struggles at school in 2nd grade, ds was diagnosed with ADHD (inattentive) by his neuropsych, but that was based purely on behavior ratings and in large part impacted by his then-teachers perceptions of his behavior in the classroom. Once we had accommodations in place for his disabilities (which had been undiagnosed until that eval) the behaviors that had looked like ADHD disappeared. We looked at ADHD again as he was going into his IEP eligibility process in 4th grade because the school raised the question, and he had a thorough screening by his ped at that time - his ped felt that the behaviors that looked like ADHD were instead due to a combination of DCD and high IQ. His neuropsych also screened for ADHD again when she saw him in 5th grade and this time around the teacher ratings (filled out by two teachers) didn't place him as ADHD at all.

All the different possibilities and symptoms can be so confusing, but like DeeDee, I've found that having quantitative data wherever I can get it has been helpful. And although I feel like now, at 12, I have a good understanding of ds' challenges and agree with his diagnosis, I sure wasn't there when he was 8, or 10. It took quite a few years of therapy of different types, accommodations for his challenges, and a lot of "data mining" - 2 trips to the neuropsych, IEP eligibility review at school, input from 2 counselors, ADHD screening through his ped, occupational therapy assessment + therapy, speech assessment + therapy = it was a *long* road to get to where I feel like I have that understanding of what his challenges really are and to feel comfortable that he has the correct diagnosis. I did a ton of research along the way, and talked to as many other parents as I could (mostly online). We tried a lot of different things along the way, some helped, some didn't - but even the things that didn't help ds with specific challenges gave us more information, so they were at least helpful in that way.

I've rambled so much now I can't remember if there is more I had to say - lol. I hope some of it helped!

Best wishes,

polarbear

I'll have a look (thanks)


Oh, I know that feeling. For me it started with DS's sister, who's 19 months older. I won't take up too much space with details other than to say she was I.T.E.N.S.E., cognitively precocious, persistent, intense (did I mention that?), emotional, anxious, ritualistic, serious, PERFECTIONISTIC, oh yeah - intense, kinetic, driven, bossy, argumentative, defiant, (can I say intense again, or is that getting old?). She was this old soul GIANT trapped in this tiny, girlie little person. She wore me out. I thought I was going to lose my mind until her grade 2 teacher saved my sanity with some kind words about how different DD really was (ohh PHEW, it's not just me).

Anyway... by the time I was dealing with DS's issues (totally different, of course - no experience to fall back on, again!) ...I had pretty much resigned myself to the fact that I have challenging children.



Interesting... as in, they can outgrow certain symptoms or learn specific strategies and still have the condition, but with new/other symptoms... I hadn't considered that (thank you!)


My DS in KG: impulsive, odd sounding speech, chewed everything, spinning, falling out of his desk chair, lying on the floor during circle, day dreaming, fixating on things he was curious about, pathologically curious, pathologically (good word ) friendly to a fault - had no fear of anyone and would leave with strangers, flight risk, inappropriate social responses, LOVED to run (couldn't "walk" with us - either sat down or ran ahead), intense, silly, excessively affectionate - loved to hug and climb onto people's laps, obsessed with taking things apart to see how they work (since 1 yr old), very tactile - MUST TOUCH EVERYTHING, very distractable (unless he was focused on something that interested him, played alone a lot (happily), also wanted to play with other kids but wasn't sure how, declined fidget toys because he was very self-conscious about being different. I could go on and on but I won't. Anyway, you get the idea. Some are classic spectrum things and some are not as much.


Same here. At 8, DS appears to have stopped most of the above. Now we recognize the language processing issues (likely always there), he daydreams excessively, gets emotional, still adores running!, fidgets & squirms, impulsive (but getting better), gets frustrated when he's trying to express himself verbally, gets frustrated when he knows something that others don't, intolerance for repetition, impatient, can be argumentative (i.e. too persistent), great sense of humour but has trouble recognizing the social cues of: "it's stopped being funny." Again I could go on, but you get the idea. Just like your DS he's changed dramatically but still has challenges.

(oh, and he walks with us now!! He still runs ahead but asks first now and stops when I tell him).


Yup, I'm with you there. Thank you

It all helps Thank you

Re the language immersion program: we have several language immersion programs where I live and I would have *loved* to have sent my kids through them - they are lottery schools and we tried to lottery ds into them when he was going into kindy, but he didn't get in. We have instead had each of our children in some type of language learning program outside of school since they were very little (toddlers), and now that they are older my ds12 and dd10 have Spanish integrated into their required curriculum.


This would be my one concern in keeping my child in the program - the impact of having to compensate. Children with challenges are constantly having to cope with compensating in some way or another depending on the challenge. The impact seems (from what I've seen) to be the largest in early elementary. My ds12 still gets tired and fatigued more than his peers from dealing with school, and it takes him significantly longer than other kids his age to complete his homework, even though he has accommodations. That may or may not happen with your ds, but if it does, I'd consider that for now, maybe adding in the second language isn't as important as learning how to deal with the language processing challenges. I've seen with our ds that giving up some of the things we felt he could do or had hoped he'd have an opportunity to do was necessary in elementary school so that he had time and energy to do the therapies and learning he needed to do to catch up and keep up with written expression. Dealing with the challenges head-on early on made it possible for him to go into middle school able to have the time to add in some of the other things he wanted to do since he had made progress his challenges.

The other thing I'd be concerned about (but hasn't happened with your ds) is that a challenge might go unrecognized longer than it would have otherwise due to differences in curriculum.

I'm a *huge* fan of K-12 language immersion programs. Several of our friends and neighbors' children have gone through them and absolutely flourished - but they were kids who weren't dealing with other challenges. I truly believe that outside of growing up in a household where a 2nd language is native to one of the parents and spoken routinely, a K-12 immersion program is the 2nd best way for a child to learn a 2nd language - but otoh, I also know a ton of adults who've done well learning a 2nd language who didn't start until high school or later - so if I had to choose due to the amount of "stuff" I was piling up on my child's school plate, I'd choose the remediation for challenges over 2nd language in elementary school - simply because I think ultimately that is what will be of more benefit in the long run.

Also not exactly related to your situation, but fwiw, each of my three kids later chose to learn a different 2nd language than the 2nd language we started them on as young children.

polarbear

Please don't feel like you have to multi-quote and respond to all of it lol!

BTW, the CELF was the test that my ds had from his SLP. His scores aren't low, but they have a huge discrepancy between two sets of subtests, and the SLP also noted on the areas that he scored relatively low in that he took *forever* to answer the question - so even though he got an answer that counted as correct, she could tell something was causing him to struggle with that particular expressive language function.

I'm not sure we would have gotten that specific type of input from a school speech eval. At least not in our school district

polarbear