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Social skills were very big issues for me (for different reasons - primarily the late diagnosis of my disability - all my IEPs that I found had a big emphasis on social skills). As a adult, I still find it hard to deal with large social settings especially if it involves a noisy environment.

Unfortunately for elementary school, I have no suggestions since those years for me were the years I struggled the most with social situations and making friends that I trusted - but one place where I found refuge in the latter part of my elementary school years was the barn - mostly because with horses and dogs, I never had to struggle with trying to figure out social nuances that came naturally to everyone else since animals don't care about that, and because the topic of horses would allow me to interact more naturally with others who had the same interests and not be constantly on guard or trying to decipher their body language, words etc. (as an adult, I have found similar refuge in a different sports environment - for similar reasons)

Is there something like that - an activity that she enjoys that she could spend time with others who have the same interest - that is away from those mean kids? That may allow her a place to just be herself, and then all the emphasis on social skill learning won't be so overwhelming.

If you are going to pursue an IEP anyway, I would suggest that you ask the school to evaluate her more comprehensively. You can cite both the existing anxiety and the significant difference between verbal and nonverbal on the KBIT.

Again, the KBIT is a screening instrument, so you can't put too much weight on the results, but I will mention that her test profile is very consistent with what you are reporting about her academic strengths and interests. The expectation for a student with strong verbal and average nonverbal would be that she would excel in language-related areas, like reading, writing, and history, and be average to high average in mathematics.

The social issues, anxiety, misperceptions, and hypersensitivity are also not unusual in kids with this kind of cognitive profile. Variously called right hemisphere LD or nonverbal LD, it is often associated with deficits in social perception, often comorbid or confused on differential diagnosis with ADHD, and often presents late, usually when abstract mathematics demands increase in late middle school or high school (or sometimes much later in a high cognitive child like your daughter). Sometimes there are physical coordination issues, too.

Every year I evaluate at least a few children who have either managed to get by until they reached the secondary level, or were on an IEP in elementary school, but dismissed at the beginning of middle school, before they hit the hard stuff. (In some individuals, there are early delays in reading, which resolve once decoding itself is mastered, and academic demands switch to comprehension. If this happens before math becomes abstract, they look like they're out of the woods, and are no longer eligible for an IEP.)

One caution about evaluators: not all evaluators (especially academic learning specialists; most psychologists will be fine) are familiar with NVLD/RHLD. I would suggest feeling out the school a little if you decide to try testing through the school, by experimentally bringing up NVLD as a concern of yours. If you get a blank look, find a private evaluator who knows about it.

Schools are not required to accept the recommendations of private evaluations, but they are required to consider the results.

Another route you can take is to have the district do the testing, then ask for an independent evaluation (at their expense), if you don't agree with the results of the testing, or believe that they are invalid for specific reasons. The district will have to approve your private evaluator (since they're paying for it), but there is no obvious reason they would object to a licensed professional with a legitimate practice or hospital affiliation. The other condition is that, since they are paying for it, they have a right to the results. So if you don't believe those results are representative of your child, you will not have the right to withhold them from the school.

Esmomma, you've received a lot of wonderful advice already - I have just a few thoughts to toss into the mix - sorry if they are in a bit of a random order, hope they make sense!


I believe that you are on the right path thinking of pursuing a neuropsych eval as soon as you have the insurance - I suspect it might be extremely helpful in teasing out whether or not there are underlying issues that are impacting situations, outside of merely social challenges. For instance, I would have written exactly the same thing you've mentioned here about my older dd at your dd's age - she seemed to have extreme anxiety surrounding loud situations that involve other children. When she was young we ran through a myriad of thinking re what the reason was, including both social anxiety and wondering if she had an issue with auditory processing - and her neuropsych revealed something we had completely *NOT* anticipated - she had a possible issue with vision. When she went through therapy to resolve the vision issues, the problems that had looked like anxiety disappeared. I'm not suggesting that your dd has a vision issue, just pointing out that until we had our children's neuropsych evals, it wasn't easy to understand what was at the root of the behaviors we were seeing in our children. The same was true for our dysgraphic ds - I had never heard of either developmental coordination disorder or dysgraphia before his neuropsych eval, but we landed with a referral for the neuropsych eval from our ped in 2nd grade due to extreme anxiety and challenging behaviors at school. What we thought was the primary issue (the anxiety) turned out to be secondary to, and caused by, a completely different developmental challenge.

And fwiw, it's so important to have the "big" picture and to really understand as much as you can what's at the root cause of the challenging behaviors - because if you don't get down to that level to remediate/accommodate - you aren't going to take away the challenge, and addressing the problem behaviors without that will only be like putting a temporary bandaid on the problem - a bandaid that's going to peel off with time, and your child will continue to struggle.


FWIW, drama doesn't necessarily fade with girls after 2nd grade. What I've found with my daughters (and with my ds' classmates) is that the drama is somewhat dependent on the group of girls. Girls are different social creatures than boys in elementary - that's for sure! But not all cohorts of girls have the same issues with drama, and some teachers are better at handling it than others. The other thing I've heard - and seen happen with my ds' friends who are now older - is that once the drama-filled girls get through puberty (which can be a whole 'nother escalated level of girl drama!) the drama subsided and they turned into truly accepting, calm, really nice friendly girls


I'd suggest you spend some quality time reading the material that Pete Wright (www.wrightslaw.org) has put together. Grades are irrelevant (legally) for a 504 plan - but the school may be "ok" in not writing up one from a different perspective - the 504 is put in place to assure FAPE for students with disabilities - *if* the school doesn't already provide FAPE. Your school may be making a best attempt to provide FAPE through the behavioral plan. We had a similar situation with a medical issue for our older dd. Many children in the US with similar medical needs have 504 plans, but our district will not write one for it - instead they have their own "health plan" which essentially is meant to provide the same FAPE.


I don't know how frequently differences in scores such as this occur, but I'd want to know more about why the difference. I also don't know for sure what the standard deviation and norm are on the kbit, but if the norm is 100 and the SD is 15 (which is typical for quite a few of these types of tests), then your dd has a relatively high verbal score and a difference between verbal and nonverbal of greater than 1.5 SD - which is a potential red flag for a potential LD. It's possible the split you see on this one test has nothing to do with anything - perhaps your dd was bored during the test and checked out, maybe it was too brief of a test to get a full picture etc. OTOH, when you see a split like that in testing and you know that the student is having difficulty in either life or school - it's a good idea to follow-up with more complete testing. A neurospych eval typically includes one of the more thorough individual IQ tests such as WISC and achievement testing, as well as a detailed parent interview and developmental history. The neuropsych will look for clues in all of that to explain why a split in scores exists, and typically also includes other types of testing such as executive functioning, visual motor integration etc - depending on what they see - to help discern what is going on.

While you wait for the neuropsych testing, I'd do two things. First I'd think through her academic performance in school - do you feel that there are any areas that are frustrating to her? Not just the social issues, but specifically academics. Next, I'd request an IEP eligibility review. There are things you've mentioned here that suggest, to me, even with her current anxiety and ADHD diagnoses - without any other clarification from a neuropsych eval - your dd might qualify for an IEP. You might want to see if you can find a parent advocate's group in your area to help you with advice - we found our local group by looking through the yellow pages list on wrightslaw.org. The benefit of consulting with a local advocate is that they know the ins and outs of your particular school district and are familiar with the politics that often come into play - such as the comment that you've heard that grades disqualify a student from receiving a 504.

If you can get your child an IEP eligibility review, you will most likely get testing that will give you more detailed info. My experience has been it's not as useful as neuropsych testing (the upside to private neuropsych testing is two-fold - the tester has no bias or motive to not fully explain or delve into what is up with the test results, and it is typically more thorough) - but it's worth pursuing in spite of the possibility it might not be "enough". I'd just go into it realizing you'll need to do your research to understand your rights, and to know what you really want to ask for - at the end of the day, you'll need to be the expert on what your child needs.

Hope some of that helped! Hang in there -

polarbear

I really appreciate everyone who has taken the time to respond. It allows me some possible insight into E's world.

Sometimes she's very upset about her lack of friends; and other times she's happily playing alone, pretending, dressing up, doing a puzzle, reading her presidents books, creating a mess (i mean art ;-)) I do not care one bit if she only has 1 friend or 1449; I just don't want her self esteem to take a significant hit while we're figuring it all out.

another point of concern is possible prenatal exposure to alcohol, cocaine, and marijuana until about the 4th month of pregnancy. her birthmom is a recovering addict, but did struggle during the first part of her pregnancy.

Polarbear-other than socially, I don't see her consistently struggle academically yet. She definitely prefers reading over math, but sometimes her brain just "clicks" in math...I don't know how else to describe it. It has to be on her terms..for instance, the other night she was counting by 6's, 7's, and 8's fairly quickly. If I asked her to do it, she wouldn't be able to as quickly. The other thing, she doesn't do well on comprehension tests at school, but she can summarize a story she's read very well at home. I think that's due to distraction/inattention. Once I challenged her to get 100% on her comp test, and she did. She was very excited to bring it home to show me she did it. Then she missed 3 questions on the next test. Inconsistent. She is a phenomenal speller.

I'm very interested in the visual issue...dd intermittently complains her eyes bother her. I had chalked it up to allergy symptoms. She's had a normal ophthalmology exam, which I just now realize is different than a developmental optometrist exam.

Since school is already out, my plan is to research this summer the laws regarding 504s and IEPs. I had placed a phone call to an educational advocate a few months ago. I never heard back, and I've been so overwhelmed, I never followed up. I've emailed her OT to see if she is doing social skills groups this summer. I already filled out the form for a neuropsych to get started. My new insurance kicks in July 1st. The other thing I'm excited about (I don't get out much), is the only developmental optometrist in the area takes my new insurance, too. I may go ahead and make an appt for dd, since I'm not sure of the wait time on the neuropsych.