Gifted Issues Discussion homepage Forums Twice Exceptional What type of doctor - where to start

Greetings.

A friend has a daughter who is 9 and they want to have her evaluated for LDs because she is barely reading. She is in a good school system and getting support, but the school hasn't been able to identify an issue.

I have known this girl since she was an infant, and she has always been on or ahead of target for development and appears quite bright. She does well enough in school in all areas, including math, with the exception of the fact that she has a very hard time with patterning. My guess is that she has some decoding issues and that causes the reading problem, but I really don't know much about it. She has been checked for vision issues by her ped. (although not a specialist) and her vision appears fine.

My question is, what sort of a doctor should they look for? A developmental neurologist??? Just not sure where to suggest they start, and they really have no idea themselves, and are not getting much help from the school.

Thanks, Cat

In our area the best expert on LDs is a neuropsychologist. Some take insurance, some don't; so a call to the insurance company is a good idea. Sometimes the pediatrician (if they are well connected and astute) can tell you who the right neuropsych is.

Can your friend connect with other parents and see who's good in your area? Word of mouth is sometimes very useful for this, too.

DeeDee

Cat I wish I had some advice for this, but I don't really have knowledge. It seems like having an IQ/Achievement testing might be part of the solution (educational psychologist) but 'one stop shopping' where the professionals all work together would be great, wouldn't it?

So maybe to call the local university and ask someone 'if you had a bright 9 year old daughter who wasn't reading, who would you take her to?'

another approach is to see if you can hire a really excellent reading tutor. Some problems are really specific and can best be taken as a 'first problem first' without too much worry about 'what it all means.'

Also, as a friend of the family, I think you are in a good position to 'play math games' and see if you can find any glitches in her math approaches that might point to what is the problem in reading. At the very least, close observation about the best way she learns in Math might be used to help develop stratagies in how to facilitate Reading learning.

When you say 'barely reading'-is she below grade level? If so, what has the school tried? - Can you describe what reading she can do? Does she have any love for literature if it's presented audio? Any books she likes to read? (Sideways School is so funny.)

A local homeschooling mom had a son who didn't read until he was about 11. She didn't go for testing, just kept accomidating his strengths and kept the whole family listening to a lot of books on CD, so that the motivation to read would develop, and the exposure to ideas and vocabulary wouldn't fall behind. I wouldn't have the nerve for that approach, but if nothing can be found, it's nice to know that at least once in a while this sort of thing is just a blip.

I love DeeDee's idea to network with other parents. Our state has a 'Parent-Advocacy' group that will talk to parents over the phone and help them plan their approach. The state education department might also have ideas. In our state the state level resources can't be called into play unless the request comes from the district, and our districts tend to function very autonamously. Perhaps a gentle reminder that there is resource 'above' might trigger that sort of request.

Love and More Love,
Grinity

Generally a neuropsychologist would do this kind of evaluation - be sure that he or she specializes in pediatrics and education. Many times LD schools maintain a list of evaluators that they respect, have expertise in learning disabilities, and write complete and usable reports. Some tutors can administer certain diagnostic tests, but they are often limited in their ability to diagnose and look at the complete cognitive profile of the student.

Many times a developmental neurologist works with a neuropsychologist and other experts such as speech and language pathologists. In fact, my son's Neurologist heads up the LD unit at a large Children's Hospital. But, he does not do the testing himself - just oversees each discipline.

If you can get your insurance to pay - go for it! But I found that more and more insurance companies are limiting their coverage for educational matters. They are more apt to pay if the concern is attention (ADHD) or other developmental delays or conditions such as Autism. Your primary care can probably help you to position your referral in a way that is more likely to be approved.

The other course of action is to ask the public school to evaluate. Under special ed law (child find provisions of IDEA), they must evaluate in all areas of disability if they get a written referral. Some school evaluations are very good, but many are somewhat limited and even biased in their interpretation. But, if the family hopes to get services from the school, this might be their first step. To get more information about evaluations they can go to http://www.ldonline.org/questions/evaluation

Best of luck.

Thanks for all of the advice, I am passing it all along.

I asked around (I am in a larger town/school district) and have been given the name of the same developmental pediatrician (twice) and have passed that along. He is in a larger group with a pediatric neurologist, etc. so I think they will end up with the right combination.

And thanks for the reminder about checking re: insurance - I def. will pass that advice along.

Grinity, she is barely reading, I would say at about a first grade level (hard for me to know because I would compare her to DS which isn't a fair comparison), but def. below grade level by at least one year. I am sure some of it is lack of confidence and fear at this point, but I would feel confident something else is going on beyond that. I think you are right that IQ/Achievement testing is the place to start.

Thanks again.

Cat