After some concerns from my 4 year old son's PreK teacher, we had an appointment with his pediatrician. He recommends OT therapy for my son's sensory issues (tags, being messy, noise and crowd overload, social skills etc.) and handwriting skills (grasping crayon and writing). He also recommended IQ testing through our local school system. I have made appointments. What should I expect? Is going through the school system for IQ testing a good idea, or is private better? What should I expect from an OT evaluation and therapy?
I know it's hard to evaluate, not knowing my son's particular case, but I am just looking for some advice from people who have already traveled this road.
Thanks!
Hi Amielynn,
We were so in your shoes several years ago. It's awesome you are getting input on this early.
We never went through our school system- only because I've become cynical and suspicious and wanted to digest information before I gave it to the schools. But based on input from preschools, we followed most of the same ideas that have been suggested to you. We (privately) did some sensory OT and also (privately) had WPPSI administered along with screening for autism/Asperger's.
The sensory OT didn't hurt, but neither did it help that much to be honest. Maybe a little. I never felt that the OT was getting to the heart of the matter. It probably gave our DS (4 years old at the time) some coping skills, but it didn't alleviate the problem in any meaningful way.
The ASD/Asperger's screenings were negative. The WPPSI showed we likely had a bright little boy on our hands, who had a lot of anxiety about chaotic, loud, crowded places (read: "school").
When DS went to K, his struggles really ramped, and we decided to get a full neuropsychological evaluation. It was very, very expensive. And very, very worth it for us. Instead of getting little snippets of information from one specialist or another, we got a comprehensive picture that really helped us understand (1) strengths and how to foster them and (2) weaknesses and how to help them. The assessment came with an educational plan that included practical suggestions for easing his struggles in school and allowing him to enjoy school a little.
We have an upcoming meeting with the school, and I have no expectation that it will be happy-happy-joy-joy from here on out. But on the other hand, we have hard data, a solid plan and backup from a well-regarded neuropsychologist if we need it. So, I'm a little hopeful that these meetings will be more fruitful than the head-banging meetings we had last year.
So - I think your son might be a little young yet for this kind of assessment. But maybe not. More knowledgeable folks can weigh in on that, I hope.
But - I know for a fact that our school district would never have done an assessment that was broad enough to give the picture we have now. And narrower assessment would likely have just facilitated them putting in the box they had targeted for him. So instead of - "he is profoundly gifted but needs accommodation for dyslexia/dysgraphia" we would be facing "well he's performing almost at grade level, so there's really nothing we can do for him."
To be fair, the schools do have limited resources. We can pound on the desk and they are obligated to give our kids what they need to "access the curriculum." But in my cynical/pragmatic view - if they can shut that door after a cursory assessment, they darned well will. They have too many cases where kids don't show grade-level performance on a cursory screen. And for some weird reason, it's just easier/more fun/more rewarding/more praise-generating/more self-aggrandizing [sorry - cynicism alert] or something for the schools to help those kids rather than ours.
Best of luck to you,
Sue
I'm not sure what they would do, but at the OT he might be given the BOT2 or similar test for motor skills. You might be given a sensory profile to fill out. If you do IQ testing through the school system, be aware that it will be in his records. I'm not sure how many people would have access to the information. I'm surprised the school system would do IQ testing, unless you are having them do a full eval for special ed. When DS was 4 we had a lot of testing done privately and the school system wanted those private records in order to write an IEP for him (at that time it was just for speech articulation). I gave them everything but the IQ results, even though they asked specifically for it, I just ignored them. DS wasn't cooperative during testing and I didn't think the scores were accurate (we had testing again a couple years later and his scores DID go up a lot, so I was glad those old scores never made it into his records). His IQ testing was covered through our insurance since they weren't testing him for giftedness and it was done in a children's hospital. A developmental pediatrician referred him to a psych for testing.
Sue,
Thank you! That is some much needed information! I am waiting for the school district to call me back, if they ever do. Though I am interested in private testing as well. I do like your point of not getting the district too much information. I never thought of a neuropsych evaluation, but I will keep that in mind for the future. He is already having issues in PreK and I know it's going to get worse in Kindergarten. Right now he has two teachers to 12 kids. The Kinder is 1 to 22!!
Take a look at the thread I started yesterday - I think it will be somewhat relevant for you:
http://giftedissues.davidsongifted....luations_am_I_going_abou.html#Post202576My one piece of advice is that you need to make sure you have the right practitioner. Don't go to just anyone - there are huge differences in experience and quality.
Thanks Jkim, I will check it out. I am having trouble finding private testing in my area. I am sure there are testers out there, it's a huge area outside of Houston, Texas, but I think I am searching for the wrong thing. Any suggestions?
Jkim, thanks for the link. Great info! I think my DS might be too young for neuropsych evaluation. Is there an age minimum?
I'm going to throw this out there:
Anyone from the Houston, Spring, The Woodlands Texas area know of any private IQ administrators? Thanks!
What about checking in the psychology department at Texas A&M? I think folks often do this through universities (though we did not). Also - check the Hoagies website for recommended folks in TX (
http://www.hoagiesgifted.org/psychologists.htm#list)?
Sue,
Just wanted to say I understand your cynicism; I have seen all of the things you mention, from the inside. But I'll add that the primary reason schools seem quick to dismiss 2e and gifted kids is probably lack of funding. Title I funding won't go to grade-level kids. Javits is largely unfunded. NCLB has never been fully-funded. Special ed funds are basically distributed based on triage.
And I have worked in systems that identify and serve 2e kiddos; they DO exist.
Amilynn,
Evaluations can be informative in children as young as two, but you have to be realistic about what you can gain from early childhood assessment. Every test result obtained from a 4 year old has to be taken with helpings of salt. It is more of a snapshot of this moment in time, useful as baseline and a working hypothesis.
School personnel tend to trust school-based evaluations more, and they do have the specific advantage that they are in the natural educational context of the child. Also, many evaluators are able to spread the testing out over multiple short sessions. Yes, some school systems are motivated to find no disability.
Private evaluations are more likely to have a single person who pulls the results together at the end (in a school eval, this may happen at the IEP eligibility meeting, but probably not before), and presents it to you in a neat package. All the advantages of someone who works for you. One disadvantage is that nearly every outside eval will result in a diagnosis, as otherwise they will be challenged to bill insurance for it. And since one can come up with a diagnosis for anyone, if the evaluator is sufficiently motivated, this occasionally results in rather soft Dxs.
Jkim, thanks for the link. Great info! I think my DS might be too young for neuropsych evaluation. Is there an age minimum?
I would actually talk to the autism program of a children's hospital and see whether they have diagnostic appointments.
Barring that, a neuropsych is going to give you much better information. Yes, even at age 4.
Social skills are not a "sensory issue," and OTs are not the right people to go to for that.
Maybe look at this:
http://txgifted.org/No specific tester recommendations, but perhaps you could connect with local parents
Suevv, thanks! I hadn't thought of university. Will check it out.
aeh, Good point about private testing. They have to make some diagnosis, but I like the idea of the testing setting and it being one evaluation administrator. I know it's going to be limited at this age. Honestly, I'm not looking for much. I know a test later on, say age 9, is preferred. The school system here is not in any hurry to find a disability. They want kids to fall into the average scale. They are not prone to skipping grades and GT classrooms. I know it's going to be a year to year, teacher based struggle for us. Thanks!!
DeeDee, Thanks. Someone else mentioned Texas Children's to me today as well. It's a huge children's hospital here. I am still milling around the neuropsych evaluation. Need to read more about it. He mas very mild sensory issues, social in the sense that he gets overwhelmed with large crowds and loud noises as a result from those crowds. He does best with 2 to 3 playmates. That's going to be a very hard transition into kinder.
Thanks everyone! I did receive a tester list from my pediatrician today. Now I just have to cross reference with insurance. Hoping some portion of it will be covered. Now, these test. There are so many! I need to read about those as well. Which is best for age 4?
Not sure if any of this helps you, but we went through an OT eval about 6 months ago when our DS was 3. I was convinced he has SPD, but the OT said he is "sensory sensitive" but does not have SPD or any other diagnosis. This is a child who has hated water since day 1, still screams when taking a bath, and has a whole other host of sensory experience sensitivities. Some of his reactions are more from emotional overexiteability than sensory, but they blend so it's hard to know why he's having a meltdown. We did the ASD eval with pediatrician and then saw a child psychiatrist, who echoed the same findings as the other two, does not have SPD and is not qualify as ASD. She actually said, "He's a genius in a 3 year old's body, it's hard for him."
In regard to worrying about public school evaluations, I did them myself, had 2E kids in many classrooms and I just differentiated like all Special Ed teachers do. I would have NEVER fudged numbers, there is an integrity to those tests and the people using them. The school psychologists are trained professionals, often times they come from other professional environments like private practice.
We are trying to decide to go public or private for evals, and the main upside that I can see for going with the public school system, is that a principal is more likely to hear what the school psych has to say rather than believe what a piece of paper says from a private eval from someone they don't know. The schools usually use the Special Ed teacher for the acadmice assessment and the school psych for the cognitive. They aren't perfect but can be very informative.
I hope whatever way you go, you find solutions and hope for your child. : )
And for completeness: I actually do the bulk of the testing myself, other than very well-defined specialist assessments, like speech/language, OT, and APE/PT. Not unlike what a private psych would do. So not all school evals are piecemeal.
GGG, I think we might be looking at private testing now, then public once he is in school. My husband and I are still deciding. It's hard, all these specialists, and fighting for what your kid needs. Just because your son is a genius doesn't mean he should not receive help. Did you get a second opinion? That's another thing, should I get a second opinion, especially after OT evaluation?
Questions, thank you for the PM!
Aeh, You do the testing yourself, at home? Do you have links or resources I could look over? Never thought about doing it myself. Are you trained to administer these tests?
Jkim, Just noticed the link. Thank you!
School district denied testing until he's enrolled in school and trying for the GT program. Thinking about private testing or just waiting until GT testing.
OT evaluation today. Said DS was on the very edge of not needing therapy. So, we are opting to do some activities at home. She said sensory issues were very mild and his handwriting (grip) just needs a bit of work. It's not that he can't do it, he doesn't want to stop and do it. He's so busy inside his head that he dislikes slowing down to focus on writing.
Now, I am setting up a meeting with his PreK teacher. He's just bored in her class. How do I explain this to her without stepping on her toes?
GGG, I think we might be looking at private testing now, then public once he is in school. My husband and I are still deciding. It's hard, all these specialists, and fighting for what your kid needs. Just because your son is a genius doesn't mean he should not receive help. Did you get a second opinion? That's another thing, should I get a second opinion, especially after OT evaluation?
Questions, thank you for the PM!
Aeh, You do the testing yourself, at home? Do you have links or resources I could look over? Never thought about doing it myself. Are you trained to administer these tests?
Oops, confusing you...I'm an assessment professional. I don't test my own children, though (at least not for high-stakes). I meant that a single person (the psych) does or can do the bulk of the assessments in a school eval, with the exception of a few specialized ones, like speech & OT.
There really are some things you could do yourself, though, that would be informative, though possibly not accepted by the school system. You can take data on some aspects of academic achievement, such as oral reading fluency, reading inventories, writing fluency, math fluency, sight word vocabulary (e.g., Dolch list), knowledge of isolated phonograms. You can also use validated screeners for ADHD and emotional indicators. You can also find checklists for developmental milestones, that may include language and cognition, that will not give you an IQ, but will give you some sense of the range.
What aspects are you most interested in? I can point you in some directions for downloadables.
aeh, thanks! I am very interested "oral reading fluency, reading inventories, writing fluency, math fluency, sight word vocabulary (e.g., Dolch list), knowledge of isolated phonograms". Anything that would show his strengths and weaknesses. At this point I would rather help with the weaknesses then always focus on the strengths. His strengths seem to balloon and he becomes high adsorbed.
aeh, My head hurts. This is so much information! It's going to take some time to have all this sink in. Thank you so much.