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Posted By: apm221 Unexplained delays and further testing - 02/06/14 02:21 PM
I've tried posting this a few times and always changed my mind thinking it was unclear.

I have an 8 year old who has always been very academically advanced; she gets very high scores on tests and is a DYS. However, we've had to fight for every academic accommodation she has ever been given. The schools just told us, "we have many bright students."

I also have a 6 year old who is very different. When he was younger, he had severe developmental delays and had many, many assessments by a great range of different professionals. Over time, he has completely caught up. However, I haven't thought that he was gifted. He is just very different from my daughter. On his last IQ test, he scored high average overall but over 130 for the brief IQ. His preschool teacher and therapists always told me he was bright, but I didn't think he was gifted.

Since he started school, his teacher has been telling us how gifted he is. They have called in the gifted specialist even though they don't start screening for GT until second grade. Without my even asking, they started moving him to first grade for part of the day. They give him fun activities (e.g., last week he wrote a report on the death of stars because he loves space). His teacher tells me his delays must have been like Einstein's (and yes, I do know that people speculate that Einstein had an autism spectrum disorder - my son has been screened repeatedly for that).

It's making me wonder if something is still holding him back in testing that might be an issue later on. If he's high average, that's wonderful (we used to worry he had an intellectual disability). However, I don't want to underestimate him and his school seems to think he is capable of much more.

He has had many evaluations and no one has suggested any underlying problems except some lingering fine muscle weakness for which he sometimes has occupational therapy.

Has anyone experienced this sort of situation? He seems to be doing well academically, so what would hold him back in a testing situation? Something must have caused his early delays, right? Could the schools be making assumptions based on my daughter, meaning they may be expecting too much from him? He is not at the same school.

I'd appreciate any advice so we can help give him the right level of academic work and not miss any lingering issues that might be holding him back.
Posted By: DeeDee Re: Unexplained delays and further testing - 02/06/14 02:27 PM
I'd look at the whole kid, not just the academic skills. How is his language now? Social skills? Self-management (i.e. sitting at circle time, following the line leader)?

If there is any 2e, including fine motor, that will affect testing. Most achievement tests include writing; you might want to look at the particular tests and see if he scored lower on the writing-based subtests.

If you really want IQ numbers (and I don't know that you need them if he's already being accommodated well at school) there are alternative tests that some quirky kids do better on. The Differential Abilities Scale is one.

It is a great blessing when a school just notices needs and does the right thing.
Posted By: apm221 Re: Unexplained delays and further testing - 02/06/14 02:35 PM
Thank you, DeeDee! I appreciate the advice. He usually does very well at self-management. Every so often, he gets into trouble through being bored. That has only happened a few times, though, and I've been sending books and activities for him (his teacher is also letting him do reports).

He tests in the normal range in speech and language assessments now, but that was the area in which he had the most severe delays (he used to have profound delays, using the technical description). I've wondered if he might still be having a little difficulty with more complex language like on an IQ test (perhaps with instructions or with questions that require a verbal answer). His teacher says his vocabulary is impressive, but the speech and language assessments seem to test very simple concepts and I definitely wonder if he might be having a harder time with the complex verbal instructions.
Posted By: DeeDee Re: Unexplained delays and further testing - 02/06/14 02:40 PM
Originally Posted by apm221
He tests in the normal range in speech and language assessments now, but that was the area in which he had the most severe delays (he used to have profound delays, using the technical description). I've wondered if he might still be having a little difficulty with more complex language like on an IQ test (perhaps with instructions or with questions that require a verbal answer). His teacher says his vocabulary is impressive, but the speech and language assessments seem to test very simple concepts and I definitely wonder if he might be having a harder time with the complex verbal instructions.

Speech is an area where we've found a huge difference between different practitioners in terms of their ability to assess the fine points of language use (not just articulation, but also expressive and social language). If you're wondering, it is certainly justified in your case to get a referral to a private SLP for detailed testing, just to establish where you stand.

After you remediate large delays like those, sometimes what's left are subtle issues that are treatable but not catchable by school.

It's so great when a child comes that far!
Posted By: apm221 Re: Unexplained delays and further testing - 02/06/14 02:49 PM
He has a private SLP that we LOVE (that is not too strong of a word - his SLP was a huge help when we first started navigating the world of having a delayed child, and his SLP always believed in him even when others told us very discouraging things).

The school offered to give him a speech assessment, but I didn't think it was worthwhile as I know he would pass the basic assessments that they use. We haven't checked in with his SLP for a year and could definitely ask advice.

I appreciate your help! I always wonder what caused such substantial issues.

Posted By: DeeDee Re: Unexplained delays and further testing - 02/06/14 02:54 PM
Originally Posted by apm221
I appreciate your help! I always wonder what caused such substantial issues.

With my 2Es, we see both genetics and environment playing huge roles. I'm usually too busy fixing problems to get too deep into wondering why any more, but yeah, -- if an identifiable underlying cause can be named, sometimes it helps you put the pieces together...
Posted By: apm221 Re: Unexplained delays and further testing - 02/06/14 02:57 PM
It just seems so odd to have such substantial problems that seem to go away. I keep waiting for "the other shoe to drop." We were told he might never leave home, have an intellectual disability, etc... and it's so hard to believe now that his teachers think he is doing so well. A psychologist once told me he could never attend a regular school.
Posted By: DeeDee Re: Unexplained delays and further testing - 02/06/14 03:11 PM
I know what you mean about the shoe. In our case, the issues do morph over time, and we are still working out some of the subtler stuff.

Children do grow and change. I'd say, go ahead and talk to the SLP, get data just in case, but also trust yourself to notice if something unusual or 2Eish is going on.

Posted By: blackcat Re: Unexplained delays and further testing - 02/06/14 03:23 PM
He sounds kind of like my DS, who is now almost 7. He had a lot of delays with speech, language, and motor skills as a toddler/preschooler. Cognitively he always seemed bright but his speech kept him from appearing bright. Ultimately he was diagnosed by a neuropscyh with developmental coordinator disorder/dyspraxia last year. He has had two IQ tests and his score went up a lot the second time. So first time when he was 3, he was in the average range (but there was a big gap between verbal/non-verbal with non-verbal being a lot higher). Second test when he was 6, he had the same gap but everything had shifted upwards about 20-30 points, putting his GAI in the gifted range, with non-verbal being super high in the 140's.
Looking through his records, no one would have ever been able to predict that would occur and that he would advance so much as he aged.
I think on the verbal section of the WISC he has a problem with speech, and the test isn't going to pick up on verbal ability unless a child is good with expressive speech. If a kid isn't very articulate, they are not going to get good scores, even if they understand the concepts. I am probably going to take DS in for more testing, because while his expressive language is greatly improved, I still think he struggles. speech/language impairment is one feature of DCD.
What kinds of delays have you seen?
Posted By: apm221 Re: Unexplained delays and further testing - 02/06/14 03:33 PM
Thanks, Blackcat. What sort of additional testing are you planning to do? I'm not worried about scores, but don't want anyone to underestimate him or to have excessively high expectations from knowing his sister.

He had global developmental delays, with substantial delays in everything except for gross motor. Speech and cognitive were the worst, especially speech. When his cognitive score went up to the low average range, his psychologist said it was a surprisingly rapid improvement. His SLP (and the psychologist) felt his speech issues had caused the earlier low cognitive scores. He has an audiologist (when he was very young, the first audiologist to examine him thought he had hearing loss and he was referred to a pediatric audiologist who was able to determine that his hearing was fine), an occupational therapist, a speech therapist, a psychologist, and a former developmental therapist from early intervention.

A therapist once said she thought he had an auditory processing disorder, but I talked with his audiologist and she referred me to the specialty testing team (an audiologist and SLP) who assured me that his development sounded normal. He was responding more quickly to visual than to verbal commands, but she said that was normal at that age and just to bring him in for an assessment if we continued to have concerns when he was older. He's reaching the age that we could do that if needed.

He was kicked out of Montessori school after one week for looking out the window instead of participating (they didn't refund the tuition or deposit either and told me to take him for an autism evaluation immediately), but his preschool teacher and his current teacher say they don't see social problems and that he is well-behaved with good friends in class. He's had plenty of autism evaluations (one with every annual psychological assessment with multiple different psychologists) and they have thought everything probably stemmed from the language delays ("but continue to monitor as he has to deal with more complex social situations").
Posted By: apm221 Re: Unexplained delays and further testing - 02/06/14 03:40 PM
I have often thought that he must really have more difficulty than other children learning and processing language, but that he has been able to compensate for it and catch up.
Maybe here delay is just very literal, delay as timing rather than pacing.

Train A leaves the station at 3:00am travelling at 100 mph
Train B leaves the station at 5:00am travelling at 145 mph

Luckily it isn't all quantitative and the teachers have been able to clue in on the qualitative difference.
Posted By: geofizz Re: Unexplained delays and further testing - 02/06/14 03:57 PM
Did I catch right that you haven't seen the SLP in a year? I would write out all your concerns with social speech, splits between receptive and expressive, and anything else you see and request that the school do an evaluation. If you pick up on subtle speech quirks, document them and describe them as best as possible. Same with fine motor control.

I would also head back to that SLP you loved so much and ask for a reevaluation. My poor 8 year old has been through 5 (? 6?) SLP exams. When the kids get older, some of the issues become clearer on their testing tools. Particularly for bright kids who have found other ways to communicate, more information is better than less. I'd want the school eval (including a classroom & lunchroom observation) on top of the other parts to help pick apart problem areas.

In our case we finally got a diagnosis that seemed to bring the pieces together with a brain-functioning based explanation, whereas previous diagnoses pretty much described the symptoms (expressive and phonological speech delays). No way could we have uncovered that diagnosis without remediating the symptoms.

Good luck! He sounds like a great kid, and the teacher sounds like a gem.
Posted By: apm221 Re: Unexplained delays and further testing - 02/06/14 04:01 PM
Yes, we checked in with the SLP every 6 months until the last year (when my son was declared "fully graduated"). Of course, that was with the knowledge we could bring him back at any point. We have sent a few e-mail questions since then, but haven't seen clear issues for which we'd need an appointment. I've just been puzzled by the disconnect between what the teacher is reporting and what we have on paper.

The teacher is definitely a gem. If I see a teacher of the year award, I fully intend to nominate her... The principal is a gem as well because he supports everything she recommends (like calling in the GT specialist to consult and allowing the partial acceleration).
Posted By: blackcat Re: Unexplained delays and further testing - 02/06/14 04:05 PM
I'm not sure what kind of testing we would do (if anything). He always scores Ok on language assessments. But he is just not very articulate. He has a new teacher who has a Master's in special ed and she is in contact with his new SLP at the school so we'll see what they come up with, or know of a good person to do an outside eval.

Does he have issues with articulation or motor output (in terms of speech), or is it more of a language issue? Does he use age appropriate grammar? Sounds like maybe a pragmatic speech disorder but hard to tell from the info you posted and I'm no expert anyway.
Posted By: apm221 Re: Unexplained delays and further testing - 02/06/14 04:12 PM
He tends to be on the lower side of average for articulation, but keeping up. His grammar seems delayed to me, but I'm used to a highly verbal PG child and his teacher and SLP seem to think it's normal. He just has a few problems with unusual tense constructions. He can have a complex conversation with us; he gets fewer opportunities to do so with his teacher so I can't tell if she would see anything unusual in his speech. I think I will ask her to try having a longer conversation with him at some point to get some feedback. When I picked him up after his pre-kindergarten screening at the school, the tester came over to me to tell me how impressed she was at his verbal ability (his vocabulary and knowledge of sight words). I don't think that most people actually take the time to have a longer conversation, though, and that might make issues more obvious.
Posted By: geofizz Re: Unexplained delays and further testing - 02/06/14 04:46 PM
Originally Posted by apm221
He tends to be on the lower side of average for articulation, but keeping up. His grammar seems delayed to me, but I'm used to a highly verbal PG child and his teacher and SLP seem to think it's normal. He just has a few problems with unusual tense constructions. He can have a complex conversation with us; he gets fewer opportunities to do so with his teacher so I can't tell if she would see anything unusual in his speech. I think I will ask her to try having a longer conversation with him at some point to get some feedback. When I picked him up after his pre-kindergarten screening at the school, the tester came over to me to tell me how impressed she was at his verbal ability (his vocabulary and knowledge of sight words). I don't think that most people actually take the time to have a longer conversation, though, and that might make issues more obvious.

I would keep track of the speech quirks -- make note of what he says and the situation, including time and date.

When he was "fully graduated" was that based on the original diagnoses, or was that with further investigation? There are some speech evals that aren't normed until 6 or 7.

Teacher of the year -- even if you don't have an award like that, I've gotten into the habit of writing a thank you note to the principal delineating exactly what it was about the teacher that really served my kids well. I keep all negatives out of the letter. It's 100% positive. In the day and age of "value added" teaching evaluations and such, I figure these are more beneficial in the long run to the teacher. Also, by writing out in a 100% positive manner what worked for my kid, I've found that my kids are more likely to be similarly well placed in the future.
Posted By: apm221 Re: Unexplained delays and further testing - 02/06/14 04:54 PM
It was based on his last full evaluation at age 5. That included expressive and receptive speech, articulation, and an informal pragmatics assessment (because, as you mention, those tools aren't standardized for younger kids).

I've been thinking of writing a letter to the principal and also to the superintendent (so I can thank the principal as well).
Posted By: geofizz Re: Unexplained delays and further testing - 02/06/14 04:55 PM
Originally Posted by apm221
I've been thinking of writing a letter to the principal and also to the superintendent (so I can thank the principal as well).
This sort of thing is so far my biggest "bang for the buck" in advocacy. Put it in your calendar for the end of the year and do it.
Posted By: apm221 Re: Unexplained delays and further testing - 02/06/14 04:59 PM
I'm thinking about sending letters, then also giving a gift card for classroom supplies. They seem to have nice supplies, but I figure there is always something more that could be used.
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