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We requested that the school evaluate DS5, who is in kindergarten, despite the fact that his (excellent) K teacher thought that he was within the normal range for all of his behaviors. We had the evaluation meeting just before break, and it turned out that they qualified him for an IEP on the basis of behavior and also speech. Our IEP meeting is this Friday.

DD9 is on a 504 for dysgraphia and ADHD, neither of which I believe that she has (at least not any more), and SPD, which she probably does. Honestly, I don't think she's actually receiving any accommodations that any kid in the class wouldn't get without a need for a 504 right now. But the IEP process is a little different and new to us.

They were talking about "push-in" to work with him on social skills in the classroom. Can anyone explain to me a little about what that means? Right now he's still really in a parallel play phase, and rarely interacts much with other kids in the classroom. He likes them - he just doesn't really do stuff with them. I'm sure they'll tell me more about what they're planning at the meeting on Friday, but I'd like to go in having some understanding.

The SLP wants to work with him on summarizing and other comprehension skills (I assume on a "pull-out" basis). His teacher has him in a much lower reading group than we expected, mostly because he can't seem to retell a story that he just read. But the SLP discovered that he can't retell a story that he just heard any better, so the problem doesn't really necessarily seem to be reading comprehension. "Hyperlexia" has been thrown around a bit, but he's able to define words quite well, so I don't think that's exactly right. He did really well on a test of identifying opposites of words, for example.

We had a neuropsych test done, and the advice pretty much boiled down to "no diagnosis, but something is not quite right with this kid."

Does anyone have any BTDT advice for me?

Hi Elizabeth,


At this phase, the first task is to make a list of all the issues identified in the evaluation, and start imagining what is needed to remediate or accommodate those issues. I like to walk into IEP meetings with a summary list of all the things that MUST be addressed before we leave.


We had a ton of push-in services for DS11, and it was the single best thing that school did. Instead of pulling DS out, we had a special ed teacher in the classroom to support skills like learning to participate appropriately, work in a group, raise your hand at the right time, etc. The goal from the outset is to build specific skills, then fade the support so the child is demonstrating those skills more and more independently.

The special ed teacher can also take data on problem behaviors (or lack of positive behaviors like hand-raising or conversation with others) and that data tells you how things are going and how to adjust the strategy.


Likely pull-out, and likely a good idea.

Honestly, I wish our school had been this proactive with DS11 at that age.


Both of my kids have retelling issues. For DS11 it is a perspective-taking deficit: he cannot imagine that the other person doesn't already know what's in the story (especially the teacher who gave it to him in the first place)-- and then he can't figure out what is important to tell. This has improved with experience and perspective-taking training.

It can help to have specific testing that separates out the components of reading, so that retelling is tested as a separate skill from decoding or comprehension.

Because our school uses a retelling-based reading test, they have systematically underestimated my kids' comprehension skills.


A hyperlexic may be able to identify meanings of individual words, but then they don't process those into an overall meaning.


How long ago was that? We found that the accuracy of neuropsych evaluations improves as a child goes through the elementary years, and it can take more than one eval to get closer to the truth of what's going on.

What tests did that neuropsych eval include? And what did they find?

DeeDee

For my older son who is now 13, we didn't get an Asperger's dx until my son was nearly 8 years old....that vague speech language social behavior anxiety not sure what is wrong but something is...until I finally pushed for it to be ruled in or out officially.

That's really common, especially with the gifted kids. Our DS11 (2E Asperger's) is so verbally fluent that nobody could really believe he was autistic, and we consulted a lot of professionals before we figured him out.

DeeDee

Well, maybe that's right, then. He's been reading since he was three, and he can read difficult books aloud with very good expression. He's not great at explaining them, but he does fine with comprehension tests that ask questions that are no so open-ended.


The evaluation was in August, just before he started kindergarten. Tests were:

WPPSI-III: VIQ 116, PIQ 121, PSQ 100, FSIQ 119
CTOPP-2: mostly 13's (one 12), Standard score in Rapid Naming 116
Beery VMI: VMI 113, VP 107
WIAT-III: Early Reading Skills 121/133, Alphabet Writing Fluency 80, Numerical Operations 110

She gave him WIAT Word Reading, but couldn't calculate a score given his age. (The computer apparently won't let you fill in some parts when the child is so young.) Test was discontinued when he refused to go on, instead of getting four consecutive zeroes, but he got pretty far into it.

It appears to me that the problem is with retelling, not with comprehension. The neuropsych report says, "Further, although he displays some characteristics of hyperlexia (precocious early reading ability without formal training; "word calling" generally with poor comprehension), his parents and teachers reported that his reading comprehension is quite good. Tests of verbal ability also showed good general verbal comprehension skills."

I don't have a copy of the school testing to be able to tell you which tests they gave him and how he scored on those. I remember that the SLP tests were all over the place, from a 130 on a test of antonyms to a 6th percentile on paragraph comprehension. Based on parent and teacher questionnaires, he was found to be entitled to services for social/emotional behaviors. He flies off the handle at the least thing, and doesn't seem to have strategies beyond screaming for dealing with the world not going his way. The school psychologist wasn't at the meeting in December (he was sick), but we got the report he compiled. Reading it after the meeting, it also says that the test is not diagnostic for autism, but that he scored moderately high on autistic traits. I want to talk to him about that and about whether he should get an ADOS or something.

I expect that we'll wait a couple of years before doing another neuropsych evaluation, but I think it's likely that we will want another one.

This sounds a lot like my ds who has an expressive language disorder. Any type of open-ended writing assignment through him for a loop, but he was (is) a very advanced reader who understands everything he reads. Working with an SLP on summarizing has helped tremendously.


It sounds like he's had a good SLP eval and the school's SLP has a good plan for helping your ds - truly the SLP part of this all sounds very encouraging! The one thing I'd ask about in the meeting is that he be moved up into a higher level reading group that is appropriately challenging for him. With my 2e ds, the one thing that was really difficult to see until it was actually tried, was that remediation didn't work for him when he was given material to work with that was below his intellectual ability. The first time he successfully tackled a writing assignment in school (after literally not producing anything for several years) was when he was given a complex and challenging writing assignment in his gifted pull-out. It's really important to note here that I'm not saying the problem he had with writing was that he wasn't given gifted-level assignments - he had very real problems with expressive language - what I'm saying is he *learned* best and remediation worked much more effectively when it was given at the intellectual level his brain was working at, not at a lower grade level.

Best wishes,

polarbear

We are on the same wavelength (as usual), because that was already something I was going to ask about. I think he actually is in the top-level reading group already, but I want to ask about what books they're having him read in class and how he is doing with it. (At parent-teacher conferences, she said that his measured reading level was at about the level they want kids to reach by the end of kindergarten, so even the level they have him at is relatively high - I just don't think it's as high as what I thought would it would be given what we see at home.) I really do think that his kindergarten teacher is really good and really wants to work with him, so I'm not expecting a lot of pushback there. None of us were expecting the paragraph comprehension scores he got, so we're all sort of feeling our way in figuring out what to do next.

I agree that I really liked the school SLP. I hope she is able to make progress with him. He did seem to enjoy the testing with her, from what she said about it. (When she came to pull him out of class, he insisted on going and asking the teacher if it was OK to go with her, which she said she's never had a child do before. We were all amused by that.)

It is worth paying attention to how they measure reading level. We ended up requesting that they use only a non-retelling-based assessment. Reading A to Z is one such.


A good SLP will help sort this out.

I would *not* call that hyperlexia. Hyperlexics truly don't understand what they're reading.

My DS11 was thought to be possibly hyperlexic, when actually he was just an autistic very early reader. Sometimes the distinction is not obvious.


From what you say, me too.


They didn't give you a copy of the written evaluation team report? They should have. I'd request one. You need that as your guide to what the team found.


My sympathies. DS11 was like that too, and I don't remember K as being our best year, for sure. Things will get better.

I would get a private neuropsych involved, not to repeat the testing you've already got, but to do some supplemental testing. For educational planning, it is worth figuring all this out.

I would definitely want an ADOS and a NEPSY, as well as a Conner's rating scale and a Vineland adaptive skills questionnaire. Perhaps an ASRS (Autism Spectrum Rating Scale) and Achenbach Child Behavior Checklist, though I think those don't start being valid until age 6.

And yes, my preference would be to go to a place where there is a high level of expertise about autism. We got our first testing that started to make sense at the autism center of a children's hospital.

Having a very clear idea of what's going on is, IMO, essential for knowing what to do to improve things.

DeeDee

Oh, I'm sorry - I was unclear. I do have a copy of the school testing at home. I don't have it with me here at work.

Should I ask the school to do the autism testing, or go to his pediatrician and ask for a referral to an autism center? The autism stuff was mentioned in the written report that they gave us in December, but they gave it to us at the meeting, and no one pointed out that bit while we were discussing the report, so I haven't talked to anyone at school yet about it.