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    geofizz Offline OP
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    ...and by stealth, I mean really stealth.

    DS8 is starting 4th grade. CTOPP/AIMSWeb, nonsense spelling all 60-90+ percentile. His WM and PS were between his VCI and PRI, all in the gifted + range. Mathematical reasoning is a significant area of strength. He's single grade accelerated, 3x accel in math.

    He has a diagnosis of oral apraxia/oral motor dysphasia, and he's been working with an OT this summer who sees it in his fine motor coordination as well. OT has been doing HWOT and core strengthening work. SLP has been working on the apraxia, social speech, and fluency of generating ideas. At our last speech session of the year last week (ins runs out - met gag reflex/chewing goals), he was in tears over being asked to write something, an increasing pattern of reluctance and struggle with writing. She strongly suggested OG.

    Reading tests at above grade level despite the fact that he can't read orally well due to the oral apraxia. I suspect his reading level is radically above where he places at school.

    We have a bonus dx of ADHD based on a classroom observation that included only writing time - math was not observed. He was observed to avoid the writing tasks using a variety of strategies from sharpening pencils, using the bathroom, removing his shoes, etc. None of the Connors/Brief or WISC-WM suggest ADHD.

    His spelling shows difficulties with consonant blends, vowel sounds, sequencing of sounds & letter reversals. The lack of automaticity of spelling even basic words appears to be his biggest (though certainly not only) hurdle in producing written work. This includes things like math, so using things like Dragon Dictate or co:writer are only partial accommodations.

    So with that profile, I do not anticipate the school will ID DS. His sister was ID'd in 4th grade based on slightly lower phonological scores and much higher VCI scores. 4 months of daily OG fully resolved her issues to the point of being undetectable.

    I've called 10 OG tutors. Several won't accept him without a dx. Others don't know what I'm talking about, telling me my expectations are too high or that we shouldn't have skipped him or that he should just type everything. The bottom line is that he's frustrated and it's taking an emotional toll. The two I've contacted that get it are employed by school districts and are maxed out by private clients (with a >20 mile commute to boot).

    I will keep at the school and OG tutor hunt, but he needs help now before his self esteem tumbles more and he encounters more frustration.

    Sequential Spelling is too hard/too frustrating/too dull/rules not explained.

    I'm finding All About Spelling and Barton. They appear to be nearly identical (is that true?) with an order of magnitude difference in price.

    Can anyone guide me on how to help him on my own? Another program? Strategy?
    Can anyone guide me on how to figure out the right level placement on AAS?

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    aeh Offline
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    I feel for you, geofizz. You could be describing one of my kids, without the oral apraxia. (No official diagnosis, but pretty much the same profile based on my clinical observations and informal probes.)

    Both AAS and Barton are OG-inspired, and likely to be equally effective on your son. We've used AAS with our equivalent child. Prior to using it, we tried a few traditional spelling programs, and found that, although all the spelling exercises looked all right at the time, there was negligible transfer or retention. Also, it was a tremendous struggle to get through any kind of written work (likewise including math). We have now been through a few levels of AAS; spelling is actually an enjoyable subject (love the fact that you can finish a meaningful session in 15-20 minutes). I did a fair amount of poking around before I decided to try AAS; I was specifically looking for a home OG-style program. I actually do know a couple of school-based OG-certified tutors in our area who probably would have done it, based on my personal relationship with them, but since we homeschool, and I have a certain amount of exposure to the approach myself, I thought I would try AAS first. It has been very easy to do, as it is all laid out for you and scripted. It's very hands-on and visual, which has been very suitable, and allows you to practice your spelling separate from letter formation/handwriting, which initially was tremendous for us (you use magnetic letter and phoneme tiles to assemble words). In terms of results, of course I don't have a control! But the retention of spelling words appears to have improved, as has generalization to applied writing tasks. Most importantly, I've seen substantial reduction in resistance to writing. It's also much less common that I see peculiar dysphonetic misspellings now, which is a big step for us.

    On placement: I started from the beginning, on the basis of research that indicates that the core deficit in dyslexia is in some level of phonological awareness, and that it is critical to remediate the PA deficit prior to investing too much time in learning actual spelling words, as kids will develop bad habits for word attack and attempts at encoding otherwise. One of the issues when they already have an extensive written vocabulary is that they 1) will overrely on rote memory, and 2) have less incentive to practice good PA, orthographic, and morphological strategies enough to reach automaticity (which is already a primary difficulty for them). We moved very quickly through the first couple of levels, but did not skip any steps/lessons. In the process, I found that a lot of words were familiar and accurate, but quite a number of very easy words were oddly challenging. In the design of the curriculum, those words remained in the review rotation for months, while most of the other Level 1 and Level 2 words were reviewed only a couple of times before we moved on.

    On the topic of diagnosis/eligibility: do you remember if he had multiple CTOPP subtests, and if so, how he did? I'm looking in particular for phoneme reversal, which is a supplementary subtest that can be critical in identifying compensated (or stealth) dyslexic/dysgraphics, such as your son may be. It's possible to use vocabulary and cognition to blind the test on many of the standard core subtests, but this one is trickier.


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    geofizz Offline OP
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    Wow, thank you. First for not telling me I'm crazy, and second for your wealth of information.

    "you can finish a meaningful session in 15-20 minutes" That's very useful. I'm staring down the fall's schedule with fear. It's also useful to read that the programs are equivalent. Does AAS only use the tiles or does it ever put a pencil in the child's hand? In our case, I strongly suspect that making the transfer to forming the words by hand & typing will also be required for transferability.

    "On placement: I started from the beginning" gotcha, thanks. AAS makes that about $250 more palatable than Barton.

    "do you remember if he had multiple CTOPP subtests, and if so, how he did?"
    CTOPP:

    Phonologial Awareness Composite Standard Score 103
    Elison 11
    Blending Words 10
    Phonological Memory Composite Standard Score 118
    Memory for Digits 12
    Nonword Repetition 14
    Rapid Naming Composite Standard Score 112
    Rapid Digit Naming 12
    Rapid Letter Naming 12

    Whoops. I misrepresented his scores in my OP. Blending words puts his lowest score at 50th percentile, so 2 sigma below VCI.

    Is Phoneme Reversal the names of the subtest in the CTOPP? I'm planning to ask for a retest of the CTOPP and a TOWL. I can specify this if it's something that comes with the standard CTOPP as the district would purchase it.

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    geofizz Offline OP
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    Also - what is phoneme reversal? Is it: if I say "KA," he responds "AK"? Or is it something else?

    I just tried it on him. "KA" -> "AK" was easy. "MAT" to came out "ti--ih -- mat"?? After about 20 seconds of thinking. DD can't do it very well either, but her guesses weren't so loopy.

    Can I give AAS to a (bright, engaged, interested in education) babysitter? Can we trade off on this where she does some sessions and I do others?

    Last edited by geofizz; 08/18/14 10:13 AM.
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    aeh Offline
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    Yes, that is phoneme reversal. And wait until you see how he does on multisyllabic words...

    Phoneme Reversal is the name of one of the supplementary subtests in the CTOPP. Unfortunately, it has no equivalent in the CTOPP-2, which is the latest edition, out this past year. If the district gave him the CTOPP originally, they should already have the materials necessary to administer Phoneme Reversal. Some other measure of sophisticated phoneme manipulation would likely work as well. It has to be something more than simple deletion or blending, like reversal or substitution, since he's already demonstrated age-appropriate ability to elide and blend. (Granted, 2SD below verbal ability.)

    The TOWL will be good for exposing written expression difficulties, as distinct from mechanics. You can also consider using a Six Traits rubric to qualitatively assess his writing products vs classroom expectations:

    http://educationnorthwest.org/sites/default/files/new-rubrics-3-12.pdf

    Absolutely, you could give it to a bright, engaged, education-oriented babysitter. It is literally scripted ("Say, '...'"). The main thing you might have to discuss with her is how many successful reviews is your threshhold for moving a phoneme/sound/rule/word card to the mastered list, and maybe some means of tracking which words are accurate/inaccurate on any given session. I keep it in my head, because I'm the only one teaching, and I only have one student--and I'm not too concerned about reviewing an extra time or two. You might consider photocopying the list of words taught from the back of the teacher's manual and using it as a checklist for words mastered/words to review/number of times in a row correct, or whatever metric you want to use to decide on mastery.

    I take an errorless teaching approach to the reviews, immediately correcting every error, without giving my child any overall score. There is an understanding that mastered words will leave the rotation after a few sessions of correct, fluent spellings, and that more challenging words will remain until mastery. I plan to accomplish a certain amount at each session, but prioritize a short, successful, happy session over pace, as we were starting from a negative set toward writing and spelling. Because I can adjust how much practice with letter/phoneme tiles we engage in before writing any words down, by the time we reach written work, the success rate is usually high, which is satisfying for both of us.


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    geofizz Offline OP
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    I'm fairly confident I can't reverse two syllables.

    Originally Posted by aeh
    The TOWL will be good for exposing written expression difficulties, as distinct from mechanics. You can also consider using a Six Traits rubric to qualitatively assess his writing products vs classroom expectations:

    http://educationnorthwest.org/sites/default/files/new-rubrics-3-12.pdf

    Do you mean this to assess his writing independent of the mechanics? Him mechanical difficulties are a clear barrier to the content. The only place I'd score him above a 2 (or a generous 3) is in vocabulary and word usage.

    When dictating and working off a graphic organizer done with the SLP, I'd put him well into the proficient range for each category.

    Hopefully the rest about the AAS details will make more sense when I have it in front of me. We'd certainly start off with just the two of us.

    Many, many thanks again.

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    aeh Offline
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    I would assess him on Six Traits each way (oral and written). If he scores poorly both ways, then it suggests an OWL LD. If he scores well orally, and poorly written, then it documents written expression difficulty as distinct from language. If he does well on written work with accommodations, as compared to poor independent written work, then it documents the value of the accommodations. The rubric is not a norm-referenced instrument, and thus does not have the psychometric and statistical robustness of a good NRI, but it does have the benefit of being more familiar and comprehensible to educators, and more clearly tied to aspects of writing instruction. It also falls into the general category of curriculum-based assessments, since 6T or 6T+1 is a part of quite a few curriculum frameworks. Hence RTI-friendly. You might even request that a grade-level teacher or curriculum specialist (preferably both) use the rubric to score writing samples (blinded to condition, obviously). That might require having someone re-type all the final products so that it isn't obvious from the handwriting when he's being scribed.


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    geofizz Offline OP
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    Thank you, thank you, thank you.

    OWL is not a term I've encountered before. Googling, I'm a little confused. Based on the explanation on the wrightslaw website, the oral part of an OWL LD is not an issue now (morphology & syntax) He still had morphology & syntax errors galore when he was discharged from speech his first time at age 5 (over our objections - the SLP wasn't prompting any complex speech like we were hearing at home, so she never heard him fail to use 'the' 'a' words, etc). Since I pay attention during speech therapy sessions, we kept at the same style of therapy at home, and his CELF scores are now quite high (124+ in all areas, no subtest holes - the school SLP thought it was cool that she got to the end of the test on vocab - something she'd never done before).

    He continues to struggle in spontaneous speech giving context and presenting information sequentially. He does pretty well when given "think time" and prompted to use WhoWhatWhyWhenWhereHow.

    So does he maybe has an OWL LD where we've remediated the O part of the LD?

    My gut, though, says that if we address the spelling, the bar will be lowered significantly to enable him to make progress in other areas of writing.

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    aeh Offline
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    That history does sound consistent with an OWL LD where significant remediation has been applied to the O. It sounds like he continues to display effects in more complex spontaneous language, but if you can keep his accommodations in place (and ultimately teach him to cue himself), oral language will probably be okay.

    So if I'm getting the picture clearly, his spontaneous oral language expression is strong in many areas, but weak in organization, fluency, and elaboration, and perhaps in speaking to the audience. His scaffolded oral language expression (when you provide accommodations and prompts) is good. His spontaneous written expression is limited. I think this is what you want to convey to the school, or help them to document on either a norm-referenced instrument, or a widely-accepted rubric.

    I would agree that addressing spelling will free up mental energy for higher-level written expression, much like reaching automaticity with math facts frees up working memory for problem solving.


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    geofizz Offline OP
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    Originally Posted by aeh
    So if I'm getting the picture clearly, his spontaneous oral language expression is strong in many areas, but weak in organization, fluency, and elaboration, and perhaps in speaking to the audience. His scaffolded oral language expression (when you provide accommodations and prompts) is good. His spontaneous written expression is limited. I think this is what you want to convey to the school, or help them to document on either a norm-referenced instrument, or a widely-accepted rubric.

    Oral language expression is best with strangers or people where he feels like he should perform (hence the multiple speech evals where the recommendation was for me to get my own hearing checked...) -- so he's actually really good at speaking to his audience.

    As things get complex -- generally reserved for just us -- he tends to leave out transitions, starting telling us something from the middle. He responds easily (though with irritation) when prompted to tell us the presuppositional information. In the apraxia diagnosis stage a year ago, he has a scaled score of '3' on coherence on the CCC-2 that I filled out; an '8' on the form his 2nd grade teacher did. This was a time when we'd hear about black holes and ancient history. His teacher would hear that he had pancakes for breakfast. His 3rd grade teacher and the gifted teacher observed nothing notable last year, while I hear that he spoke to them at length on the obsession-of-the-week.

    Up until now, I've been working on the hypothesis that the leaving out of the small words at age 5 (and all but nouns on initial round of speech therapy at age 3) was trying to work around the (then undiagnosed) apraxia. He was simply trimming everything he could.

    I'll add OWL LD to the list of hypotheses. Thank you. Honestly, my 2e parenting philosophy is one of symptom/frustration whack-a-mole.

    Hopefully the TOWL and CTOPP phoneme reversal will elucidate more. In the meanwhile, I've ordered AAS. Thank you again for your time and thought.

    Last edited by geofizz; 08/19/14 08:20 AM.
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