Gifted Issues Discussion homepage Forums Identification, Testing & Assessment 4 Year Old Testing and Sensitivity OT Therapy

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#Post202576

My 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.

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.