Stupid Auditory Processing Disorders (APD) report, stupid audiologist

[Ktllc]

Got V's report in the mail yesterday, one page and a few check marks. That's it! Not even any summary or explaination by the audiologist. Just a standard forms with check marks.
Here is the info I have:
tests given: Phonemic synthesis Picture test and Auditory Skills Assessment (ASA).

For the picture test: 5 correct out of 15. She checked within normal limits (within Normal Limit). But then checkes that it indicates deficits in phonemic decoding and Tolerance-Fading memory.
No further explanation! If it is within normal limits, why does she mention a deficit?? If she does, you would think she would give an explanation. Argh!!!

Then her conclusions, checked:
-normal hearing sensitivity (although she had told me he was actually oversensitive, he covers his hears...)
-Speech discrimination in quiet: excellent. But then she did not test in noise!
-Deficits in phonemic decoding and Tolerance-fading memory.

As far as recommendations, she checked a few things out of a list:
-Speech therapy emphasizing phonemic analysis, synthesis and decoding
-Repetition should be used in repairing communications - not rephrasing
-Reduce auditory overload by giving breaks from "listening"
-Occupational therapy for evaluation of sensory integration problems
-Auditory memory training
-Will benefit from activities that use both hemispheres: chess, gym, dance, music, etc
- could possibly benefit from es of FM system (she hand wrote: trial period recommended, as in our phone conversation she stated she did not know if it would help as she did not test in noise...).

I almost cried from anger yesterday. This report does not tell us ANYTHING!!! It is completely useless.
I even wonder if there are indeed any deficits, since the tests are within normal limits???
How is this report supposed to help our Speech Language Pathologist (SLP)?? It really does not give anything.

I want to pick up the phone and complai, but what good would it do?

 

[TeDo]

That's the sad and extremely frustrating part about "professionals". You have to dig and dig for the GOOD ones. Did someone recommend this woman or how did you find her? Is there a way to find a REPUTABLE one for a second opinion? That's where I would go next. As far as the recommendations, those would give an Speech Language Pathologist (SLP) somewhere to start. They don't usually work on everything at once anyway.

Hang in there. I know this type of scenario all too well. ((((HUGS))))

 

[buddy]

NO test in noise? What a waste of time. I am so sorry for you. When he is seven, do it over. For now, you really KNOW that there are issues, even this inadequate evaluation says so and that is what we did for Q too, the district used their FM equipment and I didn't order our private one until we knew it was working.

 

[susiestar]

Of course you should complain. She did a half-mule job. She needs to complete the job and test in noise and give you a COMPREHENSIVE report. is thsi a school or private evaluation? if it is school, this is what you will get - what she has done. It is designed not to find things, or that is how it seems here. They don't test in noise but the kids are always in noisy classrooms, so they are clearly not testing to find the problems. If it is private, then complain loud and long that you paid for a complete, comprehensive set of tests and you want him tested in noise. If it is through the school, get a private evaluation done asap and let them have a copy of that report, which should have quite a bit more than what this one does.

even if she won't test him further, get her to explain the reason for the normal and the problems listed for the same thing. don't accept just an oral report on this, get it in writing so you can take it to school.

Or, if she is private, have another audiologist test him and pretend her results/testing never happened.

 

[buddy]

If I remember this one was found after a LONG search to find someone who would do it even though he is so young....so it was private if I am remembering???? But maybe this is why she/he agreed, because she/he really doesn't get what is involved here???.

 

[Ktllc]

It is private. She is the only one that I found in my state... To be honest, I'm not in the frame of mind of searching for anyone else.
To top my disappointment, I have to deal with my parents who just came back from the beach with the boys. The boys are fine and had a really good time. Now I have to listen to my parents "explaining" (that is a quote) what is going with V. Grrrr... I am using all my energy to keep my mouth shut. The grand conclusion from my Father: V is annoying, that's all. Why didn't I think of that sooner?? Ok, I have to stop, I'm getting off topic for this thread.

 

[InsaneCdn]

JMO, but...
1) he's four. not 14, or even 7 or 8. the ripe old age of 4.
2) you actually got a pretty good recommendations, even if you didn't get an actual diagnosis at this point.

Take the recommendations and run with it.
For now - those are what count.
You can say that he's a bit too young for a complete audiological evaluation, but the audiologist recommends that we do x, y, etc. Which in fact, is probably the truth.

Re-test when he's 7, and you will probably come out with a diagnosis.

 

[buddy]

It is private. She is the only one that I found in my state... To be honest, I'm not in the frame of mind of searching for anyone else.
To top my disappointment, I have to deal with my parents who just came back from the beach with the boys. The boys are fine and had a really good time. Now I have to listen to my parents "explaining" (that is a quote) what is going with V. Grrrr... I am using all my energy to keep my mouth shut. The grand conclusion from my Father: V is annoying, that's all. Why didn't I think of that sooner?? Ok, I have to stop, I'm getting off topic for this thread.

HUGS, put some cotton in your ears and sing to yourself as much as possible till they leave.

 

[keista]

The grand conclusion from my Father: V is annoying,

It's kinda funny but not funny if you Know what I mean?..... That's a perfect 'simple' description of high functioning Autism Spectrum Disorders (ASD).

 

[BusynMember]

My two cents: There is no way I'd trust an audiologist to diagnose a childhood disorder. I'd go to a neuropsychologist first.After that you can ask if he feels an audiologist is necessary. usually Neuropsychs can pick up the stuff that others miss. Audiologists mostly test hearing (they CAN do this for a young kid...they do it by sound waves...my son had an evaluation at age four or five too). His hearing was normal. The neuropsychologist figured out what he was deficient in. Maybe your son actually doesn't have the kind of things an audiologist can find, but he still may have something.

A neuropsychologist will test in detail for everything from 6-10 hours and you will probably get a 3-15 page report (ours was 15 pages). He was tested for processing problems and Sensory Integration Disorder (SID) during his evaluation and it was very helpful. He could also help us with a dignosis that the school had to pay attention to.

I agree that V. sounds a lot like an Autism Spectrum Disorders (ASD) kid, but you need a complete evaluation for that. Often Autism Spectrum Disorders (ASD) kids struggle with sensory issues, phonetic issues (any sort of speech or reading, really) and many other things. They can all be a part of the Autism Spectrum Disorders (ASD). At the very least, why not try it? You can find neuropsychs at university and children's hospitals.

And, yes, Autism Spectrum Disorders (ASD) kids---from making obnoxious noises to making strange lip smacking to tapping on the table to repeating things over and over again or over-talking--can be the very epitome of "annoying." Not saying he has it, but I'd definitely consider it.

Good luck!

 

[buddy]

MWM and I have gone round about this before, smile. We all have different perspectives here so I will share mine but I consider her a strong advocate and my view is just my view, no disrespect intended in any way. I really do agree that neuropsychs are super at what they do but they are not unlimited in what they know and what they can diagnose and each of the other specialties do have the unique ability to do the best in their areas. It is just important to make sure that the people we go to have experience in the issues we are looking at.

Over the years Q has had 7 (I think I counted right) neuropsychologist evaluations. Several at a university site and the others at two different hospital sites, and beyond Autism Spectrum Disorders (ASD), ABI, anxiety-not otherwise specified and Attachment Disorder (which was provided by the psychiatric he saw before them and they did nothing to assess that, it was all record review) they never said anything more about the severe language issues he has other than that he had language delays (saying he has general receptive and expressive delays, vocabulary is a relative strength but...what types of receptive and expressive issues were never discussed). That is because the tests used, which I have seen in detail including the scoring manuals, only have subtests looking at these areas, they are not in depth language evaluations... That was left to the Speech Language Pathologist (SLP). There was not even mention of the language processing disorder....certainly never-ever mentioned for a second....auditory processing disorder but all the Speech Language Pathologist (SLP)'s and I knew there was a strong chance esp given the temporal lobe injury. Sure enough, I finally had it formally tested and it is a part of the picture.

For the detailed, more symptomatic issues, and the specific therapies needed, I actually feel things can be missed if we do not pursue the appropriate specialists. My experience is that the neuropsychs are excellent for the big umbrella diagnosis. and monitoring overall progress. The ability testing they do can help show learning style and strengths/weaknesses in that sense. They are excellent at taking other's testing and putting the puzzle together and often they can also use what they find in their testing to recommend more detailed testing in any areas that their more generalized testing suggest may show a possible problem. But if they miss on that, and we still think there is an issue I would still see the specialists in those areas to get the full picture.

I would NEVER expect a neuropsychologist to be able to tell me if my son had muscle weakness or tightness in his legs (he has a left sided weakness), bilateral motor integration challenges or auditory processing disorder or apraxia of speech. They are not qualified to diagnose those kinds of problems. Only to point us in the right direction. Again that is my own parenting experience and also my experience in working with other professionals thru the years. Everyone has a different view though and certainly there are some who are exceptions to the rule, I knew a neuropsychologist who started as a speech-lang. pathologist, he is now at John's Hopkins. Now THAT was a great guy.

Diagnosis of auditory processing disorder takes an audiology booth. It takes calibrated equipment and specialized protocols, with hookups for certain sounds and recordings to enter either or both ears at the same or different times and a high level of training to interpret the results. For sure I would trust an audiologist and only an audiologist to diagnosis auditory processing disorder. The audiologist we use for Q's auditory trainer is a PhD level audiologist. Ktllc had searched for this kind of specialized audiologist so hard, and there just wasn't one. True, as MWM said, general audiologists do not really go onto this, it is just not as common to find people who are doing this level of testing. I sure hope that you can find someone in a few years to help get a better picture but as IC said, it is a start.

 

[InsaneCdn]

Diagnosis of auditory processing disorder takes an audiology booth. It takes calibrated equipment and specialized protocols, with hookups for certain sounds and recordings to enter either or both ears at the same or different times and a high level of training to interpret the results. For sure I would trust an audiologist and only an audiologist to diagnosis auditory processing disorder. The audiologist we use for Q's auditory trainer is a PhD level audiologist.

I'd go one further on that... To get accurate testing for APDs, I would trust nothing other than a PhD level audiologist with a specialty in APDs, at least at the "he doesn't have it" level... if anyone other than a PhD Audiologist sees signs and symptoms of APDs, and wants to recommend further testing, I'm all for it. But for anyone else to say APDs are "not a factor"... I wouldn't trust it.
Just based on our own experience.

 

[Ktllc]

Thanks for all your input. It is very helpful, and I think I will now wait a few years for more Auditory Processing Disorders (APD) testings. Like many of you said: it is a start. Even this less than perfect audiologist saw some issues, so I will not forget to monitor improvements/deficits in a few years.
But his lack of comprehension could also be part of an Autism Spectrum Disorders (ASD) diagnosis. At that point, being so young, it is hard to really know. The Autism Spectrum Disorders (ASD) center that will do more testing is aware of the Auditory Processing Disorders (APD) issues and will take the report into account. 3 doctor will do the Autism Spectrum Disorders (ASD) evaluation (a phd level one will supervise it all), so I feel they will be able to make sense of all the issues.
Keista: I know, kinda of funny what my father has to say. He also said that when V has something in his mind, it's hard to get him past it, that's all. HaHaHa, Dad... Or that V is very social: he talks to Grown ups! Even too much, what a great social little guy. (again, that's a quote).
But I keep my mouth shut. They (kids and grand-parents) had a good time, and that is such an accomplishment.

 

[BusynMember]

Buddy, I respect you too It is good for the posters to get all sorts of perspectives! Peace