Question for those with some knowledge of....

[TeDo]

APDs.

I just got copies of difficult child 1's records from the GOOD Occupational Therapist (OT) today. She did a LOT of in-depth testing of many different areas. One area that I didn't realize she'd done was some auditory processing test (didn't list the name). His scores were:

Word discrimination: Raw score 27, scaled score 5, 5% ranking
Phonological segmentation: Raw score 26, scaled score 6, 9% ranking
Phonological blending: Raw score 15, scaled score 6, 9% ranking
Number memory forward: Raw score 16, scaled score 7, 16% ranking
Number memory reversed: Raw score 10, scaled score 7, 16% ranking
Word memory: Raw score 18, scaled score 8, 25% ranking
Sentence memory: Raw score 21, scaled score 6, 9% ranking
Auditory comprehension: Raw score 16, scaled score 5, 5% ranking
Auditory reasoning: Raw score 2, scaled score 1, less than 1% ranking

Patient is struggling in many areas below the average of 16-84% for his age which can result in increased frustration and increased challenges at home as well as with academics.

Is anyone familiar with any of this? Can anyone tell me what these things mean and what can maybe be done to help him with these issues? Any insight at all would be greatly appreciated.

 

[Ktllc]

I am NO expert but have been exposed to some info when trying to understand and diagnosis V's issues.
I knew Speech Language Pathologist (SLP) can do screenings (did not know Occupational Therapist (OT) could do screenings as well) but if you want a firm diagnosis you need to find an audiologist specialized in Auditory Processing Disorders (APD).
Treatment can fall under an Speech Language Pathologist (SLP) and/or Occupational Therapist (OT) though.
You son is old enough to do a full range of testing witha specialized audiologist. The audiologist should then recommend the right treatment for his specific deficits.
I'm sure our dear friend Buddy will give you more detail on what the report means. I'd hate to give you wrong info or less than perfect explanation.
If you want, I cam pm you the info of an online support group for Auditory Processing Disorders (APD). The group is organized by a very reputable double certified Audiologist/Speech Language Pathologist (SLP).
My understanding is that Auditory Processing Disorders (APD) is very treatable and manageable, so I would see this finding as good news.

 

[InsaneCdn]

This testing was done by Occupational Therapist (OT), not by Speech Language Pathologist (SLP), right?
In that case... it's a "flag", not a result... auditory is not Occupational Therapist (OT) specialty, so I'd be pursuing a full Speech Language Pathologist (SLP) evaluation.
Speech Language Pathologist (SLP) evaluation would have resulted in recommendations... either for specific interventions and accommodations, OR for advanced testing (or both).

 

[TeDo]

We tried the ony Speech Language Pathologist (SLP) we have and it was a HUGE joke. Buddy can back me up on that! I will have to look around and see if I can find a specialized audiologist that isn't over 2 hours away. My budget can't take that kind of travel expense. Do these scores mean ANYTHING?

 

[buddy]

Hi! We are home from the zoo, had a nice time (only one incident but he turned it around and we had another great time, gosh wish we didn't have any rages (he pushed, hit, actualy went to the ground like a toddler, sigh... but it was maybe 20 minutes of 4 hours of fun and now he is with Integrated Listening Systems (ILS) and doing great, so sorry I couldn't answer the text right away.... )

Anyway, this might have been part of an overall developmental test that had sections that covered motor, speech. language etc. and she decided to check it out. If she is trained in the standardized procedures for that test she probably did reliably give it, her interpretation can only then follow along the lines of what she said, that he has low scores and it could mean he has issues with auditory language.

What testing did that Speech Language Pathologist (SLP) do...anything? Do you have any of the older testing from school?? Can you ask the Occupational Therapist (OT) where those scores come from (and what age was it done?...how old was this testing?)

gosh TeDo, given that he has such challenges when in a class setting and does so well with you for online school...(and I know you do not do his work for him, he really IS doing better) this all actually makes sense. The question is whether it is a language based issue or an auditory processing issue or both??? . Mind if I ask the audiologist where I got Q's fm system (she is a phD) if she knows anyone in southern part of the state? What about Mayo? At least that is not as far as the cities, right?

Look, in any event, you have naturally made the accommodations that he needs so far. (breaking things into chunks, explaining little by little in "his" way, etc...the one on one education you provide him).... But if he really does push for going back to public at any point, knowing this could shed a whole new light on how to help him.

Those are significantly low scores, esp those that are under the 10th percentile. (but even those that are at the very lowest end of "average"...any parent would still be concerned ...like the 16th percentile scores)....it is the overall trend to having an issue with this stuff. Do you consider him a visual learner?

 

[TeDo]

Buddy, the Mayo is actually 3 hours away. Your area is the 2 hour range. If your Speech Language Pathologist (SLP) knows of any good ones in the southwestern area, let me know. I have no idea what the joke of a Speech Language Pathologist (SLP) did but am waiting for their records also so then I might know something. The school Occupational Therapist (OT) did a cursory of his writing and that's it. She found no issues but the GOOD Occupational Therapist (OT) found he held the pencil with "an immature grip" and "wrote too hard indicating that the pressure he was using wasn't registering". She gave him a weighted pencil and he did MUCH better but it is so bulky, he refuses to use it.

He IS pushing to go back to public and this report from the GOOD Occupational Therapist (OT) will help a lot to get more accommodations for him, especially when I show the school Occupational Therapist (OT) the report. SHE might be willing to help push for more. She's pretty good but as you know, they only test educational issues but now that this report says so much more that ALSO impacts school, who knows.

This report also talks about how she had him try a special kind of headphones (HD500) to listen to a special kind of CD (HS103 Simona) that he responded well to. I remember her telling me the CD plays music in a different way and that the headphones produces the sounds differently also.

I really wish I could find a GOOD Speech Language Pathologist (SLP) that can do more in-depth evaluations. Buddy, if there is one near you that can do it all in one or 2 days, we might be able to swing a 1-time trip. It would be worth it....if we have to.

 

[buddy]

She was probably doing the hemispheric auditory training program.... it targets different parts of the brain and is designed to improve auditory processing. There are some programs like that that are used for overall sensory integration and calming too. I dont know them well.

I haven't looked at a map of where you are I pictured you more directly below Rochester so closer than us but I remember now where you said so I will look. Will be interesting to see what worthless Speech Language Pathologist (SLP) did, if anything much, she had to have something to get insurance to cover it but what that was???

I think this could really be good for him, (along with your neuropsychologist report)....and with some different players, well if you do make that decision, maybe it will work out. First things first.... I will ask specifically for your area.

 

[lovelyboy]

Tedo.....I am glad that they could identify this problem!
The thing is....it will be great if you could get a propper assessment, but afterwards.....you would need her to help with therapy!
Something I was also thinking about.....if he has such a big Auditory Processing Disorders (APD)....then there could, often is....some motor planning problems also....but that will be in the Occupational Therapist (OT) field if she is knowledgeable regarding sensory integration dysfunction......
Also regarding the pencil grip.....there could be a few reasons for that: If she says not "registering" it...she might be thinking along the line of sensory integration, poor tactile or proprioceptive registering....?
Some other reason to consider could also be, poor muscle tone, resulting in poor shoulder stability....causing him to want to press harder on the pencil for more stability.....or his body posture endurance could be week.....resulting in him getting tired and his handwriting worstening as the task progress.....This in turn could be connected with maybe poor vestibular integration....Does he tollerate spinning, sudden change in body position....easily get nausia from swinging...exct....or maybe even craves these movement activities?
Regards LB

 

[lovelyboy]

Oh...I also wanted to mention regarding the Auditory Processing Disorders (APD).......I am no expert with this, but because my son struggles with this, I will just give some mommy advice....
I noticed that when talking to my son.....I need to try and face him, so he can follow my mouth.......try and speak SLOWER....this helps allot! Also just one concept at a time.......give processing time.....ask feedback to make sure he understands, sometimes he hates this and just say...."I am not stupid!"...so its better to indirectly listen if you think he understood, by his respons.....they often hear the words incorrect.....The times when his answers sounds irrasional is often when they didnt understood correctly.....
Also with giving written instructions, especially maths....he struggles to understand the instructions...For example...circle the one that is smaller than x and bigger than Z.....confusing!
He might also struggle with comprehension tests....So make sure he understands his reading info....help him how to identify important info, exct.
Hope this helps a bit! You might find that it will take a while and patience to change the way you speek to him.....Its almost like stepping back and making sure what you sead makes logic, simple sense!
Oh...and talking with less background sounds.....put TV softer, or music softer....Also try not to talk to him 2 people at a time.....If he also has problems with direction identification of sound....maybe touch him or make sure you have his attention before talking.....
He might easily get bored or irritated with to many verbal info and mentally switch of, because its overfloading his auditory system.....

 

[TeDo]

Great suggestions LB. He loves to spin and swing and rock. If we get a GOOD evaluation and he does go back to public school, I will have the "ammunition" to get him the services there. Our ONLY Speech Language Pathologist (SLP) outside of school is a joke. You can tell she's used to working with younger children by the tone of voice she uses (quiet, almost condescending). Her voicce grated on difficult child 1's nerves and he also thought she was "treating him like a baby or that he's stupid".

At home, I do break things up and make sure we have eye contact. That's one of the things about doing school at home, I can break everything up for him. That's what makes me nervous abouat him going back to public school. I can't guarantee they will give him all the help he needs and I don't want them to push him back to where he was last year. That was NOT GOOD AT ALL.

 

[buddy]

Hey TeDo, was thinking of the class difficult child 1 has to take for his probation....this could maybe help with explaining why he needs disability accommodations to be able to complete such a thing (I still can't imagine it...four hours of "safety class" ugg...Q would be kicked out within ten minutes).

You said you have a connection to them so maybe showing them the results even could help them see that you are talking about a legitimate issue, not just trying to get him out of things or make an excuse. He likely can learn some of the information (though how relevant it is to him in real life, well that is another topic) but needs it presented in a different way so maybe her notes can be made available and he can have some time with you helping him...or maybe they would even be willing to do some individual time? Seems like since they are a public agency they should have to make ADA accommodations.

 

[TeDo]

The PO doesn't see his issues since he only sees him at Boy Scouts and 4-H. I do plan to talk to the person presenting the "class". The LAST thing I need is him to get in trouble there. Yes, I worry about the 4 hours of sitting, listening to things that have NOTHING to do with him. UGH

 

[lovelyboy]

I just saw now that both your kids are on the autism spectrum! Jip....that can also explain it....Auditory Processing Disorders (APD) is very often part of Autism Spectrum Disorders (ASD)! My son also gets very aggitated with that kind of therapist...or one that speeks in a high pitch or very loud and fast!!!!!! It does limit our choices! My sons teacher just try and do things more visual....must be honest dont know how he will cope next year when they start changing classes with plenty of teachers! I bought a book.....10 things your student with autism would like you to know.....very nice.....

 

[InsaneCdn]

Our ONLY Speech Language Pathologist (SLP) outside of school is a joke

In other words, there is a Speech Language Pathologist (SLP) inside the school system who is good?
In that case, fight for a Speech Language Pathologist (SLP) evaluation through the school, specifically including the "full range of APDs"... you already have the Occupational Therapist (OT) raising the flag for this...

 

[TeDo]

Insane, the reason I said "outside of school" is because my kids aren't eligible for services through the school here because they are fully enrolled in a different one(an onlline school that doesn't have access to therapy services) . Also, I have no idea if the school one is good or not. It used to be the principal's (the idjit that caused ALL the problems that led to me pulling difficult child 1 out) wife but she left that position after last year to be the head of Special Education (what a joke) so they hired a different one this year and she's leaving after the end of this year so they're looking for a new one.

In other words, the only Speech Language Pathologist (SLP) we "have access" to.

 

[TerryJ2]

Gosh, I have no advice but I like that kind of testing. Who would I go to to test our difficult child?

 

[InsaneCdn]

In other words, the only Speech Language Pathologist (SLP) we "have access" to.

Ugh, Ugh and Triple Ugh.

{{hugs}}
Kinda like us trying to access a neuropsychologist... simply not an option.

Hmmm...
Here, Speech Language Pathologist (SLP) recommendation and/or "red flags" = fam doctor referral to advanced specialist audiology (i.e. PhD-level Auditory Processing Disorders (APD) audiological specialist)...
Any chance the fam doctor would take the Occupational Therapist (OT) report and use that as the basis for such a referral?

 

[TeDo]

Insane, with our insurance I don't need a referral to see a specialist. I just need to FIND one.......preferrably within a reasonable driving distance and won't include a hotel room and meals as an added expense.

 

[InsaneCdn]

Hmmm... how close to the nearest teaching hospital? That would be the first place I would look.

 

[TeDo]

Insane, two and a half hours....that's where we went for the neuropsychologist last November. It involved a hotel room and meals because the appointment was so early in the morning and lasted all day. That's the issue I run into all the time. We live out in the middle of nowhere far from anywhere. I just wish I had the money. It hoovers to be unemployed...