Wee difficult child's evaluation results - prepping for IEP

Discussion in 'General Parenting' started by Shari, Mar 25, 2009.

  1. Shari

    Shari IsItFridayYet?

    Ok, so...I'm finally to a place I care to talk about this again. Here's the results of wee difficult child's evaluation. I am forwarding this to all his docs, too, cause it pretty much completely contradicts the results of the neuropsyche evaluation done 9 months ago that was a total waste of time and money and effort.

    His current "main" diagnosis is severe ADHD and possible BiPolar (BP). None of the school personnel feel that either truly fits.

    I have a list of requests for the IEP. Would love to hear any input.


    Visual Motor Integration is a tool used to determine if a child has difficulties coordinating what they visually perceive and their motor movements.
    difficult child's percentages: VMI Overall 12%, Visual 4%, Motor 7%

    Sensory Profile Companion filled out by school personel, he was ranked with a Definite Difference in every category with the following comments:
    Auditory: difficult child is frequently distracted and has trouble functioning with lots of noise around him, misses oral directions frequently. Becomes distressed during assemblies and other large group gatherings. Overly bothered by unexpected noises.

    Visual: difficult child frequently has trouble keeping supplies organized, watches other students move around the room, and looks away from tasks to notice other activity in the room.

    Movement: difficult child always seeks all kinds of movement that may interfere with his day, is always on the go, fidgets during activities, and finds excessive reasons to move around the room.

    Touch: difficult child displays an unusual need to touch different textures, comes close to people's personal space when talking, touches people and objects to the point of irritation, and has difficulty standing in line when close to people.

    Behavior: difficult child is inflexible, withdraws from changes in routine and new situations, is easily frustrated, and more over-reactive to situations compared to peers.

    WISC-IV scores: Full scale IQ 92; Verbal comprehension 102; Perceptual Reasoning 104; working memory 80; processing speed 80.

    Additional note on this says he was unable to repeat a 2 digit sequence back to the tester. Initially, the test asked him to repeat a sequence backwards. If she said A2, he was to say 2A. He could not do that, so she asked him to just repeat the sequence back to her (he should say A2 back) and he could not do that.

    ABAS Scores significantly significant by over half of all raters in the following categories Communication, Community Use, Functional Academics, Health and Safety, Self care, Self direction, and Social.

    All 13 categories in the Connors Rating Scale were "significantly problematic" (scores above 66) when rated by his mainstream teacher - all of her scores were above 80, some into the 90's. His SpEd teacher and family only rated him problematic in the categories Oppsitional (67), Hyper (68), and Emotional Lability (86).

    The BASC-2 had 4 raters from school, clinically significant by 3 or 4 raters in the clinical categories Hyper, Aggresive, Depression, Atypicality, and Withdrawal. Conduct problema, Anxiety, Somatization, and Learning Problems were normal. Attention Problems was one number above average. In the adaptve categories, he's clinically significant or at risk in every category: Adaptability, Social Skills, Leadership, Study Skills, Daily Living, and Functional Communication.

    He scored an overall academic skill of 58 on the Woodcock-Johnson, having refused to do at least half of the test.

    Social/Emotional/Behavioral report from the mainstream teacher - difficult child can not interact appropriately with peers during instruction or during non-instructional time, does not have friends, is not accepted by peers, and can not interact appropriately with adults. He has low self esteem, unwilling to take academic or interpersonal risks, is aggressive, argues with peers and adults, verbally threatening, has difficulty working in cooperative groups, manipulates, angers easily, and has tantrums. Additional notes say he "lacks social skills in all situations. He is volatile and impulsive and I often don't know what triggers this. He does not understand personal space or classroom behavior. He does not work well in a group setting, avoids academis tasks, and is manipulative to avoid work, wants to be on his own schedule and not told what to do. He can be aggressive, harmful, and destructive."

    Reading report from the mainstream teacher - "refuses to read when asked. Can understand some phonemic awareness tasks, but makes no attempt at reading strategies and little attempt/success at sight word recognition."

    Written Expression report from mainstream teacher - "uses none of his own spelling, always dictated to him by the paras. Writing usually has something to do with war/military. Does not write his own stories with events that have happened to him."

    Math report by mainstream teacher - "Math seems to be a stronger subject. Still presents a challenge when asked to complete a task. He can count, skip count by 10, use manipulatives to solve simple problems (with much help from para to focus and complete). Place value is tricky."

    Study skills report from mainstream teacher - "is very inconsistent and many times inpredictable. He especially is if asked to do something he doesn't want to do. He doesn't really seem to come to school knowing he is there to learn."
    Last edited: Mar 25, 2009
  2. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Does anyone else think Autism here?
  3. AnnieO

    AnnieO Shooting from the Hip

    Shari, this post, in a manner, frightens me...

    difficult child 2 is 10 and this report could have been written about him... Only a few minor differences...

    We recently got a referral to a neuropsychologist for difficult child 2, after I kept seeing his behaviors pop up on this site in different places, and he started to really regress. The guy is the same one who originally (2 years ago) diagnosed him with ADHD after biomom took him. (Side note: her report was the poster child for all ADHD symptoms; ours, and his teacher's, were close to identical and almost the polar opposite of biomom's.) I was a little upset when husband told me this. However... New pediatrician (well, since we took over residential of kids) suggested this guy because he has the background on difficult child 2; and this guy did not prescribe any medications for difficult child 2, that was done by old pediatrician. Come to find out, biomom TOLD THE pediatrician WHAT SHE WANTED HIM ON. WTH?! A doctor that listens to that? He actually asked husband at one point what he wanted him to prescribe for difficult child 1. Can we say, new docs all round?!

    Anyway... the writing about war... WHEW. difficult child 2 loves Star Wars video games, and pretends everything is a gun. (Even down to chicken nuggets that have a silencer made of french fries.) He owns approximately 5 billion little green army men (although the rate of attrition is high as the rule is, if it's left out, husband or I trash it). Another 30 or so of the Star Wars clone figures (these cost too much to pitch, so I put them in a drawer; right now there are about 15 in there). War movies. Last week I took away his recorder bag (like a flute with a mouthpiece?) that he had filled with marbles and bent and was pretending to shoot people with. (I actually took it away because a) he was not supposed to have anything but the recorder in it and b) I had just stepped on a marble and fallen on my bad knee - on the dang marble!!!)

    Now that I've made this all about me... or my difficult child... :redface:

    I am thinking you are likely right and the Pervasive Developmental Disorder (PDD) and anxiety are doing it, too. I have read in more than one place that Pervasive Developmental Disorder (PDD) and other Autism Spectrum Disorders (ASD) are frequently first misdiagnosed as ADHD - then, of course, the stimulant medications just make life worse for child and parent... and everyone around them.

    Also I started working on my response before Janet responded but, YEAH! What are the odds of your speaking with the neuropsychologist again?!
  4. 'Chelle

    'Chelle Active Member

    Oh yeah, Janet, it was sending up lots of signals to me for for Autism Spectrum Disorders (ASD) as well. Many of the things in this evaluation I see my own difficult child.

    My difficult child was finally diagnosis'd by a psychiatrist who specialized in developmental disorders, and was pres. of the Board of the Austism society here. Perhaps you could look for an Autism Spectrum Disorders (ASD) specialist and have your difficult child re-evaluated by him.
  5. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Shari....if we are right and wee difficult child is really autistic which honestly I am suspecting he is, what do we do now? I watched a show on the Discovery Health channel about a family with 6 kids all on the Autism Spectrum Disorders (ASD) spectrum and they talked about all the different school settings the kids had...omg.

    So what interventions are you going to be able to get? Is there any self-contained autism classroom? Honestly that is where it sounds like he needs to be. He isnt going to make it in a mainstream class when he acts like they say he does. He needs to be in a very small class with aides. He probably needs Occupational Therapist (OT) to help with over stimulation. I dont know anything about autism intervention except what I have seen here. I do know the faster you get it implemented the better off he will be. This has to be miserable for him.
  6. klmno

    klmno Active Member

    ((HUGS)) I have no experience with Autism Spectrum Disorders (ASD) so I can't offer an opinion on that. I'm sure you are aware of the difficulty profs are having these days distinguishing between Autism Spectrum Disorders (ASD) and BiPolar (BP). That worries me so I doon't know that I'd cast any diagnosis along those lines in stone just yet, especially given your difficult child's young age. Concentrating on helpful accommodations and supports seems most useful- which I know, this is what you are trying to get the sd to do.
  7. 'Chelle

    'Chelle Active Member

    Oh, sorry, IEP interventions. Does he have an aide? If not definitely needs one if you can push for that. difficult child in high school still has one, relys on her even more now with additional high school workload. She keeps him on track, helps with the abstract writing stuff ("Does not write his own stories with events that have happened to him." This is part of that for my difficult child as well), they would get to know the signs difficult child would put out that he was anxious/overwhelmed and try head things off. In grade school difficult child had a "spot" he could take himself off to when things where overwhelming him. This is a definite plus with the sensory/auditory problems. These things would irritate my difficult child to the point of meltdown at times, and having somewhere to go let him get away and calm down. The aide would of course go with him, and when difficult child was more relaxed they would at times work there to get the work done. Now they just go to the back of the classroom and work quietly when he needs it. In regards to the inflexibility to changes etc. my difficult child was a little older than yours, but they would print out a daily schedule for him so he had it in front of him and knew what was happening next and when eg math, then reading, then recess, etc. They did work with him (therapist & school) on accepting transitions and sudden changes in routine, but having the schedule helped. Check with therapist/psychiatrist/school for social skills programs that might be available for his age group. My difficult child was in 3 or 4 of those, and they helped with the social problems, learning personal space etc.

    Getting accomodations similar to these might help your difficult child, whether he's diagnosis'd Autism Spectrum Disorders (ASD) or not.
  8. jal

    jal Member

    Shari - OMG! I felt like you were writing about my difficult child. Not to hijack your thread but a little of our story for comparison. difficult child was originally diagnosis'd as BiPolar (BP) and severe ADHD. We went along with that diagnosis for over 1yr. None of the medications we tried ever helped him a bit. I began to suspect he was AS. After psychiatrist would not consider AS we took on 2 new dr's that both concurred Pervasive Developmental Disorder (PDD)-Aspergers. My difficult child could not handle mainstream class so we opted to transfer to a therapeutic school. In main stream he could not focus, his writing was not where it should of been, let alone try to get him to do homework -ugh! He even struggled when he started the therapeutic school. Upon the AS diagnosis, the psychiatrist introduced a small amount of prozac. Unbelievably, we and the school noticed a difference in him in about 7-10 days. He stepped up and started learning. He was behind where he should have been when he started and now has caught up and exceeded. He even comes home and does his homework without being told to.

    During our last PPT (2 weeks ago), they showed us the 3 ring binder of his work. His writing has improved immensley, his reading is really coming along and his math skills have exploded. He is taking 100 math problem tests (timed) and completing it all and getting 100%. His spelling tests are all 100%. It is amazing! He has gained confidence.

    His behavior at home has improved, no more tantrums, no more angry all the time. We are enjoying him finally after 4+ years! This has just been something that has made a tremendous improvement in home and school life. I am in no way suggesting that this is the answer it's just what has finally worked for us.

    Things we have in place for him are:

    Therapeutic day school
    para (1 on 1) in school
    Occupational Therapist (OT) services in school
    daily group therapy at school
    individual therapy 1x week in school
    intensive in home therapy 2x a week

    Good luck to you. It can turn around.
  9. susiestar

    susiestar Roll With It

    Wow. I hope hte school respects the testing and gives appropriate help. Not sure exactly what to say except I see so much of Wiz in there.

    The gun thing was totallyWiz. EVERYTHING was a weapon of some kind. We could not allow army men, toys of any kind with weapons (when he had the action figures - Gargoyles and superheros mostly - he would not play with the person, just the weapons that came as accessories). He combined it with the pokemon obsession and was very very dangerous. We even pulled every video with ANY sort of violence - even a LOT of the Disney movies. He couldn't think of his own stories until 10 or so but he would act out or adapt movie and book scenes. And his sister was always the person who got hurt. He wasn't satisfied unless she actually got hurt (did NOT have empathy at that age, or understand it hurt her. He processed pain VERY differently and had a hard time with that.)

    Anyway, I think that seeing the doctor you pm'd me about would really help. Take all the test results to him.

    Good luck with the IEP meeting!
  10. jannie

    jannie trying to survive....

    I agree with the others on so many thoughts. I too would strongly recommend a high structured self-contained special education classroom with a very small student/teacher ratio. Expectaions clear and consistent. Frequent feedback and reinforcement....every three to five times minutes difficult child is displaying positive behaviors he should be reinforced; verbally/non verbally - thumbs up--establish eye contact prior to giving directions-establish non-verbal cue to redirect difficult child attention--visual schedule/visual checklist--have difficult child use a checklist/chart to monitor task completion--

    Did the school system do any Pervasive Developmental Disorder (PDD)/Autims rating scales or only the BASC and Connors scales?

    Related services to include: Occupational Therapist (OT), speech, social skills, counselor/therapy; and any other related services the school system provided: small group instruction and/or 1:1 instruction

    I would recommend specific research based interventions for decoding such as Wilson Fundamental, Horizons, Orton Gillingham...

    Brain gym exercises throughout day//allow for scheduled and unscheduled breaks--redirect/distract/antiseptic bounce/hurdle help/

    Strategy based instruction...

    Hands on learning--short guided groups--rotations through a vareity of centers --use of manipulatives/games to reinforce and teach math concepts -- use of computer programs LEXIA is a great prorgram for reading -- use of wipe board, magnetic letters, to teach/reinforce reading and writing--greatly minimize the use of paper pencil tasks--listenging center to hear books; PAIR-IT BOOKS on the computer: making puppets--using puppets to help to retell/summarize stories...

    BIP intervention plan that allows for frequent rewards and motor breaks; system in place for handling explosive behaviors

    Teach difficult child anger management strategies: goals for learning anger managments strategies; goals for utilizing strategies; helping difficult child to recognize that he is feeling overwhelmed frustrated: make safety a priority to have teacher be aware of triggers to avoid the meltdown

    Lots of babble, but I hope these ideas are helpful--
  11. JJJ

    JJJ Active Member

    Shari -- I would think his IEP would have the following:

    1. Placement in a small self-contained classroom (aim for 10 or fewer kids, preferably closer to 5)

    2. Occupational Therapist (OT) - both direct and consult; along with Occupational Therapist (OT) stations set up in the room for sensory breaks

    3. Speech-Language services

    4. Social work services

    It does sound like an Autism Spectrum Disorder and if your school has an Autism team, hopefully they will get involved.

    The best part of the evaluation is a normal IQ!!

    My older son was "clinically significant" on the BASC almost across the board when he was 6. When he was retested at 9 (after 3 years of services) he did not have any areas that were still clinically significant. Starting so young, you should see great progress over the next 3 years.
  12. Shari

    Shari IsItFridayYet?

    With regards to the Autism Spectrum Disorders (ASD) thing...I saw the show on Discovery about the 6 kids in one family.
    Until then, I had resigned to this not being a case of a spectrum disorder. So I was happily sitting at home one night, 5 or 6 months after the last wasted neuropsyche evaluation that said he's "just ADD", and my phone rang, and a friend was frantically on the other end saying "your difficult child is on Discovery! This kid is just like him!" So I watched. And it is. I see it all the time...kids who are little carbon copies of my difficult child, diagnosis'ed with some Autism Spectrum Disorders (ASD). Yet mine is not. And I'm not sure why.
    The boy on the show was in 1st or 2nd grade and I beleive they called him Aspergers. I don't know, its just very frustrating to have this continually surface, and not just with you guys, with other professionals, as well.
    He is also obsessed with guns and we don't watch violent stuff with him and haven't. He's infatuated by his brother, who's in the military, but he really has no concept of what it is. But the only imagination he had/has is guns. He doesn't watch Star Wars, can't watch anything "scarey" (101 Dalmations is too scarey), but gun guns guns! Its crazy.
  13. KTMom91

    KTMom91 Well-Known Member

    Shari, I have no first hand experience, but wanted to add my support.
  14. totoro

    totoro Mom? What's a GFG?

    As I am reading this I was thinking, although he has sounded in some ways like K in the past, he really does sound more like he is on the Autism Spectrum.
    Now as I have said before, I believe that Mental Illness is a Spectrum also.
    People who have Mental Illness vary greatly in their severity/functioning just like people who have Autism.

    But reading this, he really sounds so much different that K, all of her testing results have resulted in everyone stating that she is classic BiPolar (BP).
    Who knows?
    I believe that a lot of the symptoms overlap for most of the disorders as well, especially with a lot of the sensory things.
    But it seems like there is much more going on.
    Whether it is a Mood Disorder and Autism, or no Mood Disorder. He needs a lot more in School!

    You are doing a great job and are now armed with some great info to get him more help.
  15. SRL

    SRL Active Member

    Because of how your difficult child presents, it's probably not going to be a productive IEP meeting if you focus on diagnosis. Focus on services based on results of the testing. I'm also all for borrowing from whatever camps that might be helpful so for instance even if he doesn't have an Autism Spectrum Disorders (ASD) diagnosis, social skills sessions geared towards Autism Spectrum Disorders (ASD) kids might be helpful.

    I agree witih JJJ on the services, but I would also push for outside consultation if they are all sitting around talking about him like they've never seen a kid like him before. If they don't know what to do to make sure that he is successful in some educational environment then it's *their* job to make it happen whether that means bringing someone in to consult, train staff, or send him out to another school setting. When nothing else was working my district forked out big bucks to bring in a consultant at their suggestion and it was helpful. That's their job.

    Were you ever able to talk the doctor into doing Fragile X testing? This--or something similar--could potentially explain Autism Spectrum Disorders (ASD) like traits but not a clear presentation.
  16. Shari

    Shari IsItFridayYet?

    Thank you all for the input. I do plan to leave diagnosis out of the IEP meeting, but I may push the issue outside of school again. I don't think we have a clue what we're dealing with in him. Not one iota. One thing EVERYONE who spends any time with him at all agrees on is that ADHD doesn't explain anything.

    We are "in the queue" to go to Mayo, and also I am working on scheduling with a DevPed in another state to look at this with fresh eyes. No one here would do the fragile X test, but I'm hoping a new set of eyes will look into things like that.

    And thanks for the reminder that the school has to figure this out. They have repeatedly said (particularly the principal) that they don't know what to do with him (yet he continues to make knee-jerk decisions on his placement). That's a reminder I may need to post on stickies all over my area for a while..."I don't know" doesn't cut it.
  17. ML

    ML Guest

    It does sound like you're getting closer to getting some answers.

    By the way how are you holding up healthwise?

    Hugs, ML
  18. Shari

    Shari IsItFridayYet?

    Pretty good, actually. We went camping a couple weeks ago and I really overdid it (just out enjoying the days - not working!) I've been paying since, the fever came back and the sore throat and all that good jazz...but not as bad and I'm recouping quicker! Thanks for asking!

    Oh, and PS, I got my latest labs back and they think the RA diagnosis was wrong! Happy day!! With diet, the inflammation and all that jazz is way, way down, and the ANA or whatever that marker was is not there this time. And my proinsulin level is down to 19 from 71, which is still high, but the blood draw was done when I was still pretty much living in my recliner eating things from scratched open boxes...so hopefully as I feel better from the mono and cook and eat better, even that will come down more. Hopefully.
    Last edited: Mar 25, 2009
  19. SRL

    SRL Active Member

    He should be tested for Auditory Processing Disorder and Language Processing Disorder--both by liscenced professionals that the district typically wouldn't have on staff. If he can't repeat back a short sequence, then there may be auditory memory issues happening. There are a lot of aspects to each of these issues and they can cause big time problems for kids in classroom settings when undiagnosed.
  20. Shari

    Shari IsItFridayYet?

    Thanks, SRL. I'll request it.

    It looks like we have an appointment with another devped in May!