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post #81 of 97
Welcome. Thanks for posting the update.

One thing I wish somebody would do. Get a sample of "normal" future engineer/computergeek/scientists and test them on all this stuff at age four. Would we find it is actually normal for kids at the 99.9% in visual/spatial to be low on receptive language? Not to say that might not be frustrating to a kid, but still it might be within the range of normal, well at least for geeks.

Even if auditory processing disorders don't sound like a total fit, it might be helpful to try out some of the strategies that work for this group. On a sort of related note, it may be good to try using more visual reminders, charts, etc.
post #82 of 97
Welcome. Thanks for posting the update.

One thing I wish somebody would do. Get a sample of "normal" future engineer/computergeek/scientists and test them on all this stuff at age four. Would we find it is actually normal for kids at the 99.9% in visual/spatial to be low on receptive language? Not to say that might not be frustrating to a kid, but still it might be within the range of normal, well at least for geeks.

Even if auditory processing disorders don't sound like a total fit, it might be helpful to try out some of the strategies that work for this group. On a sort of related note, it may be good to try using more visual reminders, charts, etc.
post #83 of 97
Thread Starter 
Quote:
Originally Posted by joensally View Post

 

Will you now go to the "gifted" section for further eval?  What will this mean for kindie?



 

I think I am going to hold out on pursuing gifted testing for now. We know now that at the moment, he appears to be at least MG, possibly HG+ in the visual-spatial field which is helpful to me to have confirmed, though I wasn't surprised. And if we ever need to in the near future, we can refer to those scores. We can also assume that he is a very dominant right-brain thinker, which is also helpful to me to know.

For our day-to-day challenges with self-regulation, I'll see how helpful the OT and this developmental counseling is. I was a bit shocked to hear that the profile his preschool teachers filled in showed these strong anxious, depressed and avoidant tendencies, I thought he was doing better. But to me, high sensitivity is established as well, not sure gifted testing or consultation would now turn up stuff I am not already aware of. Implementing helpful strategies would be another kettle of fish, if the OT isn’t helpful I may look into therapy. Possibly for me too!

NO, right now I badly want to find out more about the low verbal scores, particularly as they don't fit at all with his extreme verbal precociousness. I would have expected high verbal scores because of that, but I have now been collecting further evidence in my mind about this. To wit: auditory overresponsivity, high stress in noisy places with meltdowns or explosions after, meltdowns at "sad songs", not wanting to explore more chapter books, problems with social cues, frequently asking "what" with answering correctly after delay, subvocalization, some scripting, not reacting to being given directions in tones of increasing loudness and annoyance, then having a meltdown if someone starts yelling, sometimes telling me "I don't understand you!" after being told off for something, or yelling "don't say anything about me anymore!" in that situation. And sometimes, weirdly, jut not "getting it". It's hard to explain.

So beyond his being a very visual spatial thinker, there are three likely explanations and I am afraid they might even all play a part in combination:

auditory processing disorder as part of SPD (or part of his very mild spectrumy tendencies; I understand there are theories it might be the same thing)   ) ; I understa  which I think is extremely likely but am not sure whether he might be too young to test for,

pragmatic language impairment which might be just another way for his mild spectrumy tendencies to show up,

and mild left hemispheric cerebral palsy as a leftover greeting from prematurity and the NICU.

I have read that apart from affecting language skills, left hemispheric damage can lead to problems with boundaries, body awareness and autistic-looking avoidant behaviour. He used to show gross motor neglect on the right hand side but appeared to have outgrown it after torticollis treatment. PT testing recently was inconclusive (a little right side weaknesss, a little left side weakness, overall low coordination). Very rarely, he still drags his right leg but can correct it when told. I noticed he was dragging it when he came back from the testing! This is the one that is most scary to me as it would involve a brain scan and is the one which I think is least amenable to intervention, as it is simply damage to be compensated for, less about growing pathways to be developed and nudged in the right direction. I am not sure however how that fits with his adult-sounding language – compensation? No clue. I will need to mull this over a bit, maybe set my father to it who is a retired neurologist, but does not do developmental neurology at all.  

 

Kindie will be a pullout program in preschool, formal schooling starts in first grade only. His birthday falls into the “grace period” after the September cutoff, so he could in theory start kindie this fall if his preschool teachers are agreeable (and we still want to enter him early). At this point, while we are still sorting it all out and the memories of his behavioral difficulties this winter are still fresh, I do not want to raise the question, so they do not have to formulate a “no” they’d have to back away from, KWIM? He does not have to apply for anything, he could just start taking part come September as soon as OT and maturity and maybe language therapy have helped him develop better compensation skills. And taking part is not a prerequisite for first grade, so we have time to make up our minds. One part of the program is a phonemic awareness training which I do want him to take part in if at all possible, even though to me this seems the one area he does not appear deficient in!

 

It seems more and more likely to me though that he might do best in the Montessori school, maybe entered early with the understanding that he could just do five years in lower el as opposed to four (local speciality due to tracking starting in 5th).

 

 

post #84 of 97
Thread Starter 
Quote:
Originally Posted by Roar View Post

One thing I wish somebody would do. Get a sample of "normal" future engineer/computergeek/scientists and test them on all this stuff at age four. Would we find it is actually normal for kids at the 99.9% in visual/spatial to be low on receptive language? Not to say that might not be frustrating to a kid, but still it might be within the range of normal, well at least for geeks.

Yeah, I'd love to have known DH as a child! He looks very typical now (and is a very succesful teacher and chairman of a volunteer society with some public exposure), but he does have some weird social "abruptness" and definitely had some spectrumy-looking tendencies as a child. His sister is special needs (not a functional adult though superficially normal if "slow" and immature-seeming) with epilepsy. And don't get me started about the anxiety and depression and high expressed-emotion in our family!

post #85 of 97
You have probably already gotten this bit of advice and may already be doing it but just in case you aren't...
Not necessarily this minute but over the next couple of years I would look for some kind of physical activity he enjoys that involves coordination of both sides of the body and some use of patterned movements. Some examples: swimming, martial arts, dance, horseback riding. We got this advice a lot and it kind of got on my nerves - gee my kid is struggle and the best suggestion you've got is karate? But, really the patterned movements of these activities can be incredibly helpful in improving some of those neural pathways and in connecting mind and body. Also, even for kids who tend to be generally "in their head" and not very physical really benefit from these activities. Especially good are activities that focus more on individual development tthan competition. That way the kids are always progressing and area aware of their progress without getting caught into too many comparisons in the way they might on a soccer team or whatever. Also, some musical activity can be good for auditory integration too.
post #86 of 97
Quote:
Originally Posted by Tigerle View Post

And now for the really weird part: he scored at the 30th percentile for expressive language and the 7th percentile for receptive.

The psych said not to read too much into the latter as he may have been put off by the format (acting out storylines with dolls) but still – for a kid that has been talking in full sentences including correct pronouns, modi and tenses since before he was two, I think it’s super weird. And it ties in with stuff I’ve noticed – he keeps saying “what”, he repeats everything sotto voce to himself, he knows whole passages from his favourite videos by heart but you can tell he doesn’t fully understand them. There must be something else going on, but it beats me what. Same for the expressive. I remember he refused to explain what it meant to say “I am hungry” or I am tired” at his 4yo well child visit. In this developmental test he couldn’t or wouldn’t define mailman, for instance. WTF? We’ve talked about mailmen. I don’t get it. For the receptive, I need to look into auditory processing disorder now, but it doesn’t explain expressive to me.

 

 

 

Did anyone talk to you about Mixed Expressive Language Disorder or Specific Language Disorder?

 

DS1 hit all of his speech and communication  milestones, but has MERLD.  On a WISC, he hit the ceiling on the matrices and his performance IQ score was in the highly gifted range. His verbal score was in the average range. When he had a speech assessment, his scores were somewhat below age level, but only enough to be catergorized as mild to moderately delayed. The speech therapist also tested for auditory processing disorder, and it wasn't there.

 

 When they said "language disorder," I couldn't believe it. This is a kid who taught himself to read after learning a little phonics from Between the Lions. He hit all of his developmental milestones. How could he possibly have a language disorder.

 

Our psychologist advised us to get treatment, because while his scores were only mildly lagging compared to his peers, they were more than two standard deviations below his performance IQ.

 

We did 18 months of speech therapy and are taking a break now. Speech therapy  helped tremendously.  They worked on social communication skills, in addition to working on expressive and receptive language skills.

 

 

post #87 of 97

 

Quote:
Originally Posted by Tigerle View Post

To wit: auditory overresponsivity, high stress in noisy places with meltdowns or explosions after, meltdowns at "sad songs", not wanting to explore more chapter books, problems with social cues, frequently asking "what" with answering correctly after delay, subvocalization, some scripting, not reacting to being given directions in tones of increasing loudness and annoyance, then having a meltdown if someone starts yelling, sometimes telling me "I don't understand you!" after being told off for something, or yelling "don't say anything about me anymore!" in that situation. And sometimes, weirdly, jut not "getting it". It's hard to explain. 


I've been staying out of this thread, mostly because I feel like I don't know enough to be helpful.  But I couldn't read this list of things, especially with that "It's hard to explain" at the end and not respond.  My DD has (or had at 4) every single one of these behaviors.  This stuff is part of the reason we recently decided to get an eval at our local (but nationally-prominent) gifted clinic.  And I really don't want to be that annoying person who says, "Oh, that's all normal" when clearly I haven't met your kid and you certainly know better than I do, so please don't take that in that way.  But what they said was that DD seemed like a "normal gifted kid," definitely not on the spectrum, but with some overexcitabilities.  Now, granted, they don't see DD at her worst, but I was honest and descriptive, and I'm sure that some of it came out in their interview with DD as well.  For example, when asked what makes her sad, DD responded, "My mom singing," and then sang a bar of "Clementine."  Still, they said she was normal.  I don't know if she'd have seemed so normal if they weren't so familiar with gifted and highly gifted kids, though.  Anyway, good luck with everything and I'm glad you've gotten some of it somewhat figured out. 

post #88 of 97
Thread Starter 
Quote:
Originally Posted by Roar View Post

You have probably already gotten this bit of advice and may already be doing it but just in case you aren't...
Not necessarily this minute but over the next couple of years I would look for some kind of physical activity he enjoys that involves coordination of both sides of the body and some use of patterned movements. Some examples: swimming, martial arts, dance, horseback riding. We got this advice a lot and it kind of got on my nerves - gee my kid is struggle and the best suggestion you've got is karate? But, really the patterned movements of these activities can be incredibly helpful in improving some of those neural pathways and in connecting mind and body. Also, even for kids who tend to be generally "in their head" and not very physical really benefit from these activities. Especially good are activities that focus more on individual development tthan competition. That way the kids are always progressing and area aware of their progress without getting caught into too many comparisons in the way they might on a soccer team or whatever. Also, some musical activity can be good for auditory integration too.

He was supposed to start swim class three times this winter, and each time I had to beg out due to some minor health problems. Twice, he had a cold, and this time it's an inftected thumbnail from chewing and picking and he is actually on antibiotics now because it got worse and worse.
I hope we may be able to start in late spring or summer. Martial arts are also on my list but I think he's too young.

He's in music school, which involves a lot of dancing, clapping etc and likes it. But the program will be over this summer. He keeps saying he wants to play the violin, like me, but we have held out from adding yet anything else to his plate. We will now have weekly OT appointments and maybe language appointments...
 

 

post #89 of 97
Thread Starter 



 

Quote:
Originally Posted by RiverTam View Post



 

 

Did anyone talk to you about Mixed Expressive Language Disorder or Specific Language Disorder?

 


Speech and language was not part of the eval. It is certainly not something anyone would ever have considered before this. Like I said, they did not seem to view this huge score discrepancy as worrisome as I did. I am waiting now to get our stuff in writing and then find out more about speech and language evals.
 

post #90 of 97
Thread Starter 



 

Quote:
Originally Posted by no5no5 View Post

 



I've been staying out of this thread, mostly because I feel like I don't know enough to be helpful.  But I couldn't read this list of things, especially with that "It's hard to explain" at the end and not respond.  My DD has (or had at 4) every single one of these behaviors.  This stuff is part of the reason we recently decided to get an eval at our local (but nationally-prominent) gifted clinic.  And I really don't want to be that annoying person who says, "Oh, that's all normal" when clearly I haven't met your kid and you certainly know better than I do, so please don't take that in that way.  But what they said was that DD seemed like a "normal gifted kid," definitely not on the spectrum, but with some overexcitabilities.  Now, granted, they don't see DD at her worst, but I was honest and descriptive, and I'm sure that some of it came out in their interview with DD as well.  For example, when asked what makes her sad, DD responded, "My mom singing," and then sang a bar of "Clementine."  Still, they said she was normal.  I don't know if she'd have seemed so normal if they weren't so familiar with gifted and highly gifted kids, though.  Anyway, good luck with everything and I'm glad you've gotten some of it somewhat figured out. 



Yeah, what is "gifted normal"? or more specifically "visual-spatial gifted normal"? I am sure that at some point during the next academic year we will pursue an eval by the "gifted" people at our university hospital. It's hard to set priorities now. Particularly as I've just been diagnosed with scarlet fever and feel a wet mess...

post #91 of 97
Quote:
Originally Posted by Tigerle View Post


Yeah, what is "gifted normal"? or more specifically "visual-spatial gifted normal"? I am sure that at some point during the next academic year we will pursue an eval by the "gifted" people at our university hospital. It's hard to set priorities now. Particularly as I've just been diagnosed with scarlet fever and feel a wet mess...


Ugh!  I hope you feel better soon. 

post #92 of 97
Quote:
Originally Posted by Tigerle View Post



 



Yeah, what is "gifted normal"? or more specifically "visual-spatial gifted normal"? I am sure that at some point during the next academic year we will pursue an eval by the "gifted" people at our university hospital. It's hard to set priorities now. Particularly as I've just been diagnosed with scarlet fever and feel a wet mess...

 

I don't think it's uncommon for kids with a very strong visual-spatial gift to be delayed in speech.  At the same time, we found that the delay caused some problems and that speech therapy was really helpful.

 

 

The upside on any LD is that outcomes are often better in gifted kids than they would be otherwise. 

 

 

post #93 of 97

Tigerle, would you have any access to horse back riding?  There's good research to back up its efficacy, and we've had great success with hippotherapy (horseback riding with an OT), as well as regular horseback riding.  It's expensive, but we've found it very helpful and less expensive than other therapies.  We've also seen great improvement through non-competitive gymnastics.  Rythmic, patterned movement that crosses the midline does re-wire the brain.

 

Your DS is too young for auditory processing disorder testing (I think 7 is the earliest), but I think it sounds like a great idea to explore the language/speech stuff. 

 

Our sons aren't the same, but I'll share my experience.  DS tested 99.7 percentile VS at 5, but was >99.999... VCI at 8 and lower on the PRI (the two tests úsed employ different types of subtests, so it's hard to strictly compare).  But it kind of looks like he switched his "highs" - although I think it's just point of development at time of testing.  This stuff is complicated and kids change over time.  My DS is clearly very divergent/VS, but his vision and sensory issues came into play in later testing.  APD was strongly suspected but we've ruled it out.  There is clearly some auditory stuff going on but we've never been able to nail it down and it's not the most complicating factor in his life so we leave it.  My point is that at this time you don't have definitives, but you have clues.  The clues will direct you to further exploration, some good ideas and some false starts.

 

I hope you're ok and that you have a quick recovery.

post #94 of 97

I've skimmed bits and pieces of this thread, so I apologize if this is off-topic/irrelevant or redundant...

 

my son (just turned 5) is in some ways similar to your son--though, he has significantly higher verbal scores (99.9th percentile) and relatively lower spatial scores (80th-90th percentile). We think the spatial scores are an underestimate though, because he is actually mind-bogglingly spatially intelligent.

 

but, we've dragged him to a developmental pediatrician, an occupational therapist, and a psychologist--looking at ASD, SPD and anxiety disorder. they all said, "he's perfectly delightful and very intelligent and a little quirky, but he's totally normal."

 

we pulled him out of his Montessori school, and put him in a regular old daycare center.

 

last month, he failed his hearing screening at his well-child visit. today, I took him to the audiologist for follow up. his hearing is perfect, but, at my request, she did a brief screener for CAPD.She had to stop because as soon as the 40db white noise was in his right ear, he tore the headphones off, and climbed under the chair. A full CAPD test can't be done until a child is closer to 7.

 

so, she gave him a tentative diagnosis of SPD from auditory defensiveness--which, as I have read both tonight and in prior research--presents for a lot of kids as anxiety, and for others as ASD-like behavior. he's got them both.

 

so, just one more thing to think about if the other diagnoses don't really fit.

post #95 of 97
Sorry for thread crashing but I just wanted to thank spedteacher for sharing. I found your post really helpful.
post #96 of 97
Thread Starter 

Thank you for your good wishes! The last two days were hell but the antibiotics are kicking in now. Rarely have I been so grateful for medical science. To think that people had to go through this without antibiotics or ibuprofen only 60 years ago...

My mother who has come to help out insists that we have too many activities on our plates (meaning she wants DH to scale back his hobbies and volunteering) but I told her that our immune systems would be much better if only our kids would let us sleep! After DD demanded to be brought to me to nurse 5 times between 7pm and 4am, she changed her tune. Now she thinks I ought to wean, and that DS needs to sleep in his own room. I said I'd love to have him anywhere just sleeping through the night! My kids are truly draining me. I can't believe I once used to have a very competitive job. I don't think I could be a part-time secretary at the moment. I think this will have to be a different thread though, not quite sure where to put it - I can't believe all kids are this needy for love, attention and reassurance...

 

Gymnastics and horseback riding are duly noted. He'd love the latter, actually. Have to find out what there's around. 

 

Spedteacher, that was really very helpful. So we can just conjecture on this for a while.

 

The thing that I can still not quite wrap my head around is that his language skills, on the surface, are stellar. He sounds like a much older kid, very precise, with big vocabulary (which was one the the reasons I am sure prompted the psych to do the ASD eval.) And he spoke well very early, before he was two, said his first words at 12 months or so and then just raced through verbal development - no Einstein syndrome here. I am not quite sure what this might be masking, if it is masking anything at all.

post #97 of 97

If I were you I wouldn't worry too much about the low language scores at this time, but I would pursue a full language assessment (including receptive, expressive, and pragmatic language) by a Speech-Language Pathologist. That will help you to know whether the previous results were accurate or not, and get a better understanding if there are any areas of difficulty.

 

My eldest DS (age 6) recently had a ton of testing done including IQ testing (WISC) and the ADI-R. We don't have the full report yet, but his verbal scores on the WISC also came out lower than expected (average range, but more than 2 standard deviations below his perceptual reasoning). He also spoke relatively early (first words around 9 months, by 18 months he had hundreds and hundreds of words and used many short sentences, by 2 used fairly long sentences, and at 3 when assessed for stuttering the speech pathologist commented on his complex and advanced language), so initially it seemed surprising that his verbal scores were relatively low. However, he does seem to take things fairly literally and has some difficulty understanding social situations, and he has in the past 2 years started saying "what?" (but does answer correctly after a delay) and "I don't get it" more frequently. We just had Central Auditry Processing testing done (they will do it at 6 here), and his scores were all within the "normal" range, although auditory ground-figure was at the very low end of that range. I suspect that testing conditions impacted his scores on the WISC verbal testing somewhat (administered by someone whose first language is not english, on a day when DS was tired). His scores on the oral expression subtest for achievement testing (WIAT) were in the "superior" range (tested by a different person on a different day), but I think that test does not entail as much open-ended question/answer, and he still scored within the average range on vocabulary on that test. Regardless, we will have a full language assessment done to ensure there are no receptive or expressive difficulties at this time, and to assess his pragmatic language skills.

 

Sometimes I feel like any sort of testing results in more questions than answers...

 

Hope you continue to recover, and things get easier for you soon!

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