Yesterday was a Student Support Meeting for Liam. It was ill fated from the beginning.....the purpose of the meeting was not entirely clear to me, Dave is out of town, I was awake with insomnia from 1:30am, and on top of all of that, I am sick with what I can only assume is deadly pneumonia (I joke, but it feels that way).
In the room were: Liam's teacher, the school counselor, the school psychologist, the school SLP, the vice-principal, and the principal.
--First import point, I need to insist the AIG teacher attends all future meetings as she knows Liam really well....probably the best out of those that did attend the meetings.
We addressed Liam's anxiety in the classroom. The school counselor has made him a social story book with photos of him, and suggested relaxation techniques (deep breathing, counting to 10). Now when he starts to get anxious, the teacher directs him to the book. She said she is more responsive and has learned to direct him to the book before he starts crying. She reports it is working well and he seems to have more confidence.
--Point for the school: they are writing social stories for him without an IEP and doing some things I'd want written into an IEP, like he takes the book to a quiet corner of the classroom and gets time to decompress and gets a sensory break.
I was asked what I am doing at home to help him manage anxiety and ensure a healthy brain-body connection. I mentioned he does gymnastics and it was suggested that I look into kids yoga or karate for him.
--Do they really think I am not doing enough for my child? I am not sure when we would fit in another activity. I started to feel defensive around this point.
We talked about his reading fluency and this kind of took me by surprise as I had not been told it was an issue though I had some suspicions. His reading evaluation show he is ABOVE grade level in reading. His fluency score are BELOW grade level despite this. Then of course, the fluency was averaged in to the total score which brings it down (but still above grade level). Because of this, they are "working on fluency by having him read below his tested ability." They talked to me about having him use a ruler when he reads at home and said this is a maturity thing that he should outgrow around age 7. I am not sure I believe that.
--I need to figure out who to see to test either his reading or his visual tracking or both.
--I am unsure about this idea that it isn't a big deal especially since it means he is not performing up to his abilities.
Then we discussed Liam's writing, and this was when things really went downhill and I started to feel very frustrated. According to his teacher, writing is not an issue at school. The fact that crying ONLY happens during periods of writing is a coincidence and all chalked up to his anxiety. She claims his writing is "middle of the pack" at school but acknowledges that her class this year does not have many middle students, almost all above grade level or below grade level. In addition, she acknowledges that he does not form his letters correctly (starts in the wrong place and the result is awkward). I asked for him to have accommodations and the only one completely agreed upon is using the paper from Handwriting Without Tears.
Once again, all the focus was on what *I* can do to help him. They did agree to keyboarding his homework but declined allowing me to scribe it for him. At school they would like him to write. They asked how much I make him write and whether I offer a variety of writing tools (i.e. colored pencils and not just crayons, etc). They ask whether I do "OT homework" with him and how often I make him write. He gets on the bus at 6:50am and gets off at 3:15pm. On Mondays, I pick him up at school and we spend 2 hours doing speech and OT with him and Ben after which we immediately do dinner and bed. Tuesdays we do homework when he gets home, then eat an early dinner, then take Ben to ballet, and then it is bed. Wednesdays we go right to gymnastics then do homework then cook dinner then bed. Thursdays and Fridays he is free after he gets home (other than homework on Thursdays). Somehow I am supposed to fit in karate and making him write an activity he hates. When does he get to be 6? Why do *I* need to remediate his writing? Is that not a function of school?
Then the SLP asked about his speech. She cannot work with him on the R sounds but it sounds like she has been watching him and would be willing to advocate for him, if needed.
Then they asked whether I was requesting testing and while they said it was in my right to do so, they did not see how they could prove academic need based on the fact he is at or above grade level. By this point, I was just weary, and Liam kept interrupting the meeting and I just wanted it over. The school psychologist asked if I really wanted him pulled out for special education when he is already being pulled out 3 times a week for AIG. I want him to have an individualized education, which obviously includes 3x a week AIG pull out. If he needs reading pull-out or special education pull out to meet his needs, then that is what I want. I am pretty sure, actually positive, he can have an IEP with all his needs met in the classroom and if that is possible, then that is what I want.
--I need to research NC law especially regarding initial eligibility as he no longer has an IEP and needs testing done to be eligible.
--I need to figure out if there is advocacy and if someone can attend meetings with me.
Showing posts with label anxiety disorder. Show all posts
Showing posts with label anxiety disorder. Show all posts
Wednesday, October 30, 2013
Sunday, May 12, 2013
The battle with strep continues
On Monday and Tuesday morning, I noticed blood in Liam's nighttime diaper. This reminded me of March 2011. I had a Wednesday afternoon doctor's appointment scheduled for him when Ben's school called on Wednesday morning that Ben had thrown up. Due to Ben's social language delay, they found a pile of puke and had no clue who did it until they found Ben with some on his shirt and crocs. A strep test confirmed that BOTH boys have strep.
AGAIN.
What is interesting about this is that Ben had been in underwear for 2 plus weeks and about 5 days before the positive test began peeing in his underwear and went back into diapers.
Let me remind you of the criteria of PANDAS:
Symptom onset includes Primary ONSET of OCD* and/or Tics
along with at least two other following symptoms:
AGAIN.
What is interesting about this is that Ben had been in underwear for 2 plus weeks and about 5 days before the positive test began peeing in his underwear and went back into diapers.
Let me remind you of the criteria of PANDAS:
Symptom onset includes Primary ONSET of OCD* and/or Tics
along with at least two other following symptoms:
- Tics or other abnormal movements
- Severe separation anxiety, Generalized anxiety
- Irritability, Emotional lability, Aggression, Personality Changes
- ADHD, Inability to concentrate
- Sensory sensitivities
- Deterioration in learning abilities and school performance
- Developmental and age regression (inc. Deterioration in handwriting)
- Sleep and night time difficulties
- Urinary Frequency or Daytime or night-time secondary enuresis
*OCD may present as severe anxiety
Ben has been waking up early, and repeating everything he says.
Liam's hyperactivity, aggression toward family members, and anxiety is over the top.
I hope we figure this out soon as I am tired.
Friday, April 27, 2012
Neuropsychological report: lots of numbers & his teacher's perspective on it
I got Liam's report yesterday, and am still emotionally processing everything, so this post is basically just a summary of what the report says. I will do a separate post on my reactions when I figure out how exactly I feel about it.
Liam was given two measures of intelligence: Weschler Preschool and Primary Scale of Intelligence (WPPSI-III) and Kaufman Brief Intelligence Test. To understand the scores of his WPPSI results, see this page: http://www.hoagiesgifted.org/highly_profoundly.htm
The highest he could have gotten on either subtest was a 155 and the highest overall he could have gotten was a 160.
Verbal IQ 129
Performance IQ 150
Full Scale IQ 144
His verbal IQ would have been quite a bit higher, but his score on one subtest was lower than the other area. The highest a scaled score can be on any subtest is 19. All of his performance subscales were 18.
His results on the Kaufman were also 144, which places him in the 99.8% on both IQ tests. His non-verbal score on the Kaufman was a 160.
To test academic functioning, Liam was given the Woodcock Johnson Test of Achievment, 3rd edition. Like IQ tests, the average score is 100. His scores varied between a 123 and 188, with most of his scores being in the 140 range. Grade equivalents were given and Liam's academic functioning is that of a child near the end of 1st grade. His basic reading skills were 154 (higher than the 99.9%) and his math reasoning was a 145 (at the 99.9% level). His lowest scoring area was spelling with a 123 and his highest was writing samples with a 188.
His motor skills were assessed with the Beery VMI and his motor coordination was in the 5th percentile. His score was a 76, which is just about the cut off for receiving OT services, but compared to his knowledge, this is a huge weakness for him.
His speech was tested with the following measures: Expressive Vocabulary Test (EVT-II), Peabody Picture Vocabulary Test (PPVT-IV), and NEPSY Developmental Neuropsychological Assessment--Second Edition. All language testing showed him to score above average.
Summary and Impressions: "Liam's overall intellectual abilities are clearly in the highly gifted range and his nonverbal reasoning skills are in the very superior range, falling a full four standard deviations above average performance." That is a direct quote from the report, and I will note here that scores only have to be 2 standard deviations above average to qualify as gifted and Liam's nonverbal reasoning is 4 standard deviations above. She notes that while his intelligence is a strength, it places him at increased risk for social maladjustment. His language scores ranged from average to superior, showing some pockets of weakness. His scores of social perception were average which is "well below expectations given his general intellectual abilities." That is again a direct quote. During the parent conference, she talked about Liam not being on the autism spectrum, but I am guessing she kept the diagnosis given this.
She talks about his only overt weakness was on paper and pencil tasks of graphomotor precision, and this was despite the fact that he has been doing OT since 24 months of age. She notes that findings show a "relative weakness" in language related to pragmatic language and conversation, as well as social functioning. "Overall, Liam continues to show patterns of difficulty involving pragmatic language, mildly restricted interest levels, sensrimotor concerns, and difficulty with social integration characteristic of individuals with pervasive developmental disorder."
The diagnoses she gave are:
Axis I:
299.80 Pervasive Developmental Disorder, Not Otherwise Specified
311.00 Anxiety Disorder Not Otherwise Specified
315.4 Developmental Motor Coordination Disorder
Recomendations: She recommends continued "intensive occupational and speech therapy interventions." She talks about increased fine motor demands in kindergarden and says that it is extremely important that OT not be interrupted and be provided in both the school setting as well as in private therapy. She cites Liam's problems with pragmatic language as the likely reason for his social delays. She notes that his extreme intelligence is a risk for additional social difficulties. She recommends ongoing speech therapy and social skills groups to address these needs. She notes that "Liam does show indications of significant underlying anxiety." She says the move this summer will likely make his anxiety worse and recommends formal counseling to address this. She ends by saying that it is extremely important that Liam is in an educational setting that addresses his very superior intellectual and academic skills, and recommends placement in a self-contained program for the highly gifted.
____________________________________
Below is the reponse from Liam's special education teacher about the report, as well as her suggestions for modifications to his IEP. She has known Liam for 2 years and is such an asset and a wonderful advocate for Liam. She is one of the many reasons I will be sad to leave Alaska.
"Wow...I just finished reading Liam's report and did not find any real surprises. His intelligence is really up there isn't it :-) I've always known that but it's good to have it on paper for your move :-) With the interspersed delays and high intelligence it's easy to see why there are emotional/anxiety issues. He's going to be (and probably already has been) a difficult boy to raise. But you two have done everything right! The trick will be to keep that going in Alabama :-) I was glad to see that my scores were mostly in agreement with yours (although I don't get to see the real meltdowns and adaptive delays). It's good to know how well he's able to hold it together here (although then you get the brunt of it!)
Thanks for sharing the report with me. I'm glad to know that we've always been on the same page! If there is anything else I can do for you all before you move, please let me know. I'm thinking of giving him support in kindergarten throughout the entire day, at least to start. Then the hours may be able to be reduced (once he gets used to the new, full-day setting). What do you think? If we don't give him 32.5 hours of special education, we could still give him some plus make sure before/after school, recess, and lunch are covered for awhile. And I will be putting in that he'll need a quiet place to go when needed and possibly an individual work station for times needed. What do you think?"
Liam was given two measures of intelligence: Weschler Preschool and Primary Scale of Intelligence (WPPSI-III) and Kaufman Brief Intelligence Test. To understand the scores of his WPPSI results, see this page: http://www.hoagiesgifted.org/highly_profoundly.htm
The highest he could have gotten on either subtest was a 155 and the highest overall he could have gotten was a 160.
Verbal IQ 129
Performance IQ 150
Full Scale IQ 144
His verbal IQ would have been quite a bit higher, but his score on one subtest was lower than the other area. The highest a scaled score can be on any subtest is 19. All of his performance subscales were 18.
His results on the Kaufman were also 144, which places him in the 99.8% on both IQ tests. His non-verbal score on the Kaufman was a 160.
To test academic functioning, Liam was given the Woodcock Johnson Test of Achievment, 3rd edition. Like IQ tests, the average score is 100. His scores varied between a 123 and 188, with most of his scores being in the 140 range. Grade equivalents were given and Liam's academic functioning is that of a child near the end of 1st grade. His basic reading skills were 154 (higher than the 99.9%) and his math reasoning was a 145 (at the 99.9% level). His lowest scoring area was spelling with a 123 and his highest was writing samples with a 188.
His motor skills were assessed with the Beery VMI and his motor coordination was in the 5th percentile. His score was a 76, which is just about the cut off for receiving OT services, but compared to his knowledge, this is a huge weakness for him.
His speech was tested with the following measures: Expressive Vocabulary Test (EVT-II), Peabody Picture Vocabulary Test (PPVT-IV), and NEPSY Developmental Neuropsychological Assessment--Second Edition. All language testing showed him to score above average.
Summary and Impressions: "Liam's overall intellectual abilities are clearly in the highly gifted range and his nonverbal reasoning skills are in the very superior range, falling a full four standard deviations above average performance." That is a direct quote from the report, and I will note here that scores only have to be 2 standard deviations above average to qualify as gifted and Liam's nonverbal reasoning is 4 standard deviations above. She notes that while his intelligence is a strength, it places him at increased risk for social maladjustment. His language scores ranged from average to superior, showing some pockets of weakness. His scores of social perception were average which is "well below expectations given his general intellectual abilities." That is again a direct quote. During the parent conference, she talked about Liam not being on the autism spectrum, but I am guessing she kept the diagnosis given this.
She talks about his only overt weakness was on paper and pencil tasks of graphomotor precision, and this was despite the fact that he has been doing OT since 24 months of age. She notes that findings show a "relative weakness" in language related to pragmatic language and conversation, as well as social functioning. "Overall, Liam continues to show patterns of difficulty involving pragmatic language, mildly restricted interest levels, sensrimotor concerns, and difficulty with social integration characteristic of individuals with pervasive developmental disorder."
The diagnoses she gave are:
Axis I:
299.80 Pervasive Developmental Disorder, Not Otherwise Specified
311.00 Anxiety Disorder Not Otherwise Specified
315.4 Developmental Motor Coordination Disorder
Recomendations: She recommends continued "intensive occupational and speech therapy interventions." She talks about increased fine motor demands in kindergarden and says that it is extremely important that OT not be interrupted and be provided in both the school setting as well as in private therapy. She cites Liam's problems with pragmatic language as the likely reason for his social delays. She notes that his extreme intelligence is a risk for additional social difficulties. She recommends ongoing speech therapy and social skills groups to address these needs. She notes that "Liam does show indications of significant underlying anxiety." She says the move this summer will likely make his anxiety worse and recommends formal counseling to address this. She ends by saying that it is extremely important that Liam is in an educational setting that addresses his very superior intellectual and academic skills, and recommends placement in a self-contained program for the highly gifted.
____________________________________
Below is the reponse from Liam's special education teacher about the report, as well as her suggestions for modifications to his IEP. She has known Liam for 2 years and is such an asset and a wonderful advocate for Liam. She is one of the many reasons I will be sad to leave Alaska.
"Wow...I just finished reading Liam's report and did not find any real surprises. His intelligence is really up there isn't it :-) I've always known that but it's good to have it on paper for your move :-) With the interspersed delays and high intelligence it's easy to see why there are emotional/anxiety issues. He's going to be (and probably already has been) a difficult boy to raise. But you two have done everything right! The trick will be to keep that going in Alabama :-) I was glad to see that my scores were mostly in agreement with yours (although I don't get to see the real meltdowns and adaptive delays). It's good to know how well he's able to hold it together here (although then you get the brunt of it!)
Thanks for sharing the report with me. I'm glad to know that we've always been on the same page! If there is anything else I can do for you all before you move, please let me know. I'm thinking of giving him support in kindergarten throughout the entire day, at least to start. Then the hours may be able to be reduced (once he gets used to the new, full-day setting). What do you think? If we don't give him 32.5 hours of special education, we could still give him some plus make sure before/after school, recess, and lunch are covered for awhile. And I will be putting in that he'll need a quiet place to go when needed and possibly an individual work station for times needed. What do you think?"
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