UPDATE: DD's ADD/ADHD (etc) Evaluation and Parent Meeting

[niccig]

So, what he said was that, in his experience, children with ADHD often have speech-language issues, especially in phonemic awareness. They noted this during her evaluation last week, and encouraged us to keep up with the therapy. We have currently exhausted this year's benefit w/r/t private therapy through insurance.

What I have noticed since she began speech therapy is her ability to sound out words (phonics) has improved because she's better able to match the letter with the phonetic sound it corresponds to, so I think it's helping, though we have to set time aside to do the practice homework. It's pretty easy for me to get what the speech teacher intends for the week's practice because a lot of it dovetails with my choral training, but it's often a pain in the backside to get DD to cooperate. (I've actually been using a few songs from Hamilton to complement the speech homework. I know that sounds weird, and mildly inappropriate due to some of the language, but the fact is she can't keep up with her favorite lyrics if she's not positioning her lips, tongue, and teeth correctly, so it seems to work. Unorthodox, but I'll do whatever it takes.)

This is probably due to her decreased attention. Phonemic awareness is your ability to be aware of all the speech sounds (phonemes) in a word. So, cat is /k/ + /a/ + /t/, it's 3 sounds. Phonemic awareness is a needed skill to then learn phonics - ability to match speech sound to the written letter (grapheme). If you're not aware of the speech sounds in English, you can't match a grapheme to the sound, and this affects your reading. I have one student who has severe working memory deficits and he struggles with phonemic awareness as he can't retain the earlier sounds that were spoken, so there's several things that can affect phonemic awareness. DS was struggling with reading and he had very poor phonemic awareness, so I had him tested and therapy concentrated on improving phonemic awareness skills - rhyming, breaking a word up into syllables, then breaking up into sounds, then changing the sounds e.g. /k/ + /a/ + /t/ now change the /k/ to /m/ and what word do you have e.g. mat - Note, you're not saying the name of the letter, you're saying the speech sound. Once phonemic awareness skills have been strengthened, you may need to reteach phonics as previous lessons probably weren't understood by her.

Use whatever works with your DD. If it's Hamiliton songs, go for it. I used to have DS practice in the car. I'd have him break words into sounds and use street signs and things that we saw. E.g. "stop" sign, how many sounds in "stop", sound out /s/, /t/, /o/, /p/. Ok, now do "tree", "park", "house" etc. Not for the entire car ride, but 5 or 6 words. Initially, I had to do it with him together to model it, and have him count on his fingers as we said each sound, then he could do it on his own.

In my opinion, phonemic awareness isn't taught enough or correctly in preschool, pre-K, K. I actually incorporate some practice with many students I see for speech therapy as a warm=up activity.

[lizzywednesday]

Now you have a diagnosis, get the full report and take it back to the school with a letter in writing requesting a full psych-educational evaluation at school. You want the school psychologist and the resource room teacher (special ed. teacher that pulls students out for academic work in small group) to test her. Your school district may call the resource room teacher something else. Every state and school district is different, but where I work, if a parent brings outside report with a diagnosis and a request for evaluation in writing, we have 15 days to respond to say if will evaluate or if not, why we won't. In most cases we do go ahead and evaluate. The psych looks for possible special education eligibility like Other Health Impairment (includes ADHD), Autism, Specific Learning Disorder (processing difficulties like visual or auditory). The resource room teacher is testing academic abilities in reading, writing, math. The way it works here is, if the psych finds eligibility and the resource teacher finds low in academics, the team recommends the child get pulled out for resource room time to work on reading, writing, math. And you can have written into the IEP modifications for the teacher that help with her ADHD - more time on tests, repeat instructions etc , and a behavior support plan to deal with behaviors. If she doesn't qualify for academic help as not below average academically, you can do a 504 plan which includes modifications and behavior support plan. Speech therapy only won't help with ADHD, so you want the school to look at other supports she may need.

Keep persevering, you're getting her the support she needs.

Thanks Nicci.

I have like 5 copies of the relevant NJ statutes for the language and what I have to quote.

As she already has an IEP for speech, it shouldn't be too difficult to call for a meeting to revise it to accommodate this new information, but I want to be prepared with the statutory language (etc) to make my case when I revise my letter. This week may end up being a wash, as we have an abbreviated week due to the state teachers' conference Thurs & Fri.

Anyway, I want to get the support plan in place because otherwise the only recourse the teachers have is to send her to the principal's office as if she were a discipline problem, which is not the case.

Currently, she's in a classroom with a team-teacher situation - one is identified as the "lead teacher" with the other identified as the "resource teacher" so she has a good environment to implement the supports. Her academics, in general, are at grade-level except for reading. She's lagging with reading, but has the tools in place, IMO, to catch up. Getting her support will not hurt; thank you for the additional input from the therapist side!!

At DD's school, I believe they call that kind of coordinator a "learning specialist" or something like that.

If I'm being completely honest, I don't much care what they call it as long as it's someone who can help DD. Whatever her title, she's a member of the child study team, AFAIK.

Now that I think of it, I'm pretty sure that we have met with her before (last year) when we were discussing evaluations and speech therapy.

This is probably due to her decreased attention. Phonemic awareness is your ability to be aware of all the speech sounds (phonemes) in a word. So, cat is /k/ + /a/ + /t/, it's 3 sounds. Phonemic awareness is a needed skill to then learn phonics - ability to match speech sound to the written letter (grapheme). If you're not aware of the speech sounds in English, you can't match a grapheme to the sound, and this affects your reading. I have one student who has severe working memory deficits and he struggles with phonemic awareness as he can't retain the earlier sounds that were spoken, so there's several things that can affect phonemic awareness. DS was struggling with reading and he had very poor phonemic awareness, so I had him tested and therapy concentrated on improving phonemic awareness skills - rhyming, breaking a word up into syllables, then breaking up into sounds, then changing the sounds e.g. /k/ + /a/ + /t/ now change the /k/ to /m/ and what word do you have e.g. mat - Note, you're not saying the name of the letter, you're saying the speech sound. Once phonemic awareness skills have been strengthened, you may need to reteach phonics as previous lessons probably weren't understood by her.

Use whatever works with your DD. If it's Hamiliton songs, go for it. I used to have DS practice in the car. I'd have him break words into sounds and use street signs and things that we saw. E.g. "stop" sign, how many sounds in "stop", sound out /s/, /t/, /o/, /p/. Ok, now do "tree", "park", "house" etc. Not for the entire car ride, but 5 or 6 words. Initially, I had to do it with him together to model it, and have him count on his fingers as we said each sound, then he could do it on his own.

In my opinion, phonemic awareness isn't taught enough or correctly in preschool, pre-K, K. I actually incorporate some practice with many students I see for speech therapy as a warm=up activity.

I tend to agree it's due to her attention, but even if it's not, working on it won't hurt.

The speech-sound homework has been very beneficial for her to pick up this kind of sound-matching. We have also been using different rhyme patterns while reading aloud to reinforce word-elements.

She has had related work as English-language arts type homework/practice, too. They use a "tap out" method to associate their letters to sounds, which she's picking up fairly well when we sit together to do it. I don't recall doing anything like this as a child, but I was already reading (and reading quite well!) when I was in 1st grade.

[niccig]

The school will probably have to change her special education eligibility from SLI (Speech Language Impairment) to OHI (for characteristics of ADHD). That means the school psych needs to evaluate, so ask for academic testing to be done as well to make sure no needs in other areas (e.g. writing, math). You can get a behavior support plan added as well. At least in my district, a behavior support plan is not added to SLI only IEPs. If there's behaviors that need support, the eligibility has to be more than SLI, but every district is different with how they do things.

DS doesn't have ADHD, but did have similar difficulties with phonemic awareness. It was so frustrating for DH and I as we both were reading at a young age. I was told DS was a boy and was just taking longer for things to click. I was in a grad school class where learned about phonemic awareness and then brought DS to the grad school clinic to get evaluated and get therapy. Good news is that as there wasn't any other learning disorders (e.g. dyslexia), he caught up to grade level for reading and now reads a few years above his grade. I still think he's a slower reader, but even that seems to keep improving.

Keep advocating for DD

[lizzywednesday]

The school will probably have to change her special education eligibility from SLI (Speech Language Impairment) to OHI (for characteristics of ADHD). That means the school psych needs to evaluate, so ask for academic testing to be done as well to make sure no needs in other areas (e.g. writing, math). You can get a behavior support plan added as well. At least in my district, a behavior support plan is not added to SLI only IEPs. If there's behaviors that need support, the eligibility has to be more than SLI, but every district is different with how they do things.

...

Keep advocating for DD

I have to check the statutes, but "OHI" was mentioned during our meeting with the diagnosing psychologist, so having her IEP revised or implementing a 504 to complement her speech IEP or whatever needs to be done is actually one of the summary items in the report.

I'm going to call them "action items," because it feels a lot like a checklist to me. It'll help me marshal my thoughts into some kind of coherent advocacy plan.

I do really well with checklists.

[niccig]

I have to check the statutes, but "OHI" was mentioned during our meeting with the diagnosing psychologist, so having her IEP revised or implementing a 504 to complement her speech IEP or whatever needs to be done is actually one of the summary items in the report.

I'm going to call them "action items," because it feels a lot like a checklist to me. It'll help me marshal my thoughts into some kind of coherent advocacy plan.

I do really well with checklists.

Here in CA, it's Other Health Impairment (OHI) due to characteristics of ADHD - schools don't diagnose, so can't say it's ADHD. I would want the OHI eligibility as Speech Language Impairment eligibility can be dismissed once a child no longer meets eligibility criteria and other services or supports will be lost unless the child gets re-evaluated. Here, we can't have 504 and an IEP, so we would have eligibility changed to OHI as primary eligibiltiy, and then speech is considered a related service. I can then dismiss a child from speech and their OHI eligibility and other supports stays. Other states have different rules and do have 504 with IEPs.

[lizzywednesday]

Here in CA, it's Other Health Impairment (OHI) due to characteristics of ADHD - schools don't diagnose, so can't say it's ADHD. I would want the OHI eligibility as Speech Language Impairment eligibility can be dismissed once a child no longer meets eligibility criteria and other services or supports will be lost unless the child gets re-evaluated. Here, we can't have 504 and an IEP, so we would have eligibility changed to OHI as primary eligibiltiy, and then speech is considered a related service. I can then dismiss a child from speech and their OHI eligibility and other supports stays. Other states have different rules and do have 504 with IEPs.

Like I said, I have to go over the statutes.

The adaptive stuff for her ADHD is mostly classroom-based and will need the buy-in from her teachers (who strike me as Very Willing and Able to implement them), while the speech-language stuff is pull-out twice per week.

It's my experience that many kids have multiple diagnoses on their IEPs here as part of the NJ understanding of "free and appropriate education" (FAPE) mandates.