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Student psych profile - need help with 8 year old boy

Submitted by an LD OnLine user on

The student is 8 years old. He has demonstrated visual perceptual difficulties. He is also inattentive in his classes - tends to space out. He does have a sister with ADHD - hyperactive type, but he has never been diagnosed. Student has problems with multi-step directions. He is well liked by peers and enthusiastic about school. Teachers note he is often off task and answers questions with answers that are “off the wall”.

Vision is 20/20 and hearing is passing. Height is 50 3/4”/ Weight is 53.5 lbs. / BP: 89/60 - Health within Normal Limits.

According to the Psychoeducatonal report, results from the Bender Visual-Motor Gestalt Test were as follows: student’s scores were slightly below age level expectation but basically within the expected range when compared with individuals of similar age and borderline intellectual skills. Designs were copied with limited attention to detail and there were scoreable errors in distortion, integration and perseveration. The results also suggest poor organizational skills.

The SLP noted that observation of the oral mechanism revealed all structures to be intact and functioning adequately for speech production.
ARTICULATION - Goldman Fristoe 2 test of Articulation: Substitution of phonemes /sr/ for /tr/ noted. However, student was able to self-correct the /tr/ sound in ‘tree’, ‘train’, ‘track’, etc.
LANGUAGE - Clinical Evaluation of Language Fundamentals Screening Test 4 (CELF-4) +7 above Criterion. Total Score - 25. Within normal limits. No further testing needed.
FLUENCY - No dysfluency detected in conversational speech.
VOCAL QUALITY - within normal limits

Ongoing communication with parent throughout the school year. At most recent Referral, parent indicated that she is concerned with student’s attentiveness to complete assignments. He often rushes through tasks. There was also concern expressed with student’s fine motor skills and visual integration.

Student lives with both of his parents along with his 11 year old sister. He has no record of serious diseases, illnesses or hospitalization. His current health was described by his mother as being excellent. Mom did indicate that she felt he has difficulty with his speech. Student was described to have good eating habits and is not currently on any medication.

Woodcock-Johnson-III
Broad Reading: 87 Broad Mathemeatics: 103 Broad Written Language: 91 Basic Reading Skills: 78 Reading Comprehension: 85 Math Calculation: 116 Math Reasoning: 89 Writ Exp: 88

Subscales:
Letter Word Id: 91 Reading Fluency: 90 Calc: 116 Math Fluency: 112 Spelling: 95 Passage Comprehension: 87 Applied Problems: 92 Writing Samples: 86
Word Attack: 66 Reading Voc: 88 Quantitative Concepts: 86

WISC-IV
Verbal Comprehension Index - 79
Perceptual Reasoning Index - 69
Working Memory Index - 77
Processing Speed Index - 88
Full Scale IQ - 71

Bender Visual-Motor Gestalt Test: On this test student’s scores were slightly below age level expectation but basically within the expected range when compared with individuals of similar age and borderline intellectual skills. Designs were copied with limited attention to detail and there were scoreable errors in distortion, integration and perseveration.

OT Motor Evaluation:
MVPT-3
Raw Score - 28
Standard Score - 81
Confidence Interval - 72-91
Percentiles - 10%
Age Equivalent - 6 yr 6 mo

Visual perceptual standard scores are in the Low Average range for age and grade level peers. Average scores are between 90 and 109. Low average range is between 80-89. Errors were noted mostly in the areas of picture completions and visual memory.

VMI
Raw Score - 20
Standards Score - 85
Scaled Score - 7
Percentiles - 16%
Age Equivalent - 7 yr 6 mo

Handwriting sample: student demonstrated a basic understanding and knowledge of cursive writing by competing 3 writing tasks with 89-92% accuracy. Within the context of language usage, there were errors in syntax and grammar that decreased the overall content of sentences he wrote.

OT concluded in her evaluation that student’s visual motor skill performance is slightly below average while perceptual motor ability is moderately below average. His handwriting legibility in terms of mechanics, speed and fluency is adequate but language content is awkwardand disjointed.

Just got psychoeducational back on Monday. An adaptive has not been completed yet. Screeners are being completed today but still need to be scored. He is doing poorly in all of his classes.

Not sure how to help this little guy and where to go from here! Our 90 days ends January 6th, but we leave for Christmas next week. Right now he is not meeting eligibility for SLD because of the lack of negative discrepancy. He is bordeline Intellectual Disability-Mild or EMD because although he meets the IQ criteria with the standard error of measure, I am doubtful he’ll meet the adaptive criteria. Unless adaptive comes back with 2 SD below mean in one domain or 1.5 SD in 2 domains (which I am doubtful it will) I think we may end up noting him inelligible and going with a 504 plan. Even then though, not sure how best to meet his needs. I just don’t want him to fall through the cracks.

Submitted by Dr. LD on Wed, 12/29/2010 - 5:07 PM

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Given the information provided ADHD appears to be a strong possibility. Given his average math skills, the IQ scores are probably deflated (possibly due to inattention and/or impulsivity). Although 504 is a nice idea, it may be difficult for him to meet that eligibility criteria either without some sort of medical diagnosis (unless you go with the idea that he is “regarded” as having ADHD). For specific strategies related to ADHD or to get another perspective on his processing issues, check out http://www.LDinfo.com

Submitted by Mandi on Sat, 12/18/2010 - 6:48 PM

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Have you considered psych isn’t the answer? There are over 400 different physical diseases that present as or similar to ADHD.

I would ask you to make his parents get him blood tested see what his levels of vitamins are. Maybe an iron deficency or viamin B deficiency? If so, I would have his parents take his sister to a medical doctor for the same blood test because that also can present as ADHD and maybe it is just a vitamin deficiency? I have seen this over and over and over again. Where later it just comes out that the child was diagnosed in kindergarten and was one of the youngest 2 in the class or, that the child has vitamin deficiencies. I am not saying this is the answer to your problem, but it is definately something worth looking at.

You can eat regularly and frequently good portions of food and still have a deficiency somewhere. That is just a fact and those 400 things that can appear to be ADHD or similar to it, are NOT part of the standard battery of tests done. So unless he has been tested for a whole slew of extra stuff, no way to be sure if he is ill.

Another option is allergies, to food or some other substance. People can be allergic to the strangest things. I have a friend that eats with wooden silverware cuz she is allergic to metal and i, i can’t use bettadeine, allergy. All kinds of allergies you would never even dream up can exist and effect in a wide range of ways. Also worth checking.

It’s good to know there are people in the school system actually doing their job and looking for solutions to help their students. There are not enough like you out there. You are looking at everything and keeping an open mind also unusual in an educator that generally just looks to slap a label on it and shrug it off as no longer their problem. Thank you so much for doing what you are doing keeping an open mind and actually looking to help rather than just looking for a way to keep him a docile zombie all day.

Submitted by Jack on Mon, 05/02/2011 - 9:33 PM

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If you need a tutor in the North New Jersey area, I have a great program teaching a direct muti-sensory way of learning reading,writing,spelling and grammar. Orton-Gillingham approah to learning.I have many years experience teaching students with special needs.

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