Got Bonnie Terry questionaire...questions about visual processing

[Holly IN]

According to the questionaire I got from Bonnie Terry...My son has very bad marks on the Visual Processing area due to his history of poor comprehension but excellent reading skills. I thought excellent reading skills equals excellent comprehension. We also suspect he has problems with auditory processing.

I am still having a hard time buying into him having visual processing problems when his auditory skills are severly lacking or do they go hand in hand.

Riding a bike...He struggled with this. He does this well now but didn't learn until about 10 years old compared to his brother who learned when he was 4.

Clumsy...always have been clumsy and awkward.

comprehension...He is a 7th grader but his comprehension is of a 5th grader where his reading skills is of a 9th grader. What is up with this? Can somebody explain this one to me?

Disorganization....messy room, messy desk...he is responsible for the chickens so when he goes out there to do his chores, he will only do one aspect of it. For ex: check their water but not their feed or eggs so when he comes in we ask him if he checked this and this and this...He would groan and say he forgot. We send him out again and again and again. Help!!!

The above are the major areas. Also his major area is sloppy handwriting which is in the visual processing area.

I really need help in figuring this out. Exactly what is visual processing? Any must see websites out there? Do you have any children with this and how do you deal with this? Can visual processing mimick something else? Another reason for my son's sloppy handwriting, awkwardness, late in riding a bike...

Help!!

Holly

[Kathy in MD]

have other problems in addition to those two. My ds was in this situation, and I suspect your ds does as well.

You posted that your ds is clumsy and awkward and stuggled to learn to ride a bike. This implies that your ds may have problems with his inner ear. This would also affect his ability to understand and process language.

Furthermore you post that he is disorganized and can't follow multistep instructions. Then he also has poor handwriting and clumsiness. Combine all this with his problems in both visual and auditory processing and I suspect that he suffers from Sensory Integration Dysfunction or, its new name, Sensory Processing Dysfunction.

SID is a problem with how the senses take in information from the outside world. For the brain to process information well, it must have good data to process. To use the old computer motto, "Garbage in, garbage out".

I suggest you read The Out-of-Sync Child by Kranowitz. There is a web site with a brief check list for younger children but the book is much better. http://printables.familyeducation.com/forms-and-charts/behavior-checklists-and-charts/51756.html

I assume that you've been getting therapy for auditory problems. If so, the second step I recomend for you is a general cognitive therapy program. This will build on the foundation of SID therapy (if needed) and speech/auditory therapy. I recommend either PACE or Learning Rx, both by the same company. There is a new home-based program that is supposed to come out this year that sounds very promising.

It's not unusual for people to have multiple problems. My personal belief is that people with only one problem can compensate, so their single problem isn't caught. When an individual has multiple problems, he can't easily compensate and parents go looking for answers.

[Claire]

Who is Bonnie Terry?

All of the symptoms you mention can be related to auditory processing disorder. Has your son had an occupational therapy evaluation? The first thing I would want to check is sensory processing, and an OT can do that. Many of the symptoms you mention can be the result of vestibular development delays, and this type of delay can be a result of auditory processing disorder.

Based on what you posted, I don't see the symptoms of visual processing disorder. The handwriting issue can be associated with motor planning problems. Although this can be related to visual processing problems, it can also be related to vestibular and motor planning problems.

It sounds as if the visual processing disorder diagnosis was made solely on the fact that his comprehension level lags four years behind his decoding level. That's not a valid way to reach this conclusion. Comprehension difficulties -- especially with oral material as well as written material -- are much more likely to be the result of weak visualization skills. The IdeaChain website (http://www.mindprime.com) has a good explanation of how visualization skills affect comprehension. Just click on the "why people have problems with comprehension" section in the upper lefthand corner.

The difficulty with the chickens could be with auditory memory (difficulty remembering multi-step instructions), but it could also be due to poor visualization skills. I would suspect the latter because he has difficulty remembering all of the steps even though they are the same steps every time he goes out.

A good way to assess visual processing skills is to get a developmental vision evaluation.

In short, before jumping on the visual processing bandwagon, I would want to get an occupational therapy eval. If visual processing disorder is still suspected at that point, I would get a developmental vision evaluation.

I should add that the clumsiness is often associated with a vestibular issue -- timing. Interactive Metronome is a therapy that works on developing timing skills and motor planning issues. Clumsiness often improves a lot with IM.

[Laurie4b]

You certainly describe a cluster of problems. The difficulty with gross motor skills, fine motor skills, high decoding in reading compared to much lower comprehension, poor spatial relations (the messy room), and distractibility could have several explanations. Does your son have any social difficulties? Difficulties with transitions? Rigidity? One possibility if the social issues are present is nonverbal learning disability (caution: do not read Rourke's site if you go googling. It's needlessly negative). That would cover everything you mentioned, but it could also be a combination of other things.

Like Claire and Kathy, I would suggest an occupational therapy evaluation. They can evaluate the problems with balance, coordination, and fine and gross motor skills. They will not make any diagnoses other than in their field. (ie you already know there are balance, fine, and gross motor problems. They will tell you that. However, they will also treat those problems.) The neurological system is very interwoven, so treating those issues can impact academic issues as well, even though you don't think of them as directly related.

You could also be looking at auditory processing skills (has this been evaluated or just suspected?) A good neuropyschological eval would include a WISC IV that would tell you if there are disparities between verbal IQ and the rest of the IQ substests. A neuropsychologist is also qualified to make the diagnosis of ADD, which could also account for the distractibility.

Below, I posted a link to a series of articles on attention that were on Mel Levine's site. You might find a suggestion for working with your son's distractibility in those articles.

[Holly IN]

have other problems in addition to those two. My ds was in this situation, and I suspect your ds does as well.

I assume that you've been getting therapy for auditory problems. If so, the second step I recomend for you is a general cognitive therapy program. This will build on the foundation of SID therapy (if needed) and speech/auditory therapy. I recommend either PACE or Learning Rx, both by the same company. There is a new home-based program that is supposed to come out this year that sounds very promising.




No he is not in any therapy for auditory problems. All of these are cropping up in the past year. Our concern is warranted to possible help. Since he is not in any therapy then what is the 1st step?

Thanks so much-
Holly

[Holly IN]

Who is Bonnie Terry?

All of the symptoms you mention can be related to auditory processing disorder. Has your son had an occupational therapy evaluation? The first thing I would want to check is sensory processing, and an OT can do that. Many of the symptoms you mention can be the result of vestibular development delays, and this type of delay can be a result of auditory processing disorder..


Bonnie Terry's website is: www.bonnieterry.com

He hasn't had an occupational therapy eval at all. This would be a possibility for us to do. Do you know what the normal charge for this is? Normally do insurance cover this? I know mine covers evals but not sure for what though.
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A good way to assess visual processing skills is to get a developmental vision evaluation.

In short, before jumping on the visual processing bandwagon, I would want to get an occupational therapy eval. If visual processing disorder is still suspected at that point, I would get a developmental vision evaluation.

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Who does developmental vision eval? Eye dr? or??

To clarify...He has no diagnoses at all. This was based on Bonnie Terry's worksheet questionaire. We know something is up with our son. We told him something is up with him. He is in denial over this. We have an autistic dd so he is really freaking out over this issue of something being wrong with him. When we talked to him about this he blurted out to us that we think he is autistic. We told him no. We told him there are numerous learning problems. Autism is not one of them for him. So he is in denial that anythign is wrong. We told him that if we can figure out what is wrong then we can work on that and help him improve on that.

Thanks!! I will look into those websites you mentioned.

[Holly IN]

Does your son have any social difficulties? Difficulties with transitions? Rigidity? One possibility if the social issues are present is nonverbal learning disability (caution: do not read Rourke's site if you go googling. It's needlessly negative). That would cover everything you mentioned, but it could also be a combination of other things.

.


No social difficulties. He has so many friends in the homeschool group. He is one of the popular kids and everybody including adults love him. No problems with transitions or rigidity. He is a very loveable kid to everybody else. He exasperates me though. He is extremely mature for his age. Hope this helps a bit...

About the auditory processing...No evals done or diagnoses made. We (his dad and I) suspect very strongly that he has APD. DS is requesting a hearing test. In this area I need to know if there is a specific audiologist I need to go to. I know of one that our insurnace will cover. I really like her alot but not sure if she is still at the hospital. She was the one who told me that my dd's hearing is fine even though she failed the hearing test. She said it is something else like APD or autism. This was before I told her about her possible autism diagnoses. I would feel comforatable for her to give my ds a hearing test.

Thanks and I will look for your links below.

Holly

[Claire]

He hasn't had an occupational therapy eval at all. This would be a possibility for us to do. Do you know what the normal charge for this is? Normally do insurance cover this? I know mine covers evals but not sure for what though.


Your best bet is to find a good OT clinic and call them first, before you do anything else. Write down your son's physical symptoms (difficulty learning to ride a bike, clumsiness, difficulty remembering oral instructions, difficulty with handwriting) and describe your son to them over the phone. Ask if he should be evaluated. If they say yes, ask about insurance coverage for the evaluation. Clinics work with insurance companies every day and can usually tell you *exactly* how a referral needs to be worded or coded. Take that information to your GP so the referral is made out correctly. This is important, because if the insurance company decides a problem is educational in nature (hasn't been taught how to write, for example) they will deny coverage. From your description, I would guess you have enough physical symptoms to get coverage. The handwriting problem, for example, could be described as difficulty with fine motor skills. Do talk to the OT before the eval and stress that you want sensory integration assessed. However, most insurance companies will not pay for an eval if the referral is for sensory integration.

I'm not sure how much an OT eval costs. Ours was done quite a few years ago. I think it took 2 hours and cost in the neighborhood of $500 or less.

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Who does developmental vision eval? Eye dr? or??
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Usually the best person to do this eval is a board-certified developmental optometrist. Regular eye exams do *not* include assessment of visual efficiency and visual processing skills. A child can have 20/20 acuity and still have severe visual processing deficits. For more information, the Children's Vision Website (http://www.childrensvision.com) is very good. To find board-certified developmental optometrists in your area, run a search at the COVD website (http://www.covd.org). If you have a choice of optometrists, do some research before making the initial appointment. Post here when you are ready, and we can give you some tips on this process.

Developmental vision evals are usually not covered by insurance. Where we live, a good eval takes 2 hours and costs about $200 (plus an additional $75 for a written report, necessary only if problems are found). However, costs can vary a lot depending on area of the country and individual optometrist.

[Claire]

About the auditory processing...No evals done or diagnoses made. We (his dad and I) suspect very strongly that he has APD. DS is requesting a hearing test. In this area I need to know if there is a specific audiologist I need to go to.
Holly

Regular audiologists test only the physical components of the auditory system. Auditory processing disorders involve how the brain interprets auditory data. A child can pass regular hearing tests perfectly but have major APD deficits.

APD can be definitively assessed only by audiologists who have specialized training in this area. Many insurance companies will not pay for APD testing, and it can be quite expensive. Here is a website (http://www.ncapd.org/php/index.php?menuoption=Professional%20Listings) that lists audiologists who specialize in APD testing. There may be other lists online also.

[Kathy in MD]

auditory problems. OT's specialize and you want to find one that has trained, or better yet is certified, in SID. Rarely you may find a physical therapist that has trained in SID. For a diagnosis, I would travel some distance.

For auditory processing problems, you could see a neuropsychologist or an audiologist that specializes in APD. Note that most audiologists don't specialize in this field.

From your post, I think it's less likely that your ds has dev. vision problems. However some students are able to compensate for visual efficiency problems until they reach the more complex and heavy reading assignments of jr. high and hs. Check out this site to see if you think your ds might benefit from obtaining a dev. vision exam from a developmental optometrist. http://www.childrensvision.com/symptoms.htm.

Once you have the diagnosises, then we can give you some imput on possible therapies and things to help. BTW, the individuals who do the testing should also be able to help get you started in therapies, although some aren't so good at that.