I tend to write funny little things that Em does, but there is sometimes more serious stuff going on, and this seemed a good time to bring it up.
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\nAs we began the process of revamping Em’s IEP (individual educational plan) for middle school, we decided to spring for testing from a private psychologist. This was because we were concerned there may have been an ADHD component that was being overlooked as we focused on autism. There are many reasons for this, mostly dealing with attention in the classroom, patterns of behavior doing homework, and difficulty recalling a fact shortly after hearing it.<\/p>\n
After much soul-searching and several incidents I won’t go into, we finally decided that it was time to consider medication. We have had many years of various therapies. This was considered as a last resort, something we thought we’d never do. But if medication could be another tool in our toolbox, then it was worth at least exploring. If there is something available that will help, but we refuse because we’re uncomfortable with the idea, that’s not really fair to Em.<\/p>\n
Contrary to what you may have heard, it’s rather difficult to get ADHD medication for a child. We consulted with our daughter’s very good pediatrician, who reassuringly wasn’t just going to hand out pills. She wanted a full psychological workup before considering it. If there were, for example, an OCD component (there isn’t) then that would require a different approach to medication. So we got a full workup, which miraculously cost exactly the same amount as our federal tax refund. Autism is still in as a diagnosis, obviously, but some of the other results were surprising.<\/p>\n
Of interest immediately is that the tests don’t show ADHD. Hyperactive, yes, attention deficit, no. This isn’t a total surprise. She is constantly doing something with her hands. Twisting string, peeling off labels, ripping bits of paper, etc. If I could get this kid to knit, she could crank out enough Jayne hats for me to retire. The psychologist feels that medication could benefit the hyperactivity, and my husband and I are discussing it but right now leaning away from it. If it’s not affecting her schoolwork or social life (we’re figuring out whether it does) then we need to consider whether it’s something that requires medication or something that we should view as just part of who she is.<\/p>\n
A couple of new tests that Em hasn’t had before were given, the SCAN-C<\/a> and the TAPS-3<\/a>. The SCAN-C in particular tests auditory processing – basically, the ability to focus on different auditory stimuli. Em scored in the 0.1th percentile on each part of the test. Now, Em occasionally has bad testing days, particularly late in a session, but I don’t think any amount of “I had a bad day” would account for a 0.1 percentile result. This leads to a diagnosis of Central Auditory Processing Disorder (CAPD).<\/a> This doesn’t mean there’s anything wrong with her ears, but rather with how her brain processes the sounds it’s receiving.<\/p>\n That’s a new piece of the puzzle. It could help explain why she may have more trouble taking in information in a noisy school environment than she does at home. It also looks like her long term memory is okay on things that have been repeated a lot (favorite books she’s read a thousand times) and short term is okay on things she just heard (although less so) but it’s the in-between part that’s really hanging her up. The psychologist feels that it’s not that she can’t pay attention, it’s that auditorily she’s having trouble understanding what’s being said and taking it all in, and that it’s not really making it from short term to long term memory. I feel this is a huge obstacle to greater success in school.<\/p>\n Summing up, we have basically the same PDD-NOS diagnosis, however without the ADHD we were worried about but with CAPD (central auditory processing disorder).<\/p>\n Fast forward a week to an IEP meeting at the school. Her “dream team” of specialists has the report and they disagree with the diagnosis. They agree with autism, but feel what the psychologist sees as CAPD is really an attention issue, not an auditory processing one. In their favor is that one of Em’s testing modifications is to be able to read the information aloud during a test, or to have it read to her. It does seem to help. Also in their favor: they’ve worked with Em since kindergarten. The doctor who tested her has a great deal of experience with CAPD, but she only saw her for a total of four hours.<\/p>\n At this point I’m trying to work out scheduling so they can all come together and talk and tell each other what they’re seeing. They’re all willing to do so, because they’re all awesome, but this week is the week of the EOGs (end of grade testing) and things have been nuts at the school. I’m going to start making calls again on Monday.<\/p>\n