Mom Evaluates the Evaluations

Preface: Following is my attempt to evaluate the evaluations performed on my son for determination of IEP eligibility via IDEA. The reader should be aware that I have no formal training in evaluations -- this is strictly a parent's interpretation of the professional evaluations and it is written from a parental perspective. There may be some erroneous interpretations set out when viewed through the eyes of a professional.

It is my opinion that averaged test scores and subtest scores must be considered on an individual basis to fully understand what the testing has discovered. For instance, it's wonderful that a child can spell and read. However, if that same child is unable to comprehend what he has read or the child is unable to retain the definition of the words he can so beautifully spell -- there's a problem.

It is also my hope that as parents read the following correspondence, they will come to have a deeper understanding of why it is so important for them to get full copies of all their child's evaluations -- it matters not whether the evaluations were developed by a private source or by a school district. Also, it's important for parents to gain at least a broad understanding of what test results are reflecting.
May XX, 2002

ARD Committee
Anywhere Independent School District
441 FM 2021 East
No Name, USA 77XXX

Attn: Ms. Special Education Director

Re: Stephen XXX
IDEA eligibility

Dear Sirs and Madams:

Due to Stephen's struggles with school, we requested Anywhere Independent School District to evaluate our son. A summary of the review of all evaluations performed in this endeavor is presented herein.

Stephen has been described to us repeatedly in sincere manners by various professionals as "smart," "very smart," "bright," "very bright," "so smart he's hard to stay ahead of." These descriptions have come from his teachers at Barnett Elementary (Ms. Jordan, Ms. XYZ, and Ms. ABC); Ms. Todd, Assistant Principal; Ms. XISD Diagnostician, Dr. Sharon Lynch with SHSU; and most recently by XISD Psychologist Dr. R. Runson. Robert and I concur with those descriptions. In contrast, Stephen's IQ is denoted as "average" at 104 (School District Diagnostician) and 86 (Lynch). This conflicting information begs an answer to the question, "Why?"

The brain's ability to integrate and successfully further process information with consistency affects learning. By definition, processing includes organization, memory sequencing, discrimination, attention and speed. These terms appear numerous times throughout Stephen's evaluation reports. Sometimes the findings in various segments of the reports are in agreement, sometimes not.

Reviewing the academic portions of the evaluations and familiarizing myself with what the various subtests attempt to measure, it became clear that "processing" factors into every test across the board. Further, the subtests are the basis of the Intelligent Quotients (IQ).

Stephen has been diagnosed with Attention Deficit Hyperactivity Disorder (Combined), Central Auditory Processing Disorder (CAPD), and apraxia. He also has many components of Sensory Integration Disorder (SID). These are all neurologically based problems known to adversely impact "processing."

With this knowledge comes the realization that the educational portions of the evaluations set the lower limit of Stephen's intelligence. However, the opposite is the case when considering the upper-level of Stephen's intelligence. Processing deficiencies are depressing Stephen's subtest scores and therefore his IQ scores.

In determining student eligibility for special education under IDEA, Ms. Diagnostician and Ms. Special Education Director advised that a "severe discrepancy" is evidenced by a -1 Standard Deviation (15 points) on a mean of 100 via comparison of performance to ability. This equates to a 15% variance.

A review of Ms. Diagnostician 's educational evaluation of Stephen reflects that Stephen met that criteria on three tests: Similarities, Vocabulary, and Comprehension. Presumably because of the inaccurate shading on the graph in the Ms. Diagnostician's report, these facts were overlooked by all XISD ARD Committee members in January 2002. One Standard Deviation in this section of the test results equates to 8.5 rather than the 8 depicted.

Federal IDEA law sets out 13 areas wherein a child is eligible for special education if a disability exists within one of the defined categories. Although only one category is required to received special education, Stephen qualifies in five areas. Those being:

1) Hearing impairment: An impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance but that is not included under the definition of deafness.

2) Other health impairment: Having limited strength, vitality, or alertness due to chronic or acute health problems such as a heart condition, rheumatic fever, asthma, hemophilia, and leukemia, which adversely affect educational performance.

3) Serious Emotional Disturbance: A condition exhibiting one or more of the following characteristics, displayed over a long period of time and to a marked degree that adversely affects a child's educational performance (those applicable in bold type):

An inability to learn that cannot be explained by intellectual, sensory, or health factors

An inability to build or maintain satisfactory interpersonal relationships with peers or teachers

Inappropriate types of behavior or feelings under normal circumstances

A general pervasive mood of unhappiness or depression

A tendency to develop physical symptoms or fears associated with personal or school problems.

4) Specific Learning Disability: A disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations. This term includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. This term does not include children who have learning problems that are primarily the result of visual, hearing, or motor disabilities; mental retardation; or environmental, cultural or economic disadvantage.

5) Speech or language impairment: A communication disorder such as stuttering, impaired articulation, language impairment, or a voice impairment that adversely affects a child's educational performance.

As Ms. Special Education Director has pointed out, IDEA has a two-pronged eligibility standard. Special education and related services of IDEA are available to students who have a disability and who need special assistance to benefit from education. Stephen meets these criteria.

In conclusion, Stephen requires classroom accommodations, technical assistive devises, occupational therapy, and other assistance as set out in the evaluation reports in order to receive benefit from education.

Your attention is invited to the attached report, which form in part the basis of the conclusion.

This document is to be retained in Stephen's file until written parental consent is received to destroy it.

Respectfully submitted,

Alisha Leigh


Summary Review Table of Contents

Introduction 4

Educational/Academic Evaluations 4

Auditory Evaluations 6

Occupational Therapy Evaluations 8

Psychological Evaluation 10

Miscellaneous 11

Conclusion 12


Summary Review Introduction

Contained herein is a summary review of the evaluation reports pertaining to Stephen. Namely:

Full and Initial Individual Evaluation by XISD Diagnostician dated
12-2001,
SCAN - A Screening Test for Auditory Processing Disorders by XISD Speech
Pathologist #1 dated 01-2002,
Individual Educational Evaluation by Dr. Sharon A. Lynch with SHSU dated
03-2002,
Audiologist report by Lisa Wildmo, M.Sc., FAAA, Board Certified Audiologist dated
03-2002,
Occupational Therapy Evaluation by XISD Occupational Therapist performed
04-2002,
Occupational Therapy Initial Evaluation by Lynne C. Tupper, MPH, MOT, OTR,
Board Certified Pediatric Occupational Therapist performed 04-2002.
Speech/Language Evaluation by XISD Speech Pathologist #2 dated 04-08-02.
Psych Evaluation by Dr. Robert Duncan, by contract via XISD dated 04-2002.

For general information purposes, the reader of this report needs to be aware that Stephen was diagnosed ADHD-Combined in May 2001 by Dr. K. Harris, Clinical Psychologist.

None of the data or comments contained in the depicted reports was dismissed out of hand with two exceptions. Those being:

1) The commentary contained within XISD's Full and Individual Evaluation pertaining to opinions regarding sensory and motor problems, speech/language, emotional, behavioral and developmental deficits. There had been no evaluations performed in these areas, therefore, there was no basis for opinion in these areas;

2) The auditory processing screen dated January XX, 2002, addresses two areas: auditory processing and one sentence regarding Speech/Language. This sentence states that Stephen does not have a speech/language impairment that adversely affects his educational performance. Subsequent to the report, Ms. Speech Pathologist #1 advised that her judgement was predicated on "a brief conversation with Stephen." In view of this, the opinion regarding speech/language was disregarded.

Educational Evaluations
XISD's report depicts Stephen's IQ at 104; Dr. Lynch's testing rates it at 86. It is Dr. Lynch's opinion that Stephen's IQ is actually in the average range (90-110) rather than 86. Reading both reports, it is evident that it was challenging to keep Stephens' attention focused on the matter at hand. In addition, it should be noted that four of the subtests via Dr. Lynch were conducted utilizing a tape recorder.

Based on my knowledge of Stephen, some of the scores within the educational portions of the reports make perfect sense. On the other hand, some are so far out of line they are inconceivable. Stephen is strong phonetically as exhibited by XISD's Word Reading test (118), Pseudoword Decoding (120), and Spelling (107). However, he has great difficulty comprehending grade-level reading material when inferencing is required. As another example, when Stephen is in a hyper-focused mode, there is every confidence that he would achieve a high Digit Span score in a controlled test environment. However, he is not able to hyper-focus for sustained periods of time and he must function in a classroom. Factually, he can be given verbal direction to perform a task, process the direction and the information completely leaves his memory before he gets 20 feet away. His "real life" auditory memory is impaired.

A compilation of the standard scores from the academic reports is presented below. Some of the tests results in the Evaluations are presented on mean of 100 and some on a mean of 10. Those depicted within the reports on a mean of 10 were converted to a mean of 100 for ease of comparison to IQ difference. In that Dr. Lunch indicated that Stephen's true IQ score is higher than depicted and Ms. Speech Pathologist #2 utilized XISD's IQ score of 104 for comparison measures, it is apparently appropriate by professional standards to utilize data in this fashion.

It is my understanding that the results of these type test depend on many variables. As such, the results do not present "exact science" conclusions. Based on XISD's definition of a "significant discrepancy" equaling a 15 point difference, it is not unreasonable to include the -14 point indicators in the analysis of overall weaknesses. Regarding Ms. XISD Occupational Therapists' evaluation, her report reflects that weak verbal attention and/or fluctuating auditory registration in short-term memory and inability to sustain listening may be interfering with Stephen's performance.


As set out in the transmittal letter, the evaluations only set the floor level of Stephen's intelligence -- they do not accurately depict the ceiling. For this reason, it can be logically considered that his IQ exceeds 104 thereby deepening the degree of discrepancy indicated by the evaluations.

Of further concern is that the depth of Stephen's receptive and expressive language disabilities may not be accurately identified by the CELF-3 without considering any other factors. A Syracuse University study "&examined the statistical and clinical differences within and across subject scores on the CELF-R and the CELF-3. &Results revealed significant differences between CELF-R and CELF-3. Receptive and Expressive scores, as well as for three subtest scores, with the CELF-3 scores always being higher. Further analyses found a significant inverse relationship between age in months and CELF-R to CELF-3 Receptive Language Scores differences."

It was noted by each examiner of the academic reports that Stephen was seeking feed back during testing that he was performing to their expectations. The reports indicate he was concerned about the "grade" he would get and wanted to know that he was doing the work correctly. It was also noted that as the difficulty levels increased, likewise did Stephen's anxiety. Notations were also made regarding what I refer to as "OCD tendencies" and the educational professionals describe as perserveration. The reports note Stephen's inability to sustain attention. Based on my knowledge of Stephen, these comments are accurate.

With this in mind, it is ironic to read that all of Stephen's low scores are discounted by the examiners. In nearly every instance, low scores by the examiners are explained away due to opinions regarding "lack of motivation" and/or that Stephen was not putting forth his "best effort." No information was located in the reports or file data that indicate that the examiners enlisted the expertise of those proficient in Central Auditory Processing Disorders, sensory integration issues, apraxia, and anxiety in order to ascertain how the co-existing conditions can impact test performance.

One certain thing about these tests is that they do not measure "motivation." In addition, the examiners do not possess the personal knowledge of Stephen or his behaviors to the level of being in a position to so narrowly explain away his low scores.
Based on XISD's significant discrepancy formula, learning disabilities are identified as written expression, oral expression, listening, and comprehension.

Auditory Evaluations

Regarding Stephen's auditory processing problems, this was first recognized by School District Speech Pathologist #1's CAPD evaluation dated January 14, 2002. Ms. Speech Pathologist's report together with the Scoring Summary from the District's file reflects Stephen did very poorly in the "Competing Words" test.

According to the test manufacturer information on the document, this is representative of "severe discrepancy."

Subsequent to XISD's CAPD screen, Stephen was referred to board-certified audiologist, Lisa Wildmo and tested utilizing a sound proof booth in conjunction with administering the SSW. The test was originally scheduled for March 2, 2002, however, it had to be postponed until March 8th because a "mild conductive hearing loss was present with type C Tynpansgrams," i.e., Stephen had fluid in the middle ear.

Ms. Wildmo's evaluation indicates that an individual with auditory cohesion "may" interpret words too literally, need remarks repeated often, ignores people, confuses similar sounding words and has difficulties following directions in a series. There is no "may" to it -- these are perfect descriptions to of some of Stephen's behaviors.

Ms. Wildmo advised that the diagnosis of "impaired hearing discrimination" (code 388.43) is applicable to Stephen.

XISD Speech Pathologist #2, utilized the Test of Auditory Perceptual Skills - Revised (TAPS-R) in her evaluation. Information from the published estimated this test to take 10 to 15 minutes to administer. It is billed as an attempt to measure what a student does with information auditorily perceived.

Pertaining to auditory processing, Lynne Tupper's Occupational Therapy Initial Evaluation states that "Praxis on Verbal Command can be an indicator of auditory processing as well as motor planning." Based on this segment of testing, Ms. Tupper rated Stephen's auditory processing as average.

Central Auditory Processing Disorder (CAPD) means that the ear and the brain do not coordinate fully. CAPD is also known as auditory perception disorder, auditory comprehension deficit, and auditory perceptual processing dysfunction. It affects every avenue of life from understanding conversation, to reacting in a socially acceptable manner, to learning how to read. Although CAPD is closely related to "language," the American Speech-Language-Hearing Association has determined that diagnosis of CAPD falls under the scope of audiology practice.

Various neurological disorders have what appear to be overlapping symptoms/weaknesses. In many instances, examiner's have attributed Stephen's deficits to ADHD -- and there is no argument that is a major contributing factor. However, it is important to define symptoms as accurately as possible in order to be able to treat the underlying problems.

Recent research has produced a comparison list that can assist in assessments when attempting to distinguish CAPD from ADHD. The list is summarized as follows:

--------------------------------------------------------------------------------

Auditory Memory - Forward 93 104 -11
Auditory Memory - Reversed 104 104 -0-
Auditory Sentence Memory 95 104 - 9
Auditory Word Memory 97 104 - 7
Auditory Interpretation of Direction 85 104 -19
Auditory Word Description 102 104 - 2
Auditory Processing 112 104 +8


Inattention
Distractibility
Hyperactivity
Restlessness
Impulsivity
Interruption/Intrusion

Inattentiveness
Distractibility
Difficulty hearing in backgrouond noise
Poor listening skills
Academic difficulties
Poor auditory association skills
Difficulty following directions

ADHD Auditory Processing Disorder

Additionally, information available sets out five main problem areas that can affect both home and school activities in children with CAPD.

1. Auditory Figure-Ground Problems: This is when the child cannot pay attention
when there is noise in the background. Noisy, low-structured classrooms could
be very frustrating to this child.
2. Auditory Memory Problems: This is when the child has difficulty remembering
information such as directions, lists or study materials. It can exist on an
immediate basis ("I can't remember it now") and/or a deferred basis ("I can't
remember it when I need it for later").
3. Auditory Discrimination Problems: This is when the child has difficulty
hearing the difference between sounds or words that are similar (COAT/BOAT
or CH/SH). This problem can affect following directions, reading, spelling, and
writing skills, among others.
4. Auditory Attention Problems: This is when the child cannot maintain focus for
listening long enough to complete a task or requirement (listening to a lecture in
school). Although health, motivation and attitude may also affect attention,
among other factors, a child with CAPD cannot (not will not) maintain attention.
5. Auditory Cohesion Problems: This is when higher level listening tasks are
difficult. Auditory cohesion skills - drawing inferences from conversations,
understanding riddles, or comprehending verbal math problems - require
heightened auditory processing and language levels. They develop best when all
the other skills (levels one through four above) are intact.

This understanding of CAPD brings the knowledge of why the Audiologist recommended use of an Auditory Trainer. Ms. Wildmo also conveyed a 17-page document to assist in implementation of CAPD therapy. (copy attached)

To my knowledge, to date there is no absolute method or testing that can categorize symptoms common to various neurological disorders with 100% scientific accuracy. However, the sophisticated equipment utilized by the Audiologist is the nearest scientific evaluation. Based on a review of the evaluations and in conjunction with personal knowledge of Stephen's behaviors, it is reasonable to conclude that Stephen has imperfect hearing which interferes with educational benefit and constitutes educational need.

Occupational Therapy Evaluations

Information very important in understanding some of Stephen's behaviors is located in the Occupational Therapist's reports. These reports have answered questions such as "why" Stephen is physically strong, but can't unlock the backdoor with a key; why he can tie his shoes but is seems to take forever; why he's a gum-a-holic; why he has peculiar behaviors such as rocking when concentrating, draping horizontally across a chair when doing homework; why he loves swinging and spinning; why he has developed aversion to writing tasks and maintains that writing causes his hand and shoulder to hurt; why he has such a high pain tolerance. Along with everything else, Stephen has sensorimotor problems.

These reports reveal that Stephen has fine and gross motor skills problems inclusive but not limited to motor planning , proprioceptive dysfunction, motor control and sequencing . In addition, he has vestibular problems , lacks tactile discrimination , tactile defensiveness , and other components of sensory integration dysfunction .

In that I do no yet possess a good command of occupational therapy terminology, and the book Ms. XISD Occupational Therapist recommended is descriptive, I have taken the liberty of including some excerpts from The Out-of-Sync Child by Carol Stock Kranowitz to facilitate understanding of how the afore-mentioned impact Stephen.

"Tactile integration has a big impact on a child's ability to learn at school. Many objects require hands-on manipulation: art materials, science equipment,&, pencils, and paper.

Tactile dysfunction prevents a child from learning easily because sensations distract him. He may fidget when quiet is expected, complain that others are annoying him, and have trouble settling down for academic tasks.

If the defensive system isn't integrated by the time a child is three or four, then the discriminative system can't arise to "take charge." With inefficient or immature discrimination, the child will have difficulty using his tactile sense for increasingly complex purposes -- like learning at school.

Fantasy and make believe may be beyond his scope, the difference between real and pretend may be vague. &He misses out on learning problem-solving, communication and "people" skills.

The child who is hypersensitive to touch has tactile defensiveness, the tendency to react negatively and emotionally to unexpected, light touch sensations. The child will react not only to actual touch but also to the anticipation of being touched. Instead of responding with an appropriate "Uh, oh" to light touch, the child responds with "Oh, no! Get Away! Don't touch me!" Perceiving most touch sensations to be uncomfortable or scary, he overreacts with a fight-or-flight response." While the child avoids light touch, he not only accepts but craves deep touch&.

It is important to understand that the out-of-sync child may be both hypersensitive and hyposensitive. For instance, he may jump when someone grazes his elbow, yet be indifferent to a broken collarbone.

Motor planning is necessary for another category of movement: fine motor control, which a child develops after establishing gross motor control.

A well-regulated tactile sense is fundamental for getting along well with others.

Exhibit behavior that seems willful or "difficult," when it is actually an aversive response to tactile stimuli.

Act silly in the classroom, playing the role of the class clown.

Appear very stubborn, rigid, and inflexible.

The child may often lay her head on the table, or sprawl on the floor, or slouch in her chair. She may have difficulty turning knobs and pressing levers.

Because the vestibular system is crucial for effective auditory processing, the child with dysfunction frequently develops problems with language&. The child may have difficulty detecting likenesses and differences in words. She may find it hard to attend to the teacher's voice without being distracted by background noises. Her receptive language may suffer: she may be a poor listener, have trouble following directions and struggle to read.

The child with vestibular and language problems benefits greatly from therapy that simultaneously addresses both types of dysfunction. Speech and language therapists report that just putting the child in a swing during treatment can have a remarkable results. Occupational therapists have found that when they treat a child for vestibular dysfunction, speech and language skills can improve along with balance, movement and motor planning skills.

Tactile-proprioceptive (or somatosensory) perceptions refers to the simultaneous sensations for touch and of body position. This perception is necessary for such ordinary tasks as judging the weight of a glass of milk or holding a pencil efficiently in order to write.

Manipulating objects may be difficult. He may exert too much or too little pressure on objects, struggling to turn doorknobs and regularly breaking toys and pencil points.

When a child is adept in several areas or achieves a splinter skill , parents, teachers, and pediatricians frequently believe that she has no definable problems. They think she is "just lazy" about learning new skills.

No child chooses to be disorganized, but the out-of-sync child is typically inconsistent in behavior.

You child's "hardheadedness" is a survival skill. Nobody awakens in the morning thinking, "Today I'm going to resist everything." Human beings learn to cope with a changing environment by being flexible. Your little fellow appears stubborn, however, because he is not the boss of his own body and he is not in control. His life is full of uncertainties and obstacles.

The vestibular and auditory systems work together as they process sensations of movement and sound. These sensations are closely intertwined, because they both begin to be processed in the receptors of the ear. The ability to hear does not guarantee&that we understand sounds. We are not born with the skill of comprehension; we acquire it, as we integrate vestibular sensations. Gradually, as we interact purposefully with our environment, we learn to interpret what we hear and to develop sophisticated auditory processing skills." [End passage quotes.]

At first, it was somewhat perplexing that Ms. Wildmo (audiologist) and Ms. XISD Occupational Therapist both recommended that we purchase the Simon2 toy for Stephen. Apparently, it provides therapeutic benefit in both vestibular and auditory processing.

In any event, both Occupational Therapists have indicated that Stephen would benefit educationally from OT therapy: Ms. Tupper via recommending treatment for one hour per week (preferably in two 30-minute increments) likely for a two to three year period; and Ms. XISD OT has verbally stated weekly therapy would be beneficial (undefined durations). It is further noted in Ms. XISD OT's written recommendations that Stephen would benefit from a home program of hand exercises as well.

Based on the aforementioned, we agree that Stephen requires Occupational Therapy in order to benefit from his education.

Psychological Evaluation

The Evaluations performed by Dr. Lynch, Ms. XISD Occupational Therapist, and Ms. Speech Pathologist #2 recommended Stephen have a psychological evaluation. Commentaries within these reports reflect that some of Stephen's anxiety symptoms were observed. In addition, Ms. Special Education Director recommended a psychological evaluation.

In response to the recommendations, the Psychological Evaluation was conducted by XISD's psychologist, Dr. R. Runson, III. The report is dated April XX, 2002; it was received by us (parents) from XISD on May XX, 2002. At the writing of this Summary, the report has been read, however, we have not subsequently consulted with Dr. Runson.

There are a couple of clarifications that need to be made in Dr. Runson's report, and they would likely have no overall impact on his final opinion.

The last sentence on page 1 of the report states, "Mrs. Leigh informed the examiner that she believes that most of Stephen's problems at home are related to his experience at school, that he possesses anxiety from school and tends to pick his nails, and has nightmares after he gets in trouble at school." Perhaps it is my interpretation of the sentence structure; however, it appears to come across that all of Stephen's "problems" are attributable to school. That is incorrect. However, Stephen's anxiety problems are attributable to school. The anxieties onset as we began to prepare Stephen for school start-up in August 2001 and have continued to worsen since that time. The severities of the symptoms directly correspond to Stephen being sent to the office for misbehavior. When this happens, the more severe symptoms are presented resulting in duration of one to three weeks. The symptoms include but are not limited to chewing on his clothing, biting his arm, trouble getting to sleep, nightmares, awakening in the night not a result of dreams, increased picking at nail cuticles, underwear soiling, etc. The anxiety is documented via Dr. David, Pediatrician, and Dr. Emily Tallon, Psychologist. In addition, it does not take a doctoral degree to figure out the cause when during the cycle, these subconscious symptoms abate or disappear over the weekend or holidays and miraculously reappear on Monday morning.

Page 3 states that the SSW testing by Lisa Wildmo indicated that Stephen may have difficulty listening to speech in background noise. That particular portion of Ms. Wildmo's report listed some examples of the symptoms seen in an individual with auditory cohesion. This is consistent with the diagnosis of impaired auditory discrimination.

As previously relayed in various communications to XISD and as evidenced by Stephen's quotes included in Dr. Runson's report, Stephen has poor self-esteem resulting, in part, from his perception that he is "stupid" and "bad" because he can't complete work as quickly as other students, has problems following directions and rules in accordance with authority expectations, etc.

It is noted that in addition to ADHD, Dr. Runson rendered a diagnosis of Disruptive Behavior Disorder - Not Otherwise Specified. As defined by DSM-IV-TR, this "category is for disorders characterized by conduct of oppositional defiant behavior that do not meet the criteria for Conduct Disorder or Oppositional Defiant Disorder." Stephen clearly is nowhere close to Conduct Disorder (often stealing, forcing someone into sexual activity, deliberately engaging in fire setting with intention to cause serious harm, and other things of this serious nature).

It is not uncommon for an ADHD child to also have traits that fall into the ODD category. From knowledge, out of the nine Disruptive Behavior Disorder traits listed Stephen possesses two (possibly three -- depending on what constitutes "often").

Until we can consult with Dr. Runson regarding the method/reasoning related to this diagnosis, it is felt that the basis of the diagnosis is not supported in his Evaluation. At this point in time, we disagree with this diagnosis.

It should be mentioned, however, that ODD often co-exists with ADHD, and that without proper intervention and support, in all likelihood the problems encountered will further develop to Disruptive Behavior Disorder, and progress further to ODD.

In part, it is for these reasons we have been persistent in pursuing evaluations for Stephen, i.e., the root problems must be identified and appropriate educational measures instituted as soon as possible in order to circumvent the potential for further behavioral problems.

Dr. Runson's report states that "Stephen was referred for psychological evaluation in order to determine if he meets eligibility criteria as an emotionally disturbed student." However, the report does not define "emotionally disturbed student." His report further states that, "Stephen does not meet eligibility criteria as an emotionally disturbed student at this point in time." After review of the IDEA federal law, it is assumed that Dr. Runson must be referring to a psychological definition of "emotionally disturbed student" rather than IDEA's definition.

As set out in the letter of transmittal, "serious emotional disturbance" is defined by IDEA's Definition of Disabilities via ERIC Digest E560 as:

A condition exhibiting one [emphasis added] or more of the following characteristics, displayed over a long period of time and to a marked degree that adversely affects a child's educational performance:

An inability to learn that cannot be explained by intellectual, sensory, or health
factors
An inability to build or maintain satisfactory interpersonal relationships with peers or
teachers
Inappropriate types of behavior or feelings under normal circumstances
A general pervasive mood of unhappiness or depression
A tendency to develop physical symptoms or fears associated with personal or
school problems.

Based on IDEA's definition of serious emotional disturbance, Stephen qualifies for Special Education.

MISCELLANEOUS

Documents provided to the parents by Examiners, which were not attached to the Examiners reports, include:

17 pages therapy of Auditory Cohesion from Lisa Wildmo, Audiologist
4 pages regarding Social Skills Instruction from Dr. Sharon Lynch
1 page document pertaining to vestibular, proprioceptive, tactile, auditory, etc., with
qualities that define Qualities the Make it Alerting and Qualities that Make it Calming
from Ms. XISD OT
6 pages regarding ADHD and management thereof from Ms. XISD OT
2 pages of hand-exercises from Ms. School District OT (pending eligibility
determination)
Information from Ms. Tupper regarding motor skills and sensory integration.

Please refer to Recommendations set out in each Evaluation Report. It is our opinion implementation of these items will facilitate Stephen's educational experience by providing avenues with which to derive educational benefit.

Assistive technology via an audio trainer has been recommended by Ms. Wildmo. In addition, we would like to address the benefits of FastForward at the ARD meeting on May XX, 2002.

Occupational therapy has been recommended by Ms. XISD OT and Ms. Tupper.

CONCLUSION

Stephen has ADHD, Central Auditory Processing Disorder, apraxia, tactile defensiveness as well as other problems associated with sensory integration, and school performance anxiety. As a result, he contends with problems on a daily basis that would prove overwhelming for most adults, let alone an eight-year-old child.

Due to Stephen's complexities, it has proven necessary to self-educate about many factors. With all due respect to the professionals, there is no one that has conducted the evaluations that have expertise in all problematic areas and also "know" the Subject of the report. For these reasons, it is my opinion they are at a disadvantage in analyzing and reconciling the cumulative information presented in the Evaluations.

The Education for All Handicapped Children Act (P.L. 94-142) of 1975 and the Individuals with Disabilities Education Act (IDEA) (P. L. 101-476) identified specific categories of disabilities under which children may be eligible for special education and related services. As defined by IDEA, the term "child with a disability" means a child: "with mental retardation, hearing impairments (including deafness), speech or language impairments, visual impairments (including blindness), serious emotional disturbance, orthopedic impairments, autism, traumatic brain injury, other health impairments, or specific learning disabilities; and who, by reason thereof, needs special education and related services ."

Stephen meets this criterion.

Alisha Leigh

Definitions of Disabilities:


CELF-R vs. CELF-3: The Clinical and Research Implications of the Renorming of a Standardized Language Test University of Wisconsin - Madison

KidsHealth: Central Auditory Processing Disorder

Aversive: a feeling of revulsion and repugnance, accompanied by an intense desire to avoid or turn away from it.

Sensorimotor: pertaining to the brain-behavior process taking in sensory messages and reacting with a physical response.

Motor planning: the ability to conceive of, organize, sequence, and carry out an unfamiliar and complex movement in a coordinated manner; a piece of praxis.

Proprioception: the unconscious awareness of sensations coming from one's joints, muscles, tendons and ligaments; the "position sense."

Sequencing: putting movements, sounds, sights, objects, thoughts, letters and numbers in consecutive order, according to time and space.

Vestibular system: a well-regulated vestibular system helps integrate both sides of our body.

Tactile discrimination: the awareness of touching or of being touched by something; the ability to distinguish differences in touch sensations.

Tactile defensiveness: the tendency to react negatively and emotionally to unexpected, light touch sensations.

Sensory Integration Dysfunction: the inefficient neurological processing of information received through the senses, causing problems with learning, development and behavior.

Splinter skill: an isolated ability that one develops with much effort, but that one cannot generalize for other purposes.


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