Can you help me decipher therapist notes for almost 4 yo DD?
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Anonymous
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I always feel like they are saying something without coming out and saying it. This is regarding Larla, age 3 (almost 4):
At the end of last year, she was transitioning independently following the classroom routines; but this year, Larla is struggling following direct instructions. Sometimes she shows she understands the directive but will get distracted half way or will not respond to the re-drection and continue on with her activity. Even when pointing out what other peers are doing, she doesn't always join them at the rug, even when the routine has been modeled to her in the past. It is important to note that she is not defiant or fighting re-direction; when given moderate support (holding her hand or guiding her to the rug), she will join her peers. Are they trying to say she’s regressing? Or that she doesn’t understand? Are they alluding to ASD or ADHD? What am I supposed to do to follow up or provide support here? We have similar struggles at home. I just do not know what to do. |
Anonymous
| Op here. I should note she’s already had an autism eval and we see a developmental pediatrician. She has an IEP. |
Anonymous
| It sounds like it’s pointing to ADHD and ruling out ODD |
Anonymous
No, it actually sounds like autism. ADHD is inability to focus or hyperactivity, but this evaluator is trying to describe ignoring/unawareness of social cues. |
Anonymous
(the tell is “even when pointing out what peers are doing …”) OP what did autism evaluation say? |
Anonymous
| It doesn't sound like a diagnosis at all -- which is a good thing, since teachers shouldn't be diagnosing. It sounds like your daughter is having trouble following classroom routines, which may be because of actual regression, but more likely because it's still the beginning of the year. We don't know from this description if she doesn't understand what she's supposed to do (language and/or memory) or doesn't want to (sensory issues) or impulse control/attention difficulties. |
Anonymous
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It sounds like she needs more support. For some reason she is not able to follow on the directions. She has the ability to but is maybe not retaining the info, is having trouble processing the information, getting distracted. The classroom could be noisier then last year. Directions also get more complex as the kids get older.
Make sure you check her hearing and make sure there is no wax buildup. See about getting a visual schedule to help with follow routine based directions. |
Anonymous
Op here. To be clear-I don’t think the therapist is trying to make a diagnosis or doing anything wrong. I’m just not sure what to do with this information. |
Anonymous
Op here. Support from where? And how do I make that happen? I’m unsure how to follow up. Hearing was checked recently and isn’t the problem. She’s in the same classroom this year as last year, with the same teachers. I am surprised she’s struggling, though we notice the inattention at home. |
Anonymous
Op here. The autism eval said no indicators for autism, but happened more than a year ago. |
Anonymous
| This was my DD at age 3-4. You got me at “had her hearing checked.” ADHD (inattentive type) was her diagnosis until age 15, at which point we finally got the (high functioning) ASD diagnosis. Girls express it so differently than boys, and all the research & test grids are keyed to the boys. |
Anonymous
| PP again. If you’re in NOVA and want practical, high quality help, see Dr Moshe Shtuhl at Family Cimpass in Reston. He’s less concerned with the label and can help address the behaviors that are concerning. Best of luck to you! |
Anonymous
If that evaluation was done by anyone affiliated with the school, or a doctor in the same school district, I’d get a second opinion. I’d ask, in writing, for a BCBA to conduct an assessment of transitions so they can create the necessary classroom tools or address skill deficits in this area. I’d start a home ABA program. Focus on parent training. |
Anonymous
| What therapist? It sound like receptive language. |
Anonymous
Op here. We paid privately for the autism assessment and it was done by a neuropsychologist. This was when DD was 2, almost 3, so not in school yet. We’ve tried to get ABA but can’t get insurance to cover it without an autism diagnosis. That’s why we did the autism eval was to try to get the diagnosis. We should maybe get another one. Will the school provide the BCBA or do we need to arrange and pay for that privately? |