COMAR 13A.05.01 Determination of an SLD -- Has it changed?

[Anonymous]

Anonymous wrote:Thanks, PP. I understand the difference you're talking about. My DC also took a number of achievement tests, but when the results were drastically different from expected performance the psych tended to blame attention all errors rather than a separate LD, based on her testing experience with DC. (Crawling under the table, trying to take the booklet out of the tester's hand, etc.)

This is sometimes hard -- deciding whether it is ADHD or SLD. Our neuropsych also blamed ADHD initially, and that was the only diagnosis despite clear evidence of an SLD in the IQ/achievement scores and a co-existing language disorder diagnosed by a SLP several years ago. At the meeting with the neuropsych to discuss initial score reports, prior to the drafting of the report itself, the neuropsych didn't even mention anything other than an ADHD diagnosis. I questioned why no SLD was diagnosed when the score discrepancy supported it. I also shared that I noted very ADHD like behavior much more often when my child was engaged in language-based tasks -- to me his discomfort with language was so overwhelming it literally made him physically uncomfortable. The SLP noted the same thing in her report. So, after our long conversation about the IQ/achievement discrepancy, the language disorder and the many ways in which I saw the language problems manifesting in reading and writing, the neuropsych did include SLD in the final report.

I think that without the SLD diagnosis and only the ADHD diagnosis, the IEP team would have denied my child an IEP and would have only provided a 504 plan, which wouldn't have addressed his underlying problems at all, but it would have allowed him enough time to better "mitigate" or "hide" his difficulties, and enable him to stay barely at grade level. Now that DS is getting instruction appropriate to his SLD, I see a huge difference in his ability to "focus", his behavior, and his "antsy-ness".

It can sometimes be hard to make the differential diagnosis between ADHD and SLD, particularly in higher IQ kids, or decide even if the two might be co-existing.

Of course, another way to approach the differential diagnosis is to do a trial course of ADHD medication and see what the response is. In our case, family medical history precludes the use of most ADHD meds, and there is a strong family history of language-based learning disability, so I thought it was important to treat as an SLD first and see what the response was. Neither response to medication nor response to intervention is my favorite way to make the differential diagnosis, but there often are not clear markers for decisions..... maybe some day we will have a clear "test" for these, but until then.......