Anonymous
05/04/2016 13:06
Subject: Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Anonymous wrote:*just as you can have MERLD with or without ASD*
Since the neuropsych did not find ASD, stop worrying OP.
You can't have MERLD with ASD. Part of the definition of MERLD is that you don't have ASD.
There are many conditions that can cause expressive and receptive language delays, such as ASD, and ID, and Hearing Loss. However, there are also kids who have expressive and receptive delays without a larger syndrome that explains them. Those are the children that qualify (or qualified as this is an older way of categorizing) for MERLD.
Stating that ASD was incompatible with other diagnoses was a very controversial part of DSM-IV's approach and one that was routinely ignored by clinicians, who could plainly see that their patients suffered from multiple disabilities. That's why DSM-V now allows ASD kids to have other related diagnoses. But even under DSM-IV nobody blinked an eye if you got multiple diagnoses, except maybe the DSM-IV committee and their groupies.
Anonymous
05/04/2016 11:31
Subject: Mixed Receptive-Expressive Language Disorder
Anonymous wrote:*just as you can have MERLD with or without ASD*
Since the neuropsych did not find ASD, stop worrying OP.
You can't have MERLD with ASD. Part of the definition of MERLD is that you don't have ASD.
There are many conditions that can cause expressive and receptive language delays, such as ASD, and ID, and Hearing Loss. However, there are also kids who have expressive and receptive delays without a larger syndrome that explains them. Those are the children that qualify (or qualified as this is an older way of categorizing) for MERLD.
Anonymous
05/04/2016 11:21
Subject: Mixed Receptive-Expressive Language Disorder
FWIW, we found that school and neuropsych didn't have enough experience to diagnose MERLD. Only the SLP did the testing at the finer level to get at the individual pieces of our DS's language disorder.
Also, IME, MCPS is terrible at dealing with SLP problems. From their perspective, if a student is successful communicate verbally to others at the most basic level, then there's not an "adverse educational impact". Our DS had an articulation disorder which MCPS explicitly refused to even consider addressing until age 8, and even then refused because they said he could make himself understood despite the lisp.
FWIW, for a struggling kid with a diagnosis of ADHD, dyslexia and a language disorder, I'd consider placement in a private SN school specifically geared toward language learning disabilities. My child spent time at the Siena School. It made a huge difference to have daily small group instruction tailored to dyslexics, dysgraphics and those with other language-based learning disabilities. If not private school, invest what you can in private tutoring. IME, public schools suck at dealing with dyslexia and its ripple effect thru the student's education.
Also, IME, MCPS is terrible at dealing with SLP problems. From their perspective, if a student is successful communicate verbally to others at the most basic level, then there's not an "adverse educational impact". Our DS had an articulation disorder which MCPS explicitly refused to even consider addressing until age 8, and even then refused because they said he could make himself understood despite the lisp.
FWIW, for a struggling kid with a diagnosis of ADHD, dyslexia and a language disorder, I'd consider placement in a private SN school specifically geared toward language learning disabilities. My child spent time at the Siena School. It made a huge difference to have daily small group instruction tailored to dyslexics, dysgraphics and those with other language-based learning disabilities. If not private school, invest what you can in private tutoring. IME, public schools suck at dealing with dyslexia and its ripple effect thru the student's education.
Anonymous
05/04/2016 11:12
Subject: Re:Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:It's weird that you just received a MERLD diagnosis. It's no longer in the current DSM and is covered by these categories:
--Language Impairment
--Late Language Emergence
--Specific Language Impairment
--Social Communication Disorder
--Voice Disorder
We were diagnosed with MERLD under the previous DSM. You can definitely have it with or without being on the spectrum. Language Impairment and Specific Language Impairment are so broad and lump in a lot of things in the current DSM.
You might find reading up on Social Communication (Pragmatics) Disorder helpful:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-social-communication-disorder
and Language Disorders:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-language-disorders
My guess would be on a practical level, your kid might have trouble with back and forth conversations, particularly with peers. Kids who fit the MERLD profile have difficulty tracking what others are saying as well as simultaneously processing what they want to say. Your kid may also have difficulty with group sports, like soccer--where there are a lot of other bodies, the ball, the coach. Your kid may also have difficulty organizing his thoughts to paper, organizing paragraphs for example. (A lot of these issues are also present in kids with ADHD.)
A lot of these issues are related to executive function and processing. So if your kid has ADHD and dyslexia, it doesn't surprise me that he has MERLD. I just find it surprising that the psychologist gave this diagnosis now and wondering if it was a private or school testing.
If you have MERLD, you do not have ASD/PDD, as a previous poster said.
MERLD is still diagnosed everyday. Just because it's not in the DSM doesn't mean professionals aren't using it.
Well, that's not very professional of them. BTW, PDD isn't the DSM either anymore. Having MERLD doesn't preclude you from being on the spectrum. You can have both or just one. It's a processing issue.
Ok anti MERLD MOM, we get that you do not believe in MERLD.
No, dipsh*t, my kid has a MERLD diagnosis from several years ago. (And yes, kids have been diagnosed with both autism and MERLD under the previous DSM.) You're just one of those prejudiced parents who balked at the autism label--no, horror, not my kid. So what if your kid has autism or not. There's not much that's different about your kid and one with autism, Tourettes, etc. It's all brain wiring. The point is that the OP should be getting a diagnosis that is actually in the current DSM. Her kid's issues will probably fall under the topics MERLD was folded under. (I sincerely doubt he has autism if he's already 12 and has been assess previously and that's not one of the areas in any case.) So get off your "but my kid's not autistic" soapbox. No one cares.
OP, if this was a private evaluation, then you may want to address this issue with the tester. If you're trying to get accommodations written into your IEP, e.g., preferential seating, you'll need an up-to-date diagnosis.
Not accurately. It's right there in the definition. Do you also not think the sky is blue?
Anonymous
05/04/2016 02:01
Subject: Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Dr Stephen Camarata at Vanderbilt University is an expert on this -- it may be worth a trip to see him. Our son had the same diagnosis, and Dr. Camarata is the best.
In person he is good, especially with kids. His report was worthless as someone else wrote it and there was no diagnosis or recommendation. Just raw test scores. He knows these kids but just too busy now to do wha he used to do.
Anonymous
05/03/2016 23:37
Subject: Mixed Receptive-Expressive Language Disorder
Dr Stephen Camarata at Vanderbilt University is an expert on this -- it may be worth a trip to see him. Our son had the same diagnosis, and Dr. Camarata is the best.
Anonymous
05/03/2016 20:09
Subject: Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:DS, in 6th grade, was just diagnosed with this. He's long had ADHD and dyslexia and has struggled a ton in school. He has had speech evaluations in the past but no one ever flagged this specifically. Any insights/recommendations/encouragement. We're trying to wrap our heads around this, including whether it goes together with an autism spectrum DX (he has not been DX'd ever as being on the spectrum and has had a recent neuropsych evaluation). Many thanks!
OP, MERLD is not a spectrum disorder. it is a language based disorder. Was your testing done by the school system or by an actual psychologist?
The testing was done by a very good SLP. He separately had neuropsych testing and the neuropsychologist recommended speech-language testing.
OP I totally understand your confusion. If you trust your SLP and the psychologist, and neither of them used the word "autism spectrum" then you have nothing to be concerned about. Do keep in mind however that many of the therapies will be the same as what a chid on the spectrum would receive.
We are in MCPS. My DS is 13, with significant ADHD which impairs his language and social interactions because he can't focus long enough to really "catch" social queues. You can imagine the snowball effect this has! We had him tested 3 times over the years. Twice by neuropsychologist and once by a developmental pediatrician at Kennedy Kreiger (KKI). All agreed on ADHD, and early on one psychologist suspected MERLD but that was later replaced by the signifiant ADHD diagnosis. All the while MCPS kept stomping their feet, trying to shove ASD down our throats because their "quasi-psychologist" who has MAYBE a Masters degree and not a Doctorate degree felt that was the correct diagnosis. This is because they have zero idea what they're talking about. Its easier for them to just shove your kid into a neat little box so that they can just be done with it. That has disastrous outcomes, so if you're in that position please be weary of this.
FWIW we pulled DS out of MCPS and put him in private because they pretty much washed their hands of DS. They thought they had him figured out and treated him as such- as a low achieving kid who would not amount to much.
Can you tell me how your son is doing there? Sounds like mine who was diagnosed as having a receptive delay then later we found out that it's the severe ADHD. Language is okay.
Hi PP. It feels/seems that DS is FINALLY turning the corner academically although he has a while to go still. When he was in MCPS he fell a little further behind every year - even with an IEP. it was a snowball effect and it had to stop Also, while in public he saw a tutor once a week to try to help close that gap just a little. She has been his tutor for at least 5 years. Now that he's in private he sees her once every few weeks as a "check in" and she has noticed a significant difference in his reading comprehension, and his critical thinking has also improved.
Now we are steadily working on the social part too via a weekly social skills class.
It's a very slow and steady process and sometimes you wonder if all this stuff you're doing is helping. You just have to trust it, align yourself with the right team of people. My experience, and others may disagree, is that MCPS is just not equipped to handle kids with complicated learning profiles. I believe they do try, and many of them have their hearts in the right place - but it's a really broken system
Anonymous
05/03/2016 18:49
Subject: Re:Mixed Receptive-Expressive Language Disorder
Anonymous wrote:
The point is that the OP should be getting a diagnosis that is actually in the current DSM.
A lot of clinicians disagree with some DSM-V classifications, just as many disagreed with things in DSM-IV before it. There is no requirement for a professional to diagnosis according to DSM-V, except for insurance purposes. If they need to give a DSM-V diagnosis for any reason, they will just write the closest official diagnosis, but that doesn't change their opinion.
Anonymous
05/03/2016 18:36
Subject: Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Anonymous wrote:Anonymous wrote:Where did you do Fast Forward therapy?
We did at Metropolitan Speech in NW DC:
http://www.metspeech.com/
My information is a bit dated, but when we did it you could do the first couple of sessions and the company would determine if the child was likely to benefit based on preliminary results. As I recall, you could get an almost full refund if the child was not deemed qualified.
Metropolitan ran intensive sessions in the summer done with a group of kids. We did the first part one summer and the second part the next summer. The second had okay results but nothing to compare to the first session, for which the results were stellar.
I believe you can now do this at home with your child, but that wouldn't have worked for us as I work full time and have relatively frequent travel. While the Metropolitan session was run with groups, each kid spent most of his time working alone with headphones. But they could socialize during breaks, which it made it a little more fun for them.
How is that really therapy if kids work alone on computers/tablet with headphones?
It is a computer based program where the kids learn to identify how various phonemes sound through games that increase in difficulty. Each day's results are uploaded to the company, which then downloads the appropriate games and levels for the next day.
Fast Forward improves auditory processing, deficiencies in which can greatly affect receptive language. It is also used to improve reading. Strangely, however, my DS had no problem learning to read. The SLP told me that just reading his language test scores she would have predicted a 99% probability he could not read. That he could she attributed to the teaching skills of his very experienced first grade teacher.
Anonymous
05/03/2016 18:30
Subject: Re:Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:It's weird that you just received a MERLD diagnosis. It's no longer in the current DSM and is covered by these categories:
--Language Impairment
--Late Language Emergence
--Specific Language Impairment
--Social Communication Disorder
--Voice Disorder
We were diagnosed with MERLD under the previous DSM. You can definitely have it with or without being on the spectrum. Language Impairment and Specific Language Impairment are so broad and lump in a lot of things in the current DSM.
You might find reading up on Social Communication (Pragmatics) Disorder helpful:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-social-communication-disorder
and Language Disorders:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-language-disorders
My guess would be on a practical level, your kid might have trouble with back and forth conversations, particularly with peers. Kids who fit the MERLD profile have difficulty tracking what others are saying as well as simultaneously processing what they want to say. Your kid may also have difficulty with group sports, like soccer--where there are a lot of other bodies, the ball, the coach. Your kid may also have difficulty organizing his thoughts to paper, organizing paragraphs for example. (A lot of these issues are also present in kids with ADHD.)
A lot of these issues are related to executive function and processing. So if your kid has ADHD and dyslexia, it doesn't surprise me that he has MERLD. I just find it surprising that the psychologist gave this diagnosis now and wondering if it was a private or school testing.
If you have MERLD, you do not have ASD/PDD, as a previous poster said.
MERLD is still diagnosed everyday. Just because it's not in the DSM doesn't mean professionals aren't using it.
Well, that's not very professional of them. BTW, PDD isn't the DSM either anymore. Having MERLD doesn't preclude you from being on the spectrum. You can have both or just one. It's a processing issue.
Ok anti MERLD MOM, we get that you do not believe in MERLD.
No, dipsh*t, my kid has a MERLD diagnosis from several years ago. (And yes, kids have been diagnosed with both autism and MERLD under the previous DSM.) You're just one of those prejudiced parents who balked at the autism label--no, horror, not my kid. So what if your kid has autism or not. There's not much that's different about your kid and one with autism, Tourettes, etc. It's all brain wiring. The point is that the OP should be getting a diagnosis that is actually in the current DSM. Her kid's issues will probably fall under the topics MERLD was folded under. (I sincerely doubt he has autism if he's already 12 and has been assess previously and that's not one of the areas in any case.) So get off your "but my kid's not autistic" soapbox. No one cares.
OP, if this was a private evaluation, then you may want to address this issue with the tester. If you're trying to get accommodations written into your IEP, e.g., preferential seating, you'll need an up-to-date diagnosis.
You are a very charming person who has yet to address any of OP comments and have strictly made it about you. You didn't read the OP post nor addressed anything except to talk about your child which has no relevance to OP. This really has little to do with autism and has to do with MERLD.
Anonymous
05/03/2016 18:29
Subject: Re:Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:I always wonder why the MERLD posts attract such vitriol.
I suspect it's because it gets confused with autism a lot, and nobody wants the autism label if their child isn't really autistic.
Vitriol poster here.
Actually neuropsych dx'ed DS with PDD NOS. But not on the obvious language problem alone. He added in "stereotypical behaviors" and was visibly irritated when I called them tics. It was all very confusing as those only started when DS was 7 following strep and were accompanied with OCD. He actually had what NIH dx'ed a couple of years later as PANDAS. We weren't really sure where to go after neuropsych but ended up at a psychiatrist who treats a lot of kids with autism and he said definitively DS did not have autism and dx'ed him with "tic-related OCD."
Whether it was autism or not, he would have needed the language therapy. But OCD/Tics/PANDAS requires something completely different from autism, so diagnosis can matter.
So, if your child is not MERLD,, and something very different, why are you posting regarding a MERLD question?
Kid had MERLD, dx'ed by SLP, neuropsych dx'ed PDD NOS based on language problems plus "stereotypical behaviors," psychiatrist saw the language problems and agreed with SLP but disagreed with PDD and dx'ed tic-related OCD, later re-dx'ed at NIH as PANDAS.
So in essence DS had two things: MERLD and PANDAS, and he did not have autism. The language problems plus the tic-related OCD caused the neuropsych to dx PDD NOS instead--no longer in the DSM I understand, but a variant of autism.
If all of that sounds confusing, you can imagine how confused I was back in the day before autism was a very frequent dx and PANDAS had barely been heard of.
Anonymous
05/03/2016 18:26
Subject: Re:Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:It's weird that you just received a MERLD diagnosis. It's no longer in the current DSM and is covered by these categories:
--Language Impairment
--Late Language Emergence
--Specific Language Impairment
--Social Communication Disorder
--Voice Disorder
We were diagnosed with MERLD under the previous DSM. You can definitely have it with or without being on the spectrum. Language Impairment and Specific Language Impairment are so broad and lump in a lot of things in the current DSM.
You might find reading up on Social Communication (Pragmatics) Disorder helpful:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-social-communication-disorder
and Language Disorders:
https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/communication-disorders/understanding-language-disorders
My guess would be on a practical level, your kid might have trouble with back and forth conversations, particularly with peers. Kids who fit the MERLD profile have difficulty tracking what others are saying as well as simultaneously processing what they want to say. Your kid may also have difficulty with group sports, like soccer--where there are a lot of other bodies, the ball, the coach. Your kid may also have difficulty organizing his thoughts to paper, organizing paragraphs for example. (A lot of these issues are also present in kids with ADHD.)
A lot of these issues are related to executive function and processing. So if your kid has ADHD and dyslexia, it doesn't surprise me that he has MERLD. I just find it surprising that the psychologist gave this diagnosis now and wondering if it was a private or school testing.
If you have MERLD, you do not have ASD/PDD, as a previous poster said.
MERLD is still diagnosed everyday. Just because it's not in the DSM doesn't mean professionals aren't using it.
Well, that's not very professional of them. BTW, PDD isn't the DSM either anymore. Having MERLD doesn't preclude you from being on the spectrum. You can have both or just one. It's a processing issue.
Ok anti MERLD MOM, we get that you do not believe in MERLD.
No, dipsh*t, my kid has a MERLD diagnosis from several years ago. (And yes, kids have been diagnosed with both autism and MERLD under the previous DSM.) You're just one of those prejudiced parents who balked at the autism label--no, horror, not my kid. So what if your kid has autism or not. There's not much that's different about your kid and one with autism, Tourettes, etc. It's all brain wiring. The point is that the OP should be getting a diagnosis that is actually in the current DSM. Her kid's issues will probably fall under the topics MERLD was folded under. (I sincerely doubt he has autism if he's already 12 and has been assess previously and that's not one of the areas in any case.) So get off your "but my kid's not autistic" soapbox. No one cares.
OP, if this was a private evaluation, then you may want to address this issue with the tester. If you're trying to get accommodations written into your IEP, e.g., preferential seating, you'll need an up-to-date diagnosis.
Anonymous
05/03/2016 18:18
Subject: Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Anonymous wrote:Where did you do Fast Forward therapy?
We did at Metropolitan Speech in NW DC:
http://www.metspeech.com/
My information is a bit dated, but when we did it you could do the first couple of sessions and the company would determine if the child was likely to benefit based on preliminary results. As I recall, you could get an almost full refund if the child was not deemed qualified.
Metropolitan ran intensive sessions in the summer done with a group of kids. We did the first part one summer and the second part the next summer. The second had okay results but nothing to compare to the first session, for which the results were stellar.
I believe you can now do this at home with your child, but that wouldn't have worked for us as I work full time and have relatively frequent travel. While the Metropolitan session was run with groups, each kid spent most of his time working alone with headphones. But they could socialize during breaks, which it made it a little more fun for them.
How is that really therapy if kids work alone on computers/tablet with headphones?
Anonymous
05/03/2016 18:17
Subject: Re:Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Anonymous wrote:Anonymous wrote:I always wonder why the MERLD posts attract such vitriol.
I suspect it's because it gets confused with autism a lot, and nobody wants the autism label if their child isn't really autistic.
Vitriol poster here.
Actually neuropsych dx'ed DS with PDD NOS. But not on the obvious language problem alone. He added in "stereotypical behaviors" and was visibly irritated when I called them tics. It was all very confusing as those only started when DS was 7 following strep and were accompanied with OCD. He actually had what NIH dx'ed a couple of years later as PANDAS. We weren't really sure where to go after neuropsych but ended up at a psychiatrist who treats a lot of kids with autism and he said definitively DS did not have autism and dx'ed him with "tic-related OCD."
Whether it was autism or not, he would have needed the language therapy. But OCD/Tics/PANDAS requires something completely different from autism, so diagnosis can matter.
So, if your child is not MERLD,, and something very different, why are you posting regarding a MERLD question?
Anonymous
05/03/2016 17:54
Subject: Mixed Receptive-Expressive Language Disorder
Anonymous wrote:Where did you do Fast Forward therapy?
We did at Metropolitan Speech in NW DC:
http://www.metspeech.com/
My information is a bit dated, but when we did it you could do the first couple of sessions and the company would determine if the child was likely to benefit based on preliminary results. As I recall, you could get an almost full refund if the child was not deemed qualified.
Metropolitan ran intensive sessions in the summer done with a group of kids. We did the first part one summer and the second part the next summer. The second had okay results but nothing to compare to the first session, for which the results were stellar.
I believe you can now do this at home with your child, but that wouldn't have worked for us as I work full time and have relatively frequent travel. While the Metropolitan session was run with groups, each kid spent most of his time working alone with headphones. But they could socialize during breaks, which it made it a little more fun for them.