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Schmig

Assessments and school

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Schmig

I hope this is the right forum to post in. Sincere apologies if it isn't- please let me know where to move it

 

My DD 5 is currently undergoing some assessments after really struggling this year through prep. We have been told she is still below a prep level but are finding it hard to understand why nothing was detected earlier and why we were encouraged to send her to school (especially as she is at the very end of the age cut off for prep this year).

 

I feel like I don't know what questions to ask, or what assessments to have done and am being completely guided by her OT at this stage. We have had to wait 2 months to start OT and now I am really concerned about her moving on to year 1.

 

She is a very outgoing and social child and very talkative and tall and I wonder if this has been influencing people's thoughts on how advanced she is?

 

So far the OT/ teacher have mentioned the following:

  • hypotonia
  • very poor (and well below her age) fine motor skills
  • extremely inattentive
  • very difficult to get her to focus
  • very easily distracted
  • Potential ADD
  • hard to remain calm
  • doesn't listen or take in instruction
  • cannot form letters (I cannot read her writing at all except her name)
  • below prep level for reading and maths
  • behaviours that appear to be for self- soothing/regulating purposes
  • poor balance
  • low core strength
  • can't remember days of the week in order/ all letter sounds/ can't count past 20 readily or without help

I guess I am after some advice on what sort of assessments I should be asking for? Who I get them through? What will any results mean for potential classroom assistance or is it all for us to manage outside of school? What should I be doing around potentially keeping her back ?

TIA

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FuzzyChocolateToes

I would start with a GP appointment. I would ask them for a referral to a developmental paediatrician. I would also want an assessment by an educational psychologist. The paediatrician will likely want this too. You don't need a referral for a psychologist but you do for the paed.

 

This will take some time. You can look at holding back and classroom assistance after the assessments are done as you will be well informed.

Edited by FuzzyChocolateToes
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MsLaurie

Is it your OT pushing for further assessments, or the school, or yourselves? Do you have a paediatrician?

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Schmig

We don't have a pediatrician. We only saw one briefly when she was born as she was early and in NICU and special care nursery. She has been fine since then so only at the GP.

 

The school initially just pushed us to go to an OT and 'get assessed' which is not very helpful as I am not sure what for.

 

OT has done some assessments but I understand there are many that can be done, some of which she can't do. The latest thing she mentioned is getting assessed for ADD but I have no idea whether that is done in isolation or with other things.

 

I am concerned as I don't know how to manage this. All I know is that I have a child who I can clearly see is struggling with school work and focusing on anything and I don't know where to go from here. Everyone seems to be a little wait and see or vague about assessments and treatment but I worry that if we are in September and my child can't write anything legibly and can barely read should I be asking about keeping her back to allow time for her OT or whatever else is required to help?

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CrankyM

You need to see the GP and asked for a referral to a developmental pead. They will be able to guide you regarding assessments etc. unfortunately they can be very hard to get in quickly. You could also consult an educational psych who is able to do cognitive assessments and looking at the overall learning profile. I will warn you these can be very expensive though. Some psychs can also do assessments that relate to adhd/asd as well.

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MsLaurie

If there are issues around core strength and balance, you might also want to find a paediatric physiotherapist, if your OT isn’t strong in that area.

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Dianalynch

Agree with PPS, see a go for a referral to a developmental paed.

 

Are you in Melbourne op? Educational psychologists can do a whole range of cognitive assessments - there are some university clinics that do them for a reduced fee as they’re done by interns under supervision. Krongold at Monash is very reputable. Contact them and get her on their list if it’s something you wish to pursue, as they can have long wait times - and you don’t have to go ahead when your time comes. It will cost around $600 vs $2000plus at a private clinic.

 

As for holding back... Learning support can be provided in grade 1 just as well as in prep, and she may be more socially comfortable staying with her peers. If you get some assessments underway, her next teacher will be able to implement them. Teachers are very used to a wide range of abilities in their class.

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José

repetition seems to occur less. often these days than in the past. research seems to indicate repetition doesnt help.

given what you have said i would talk to GP about regerral to a paediatrician. id also be seeing a psychologist for cognitive/ educational assessment.

 

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blimkybill

Assessment is such a confusing process for everybody. There are many possible assessments, different times at which they can be done, different people who can do different ones. It's not surprising you feel confused, most people do.

 

First of all, I wouldn't be getting alarmed thinking "why didn't anyone pick this up before?". A lot of the things you mention are things that can't be seen until formal school as the expectation to do those things is not there until prep. Others on your list can develop really well through preschool and prep in some kids. There are some things which are usually considered by professionals better to assess a bit later. For example, it is quite uncommon to diagnose ADD before formal school, often not even in the first year. Assessment of specific learning difficulties doesn't usually happen until after at least a year of formal school. Mostly professionals (like doctors and psychologists) want to see if schooling will help the child progress through this issue, or whether the issue just gets more obvious. (The exception is of course children where these difficulties are blindingly obvious earlier, but that is not everyone).

 

Next, some people have mentioned educational psychologists. They can be very useful but also very expensive. Another option is to ask your school what assessments they can do. If you are in a public school they should have some access to an educational psychologist and any assessment they can offer should be free. This could include cognitive assessment (assessment of capacity for learning), functional assessment (assessment of how well she is functioning at school), academic assessment (assessment of how her learning is actually progressing), and/or screening assessments/checklists for conditions such as ADD. So go to the school first and see if you can discuss this with the educational psychologist and put some pressure on them to do their bit with assessments.

 

Then, yes a developmental paediatrician is a good idea. But if you can go into the paed appointment with some of the above assessments, you will be ahead, and the paed will have good information to work with.

 

Good luck. it can be a long process. It's good your school have been able to speak with you about issues they have observed and they will also now be able to offer some targeted support. Once they have more assessment information, they will be able to support her even better.

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FuzzyChocolateToes

What state are you in OP? We may be able to give you some names of specialists. I am in Melbourne and when we needed to see a developmental paediatrician the wait time was around 3 months. An initial developmental assessment cost ~$500 at the time, with a Medicare rebate. It took an hour and was very thorough.

 

Re: the prematurity, I believe that there is a link between ADHD and prematurity. I'm sure Jerry can confirm if she sees this.

 

Re: holding back next year, I really feel you need professional advice on that. An educational psychologist will be able to help you with that decision. I know it's approaching the end of the school year but I think you still have time and shouldn't feel rushed to make a decision. It's not something that is done lightly these days as it can have negative consequences for some kids.

Edited by FuzzyChocolateToes
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Prancer is coming

I would not look at keeping her back a year at school until I had all the facts. I would get a cognitive assessment done. Our school has a psych and they did the assessments for free. It did take a while, but I found the worse my kid got, the quicker he was prioritised. You don’t know if your child is behind due to the ADHD stuff around distracted and lack of concentration, the OT stuff around hypotonia and fine motor skill issues or to do with her general intelligence levels. There could also be learning disabilities and other stuff in there. When your kid has one condition, there are often others that end up getting diagnosed. The paed will look at what reports you have before making a diagnosis and may order others.

 

The school stuff is tricky, but what are you hoping to achieve by holding back? It may be once issues are known and addressed the academic stuff picks up. And if it ends up being issues which mean the academics are going to be a struggle, repeating may not fix this. It may help for the first year, but if they are going to be behind others in learning due to cognitive issues, it might not help in the following year. She sounds like she is quite social which is good.

 

Best of luck, I found going through the diagnosis path my my first child was one of the hardest things we did. My most useful advise to is find a helpful person and hang onto them! Ask for help, what you should be doing, what they think you should do. The support teacher at the school was my saviour!

Edited by Prancer is coming
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Orangecake

Hi Op

I would book into a dev Paed as soon as possible. Wait lists can be 4-6 months. In the meantime an educational psych assessment will provide you and the school with more information. The Paed will also be able to use this info.

A great family GP, who is experienced with kids will be invaluable in organising referrals and coordinating.

Best of luck

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Paddlepop

Everything that Prancer is coming said. I would hesitate to hold her back, especially if she fits in well socially with her classmates.

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Schmig

Thanks so much for for the advice. I will start with the GP for referrals. For those who asked we are in Melbourne

 

In terms of potentially keeping her back, this was raised by the OT. I have asked everyone I know who has kept a child back and interestingly not one of the 10 has any regrets at all. The only person with regrets is the one who didn't keep her child back which is quite different to the feedback here. I guess we were hoping to achieve her feeling more confident at school. Although she has friends and is chatty she is acutely aware of how behind she is and is routinely upset at what others can do that she can't. I'm also influenced by the fact my eldest was the same at that age but is much more reserved and sensitive now. We aren't looking to make any decisions without as much advice as possible.

 

At the moment the school have only told me they are concerned in preparation for us receiving the mid year report. They haven't made any other suggestions except to see an OT since that initial conversation. This is where the confusion started as we have not been given any other guidance on where we should be going for more advice. So I'm just muddling through it alone at the moment.

 

 

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quartz85

Also get her eyes tested if they haven't been done this year. That's easy to do. Many behavioral problems are actually eyesight problems. Even if it's just to rule that out.

 

If she is young for her year I would consider holding her back if that is the school recommendation.

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Yippee-Ki-Yay

I have to say in regard to holding back, we did this with my older child. He did an extra year of kinder instead of heading into school due to autism and lack of social skills. It was absolutely the right thing to do. He needed the extra time to be able to deal with what was going on around with his peers. It also helped with his confidence.

 

As for assessments, it is frustrating that people are not clearly communicating the specifics with you. Again, I had similar with my older child. No one wanted to get off the fence and point to a possible diagnosis. Very frustrating as I had no idea beyond knowing he needed help.

 

Like PP's have said, a developmental paed and educational psych are great starting points.

 

A full developmental assessment (usually performed by a child psych) will oftne not give complete answers but the results can recommend a more targeted assessment for a specific disorder and is also helpful in engaging more supports for your child.

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TheirMum2

You mentioned that your daughter was early and spent time in a NICU. After discharge was she monitored by a developmental clinic attached to the hospital?

 

If so, this could also be a place to re-visit to ask for recommendations around what assessments might be helpful and links to other services that might be provide these assessments if needed.

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PuddingPlease

Thanks so much for for the advice. I will start with the GP for referrals. For those who asked we are in Melbourne

 

In terms of potentially keeping her back, this was raised by the OT. I have asked everyone I know who has kept a child back and interestingly not one of the 10 has any regrets at all. The only person with regrets is the one who didn't keep her child back which is quite different to the feedback here. I guess we were hoping to achieve her feeling more confident at school. Although she has friends and is chatty she is acutely aware of how behind she is and is routinely upset at what others can do that she can't. I'm also influenced by the fact my eldest was the same at that age but is much more reserved and sensitive now. We aren't looking to make any decisions without as much advice as possible.

 

At the moment the school have only told me they are concerned in preparation for us receiving the mid year report. They haven't made any other suggestions except to see an OT since that initial conversation. This is where the confusion started as we have not been given any other guidance on where we should be going for more advice. So I'm just muddling through it alone at the moment.

 

I'm a bit surprised that people seem so opposed to repeating too. You have already advised that she started relatively young so it doesn't sound like doing a second year of prep will leave her significantly older than the rest of her class.

 

I have known/known of a few kids who have done their prep year twice and I've never really heard of anyone regretting it. Obviously it will not instantly solve all of her difficulties but giving her some breathing room doesn't seem like a bad thing, especially if it is prompted by her school.

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Schmig

So I spoke to the GP and have a referral to the Developmental Pediatrician now. GP has seen her at two appointments this week when I went for other things and brought her along and believes an ADD assessment would be beneficial.

 

Emailed the teacher and OT asking for feedback on:

  • Where she is at now compared to before starting OT at start of term
  • What their thoughts are on current reading writing and ability to focus in class
  • How do they feel about the idea of her staying down given that information
  • If we wanted to keep her down when is the latest we can make a decision by
  • Are there any other assessments either would recommend
  • Is there anything else they would like to tell me or that I should consider

Let me know if there is anything else I should ask about.

 

Thanks everyone for your advice,

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MsLaurie

Has her hearing been checked recently? For my daughter we never suspected hearing issues as she hadn’t had any infections or anything, but it turned out both ears were totally blocked and had been for some time. Just thinking of comment about how it’s hard to get her to listen or pay attention.

 

ETA: My daughter still has a long long way to go, but hearing was clearly a huge factor and getting it sorted has helped a lot.

 

As you’re in Melbourne, maybe give Taralye (paediatric hearing centre & school for deaf children) a call? They have audiologists who specialise in testing young kids. Or just look up children’s audiologists, but many don’t work with kids under 7.

Edited by MsLaurie

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Schmig

Has her hearing been checked recently? For my daughter we never suspected hearing issues as she hadn’t had any infections or anything, but it turned out both ears were totally blocked and had been for some time. Just thinking of comment about how it’s hard to get her to listen or pay attention.

 

ETA: My daughter still has a long long way to go, but hearing was clearly a huge factor and getting it sorted has helped a lot.

 

As you’re in Melbourne, maybe give Taralye (paediatric hearing centre & school for deaf children) a call? They have audiologists who specialise in testing young kids. Or just look up children’s audiologists, but many don’t work with kids under 7.

 

Thanks. Her hearing has been monitored since she was 18 months old. She had grommets then. She has great hearing. I agree hearing issues could have a significant impact if undetected.

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JBH

Glad you’re going to a developmental paediatrician. It’s a great idea.

 

The other assessment you could consider is an educational psychologist. There are a few things to think about in terms of who to see first and how to stage it, and to my mind they are more practical than anything else. You might find it takes a long time to see the paed, maybe 6 months. If you can get in with an educational psychologist significantly sooner, you may receive some insight more quickly, so you can get the right supports started. However, all these assessments are expensive, and because you really do want the paed review, you might want to wait and ask if the psych is necessary. If money isn’t an issue, i’d Just press ahead with both.

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taters

A few things you have said are signs of cerebral palsy. Given the issues with muscles, balance and fine motor skills I would definitely be discussing it with a paediatrician.Behavioural/learning issues can also be caused by CP.

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