Auditory processing 6 yr old dd - what more can I do?

[atgalileos]

Hello, my first post although I have been lurking in this section for a few weeks. I really could do with some advise.

6 year old DD has always been behind developmentally following a traumatic birth. Its been a long road for her especially with speech & language difficulties and more recently learning. She was discharged from SEN / SLT at the end of year 1 as school felt she was making good progress. Dyslexia has been ruled out. She has always been slow at instant recall and processing instructions, I suppose we had hoped that she would continue to improve.

It was only last month that we learnt from school report that she is performing well below expected levels. We met with teachers & SEN cordinator who then suggested we appoint a private Ed psychologist asap (very costly for report and follow up sessions).

I have also read on some threads that GP involvement leading to a developmental paediatric referral in some cases would be a good idea. Am just not sure which way to go now. On one hand I feel we should give her more time, then I get panicky and think there could be more underlying problems which need addressing before she starts junior school in Sept. In the meantime, we are reading and discussing books more and I am giving her Vegepa EPA, Zinc and Magnesium. I should point out that according to her teacher she is already receiving maximum support in class that they can offer.

Anyone with similar experience or advice for me please? Should we go the ED route and how will this benefit her? Perhaps I ought to speak to GP?

Thank you

I presume you are aware of her Auditory processing/recall abilities from the SALT assessments?
The focus of your post seems to be what route to go now- Education needs vs developmental paediatric team.
Personally, I would be inclined to the latter. IME Ed Psych is very useful as part of a developmental team but generally are expected to work stand-alone; so providing their expertise in a vauum to school.
A good service (rarely available) would have free exchange if information between Ed Psych, Paediatrician, Paediatric physio, OT, SALT. This team should be the one advising school of how to manage a child's individual needs.
Hope that is of some help.

exchange of

Wannabe - thank you very much and yes, we were aware of the processing issues and her SALT who is amazing provided a report to school citing this as well as practical ways to support her learning. I have been told these have been included in her IEP. Hence the question - how else could the EP assessment assist? Can EP diagnose a learning disorder? I too am leaning towards the paediatrian route but school seemed a bit put out that we did not take up their advise to get her to their recommended EP already. So confusing.

DD did not speak properly until she was nearly 5. Halfway through year 1 she was fluent and reading ahead of some of her classmates. Its like a bulb lit up ... SALT discharged her. So although at times her recall is worrying, I look back at the strides she has made in the last year and think she will be fine in time. Perhaps am kidding myself.

Do you know if GP's can refer to EP so we would not have to pay privately?

Yes, I think GP can refer; you would need to check waiting times and weigh that against going quickly and privately ( £ouch option).
Does your DD have a specific language impairment issue? If so then, the EP would prob give you what you need along with the SALT programme.
It sounds as if you dont have other physical concerns which would warrant a referral to Comm Paediatrician.

Auditory Processing Disorders are assessed and diagnosed by an audiologist, which has nothing to do with a psychologist.
Currently a GP referral to Great Ormond Street Hospital is the best option.
You could have a look at the following links lists.
UK APD
APDUK
Speech and Language

The school should be able to request an Ed Psych come in without it costing you.

Have you considered applying for statutory assessment/statement for her if she is struggling that much at school. If the LEA agree to assess there would usually be an Ed Psych report as a part of that too. I'm not quite sure why the school are asking you to pay for all this. Meanwhile I would say it will do no harm to go to the GP anyway and ask for a developmental paed referral so that your concerns can be looked at properly and see if there is any underlying reason she is falling behind. If you are worried about auditory processing then you will need a referral to Great Ormond Street.

Wannabe - thanks again. We are dealing with only the slow processing / working memory at the moment so I agree with you that a Paeditrician referral may not be warranted. I will however discuss with GP and see if she would be able to refer her to an EP at no cost.

Dolfrog - very useful links thank you. I see I have a lot of research to do yet. Have you been in contact with GOSH audiologist yet? Did you have good results? (sorry for assumption). I will definitely be speaking to GP about getting her referred to them.

Beautiful girls - Yes I did wonder too why they would suggest a private one. Please could you clarify what a statutory assessment is - is it the same process as applying for a statement? We would apply and push for any help that would be available for her. Can we do it ourselves or need school to get involved?

Statutory assessment is what you initially request with a view to them then issueing a statement yes. You can apply yourself and I would suggest you take a trip to the IPSEA website, but also a look at SOS:SEN and ACE as well for advice. You can ask for the SA, but they may refuse to carry it out (you can appeal this), likewise if they do carry one out they may still not issue a statement (you can appeal this too.) It is a long and drawn out process for many. If you don't already start keeping a file of all notes/letters/hospital reports etc etc that may be relevant as these are going to be evidence needed. A scanner/printer is very handy too speaking from experience, unless you are lucky enough to have access to a photocopier easily.

atgalileos
I have personally been in contact with the GOSH consultant for 12 years now. Our DS3 got very good multi - discipline assessment from GOSH two years ago, which has helped a great deal in secondary school.
All of our family have a clinical diagnosis of APD, our 3 sons, my DW, and me

local cahms blocked my lad's gosh referral 3 times! So, so frustrating.

Still want it formally assessed as it explains a LOT of my lad's communication (receptive language) issues and literacy problems. However my only option now is to go private, whch at present I just can't afford.

GP & pead in first instance to get GOSH. Gosh is a tertiary service so you have to go thru the local medics route first.

EP can can't diagnose - not a doc. The EP can only signpost what might help at school, (hint:- a medical diagnosis is VERY useful to an EP).

Do I think a formal diagnosis of apd is worth it in the long run? Yes or I wwouldn't be saving up my pennies. (My son is on the borderline for asd so everyone gets confused how to best help him iyswim - "complex needs" doesn't explain much in terms of concrete strategies).

Thank you everyone. Wow, theres so much to take in and look into ... I really should have taken action earlier.

Yesterday I spoke to SALT and requested her to re-open DD's file which she will do and visit her at school in a couple of weeks to re-assess her language. I have an appointment with GP for tommorow. I will be pushing for the GOSH referral, on basis that DD's problems are well documented from birth and she was expected to face a lot of difficulties.

I will be back with an update.

Hi bochead

slight diversion of the thread. You might find some useful information regarding your DS's issues if you scroll through nad have a look at some of the research papers included in the CiteULike Group "Audiology and Auditory Processing Disorder" library just a thought.