One thing which came up in her eval with dr Li, was the fact that she not only was suicidal last year, but she actually attempted to commit suicide by trying to strangle herself. As we all know , that wouldn't work, but we also know that a 9yo might not be aware of that. She had told her older sister, but no one else.
It scares and worries me how deep she was in her depression without me picking up any signals from her at all. It is very sobering, and makes me grateful that I am working on getting her the help she needs. She is doing much better already with prozac and therapy, and I hope school will be as much a positive influence for her as it has been for Zack.
Saturday, June 21, 2008
Violet: A Long Time Ago
While getting ready for all the evals, I decided to go through my old files and find Violet's evaluation from about eight years ago, when I had her screened by the school system. She was 39 months old, and I had her tested because she wasn't talking much at all. The speech that she had was not very clear. Reading this old evaluation was giving me interesting background information.
Screening Information: The Battelle Developmental Inventory Screening Test was used to assess overall development. Violet was very difficult to test and it could not be established whether this was due to her overall shyness or to a lack of understanding of what was being asked of her in English. Violet's mom was asked to complete the areas this examiner could not.
Personal-Social Domain: age equivalent 31-32 months old
Adaptive Domain: age equivalent 41-42 months old
Motor Domain: overall 40-41 months old.
Communication Domain: overall 34-36 months old. Receptive language 48-52 months. Expressive language 24-27 months.
Cognitive Domain: 20 - 22 months old.
The conclusion was that her overall score is within 6 months of her chronological age, so we could either just give her time and see whether she improves language wise / behavior wise, or we could proceed with further evaluations.
End of report, start of my remarks about it:
Back then, we decided to give Violet time and she started speaking more. But looking over this report now, I am amazed how her social issues were pretty clear back then, even as a itty bitty 3 years old. And it both slightly amuses me and slightly annoys me that their first thought was 'maybe she doesn't understand english because they speak dutch in their home' Um... her receptive English is 52 months old, that doesn't sound like language was a barrier here.
To me it is interesting to read about the big gap between her receptive and expressive language. It also is intriguing to notice how low she tests on her cognitive domain. I never had any worries that this reflected her true intelligence, but looking back, I can see where it reflects her social anxieties and test-taking anxieties. They did come to the house to test her, so she was in a familiar environment, but she still was totally unwilling to say anything to them.
I was happy I found this old information, since it helped me, and hopefully dr Li to fill in more of the complex and beautiful picture of Violet.
Screening Information: The Battelle Developmental Inventory Screening Test was used to assess overall development. Violet was very difficult to test and it could not be established whether this was due to her overall shyness or to a lack of understanding of what was being asked of her in English. Violet's mom was asked to complete the areas this examiner could not.
Personal-Social Domain: age equivalent 31-32 months old
Adaptive Domain: age equivalent 41-42 months old
Motor Domain: overall 40-41 months old.
Communication Domain: overall 34-36 months old. Receptive language 48-52 months. Expressive language 24-27 months.
Cognitive Domain: 20 - 22 months old.
The conclusion was that her overall score is within 6 months of her chronological age, so we could either just give her time and see whether she improves language wise / behavior wise, or we could proceed with further evaluations.
End of report, start of my remarks about it:
Back then, we decided to give Violet time and she started speaking more. But looking over this report now, I am amazed how her social issues were pretty clear back then, even as a itty bitty 3 years old. And it both slightly amuses me and slightly annoys me that their first thought was 'maybe she doesn't understand english because they speak dutch in their home' Um... her receptive English is 52 months old, that doesn't sound like language was a barrier here.
To me it is interesting to read about the big gap between her receptive and expressive language. It also is intriguing to notice how low she tests on her cognitive domain. I never had any worries that this reflected her true intelligence, but looking back, I can see where it reflects her social anxieties and test-taking anxieties. They did come to the house to test her, so she was in a familiar environment, but she still was totally unwilling to say anything to them.
I was happy I found this old information, since it helped me, and hopefully dr Li to fill in more of the complex and beautiful picture of Violet.
Friday, June 20, 2008
Violet Evals Part II
Before I tell about the dr Li evaluation, I want to tell about a Violet incident a few weeks ago. When we went to dinner, she was making up all kinds of small notes, and left a stack of them on the table when we left, for the server to find. They had cheersome notes like 'There is a bomb hidden in your bathroom, it will go off tomorrow morning at 10am.'
I am so glad I caught them and took them away before we had the FBI wake us up the next morning :p I talked to her about it to try to make her understand the severity and unacceptableness of this behaviour, but not sure how much reached her.
She had been drawing a lot about therapy sessions, and themes in there were very dark. Much killing, torturing, and death going on in there. The drawings lead to an interesting insight in her mind. We shared them with her therapist.
Let me introduce dr Li to y'all. He is a very reputable psychologist around here, works with the schools a lot, is very knowledgeable and has a waiting list which is ... long. It is not easy to get a consult with him.
In February, he evaluated Zack, and I was very impressed with him. Last month, I was thrilled to find out that he made a special exception for Violet and squeezed her in for this month.
Yesterday, the long awaited day arrived. She spent the whole day with him in his office. He gave her a full battery of neuro psych tests, to get a good picture of her. He is amazingly thorough and very good at what he does.
At the end of the day, I came to pick her up, and he shared the most important results with me. One striking result was reading faces. She not only got many of them wrong, but she often had the exact opposite of what the facial expression was saying. He thought she was very socially immature.
She often went to a very repetitive 'What's the point?' answer when she got lost or frustrated in any of the testing. She was not worried at all about how other people would perceive her, and told him that she holds grudges very long. For her sister Penny, she was going to hold a grudge for 'the rest of her life!' For friends at school, she would hold a grudge a few days , but she would tell them how they had done a very bad thing before she would give up on her grudge. He remarked that they might not like to hear that and her reply 'So why would I care?'
She did get idioms, but she could not figure out analogies very easily.
He did all kinds of IQ testing, and the interesting results are that she tends to test high (in high 120s ) for right hemisphere related tasks. She tested just as high for left hemisphere related tasks. But! The part of her brain that is used to communicate between the two hemisphere tested average, showing that those two hemispheres are not as good at talking to each other as you would like them to be given their high scores.
Dr Li felt it would be in her best interest to start in fifth grade. He says that she definitely needs social training to support her with her social skills. Not much of a surprise. I talked about the bomb threat notes, and he remarked that she said something similar when he took her out for lunch and he felt that this was very important information for him to have. I am glad I shared it with him.
Dr Li wants to go with official diagnosis of PDD-NOS for now. Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS). It is a diagnosis that means "on the autism spectrum, but not falling within any of the existing specific categories of autism." He agreed with me that she has a very specific Asperger-y flavour to her. He was hesitant to diagnose Aspergers for now, because 'she hasn't had many social interactions' (yes, it's all about homeschooling again :p) He didn't say that, but i felt it was gently implied in his remarks.
For school, PDD-NOS is just as fine as Aspergers, it will definitely qualify her for services and entitle her to an IEP. And that is all I need for now. I wouldn't be surprised if she gets 'upgraded' to Aspergers a few years from now though.
I am so glad I caught them and took them away before we had the FBI wake us up the next morning :p I talked to her about it to try to make her understand the severity and unacceptableness of this behaviour, but not sure how much reached her.
She had been drawing a lot about therapy sessions, and themes in there were very dark. Much killing, torturing, and death going on in there. The drawings lead to an interesting insight in her mind. We shared them with her therapist.
Let me introduce dr Li to y'all. He is a very reputable psychologist around here, works with the schools a lot, is very knowledgeable and has a waiting list which is ... long. It is not easy to get a consult with him.
In February, he evaluated Zack, and I was very impressed with him. Last month, I was thrilled to find out that he made a special exception for Violet and squeezed her in for this month.
Yesterday, the long awaited day arrived. She spent the whole day with him in his office. He gave her a full battery of neuro psych tests, to get a good picture of her. He is amazingly thorough and very good at what he does.
At the end of the day, I came to pick her up, and he shared the most important results with me. One striking result was reading faces. She not only got many of them wrong, but she often had the exact opposite of what the facial expression was saying. He thought she was very socially immature.
She often went to a very repetitive 'What's the point?' answer when she got lost or frustrated in any of the testing. She was not worried at all about how other people would perceive her, and told him that she holds grudges very long. For her sister Penny, she was going to hold a grudge for 'the rest of her life!' For friends at school, she would hold a grudge a few days , but she would tell them how they had done a very bad thing before she would give up on her grudge. He remarked that they might not like to hear that and her reply 'So why would I care?'
She did get idioms, but she could not figure out analogies very easily.
He did all kinds of IQ testing, and the interesting results are that she tends to test high (in high 120s ) for right hemisphere related tasks. She tested just as high for left hemisphere related tasks. But! The part of her brain that is used to communicate between the two hemisphere tested average, showing that those two hemispheres are not as good at talking to each other as you would like them to be given their high scores.
Dr Li felt it would be in her best interest to start in fifth grade. He says that she definitely needs social training to support her with her social skills. Not much of a surprise. I talked about the bomb threat notes, and he remarked that she said something similar when he took her out for lunch and he felt that this was very important information for him to have. I am glad I shared it with him.
Dr Li wants to go with official diagnosis of PDD-NOS for now. Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS). It is a diagnosis that means "on the autism spectrum, but not falling within any of the existing specific categories of autism." He agreed with me that she has a very specific Asperger-y flavour to her. He was hesitant to diagnose Aspergers for now, because 'she hasn't had many social interactions' (yes, it's all about homeschooling again :p) He didn't say that, but i felt it was gently implied in his remarks.
For school, PDD-NOS is just as fine as Aspergers, it will definitely qualify her for services and entitle her to an IEP. And that is all I need for now. I wouldn't be surprised if she gets 'upgraded' to Aspergers a few years from now though.
Violet Evals Part I
This is going to be a few posts about Violet to catch up on all the things which have happened over the last few months.
The more I thought about things, the more I felt that school could be a good experience for her, to help her how to figure out social rules. Make friends. Get fun art experiences. Find out how smart she is. I have to say that it helps me that Zack has had very good experience at school. Violet's school seems willing to work with her too.
Violet did enjoy the art classes, and after the last art class, someone interviewed her and she was 'student of the week'. She loved seeing herself in the school newspaper. And she was planning which comics she could write for them next year.
Her introduction to school via art was a positive one.
The harder issue was which grade to place her. She has a summer birthday, so she could either be the youngest in a sixth grade class, or the oldest in a fifth grade class. With her social issues, we were leaning more towards fifth grade. This would give her two years at this school before having to switch to middle school.
We tentatively thought fifth grade, till the academic testing got done. Apart from math, where she totally blanked out on anything she had ever known 'Division? No, NEVER done division! NEVER seen division! No idea what you are talking about! What's the point anyway?', she tested end sixth grade on lowest, and up to eleventh grade on highest level of academic subjects. Not bad for a girl who was a very late reader.
Her case manager, Trillian, called me and told me about Violet's results.
Me 'Hmmm, that is not bad at all, this makes me wonder about her placement all over again.'
Trillian 'Yes, I think we should place her in sixth grade. Violet might never be a girl who is socially motivated, she might be more academically motivated.'
Me 'That is a good point.'
Trillian 'Of course, we could put her in fifth grade, and give her harder work.'
Me 'But that would single her out and make things socially more awkward for her.'
Trillian 'Right, and there is a very nice sixth grade class she could enter.'
Me 'If she is at least end of sixth grade level at everything already, apart from math, even sixth grade will be easy for her.'
We talked back and forth for a while, and decided that it was hard to decide on fifth or sixth grade till she had had her full neuropsych workup with dr Li. But we leaned towards sixth grade, unless proven otherwise.
It kind of made me feel good that we basically unschool, and she still tested so high on all subjects but math. And that was more testing anxiety than anything else. Even so, she scored halfway third grade on math. It also means that she can focus on social skills instead of academic skills when she does enter school.
More later, I am really tired, and it's hours past my usual bedtime. I just wanted to get the Violet catchup started though.
The more I thought about things, the more I felt that school could be a good experience for her, to help her how to figure out social rules. Make friends. Get fun art experiences. Find out how smart she is. I have to say that it helps me that Zack has had very good experience at school. Violet's school seems willing to work with her too.
Violet did enjoy the art classes, and after the last art class, someone interviewed her and she was 'student of the week'. She loved seeing herself in the school newspaper. And she was planning which comics she could write for them next year.
Her introduction to school via art was a positive one.
The harder issue was which grade to place her. She has a summer birthday, so she could either be the youngest in a sixth grade class, or the oldest in a fifth grade class. With her social issues, we were leaning more towards fifth grade. This would give her two years at this school before having to switch to middle school.
We tentatively thought fifth grade, till the academic testing got done. Apart from math, where she totally blanked out on anything she had ever known 'Division? No, NEVER done division! NEVER seen division! No idea what you are talking about! What's the point anyway?', she tested end sixth grade on lowest, and up to eleventh grade on highest level of academic subjects. Not bad for a girl who was a very late reader.
Her case manager, Trillian, called me and told me about Violet's results.
Me 'Hmmm, that is not bad at all, this makes me wonder about her placement all over again.'
Trillian 'Yes, I think we should place her in sixth grade. Violet might never be a girl who is socially motivated, she might be more academically motivated.'
Me 'That is a good point.'
Trillian 'Of course, we could put her in fifth grade, and give her harder work.'
Me 'But that would single her out and make things socially more awkward for her.'
Trillian 'Right, and there is a very nice sixth grade class she could enter.'
Me 'If she is at least end of sixth grade level at everything already, apart from math, even sixth grade will be easy for her.'
We talked back and forth for a while, and decided that it was hard to decide on fifth or sixth grade till she had had her full neuropsych workup with dr Li. But we leaned towards sixth grade, unless proven otherwise.
It kind of made me feel good that we basically unschool, and she still tested so high on all subjects but math. And that was more testing anxiety than anything else. Even so, she scored halfway third grade on math. It also means that she can focus on social skills instead of academic skills when she does enter school.
More later, I am really tired, and it's hours past my usual bedtime. I just wanted to get the Violet catchup started though.
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