dr.j (ID=0) (Sep 18, 2001 8:58:31 AM)
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dr.j (ID=0) (Sep 18, 2001 9:06:21 AM)
good morning to anyone who enters the chat.

dw (ID=1) (Sep 18, 2001 9:15:36 AM)
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dw (ID=1) (Sep 18, 2001 9:15:57 AM)
hi dr j, it's debbie, i just stopped for amoment from work

dr.j (ID=0) (Sep 18, 2001 9:16:31 AM)
good morning dw debbie. How are you and the family?

dw (ID=1) (Sep 18, 2001 9:16:43 AM)
i was not sure if you were going to be doing the chat this am or not.

dw (ID=1) (Sep 18, 2001 9:17:06 AM)
we are all doing well.

dr.j (ID=0) (Sep 18, 2001 9:17:18 AM)
I posted a reminder last night. And, since no one was here, I just posted another come over to the chat.

dw (ID=1) (Sep 18, 2001 9:17:39 AM)
i didnt get the reminder about the chat, but i've had alot of trouble with email the last week

dw (ID=1) (Sep 18, 2001 9:17:48 AM)
i wonder if others missed it also

dw (ID=1) (Sep 18, 2001 9:18:42 AM)
i can only stay a second and i must get back to work

dr.j (ID=0) (Sep 18, 2001 9:18:54 AM)
I hope it's not the listserv? ? ? You know, that 's funny, I don't think I saw my posting to the CAPD list either. I have to check this out.

dw (ID=1) (Sep 18, 2001 9:19:17 AM)
no, it wasn't on the listserv....might want to check archives.

dw (ID=1) (Sep 18, 2001 9:19:29 AM)
i think email everywhere is slow right now with the system being bogged down

dr.j (ID=0) (Sep 18, 2001 9:19:36 AM)
I understand. It was really nice of you to drop by. I think I have to do more postings to remo=ind people.

dw (ID=1) (Sep 18, 2001 9:19:55 AM)
i will now that we are back on a regular schedule agan too

dw (ID=1) (Sep 18, 2001 9:20:03 AM)
have a wonderful wonderful day!

dr.j (ID=0) (Sep 18, 2001 9:20:03 AM)
Yes, and yesterday, things may have been clogged with the reopening of the stock market.

dw (ID=1) (Sep 18, 2001 9:20:20 AM)
talk toyou soon!

dr.j (ID=0) (Sep 18, 2001 9:20:44 AM)
Yes, have a wonderful day and I hope you and the family are safe and secure in these "crazy" times right now.

dw (ID=1) (Sep 18, 2001 9:20:56 AM)
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Joan (ID=2) (Sep 18, 2001 9:28:21 AM)
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dr.j (ID=0) (Sep 18, 2001 9:28:37 AM)
good morning joan. How are you this am. It's good to see you.

Joan (ID=2) (Sep 18, 2001 9:29:01 AM)
Hi Dr. J, I'm fine. Haven't been on a chat for a loonnngg time.

Joan (ID=2) (Sep 18, 2001 9:30:09 AM)
Actually I thought I'd just check in and see what happend with the Listserv. I haven't been able to get onto the website and have had no digest since last Tuesday. Is is down?

dr.j (ID=0) (Sep 18, 2001 9:30:17 AM)
Well,it's really been a long time for me that ANY one hasbeen here. I know the summer schedule (esp. because of my summer schedule) was irratic. ANyway, you just missed one other person, dw (debbie) one of the many debbies on the list.

dr.j (ID=0) (Sep 18, 2001 9:31:17 AM)
I don't know what is going on, but I too can not get into the website and check the archives and, for me as listowner, make adjustments when problems occur. I have emailled the maelstrom webmaster to see what is going on.

Joan (ID=2) (Sep 18, 2001 9:32:39 AM)
Unfortunately I'm at work so I don't know how long I'll be here myself, but since I have a captive audience (ha ha) I'll ask you a few questions. I just had my 10 year-old daughter's auditory battery repeated (lat one in 6/99) at Stony Brook University Med Center on Long Island. She shows some deficits and some borderline problems. I just happened to bring the report with me to work today.

dr.j (ID=0) (Sep 18, 2001 9:33:43 AM)
Of course you did. (just kidding) ;-)

Joan (ID=2) (Sep 18, 2001 9:34:29 AM)
For speech in noise she scored 75% for right ear and 735 for left which they say is borderline (72% bilaterally). Also, SSW, right ear competing errors 7 (normal limit is 4) and left competing erros 7 (normal limit is 6).

dr.j (ID=0) (Sep 18, 2001 9:35:08 AM)

Joan (ID=2) (Sep 18, 2001 9:35:11 AM)
Also, low pass filtered speech test, right was 32% and left was 16% whic are below normal limit of 50%

dr.j (ID=0) (Sep 18, 2001 9:35:22 AM)

Joan (ID=2) (Sep 18, 2001 9:36:10 AM)
Further, competing sentences 80% right ear and 37.5% left . Normal supposed to be 100 for better ear and 80% for worse ear. Pitch pattern sequence test was normal.

dr.j (ID=0) (Sep 18, 2001 9:37:04 AM)

Joan (ID=2) (Sep 18, 2001 9:37:55 AM)
I guess my question is this, what type of remediation do you recommend based on these findings? Of course, my audiologist had all the usual classroom mods, ie. preferential seating, frequent breaks etc. but no mention of any real remediation. She evidentily has problems decoding, auditory closure and sound blending, resistance to distortion, binaural separation skills for sentences and borderline problems with auditory figure ground and tolerance facing memory.

dr.j (ID=0) (Sep 18, 2001 9:38:00 AM)
FOr competing sentences, I have no idea how they came up with 37.5% since there are 10 sentences inBOTH of the standardized CS tests and there is NO partial scoreing.

Joan (ID=2) (Sep 18, 2001 9:39:38 AM)
Also, Jillian has been on Concerta, the time-release version of Ritilan since last April and we have seen a huge difference in her school work and functioning in the classroom. I am trying to cover all bases here and I'm not sure how much weight to put into this report.

dr.j (ID=0) (Sep 18, 2001 9:39:43 AM)
Joan, without having the raw data and info like WHICH competing message test was use (for example) I could not answer your question. I have found that audiologists all the time either leave out information or make calculation errors because of lack of familiarity with the test (especially the SSW test) and just knowing what you said for the SSW is not sufficient for me to make ANY interpretation.

dr.j (ID=0) (Sep 18, 2001 9:40:08 AM)
Well, was Jillian on her meds at the time of the APD testing?

Joan (ID=2) (Sep 18, 2001 9:42:00 AM)
Yes, she was on her meds. I had a long discussion with the audiologist about whether or not she should be on them. We decided it would give a truer picture of her audiological abilities instead of her attention problems.

dr.j (ID=0) (Sep 18, 2001 9:42:05 AM)
Back to what I was saying, if I were asked to come in on the case, and review the raw data as well as recent psychological or neuropsychological tests, and SLP tests, I could come up with a comprehensive assessment of Jillian's aduitory processing strengths and weakensses and then I would be able to specific accommodations that would be useful in class and school and at home as well as specific goals for remediation.

dr.j (ID=0) (Sep 18, 2001 9:42:55 AM)
Yes, if the goal of the APD testing is to determine how Jillian functions in school and she is on meds in school, it is best for her to be on the medication the day of the testing. That was a smart idea.

Joan (ID=2) (Sep 18, 2001 9:44:43 AM)
Yes, I was afraid that this report was going to be rather vague. I do have a good relationship with the audiologist. I am going to give him a call just to review these findings. What kinds of questions do I need to ask him? I did ask him his approach to testing and he takes the age norm approach as well as pass/fail approach on certain portions of the test. He also suggested I see a neruo-physch. What will a neuro-physc do? I'm glad I made the right decision on the meds during testing. I was worred about that.

Joan (ID=2) (Sep 18, 2001 9:45:35 AM)
By the way, ABR was also normal.

Joan (ID=2) (Sep 18, 2001 9:47:27 AM)
Binaural integration skills for non-linguistic stimuli, organization and sequencing and pattern perception and temporal sequencing skills were all normal.

dr.j (ID=0) (Sep 18, 2001 9:48:41 AM)
THe age norm or pass/fail approach ONLY says Jillian passed or failed the tests and says NOTHING about what her results and behaviors on the APD testing really mean. If this audiologist does not understand a categorical approach (breaking down each test and the overall tests to determine the specific category or underlying area of APD that is affected). It is only through some categorical approach (and there are a few categorical approaches including my own) that we can find the specific underlying area of processing deficit.

dr.j (ID=0) (Sep 18, 2001 9:49:08 AM)
As for the neuropsych......has Jillian had a psycholological eval and if so when?

Joan (ID=2) (Sep 18, 2001 9:49:09 AM)
Also, one of his recommendations was to use the auditory trainer. She did use it regularly in third grade, not so regularly in 4th. But for 5th, it was such a battle last year I have abandoned it with the blessing of her SLP. Just seems to be a hindrance to her now and makes her different instead of special. I saw no improvements with it.

Joan (ID=2) (Sep 18, 2001 9:51:43 AM)
She has had not physchological eval other than the school physcologist who does your basic Conner scale and the WISC. I'm unsure if this is something I really need to do or not. I'm all for it if helps understand better what's going on. If it's going to give me the same answers I already have, then I don't see the point.

dr.j (ID=0) (Sep 18, 2001 9:51:45 AM)
Joan, from the limited information you provided to me, an FM trainer does NOT seem to be appropriate for Jillian regardng her auditory processing abilties. It seems that she has a higher level breakdown, possible what is called (in my model and a few others) integration. BUt, there are still many different types of integration problems, and knowing just the scores can not provide me with sufficient knowledge of which integration area or type is at the route of Jillian's problems in APD. But, for ANY integration problem, an FM trainer is not an appropriate accommodation. Also, please remember, an FM trainer is NOT a treatment or remediation for APD.

dr.j (ID=0) (Sep 18, 2001 9:53:57 AM)
Well, from an APD perspective, a WISC is sufficient for looking at both verbal information processing and non-verbal information processing (performance) to see how Jillian performs in these areas and what the subscales tell us about her information knowledge and processing of meaningful, linguistic material. An SLP eval would add to the linguistic piece. SO, we could see how the APD problem impacts her langauge and cognitive abilties.

Joan (ID=2) (Sep 18, 2001 9:54:52 AM)
Yes, I am aware that the trainer is not a treatment or remediation and that is why it was so easy for me to give it up. I must say that this year, Jillian's teacher thinks things are going really well so far (short as it has been). We considered FFW 1 this past summer but I put Jillian in a Kumon math and reading program instead. Not sure if you are familiar with Kumon, it's a Japanese method of teaching and it's almost been like a tutoring for her. She has done very well. I am thinking about some sort of phonemic tutoring or program as academically, that's where she needs the help.

dr.j (ID=0) (Sep 18, 2001 9:56:23 AM)
Yes, I am aware of the Kumon approach and from the little I know of Jillian it would be a good approach since it is primarily a decoding approach to math and reading and NOT an integrative approach. SO, you were building up her skills in math and reading using her strength which seems like it is in decoding areas.

dr.j (ID=0) (Sep 18, 2001 9:57:17 AM)
As for FFWD, again, this approach MAY be a good tool to do at a future date depending on the specific area of integration with which JIllian is found to have problems.

Joan (ID=2) (Sep 18, 2001 9:59:06 AM)
Well, actually last June we had our annual review for the special ed committee (of which I am a member who sits in on other children's meetings and makes decisions) so I am pretty well versed in this area. She had made significant academic gains over 3rd grade and didn't really qualify for spec ed services. However, we look at how these types of children function in the real world, ie the classroom and take that into consideration. We actually reduced her resources room from 5 to 3 periods a week and have a 1X month OT consult instead of 1X week. I see a maturation myself but wonder if there's something else I should be doing. Of course, without more detail, I know that is difficult for you to know. I do feel very confident in the course I have taken thus far. I guess as a parent, I just need to touch base every now and then with someone "in the know".

Joan (ID=2) (Sep 18, 2001 10:01:19 AM)
Seems like I am on the right track. Guess that's what I really needed to know. We are going to continue with the Kumon as least for a couple of more years. It certainly can't hurt. My older daughter does Kumon math just because she LIKES it if you can belive that! So, are there any questions I should be asking my audiologist when I chat with him?

dr.j (ID=0) (Sep 18, 2001 10:01:33 AM)
Joan, no that is fine touching base. ANd please note that if you feel you would want me to come in as a consultant and review ALL of Jillian's information including IEPs and write a detailed report specifying the underlying areas and how they impact her eduationally and in the real world, and set up recommendations for appropraite accommodations and specific goals for remedaition, this can be arranged.

Joan (ID=2) (Sep 18, 2001 10:02:37 AM)
That would be wonderful, how would we accomplish this?

dr.j (ID=0) (Sep 18, 2001 10:03:13 AM)
Yes, you should ask your audiologist to identify the specific underlying areas of auditory processing that account for the test results obtained and how these relate to the presenting problems in school. Ask the audiologist to identify specific areas of processing deficit and then what accommodations go with each specific area. Ask the audiologist to identify specific goals for remediating the specific underlying areas of APD.

Joan (ID=2) (Sep 18, 2001 10:05:12 AM)
Great, I'm going to put this in writing, fax to him so he has it in front of him before I call. (I'm a real paper-trail person, I run a law firm). Is there any way I can print off this chat? I don't chat much so I'm a little rusty. I know they get archived but how long does it take to do that?

dr.j (ID=0) (Sep 18, 2001 10:05:44 AM)
If you'd like me to come in as a consultant, I would need all the data, info, especially on the APD test the raw data so I can see the actual responses obtained. THis is critical because, for example, and I am only stating fact based on my knowledge of the tests, the CS test scores correct or incorrect for each sentence so that the results are in units of 10% there is no partial credit. ALso, since there are a number of different filtered word and competing sentence tests, I would need to know which one was done to determine the real normal ranges and reliability and validity of the tests.

Joan (ID=2) (Sep 18, 2001 10:06:16 AM)
OK, I'll see what I can obtain from Stony Brook

dr.j (ID=0) (Sep 18, 2001 10:06:29 AM)
Yes, these chats are archived, but, I don't know how to get into the archives. Debbie Wood set up the archives, so you may want to email her at debbie@ncapd.org

dr.j (ID=0) (Sep 18, 2001 10:07:16 AM)
YEs, and if you do want me to come in as a consultant you can email me or send me the packet to my office in Washington, DC it's in my signature in my email on the chat list.

Joan (ID=2) (Sep 18, 2001 10:09:00 AM)
OK, I will contact Debbie. Thanks so much for all your advice and help. I'll see what I can gather together and get back to you. Hopefully the Listserv will be back up and running soon. It may have gone down as a result of last weeks terrorist attacks. Recent world events are really terrifying. I'[ve been crying a week. Good talking to you. I'll sign off now and get back to work. I appreciate your advice and I'll get back to you as soon as I get everything together. Thanks again, Joan Lyons

dr.j (ID=0) (Sep 18, 2001 10:10:28 AM)
Yes, Joan, that is very reasonable. It may be that the maelstrom system was affected in some way. Even though it's in Jamica, Queens, it may be affected. I emailed the maelstrom webmaster to see what is going on.

dr.j (ID=0) (Sep 18, 2001 10:10:52 AM)
I hope you get the answers you need for Jillian. BUt, if you need my help, please let me know.

Joan (ID=2) (Sep 18, 2001 10:11:43 AM)
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Joan (ID=2) (Sep 18, 2001 10:12:28 AM)
Thanks again.

Joan (ID=2) (Sep 18, 2001 10:12:36 AM)
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dr.j (ID=0) (Sep 18, 2001 10:12:51 AM)
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Barb (ID=3) (Sep 18, 2001 10:34:37 AM)
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* (ID=5) (Sep 18, 2001 10:37:16 AM)
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Barb (ID=4) (Sep 18, 2001 10:37:30 AM)
Good morning

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lynne (ID=8) (Sep 18, 2001 5:58:38 PM)
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