The meeting

Today was the day. It was the meeting I have both been anticipating and dreading at the same time. Andrew will be turning 3 next week so legally the Birth to 3 program and the school district have to test him and decide what to do about services before that birthday. Because of our family history, Andrew was given both the standard developmental testing that would occur when a child ages out of the Birth to 3 program and Autism testing. This past month I have been taking Andrew over to the school for that testing and filling out evaluations and questioners. All told Andrew was given 10 different tests or evaluations

The first part of the testing was the full-scale developmental evaluation. This measures the language skills , gross and fine motor skills, and cognitive development. The test took a little over an hour. Andrew was tested by one of the Early Education Teachers, the Speech Language Pathologist, Occupational Therapist, and Physical Therapist. He was also observed by another speech therapist who is also the Autism consultant. He was required to do a series of tasks such as pointing to a correct object or stack blocks or answer a question appropriately. I was not present for the PT and OT or speech part but Andrew was cooperative and did pretty well without me.

To save time I was given a bunch of checklists and the Gilliam Autism Rating Scale and Asperger Syndrome Diagnostic Scale to fill out and bring back. It was also decided that Andrew would do much better if the testing was broken down into smaller chunks of time so the Autism testing that would normally take 2-3 hours was broken into one session to do the Autism Diagnostic Observation Schedule (ADOS) test and another to do the interview/intelligence testing. Andrew was also observed during MOPS when he was in the MOPPETS room. Normally the child would be observed during class time but since Andrew does not go to school or daycare we needed a setting where he was with a group of children.

I have filled out most of the checklists and tests before so this was not unfamiliar. Even so, it still was a challenge since I was being asked specific question about my child and some of them I could answer many different ways. He's 2 so how am I supposed to answer questions on whether or not he makes and keeps friends or if he shares his toys with others. I did have my Birth to 3 speech therapist and occupational therapist help me with some of the questions since they can be more objective than I can. In addition to the paperwork, I was asked a series of similar questions both by the Psychologist and the Autism consultant. The actual testing was very similar to what the developmental testing was. In the case of the ADOS, Andrew was observed doing tasks very close to what he did the week before. To an untrained person it really looked like Andrew was playing games with the tester. The main difference was he was being judged on different criteria. The observers were looking for specific behaviors that he would or would not do. Did he make appropriate eye contact, did he interact with the people appropriately, did he play with the toys appropriately, when given a certain situation, did he react appropriately....you get the idea. He only had two meltdowns so I was pretty pleased.

The third series of testing involved more questions and asking Andrew to do more educational type things. These were the IQ and intellectual ability tests. This part was pretty easy since all I had to do was answer yes or no and when I hit 3 No's we moved on to the next section. At one point I had to leave and take Carolyn to OT so I left Andrew there. He did just fine although according to the psychologist, Andrew discovered that the puzzle pieces had numbers on the back of them so he started to focus on the numbers and not the puzzle pieces themselves.

So after all that testing was completed, the team would then meet and interpret scores and determine if Andrew met criteria for both the Early Childhood Special Education program and Autism Spectrum Disorders. This is where I totally love the Brandon Valley School District. They are smaller than the Sioux Falls District and more progressive when it comes to special services. Because of that my children have had success getting services that if we had been in Sioux Falls would not be available. This is not a knock on the SF school district, they are still a great district but they also have a lot more special needs children competing for a limited number of spaces so the test scores of my kids would probably be too high to qualify for SF but do qualify here. If Andrew did qualify for services then he would enter on an Individual Education Plan (IEP) and that would be reviewed yearly until he no longer qualified for Special Education Services.

So fast forward to today. Carolyn has speech and OT from 9:15 to 10:15. The plan as has been all month was to leave after transportation picked Carolyn up and then be back home by 10:20. This morning my phone rang at 9:15, it was Lisa the Early Education Coordinator who was in charge of Andrew's meeting. I told her no, I did not forget the meeting, transportation had not showed up yet. A few phone calls later and I find out Carolyn's driver forgot to pick her up. No, I don't want the Transportation secretary to come and get her, I'll just take her over myself. Needless to say I got there 20 minutes late. I apologised to all who had shown up on time. So with even less time than usual, the meeting began.

The PT and OT were the first to speak since they had kids to see and did not want to run late. That part of the meeting went very well. Andrew is on track with the majority of his gross and fine motor skills. There were a few problems here and there but overall they were pleased. Amy, the OT was thrilled when she discovered Andrew possessed the proper pencil grip and the ability to write correctly on paper (both Matthew and Carolyn struggle with this and with the fine motor skills needed for handwriting). Both OT and PT were pleased with Andrew's abilities and he scored in the normal range so he does not need their services.

Speech went next. Overall Andrew did wonderful. He improved in scores since the first evaluation at 18 months. He tested out in the normal range. A lot of time was spent on the speech stuff since it is such a huge part of the overall evaluation. This is the area Andrew has had problems in and is the area all my kids struggle with. As far as speech goes, there are several components that get scored. Andrew is scored on how well he knows words, how well he understands words, and how well he speaks and pronounces words. Trust me, there are lots of sentences and paragraphs dedicated to the language scores in his evaluation. The language part that deals with how Andrew responds to directions and questions is a whole other set of numbers. Andrew still has delays in certain areas of language such as spontaneous speech ( intitating a conversation) and social language (having a back and forth conversation). Andrew also has problems answering certain questions appropriately or following complicated directions. I'm not too surprised. He did qualify for speech services and will get therapy 2 times per week.

The biggest part of the meeting was the discussion of the developmental scores and the results of the Autism testing. This was the confusing part. All the information is tallied and scored and put out in the report and the Psychologist goes through and reads both the scores and what they mean. Because we were so time limited, he tried to skim over and compress things. According to the report, Andrew did not meet criteria for a specific learning disability or developmental delay. That made me very happy. What that meant was according to the test scores, Andrew is functioning in the normal range for a child his age. Things were looking up.

When it came to the Autism scores things got even more confusing. Andrew does not show "typical" behavior. He does have the speech/language difficulties that would be associated with the disorder but does not have the social impairment that would normally be seen. However, he does love numbers and letters...a lot. I will admit to being on the "huh" side of confused when all the test scores were being interpreted so I'm not quite sure how to explain things so I will just wing it. According to the Psychologist, they too had difficulty with how to score and rate Andrew. He has a family history of ASD and in order for something to count at least 2 people had to observe the behavior or action. Because of his young age, some of the data isn't the best indicator. He ended up meeting the criteria for the Autism Spectrum Disorder diagnosis. Basically, he functions very close to someone with Aspergers Syndrome but does not meet the criteria for that diagnosis. Aspergers kids don't have the language and speech delays, have social impairment issues and are usually focused on a narrow topic or item. Andrew has speech and language delays, is OK in the social skills department, but is obsessed with letters and numbers. He also appears to have a normal IQ. OK, I'll go with that.

To sum things up, this meeting went almost like I expected it to. I was surprised that Andrew got the Autism Spectrum Disorder (ASD) diagnosis. I expected that he'd get he *Pervasive Developmental Disorder-Not Otherwise Specified diagnosis that Carolyn got but I guess since he has no real delays that does not apply. Am I surprised he's on the spectrum? No, not really. Am I disappointed or upset? Once again I have to say no, I'm not. I knew Andrew had huge odds stacked against him when it came to escaping any type of Autism diagnosis. He's a boy and has 2 older siblings diagnosed. I'm just happy Andrew is not developmentally delayed or more severely affected by the disorder. *PDD-NOS is considered an Autism Spectrum Disorder even though it does not have Autism in it*

Because of the need for speech services and his ASD diagnosis Andrew did qualify for the preschool so he will start on the day after his 3rd birthday which is this Wednesday. He will have the same teacher Carolyn did so I don't have to worry about meeting a new teacher. I know Andrew is going to have so much fun. Preschool here he comes!!