IEP: When a child has perfect hearing, but complains that she can't hear, and really can't spell?

Question

I am the legal guardian of my younger sister. We are in the process of evaluating her for an IEP, which has been put on hold for the summer (I'm not in the States). On her WIAT-II, her spelling was only in the 5th percentile and her written expression was in the 13th percentile. Her reading was at the 87th percentile (reading comprehension was very high, decoding was lower) and her math was in the 61st percentile. I took her to the audiologist a month before this whole process started, because I was concerned, and as was she and the school, that she was not hearing properly. However, her audiograms were perfect. Yet, she still can't seem to hear. From my own observations she has problems with hearing over back-ground noise, she has problems distinguishing between 'i' and 'e' sounds. The school seems to think she has a 'disorder of written expression', a writing disability. I however feel it may be something more. Any ideas as to what I should do to help her? Thanks

Answer 1

auditory processing can cause difficulty spelling-because you can't hear the sounds of the word right.....

she may be writing the way she is hearing---it sounds like it is auditory based rather tahn visually (written expression) based

Answer 2

You stated that your sister had audio-grams and they were perfect.  An audio-gram I believe only tests for normal hearing.  Did you have her tested for Central Auditory Processing?

My son has  "normal hearing" but has an auditory processing deficit. He cannot process what he hears in his left ear when there is background noise and/or competing noise coming at his right ear at the same time.  

He has the same problem in school he cannot hear well in the class room.

CAPDmom

Answer 3

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Answer 4

As has been pointed out by other responders, this situation strongly smacks of a suspected CAPD.  Only a licensed audiologist can assess for and diagnose CAPD.  Many school districts will not volunteer a referral to an audiologist who performs this type of assessment (not all of them do, as evidenced by the audiologist who only tested your sister's hearing).  Many of these school districts are not well trained on this issue while others simply don't want to have to pay for the testing or any therapeutic intervention that might be found to be educationally necessary as a result of it.  

Nonetheless, your sister is entitled to a Free and Appropriate Public Education (FAPE) and that includes assessment in all areas of suspected disability by qualified assessors.  That's federal law (see sources below).  

Make a written request for a CAPD assessment by a licensed audiologist of your sister's school district.  A speech/language assessment would also need to be conducted, if a proper one hasn't already been done.  The audiologist will want to consult with the SLP to determine what kinds of testing the SLP should do during the speech/language evaluation.

The only way they can turn you down is with a written explanation as to why they don't think it's necessary.  If you disagree, you have recourse.  You can either pursue the appropriate assessment privately, present the findings to the IEP team, and request reimbursement from the district for the cost of the assessment or you can file for due process against the district and pursue the CAPD assessment as your proposed remedy.  

How you proceed if they turn down your request for CAPD assessment will likely be govered by whether you have the resources to pursue the assessment privately or not.  If you can produce evidence of the disorder through private assessment, they can't really argue that it wasn't an area of suspected disability and you're more likely to get reimbursed after the fact.  If you take the district to due process to get the assessment, things will likely become adversarial between you and the district for a while, if not forever (depending on how long it is before the key people retire from or otherwise leave the district).  But, if you don't have the resources to pursue the assessment first at private expense, then the only option you're really left with if they deny your request for CAPD assessment is due process.

Litigation is always the last resort, though due process is supposed to be an informal administrative hearing and not as complicated or involved as actually going to court - plus, chances are the district would settle before it ever got in front of a hearing officer.  It is always in the child's best interest to work things out without having to file for due process, but if it comes right down to it, that option does exist.

I only speak of the possibility of due process now because I've been down this path with families we have assisted before.  Some school districts are very proactive and not only have the internal resources to assess for CAPD, but suggest that it be done when symptoms such as those you've described become apparent.  Other school districts will deny the need for such assessment, and resultant services, by scratching and clawing their ways through ugly, undignified, venomous litigation and retaliatory conduct against children and their families.  Then you've got all the remaining school districts that fall on the continuum somewhere in between these two extremes.  

Hopefully the advice regarding due process will never be needed.  Request the assesment first and see where that takes you.  Do EVERYTHING in writing.  If it happened on the phone, it didn't happen.  Make the record.  If a dispute arises later, you'll be glad you documented everything.  Documenting everything is your best deterrent against things going wrong, anyway.  If they know evidence exists that supports your claims, they're more inclined to work with you rather than against you.

With respect to the scoring data you provided, I suspect that your sister is actually very bright and has managed to figure out the meaning of text from contextual clues and sight word recognition rather than decoding a whole lot.  That's an extremely difficult adaptation for her to work out for herself, if that's the case.  Nonetheless, difficulty distinguishing sounds from an auditory processing perspective can have signficant bearing on how much your sister is gaining (or not) from classroom instruction.  It can also impact her communications with others in social situations, which can impact her social/emotional functioning at school.

You didn't state your sister's age, so I don't know whether therapeutic recommendations will be made for her or not, presuming she's diagnosed with CAPD.  While windows of opportunity for therapeutic intervention never close, they do become increasingly narrow over time.  The younger she is, the more receptive to therapeutic intervention she is likely to be, so acting on this sooner rather than later is probably for the best.  GOOD LUCK!!!!!

Update:  Well, the information I provided above pertains specifically to special ed law in the United States, so for families with similar concerns in the U.S., there you go.  

For your specific situation, I did a search and came up with the regulations for Ontario, which I'm not sure that you in or how similar they are to the regulations where you are in Canada, but I can't imagine they're too different.  (See additional source below.)  It does not appear that the regulations call for assessment in all areas of suspected disability. See Part IV, Section 15(1) which only mandates an educational assessment.  I take that to mean a measure of academic achievement.  

Sections 15(2)-(4) call for a health, psychological, and/or interview assessment only if the committee determines that such is necessary.  Section 15(6) requires the committee to consider any information provided by the parent/guardian.  I take this to mean that you can go out and privately obtain a CAPD assessment and provide the report to the committee, but it doesn't appear to obligate the public schools (at least in Ontario) to conduct the CAPD assessment.

I suggest that you contact a special education advocacy organization in Canada for specific information on how to achieve this kind of testing and ensure that its results are properly considered by the committee.  I found a group online called EduAdvocates.  I have no idea what the quality of their work is and I certainly can't vouch for them, but their web site describes work very similar to the kinds of things our organization does here in the U.S., so I imagine they probably have good information to help you.  A link to their site is below in Sources.

Answer 5

I would ask the school to specifically test for auditory processing problems.  Auditory processing is basically "what the brain does with what the ears hear."  

Between the psychologist and the speech/language path, there are tests of auditory processing and phonological processing that can be done in school.  If that is inconclusive, you can talk to your sister's pediatrician about a referral to a hospital-based clinic to assess for central auditory processing disorder (CAPD) which involves more invasive testing than can be done in school.  Usually an auditory processing problem would translate into difficulty with decoding and spelling (both of which stem from the inability to differentiate sounds well enough).  Still, even if she does or does not have problems with auditory processing, a disorder of written expression could still be present.

Answer 6

Go to another audiologist!  My daughter's audiologist told us that she was "fine", just had some fluid on her ears and put a set of tubes in her ears.... in all actuality she was profoundly deaf in one ear and had a moderate loss in the other.  I guess that she passed her hearing tests using one ear!!!  The doctor told us that we wanted something to be wrong with our child and that we knew too much for our own good.  (I'm a special education teacher and my husband is a critical care nurse) Anyway, long story short, after 2 years of going from the ENT to speech therapists, we finally got a diagnosis.  She is now a cochlear implant recipient and doing wonderfully.  Good luck... I will say a little prayer for you and your sister.

Answer 7

It does sound like my child that has been diagnosed with a Central Auditory Processing Disorder.  She was diagnosed as ADHD-inattentive type also, but CAPD was diagnosed after.  They can occue together, but it is hard to tell ADHD from CAPD.  

To diagnose CAPD, you need a Doctor of Audiology that has expreience is testing for CAPD.  My daughter had "normal" hearing also.  She is a very poor speller, mostly because she does not hear the individual sounds in word correctly...problems with phenomes, and phonological reading.

We have recently gotten an IEP in place and she is using an FM System so she can "hear" the teacher better above the background noise.  She also gets extra help and speech therapy.

Answer 8

It could be a processing problem not an actual audiological deficit. Thus the normal audiospectrogram. It doesn't sound as if it's a writing disorder either (as you think not also). The best approach is usually teaching listening techniques (similar to hearing impaired training, but more focused on interpretation). Not in the States? I presume Canada (IEP). I'm in B.C. Did she ever have any speech/language difficulties? My daughter did and after 2.5 years of therapy she seemed to be able to better process what was said to her. Originally went to audiologist... negative also. e & i were also a problem for her back then. Interpereting what is heard is often a function of language processing rather than physical disorders. Sign language training helped to get beyond problems of hearing inflection and pronunciation as well as directly improving my daughter's spelling. I hope this may give you some new ideas. A speech language pathologist might be a good step in diagnosing your sisters problem(?).