Gifted Issues Discussion homepage Forums Twice Exceptional Newly diagnosed 2E - need recommendations please

Hi,

My 15 yo son was just labeled "Twice Exceptional" in a neuropsych report. The Dr. said his profile is unusual and special ed coordinator agreed. I hadn't ever heard of it, but the results seem to explain why school is so hard for him.

I'm looking for recommendations and insight - should I have additional tests? Other processing disorders? Here are his results:

WISC IV:
VCI - 128
PRI - 106
WMI - 88
PSI - 75
Coding - 4
Symbol - 7

Complex graphomotor speed - impaired (2nd percentile)

Woodcock-Johnson-3
Basic reading - 99
Reading comprehension - 118
math calculation - 96
Math reasoning - 111
Written expression - 95

D-KEFS Color-word interference
2nd, 37th, and 1st percentile

Verbal problem solving, visuospatial analogic reasoning, abstraction skills 95 percentile.

Info processing speed and complex psychomotor speed - impaired
Executive functioning - weak

Disparity stress and anxiety

There are a few other scores on the report but not sure if they are relevant. Dr didn't provide copies of the tests, just a 13 page report.

My son is smart but can't produce any written material in a reasonable amount of time. He works so hard but can't keep up. School is giving me a hard time about getting an IEP, says he doesn't qualify.

Meanwhile, I'm wondering about visual and auditory processing issues? Does graphomotor impairment mean the same as dysgraphia? Any other ideas?

Thanks, I appreciate any words of widsom.

Yes, school must have been very interesting for this young man, and not necessarily in a good way. The good news is, chicks dig men with superior verbal ability who know about struggle. If he volunteers to wash dishes, even better!

I've going to be seriously oversimplifying here to try and explain where the school is coming from. The WISC tests cognitive ability, which is assumed to be constant. The WJ-3 tests academic achievement, which varies all over the place. As part of an IDEA evaluation, they would be looking for a specific learning disability: a gap where the academic achievement is lower than the cognitive potential. That's what you might call underachievement, and that's what Special Education can do something about.

He's got a double whammy of low processing speed and low working memory. One of those makes school more difficult than we want it to be for kids. Two of those makes it freakin' hard.

What we see in your son's profile might be called overachievement. He has leveraged his superior verbal ability in order to do more for himself than special education could reasonably hope to do. Let me underscore this: what he has achieved in school so far is a remarkable accomplishment that we would not normally expect for someone with this cognitive profile, and we need to give him credit for that.

If I were his teacher, and I wanted to call on him, I might both work out a secret non-verbal cue (if I come by and tap on your desk, I will call on you for the next question) and be prepared to wait about 30-60 seconds for a reply from him. In a typical middle or high school classroom environment, 5 seconds is an uncomfortable silence. But when I gave an academic assessment to a kid with a similar cognitive profile, the rules let me wait forever for an answer, and I often got a correct one.

BTW, the doc would be in serious hot water with the test publishers if he did provide you with copies of the test.

You might see if any of his teachers will let him submit digital voice recordings (.mp3s, for example) for his longer written assignments. You might also investigate voice recognition systems. Those aren't perfect, but they are getting better every year.

Welcome WinonaTac, I think you'll find quite a few of us here who have children with similar challenges. There are several different forms of dysgraphia, but fwiw graphomotor impairment is essentially dysgraphia - but schools don't usually use the term dysgraphia. My ds12 has fine motor dysgraphia, as well as dyspraxia and an expressive language disorder. We successfully advocated for an IEP for him, but it took a *ton* of research and advocacy as well as a bit of karma. It also took a few years, so in the meantime we tried our best to do what we could outside of school as well as advocating for accommodations at school.

Here's my list of random thoughts and questions for you:

1) Do you think your ds really needs an IEP or will accommodations accomplish what he needs for school? An IEP is used when a student needs individualized instruction; a section 504 plan is used when a student needs accommodations to participate fully in school but don't need additional instruction above and beyond what is offered in the regular classroom.

2) There are quite a few things (AT) that your ds can be using to help work around handwriting difficulties. My ds uses a laptop for all of his schoolwork and homework, and uses specialized software. One of the types of software that helps ds the most is word prediction, which displays a list of words to choose from based on typing the first 2-3 letters of a word - this really increases the speed of his typing as well as freeing up his working memory which leads to better punctuation/grammar/etc. He has math software that allows him to graph, write equations, etc on his laptop. He has a LiveScribe pen for taking notes, but is transitioning to similar tools on the iPad next year. He likes voice-to-text software (he speaks to the computer, it writes out what he's said). He also uses text-to-speech software when editing (the computer reads back what he's written).

3) I am not sure if visual or auditory processing challenges are indicated in your ds' testing, but one thing you can do is to compile a list of all the questions you have and ask for a follow-up session with the psych who did the testing - either on the phone, via email, or an appointment in person. We've done this every single time we've had an evaluation for ds (and our dds) simply because I usually have more questions after I've had time to read the reports over and think things through.

4) My ds' dysgraphia is rooted in fine motor challenges (as opposed to visual), and is specifically referred to as graphomotor - so I'm guessing fine motor is the cause of your ds' too. If you google types of dysgraphia you should be able to find a description of the various types and compare it to your ds' testing results.

5) Do you have subtest scores for the VIQ and PRI parts of the WISC? Is there a lot of scatter in them? Trends there might point to visual/auditory challenges.

6) I am not sure what the comment "Disparity stress and anxiety" means in your report, but fwiw our ds developed severe anxiety during the time his disability went undiagnosed and he was struggling in school. His anxiety lessened *SO* much once we (and he) knew what was going on, why he was struggling, and as we began to make changes such as accommodations etc. It seemed like it took much longer to get his accommodations etc in place than I would have liked, but just knowing what was up and moving in a direction eliminated most of his anxiety - which was probably more important than anything else we could do at the time.

7) Did the psych who did the testing put any specific diagnoses in the report (things like "Disorder of Written Expression" "Anxiety Disorder" etc)? It's helpful when advocating to have actual diagnoses.

8) What specific reasons did the school say were the reasons your ds doesn't qualify for an IEP? Has he been through an official IEP eligibility process? Have you requested an eligibility review in writing? If you haven't, I'd start with this report plus a list of your concerns and turn in a written request.

That's all I can think of at the moment - best wishes as you advocate for your ds!

polarbear

ps - I forgot to add one thing - our ds was diagnosed when he was much younger and basically too young to really be able to easily describe how his disabilities impacted him - but as he moved on into middle school, it really helped (or seemed to help) to have him contribute specific descriptions of how his challenges impact him, and to contribute his own ideas for accommodations etc. It helped in two ways - first, it helped because he understands himself better and motivates himself better than I or anyone else ever will, and secondly - for the purposes of advocating at school - the school didn't see him as an over-involved or overly pushy parent, so in some ways his voice had a bit more credibility than mine did.

Best wishes,

polarbear

Great idea!

Hi polarbear,

1) great question about IEP vs 504. He had a 504 last year but part of the issue is the school insists that he has to ask every time he needs extra time on an assignment. This is unmanageable for him. They won't give him automatic extended time. Another district I called said they wouldn't require that of him. He needs to take some tests and do some writing assignments verbally. The school said he'd have to do everything the "regular" way first, then challenge for oral and have to do them over! Again, too much burden for what he's dealing with. He needs reduced volume in Language Arts and in other classes with writing assignments... school said it's very discouraged and totally at teachers discretion. School said they probably couldn't meet his needs. He attends a public STEM college prep school that I think doesn't want to deal with it. I've met with the counselor many times, the spec ed coordinator, vice-principal and principal. I'm looking for a new school because I think even if I force the issue, it won't be a supportive environment. My kid is OK with it. He's been socially isolated and treated very badly by peers.

2) love these ideas, great, thank you!

3) yes, good plan, started my list of questions.

4) yes, fine motor is the issue, will do more research

5) WISC
Verbal - 128 / 97% - is this VIQ?
Similarities - 15 / 95%
Vocab - 14 / 91%
Comprehension - 15 / 95%

PRI - composite 106 / 66%
Block - 10 / 50%
Picture - 8 / 25%
Matrix - 15 / 95%

6) yes, report mentions that the disparity between high and low scores cause kid stress/anxiety. I think he is processing the situation but do see some relief from knowing that he is not just lazy and cant really get through this by just trying harder, so it is helpful for him and me to know what we are dealing with.

7) diagnosis - ADHD innatentive, cognitive disorder NOS - slowed info processing and marginal graphomotor skills

8) doesn't qualify for special services cuz they use only 5 scores from Woodcock which don't reveal the severity of issues:
Woodcock-Johnson-3
Basic reading - 99
Reading comprehension - 118
math calculation - 96
Math reasoning - 111
Written expression - 95
They don't look at academic fluency, even though he's in the 14% or other test scores. They said to address with 504 which is poorly administered there.

Thank you so much for taking the time to reply - your info is very helpful and I appreciate it very much!

Hi master of,

My son has also internalized the messages of being told he could just try harder and pay attention, etc. I agree that having a diagnosis will help. I hope both of our sons work through this - it's very hard on their self esteem to constantly be told they aren't measuring up, and my son has also received zero credit this year for assignments that he's worked on diligently. I can't believe that he gets back up over and over again and keeps trying although very very discouraged, misunderstood, and hurt.

Yes, love your viewpoint and step by step method to walk him through this and can relate to him thinking that accommodations are "cheating." Prior to this year, he refused to be on 504 because he wanted to do it like everyone else. He finally relented last fall but it was poorly administered. I like the thoughts of helping him change his picture of himself, and since he is high in verbal, I'm sure we can have have some very good conversations about it. I sense some relief from him over the past few weeks since he started processing through it.

...will think long and hard about the IEP and talk to the Dr again who recommended it. He felt that 504 wasn't going to provide enough support, but I will get more specific info from him.

See my reply to Becky about the Dr explaining to him that he's a Lamborghini/Fiat, or the "village" wise man - a very long thinker but comes up with answers that are accurate and unique. LOL, this helped a lot.

Thank you, thank you for taking the time to reply - Your insights are helpful and I appreciate it very much. I hope your son does well too (and you!).