Gifted Issues Discussion homepage Forums Twice Exceptional how important is a correct diagnosis

I posted recently in the scores forum about my son's recent testing. In the discussions about his scores, his 2e status with a sensory processing diagnosis came up (his processing score is at least 50 points lower than his verbal score) and someone mentioned dysgraphia as a possible issue, either rather than or in addition to sensory processing problems.

DS will be getting OT both at school and outside (we have an eval with an outside facility next month). He is on an IEP and will be having accommodations in class. All of this is wonderful. But I'm suddenly wondering if the dysgraphia angle was explored fully, and if not, if a fully correct diagnosis is needed there? Is that something an OT diagnoses, or a psychologist?

Thanks so much for your insight and patience - I'm pretty new to all this!! :-)

Dysgraphia is diagnosed by a psychologist. DD9 has a dysgraphia diagnosis, but she has made such strides in writing this year that I'm really starting to think that it may be another manifestation of her SPD, rather than a "true" diagnosis. (Current handwriting example, done for fun at home.)

If he's already got an IEP and receiving the appropriate services I'm not sure it matters much to have the official diagnosis.

Elizabeth, your dd's writing sample was just TOO cute!!!! Loved seeing it

But - fwiw - just because a dysgraphic child's hw starts becoming legible and looking neat doesn't necessarily mean the dysgraphia wasn't really dysgraphia or that it's gone away - you need to be sure that your dd is not only continuing to progress in how legible and neat her handwriting looks, but also be sure she's writing at a speed that is comparable to her age/grade level peers, and that there isn't still a discrepancy in how well she uses puncutation/spelling/correct grammar etc with hw vs keyboarding - as well as be sure that the stories and information she's getting down via hw are comparable to the detail and length of what she's capable of telling orally.

Dysgraphia is more than just legible handwriting

polarbear

Wow! her writing looks nice! The Eides said something like often times dysgraphia is caused by sensory integration problems and the hands not getting/giving the proper amount of sensory input or something? I am actually looking into that aspect with a therapy place with my son on Tuesday but just saying that you may certainly be on to something with that!

FWIW in my experience having official diagnoses does help. Whenever I get push back I pull out the official dx paper/reports/evals and push-back tends to melt away....I'd be nervous not having it as they are always trying to find a way to take away my son's accommodations by saying he doesn't 'need' it anymore.

Thanks for the caution, polarbear! I know that the dysgraphia is not just about neatness (or not). But she's much, much more willing to write than she was a year ago (as evidenced by the fact that she wrote that page just for fun!), and she's writing at an appropriate speed now, too. She still sometimes skips letters when she's in a hurry, but I think it's in an age-appropriate way. She can still "tell a better story" orally than she can in writing, but isn't that age-appropriate at 9 anyway? Or am I inferring too much from the fact that I would talk your ear off at that age but avoided writing?

In some cases, I'd agree with this. Here I wouldn't agree, because understanding the correct diagnosis is needed to understand what's needed long-term for accommodations and remediation. If this is SPD, there's a chance that OT is going to remediate the issues with handwriting fully and accommodations aren't going to be needed long-term. If it's dysgraphia, chances are good this child will need to rely on keyboarding or voice-to-text for the majority of written work moving forward in school and life, and getting a head start on that is important.

Having a correct diagnosis and understanding potential symptoms/challenges associated with it can also help you ferret out information from a younger child - for instance, hand and wrist pain are sometimes associated with dysgraphia. We didn't have a clue that our ds' wrist hurt when he wrote, but once we knew to ask about it, he told us absolutely it hurt! It's just that being only 8 years old, he didn't anticipate that we, as his parents, didn't already know that. My dd otoh, had some fairly severe sensory challenges and went through sensory OT as a child. I don't remember pain ever being mentioned as a potential symptom - so if our ds had been diagnosed with SPD and not with dysgraphia, we never would have asked about the hand pain.

Having a correct diagnosis can also be important for helping a child understand what's going on with themselves.

On the flip side, I can't really see a situation where having a diagnosis is going to hurt or cause harm in any way, so if there's a question I can't imagine it wouldn't be a good thing to move forward and really get to the root of a diagnosis.

polarbear

ps - fwiw, my ds has some sensory challenges too which I understand from his neuropsych are part and parcel of his overall diagnosis (Developmental Coordination Disorder) - I don't think it's unusual to see both dysgraphia and SPD in the same child.

This is another good reason to have an official diagnosis, and having the correct diagnosis is going to help when you're advocating, because even with the official diagnosis, many of us have to advocate like crazy and be able to show examples of how a diagnosis is impacting our child - having the incorrect diagnosis or missing a diagnosis isn't going to help with advocacy.

polar

Elizabeth - I didn't mean to suggest that your dd does (or doesn't!) have dysgraphia, just wanted to point those things out to other parents who might be reading and hadn't been through the journey yet

I do think it's something I'd watch with her though - it's really tough to tell sometimes in those early elementary years what's a challenge and what's completely typical development. If she starts struggling again when middle school and larger loads of writing demands start happening, I'd look at the possibility of dysgraphia again.

Best wishes,

polarbear