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    Originally Posted by Cookie
    Polar bear... Maybe I missed it. What was the one thing you were making us wait to read?

    OOPS!!! I forgot to mention it… after all that rambling *blush*. Thanks for the reminder smile

    Sooo… what I made you wait to read was… after all that went on with ds and having to wait until he was almost in 3rd grade (and so full of anxiety he was scared out of his wits)…. the thing was.. we'd had the basic info we needed before kindergarten but no one thought to flag it as a potential issue. DS was tested for entry into our district's HG magnet, and his ability testing and "math achievement" (WJ-III) were all high enough, but his "reading achievement" (WJ-III) was only at 60th percentile. We (parents) thought nothing of it because we'd never tried to "teach" him to read. The school thought he'd just catch up on that part of the test if he was retested the next year. I no longer have those test results, but I suspect the low score was related to fluency, because the tester told us that we could have him tested privately but to be sure to stay away from any timed assessment - so she'd apparently noticed he was slow with some type of task. Since he didn't qualify via the school we took him in for a private IQ test with a psych who tests lots of kids for entry into the program (Kindy-age kids). On that testing, he had the classic dip in processing speed (timed, handwriting) task. The psych who tested him thought he was just slow because he didn't understand that it was important to try to move fast when being timed. I had absolutely no clue that the relatively low score in processing speed meant anything at all, but that dip was a key indicator in ds' later neuropsych testing.

    So, basically, once he was in school and I started wondering about achievement and letter reversals and homework frustration and all that - I already had a big clue in the previous testing, but I continued to think it was simply perfectionism or quirkiness or whatever, because that's all the folks who'd tested him said about it.

    polarbear

    ps - the other piece of data we had (and didn't realize we had) was ds' developmental history - there are a ton of indications he was dyspraxic when he was very young (late crawling, late sitting, not really crawling, not really sitting, late talking etc)… but he was just so darned cute it never occurred to us anything was not on track. Plus I'd walked/etc late, and the men in ds' family are notorious for not talking. Soooo… we just thought, hey, he's quirky and he's cute. If I'd *known* about dyspraxia or if our ped had once even mentioned how far on the "late" side of developmental milestones ds was, I'd have been more on-the-ball with realizing something was up.

    Which brings me to the last "ah-ha" moment. Back up there somewhere I think I mentioned dh's family includes several dyslexic people. Guess what? We didn't know that until long *after* ds was diagnosed - because no one talked about it. I also suspect dh's dad had some type of expressive language disorder because he was known for never talking. When I met him, he was quite elderly, so I thought the "not talking" was just not being interested, but once we found out about ds' challenges with getting his thoughts out, it made me very sad to think that dh's dad might have been stuck not *able* to communicate throughout his life.

    Now back to ds - he absolutely knew something wasn't working for him re writing when he was in Kindergarten and beyond - finding out what was up through testing was a huge relief for him. Even if we'd not had any lost opportunities to remediate through early diagnosis, simply being able to let him know it was something other than his "fault" - being able to explain it to him early on - would have made a world of difference to his psyche, and in helping buoy his self-confidence.

    Last edited by polarbear; 09/01/14 03:58 AM.
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    Originally Posted by puffin
    Originally Posted by Displaced
    Originally Posted by Cookie
    Polar bear... Maybe I missed it. What was the one thing you were making us wait to read?

    I figured it was just hidden in all the other useful information smile

    I thought it was the age the LD is discovered depends on whether you are looking for one.

    Exactly smile

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    Originally Posted by Displaced
    Originally Posted by KJP
    Can you share the specifics from the test last year?

    Testing last year was done by an ed psych. There was a RIAS IQ and a bunch of other tests as my bigger concern before was dyslexia, so a ton of phonological tests. Sorry I'm not sure what would be helpful?

    RIAS verbal 143
    Non verbal 118 (officially the number, but ed psych thinks it may be higher because he started not paying much attention and answered the ones wrong to stop the test officially. She continued informally testing after that and he still got a lot right but put the official number as above)
    Composite 135
    Composite memory 115

    Also tested were WJ-III COG cluster, ACH cluster, CTOPP-2, PAT2, Beery VMI.

    I'm not sure what would be helpful? The achievement scores are all mostly average or high average. At the time I asked if there's a possibility of just high verbal knowledge and a false + with giftedness. She said she didn't think so but IDK, a lot of the scores report as average or high average for achievement results.

    I mean, I feel he's smart and we have good conversations, he talks and understands and communicate what I feel are pretty big things for his age (but DH and I discuss adult topics with the kids too).

    We used Vanderbilt for ADHD screen and teacher's was negative. I asked regarding dysgraphia but honestly IDK if she could test for it or not.

    Given the tests that were given, you would be okay starting a comprehensive assessment now, other than the concern with over-testing as an emotional experience. You did not have a Wechsler or the SBV, which would be the go-tos for either an initial school eval or a private (neuro)psych. If the WJ is common in your area, he would have to have the WJIV COG, as it's too soon for a WJIII COG re-test. (I think the IV will be a better instrument anyway.)

    I would be significantly concerned looking at the discrepancy between VIX 143 and average to high average achievement across the board. Even with the instability of IQ measurements at age five, it seems quite unlikely to me that his true ability measurement would be merely average to high average in the verbal domain. As you say, the nonverbal domains are a little foggy, given the signs of invalidity for the NIX, so I can't make much comment on that.

    How did he do on the subtests of the CTOPP-2 and PAT2? I'm especially interested in the manipulation tasks (deletion, substitution). A kid with his VIX could very easily score average on the basic PA tasks even with dyslexic traits. Unfortunate that they removed Phoneme Reversal from the CTOPP-2, as it would have been a more sophisticated manipulation task, thus more likely to expose reading disability in a high-cognitive kid.

    Look into the PAL-II for dysgraphia, at this age. The TOWL-4 (beginning at age 9) and subtests of the WJ are also useful, but I would start from the PAL-II, particularly for its age norms for a little one. It specifically claims utility in diagnosing dyslexia, dysgraphia, and OWL LD (the last less likely to be a factor here, with this VIX).


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    I'm going to piggy back a bit on polarbear's personal narrative in case something in our experience proves helpful to someone.

    DD was a superstar as an infant - doing *everything* super early. I had never spent time around babies so I didn't see how unusual it was. I thought all those milestones I read about were aimed at concerns for babies who were falling behind, people making "amazing" comments were just trying to make a first time mom feel good, etc. Every time we went to the pediatrician for a well baby check up we got another exceptional added - DD was "exceptionally verbal", "exceptionally social", "exceptionally flexible", etc.

    We enrolled her in a Gymboree class around her first birthday and she was a superstar - doing every task as the teacher was explaining it to the adults and repeating it over and over before any other baby even considered trying it once. At the end of these classes they would blow bubbles and sing a song about catching the bubbles. When DD was 18 months old I noticed that every other baby was grabbing the bubbles with joy - she was never able to grab a single bubble. Not even once. She never developed a pincer grasp for eating Cheerios. She did not want to feed herself. She did not want to play with puzzles, sorters, blocks or any other toy that required fine motor skills. She never wanted to color and when she did hold a crayon she "fisted" it.

    Starting at her 18 month check up I began asking about possible problems with her fine motor/ hand eye coordination. The pediatrician kept telling me "She's just so far ahead in everything something that is age appropriate appears to be a deficit even when it isn't." It took me 3 1/2 years to get a referral for an OT eval. And that was only because I became adamant at DD's 5 year check up about concerns over kindergarten.

    We had her in a wonderful play based preschool that never forced kids to do tasks, didn't do traditional academics, etc. Her teacher noticed that she avoided fine motor tasks, wasn't interested in writing but made up *amazing* stories she dictated, etc. As kindergarten approached she had some difficulty identifying some letters and numbers but teacher assumed DD didn't like being tested and was pretending. We started asking about dyslexia but were told our district wouldn't even consider looking for it prior to 3rd grade.

    OT eval showed major fine motor deficits, low muscle tone, upper body weakness and hyper mobility in her joints. OT couldn't understand why we waited so long to bring her in for an eval. She should have been there at least a year earlier - she needed a year of PT before starting a minimum of 6 months of OT if she was going to be ready for kindergarten...

    Kindergarten was a total disaster. Teacher not only refused to accommodate her fine motor deficit she actively punished her for it. (ie no recess because DD could not complete the writing tasks). School refused to even consider testing her to see if she qualified for services in school "She'd never qualify for services - she's too smart." Her writing delays were "laziness" and "disrespectful attitude". Her reading issues were her "not being ready". When we expressly asked the literacy specialist about dyslexia she refused to make eye contact, changed the subject and showed us out of her office.

    Fortunately the school psych at our district's central office got involved because we were at an interdistrict magnet. She did an amazing job and really saved DD. Since then DD has been identified as 2E with every possible LD. Neuropsych labeled her as "NLD-ish" not because she has NLD but "because its easier than saying super high verbal along with dyslexia, dysgraphia, dyspraxia, math disability, etc." She is now in an out of district placement at a spec Ed school where most of her day is spent with interventions (OT, speech, Wilson reading,etc). Fortunately she is learning to use AT (iPad, audio books, etc) as work arounds but it will be tough. I will never know if her path would have been different if she hadn't been so advanced the pediatrician would have been willing to refer her for those early issues.

    By the way yes we have family history here too. DH found out he was dyslexic after be became a teacher and he was used as an example of an obviously dyslexic adult during a spec Ed training session. After learning all of this about DD his parents told him they had been approached several times by the spec Ed teacher at his elementary school about providing him services and they declined. "Oh no he'll be fine in regular classes." His 85+year old father cries any time we discuss DD's situation because he was obviously LD at a time when no one understood them. "They told me I was lazy and stupid. But I wasn't. I tried as hard as I could but I just couldn't do it..."

    So yes they get found earlier if you are looking for them but only if someone takes your concerns seriously...

    Last edited by Pemberley; 09/01/14 08:10 AM.
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    aeh -- Thank you so much for your insight. I'll list the whole kit and caboodle in case it may be helpful for interpretation or for us. I'm not sure what should be listed. Sorry it's so long! Because of the achievements being low vs his Verbal IQ, is it possible/likely the verbal IQ was inaccurately elevated?

    RIAS:
    Verbal IX 143
    subtest guess what 77
    subtest VR 71
    Nonverbal IX 118
    subtest odd item out 51
    subtest what's missing 68
    Composite index 135
    90% confidence interval 129-138
    Composite memory index 115
    verbal memory 44
    nonverbal memory 72

    WJ-III COG cluster
    cognitive efficiency 113
    subtest visual matching 94
    subtest numbers reversed 115
    Long term retrieval 112
    subtest visual-auditory learning 118
    subtest retrieval fluency 97
    Short term memory 114
    subtest numbers reversed 115
    subtest memory for words 107
    Visual spatial processing 108
    subtest spatial relations 107
    subtest picture recognition 105
    Processing speed 106
    subtest visual matching 94
    subtest decision speed 122

    WJ-III ACH cluster
    Oral language 126
    subtest story recall 118
    subtest understanding direction 123
    broad reading 100
    subtest letter word ID 111
    subtest reading fluency too hard
    subtest passage comprehension 90
    broad written language 113
    subtest spelling 109
    subtest writing fluency too hard
    subtest writing samples 119
    broad math 118
    subtest calculation 118
    subtest math fluency 107
    subtest applied problems 111
    academic skills 115
    subtest letter word ID 111
    subtest spelling 109
    subtest calculation 118
    academic applications 108
    subtest passage comprehension 90
    subtest applied problems 111
    subtest writing samples 119

    CTOPP-2
    rapid digit naming 11
    rapid letter naming 11

    PAT-2
    Rhyming 106
    subtest discrimination 91
    subtest production 114
    segmentation 101
    subtest sentences 94
    subtest syllables 99
    subtest phonemes 110
    isolation 116
    subtest initial 110
    subtest final 114
    subtest medial 117
    deletion 119
    subtest compounds and syllables 122
    subtest phonemes 114
    substitution 109
    subtest with manipulatives 109
    blending 116
    subtest syllables 112
    subtest phonemes 106
    phonological awareness total 114
    Lots of graphemes and decoding listed, either 0 for ones he didn't know yet, or range from 112-125

    Beery VMI 89
    visual perception 100


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    Originally Posted by Pemberley
    I'm going to piggy back a bit on polarbear's personal narrative in case something in our experience proves helpful to someone.


    So yes they get found earlier if you are looking for them but only if someone takes your concerns seriously...

    Thank you so much for your story! I want to reread it more carefully too. I'm glad to hear you had such a knowledgeable person helping out.


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    Originally Posted by Displaced
    aeh -- Thank you so much for your insight. I'll list the whole kit and caboodle in case it may be helpful for interpretation or for us. I'm not sure what should be listed. Sorry it's so long! Because of the achievements being low vs his Verbal IQ, is it possible/likely the verbal IQ was inaccurately elevated?
    Doubtful, at least not enough to make the achievement discrepancies insignificant. It's more likely that something is interfering with his acquisition of academic skills--aka a learning disability of some kind.
    Quote
    RIAS:
    Verbal IX 143
    subtest guess what 77
    subtest VR 71
    Nonverbal IX 118
    subtest odd item out 51
    I assume OIO is where he reached a premature ceiling?
    Quote
    subtest what's missing 68
    Composite index 135
    90% confidence interval 129-138
    Composite memory index 115
    verbal memory 44
    nonverbal memory 72
    This verbal memory score concerns me, falling as it does at the lower end of the Average range, especially with those high VIX scores. I'm always on the alert for memory and processing speed issues in dyslexia/dysgraphia situations.
    Quote
    WJ-III COG cluster
    cognitive efficiency 113
    subtest visual matching 94
    subtest numbers reversed 115
    Long term retrieval 112
    subtest visual-auditory learning 118
    subtest retrieval fluency 97
    Short term memory 114
    subtest numbers reversed 115
    subtest memory for words 107
    Visual spatial processing 108
    subtest spatial relations 107
    subtest picture recognition 105
    Processing speed 106
    subtest visual matching 94
    subtest decision speed 122
    Again, auditory-verbal memory scores have relative vulnerabilities in them (memory for words (short-term), retrieval fluency (long-term)). Also, now we see processing speed relative concerns, especially with symbols (visual matching). Interestingly, decision speed, which uses pictures of common objects, is a strength.

    The nonverbal/visual area is a bit of a mixed bag over the two tests (RIAS and WJ), with a good score in attention to visual detail of concrete images, and average-to-unclear results in spatial and reasoning areas.
    Quote
    WJ-III ACH cluster
    Oral language 126
    subtest story recall 118
    subtest understanding direction 123
    Oral language achievement approaches the level found on the RIAS VIX, which suggests that the verbal cognitive ability is grossly accurate.
    Quote
    broad reading 100
    subtest letter word ID 111
    subtest reading fluency too hard
    subtest passage comprehension 90
    Reading achievement is far below levels predicted either by the RIAS VIX or by the WJ OL achievement. Notably, the speeded, fine-motor involved aspect of reading was untestable, and reading comprehension was even further below expectations than word calling. (Keep in mind that a typical five year old is not expected to have much reading comprehension at all, so a low average result in this area in a child with this level of verbal cognition is quite striking.) Also, at this level, almost all of the words read are sight/high-frequency words, or simple cvc words, so minimal draw on sophisticated phonological awareness or phonics skills is needed.
    Quote
    broad written language 113
    subtest spelling 109
    subtest writing fluency too hard
    subtest writing samples 119
    broad math 118
    subtest calculation 118
    subtest math fluency 107
    subtest applied problems 111
    academic skills 115
    subtest letter word ID 111
    subtest spelling 109
    subtest calculation 118
    academic applications 108
    subtest passage comprehension 90
    subtest applied problems 111
    subtest writing samples 119
    Same thing happens in the remainder of academic achievement. Untimed skills are slightly low-to-approaching appropriate for this cognitive ability, and timed, fine-motor-involved tasks are untestable.
    Quote
    CTOPP-2
    rapid digit naming 11
    rapid letter naming 11

    PAT-2
    Rhyming 106
    subtest discrimination 91
    subtest production 114
    Rhyming appears age-appropriate overall, but there is a 23 point difference between ability to produce rhymes and ability to hear rhymes.
    Quote
    segmentation 101
    subtest sentences 94
    subtest syllables 99
    subtest phonemes 110
    isolation 116
    subtest initial 110
    subtest final 114
    subtest medial 117
    deletion 119
    subtest compounds and syllables 122
    subtest phonemes 114
    substitution 109
    subtest with manipulatives 109
    blending 116
    subtest syllables 112
    subtest phonemes 106
    phonological awareness total 114
    Lots of graphemes and decoding listed, either 0 for ones he didn't know yet, or range from 112-125
    Overall, did adequately on this level of phonological awareness, but still well below verbal ability in several areas, especially rhyming, segmenting, and substitution.
    Quote
    Beery VMI 89
    visual perception 100
    Fine-motor definitely looks like a relative weakness, in the bottom of the average range, well below verbal cognition, and even aspects of nonverbal/perceptual cognition.

    I would be investigating reading and writing disabilities (dyslexic/dysgraphic), with the related cognitive processing areas mainly visual-spatial reasoning, language processing/memory, processing speed, and fine-motor/visual-motor integration. I would consider speech and language eval (especially for language memory, retrieval fluency, and auditory discrimination), and definitely include OT.

    While the process is winding its way, do lots of read-aloud, with him narrating back to you, to maintain intellectual stimulation and access to higher-level vocabulary, as well as to exercise auditory working memory. And scribe any written response longer than a word or two.


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    Originally Posted by polarbear
    So, basically, once he was in school and I started wondering about achievement and letter reversals and homework frustration and all that - I already had a big clue in the previous testing, but I continued to think it was simply perfectionism or quirkiness or whatever, because that's all the folks who'd tested him said about it.

    This is my biggest beef with everything going on. The Kindy teacher was discussing remediation. After testing and finding an elevated IQ, why would such a smart child getting such intensive help still not perform on average levels to peers? Even with a tough curriculum? Even at his age, unless there's something else going on? IDK.

    Originally Posted by polarbear
    ps - the other piece of data we had (and didn't realize we had) was ds' developmental history - there are a ton of indications he was dyspraxic when he was very young (late crawling, late sitting, not really crawling, not really sitting, late talking etc)… but he was just so darned cute it never occurred to us anything was not on track. Plus I'd walked/etc late, and the men in ds' family are notorious for not talking. Soooo… we just thought, hey, he's quirky and he's cute. If I'd *known* about dyspraxia or if our ped had once even mentioned how far on the "late" side of developmental milestones ds was, I'd have been more on-the-ball with realizing something was up.
    DS was premature by 5 weeks so his development was normal after being adjusted for his prematurity (but barely). Except talking was always great. Dyspraxia was mentioned by a PT as a possibility, but we'll be getting OT help now I think.

    Originally Posted by polarbear
    Now back to ds - he absolutely knew something wasn't working for him re writing when he was in Kindergarten and beyond - finding out what was up through testing was a huge relief for him. Even if we'd not had any lost opportunities to remediate through early diagnosis, simply being able to let him know it was something other than his "fault" - being able to explain it to him early on - would have made a world of difference to his psyche, and in helping buoy his self-confidence.

    I just tell DS that his brain is too smart for his hands and we have to make his hands smarter to write to keep up with his brain (as I strongly suspect dysgraphia). If there's dyslexia as well I'll have to come up with a new way to explain it. He's so easy going. I know he's frustrated too.


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    Originally Posted by aeh
    Look into the PAL-II for dysgraphia, at this age. The TOWL-4 (beginning at age 9) and subtests of the WJ are also useful, but I would start from the PAL-II, particularly for its age norms for a little one. It specifically claims utility in diagnosing dyslexia, dysgraphia, and OWL LD (the last less likely to be a factor here, with this VIX).

    Sorry, but what is OWL LD?


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    Originally Posted by aeh
    Originally Posted by Displaced
    Because of the achievements being low vs his Verbal IQ, is it possible/likely the verbal IQ was inaccurately elevated?
    Doubtful, at least not enough to make the achievement discrepancies insignificant. It's more likely that something is interfering with his acquisition of academic skills--aka a learning disability of some kind.

    Ok. Do you have any thoughts if ADHD could be a cause of the achievement discrepancies? I suspected it last year but the Kindy teacher's vanderbilt survey was basically as negative as could be, me and DH were highly positive, and grandmother was negative (though the ed psych mentioned DS kicked her under the table while testing about 500 times). The ed psych suggested the testing results were a result of his youth/maturity, thinking his skills will naturally improve as he ages. But we're working hard for everything. Is that possible and/or likely for youth to cause the achievement discrepancies?

    Originally Posted by aeh
    I assume OIO is where he reached a premature ceiling?

    Sorry I don't understand. Are you asking if that's where the ed psych said she stopped the official testing results? IDK if it was that subtest or not.

    Originally Posted by aeh
    This verbal memory score concerns me, falling as it does at the lower end of the Average range, especially with those high VIX scores. I'm always on the alert for memory and processing speed issues in dyslexia/dysgraphia situations.

    Could other things cause that? Or even briefly explain what that test was (repeating a word she said or a string of letters or something)?

    Originally Posted by aeh
    Oral language achievement approaches the level found on the RIAS VIX, which suggests that the verbal cognitive ability is grossly accurate.

    OK, even though it's much lower?

    Originally Posted by aeh
    Reading achievement is far below levels predicted either by the RIAS VIX or by the WJ OL achievement. Notably, the speeded, fine-motor involved aspect of reading was untestable, and reading comprehension was even further below expectations than word calling. (Keep in mind that a typical five year old is not expected to have much reading comprehension at all, so a low average result in this area in a child with this level of verbal cognition is quite striking.) Also, at this level, almost all of the words read are sight/high-frequency words, or simple cvc words, so minimal draw on sophisticated phonological awareness or phonics skills is needed.
    This test was done after about a good 1-2 months of me teaching him phonics. His skills in reading by the time this test was done were significantly better than when I did the original consultation before testing. Sight words for DS are getting better as I'm working more on them with him this year. I started more with phonics because for him, logically following the directions worked better than the system they teach at his school (looking at pictures and first letters and guessing words, basically). He still guesses words instead of sounding them out, and maybe I should have focused more on sight words but last year but I taught him phonics so he wouldn't have to guess and can actually have the skills to read.

    Per reading comprehension I'm still a little confused. He should have scored higher by your guess? He does tend to do well with comprehension in school and their FAIR(?) testing, and can discuss the books we read if I ask him questions.
    Originally Posted by aeh
    Rhyming appears age-appropriate overall, but there is a 23 point difference between ability to produce rhymes and ability to hear rhymes.
    IDK if that's significant or just an interesting difference?

    Originally Posted by aeh
    I would be investigating reading and writing disabilities (dyslexic/dysgraphic), with the related cognitive processing areas mainly visual-spatial reasoning, language processing/memory, processing speed, and fine-motor/visual-motor integration. I would consider speech and language eval (especially for language memory, retrieval fluency, and auditory discrimination), and definitely include OT.
    Thank you for these recommendations and for all your help with these results and translations! I am very grateful. Can you recommend how I go about finding a speech and language eval (are there special testers for this)? Would a school use them or should I find a private person or a neuropsychologist? I'm setting up a consult for OT (we had an eval last year but in retrospect I think it was by PT) and likely going to start services soon (within a month at the most). I'll continue working on HWT but I'm not certain how much that has helped at all.

    Also, I'm not certain if I mentioned in a prior post or this one or not, but DS did have quite a few stutters prior to last school year (5 years old), as well as mispronouncing words (now resolved). I always attributed it to his peers at his daycare because as soon as he stopped going there it stopped. He still has difficulty saying words that rhyme or sound like the /ir/ in bird. They sound like /or/ (sorry can't write them phonetically). Is that another clue or just a normal deviation?

    Originally Posted by aeh
    While the process is winding its way, do lots of read-aloud, with him narrating back to you, to maintain intellectual stimulation and access to higher-level vocabulary, as well as to exercise auditory working memory. And scribe any written response longer than a word or two.

    Thank you for these recommendations as well. I do read alouds daily. Usually picture books at a higher level than he can read as he still likes to look at pictures. Chapter books he likes too so maybe I should start a gradual transition as they tend to be more complicated. We also use Myon, a website that reads books aloud on the computer while pages are flipped on the screen. In the car we do listen to audiobooks but only drive together once a week or so. I will start discussing what we read a little more too. And stop making him write so much, instead write for him. I thought it would be good for his practice but maybe not?

    I am so grateful to this board. Thank you to everyone giving of your time to help us. smile


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