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First, thank you again to all of you who helped me buck up and prepare for the meeting with our psychologist this week about DD7. Second, apologies for long-post to follow.

The good news: the results make sense, and match what we see. The not-so-good news: LD in reading and writing, probably ADHD-inattentive, perhaps CAPD. Thanks to much obsessive reading of this forum over the last month, I am at least not feeling shell-shocked, just - OK, now what?

Your BTDT advice would be hugely appreciated. Priority looks like it ought to be on an immediate O-G type reading program. First steps seem to be figuring out what I might reasonably expect the school to do, and how we can most effectively complement that at home. School is grade 3 in a regular public program, full time French Immersion (since SK), with a one-hour English class each day (since grade 2).

We’ve already met with her teacher; she’s lovely, willing and eager to help. But she’s young and has no idea what to do. I don’t know what shocked her more - the 99%ile VCI or the 1%ile “write a sentence using word x”. It’s clear she has little experience with either E. And 23 other busy kids to deal with. So beyond the obvious accommodations - more time, technology etc - what are the most important things we could reasonably expect her to do in a classroom?

The school has a teacher who is the part-time Learning Support and will be the lead in making the plan/ IEP and providing any pull-out extra teaching. But there’s 500 kids in the school, and I don’t know if they have the time or training to provide any substantial amount of remedial phonological-based reading training. What might I reasonably expect a school to do? (Canadian experiences especially useful here). And do I need to be worried that a little bit may be more detrimental than none at all, or conflict with non-school remediation?

From what I understand, the standard approach is multi sensory structured language teaching, of which O-G is the foundation. I’ve seen a lot of support in the forum for Toe-by-Toe in particular, and was trying to figure out if this would be good to do at home. Some immediate questions are: How important is a trained tutor - lots of comments suggest it’s critical, while others have had great success with parent-led work at home. There’s no Lindamood Bell in Canada, but a quick google reveals a couple tutoring centres specializing in dyslexia. TbT doesn’t seem “multisensory”, being just a workbook - is it missing a key element? Any views on for whom/ under what needs and circumstances TbT works best, and if other approaches are better for some kids?

Under what circumstances could a tutor and/ or TbT at home conflict with whatever they might be trying to do at school? Orally, she does excellently in French at school (her new teacher actually asked me if we spoke French at home), so the second language is not a problem. But any thoughts on whether remediation should focus on her main school language or her home one? Would it make a huge mess of things if they worked on French at school and we did English at home? Should we defer all regular reading while we work specifically on the tutoring/ TbT/ whatever?

OK, deep breath. Enough questions for one post! As you can see, I’m looking for advice in any and directions - especially the ones I haven’t even thought about yet. Meds? - - oh, yeah - - - next post.

Testing in a nutshell: WISC-IV, WIAT-III, WRAML2, CTOPP2, parent and teacher questionnaires PRS-C and TRS-C. All data in percentiles (seems to be the Canadian way).

WISC: VCI 99th; PRI 86th (but split with Picture Concepts and Matrix Reasoning at 63/ 50 and Block Design at 98th). WMI 70th. PSI 42nd (Symbol Search 37th and Coding 50th).

WRAML2: 9 scores, mostly high (85th+), up to 98th on story delay. Outliers are Finger Windows (37th), and Design and Picture Memory 37/ 63 (huh? vs Block Design?).

CTOPP2: Scattered.
Non-word repetition: 25
Rapid digit/ letter: 50/ 37
Elison: 37
Blending words: 16
Phonemic isolation: 84 (huh?)

WIAT: This is where it gets ugly… but totally fits what we’ve seen. Early reading 63rd (she seemed fine through Sk - but skills have not “automated” since). Comprehension 55 (great at compensation, we suspected she was doing a good job of faking it from context/ first letters). When you take away the context and only give only words/ pseudo words, reading drops to 16th/ 12th. Overall basic reading composite is 13th, and Written is 12th.

Oddly, she did well at Sentence Combining (61), adequate at alphabet fluency (32), falls apart at Spelling and Sentence Composition (10 and 14), and tanks Sentence Building (generate sentences with target word) at 1st %ile. Math was 25th in operations and 88th in problem solving.

OK, sorry - I was trying to summarize, but that’s a pretty big nutshell.

Thank you already - just writing this has helped me sort it out considerably, and knowing I have people to actually say it to, out loud, is just huge.

WISC: very strong in language reasoning and hands-on problem solving, only average with abstract-visual reasoning. High average working memory, average processing speed.

WRAML2: memory is largely consistent with WISC working memory results, except delayed story memory tracks verbal comprehension (which fits with how meaning allows cognition to compensate for other weaknesses). Finger windows is a visual working memory task. Design and picture memory are not like block design, firstly because they are memory tasks, not copying tasks, and secondly because pencil-paper brings in a somewhat different pool of visual-motor integration skills. Especially integration. Picture memory is entirely different from block design. If you've ever seen those old "Check and Double Check" activities in Highlights magazine, that's what they're like, except that you have to do "double check" from memory. There is a verbal-conceptual aspect to it, too, which lines up slightly with picture concepts.

CTOPP2: These are all average to low average scores, with the exception of phoneme isolation. nwr is an auditory working memory task. Rapid digit & letter naming fluency are both processing speed and retrieval fluency tasks. Elision and blending are both phoneme manipulation tasks, which is the higher end of phonological awareness tasks. A lot of high-cognitive dyslexics can do low-level PA within normal limits (or even above average), but get tripped up on the more sophisticated phoneme manipulation tasks (especially the old phoneme reversal from the first edition of the CTOPP--sadly did not survive the revision).

WIAT:
Reading: comprehension is average, most likely, as you say, being supported by context and cognition. But I wouldn't call it intact, when you compare these results to the VCI. That's a huge gap between listening and reading comprehension. Decoding skills are no better than low average. I don't see this score, but I bet accuracy would fall even further if you made her read in connected text (oral reading fluency), even with the support of context, due to having to do simultaneous decoding and comprehension.

Written language: Sentence composition is comprised of both the sentence combining and sentence building component scores. With the gap between the two, the sentence composition subtest score is of limited utility. The alphabet fluency score is about on a par with her other processing speed/retrieval fluency numbers. Here's the thing that often happens with sentence combining and sentence building, especially with this weak spelling score: sentence combining assesses your ability to construct more complex sentence structures, including causal relationships, comparisons, contrasting clauses. You can generate very simple sentences for sentence building and score well. OTOH, for sentence combining, you are provided with complete stimulus sentences, which is quite handy, if you are a child with a good grasp of complex sentence structure, but weak mechanics, as you can use cognition for the language aspect of the task, and copy the spelling from the stimulus. In sentence building, all you get is one target word for each item. You don't get any benefit from your skill with complex language, and you also don't get any help with the spelling. I'm going to guess that this is something like what happened with her. It suggests that the real hangup with written expression is mechanical (spelling, punctuation, etc.) in nature, which fits with her poor decoding. I'd be interested to see how she does with idea generation and organization.

At the moment, this looks like a more-or-less pure dyslexic situation, with poor encoding (spelling) being the flip side of decoding.

Math: and the same thing happened here, with low average basic skills, but strong reasoning. In third grade, automaticity with math facts is often an obstacle to computational sophistication. Not clear if that was the basis of the num ops relative weakness.

The recommendation for OG is, of course, the gold standard, and entirely appropriate. TBT at home should be compatible with that, not so much for multisensory reasons, but for phonological awareness/direct instruction in the phonetic system/incremental approach (bcs of apparent weaknesses in automaticity). All About Reading/All About Spelling is also a home-based system with OG roots. It's scripted, so the training/fidelity part of it is less of an issue. Relatively affordable, a plus.

Where are you located? Feel free to PM. I'm swamped at the moment but will try to PM you tomorrow night with more specifics of our Canadian 2E experience thus far.

aeh - Thanks for taking so much time to review the scores. Having seen your many contributions to this forum, just knowing you think this all adds up is an enormous relief. We have the (rare?) benefit of results that feel like they make sense, so it helps to know you don’t see gaping questions so far.

You’ve also made sense of the many outliers, which is really helpful to this LD newbie. I am starting to better understand the patterns and what they are trying to tell me. Those WRAML outliers were particularly bugging me, as what limited descriptions I could find of the tests suggested the two low score tasks were visual-spatial manipulations akin to block design, but done mentally. Your explanation makes much more sense. Would depressed memory scores in these areas in particular be expected, given the dyslexia findings?

Which raises another question. Based on my attempts to read sub-test names it seems like low memory/ processing scores are more likely to be in visual rather than auditory areas. Am I misunderstanding? Our psych told us the opposite - that the weaker areas were tending towards auditory, thus re-enforcing the question about CAPD. Auditory processing disorder originally came up both because DD meets a lot of criteria (though these heavily overlap with ADHD, thus the tentative diagnosis there), and also because DD misheard some m’s and n’s in verbal instructions.

And jumping in to another area where I have no idea what I am talking about…. the memory and processing scores are much lower than verbal ability, but still mostly pretty normal. Even the CTOPPs are still average/ low average. The achievement scores, however, are much below. In my simple mind, it seems like there should be more relation between the functional and the achievement measures. Does this disparity reinforce the likelihood that there is also something else - like ADD or CAPD - going on? Or just that dyslexia doesn’t necessarily affect the things the WRAML, CTOPP and WISC can measure, even when it is having that much affect on achievement?

FYI, I don’t see anything that looks at all like the “oral reading fluency” you mentioned wanting to see - would you expect it to be there, and might it be called something else?

As for wondering how she does with idea generation and organization… well, like on almost anything, she does great on self-generated tasks. She’s incredibly creative, and loves to draw and invent stories in the form of improv songs. She’ll happily write (almost indecipherable) lists, menus and invitations to go with her games. On the other hand, her teacher is describing the page left blank for a 20 minutes, with nothing getting written, after spending two days discussing how they will start writing this particular work. As for organization, well…. the ADD shoe fits. But you may have specific kinds of examples in mind?

Now, the math side…. Hmm, I’m pretty blank here. I have a bit of a grasp of the kinds of remediation that reading and spelling will require. I have no idea if there is something equivalent we will need to do with numbers? Or how dyslexia may affect math development over the longer term? yikes. Whole new thought.

You do a good deed, and I come back with a hundred more questions. Sorry about that!

Been reading up on the All About Reading/All About Spelling system - it looks like it might be a good fit (and I noted you speak from personal experience, so a good endorsement.) I thank you again for sharing the benefits of your personal and professional expertise. Much appreciated.

P.S. squishys - she’s a plain 99th VCI, which is actually higher than I expected given that she really doesn’t read. (Her brother also resisted reading until near this age, then took off; that seemed to have a big effect on his WISC scores age 8 vs 10.)

You're welcome!
It's more like the working memory weaknesses are in symbolic areas. Picture memory is basically okay, because those are meaningful images that she has to remember. Design memory is weaker, because they are not. And yes, often you do find lower memory skills in symbolic areas in dyslexics, which has some face validity, when you consider the role of orthographic mapping in fluent decoding skills (a slightly more comprehensive version of sound-symbol correspondence).I would agree that the memory and processing weaknesses were largely in visual-symbolic areas. On the other hand, the CTOPP-2 results are consistent with auditory processing difficulties, even though they are mostly average/low average, because they are significantly discrepant from her verbal cognition.See above comment.As I've implied above, dyslexia -does- affect the WRAML, CTOPP, and WISC results, just not in such a way that the normative scores fall far below average. This is because cognition affects pretty much everything we do, and therefore colors all the other test results. You can see that she employs as many cognitive strategies as she can squeeze in to support her areas of weakness by the striking difference between her story recall (meaning and context) and word recall (rote memory), and the notable, though much smaller, difference between picture (meaning) and design (abstract/not meaningful) memory. Undoubtedly, similar compensation is involved on the other tests.I would guess they didn't administer it, after seeing the poor decoding results, figuring that they had enough information to document a decoding weakness without trying connected text. Oral Reading Fluency is the name of the subtest on the WIAT-III, so it should be pretty obvious, if it's there.That's what I was wondering about. Sounds like organization and initiation are issues with written expression tasks--very common with ADHD. Lists, menus, and invitations are all short, and have a well-established, simple organizational template, so she doesn't have to organize them. Also, they either have a formulaic beginning, or just launch off with bullet points, so the threshold to initiation is pretty low. Plus, they're high interest tasks for her, which helps increase natural dopamine levels, thus temporarily inducing more normalized executive functions.It often affects automaticity of numeral formation (just like letter formation) and math facts (most likely through the same underlying processing deficits that affect orthographic mapping). Also, some students have difficulty lining up math problems, and benefit from using large graph/square paper to help with the visual organization of math computations.I only count eight.

You’re worth your weight in bitcoin, aeh!


It’s just that I’m still formulating the other 92…

It will probably be at least another week before we have an official meeting with the school, but it looks like O-G style remediation is well beyond the school’s capacity. So we probably shouldn’t wait, as we’ve already lost a big chunk of school year, and I can see the strain and anxiety starting to come out. We’ll get going at home as soon as I can obtain some materials, probably All About Reading.

(1) For those of you who used both at home and private tutoring, what were the added benefits of the private tutoring? How can it best be used?

(2) For school, what accommodations actually made the most difference for your child, and why?

(3) Are the O-G-types programs you’ve found a better or worse fit for different kinds of kids/ challenges? Older starters (grade 3)? I notice many are equally intended to be used for starting readers, and I am worried she could be demoralized by materials clearly targeted at pre-K/K.

(4) What have you found useful to remediate or accommodate in math?

(5) We’ve been continually re-assured that the she may just be a late bloomer (especially with the French immersion), and the problem could self-resolve in a year or two. Is this just wishful thinking, or has anyone actually experienced this under similar circumstances? Not that it would change anything we do, just curious....

Thanks so much for your advice, everyone.

Feeling really mind-boggled right now. This week, I’ve talked with two trusted advisors. One was DD’s teacher last year, a great teacher, knows DD well, and has a lot of spec education experience including teaching gifted classes for many years. The other is a friend who is herself a teacher with a lot of spec ed experience (and her husband’s dyslexic, so she’s had a strong interest in the issue over the years). I was pretty astounded when both immediately began talking about alternative schools and special LD classrooms, an approach that really had not seriously crossed my mind yet and I guess I would have considered a pretty last resort. Are they hugely over-reacting? Am I failing to grasp the seriousness of the situation?

These are two people with 30 years each experience in my school system, and each was assuming pretty instantly that our regular school system was no place for a child with dyslexia.

Wow.