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    #206377 11/25/14 09:12 AM
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    I've never posted DS7's scores here and I'm going to do my best to give a brief summary of where we are on this journey because I need some advice, again. He took the WISC and WJ 9 months ago and was diagnosed with dysgraphia.

    WISC:
    VCI: 99.6%
    PRI: 98%
    WMI: 42%
    PSI: 88%
    FSIQ: 98%
    GAI: 99.8%

    I'm not going to take the time to list all the WJ scores. They are consistently 95%, with the exception of Broad Written Language at 70%.

    No major vision processing issues found, minor convergence insufficiency. No major issues found by OT, although she noted his fine motor skills are like a 5.5 year old (He'll be 8 in two months.) She didn't recommend any significant therapy.

    Our pediatrician, who is our only champion, gave us a certificate for a free assessment at LMB. We got the results back today. She indicated that his abilities are quite high (99%), but his auditory processing is weak (68%). She said that he didn't have the decoding skills to access what he's capable of reading/writing. They recommended 2-3 weeks of intensive training and significant follow-up time.

    We simply cannot afford this training right now. Are there other programs that I can do at home to fill this gap? This seems like a straight-forward set of skills, but I'm not an educator.

    Also, how does this fit with dysgraphia, or does it? Is this a piece of that puzzle or another curve ball?

    As always, thanks for your help. If more data would be helpful, just ask.


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    I have a few random thoughts and questions for you - based on this plus taking a quick look back at previous posts.

    Do you have scores from your ds' Beery VMI subtests? And the WISC processing subtest scores? Variations in these subtest scores (or no variation) may provide clues to what's up.

    Can you post the subtest scores for the WJ-III Broad Writing? The "Broad" score is a sum of three subtests. If only the fluency score is low, that would be an indication of dysgraphia because it is dependent on fine motor skills plus it's timed. OTOH, with dysgraphia many of us see all three WJ-III fluency scores dip low (math fluency + reading fluency) because for a dysgraphic child the thing being measured is handwriting speed rather than the concept that is supposed to be tested. If there are other language processing issues, you might see a relatively low score on one of the other writing subtests, and that seems like it would fit in more with what you've been wondering about your ds (but - that's just a guess on my part!).

    Re auditory processing - my older dd was suspected of having auditory processing challenge when she was younger. She was assessed by an audiologist, not by LMB. Had she been diagnosed with APD, the audiologist would also have done the remediation. It was all done with a medical referral from our ped, would not have been the intensive remediation recommended by LMB, and would have been paid partially by medical insurance (we have friends who have a dd with an APD diagnosis and this is how they approached therapy for it). They also had accommodations put into place at school right away (preferential seating etc) and the accommodations helped tremendously. I just mention that because, while the LMB approach may be wonderful and successful, it's most likely not the only approach available for APD in most areas.

    You've posted about test results and asked about how it fits with dysgraphia - would you mind posting about what you see in your ds' academics and homelike that are challenges at the moment? That might help us understand the bigger picture of what's going on right now.

    Best wishes,

    polarbear

    ps - one last question about the WJ-III scores - does "they are all consistently 95%" mean that each subtest is at the 95th percentile or does it mean each of the "broad scores" is at the 95th percentile? If it's just the broad scores, it might help to post the subtest scores.

    Last edited by polarbear; 11/25/14 12:16 PM.
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    Some of this data I'm taking out of the ed psych's narrative so I'm using her language on some of these. For example, she didn't list the Beery scores but addresses them in the narrative.

    Beery
    Visual perception 91%
    Motor coordination 32%

    WISC processing scores
    Coding SS 11 63%
    Symbol Search SS 15 95%
    Cancellation SS 9 37%

    She doesn't list the scores from each subtest in the WJ but she alludes to them in the narrative.
    Spelling skills are 38 points lower than VCI
    Writing fluency is 25 points lower than VCI
    Ability to apply writing skills 31 points lower than VCI

    She says, "His applied writing score in the 72nd percentile does not reflect a complete impression that DS left with his performance. A portion of his writing test was not evaluated due to difficulty interpreting what DS wanted to say."

    I do not have subtest scores for the WJ. She mentions that reading and math skills are developing and writing is lagging significantly. She says that at every level (basic, fluency and application) across all domains (reading, writing and math) he's at least 15 points below what would be expected of someone with his ability. His writing is just much worse. I was attributing some of this to exposure to the content for reading and math. I'm not sure if that's right or not.

    At home, I see a boy who struggles to get thoughts out. Unless he is an expert on the topic or genuinely interested, he has a very hard time coming up with what to write. When he does form a sentence it is very basic and then it takes 4 minutes for him to actually get the sentence on the paper. He often neglects simple writing conventions and his spelling is terrible. I've seen him misspell his own name multiple times. He also doesn't see the mistakes until I ask him a question about what's on the page. I also know that he WANTS to do a good job. He didn't finish work in his GT class and had to bring it home to finish. He was very concerned about writing "good" sentences. He kept asking me..."Is this good?" I didn't even know what to say to him. It wasn't good.

    His school work appears to be done with the least amount of effort possible. I've only seen a few spelling tests, but he can spell the words correctly after practicing but he also has to write sentences with half the words and then it seems to fall apart. The only other piece of school work I hear about are timed math fluency tests. He is doing poorly on those as well. He's decided he can't do subtraction because he only gets two problems done in 60 seconds.

    Last thing-his handwriting isn't terrible. I can read it, but the letters don't sit on the line the right way and he is still reversing a few letters.

    Thanks for any insight you can provide. I hope all of this makes sense.

    PS. LMB calls phonological processing, symbol imagery and decoding "auditory" function. It sounds like APD is different.

    Last edited by NikiHarp; 11/25/14 02:05 PM.
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    Thanks for the additional data and info - it really helps!

    Originally Posted by NikiHarp
    Beery
    Visual perception 91%
    Motor coordination 32%

    I asked about this to see if there was a split and if it indicated an issue with fine motor vs visual processing - both can be at the root of dysgraphia. It's clear from your ds' scores that his dysgraphia is fine motor in origin.

    Quote
    WISC processing scores
    Coding SS 11 63%
    Symbol Search SS 15 95%
    Cancellation SS 9 37%

    The processing subtest scores on the WISC also make sense for fine-motor dysgraphia.

    Quote
    She doesn't list the scores from each subtest in the WJ but she alludes to them in the narrative.
    Spelling skills are 38 points lower than VCI
    Writing fluency is 25 points lower than VCI
    Ability to apply writing skills 31 points lower than VCI

    So I'm guessing that his individual subtests on the WISC aren't all at the 95th percentile level - that's neither here nor there, because you have what you need in the report (although to be honest, I always like to get a copy of the subtest scores whether or not they are mentioned in the report, just so you have them in case, for instance, someday he has repeat testing and you want to compare how he's improved).

    I am also guessing the psych included specific writing skills in the report that needed work? And recommendations for the type of approach to remediation?

    Quote
    She says, "His applied writing score in the 72nd percentile does not reflect a complete impression that DS left with his performance. A portion of his writing test was not evaluated due to difficulty interpreting what DS wanted to say."

    Quote
    I do not have subtest scores for the WJ. She mentions that reading and math skills are developing and writing is lagging significantly. She says that at every level (basic, fluency and application) across all domains (reading, writing and math) he's at least 15 points below what would be expected of someone with his ability.

    The reason I'd want to see subtest scores here is - the 95th percentile she's reported for each broad category of reading and writing might indicate each subtest is at 95th percentile (and would be expected to be at 99th), or it could mean that he's got 1 or 2 subtest scores at the 99th percentile and one subtest that is lower. This happens frequently for dysgraphic kids - the WJ subtests labeled fluency rely on handwriting and are timed - two challenges for kids with dysgraphia, so it's not unusual to see lower than expected scores on those two subtests. If they are much lower than the other subtest scores for each category, what you might be seeing is that he's actually performing at the level you'd expect conceptually for both reading and math, but he can't show it quickly with written responses. That's just a possibility, and it might not be the issue with your ds - his psych seems to have been very thorough in her report. The reason I'd want to know that for sure, though, is that for my ds - he really did lose ground on math achievement in early elementary because he was held back in math due to his dysgraphia due to his teacher's requirements to be able to write timed math facts quickly and also be able to express every danged math problem as a word problem.

    Quote
    At home, I see a boy who struggles to get thoughts out.

    This is exactly what we saw (and still see at times) with our ds who has an expressive language disorder.

    Quote
    Unless he is an expert on the topic or genuinely interested, he has a very hard time coming up with what to write.


    I wouldn't be quick to assume that the issue is either interest or being an expert on a topic. Being an "expert" means he has factual knowledge, which means he doesn't have to generate an idea to write about. He also may "look" disinterested when he's lost and has no idea what to write about - but that doesn't necessarily mean he doesn't care about it. Does that make sense? So rather than assume that he's able to write when he's interested or an expert, track the assignments where he is able to put his thoughts into words and look for similarities across the assignments that are less subjective - can he summarize a factual article? Does he struggle when he has to come up with a creative fiction story? Does he have difficulty describing or developing characters to put into a story? etc

    Quote
    When he does form a sentence it is very basic and then it takes 4 minutes for him to actually get the sentence on the paper.

    This is most likely dysgraphia, and this is why it's sometimes difficult to recognize that there is an expressive language challenge coinciding with dysgraphia. I would suggest having him switch to typing asap for all class assignments. Keyboarding really helped us pick up on where our ds was impacted by his expressive language challenge by taking a large chunk of his dysgraphic challenge out of the equation. Adding in word prediction software was also a huge help, because it eliminated the need to do massive spell-corrections after writing, and the length and complexity of thought put into his sentences went up exponentially with word prediction.

    Quote
    He often neglects simple writing conventions and his spelling is terrible. I've seen him misspell his own name multiple times. He also doesn't see the mistakes until I ask him a question about what's on the page.

    This all sounds like classic dysgraphia.

    Quote
    I also know that he WANTS to do a good job. He didn't finish work in his GT class and had to bring it home to finish. He was very concerned about writing "good" sentences. He kept asking me..."Is this good?" I didn't even know what to say to him. It wasn't good.

    I've always been really honest with my ds and I've also always felt that I have a primary role in helping my ds learn how to write (because it's going to take him extra work over NT students), but I've also not seen any of it as a negative. For instance, I'd show your ds what you expect a "good" sentence to look like - give him an example to imitate and learn from. Our SLP helped me recognize something about dysgraphia which you don't always get from reading the references online - the thing dysgraphic people are challenged with isn't just handwriting, it's a lack of development of automaticity. They have to do certain tasks over and over again many more times to make them "stick" than NT people do. I don't know if this happened with your ds, but it took my ds literally years to learn how to tie his shoes. Handwriting never became automatic for him, and learning how to write a sentence and then a paragraph etc were all tasks that took a lot of repetition. I don't know if you have other children, but it was very eye-opening for me to see ds' younger sisters learn how to write - it was sooooo much more automatic and easy. Anyway, you can look at a sentence your ds has written and reframe how you are looking at it - if he asks you if it's "good" let him know that what the teacher (or whoever) is looking for is "x,y,z" and he has "whatever portion of x,y,z" and he can improve his sentence by doing "whatever it takes to get to x,y,z".

    Quote
    His school work appears to be done with the least amount of effort possible.

    Are you referring to work he's done at home where you are watching his effort or the result of work he's done at school? I would try to not judge his effort at this point - you can ask him if he's giving it his full effort, but even that, I'd let go of for now. You mentioned above that he cares about doing good work - give him credit and trust that he is trying his best. One of the most damaging things I've seen happen with my ds is that teachers and other students assumed he wasn't trying his best when really he was but it just didn't *look* like he was trying because he was lost and had no clue what to do, or because his dysgraphic handwriting was slow and impacted his ability to spell etc. It's easy to give up hope and check out when you're struggling with an LD that no one has figures out how to remediate or accommodate yet. It will take some work to get there, but in the mean time, the single best gift you can give your ds for the long run is your confidence in him. Self confidence at this stage might be a struggle for him, and he's got struggles with classwork - but he's also going to eventually be successful, and if you take some time to read the bios online of successful businesspeople etc who struggled with LDs as children, you'll find a common thread among all of them - either a parent or a teacher or a *someone* who was an adult who believed in them.

    Quote
    I've only seen a few spelling tests, but he can spell the words correctly after practicing but he also has to write sentences with half the words and then it seems to fall apart. The only other piece of school work I hear about are timed math fluency tests. He is doing poorly on those as well

    Again, this is all classic dysgraphia. And it in know way is a reflection of his true spelling ability or his true math ability.

    Quote
    He's decided he can't do subtraction because he only gets two problems done in 60 seconds.

    He needs to have an accommodation at school to be given fluency tests (timed tests) orally. At home, when he says he thinks he can't do subtraction, have him give you answers orally and see if he can't do more quicker that way. It's also probably going to be helpful if you start explaining to him that he's dysgraphic and what that means in terms of ability to use handwriting to express yourself. If you haven't already talked to him about it, I'd do that now. It may seem depressing or deflating to have to talk to your ds about having a disability, but the flip side is - it's an explanation and it's how you help him see he's not a low achiever at spelling or math facts and that he *can* do them given the proper accommodations.

    Quote
    Last thing-his handwriting isn't terrible. I can read it, but the letters don't sit on the line the right way and he is still reversing a few letters.

    Not all dysgraphics have illegible handwriting - but what they do share is that the handwriting isn't automatic, so while writing their working memory is completely used up with the handwriting process and nothing is left over to focus on spelling, grammar, etc and most importantly - how to express their ideas.

    Quote
    PS. LMB calls phonological processing, symbol imagery and decoding "auditory" function. It sounds like APD is different.

    Thanks - I misunderstood what they meant about the auditory function. To be honest, I am not sure I'd worry too much about the LMB report at the moment. Have you had your ds' SLP (I think he has one?) run any type of expressive language assessment? As well as the TOWL (it's a written language test) - I think from what you've described these will be more useful at the moment.

    BUT I'm not a professional, so take everything I've written with huge red flags and grains of salt the size of snowballs smile

    Best wishes,

    polarbear

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    Thank you so much, polarbear.

    I actually have a meeting with the SLP after Thanksgiving. DS missed a day of speech for the LMB assessment. When I mentioned that to her she asked if I would come in for a meeting. I'm not entirely sure what she wants to discuss but I'm grateful for the opportunity. Her son is going to LMB and this may give me an opening to request the TOWL and expressive language assessment. Crossing my fingers for an ally on the "inside."

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    polarbear's advice is very thorough and human, as always!

    I have very little to add.

    My dysgraphic-y kid also has beautiful handwriting--but it's super-slow, and clearly not automatic. Scribing, keyboarding, and speech-to-text are the way to go.

    I second the SLP eval. LMB does work, and it's an excellent product--but don't forget, they're still selling a product. As they say, if all you have is a hammer, everything looks like a nail. A language eval will get you a broader picture.

    For inexpensive alternatives to LMB, we've had good experiences with the OG-based home program All About Spelling/All About Reading.


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    It makes me a little uncomfortable that your doctor gave you a voucher for LMB and they recommended you purchase their services. I may be normal there but I like to have assessments one place and services another. Does the doctor have a financial interest? Or is he just using a free sample like some doctors do with drugs?

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    Thanks for chiming in, aeh.

    puffin, thanks for your concern. However, I trust this pediatrician implicitly. She really wants to help and this was her way of trying to do that. She knew before giving it to me that we likely couldn't afford it but she thought the information might be helpful.

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    I'm glad. A doctor you can work with is a wonderful thing.


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