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    Joined: Nov 2013
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    Thanks polarbear. The only test (other than WISC-IV and WJ-III) that she did was "The Beery-Buktenica Developmental Tests of Visual-Motor Integration, Sixth Edition". The report doesn't mention this test specifically at all, other than to list it at the beginning. The reports mentions "visual-motor integration" a few times, but it's not clear if that's just about WISC-IV PSI results. The psychologist didn't recommend any more testing either, other than maybe by a developmental optometrist.

    Did you have other clues, in retrospect?

    And what was your daughter's specific visual problem, if you remember? I am just beginning to learn some of the terminology.

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    1. It does sound like the VCI and PRI could be considered low estimates, between her perfectionism and the lack of natural ceilings.

    2. In my experience, cancellation draws heavily on visual scanning skills. It's a large field of visual stimuli, with either some or negligible visual structuring (depending on the trial). Fine motor is a fairly small aspect of it (and probably not the major factor in this case, as the other PSI scores, one of which has more fine motor demands, were higher). Sustained attention and visual organization also affect performance. I wonder how much of the lower performance on Cancellation had to do with maintaining a smaller, more structured visual field for scanning and tracking.

    3. We have insufficient information to nail down the differential diagnosis, obviously, but FYI, where low processing speed fits into dyslexia is in decoding automaticity. This is not, btw, incompatible with reading extremely quickly, for a child with very high cognition and memory, as one can reach high reading rates using predominantly whole-word/sight reading. In order to detect the lack of decoding automaticity (sometimes called orthographic mapping), one would have to administer timed tests of decoding nonsense words (such as the Decoding Fluency subtest on the KTEA-3), to reduce access to compensatory strategies that involve sight vocabulary. None of the achievement measures you listed included such a test.

    I agree that pinning down the role of vision is key right now, but I would keep dyslexia in the discussion, as that might be another factor affecting comprehension (she may be reading purely by sight, which occasionally results in key miscalls in comprehension passages).

    And yes, perfectionism is almost certainly in the mix. Whether it is primary or ancillary is another question.


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    Another correction:

    Coding was at 37th percentile.
    Symbol search was at 37th percentile.
    These two were included in the PSI, which was at 34th percentile.

    Cancellation tests, not included in the PSI, and which were the last two tests of the day were:
    Cancellation overall was at 16th percentile.
    Cancellation random was at 37th percentile.
    Cancellation structured was at 5th percentile.

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    * The psychologist mentioned orally that DD#2's eyes "opened really wide" when she saw the cancellation test. An anecdote that may mean nothing at all.

    * What you're saying about dyslexia, aeh, is exactly what I've been thinking. How much of her reading is really sight reading? She can sound words out, but with new words / names or less familiar words, she often skips a syllable the first time she says it. Of course, EVERYONE thinks I'm crazy for even thinking about it, with a child who can read so very well, loves reading, and can spell fairly well (does that matter? she is one of those people who spells better after she looks at what she's written or pretended to write - spelling by sight check, in other words, which I know is a different skill). If it really is something like dyslexia, I wouldn't even know where to begin with getting that tested. I would need someone who really knows "profoundly" (exceptionally, highly, whatever) gifted kids, right? That is what the psychologist we used was, but she didn't mention anything about dyslexia. I do have a friend whose son, a strong reader, was diagnosed with stealth dyslexia, but he had problems with spelling and I think more problems with handwriting than DD#2 has. What other things related to dyslexia would we likely have noticed?

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    The type of epilepsy DD#1 has been found to be correlated with a number of things, including "speech sound disorder". In fact, though the research is in its infancy, there have been a number of studies publishing showing a high - sometimes equally high - correlation between being a sibling of a kid with the epilepsy and particular problems. In other words, a sibling without overt seizures is just as likely to have problem X as the epileptic kid herself. (DD#2 doesn't have seizures that we know of, and she's never been tested for the characteristic EEG pattern that goes along with this epilepsy.) So there could be other problems that are more common with siblings that just haven't been researched or documented yet (and DD#1 could also have problems that were never diagnosed, of course).

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    Professional pamphlet: 2/3 of children with DD#1's form of epilepsy have trouble learning to read.

    DD#1 knew almost all letters and sounds they made by around 18 months, reading early readers at age 3.5 years old.

    Both kids could pull words apart into phonemes at the right age or earlier.

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    Originally Posted by LaurieBeth
    If it really is something like dyslexia, I wouldn't even know where to begin with getting that tested. I would need someone who really knows "profoundly" (exceptionally, highly, whatever) gifted kids, right? That is what the psychologist we used was, but she didn't mention anything about dyslexia.

    LaurieBeth, I have a HG+ dd who has a reading challenge that was far from obvious and took several years to figure out. The standard tests that pyschologists use (for standard evals) don't necessarily pick up on reading challenges, especially if it's not conventional dyslexia. We were able to get to the nuts-and-bolts of dd's reading challenge through an evaluation by a Speech Language Pathologist who specializes in working with dyslexic children and other types of reading/writing challenges. I can post the list of tests that dd was given here if you're interested - I'll have to look them up because I don't remember the names of all of them, but the key was each test looked at very specific skills relating to reading (and there are a *ton* of different skills). The one test I remember the name of is the Gray Oral Reading test... but there were at least 4 other tests dd was given too.

    Best wishes,

    polarbear

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    Your clarification on Cancellation makes it clear that, actually, 3 out of 4 PSI tasks received exactly the same score, in the Average range. The last trial of Cancellation is the only task that scored below average. That makes it less likely that it is something specifically about Cancellation that pulled the score down, and more likely that it was fatigue, as that was the actual last task completed. Most students score slightly better on the structured condition than on the random condition (factored into the norms, of course). This does not, of course, change the general finding of relatively low processing speed.

    As to diagnosis of dyslexia: most evals involve identifying two areas of deficit--an aspect of reading performance, or achievement (e.g., phonetic decoding, fluency, comprehension), and a cognitive process that is associated with reading mastery (e.g., phonological processing, phonological/working memory, retrieval fluency/automaticity). In an exceptionally high cognitive individual, these relative deficits may still lie in the average range, as the individual may be able to use cognition to compensate. This does not mean they have no deficit in that area; it may be that they are able to generate normative performance at great cost to higher-level functions and energy drain.

    Relevant measures of achievement may include the tests already mentioned, and others: GORT-5, KTEA-3, PAL-II, WIAT-III, WJ-IV, OWLS-II (tests vary in quality and range of reading measures).

    Process measures may include

    1. measures of phonological processing, such as are found on: CTOPP-2, PAL-II, WISC-V (ancillary), WJ-IV, some speech-language instruments (a standard starting point for speech/language evals is the CELF-5).

    2. measures of phonological/working memory, such as are found on: CTOPP-2, WRAML-2, WISC-V, WJ-IV, TAPS-3, D-KEFS.

    3. measures of retrieval fluency/automaticity, such as are found on: CTOPP-2, WJ-IV, WIAT-III, KTEA-3, D-KEFS.

    Although it can be helpful to give the evaluator some guidance with regard to your concerns, it is also good to keep an open mind, and let the assessment lead the diagnosis, as the obstacle is not always what one thinks it is.


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    Oh, and on spelling, her approach to spelling (visual) is entirely consistent with being a whole-word/sight reader who has not achieved automaticity for phonetic decoding/encoding. I suspect that she's just powering through reading and spelling with her exceptional memory. This works for everyday tasks, and may be sufficient to get by on all her life (especially if she slants toward less text-heavy fields, such as STEM), but it is not efficient, and likely means she is always performing under her true verbal capacity when text is involved (interpreting or generating).


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    Originally Posted by LaurieBeth
    What you're saying about dyslexia, aeh, is exactly what I've been thinking. How much of her reading is really sight reading? .... What other things related to dyslexia would we likely have noticed

    With your daughter's verbal skills + memory, and the amount of reading she does, dyslexia could be very hard to see. As aeh describes, you'd want very specific testing that dives deep into the underlying phonological processing skills, because she can fake the surface output extremely well. My daughter (for comparison, MG and average memory), was still 88th percentile in terms of phonological awareness, but her scores dropped dramatically as the phonemic manipulation tasks got more complex.

    In terms of what you can see yourself, there are a few things I can think of you may see when she reads aloud, though none definitive when a child reads as much as yours. Does she tend to do things like miss suffixes, or skip small connecting words? Substitute plausible but wrong words that may the same first letter or shape? Resist reading out loud? Dyslexics tend to scan for the big meaningful words to extract the gist of the the text, while skipping over the bits in between. It means verbally-gifted dyslexics counter-intuitively tend to do better with longer, more complicated text than short snappy bits that provide less context.

    With respect to hand-writing issues, note that dysgraphia and dyslexia frequently go hand in hand, but not always. A lot of the archetypical "dyslexia" signs, like reversed letters and handwriting issues, actually relate more to dysgraphia.

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