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    Thanks guys. I've been reading these and will follow up with more details/responses soon.

    The one thing that strikes me is that it is true that a big part of my feelings about this - why I'm even considering dyslexia or something similar, and to some degree why I'm thinking about visual problems, is simply the psychologist's testing results. Yes, there are IRL things, but I have only 2 kids, so not a huge knowledge base on what's typical (for things like making some mistakes in reading orally), and as we've discussed, there are many reasons why the testing could have come out the way it did. To the extent that this is about the PSI, I kind of wish I could just go back, have her take the tests again (practice effects wouldn't be that big after more than a year, right), and just tell her to try to go faster - she didn't make any errors on the subtests, according to the psychologist. If that happened, and her PSI was more in the range of DD#1's (I think that was in the 120s), then I probably wouldn't even be concerned. It bothers me that so much work, second-guessing, stress can be based on just a couple of minutes of testing.

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    LaurieBeth - I sent you a private message. Sue

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    Sue, wanted to make sure that you saw that I PM'd you back.

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    Not in any particular order:

    * The developmental optometrist did the evaluation. They told us at the end that she would write up a report and send it, and then we could meet in person to discuss (or on the phone if better for me). They did not tell us anything.

    * My daughter said that a machine that they were planning to use was broken.

    * She also said that she was given a test where she had to stuff from line to line - numbers - and the doctor told her she got them all right. I guess, though, that her speed would still have mattered. Also, the reason she told me that was because she was reading out loud to me and mentioned that she had started to go to the wrong line. I asked her how often that happens and she says pretty often. Of course, asking the question can influence the answer.

    * At some point, she was looking at something on a screen, maybe through an instrument, and the doctor asked her to read something and she said she couldn't see the stuff on the edges, and the doctor said, "Is it fuzzy?" and she said, "No, it's just too dark," and she said the doctor seemed surprised, but who knows.

    * DD#2 has unexplained mild headaches and mild nausea occasionally.

    * DD#1 had some blurring of vision at age 8. This happened several times in school, then resolved after 30 minutes or something like that. I took her to my optometrist and he didn't find anything wrong. They went away, so we never consulted her neurologist (the one prescribing for her epilepsy).

    * My sister had far-sightedness and amblyopia at age 4-5. She wore glasses with an eye patch for a very brief period of time, and it resolved completely.

    * DD#2 NEVER complains of blurred vision, and when I ask her about blurred vision, she says she NEVER has that.

    * If she has mild (+1.25 and +1.5) far-sightedness now, perhaps she had more when she was younger? Maybe she is happier in school this last year in part because she isn't have to strain her eyes as much to accommodate for the far-sightedness?


    * Aeh, you said, with respect to the Cancellation subtest, "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." Could you elaborate?

    * Aeh, with respect to the tests you describe for dyslexia issues, would average scores on these tests rule out dyslexia diagnosis? Or would they also be affected by unusual strengths?

    * Polarbear, thank you for these notes. If you could post the tests you mentioned, that would be great (if it's not too much trouble).

    * One thing to remember: I am not mentioning "issues" randomly - rather, I am specifically mentioning things that I think might be relevant. So I am trying to be aware of the possibility of confirmation bias on my part - e.g., I know that spelling by visualization could mean something, so the fact that she MIGHT be spelling that way more than is typical (and how much do I really know about what is typical?) is something I mention. But I could be wrong about whether she does that an unusual amount. The other day, I just gave her a real word with many syllables (I think it was "initiation") and asked her to spell it. She spelled it correctly, but interestingly, she says when I say it, she visualizes the whole word in her head. I don't do this, not for such a long word. For "home", yes, probably. For "initiation", I may sort of be visualizing it, but if I am, it's really only syllable by syllable, or a general idea of how long the word is and what it starts with. I don't think I have a strong enough visual memory to visualize a word like that in my head at one time (I'm in my early 50s). I don't know if we're doing things differently or not (sounds like it), or if I'm the unusual one or she is. But I guess that's the kind of thing to be inquiring into, maybe at some point. Basically, she shows a few signs of a difficulty (and that's including the WISC-IV and WJ-III results) and seems to be missing many others.

    * OTOH, I asked her to do the same - spell another long word that wasn't actually a word, but that would have a typical spelling in English, based on its pronunciation, and she did that okay too. (They did Saxon phonics through 2nd grade.) And I was already pretty sure she had the capacity to spell based on phonetics. But did she do it too slowly? I couldn't tell; it seemed okay to me. I guess that's what they test for, right - how difficult it is to spell nonsense words versus real words quickly.

    * Field she is interested in: She says she wants to be a writer, an actor, a teacher, and a scientist (not in any particular order). She is clearly verbally gifted, but she likes science too. Certainly I would not want to rule out humanities/writing fields for her.

    * As you can imagine, it's scary to hear all of this. There is a therapy for it, right? I have a friend - my child's kindergarten/first grade teacher (whom she loves)- who is Orton-Gillingham trained. Of course, she thinks my kid can't be dyslexic, because she had no trouble with spelling or with writing (at those ages, anyway), and read so many years above grade level and loved reading. But of course, my friend doesn't specialize in EG / PG kids, and probably hasn't had experience with dyslexic kids with such verbal strengths. (Unlike most do or would, she didn't ridicule me for even thinking it might be a possibility. Just said, I don't think so, but I'll be interested to know what you find out.

    * Obviously we need to wait and see how to visual evaluation comes out, what effect wearing glasses has, etc. But again, I wouldn't want to miss a window for therapy for dyslexia-like issues if those were in the mix. My biggest concern would be who to get an evaluation from. Esp if test results would be skewed by DD#2's strengths, and if there aren't objective tests which would isolate the weaknesses, I wouldn't know who to try to find. I suppose I could get a DYS family counselor and ask. We used a regionally very well-known psychologist who specializes in gifted kids for what I guess was a "psychoeducational" evaluation, rather than a "neuropsychological" evaluation. And she didn't mention anything about dyslexia. A friend got a surprise stealth dyslexia diagnosis from someone who is physically much closer to us, even though her son was reading years above grade level (but had spelling and handwriting problems), but she also does ed psych evaluations, so I'm not sure what more I would be getting from her? Maybe she more specializes in dyslexia, I don't know.

    * Platypus: Thanks for those details about your daughter. That's useful information, in terms of specifics. In answer to your question, she does do some of those things - when reading aloud, occasionally skipping words or parts of words, substituting plausible words that may not even look similar. I can't tell if it's an unusual amount, though. Don't we all tend to make guesses about what's coming next, e.g., finishing out a cliche before seeing that the next word is actually a different word. Interestingly, she used to resist reading aloud, but for the last couple of years, she has done the opposite - she asks to read aloud to me or her dad, and seems to take pride in it and enjoy it. I wonder if that could be a form of self-therapy. In addition, I have noticed over the last year that when I read to her (I still read to her 15-60 minutes each night, at least), she wants to be a position where she can see the words and she often follows along with me, and will catch me when I skip a word or misspeak or whatever! Again, could be a form of self-therapy.

    * Example of the kind of mistake she might make when reading out loud: The other night, she was reading and read "Giordano" as "Giorando" (otherwise pronounced like you'd expect, accent on the right syllable). I stopped her and asked her to look at the word again, and she was able to sound it out. I asked her what she thought had happened, and she said that she "didn't see" the "a", and couldn't figure out how to sound it without ("Giordno") so she just added a vowel sound. I'm not sure what this means, with respect to visual versus language processing, and it doesn't happen SUPER frequently, but it does happen. This was in a room that isn't super bright; she doesn't yet have glasses, and it was around bedtime. She was reading a fiction book by Madeline L'Engle at a normal reading pace.

    * One other thing that occurs to me. Her older sister has a diagnosis of ADHD (much more likely to skip words like "not" when taking tests, much more likely to skip problems or pages of problems on tests). However, she has a form of epilepsy that is correlated with various problems, and sometimes the attention problems that are related end up getting described as "attention deficits related to epilepsy". I'm not sure if any one really knows if "epilepsy" type attention problems are different from attention problems in those who don't have epilepsy or abnormal EEGs, but DD#1 does take stimulant medication now, with some good effect. As people often say, "inconsistency is one of the hallmarks of ADHD". As DD#2 is the full sibling of DD#1, I wonder if she could have problems that are variable. I.e., variable not just with typical things such as sleep deprivation, but just variable. DD#2 used to complain about having complicated thoughts she couldn't get down on paper - either things that were required for school, or things she just wanted to do on her own. But during the last 1-2 years, she has seemed to have less of a problem with this, which makes it seem like it's either related to maturing something-or-other (executive function? handwriting?) or related to lowered anxiety with nicer teachers and thus more confidence in her writing at home as well. At times, she writes quite "flowingly" - she wrote a 5-page play by hand in one afternoon and was happy with it, for example. Other times, not so much. But ... is that so unusual? Artistic temperament, muses, writer's block, and all that. When I start writing like this, I do feel like I’m "overthinking" the whole thing. It's really hard with unusual children (and I'm unusual myself) to know what's really a deficit of some kind, and what's just not being, y'know, perfect in every area.

    *DD#2 is right-handed and had some mild difficulty with left/right when she was younger (not sure if it was unusual at her age). Just this week, I asked her about this, and she said, "I don't have trouble now, because left hand makes an 'L'." Well, yes, but is she actually still using that mnemonic to remember which side is her left? She says yes. I am not sure if this is true. I don't think she actually looks at her hand making an "L", but it's possible she is visualizing it in her head. I'm not sure if this abnormal, but I sure don't do this. Her dad (right-handed) also has a little bit of trouble here, or maybe did in the past (though it might just be mis-speaking?). DD#1 is left-handed, and also took a while to remember left and right, but again, not sure if it was abnormal.

    Last edited by LaurieBeth; 07/11/16 03:23 PM.
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    aeh, polarbear, and Platypus:

    I have PM'd all 3 of you. Thank you!

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    Sustained attention/visual organization and Cancellation:

    The visual field for Cancellation has a big mass of visual images filling up a two-page spread, with no visual or verbal guidance about how one should search through the field in an organized manner to find the target items. Symbol Search and Coding, OTOH, are laid out in grids, with nice, neat visual boundaries for each row. An individual who relies on visual scaffolding to maintain tracking, or organization, benefits from the gridlines on SS and Cd, and lacks them in Ca. If the lower Cancellation score is a genuine finding, and not just a mark of testing fatigue at the end of the session, it might be that the absence of a visual frame impeded her speed and efficiency in the visual search task, or caused her, for example, to skip whole lines, thus omitting possible correct responses.

    Average scores:

    HG kids can definitely use cognition to power through dyslexia-related tests that non-disabled NT kids complete automatically, resulting in similar scores, but arriving by very different paths. So no, average scores do not necessarily rule out dyslexia in a high-cognitive individual.


    ...pronounced like the long vowel and first letter of the alphabet...
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    Received optometrist's report and had in-person meeting.

    Report is kind of unclear but main diagnoses seem to be (1) convergence excess and (2) oculomotor (tracking) dysfunction. However, I think the second may be without foundation in the testing - seems to be based on a typo or something in the entry of the data re the Developmental Eye Movement test (i.e., there's an extreme inconsistency between the optometrist's report and the DEM test report I was given - two important numbers are reversed which it appears should definitely change the diagnosis, per the DEM manufacturer's instructions).

    (She also has mild far-sightedness, apparently accommodated and on range of +1.5 and +1.25.)

    Has anyone ever had a kid treated for convergence excess, with vision therapy or glasses?

    Apparently the optometrist thinks she will need glasses eventually, but said that they weren't working well right now, during a fairly short appointment, and it would be something to work up to.

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    I didn't read this whole thread, only a few of your posts, but had a couple things to say.

    DD had similar WISC IV scores (except PRI and VCI were reversed) when she was 8. PSI was 94. GAI without extended norms was 150. Psych who specialized in gifted kids said it took her an hour or hour and a half longer than other kids to do the test and the "slow processing speed" was apparent. DD is extremely slow when it comes to academic work. She can't seem to do anything academic in a timely fashion, except for the fact that she is a fast and fluent reader. It took her probably 5X longer than the rest of the class to do a cursive packet. Her spec. ed teacher was elated when she finally got it done about 2 months later than everyone else. DD has ADHD--combined type and executive dysfunnction and it is extremely obvious. That being said, she did do just the PSI part of the WISC IV a year after the original test and her score went up to, I think, 118. I don't know if that was her "real" score or if the school psych was so incompetent she didn't administer or score it properly. But if it was accurate, that was a huge jump in 1 years time. So I think you may be over-thinking the score. I would not worry about it unless your DD exhibits symptoms like my DD. Her WJ scores were also not anything that you would expect from a child who scored a 150 GAI on the WISC (110 or below was considered an extreme discrepancy in the regression tables, at least in terms of qualifying for services based on having a learning disorder).

    DS had a very extreme case of vision issues when he was in kindergarten. He had a traumatic brain injury and one eye was literally stuck turned inward, and didn't track at all for months. Prism glasses would have been useless because the convergence issue was way too severe and he had extreme double vision. Like two identical clocks on the wall 5 feet apart. Two identical books side by side when he read. He would reach for a balloon ribbon and grab at air, the "double" about a foot away from where the real balloon was. He was somehow able to read fluently with an eye that didn't move even when we patched his normal eye. I don't think it was all that easy or comfortable for him but he was able to do it. So when I hear people say that their child has reading difficulty because of their visual convergence issues, I am very skeptical. His eyes are now aligned but he has obvious tracking issues when he's examined. His eyes look like they are moving independently, kind of like a lizards (this is not obvious except when he is asked to track a moving object and people are watching his eyes). He claims that he has no problems seeing the words on the page and he reads books with tiny print very quickly. Reading achievement scores are always 98th-99th percentile, similar to his cognitive ability. I am not sure if any of that info is relevant to your situation but thought I'd share our experience. Vision therapy has been suggested to me but I have no proof that his vision tracking issues are affecting him and would not shell out any money unless insurance paid for it.

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    "That being said, she did do just the PSI part of the WISC IV a year after the original test and her score went up to, I think, 118. I don't know if that was her "real" score or if the school psych was so incompetent she didn't administer or score it properly."

    Thanks blackcat. This is useful. One thing I wonder is if there is much research on repeatability of scores like this one - in HG+ kid where there is an outlier score, esp in something like PSI. DD does try to do thinks without making mistakes, unless and until she is reassured that mistakes are fine and expected and necessary - e.g., by doing a video game where she can't maximize her score if she aims at never ever making a mistake. So I've wondered if her PSI might have been somewhat higher if she repeated it with information that she had made no mistakes but needed to go faster. (I realize this would be a non-standard administration, of course. But if she could go faster and still get a higher score, that would mean something to me, in terms of my concern.) This is pretty much like real life. Default is to be cautious, something that benefits her in some circumstances, but not all. She was also anxious and not feeling well the day she took the WISC-IV.

    The psychologist who gave the WISC-IV specializes in gifted kids and this is what she does all week long, so I don't think she made a mistake in scoring or anything like that. But the info that your daughter changed scores so dramatically is reassuring. My daughter may not be a 97 percentile in PSI - given her personality, I would have been super surprised if she scored like that - but maybe it's more a situation of her needing to learn when to go fast and when to be cautious, where she can still be average or above average in speed, once she's figured out that she needs to be.

    One thing that is also concerning, I suppose, is that she scored in the bottom 1% to 17% on various subtests of a number calling test at the developmental optometrist's office. I had her sort of repeat the test at home, and she is noticeably slower than I or DD#1 (I think DD#1's PSI was in "superior" range, a personal weakness).

    But that doesn't necessarily point to a problem with DD#2's VISION. It could be, but it might not be.

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    I have a kid with a PG GAI that has had low PSI scores both times he's been tested with the WISC. In his case it is definitely more then him just being cautious, we see it play out every day with him so I don't have a reason to doubt the scores.

    Where I live they won't give out composite scores, only 95% confidence intervals. The first time DS was tested (age 6.5) he was 9th%ile, the second time (age 8.75) he was 13th%tile. At first I thought - wow, that's better, at least he isn't in the single digits but when I look at the 95%CI ranges there is a lot of overlap. (74-90 for the 9th%ile and 76-93 for the 13th). It is also a 95% confidence interval not 100% so it is possible for them to get a very different score some other time. His VCI the second time around was WAY above the first round and the two ranges for the 95CI had no overlap for example.

    Based on my experience I recommend using the scores as clues but if they don't match what you see in real life go with your gut. DS's second GAI score makes a lot more sense with what we experience with him. His low PSI also makes a lot of sense with our experience. Exactly how low it is and what the exact number is isn't the important bit - putting it together with our experiences so we were pointed in the right direction was.

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