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    Joined: Jun 2014
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    Can2K Offline OP
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    Yes we probably can send in a device for him. DH is now saying the testing was a waste of money and we should have just done that. But without the recommendation on his IEP, it may be hit or miss whether the teachers allow him to use it day to day.

    I still can't decide whether I agree with the ADHD suggestion. The psych thought that he had enough symptoms that it wasn't just him being bored in class. He does have problems with executive function (loses things a lot, needs reminders to do basic things). And he is very active and fidgety - but I always thought that was sensory; the behaviours decrease when we look after sensory needs.

    They psych also suggested the gifted class may work better for him (partly because with FI he has to move from French to English partway through the day). But he doesn't want to move at the moment - enjoys his school and his friends.

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    Can2K, my ds was diagnosed 8 years ago, so some of what went into his diagnosis may be out-of-date, but this is what went into his diagnosis. The first note - he wasn't diagnosed with "dysgraphia", but instead with "Disorder of Written Expression" per DSM-IV. I'd never heard of dysgraphia until I did some googling to learn about DOWE. I then asked his neuropsych if he had dysgraphia, and she said yes, but that DOWE was the diagnosis recognized by schools (at that time).

    The things that the neuropsych used to make the diagnosis:

    * Review of handwriting samples from his classwork
    * Discrepancy between ability measured by WISC-IV and WJ-III Achievement test
    * Scatter in WJ-III Achievement subtests (scatter occurred between tests that required oral vs handwritten response)
    * Scatter in WISC-IV subtests (difference of greater than 1.5 standard deviation between processing speed subtests and subtests that went into the GAI)

    In addition to the above testing/review that correlated with a dysgraphia diagnosis, the neuropsych refined the diagnosis to show that the dysgraphia was related to fine motor issues rather than visual with these two tests:

    * Scatter between subtest in the Beery VMI
    * Low scores on a subset of the NEPSY (finger-tapping test)

    I'm sure you've already done this, but googling types of dysgraphia might be helpful for you when trying to determine what's up with your ds. It sounds like his dysgraphia (if he's dysgraphic) may have had a visual component, and there is one type of dysgraphia in which spelling isn't impaired (I suspect it's the visual dysgraphia, but I haven't looked at the definitions recently enough to remember. If you're having a tough time finding those definitions let me know and I'll find a link for you).

    My ds has also been given the TOWL twice (once through school for IEP eligibility and once later on privately). Although it isn't a direct test for dysgraphia, it can be extremely helpful in determining specific areas of challenge with written expression.

    When my ds was diagnosed with DCD and DOWE, he'd landed at the neuropsych because his teacher was convinced he had ADHD. There are many overlaps in behaviors and symptoms between DCD, ADHD, and ASD (my neuropsych has a chart showing this - I wish I could find it online somewhere!). Teachers will often make a guess or in some cases an assumption based on what they has seen in the past - and if your area is like ours was 8 years ago, most teachers will have had students with ADHD in their classrooms but won't be familiar with dysgraphia. DS' neuropsych eval included behavior screens filled out by both parents and teacher, as well as a computer test that screened for ADHD. The neuropsych asked for us to have the behavior screens filled out by *any* adults who spent a significant amount of time with ds during the day, not just his primary teacher - unfortunately that one other person for our ds was a student teacher, and his primary teacher vetoed letting her fill it out (picture me knocking my head against the wall). When the results came in, ds' teacher was seeing a very different child than we saw at home, but that didn't line up with ADHD according to the neuropsych's observations of ds or the screening test. Combining that with the results of the neurospych testing supporting dysgraphia led the neuropsych to conclude that the behaviors of concern to the teacher were more likely due to a combination of DCD/DOWE and anxiety resulting from the impact of those disabilities in the classroom.

    I hope some of that helps - again, it was just our experience, and it's very outdated at this point in time. DS has had semi-recent testing to support accommodations for SAT/ACT, but those evals were much less thorough and were designed to show current impact in a student who already had a recognized diagnosis. FWIW, the diagnosis he uses for accommodations (at school and for standardized testing) is DCD, not dysgraphia.

    Best wishes,

    polarbear

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    Originally Posted by Can2K
    He does have problems with executive function (loses things a lot, needs reminders to do basic things). And he is very active and fidgety - but I always thought that was sensory; the behaviours decrease when we look after sensory needs.

    Two notes on this Can2K:

    My ds with DCD has challenges related to EF and organization that are attributed to his DCD - this is a common part of DCD for many people. The challenges had a huge impact in elementary and middle school, but by middle school I was able to work with him in a way that was meaningful and helped tremendously. He still has these types of challenges in high school but he's much better equipped now to deal with them thanks to a combination of maturity, increased self-awareness, and years of practice.

    I have a dd who had vision issues that were remediated through vision therapy. She *looked* like she had ADHD when she was young, before VT, because she never sat still, was extremely fidgety, and had a sensory diagnosis. All of those things improved tremendously with vision therapy, so I wonder if it might be that your ds is still dealing with vision issues. FWIW, vision therapy made a huge improvement in my dd's vision, but she still works hard at keeping her eyes tracking etc. and has been through one necessary "redo" of vision therapy, again, successful, but not a "cure-all".

    Best wishes,

    polarbear

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    Originally Posted by Can2K
    They told us they need something from a psychologist to access AT.

    We've been through this too - but keep in mind our provincial education system doesn't actually care about clinical diagnosis, per se, they care about functional impairment in the classroom. So you don't need a diagnosis of LD from your psych (although it often simplifies things, your board may also just reject/ ignore the diagnosis, because they "Identify" using educational, not clinical, criteria). What you do need, and your psych can provide without a diagnosis, is a letter from the psych stating that your child cannot access their education without [specify the AT required]. Your son's slow writing speed alone is more than enough to justify the letter, as is the DCD diagnosis. Your board is likely to have specific wording they want to see in that letter in order to make what is called a "SEA application", so ask them for their required wording, and provide it to your psych to use in her letter.

    Our own psych did not think our DS was clinically LD (but that's a whole different problem for another day), but she did note a significant discrepancy in writing ability, and recommended AT based on that. She provided the specific letter on request, and a board SEA laptop was approved. DS has no clinical diagnosis, nor LD identified on his IEP. If handwriting is a barrier to your DS demonstrating his knowledge and participating in his education, then he is entitled to accommodations, period. And yes, for the long term, even if you are providing your own laptop, it's important to have that SEA approval on his IEP, to ensure it's seen as his right, and not a special privilege some teachers may choose to grant.

    Originally Posted by Can2K
    The psych we met with seemed to brush aside the DCD diagnosis - told us they don't deal with gross motor.

    This bothers me. A lot. You can't talk about LDs and ignore dyspraxia, which goes way beyond gross motor. Honestly, if it's remotely feasible, you may want to consider taking your pile of results to another psych (thoroughly pre-interviewed!) who has a less limited view of their role, and more experience in this area. If nothing else, I cannot imagine concluding "no LD in writing" without doing any timed testing of writing fluency. The question is not "can he?" It's: can he form letters/ words/ sentences in an appropriate amount of time, with appropriate accuracy, and - the million dollar question - with appropriate levels of automaticity?

    It sounds like you may need a bit of further testing to figure out if the problem actually is dysgraphia or (and) something else. The physical problems associated with DCD may actually be all that is slowing down the writing. If he produces ability-appropriate written output when he bypasses the physical constraints via typing (if that doesn't also hurt) or voice recognition, then the problem is probably just DCD. Which still fully warrants AT and other appropriate accommodations.

    If, like mine, taking away the pencil removes the physical pain and takes writing from impossible to merely excruciating, then there are probably other things going on, too. Dysgraphia is a cognitive processing deficit, not a physical one: it's specifically about lacking automaticity in letter formation. Each letter has to be carefully thought out, how to produce it, every time it's written. The whole brain is sucked up with this, and no other thinking or listening may be possible while he's writing letters.

    ADHD can have huge impact on the ability to organize thoughts and plan out writing. (note: people with ADHD may be able to focus for long periods; the problem is that they cannot choose/ control where to focus, rather than that they can't focus at all). I'd suggest reading a range of descriptions from reputable sources, and see if they resonate with you. ADHD can be a very helpful label - as long as it is the correct label. And as he gets older, it will matter more and more that teachers recognize critical skills gaps as "can't", not "can't be bothered". If he's ADHD, he may need a lot of extra support, explicit and repetitive training in basic executive function skills, and scaffolding and accommodations where skills are lagging or missing entirely. But if ADHD doesn't feel right, or like the whole answer to you, or your psych seems determined to go there without carefully considering other potential explanations, be cautious. Unsupported LD creates huge anxiety in the classroom, and anxiety can look an awful lot like ADHD. If you and the teachers are seeing similar issues in academic AND non-academic tasks, ADHD may be part of the puzzle. If the issues are only being seen around school work, unrecognized LD and anxiety could well be making the child unable to take in what's being said to him, and to shut down or act up when faced daily with tasks he can't handle without extreme effort.

    Just to muddy the waters though, I should note that work that is way too easy can have the same effects.... our psych, for example, wasn't willing to assess for ADHD as long as DS was not in a gifted classroom, as being in an inappropriate environment (whether too hard, too easy, or both) can cause similar anxiety and behaviour. An amazing number of kids in our board's primary gifted program are referred to psychs for ADHD assessment, not giftedness - and for most, the ADHD behaviours disappear in a gifted classroom.

    And just to throw it in there, another possibility is expressive language deficits, which can make it really hard to access and organize words and ideas. For what it's worth, in our case, I suspect my DS's writing problems are a mix of fine motor issues (hypermobility), extreme inattentive ADHD and expressive language - pretty much everything but dysgraphia. Still trying to find a psych who can untangle this...

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    Can2K Offline OP
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    Thanks a lot Platypus! It makes sense that the school would mostly care about his needs/deficits - if he is slow at writing and needs AT, surely it doesn't really matter why.

    Although now I am puzzled that our school resource teacher was insisting on having a diagnosis (at least for the DCD she really wanted a letter from our doctor - wouldn't accept the OT report alone).

    I think the psych could clearly see that DS would benefit from AT, so I'm pretty sure that will end up in the recommendations (which we don't have yet - so far just preliminary finding).

    She also commented that he kept dropping his pencil and then would have a hard time picking it up - to me this is clearly the DCD, not ADHD. And thinking about it, he gets quite distracted when these things happen, so some of the symptoms are clearly DCD-related.

    After doing some reading, I see that writing problems can be generated from DCD alone - clearly he has trouble with motor planning. But to me it looks like he has trouble with automaticity - I can almost see the wheels turning in his head when he is printing each letter.

    The thing is, currently his typing is also pretty slow. And he's not too interested in typing tutors or learning to type faster. So right now, having him type will likely not speed up his writing by much. And he also has trouble either deciding what to write, or coming up with the words. I do a lot of scaffolding on written homework. Again - is this dysgraphia, ADHD, or both? Or does it really matter which one, if we get the right accommodations in place?

    ADHD - some of the symptoms fit - he loses things, has trouble organizing himself, is often inattentive at home. And apparently 50% of DCD kids also have ADHD - so I guess not too surprising?

    I hear you on finding that one person who can explain it all - DH even suggested getting the psych, the OT and vision therapist all in a room together so they can come up with an answer. But I'm not convinced that would work either - they all look at DS through their own lens/experience. I wish there was one professional who would look at the big picture - but that seems to be up to us, the parents.

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    Can2K Offline OP
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    Thanks a lot Polarbear! Sounds like there is a lot more testing that the psych could have done - I am not at all sure we got value for our money, but we'll have to see what the final report looks like.

    There does seem to be a lot of overlap among all these diagnoses - it is really confusing and hard to sort out. The DCD symptoms make sense to me and really fit what I see with DS, but a lot of those are also in the lists for ADHD and dysgraphia - as you said, a chart would be helpful.

    I did find sheets with recommended accommodations for DCD and also ADHD - the ADHD chart had most of the DCD accommodations plus a lot more - some of which might apply to DS and some not.

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    Can2K Offline OP
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    Originally Posted by polarbear
    My ds with DCD has challenges related to EF and organization that are attributed to his DCD - this is a common part of DCD for many people. The challenges had a huge impact in elementary and middle school, but by middle school I was able to work with him in a way that was meaningful and helped tremendously. He still has these types of challenges in high school but he's much better equipped now to deal with them thanks to a combination of maturity, increased self-awareness, and years of practice.

    I have a dd who had vision issues that were remediated through vision therapy. She *looked* like she had ADHD when she was young, before VT, because she never sat still, was extremely fidgety, and had a sensory diagnosis. All of those things improved tremendously with vision therapy, so I wonder if it might be that your ds is still dealing with vision issues. FWIW, vision therapy made a huge improvement in my dd's vision, but she still works hard at keeping her eyes tracking etc. and has been through one necessary "redo" of vision therapy, again, successful, but not a "cure-all".

    This is interesting - DS's fidgeting has decreased over the last year, and I think it is partly due to VT (probably also partly just getting older). I can tell when the optometrist examines him that his eye tracking is better - but he still doesn't have the stamina. I'm hoping they can keep working with him on that because, while his reading has improved, he still will read not longer than a few minutes at a time (although he does OK with comics/graphic novels).

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    Can2K Offline OP
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    So Platypus - am I right in thinking that given we already have an IEP with both gifted and DCD diagnosis listed on it, that all we need is a formal recommendation for AT from the psychologist (as well as whatever other accommodations they suggest).

    There shouldn't really be a need to list ADHD or dysgraphia unless we want to?

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    Originally Posted by Can2K
    So Platypus - am I right in thinking that given we already have an IEP with both gifted and DCD diagnosis listed on it, that all we need is a formal recommendation for AT from the psychologist (as well as whatever other accommodations they suggest).

    There shouldn't really be a need to list ADHD or dysgraphia unless we want to?

    Yes, in terms of getting the AT, the letter should be all you need (just make sure it uses the right wording for your board). In terms of adding other diagnoses, they are probably not necessary at this time, as long as the accommodations provided for the first two are adequate to cover all his needs.

    Speaking from experience, though, as he moves towards middle school you may want his challenges more specifically diagnosed and documented, so that you can ensure appropriate supports are added as time goes on. Come grade 6, we found DS's (undocumented) ADHD suddenly shifted from being a source of frustration to his teachers, to being a source of his losing a whole lot of marks.

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    Thanks Platypus - it's very helpful to hear from other parents who have been there!


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