Gifted Issues Discussion homepage Forums Twice Exceptional Should we consider dyslexia?

I have a DS10 who is MG with ADHD. He has always read above level at school, reading MAP is 95th-99th (although he is having trouble making gains now in 4th grade), his handwriting has always been very neat, and he has never been a terribly poor speller. His spelling did lag a little behind for a while, compared to his reading ability and overall intellect, but I know that reading and spelling do not necessarily advance at the same pace and it's never been awful, just not always great.

Here are things I've seen over the years that have given me pause...When he was a preschooler and I was trying to teach him to recognize the alphabet, he seemed to forget from day to day what I'd shown him. He was very interested in numbers, but not letters. He did not learn to read at the pace or with the ease that his older brother did, despite the fact that we all believed him to be smarter and a quicker thinker than his brother in general. By the time he was 5.5, he was doing ok with reading, but that seemed a little laggy to me when compared to my impression of his intellect. As the years have gone on, when he reads aloud, he skips words, he replaces some words with others, and is rarely what I'd consider a smooth, fluid/fluent reader. It can be frustrating to listen to him read sometimes due to the hesitation. If I can see what he's reading, I often have to ask him to stop and go back to get the words he missed, because they may change the meaning of the sentence entirely. He does read for enjoyment, and he can get through a book fairly quickly if he is really drawn in by it, but I'm not in his head to know what sort of effort he is putting forth internally to get that done.

Because of his ADHD, he has always been prone to impulsivity and I've assumed this was bleeding over into his reading. The speediness, the skipping, it all seemed to be reflective of his ADHD associated H/I. But the more I read about many ADHDers also being dyslexic, it makes me wonder if I should be paying more attention here. Is it possible that he is mildly dyslexic and able to compensate well? He has some traits that make me think maybe, and others that do not fit at all, but I don't want to overlook something if he could use some help.

Yes, you should consider dyslexia. You might also consider the possibility that what looks like ADHD is actually a result of the dyslexia.

I'm pretty sure the ADHD is there on its own; medication has reduced his impulsive behavior (both internal and external) in ways that everyone has noticed. His ability to focus has also noticeably improved.

His WISC V from 2.5 years ago was pretty consistent across the board, no big discrepancies. The tester did note that his impulsivity caused him to discontinue prematurely on Visual Puzzles and both subtests given for FR. He was able to answer 2-3 questions above his discontinue point in those areas (unofficially- the psychologist had warned him repeatedly to slow down and he would not, but it was obvious that he was capable of more so he was given the opportunity to do so off the record). I'm not sure what a mildly dyslexic profile looks like on the WISC, but nothing jumps out at me looking at his.

I've read that dyslexia tends to be hereditary, so I need to also do some investigating of family history, and have him read more often out loud for me to see what's happening. As kids get older, we don't have them read aloud as much, so more of that is in order. My husband says he has wondered occasionally about himself, but we need to do some digging in before I pay for more testing I think. Thank you for your response!

It's a myth that medication only works for people with ADHD. It works for everybody, which is why there is a black market among students (and, obviously others as well) for it.

This is true. It just calmed so many of his out-there behaviors that it seemed to us to be a clear case of problem-solution. He went from uncontrolled behavior that ended with discipline issues at school to "one of the better behaved kids in the class" (teacher's words) because he said he could suddenly decide whether to do things instead of just doing them without thinking.

I did ask his teachers yesterday if they have noticed any issues with his ability to read aloud (he's in our district's full day gifted program which is accelerated 1-2 grades in all subjects). I got a response today. His Language Arts teacher says they assess the kids with oral reading twice a year. In the fall, as a 4th grader, he was assessed using 5th grade standards. He read 167 wpm with 98% accuracy (well above even the spring goal). During the assessment, he had one skip and one substitution, which they consider normal. He self-corrected his reading several times, but they do not count those as errors. They are not concerned, but when he does his spring assessment next week they will communicate those results to me. I didn't know they were doing these assessments at all, so I'm glad to have a little more information from them.

Should any of that information lead me away from dyslexia concern, or does anyone have experience with a child who performs well on assessments but still shows other evidence of underlying issues?

The reading probe data you've reported tends to make me think less of dyslexia, as the reading behavior he displayed during the probes was much better than grade appropriate, and certainly within the range for an MG student. It also was different from what you observe day to day, and suggests that the difference is attention and motivation--which is much more ADHD than dyslexia (although highly-motivated compensated dyslexics can also "turn it on" for brief periods of time).

And more importantly, the reading probe data establishes that his ability to decode above-grade-level text is high, so whether his typical errors and dysfluent reading are because of vulnerabilities in sustained attention/impulse control, or because of automaticity deficits, the likelihood of significant ROI on a classical OG reading intervention is low. A different type of intervention would be indicated (e.g., a fluency intervention, if, for example, he's reading fluently only in bursts, and only with great effort). The behaviors you are describing sound more like self-monitoring weaknesses to me (i.e., impulsivity and inattention combined).

His reading approach also doesn't appear to be affecting his overall comprehension much. (Can't go by the stagnating MAP scores, as he's probably running into ceiling effects on the test, and the very large error bars up in those high percentiles.) If they haven't yet, the school should probably consider switching him over to the MAP 6+ for reading, since his fall reading probe appears to have put him at a beginning sixth grade level or better.

Thank you for your input aeh! I know on the surface that the assessment from the fall was good news, but you always provide such helpful details! We waited too long to fully recognize his ADHD problems (waiting to get in a more appropriate educational environment to round out the picture), so I wanted to make sure we weren't also neglecting something else. Your help is appreciated.