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I have long suspected dysgraphia to be an issue with my DD11 (6th grade) -- poor handwriting, horrible spelling despite a very high reading level, complaining of arm pain when she writes. She also shows some signs of anxiety under timed situations and some sensory avoidance issues (hates shoes that actually fit, hates anything tight around her waist, has to turn socks inside out, etc.) Additionally, her processing speed, while average, is 26 points below her VCI on the WISC-IV.

The clencher came yesterday when she brought home a grade in typing (a.k.a. "Keyboarding") that kept her off of Principal's Honor Roll. While she makes 100s on almost every typing test and is accurate, the majority of the class grade comes from a lesson series that will not let you save your work if you don't fully complete the lesson in the alloted class time.

I am at the point of seeking an OT evaluation and asking for 504 accomodations. I know to ask about dysgraphia. Are there other diagnoses I should be looking for?

Thanks for your input.

Sensory Integration Disorder jumps out at me. (shoes, tight, socks)
That's a whopper of a subscale score difference. ((LOL, my DS14s is a similar)) I hate to say it, but that would be enough to make me want to made sure ADD isn't an issue.

((With my son I worried about http://en.wikipedia.org/wiki/Absence_seizure but that seems like going overboard, as this only affects 1 in 10,000 kids in the US according to a quick Internet search. He just does seem to spend a lot of time staring off into space. ))

Those are just my 'off the top of my head thoughts' - I would consider hothousing the keyboarding at home...it's a wonderful skill to have. My spelling is awful, but once I learned to keyboard spell check became my good friend.

Best Wishes,
Grinity

If you are seeking services from the school, don't specify "an OT evaluation"-- write them a letter where you lay out all the specific difficulties and ask them to evaluate her in all of these areas. This casts the widest net and gets you more thorough testing.

Many schools do not recognize the term "dysgraphia"-- you might mention instead that you suspect a "disorder of written expression" and give them examples of tasks she struggles with.

Best,
DeeDee

Update:

After much discussion with the school counselor and AIG teacher, I finally stopped procrastinating and took DD for an OT eval last week. Obviously, I don't have a report yet but had an interesting conversation with the owner of the OT practice after she observed a portion of the eval. There is definite issue with pencil grip/handwriting and upper body strength/core muscles. She also mentioned the possibility of a NVLD. I had already dismissed any thought of NVLD simply by looking at the symptoms. I was wondering if any of you had any thoughts on this.
Her SB-V scores show an issue in non-verbal working memory, but also a strength in non-verbal quantitative reasoning.

Thanks for your thoughts!

An OT isn't qualified to diagnose a learning disability like dysgraphia or NVLD. If it were my kid, I'd try to see a neuropsych for a second opinion about the sensory and motor issues.

DeeDee

PRI is is much lower than VCI, which is one characteristic of NVLD, and that score is low not because of a single subtest but because two of the subtests there are more than 1 SD below the 15s that she has consistently in verbal and conceptual areas. Remember that in gifted people, scores that are in the average range but significantly below areas of strength can still indicate that there is a disability depressing functioning and scores. A gifted kid with NVLD is not going to look the same as a non-gifted kid with NVLD.

I agree with DeeDee that an OT is not the person to diagnose this. I would add that IQ score scatter is not sufficient to determine a diagnosis either, although this score pattern would certainly make me want to investigate the possibility further. A workup with a neuropsych who is familiar with 2-E / gifted children would be my next step. I say this as someone who has BTDT.

I can't recall off the top of my head if James Webb's "Misdiagnosis and Dual Diagnosis of Gifted Children and Adults" covers NVLD or not, but it would almost certainly be worth reading anyway

What I have read as symptoms of NVLD include "difficulties perceiving non-verbal behavioral or facial clues; and poor social and interactive skills" -- this is certainly not my daughter. The funny thing is also that, even though her Spatial-Visual subtest scores on the SB-V were lower, she is the poster child for the "spatial-visual" learner as discussed by Silverman (http://www.gifteddevelopment.com/Visual_Spatial_Learner/vsl.htm).

I have personal issues with that list, as people have used it through the years to try to tell me that my very-much-not-a-visual-spatial-kind-of-person son is "just a visual-spatial learner", primarily on the basis of him being wildly creative, terribly disorganized, having difficulties with math facts, and needing to use a keyboard to write. He's PG, AS, NVLD, and has a disorder of written expression, but he's not a visual-spatial learner!

At least half a dozen or more of the items on the "visual-spatial" side of that list are potential indicators of disabilities and problems with executive functioning that do not bear any relationship to having a preference for "thinking spatially". Another subset of the supposedly "visual-spatial" characteristics are general characteristics of the gifted. In fact, giftedness and creativity are even listed on the "visual-spatial" side. In a lot of ways, the left side of that list describes neuro-typical kids, and the right side of the list describes kids who are 2-E. I completely understand the neuro-diversity position, and I think that it is important to reframe challenges, emphasizing strengths. I just don't know that landing at "visual-spatial learner" is a terribly useful level of information to have when you are trying to develop interventions to help your child succeed, particularly if the things that really stand out on the list are not the exclusively visual and spatial items, but things like creativity, conceptual learning, disorganization, and poor handwriting, as with my son.

If you can, I second (or third, I think?) the recommendation to see a neuropsychologist. My 11 year old has dysgraphia, and the report from the neuropsychologist has been useful not only in diagnosis by in several IEP meetings when trying to determine treatment and intervention. My oldest, now 20 and in college, was just diagnosed with a mild form as well as ADD - but her IQ and heavy sports activity allowed her to be successful enough in school that intervention has just now been required as she is seriously struggling in college. How I wish I'd taken her to the neuropsychologist sooner!

Update: Just received OT eval - they didn't actually diagnose anything, since they cannot diagnose. There are definite handwriting/core strength issues and working memory issues, which came as no surprise.

I was given Beery scores of VMI - 4th percentile, Visual Perceptual - 91st percentile, and Motor Coordination of 91st percentile. Any info on what this means? Thanks~