When you say her fine motor skills are great, can you give some examples? How is her handwriting speed and legibility? Some kids who have problems with visual motor integration, dyspraxia, or dysgraphia can do fine motor stuff well if they do it slowly and carefully, but skills like handwriting don't become automatic to the point where they no longer have to think about how to write what they want. They may draw their letters instead of writing them fluently. Because their handwriting is neat and legible, teachers and often other professionals as well may not look at it as a problem, but it can really interfere with output speed, and it can mimic or exacerbate ADHD, because it is hard to concentrate on what you want to say if you are having to also concentrate on how to get it on the paper.
