We started this whole journey with an SLP and OT evaluation at the end of second grade (when he was 7 1/2) due to speech and handwriting concerns. At that point, they gave him the Goldman-Fristoe Test of Articulation, which he scored <.1 %-ile on, and the Beery VMI Test, with results of VMI: 93 %-ile, VP: 99.9 %-ile, MC: 30 %-ile. The OT noted bilateral small motor weakness, causing decreased fine motor skills. They also gave him a KTEA, with similar results to the more recent ones above.
We put him on an IEP for speech/articulation, which included OT for hand strengthening and handwriting and access to a Chromebook for typing as desired. In the same meeting as the IEP, we decided to do a full grade acceleration at the recommendation of his 2nd grade teacher. So he skipped third grade.
He received speech and OT somewhat sporadically through his fourth grade year. Every time we brought up concerns about it, they starting doing it again for a couple of months and then it kind of faded out again. His speech improved some; however, his handwriting showed no notable improvement.
At the end of that year, they gave him the GFTA test again and said his articulation was now within normal limits, so he no longer qualified for the IEP. (I honestly do not believe his articulation was ever as poor as their test implied, nor do I believe it improved as much as their test implies. He still has a lot of trouble using voice-to-text, for example.)
He had also started complaining about words disappearing when he reads, particularly on a computer screen, which is where the concerns about visual processing came in. His basic letter formation is still so poor that it seemed like a possibility they were related.
We've seen 4 pediatric ophthalmologists in 3 states since he started wearing glasses when he was 2, and they all swear that his vision shouldn't be affecting reading or writing.
I asked the IEP team to consider his eligibility for a specific learning disability in writing, because his writing hadn't improved. The OT then came to the next meeting and requested that we see a neurologist to evaluate for a possible neurological cause of the fine motor/small muscle weakness--particularly because he also has vision issues, along with the articulation. We set up a 504 with accommodations for writing. When I pushed the issue of IEP eligibility for a SLD in writing or for orthopedic impairment in writing, they indicated that only the psychologist could give either of those diagnoses. At that point, I requested a new IEP evaluation to look for those issues. Those papers were signed 4 days before the end of the school year last May.
Over the summer, we saw a pediatric neurologist, who also noted bilateral hand weakness, hypermobility, and limited web space. She didn't think it was necessary to do imaging to look for a possible brain lesion because his strength is symmetric and there's no focal area of weakness. Essentially, she thinks it's just a structural issue with his hands, with possible genetic causes.
They administered the KTEA again this fall as well as this WISC.
The report from the psychologist that I just got this morning says nothing about any of his fine motor issues or the visual processing concerns. Just that he qualifies as gifted and talented, which was never in question.
In the meantime, he remains at the top of his class (as a just-turned-9-years-old 5th grader) in every area except writing. He's learning algebra 1, got a score of 248 on the 6+ Math MAP, and reads at a high school level. I hope this doesn't come across as me just being arrogant, but I don't think a FSIQ of 133 accurately reflects his cognitive abilities.
However, the writing is still a huge issue. His homework a couple weeks ago involved writing declarative and interrogative sentences from a set of words, like: newspaper astronaut was the an in. He was supposed to write "An astronaut was in the newspaper." and "Was an astronaut in the newspaper?" That sentence alone took him almost an hour to write both ways. We suggested he type it instead (which isn't really better for him, but it's a different option), but he didn't want to. Voice-to-text is usually more frustration than it's worth as well. He seems to spend so much of his cognition to even be able to form semi-legible letters that spelling, punctuation, spacing between words, etc. is too much for him to focus on. Even after 1 1/2 years of focused handwriting practice and OT, there's been very little improvement. His letters in print are large, misformed, and very difficult to read. He does somewhat better in cursive, but it takes him even longer. They had a cursive worksheet in class a few days ago. He said everyone else in his class finished it in 10 minutes or less. He worked on it for nearly an hour at school (his estimate), and then brought it home and worked on it for another hour, to get the 50% done that he's required to do per his 504. And that was just rote copywork. If he had had to create and punctutate sentences by himself, it would have been even more of an impossibility for him to complete.
So I'm at a loss at what we can do besides continue with the accommodations on the 504. I may push for scribing and oral assessment to be added. But mainly I'm frustrated that because he performs at such a high level, it's a fight to get them to acknowledge this as an issue at all.
Last edited by Cnm; 10/17/18 01:53 PM.
