Gifted Issues Discussion homepage Forums Twice Exceptional Vision therapist testing

My insurance will pay for dylexia testing if my vision therapist does it. I belive my dd6 is gifted. She makes amazing connections and inferences. She loves Lego and a a great artist. She reads at a 24 dra. She memorizes chapters in long books. She loves reading. But she subs words a lot. She skips little words all the time and I can tell that she is only able to decode words because she is amazin at comprehension and figures words out by what makes sense. She spells words weird. Even spelling words. She will say and write that her spelling word said should be spelled siad. The word little is spelled liltl. Went is wiint. She does different tasks with different hands. All her numbers are backwards and until recently most her letters were too. The list of indicators is long but my computer is broken and I'm thumb typing! My question is - will the vision therapist who says she is qualified to diagnose dyslexia and dysgraphia be able to diagnose stealth dyslexia or is that left to the psychologists which are not covered in my plan?

Vision therapists are not qualified to make medical diagnoses of that kind, so far as I know. They can identify certain vision problems, but they certainly cannot give the full range of testing I would want in that situation. I'd want to take her to a neuropsychologist with expertise in dyslexia and dysgraphia to sort that out.

DeeDee

But I am told that dyslexia is not a medical diagnosis by my insurance company. I really can come up with 2800 dollars for the neuropsych test. That was not the answer I was looking for dee Dee. Maybe she will at least be able to tell us if she needs further testing? She is a behavioral optometrist and diagnoses dyslexia all the time. Ugh.

A behavioral optometrist is quite different from a vision therapist. The one behavioral optometrist I have encountered did a good job of ferreting out whether a reading issue was a serious developmental vision problem or something else. (No dyslexia here, so I can't tell you whether he would have been helpful there.)

However, once an actual vision problem was ruled out, he couldn't go to the next step and look for other kinds of LDs and cognitive problems; he definitely couldn't have isolated dysgraphia based on the tests he did. You can get a positive ID on physical eye problems from someone with these qualifications, but possibly not the whole story.

I'd say, go ahead and see the behavioral optometrist; but be prepared to take further steps afterward if you don't get useful answers.

DeeDee

Okay. Thanx. That is better news. Dd6 has already been through two rounds of vision therapy and wears glasses for a converging problem. This helped a lot. But I think there is more to the story. I think I am an undiagnosed dyslexic and I don't want to overlook anything because I know the hardship I have delt with. My dd9 has been identified as gifted and had none of the problems the little one is having. I'm not sire if I am unfairly comparing the girls but the consequences could be big if I ignore my gut. I am wondering how they will know that she is using compesation to present as a good reader. Without a real iq test how will they know she is using her unique strengths to fill in what's missing? If this is what she is doing.

Sydness, I think that you have stumbled into the middle of what makes VT controversial. It seems that many dyslexics have concurrent issues with eye function. VT may help some people improve their eye function. For my daughter, it improved her ability to focus and tracking. The controversy arises when VT professionals make the assertion that their exercises "cure" dyslexia by changing how the brain works. I personally don't buy these assertions. Others obviously have different opinions.

You may want to read some of current literature on dyslexia. I found the Sally Shaywitz, Overcoming Dyslexia, very informative. Her section on how dyslexic brains process information differently had some fascinating fMRI imagery and analysis. The Eides' book, Misdiagnosed Child, also has a section on gifted dyslexics. The Eides also have a newer book called the Dyslexic Advantage but I haven't read it yet.

Syd, my older dd went through VT to help resolve severe double vision and tracking issues. We've also had our ds (dysgraphic, dcd, possibly stealth dyslexia) go through a VT evaluation. Both evals (and dd's therapy) were through a behavioral optometrist who is highly respected in our community and state, but his office does not give diagnoses for dyslexia etc; they diagnosis tracking etc issues related to how the eyes work together. While the VT you have talked to may be able to recognize dyslexia or dysgraphia, I would be very wary of relying on that eval solely as a diagnosis. All three of my children have had challenges with spelling and reading very similar to what you've listed above when they were around the same age as your dd. My ds' spelling challenges are related to dysgraphia, my older dd's challenges with early reading and spelling were related to weak eye muscles, and we are just now sorting through my younger dd's challenges but her initial testing has revealed they are not related to dyslexia. The symptoms you've seen in your dd can be caused by a number of different challenges (and they also might be simply age-appropriate phases too) - to fully understand what's going on, you really need to have a professional look at overall ability vs achievement functioning as well as additional reading-specific evaluation. We had our older kids tested through a private neuropsychologist, but you can potentially get much of the same testing through your school district. The downside to school district testing is that you get test scores and not necessarily much info or interpretation. When our youngest dd was clearly struggling with reading and spelling, we chose not to go with the neuropscyh route initially and instead found a former SPED teacher who is licensed to give ability/achievement testing (WJ) as well as other assessments, and focuses on providing assessments for the homeschool community. Her fees were considerably less than a neuropsychologist and provided us with some very good info and answers for our youngest dd, including the piece of knowledge that her reading and spelling challenges are not related to dyslexia. It also, however, left me with more questions than answers and I expect that eventually our youngest dd will also need to be seen by a neuropsych to fully understand what's up.

Best wishes,

polarbear

eta - I noticed you mentioned you suspect your dd is gifted, so I'm guessing she hasn't had ability/IQ testing yet. FWIW, we were very certain our youngest dd was at least a high ability kid but didn't have any motivation to test for gifted programs yet so she also hadn't been through ability testing yet. Since we suspected a reading challenge and wanted to either rule in or rule out dyslexia, we thought going the route of paying for just a reading eval that included ability/achievement testing without the extended neuropsych testing and diagnosis would be a great first step - and it was *but* it left us with more questions than answers. We found out dd isn't dyslexic, but instead the ability testing revealed our dd has one significant low in her IQ subtest profile (plus a ton of scatter), so it would have been very helpful to also have the extended testing that neuropsychs typically offer... and I'm guessing we'll end up at the neuropscyh with her at some point anyway.

That's correct, dyslexia isn't a medical diagnosis - but you don't actually know if your dd *is* dyslexic at this point, you're trying to find out what's up. What our insurance company required to cover neuropsych testing was a referral from their pediatrician to the neuropsych. I can't tell you what the specific code used was (although if I was a more organized person I could look it up lol!)... but... fwiw, once we had the referral from our ped, the neurospcych's office knew what medical codes to use for billing insurance. There are a lot of companies who don't cover neuropsych evals, but fwiw, that's how we were able to get ours covered.

polarbear

I haven't read all of the response posts, so I may be repeating something someone already said. We just had our DS6, who has similar issues to your DD6, tested for dyslexia, but we did NOT do the full battery of neuropsych tests. We found a tester who works at a speech therapy center and does reading evaluations only to diagnose dyslexia. She charges $200 an hour for the testing, which takes between 2 and 3 hours.

Our insurance covered the test codes (I obtained them from the speech therapy office that would administer the test, and called our insurance company), but this particular center is out of network for us. We called a bunch of other places in network, but only some of the tests would have been covered, and in the end, it was cheaper for us to pay out of pocket at this one place than go to a place in network and get a larger battery of tests.

Because we already had IQ testing done for DS, along with some achievement testing and a Gallistel-Ellis test, the tester was able to shave off the last hour of testing, and we only had to pay for 2 hours of testing. Here are the tests she administered, so you know what to ask for:
- Comprehensive Test of Phonological Processing (CTOPP)
- Gray Oral Reading Tests (GORT-4)
- Test of Word Reading Efficiency (TOWRE)
- Test of Written Spelling (TWS)
- Woodcock-Johnson III (WJIII)

If there's a way for you to find a place that will do just these tests plus whatever our center would have administered in place of the IQ testing we already had, that would save you and your DD time and money. If you want the name of our center so you can call and find out more about the tests administered, send me a PM and I'm happy to pass along the info.

I am in Australia and which professionals do what here seems to be subtly different. I spent a lot of money with a neuropsych last year which produced no useful answers at all. Last week our DD had her assessment for spectrum disorders with a speech pathologist / psychologist team. They got to the end and said she's absolutely dyslexic, especially given she still presents like she does after obviously having had years of effective support and having started reading for pleasure. I am pretty sure she also had visual processing issues, which have resolved. There is no doubt that the improvement of her visual processing has helped her reading, but dyslexia is primarily an auditory issue, It's driven by weakness in phonemic and phonogical awareness. for us a speech pathologist has been the only professional that's really been clear on DDs dyslexia, not the BO and not even other psychs she's seen.

My second DD might also be dyslexic, but I suspect her issues are almost entirely visual processing related - and she's learned in 3 months what DD1 took 3 years to learn. She has tracking issues, reversals galore, struggles with fonts, text over pictures, font size, etc. But she powered through learning to read despite these issues. Whereas her sister could not fathom mapping sounds to symbols at all, and couldn't hear the sounds.

Thank you all for sharing. I am going to go ahead and have her evaluated by the beh. Opt. I read that kids with dyslexia or dysgraphia often can't write the alphabet in order. So I checked. She did write all the letters. She wrote two of them backwards. I also had her write her numbers in order 1to 20 and she didn't skip any. Most numbers were backwards though. She wad concentrating hard on this and demanded silence. She does multiplication and double digit adding in her head and is reading at a 3rd grade level. She is 6 and 5 months and in first grade. She rode a bike at 4. Just learned to tie her shoes but isn't great at it. Picked a dominant hand at five. Writes with her right hand but does sports with her left. She is really good at art but has a bad pencil grip. She doesn't seem to notice the difference between from and form but loves stories so much that she often memorized large chunks of chapter books. She has amazing insight and makes great inferences, but reads a chapter book five times before she considers herself done. She has tracking and converging issues and had done vision therapy and wears glasses for reading. She was put in ocupational therapy at school in k for not crossing midline but was kicked out because she was "ahead" in reading. She speeks slowly. She says deep things but she has trouble keeping up with the pace of a song and fall behind while singing. She is good with cutting but was a bit late figuring it out. She always held the scissors upside down. I suspect that I am dyslexic. So, knowing these things, how concerened should I be? I wonder if maybe I am comparing an average child to her very fast, very gifted sister and thinking ld when really, she might just be average. I understand u really can't tell unless they r tested but we are just trying to put food on the table at the moment! Ttia!

Alos she lives legos and building stuff. Almost an obsession. Like she will tune out everything on the room if she notices the cap on the toothpated might fit nicely in the whole in the wine cork, or whatever. And she just can't move on until she tries it. Once she tries it she is fine and can move on. She asked me once when she was three or four how the mall stayed up and didn't fall over. Are these dyslexic traits? She is amazing at gymnastics and has just been asked to join the team.

So sorry about all the typos. Thumb typing. But that doesn't excuse writing whole instead of hole!

Your DD sounds a lot like mine right down to the very fast, very gifted older sister. Don't assume that your DD is average. Testing gave us some real insight and helped us make some sense out of our kid's struggles-- DYS IQ scores, high math/visual spatial ability, average reading skills and abysmal spelling and writing.

We found a more affordable tester by talking to our district's gt department. I told them that we couldn't afford the "gold standard" around here (about $1800) but asked if there was someone who they could recommend who might be less expensive. They steered toward a tester with gt and some 2e experience. We got IQ and achievement testing done for $600. It wasn't perfect but it sure was helpful.

Wow! $600is really good! Maybe I need to look harder. I was told $2400!

Just an update. The first graders have one big project all year. It is to collect 100 of something small and make something our of them. Most kids are picking shells or paper clips. My dd6 is making a book on index cards of 100 ideas. Lol. She did thirteen the first day and then would just sit ans stare at the paper. She is very very excited about this project and I was surprise she wouldn't continue with her ideas. A couple of example of ideas she wore by herself are:

to make an underwater camera.
To shrink grandma and put her on my shoulder.
There should be summerschool for everyone. (she wants to go)
and the best one:
that mommy writes the rest of my ideas.

She said that she has very good ideas but by the time she is done writing the first word she forgets what she was going to write. I thought that she was amaIng at being able to tell me what was going on and wwhy she didn't want to write.

When I took over the writing part, her ideas became these:
whenever you look at roses they bloom.
Electric fences should be visible. That means able to see. Because then you will know it is there and you won't get an electric shock.

There should be cursive numbers.

You should be able to press a button on a piece of paper and the button will disolve into the air. When you are done drawing the picture- it will start moving. For example - a moving marble.

Grandma should have a lawn mower as big as her lawn and it could mow fast. Then it folds up. The handle goes down, the sides go in, it folds again toward the road. A box with a bow ends up there and it is small so you can put it any storage room.

So you get the idea. No wonder she won't write. She has such bug ideas and they seem so small on paper.

My question. She is a little above grade level in school. Top of the class, youngest in the class, but ilsewms to be learning and engaged. She has not ever been tested but frquently gets 100 on assessments. I have no idea if she is gifted.

My major concern right now is that he has a learning disability. If I tell the scool psy this info, about her not being able to remember what she wanted to write and the difference in her work when she doest have to do the writing, will she laugh? I talked to her already about letter and number reversals and she said to come back next year.

I guess wondering what are you oppinions as to whether this is normal six year old development or more of a 2e thing. I really don't want to overlook her needs. She seems so frustrated with writing most time, yet one in a whil produces something great! Maybe her expectations for herself are unreasonably high causing the frustration and there isn't a ld at all.

Still typing with thumbs.

Well, grandma has to get smaller to fit through the phone!

Based on what you have said, I would ask the school to evaluate her for learning disabilities, including dysgraphia and/or a disorder of written expression. That should give you a better idea of whether this is just a matter of asynchrony (developmentally appropriate attention, stamina, and handwriting skills, but such advanced verbal skills that she can't keep up) or whether there is more going on.

I agree with aculady, I'd ask the school to evaluate her for learning disabilities. What you described with the cards and not being able to come up with ideas could be just a 6 year old with a great concept who ran out of ideas and needed a bit of a prompt from someone else... or it could be a child with disorder of written expression - it sounds a lot like my 2e ds. Also kids with dysgraphia can know the alphabet in order at 6 - my ds definitely knew the order of the alphabet. He reversed some letters then, but his teachers said it was developmentally appropriate and that letter reversals continued for some kids until they were almost in 3rd grade. That said... he is dysgraphic... it's just not easy for a parent or teacher to recognize in a young child. It's the same with other challenges too - with our 7 year old 2e dd, we thought she had a reading challenge and instead found out she had a challenge with associative memory - we (parents and teachers) would never have figured that out without the help of an assessment by a professional familiar with LD.

I wouldn't worry about the school psych laughing if you share your concern about a possible LD. I also wouldn't be surprised if she doesn't think it's a concern... and if that happens, what you need to do (and should do anyway) is to document your concerns and request for an evaluation in writing.

Good luck! And fwiw, I think you type very well with your thumbs Loved your dd's 100s day idea too!

polarbear