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Hi
Grr, I just deleted my post, hate that!!

So starting over, I am looking for help from the experts - got the OT eval (yes DeeDee got it before the meeting!). basically after reading the write up I am wondering if he has dysgraphia.

The report focused on low tone, lack of core strength, funny arm positioning, weak fine motor, and some visual spatial, some sensory issues.

But I find myself feeling a bit defensive and argumentative about the report - in that it was hard to read, and that some things sound so much worse than what we see, so are we excusing it or are they making it sound worse.

And then what do I do in the meeting - I am worried that my natural instincts to lead the conversation and defend DS are inappropriate but am also worried that he does need defending and advocating because some of the things cited are absolutely because he is bored - which I know I can't mention! I discussed here the concerns i had before the eval and I have to say some of them still stand even though he needs help. I feel very protective of who he is and I also feel like he is making progress, so I feel very MamaBearish! Especially those posts about esteem, he is so proud of himself in so many other areas and feels so bad in this one. So I want him to have tools - I don't want him to feel like I did, covering it up after I was no longer able to compensate for the dyslexia.

So what do I want for DS - in school OT, out of school OT, what kind of accommodations would he need - do we need further diagnoses? I want him to feel confident in his writing, I want him on par with his peers, I want him easily able to express himself and do it independently.

What specific OT improves this kind of issue - he is much better now at not mixing up the type of letter, although still does it, what he is not great at is working independently on writing and spacing issues. My thought was to focus on spacing since that seems to hinder legibility so much.

Thanks!

DeHe

When my son was tested at age seven he had low tone, lack of core strength, funny arm positioning, and weak fine motor skills. He did not have the endurance that other kids had and his visual motor integration was low. After years of video games and brain games I think his visual motor integration is fine now, but he never got to a point where handwriting was comfortable for him. One of the games he has been playing lately tests his spatial memory. He is good at this. I tried it but wasn't nearly as good but I am working on it and I am improving. He likes to compete with me, especially since he usually wins. At 13, my son who was diagnosed with a "disorder of written expression" writes so much better than I do when he types. He is very articulate and expresses himself well in writing like an adult. When we had a billing problem with one of his online sites I had him take care of it. He wrote the email and followed up on it a few days later without me asking him to do this. I keep thinking that he would do well in a job as an office manager. Oh and when he was tested they also said he had some executive function issues at the time. I just can't see it at all except that his desk is kind of messy but then so is mine. I can still find everything I need, and do what I need to do.

We homeschool for many reasons but one of them was that I worried about his self esteem. We live in an area where bullying is a problem but teachers are blind to it and I can't imagine what it would have been like for him to have his handwritten work displayed on the wall for everyone to see as they often do in elementary school here. He wanted to do a good job but his mild disability made it harder for him and then he couldn't qualify for OT because he wasn't failing.

Caveat: I don't know much about dysgraphia, but we face similar concerns with our younger child and have been down a long road of services with DS9, so I'll weigh in from that perspective.


It is never nice to hear that someone thinks there is something "wrong" or "different" about your child. The defensiveness is something you'll have to work through, but I'd say, try not to let it affect your judgment.

Services need not be stigmatizing; and more help sooner can be a real blessing for a kid who's struggling with a particular skill.

In my limited experience, if school identifies problems, they are likely real. (Schools tend to under-identify rather than over-identify issues.) My default position is to accept what services are on offer and give school a chance to try to help. If you find that it's not working, you can always quit accepting the services later.


Well, this can be hard to untangle. For my elder DS, boredom played a role, but the other issues (in his case AS and attention issues) were real and limited his participation more than the boredom did in the early grades. It was around 3rd grade that the balance shifted, where the boredom started to match or exceed the disability as the thing that urgently needed addressing. Both were important, but it was key not to overlook the disability.

I think it's OK to mention in a meeting that your DS likes to be challenged with new and difficult material, and to ask the teachers whether they see better compliance on certain kinds of assignments than others.

I'd be wary of chalking issues of writing and assignment compliance up to giftedness alone. Better to assume there's something to remediate, and work on it, than to risk leaving a real issue to fester for later. Compliance with instructions is itself an important skill.


I think you see what the meeting turns up, and see what they offer to try to work on the problems, and see whether it seems accurate and sufficient to you. Then you can decide whether to pursue an outside opinion and/or treatment. If you are uncomfortable with the findings, I'd say pursue an outside opinion-- just for your peace of mind.

Hang in there,
DeeDee

Thanks all!

DeeDee Funny you mention giftedness and his lack of interest in the assignments, that's probably the one area I don't think it's giftedness,it's his personality. He doesn't think the assignments are important and so resists them, or does the bare minimum so I am concerned that the OT picked up a lot of that rather than him trying his best and having trouble - although we have seen him having trouble where he wants to do it well

MoN the part that troubled me was mostly about social, sensory behavioral stuff rather than the writing. He is very social at lunch, he does group work, etc but it just felt like they were pathologizing how he prefers to do his own thing at recess. Like he can't play rather than choosing not to and that's it's wrong to choose not to. I don't know, it just reminded me too much of the preschool teachers wanting him and others in the class to be like an ideal they had rather than who they are.

I think I am just apprehensive and uncertain what all this will mean. And I think I have heard too many bad stories about these meetings!

Thanks for talking me down!

DeHe

DeHe, if there's a serious mismatch between what a child can and will produce orally in response to a question and what they will produce when you ask them to hand write an answer to the same question, then there is almost certainly a disability present that is impairing writing, which could be purely a physical motor issue, such as hypotonia, or it could be a problem that involves other areas as well, such as problems with visual-motor integration, visual processing, phonological processing, dyslexia, or other LDs.

It is really easy for us as parents to attribute poor written output on below-level work as being solely the result of boredom or lack of effort, espeically if that is the reason our children give us, but I would caution you that my son, who is severely dysgraphic, has a diagnosed disorder of written expression, and has hypotonia, attributed his poor written output during the year he spent in school to being bored and not wanting to do assignments, but this attribution was, in hindsight, mostly because it protected his self-esteem: everyone around him could do a much better job at this than he could, and if he refused to try, then he couldn't fail, and he could maintain the fiction that he could do it just as well as everyone else, if only he'd tried. Our kids aren't clueless - they know what good work looks like, and if they can't produce it even when they try, why would they want to chance humiliating themselves in front of their teachers and their classmates, especially on assignments that are intellectually beneath them?

With the options of oral response, a scribe, and a keyboard as well as extended time, his written composition skills are well above grade level (he made a 660 on the writing portion of the SAT in 8th grade), and were that way pretty much immediately upon receiving access to the accomodations. Even with intensive OT and PT, he hasn't gotten to the point where he can write by hand with any degree of fluency and legibility. With what it seems like the OT described, and knowing what I know about how much similar issues inhibited my son's ability to show what he could do (because so much mental effort was going into just trying to control the pencil that very little was left for actually thinking about the answer), I would push for immediate accomodations in the classsroom and on testing in addition to OT - it is likely a fair amount of the resistance that you see to completing assignments will vanish once the chances of the work product being good improve and he realizes this.

Low tone and poor motor coordination could absolutely contribute to your son not liking to play with the other kids at recess - we tend to enjoy things that we are good at, especially where effort and results have some relation to each other. With the kinds of motor deficits that the OT described, it is likely that your son has at least some muscles that are easily fatigued (even if his overall "energy" and fitness is high and he doesn't appear winded, his muscles can still tire out quickly from the low tone) and it is likely that he doesn't really enjoy games where success and enjoyment is primarily based on motor skills, stamina, and coordination, and not on understanding the game or reasoning skillfully within the rules. There isn't anything "wrong" with this, but it is supporting evidence in the report that the deficits that the OT saw during testing are consistent with real-world observations of your child's behavior. It would be unusual for a child with those deficits to be as actively involved in cooperative physical sports and games of physical skill as children without such problems, so this was probably included in the report not to stigmatize your child's choices, but because it lends credence to the idea that what the OT saw was real, and not an artifact of the testing situation.

there could be some of that although he happily participates in gym, I think it's more of I really want to be in my own head with my own ideas for the 25 minutes I get to myself but i do see what you are saying.


I completely agree and there is clearly some of that, alongside the I don't care what it looks like, and the new, I'm just messy, which is why I tried to explain my disability so that he knows you can achieve even in the areas that are difficult for you

Sorry I totally messed up the quoting in your quote part, hopefully it's clear what's me!

DeHe

Well, I would consult with the OT about what accomodations are typically most helpful for kids with your child's profile, but I would expect that a K student with these kinds of problems would get accommodations of extended time and oral response and/or a scribe on all assignments (including math) except where handwriting practice (not written composition) was the sole or primary point of the assignment, and that grading for handwriting assignments would be based on current OT and IEP goals. If your kiddo makes great gains in OT, to the point where the level of written output is pretty much as good without accommodations as it is with them, then you can look at fading the supports out. Be aware that a kid who can keep up with the writing expectations in first grade may not be able to handle the expectations at all in 3rd or 4th or higher grades, so be wary of dropping things totally out of the IEP too soon.

ETA: I'd also expect keyboarding instruction and/or speech-to-text software and training in how to use it, depending on whether or not the motor issues that make it hard to write also significantly interfere with keyboarding.

Thank you everyone!

Had the meeting - was not bad at all - although DH and I did get a little teary at moments when presented with the combination of DS' wonderfulness and his struggles.

Upside - getting OT in the school, vision consult recommended, accommodations will be addressed in the future, feeling like there is a plan, and really feeling like the school cares, which I am not sure why i felt like that wouldn't be the case.

OT seems really on top of things - most interesting comment both pysch and OT seemed to agree that DS did not feel like he fit in his body, that the sides weren't in agreement.

Downside - not really many - just little irritations particularly the frequent reference to his pride in his intellectual skills - and the emphasis on his social skills, which are not a "problem" but apparently aren't "optimal"

there were other things, but not significant in the overall scheme of things. We got a great report from the pysch in terms of it being very thorough - really interesting kiddo we have, very interesting to see the way he thinks.

But we now have an IEP, we have goals, we have a plan, and hopefully we are moving forward and things will get better for DS - and he will be more comfortable and confident.

I am so glad its over! Thank you again for all your help - this place is such a salvation!

DeHe

Yeah, I didn't realize until DeeDee spelled it out that it usually takes a lot longer with a lot less done. Nothing is perfect but this went probably as well as could be expected. Told DS about it, he seemed open to the OT but you could see the underlying sadness, he actually got a little teary at one point while we were talking about the meeting and the assessments.

DeHe

I told him about my having dyslexia so he can see that it doesn't have to get in the way and there are tools and technique to make things easier. But I like the way you put it - his challenge - not his fault!!

DeHe

Does anyone know if there is a connection between dysgraphia and difficulty with keyboarding (typing) or playing a piano (or other musical instrument)? Keyboarding was recommended as an accommodation at school for DD's dysgraphia but she doesn't seem to like doing it (I have to keep reminding her at home to use 2 hands vs. hunt-and-peck with 1 finger). Also she had trouble recently with her piano class b/c the teacher wanted her to follow the fingering marked on the practice pieces but she was really pushing back. She did get a NEPSY score of 8 on imitating hand positions (still in the normal range) and overall NEPSY sensorimotor score of 102, which is 'average,' and 55th percentile. I'm beginning to think maybe she has fine motor trouble with all of these things, so that a keyboarding accommodation at school is not going to help too much, and we tried voice recognition software but it doesn't pick up her voice too well,
so I'm wondering whether I should be trying to figure something else out for an accommodation (like having her dictate stuff to me to type out for her until her voice matures enough to work with the voice software). But of course if she should be able to do it herself then I should work on that... I'm just starting to wonder whether there isn't more of a problem than we or the psychologist(s) recognized.

Dbat, interesting thought. My daughter's hand imitation score on the NEPSY was a 5 (5th percentile) and visual motor precision total completion time a 7 (16th percentile). Overall she scored 84th percentile because her finger tapping was so high.

The recommendation from the neuropsych was to get her typing ASAP and also to get her Dragon Speaking. We have not tried Dragon Speaking yet, but started in on teaching her to type.

DD9 started and dropped the flute last year, but our interpretation of her struggles was one of anxiety and perfectionism more than the coordination.

DD9 has not had a particularly difficult time learning to type, but we've not yet asked her to type anything except through the typing program. She's taking slow, plodding progress through the BBC typing program (http://www.bbc.co.uk/schools/typing/), having worked at it 5 times a week for 10 minutes at a time for the last 3 months. I like the program because it's really methodical and teaches positioning without emphasizing the speed. It also doesn't make much of a big deal of errors -- you don't do anything like strike out or have to start over, you just fix it and move on. This last part is key for Miss Anxiety.

Dbat, our ds12 has dysgraphia that's due to Developmental Coordination Disorder (fine motor related), and typing is also very slow for him due to the DCD. However - it's faster than handwriting and he does get *some* of the benefits of a reduction in drain on working memory when writing (over handwriting). Like geofizz, when our ds was first diagnosed, the recommendation from his neuropsych was to teach him how to type first, then move him to voice recognition. One thing you can do with typing is to *not* insist that your child use traditional touch typing, but instead let them figure out their own version - it's ok if your child chooses to only use thumb and first-finger for instance. Also get them to practice as much as you can (this was a challenge for us!).

Re the piano - our ds actually plays piano relatively well and enjoys it... but his finger position looks odd and the joints in his fingers sometimes bend backwards... so it's a little weird! There are some children who have a vision challenge as a component of their dysgraphia, and just fwiw - my dd who had a vision challenge had a really tough time learning how to play piano until we had her vision corrected. Just something else to consider (as if any of us needed anything else to consider lol!).

Re Dragon - we had a tough time the first time around with ds when he tried to train it. We're giving it another try, this time having him read his favorite stories to it for extended periods of time, then going back and making corrections (this technique was recommended to us by a group that works with helping clients with disabilities use Dragon etc). Our ds also prefers the free Dragon app on the iPhone/iPad - you have to be online to use it because it uses an voice recognition online database, but the cool thing about having that online database is that it draws from soooo so very many voices (from what I've been told) that it is really good at voice recognition, no matter who is talking. It's also fairly forgiving of background noise - so it might be something else you could look into. We used to let our ds use audio-recording too, and he was allowed to turn in assignments that way (he used Garage Band on the Mac). And... fwiw... I still scribe for him quite a bit for homework, since his typing is so slow.

FWIW our ds had a low score on the NEPSY fine motor tasks; his lowest scores were on finger tapping, which is a symptom of fine motor dysgraphia.

Gotta run - hope that made sense!

polarbear

My 13-year-old son, who was diagnosed with developmental coordination disorder and dysgraphia several years ago, taught himself to type a long time ago. He can type about 65 wpm. I think he is even faster at texting on his iPhone. He uses his iPhone for taking notes. He once used it to type out answers to essay questions and emailed them to his teacher at the end of class.

When he started piano lessons at age 5 his fingers were weak and that seemed to be his biggest problem. I think his teacher lets him change the fingering sometimes to make it easier for him. She also stopped having him do the workbook because writing in it and drawing notes without going over the lines was a problem for him.

DD9.5 has dyslexic dysgraphia that was diagnosed at the beginning of this school year. She has had a long history of work resistance. It is a complicated web of 'is she bored vs. is she just not trying vs. does she not care'. When she received her diagnosis, it uncorked a lot of her bottled up feelings. She was able to tell us that she stopped trying to do her best in grade 2 when she came to the conclusion that her best would never be good enough. With her new accomodations, things are much different. BUT, she still needs to be encouraged to do her best... even with her enrichment work that is plenty challenging and interesting. She has such a detest for written work that we still have to convince her that she CAN do the work. Luckily, it is becoming easier and easier as she realizes how much typing helps her out. It will never be her preference to write/type her work. Her strengths are in verbal communication.

wow that sounds like DS! In the IEP, the OT actually said that it was important to do this now in K because it gets harder to remediate when they get older because you have to undo those attitudes - I hope we can get him seeing good work before he comes to the conclusion that his best could never be good enough, because I can absolutely see seeds of that already. Psyches are such fragile things, they need to be protected!!

DeHe

Thanks geofizz, polarbear, and LoriH--very useful information.

I will definitely try the online version of Dragon for DD--I had Googled
awhile ago and hadn't seen anything about that, and was getting very
frustrated because IMO DD enunciates very well and so I don't understand
what the problem is; Dragon works very well for me.

DD's piano teacher has been wonderful despite us quitting last week
just before "graduation" because the skill tests were getting too challenging
for her in the timeframe (plus she was sick for a week at a critical time and
wasn't really up to practicing). But she has all kinds of pamphlets in her
studio about LDs so I will mention it to her--she has been very supportive.
Isn't it wonderful when teachers are like that? Bless them, every one.

I must admit after this possibility occurred to me (that DD has more
'global' fine motor issues than I had appreciated, or that 'fine motor'
has a broader definition than I realized) that I am somewhat worried.
DD8 has had 6 evaluations so far (although only 2 very detailed) and
I thought we only had to worry about AS, ADHD, ODD, and dysgraphia.
I would think that if there were something else it would have been
picked up by now, but I will keep thinking about it and looking....

Thanks again!

Dbat, we were told by the folks we consulted with that the reason voice training Dragon most likely was so tough for our ds the first time around is that he watched as he talked to Dragon (while training) and tried to correct each word as it happened. The way we were advised to try this time around is to have ds read a favorite book (using the bluetooth headgear recorder) and to *totally ignore* what is being typed on the screen - instead have the laptop screen turned in the opposite direction while ds reads. He needs to get a lot of words read into the microphone, then he can go back and correct mistakes.

I don't know yet if it will work - we're too buried in homework this week to even try it - but we'll be trying it for sure in a few weeks when school is out for the summer

Also - re the never-ending list of acronyms and diagnoses... I think that what you might be running into is that symptoms of diagnoses overlap - our neuropsych has a Venn Diagram that she used to show us why our ds has symptoms that in his case are due to DCD but in other children are associated with ASD... I think there were three overlapping circles - DCD, ASD/PDD, ADHD... but don't remember for sure. I'll try to find it (someday lol!)... if I do find it I'll let you know. I'm guessing that for your dd, you aren't facing adding another diagnosis, but instead as she grows and as time goes by and as she gets farther along in school, you'll start seeing other symptoms associated with the diagnoses she already has. At least that's how our journey has been so far.

Hang in there!

polarbear

DCD was a new one for me, I had to google that. Uhhh, not DD in any way shape or form. But so interesting that the effects are so similar! We're still puzzled at the low finger imitation score. She thrives in ASL lessons!

Thanks for the info on Dragon... It's good to know what it takes to train it.

My son's piano teacher actually asked us to pull our son from lessons when he was five. She said he had enough natural musical talent that she didn't want him to get a skewed view of music because his fingers could physically not do yet what he needed to do the play the piano "right". He still has difficulty reading music but makes up his own songs, plays by ear, and plays drums in band at school. We had heard from other people that drums can sometimes be an issue for dysgraphic kids, but we haven't seen that with him. He has great rhythm and really enjoys it.

Dysgraphia is so much more than just difficulty writing. It has affected his ability to learn to ride a bike (still hasn't mastered that one at 12), tie shoes (mastered at 10), zip zippers (also mastered at 10) and many others.

But a diagnosis helps tremendously. At least you know dragon you're fighting.

These words are so true! Be a Mama (or Papa) bear and protect their self esteem at all costs. It took a primary teacher one year to destroy DD's and we are on year four trying to repair it. The negative self-talk is hard to stop. DD's anxiety disorder is almost completely school related.

Hi, there are several issues mentioned regarding dyslexia, dysgraphia; touch typing; voice recognition etc. Another issue was whether there is a connection between dysgraphia and touch typing. I have two children (grown up) with dyslexia and have nearly 30 years working in this field. Unlike some other people, I do not see the value of 'touch typing' that said, I do think students should be able to know their away round a keyboard at a reasonable speed. My children and their father all can 'peck' at a keyboard with good accuracy at about 45 wpm, which I don't think is bad. Voice Recognition software (Dragon Naturally Preferred 10) is brilliant (wish I had shares in this company). I would think the reason your daughter is having problems with this is because one of the things you have to do is 'read something, several different things, IN YOUR OWN VOICE'. Now, the problem comes in when I have heard many students read something like this, 'The cat sat on the mat'. The student often takes a nice big breath, (usually in the quietest room in the house) and then says, 't.h.e.. c.a.t. s.a.t. and so on. Now, normally, none of speak in this manner, thereby when the student goes to use the computer, it does not recognise her voice. It is really important that students take these reading cards and read them in their own relaxed voice. Try again, it really is brilliant.
The issue between dysgraphia and touch typing, is probably because dyslexia, dysgraphia, dyspraxia etc., are not usually solely on there own, often these condition overlap and it may be that if a student has dysgraphia, they have a small part of dyspraxia, i.e., fine motor control.
Hope this helps and if you like further information, I have five books on special needs and a website: www.dyslexiaa2z.com.
kind regards
Maria