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    #127965 04/22/12 09:45 AM
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    DeHe Offline OP
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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

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    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.




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    Originally Posted by DeHe
    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.

    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.

    Originally Posted by DeHe
    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.

    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.

    Originally Posted by DeHe
    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!

    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.

    Originally Posted by DeHe
    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.

    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

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    DeHe Offline OP
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    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

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    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.

    Last edited by aculady; 04/22/12 03:06 PM. Reason: typos
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    DeHe Offline OP
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    Quote
    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.
    Quote
    [quote]

    what kind of accommodations would a kindergartener receive or is that about setting up what he would need for the future?

    Quote
    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.[quote]

    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.

    Quote
    [/Aculady]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?[quote]

    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

    Last edited by DeHe; 04/22/12 04:02 PM. Reason: Trying to master quoting
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    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.

    Last edited by aculady; 04/22/12 08:12 PM. Reason: added info
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    DeHe Offline OP
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    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

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    DeHe Offline OP
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    Originally Posted by master of none
    That sure was a lot to accomplish in one meeting!
    I'm very jealous.

    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

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    DeHe Offline OP
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    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

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