Gifted Issues Discussion homepage Forums Twice Exceptional Please help - wondering how to proceed

For some background and test results see http://giftedissues.davidsongifted....elp_Please_with_WISC_sco.html#Post130507

The problem at the moment with which I need help/advise:
I took my DS for an eye exam and developmental eye evaluation yesterday and it turns out he has something called "intermittent convergent strabismus" http://www.strabismus.org/intermittent_strabismus.html I am thinking now that it is likely that he doesn't have a learning disability at all - the symptoms I am seeing and the difficulties he is encountering with reading and doing worksheets, etc. are likely due to the intermittent convergent strabismus. What are people's thoughts on this? Polarbear, expecially!

I am thinking of maybe not going forward with the learning disability testing just yet but waiting to see what improvements occur with the vision therapy. Or should I still go ahead with LD testing, do you think? I am not sure what to do.

Also, when I asked about getting him retested privatley next year, his therapist was like no they don't test/eval in a year unless something has "changed" warranting a re-eval. I'd really like him tested again especially after he has had a decent year of vision therapy done. I know the school will test but I'd love to waive school testing and do it provately again. I asked if the discovery of an LD was consideried a "change" enough to warrant a re-eval and retesting in one year and she was not encouraging about that at all!!! Which completely surprised me. I wuld think a change like the discovery of a LD or even the discover of a vision problem would be enough of a "change." What are peoples' thoughts on this? Would the vision diagnosis and subsequent therapy be enough of a "change" to warrant retest and re-eval in a year? What are peoples' experiences with this sort of thing? Thanks so much!

OH and should I move this post somewhere else? or Open a new thread about this in a different place? or can I stay here... I realize we're kind of off-topic now for being in ID/testing!

Wow, I'm sure you're feeling a dozen or more different things after finding out about the strabismus - I remember when we found out about our dd's vision challenges that I sooo so wished we'd known years earlier! II hope that your ds has as much success as our dd did with vision therapy - it really was amazing what a difference it made for her - not just in academics (reading in particular, but writing and other areas as well), but also in her daily life.

We didn't seek any further testing for LD at the time we found out about dd's vision challenges, but instead focused on her vision therapy. However, we made that decision because she'd been through a full neuropsych exam that included testing that would have given us clues re dyslexia or other typical learning challenges were present and there weren't indications of anything else that our neuropsych felt were potential challenges. If I were in your shoes today, I'd probably pass on further testing until you've had a chance to see if vision therapy works - *unless* you see something else in the previous testing that you wonder about. I took a quick look, and there are two subtests that I can't remember anything about off the top of my head, so I'm not sure if the scores for them would be impacted by vision or not (digit span and letter-number sequencing). The other subtests that your ds had low scores were tests that use vision; if you look up a test description and find that they don't rely on vision, I would at least ask the psych who did the testing if he/she feels there is something going on there, and possibly pursue some follow-up testing. I wouldn't worry too much about any of the achievement test scores - I'm guessing the lower scores there have an impact from vision challenges.

I also disagree with the therapist who feels that testing again next year isn't warranted. Vision challenges are huge! And you'll probably find yourself wondering, after your ds has been through vision therapy, if it's made a difference in any of these scores. We didn't pursue retesting right away, but our dd did go through a follow-up educational eval again this spring. It wasn't a full neuropsych workup, but instead ability+achievement testing and a bit of extra testing to determine whether or not she had any LD related to math ability because she struggles quite a bit in math. The ability test she was given this time around was the WJ-III Test of Cognitive Abilities, so I don't have any direct subtest score comparisons with her WISC - but - her scores across subtests were all fairly consistent, including the tests that had a vision component, so I"m guessing if she was given the WISC again her previously low subtest scores would no longer be low. She had WJ-III achievement tests both times and dang it, I was so focused on figuring out what was going on with her math that I didn't think to compare the achievement test scores from before and after VT - I'll have to do that when I have a bit of free time!

What were you told about how to proceed for the strabismus? All vision therapy? Any kind of corrective lens? Our dd hasn't used any kind of lenses, but I have a niece who is in her mid-20s who has all-the-time strabismus (sorry I don't know the technical term for "all-the-time" lol)... she wears contacts that correct her eye position, but she has had trouble with reading throughout her life in spite of having the strabismus successfully. There is dyslexia/dysgraphia sprinkled throughout my dh's family, and we all suspect she has some type of reading challenge that is unrelated to the strabismus but went undetected because everyone in her academic life assumed her reading challenges were all due to vision issues.

Good luck - I'll be interested in hearing how VT goes for your ds - and I'll be cheering him on!

polarbear

Thank you Polarbear! I really wanted to hear your thoughts especially in light of your experience. Thank you so much! I also loved hearing that VT has made such a good impact on your DD. Gives me hope because I am worried even though the doctor was very positive that the therapy will help tremendously. It's a little disconcerting that there seem to be really no other way to "treat" the vision problem ... Oh, and yes, we were told to proceed with pretty much all vision therapy for the strabismus. It doesn't seem that surgery has a good success rate at all and may cause more problems. Lenses don't seem to be a viable option because other than the strabismus he has 20/20 vision (she mentioned them but didn't think they would help much - she'd know more about that when she gives him the test whre his eyes get dialated I think- that was the only test we haven't done yet)... So we are only left with VT it seems. I just feel sad about my little guy - I think he has a tremendous amount of intellignece and creativity stuck in an inadequate body (and yes I know it could be so much worse but you know it's still a bit of a bummer) He wants nothing more than to write stories and yet his hypotonia makes the physical writing so hard for him (as does the visison problem) and he LOVES to read but the vision issues make that so incredibly hard for him.

I looked up Digit Span - it measures verbal memory, concentration, visual reorganziation ability and attention span. So I guess "visual reorganization" is a vison affected taks? maybe?) Letter-Number Sequencing measures attention span, short term auditory working memeory and sequencing abilities. So not sure about those and the low scores. I do know that the vision and the hyotnia tire him so much and affect his ability to concentrate so perhaps he was just "done" ykim? Much fatigue is caused by so much close work whne you have that kind of visiual issue and my DS has hypotonia which is also fatiguing (when he is made to sit and do work at a table for long periods).

My eg/pg son (now 6.5) has had 2.5 years of vision therapy. He just finished over the holidays. He was born with muscular torticollis, hypotonia (low muscle tone, and visual processing/perceptual deficits; he's had tons of therapy. Apparently, it's common for children born with ocular tort to have strabismus so I've heard of them having surgery and/or vision therapy as well, though most have sought surgery.

My son was barely scribbling at 4 yrs old before vt started; yet he knew all his shapes, letters, and numbers and had had 4 yrs of pt/ot to encourage writing. About 6-8 months after starting vision therapy, we started to get a lot of writing. Then it was a flood and has continued on and off. He's now 6.5 and writing sentences, paragraphs, stories, e-mails, and on and on - way above other late kindergarteners.

As for reading, my ds was 'reading' before vt but not out loud or really reading. After 1 1/2 of vt, he started to read out loud. Last summer, he was struggling with phonics. Today, he's reading many, many grade levels ahead.

I've never heard of Digit Span - but this sums up a lot of situation with my ds. It also coincides with him being a visual spatial learner.

My DS had the WPSSI last summer when he was in VT and wearing glasses. Scores came back too scattered and inconsistent. I wanted to scream.

In Feb, DS took the Woodcock Johnson Achievement Test through the public schools. He did better, but still wasn't totally cooperative. He told the tester that since he's in kindergarten, he's only going to do kindergarten math - despite the fact that he was able to do more and multiply.

I'm in the process of seeing a 2e specialist. I think DS's hypotonia, sensory, and visual issues have had an affect on his attention span and testing scores. I'm waiting to get a more definitive answer though.

"He's now 6.5 and writing sentences, paragraphs, stories, e-mails, and on and on - way above other late kindergarteners....As for reading, my ds was 'reading' before vt but not out loud or really reading. After 1 1/2 of vt, he started to read out loud. Last summer, he was struggling with phonics. Today, he's reading many, many grade levels ahead."

This gives me much hope. I think my DS is doing remarkably well considering the (mostly hidden) physical limitations he has... I have so much hope that he will really start to just take off once the visoon issue is addressed.

Cdfox, I remember you posted before you were seeing the author of Different Minds about your DS - how is it going?

Yes, Marytheress. I've taken my son to see Dr. Lovecky, author of Different Minds. I've now got to wait a couple of weeks before she meets with me and my husband without ds to discuss things. I'm trying not to let my mind wander or predict what Dr. Lovecky is going to say/diagnose, which is very difficult for me .

I'm a huge supporter of vt after seeing what happened with my son. The results have been amazing. There's no question or doubt in my mind that the visual processing/perceptual deficits hampered my son's developments/skills/abilities.

My DS's behavioral optometrist specializes in treating autistic kids (http://www.autisticvision.com/), though he sees a range of children and adults and has something on strabismus. During one of the examinations, he told us that our ds was operating a couple of grade levels ahead, but it didn't fully register with me at the time because we didn't see much evidence at the time. He told me that it's a matter of time before he starts showing. Well, that started last year and has continued this been year with reading.

My DS had been in a special needs pre-k program in NYC and MA. Last year the special needs pre-k program in MA told me that they were going to keep my DS in special needs for kindergarten if I hadn't moved him due to his attentional issues (despite no diagnosis and the fact that he was starting to spell and read at home). Well, I moved him last November into a private gifted school. Within 2 1/2 months, he went through the pre-k/k/1st grade curriculum and I was told the gifted school could no longer accommodate him. Yet this was the same child who was barely counting before he entered the private gifted school.

Visual processing deficits are very much misunderstood (imo) and how it can impact a child. Dr. Linda Silverman includes the impact of vision therapy with visual spatial learners (i.e. my DS) in a chapter in her book, Upside Down Brilliance. She says that children who previously scored low do not suddenly start scoring higher; "most children do not show such dramatic and consistent gains without intervention" when referring to a child who had visual processing deficits and had vision therapy.

I used to talk to my son's behavior optometrist about these things. He's been in contact with Dr. Linda Silverman. I'd love to meet her to talk about these things. I find it really fascinating after what's happened with my DS and trying to read as much as possible on it and giftedness.