Gifted Issues Discussion homepage Forums Twice Exceptional Beery VMI and Dysgraphia

I was researching ideas for accommodations for my 6.6 yr old who is starting 1st grade in the Fall w/ subject acceleration to 2nd (this is not nearly enough as evidenced by their own testing but was a lot for school to be willing to try).

He has a "rule out disorder of written expression" from the Neuropsychiatrist who was focused (at our request)on dealing with/diagnosing his ADHD and Anxiety w/ PTSD at that visit. In a follow up call (he is out of area) when I asked about pursuing Dysgraphia he suggested we wait a bit longer to see how things develop.

After our vision testing with the developmental optometrist, we got an OT eval where the OT performed a Beery with these results:

BEERY VMI Raw score 6 Standard score 45 (very low) Percentile 2
VISUAL PERCEPTION Raw 19 Standard 93 (average) Percentile 31
MOTOR COORDINATION Raw 13 standard 69 (very low) Percentile 15

She also found low tone in his hands but nowhere else and diagnosed him with "Lack of Coordination including Dyspraxia and Hypotonia"

Can anyone enlighten me on what all this means? Is this indicative of a Dysgraphia diagnosis? Would this testing prove a Dysgraphia diagnosis? If so who would make such a diagnosis? Do we update the Neuro Psychiatrist? If not, what other testing do we need?

I have been convinced for awhile that my son had Dysgraphia because it just fits so well with the struggles I see. I haven't really connected with the Dyspraxia.... it just doesn't feel like a fit when I read about it. However we definitely see coordination issues. Can those be completely vision related or am I just in denial?

I feel pressure to get the dysgraphia figured out to support his academics and deal with the anxiety. We are asking for a 504 meeting at the recommendation of the developmental optometrist and the OT. I wish I could get him to Dr. Amend in KY who is my pick for a Neuro Psychologist but we have hit a financial road bump and this is not possible right now. We do need to do a WISC. WPPSI had too low ceilings for him at 4 and there is more we could learn there. School also mentioned wanting to update that and yes money is tight but I'd really rather get it done on our own with an expert in HG+ 2e kiddos.

On my blog, I have a mind map of dysgraphia (on the top) then about four entries down I have on of dyspraxia http://tutoringduluth.com/ It's a great visual comparison and there are so many similarities. The OTs I've worked with don't usually assess for for the speech component. But I often think my son was diagnosed incorrectly and really is dyspraxic but that term isn't routinely used my pediatric OT in our community. Another tutor and I were just talking about the diagnosis a student has, is so dependent on who does the evaluation.

I am no kind of expert, but my understanding is that writing difficulties/dysgraphia is basically a symptom of hypotonia & dyspraxia.

Interesting! fromupnorth thank you for sharing your site! Love the brain maps and printed them for our file.

When I look at the map of Dysgraphia the "organization" section doesn't ring true for my son though I admit at 6 that piece may not have come in to play for him yet. When I look at the Dyspraxia graph, the Speech section doesn't fit at all but the rest is right on. It does make it easy to see the overlap. I really appreciate the easy visual. Truly a gem.

epoh-- thanks for your response. I guess maybe if I have a hypotonia/dyspraxia diagnosis it will cover his writing issues and I need not worry with it? There does seem to be enough overlap and I have both an OT and Neuro Psychiatrist noting the symptoms.

I just really want to be covered for what he needs and not have school pushing to remediate disabilities in ways that exacerbate them. I want to have all my research ready to go. If I do I believe the meeting will go well.

My son's diagnosis is Developmental Coordination Disorder. His DCD primarily affects his fine motor skills, though his balance is also disastrous and he has joint hypermobility. He looks very fidgety ADHD in a classroom, but has no issues with concentration, memory, organization or recall.

Depending on who you ask, DCD is a "light" form of dyspraxia, though I've heard different versions of this from different medical professionals. It was simple to get a 504 with DCD that allows him to type his schoolwork, have reduced in class work or extended time, take standardized tests individually so he can wiggle without getting in trouble- though we currently homeschool.

This website might help- it's not 2e related but a lot of it made sense for us. http://dcd.canchild.ca/en/DCDFAQs/faqsparents.asp?_mid_=2918

Happilymom - I've been out of town so I'm chiming in a bit late - sorry about that. My ds13 has fine motor dysgraphia and dyspraxia - I consider the dysgraphia to be rooted in his dyspraxia. When he was first diagnosed with dyspraxia (referred to as "Developmental Coordination Disorder" in the DSM-IV)... I was honestly quite surprised - I hadn't recognized anything about him as "uncoordinated" enough to be diagnosable - but once I learned about dyspraxia and correlated his early milestones and current behaviors, I saw that it was clearly there. The confusing thing about dyspraxia (and apraxia of speech, which can be related) - is that there are so many different ways it manifests in people - some folks are only mildly affected in one or a few areas, other have significant impacts in many areas. From what I've heard from other people and what I've read, I'd guess that the reality is dyspraxia is a individual in how it impacts any one person. My ds doesn't have speech challenges (pronunciation etc) but does have expressive language challenges (getting his thoughts out). He is an amazing artist (loves to draw and draws *really* well) but he is definitely pronouncedly dysgraphic, and it took him years to learn how to tie his shoes. Buttoning and zippering are still difficult for him, and in general, he just seems to move very slowly.

Re dysgraphia specifically, my ds definitely has the organizational challenges outlined on the graph fromupnorth linked (they are great visuals btw, fromupnorth, thanks!)... but those organizational challenges didn't really impact him in school until 2nd grade and they kicked in as large challenges later on in elementary.

Re the Beery VMI, my ds also had very low scores on the fine motor part of the VMI, and those scores were considered part of his fine motor dysgraphia diagnosis. I don't know if they might also be impacted by vision challenges, because that wasn't an issue for my ds. My dd who had vision challenges scored very low on the vision perception portion of the test (lower than 10th percentile), but had (if I remember correctly) average or above average scores on fine motor. She is not dysgraphic, but prior to correcting her vision issues she had handwriting that *looked* very dysgraphic. Re the fine motor dysgraphia, my ds was given the NEPSY as part of his neuropsych eval, and had very low scores on some of the fingertapping subtests, which (from what I understand) is another indication of fine motor dysgraphia.

Re further neuropsych evals and private testing, we didn't have access to neuropsychs who had experience with HG+ kids, but having the neuropsych eval has been beyond helpful (invaluable actually) anyway. Having a local neuropsych known by the schools has been very helpful in advocating for accommodations, and having the advice of the neuropsych (rather than relying on the schools) has been extremely extremely helpful to me in knowing how to proceed with accommodations and remediations/therapies etc over the years.

Best wishes, and let us know how your school meeting goes!

polarbear