Gifted Issues Discussion homepage Forums Twice Exceptional if not dyslexia, what could it be?

DS7 is being evaluated for learning issues. Now that I've started reading about "stealth" dyslexia, my son fits most descriptions of it to a T. But I'm still wondering, if it's not dyslexia, what else could be causing his reading and writing issues? Vision has been checked and is fine. Is it possible that simply being underchallenged would cause the same issues?

Could you describe what's going on a little more? What have you observed? It might help people give you better alternative possibilities.

He knew all letters and numbers at about 18 months but never started to read until kindergarten. He has extremely poor decoding skills. He does have excellent comprehension while reading silently, especially if he is reading long and complex material. If he reads short instructions, he often is confused. His spoken reading is poor...often skipping and substituting words and letters. His IQ scores put him squarely in the PG range (he hit ceilings on multiple subtests but we didn't do extended norms, so I don't know how high his IQ really is). He only reads about 1-2 grade levels up. He is clearly dysgraphic - extremely poor spelling, poor handwriting. He can give you a wonderfully creative oral response to a question or prompt, but his written response is that of child much younger.

He loves reading and devours books. But if there are no pictures in them, he won't touch them.

There are many different things that could be going on - that's where a neuropsych exam is really valuable in helping to tease out specifically where a challenge lies. You're still in the process of considering a neuropsych (from what you've said in recent posts). What other types of screening/evals has your ds had? Has he been through a dyslexia eval by either his school or a reading specialist?

Your description of your ds and reading sounds sooo much like my dd who has a challenge that impacts reading. She is not dyslexic as it is defined by traditional screens, but she has a dyslexia diagnosis from a reading specialist. Her specific challenge is in associating symbols with sound.

I think based on what you've written, getting your ds into a private neuropsych eval would be extremely helpful if your insurance covers it or if you can afford it. Diagnosing a reading challenge in an intellectually gifted student can be extremely tough. Our dd, as you mentioned with your ds, can read and understand long complicated passages because she gathers a lot of information through context, yet she has difficulty reading simple 1-2 sentence instructions and understanding them on things like worksheets etc because she struggles to decode simple words. She scores either solidly high average or higher on most of the specific types of reading tests, with the exception of any test that has to do with associating sounds and symbols... and she has low scores (25th percentile or lower) on certain parts of the Gray's Oral Reading Test (GORT).

The one thing that is different about our dd than your description of your ds is that she does not love reading. She does only choose books with pictures, but she is not excited about any of it. She loves loves LOVES audiobooks - have you tried any with your ds?

polarbear

ps - does your ds actually have a dysgraphia diagnosis or are you guessing he's dysgraphic based on what you see with handwriting etc? FWIW, our dd's handwriting when she was around your ds' age looked like she might be dysgraphic - lots of reversals, horrid spelling, messy handwriting etc. She didn't have the odd pencil grip though, and didn't have uneven pencil pressure or wrist pain like our dysgraphic ds did (not all dysgraphic kids have those same issues). As she's grown older (she's in 4th grade now, almost 10), her handwriting has improved significantly and no longer looks dysgraphic (and she's not). OTOH, her spelling hasn't improved much at all, which is related to her difficulty with associating sounds with symbols.

How does he do reading nonsense words? If you google nonsense words you can pull up some examples or maybe a sample assessment. Examples of nonsense words would be words like "bim" or "lat"...you need to know/comprehend phonics in order to read the words, you can't read them from memory. If he has problems reading those kinds of words fluently, there is probably a reading disorder. I don't think being underchallenged would cause the issues you are talking about.

One of my old-coworker's daughters had dyslexia and it was not diagnosed until she was in high school. Since she had such a high IQ, she was able to use plenty of compensatory strategies and appeared average in reading even though she was struggling.

There is also the issue of font size - lots of kids your DS's age prefer books with lots of white space and larger size font and this isn't necessarily a vision issue. It's very common for this age to be resistant to books without pictures. Might want to try getting non fiction picture books from the subject sections, they can be dense and complicated but still have pictures so you might get a better understanding of comfort level. The magic school bus original picture books are a good example of this - although there are plenty of books with more content beyond, but many of us here found these good starter books, especially for boys because of the tons of content.

DeHe

I have a similar issue with my little guy. I feel like I have been researching and trying to figure it out for 'years.' It's a bit odd and people are thrown (and don't take my concerns re dyslexia seriously) by the fact that he can read and reads at a decently high level. I spent most of the last twos years convinced he had dyslexia because reading seems so arduous for him and, while he has always loved books and being read to, he would run and hide and do all types of avoidant stuff to avoid actually physically reading. He also reverses letters and numbers, he can not "see" the reversals, he is very bad at spelling (however, he is still on grade level for it).

I took him to a neuropsych recently to be checked for it and she said he is definitely dysgraphic but she said it's so rare that someone "as gifted as he is verbally would have a language based processing disorder such as dyslexia." I hear that a lot but it does not comfort me b/c that sounds a bit prejudicial to me - how do I know that in the future they will still have this belief that it's impossible for a verbally gifted kid to have dyslexia?' I suspect they do not know enough about the disorder still. And, isn't that what "stealth dyslexia" is all about? But, good luck finding a neuropsych or psych who understands the concept of stealth dysleixa - I know I have been unable to find one ... not one that I can afford anyway.

HOWEVER, to complicate things my kid also had/has a vision problem - his vision is 20/20 but his eyes have problems working together, focusing, tracking ect. He has what is called "intermittent convergent strabismus," which means his left eye crosses intermittently. He receives vision therpay for it and I have noticed his reading improve as a result. It's gotten easier for him too - but still is more arduous for him than it should be given his intellignece, drive, reading comprehension, and LOVE for books, etc. I can clearly tell he lacking in phonics and memorizes how the word looks, etc. He is is only somewhat decent in phonics because I tutored him with hooked on phonics for years. His go-to-stategy in reading an unfamiliar word is guessing based on what the word looks like and context... He literally seems to be pattern solving when reading. I usually have to force him to "sound -out" and it seems way too hard for him.

According to the neuropsych, and this does make sense to me as well, he has a visual processing disorder (resulting from the strabismus) and that is why he has issues with reading. What seems to support this additionally is that he does have problems with the PRI part of the WISC - when he came out he complained "those picture sections are so so hard! I can't take it." His PRI is more than one standard deviation lower than his VCI. He did well on block design but complained bitterly it was so hard, and he barely survived picture concepts and picture completion and scored very low on both. The neuropsych noted to me that he simply had to spend so much more time on the pictures to get the right answer and he became too tired and fatigued and started just guessing to get through it.

Anyway, basically, I don't know what to think. Is it dyslexia? stealth dyslexia? Or is it a visual processing disorder? I have him in vision therapy again to see if it helps more. I wanted to get him dyslexia intervention just in case due to my suspicions (couldn't hurt whether he really has dyslexia or not) but I am having such trouble finding a qualified tutor and the one I have found charges over $100 an hour. Since he does seem to be reading well (his level jumped up over the summer) and his reading comprehension is so high, we are sticking with the vision therapy for now.

So, I hope this helps you. I guess my short answer to you is that if is not dyslexia, it could be a visual processing disorder. You should have him checked by a COVD developmental optometrist http://www.covd.org/ ... The up side is that in my experience finding a COVD vision therapy is easier and less expensive than finding decent intervention for dysleixa - and that is saying something!

BY the way, back when I was first trying to figure out what was wrong with my guy it was polarbear who enlightened me to vision disorders and COVD, etc. Lo and behold we find out he has strasbimus...

Stealth dyslexia is the other difficult side of symptom cluster disorders. People are misdiagnosed with dyslexia when they are struggling to read, and others are not diagnosed because they aren't struggling.

I think it is a question of pattern matching vs. deconstructive analysis. Functionally a gifted brain can be wired towards one direction of organization or the other (good research on this, but not seen one addressing the direction of causality.)

On wiring type 1 (my term) there are large cluster brain cells (minicolumns) with the clusters widely spaced apart and this configuration favors strong pattern matching skills, at the extreme is pattern matching almost to the exclusion of deconstructive analysis. With wiring type 2 there are smaller clusters closer together and there is a strong orientation towards detail and analysis with problems pattern matching.

Type 1 wiring would be associated with stealth dyslexia and perhaps dyslexia in general ("perhaps" because again dyslexia is diagnosed as a symptom disorder rather than a causal diagnosis.) If you have strong type 1 wiring and a couple other pieces of the highly gifted puzzle (like overexcitabilities,) you cope really well and learn to read and recognize words as a sight reader very early.

But... if you are close to type 1 wiring and you have another factor that has made analysis and visual detail orientation difficult for you, your brain HAD to use pattern matching strategies to make sense of a fuzzy, out of focus, double-visioned world and that it is its #1 go to strategy. And it works really, really well, until you go to decode new words without context or follow instructions or..? For all intents and purposes this is functionally dyslexia, except your brain can liekly learn to use an analytic approach once the source of the need for pattern matching is addressed, but it will take time and may need special training in new strategies.

That's my operating theory, I don't think my DS7 has lifelong dyslexia or dysgraphia, but he only finished his therapy (patching) a year ago. So for the first 85+% of his life, his brain relied on robust pattern matching alone when dealing with visual information, one year is not a lot of time to catch up and train away what has been a pretty effective strategy.

My little guy seems to be the opposite, in that he struggles with verbal activities but not reading or visual activities. I've read that hyperlexia is the neurological opposite of dyslexia, and DS seems hyperlexic. His score was in the 140's for PRI but 27 points lower for verbal.
One thing that might help both you and OP is getting a visual perception assessment done. Since DS had a TBI and had some obvious convergence and visual tracking issues (which I think are gone now 9 months after the accident), his OT did this test. It has about 6 or 8 different subtests measuring various aspects of visual processing. For instance, one is recognizing forms in different contexts. Another is finding forms that are hidden. Another is visual memory. It's called the Test of Visual-Perceptual Skills. It might pinpoint what exact issues in vision are causing the problems.

Very interesting, Zen! Thank you for sharing ... I think what you say makes a lot of sense....