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....

PB, yes we are doing a private eval very soon. And yes he loves audio books.

Black cat, he is awful with nonsense words. Terrible. He makes almost no effort to sound them out. Just guesses.

DeHe, he will give any book a try as long as there are pictures. Any level book.

I will try to respond more tomorrow when I can access something other than my phone. Keep the responses coming! Thanks so much!

We got the results. The tester does NOT think that DS7 has any 2E issues. Although there WAS a big discrepancy between IQ and achievement scores, she attributes it to the following:

He is very reluctant to read or write things that are not 'interesting' to him. He WILL do it, but doesn't want to. She believes that his reading and writing education in his current classroom is extremely poor. So, he is acing everything they do in class and is not being stretched at all. Therefore, he is not learning anything in reading or writing at school. And since he strongly prefers non fiction to fiction, he spends very little time reading fiction at home. So, he is not developing his reading and writing skills at home either. He actually did pretty well with his decoding skills (I was shocked!). I also saw his writing samples from the achievement test and they looked good to me. So no dyslexia, no dysgraphia.

She thinks that the gap between IQ and achievement will be closed by giving him an appropriate education in reading and writing.

Any thoughts from anyone here?

Well a gap between IQ and achievement can certainly be a sign of 2E and you may find yourself coming back to revisit this, but certainly I have a child with DYS IQ who was NOT at DYS achievement levels previously due to lack of exposure/opportunity and if she's not at DYS level now in at least literacy then she's close. She has ADHD and a major handwriting challenge that is primarily physical, but she's made astounding progress on that too. Certainly in her case I feel like she's got some quirks and needs scaffolding in some areas, but it's nothing like dealing with her sister's issues (who is VERY 2E). For her she really was held back primarily by lack of exposure/quality teaching at the appropriate pace and level.

He sounds so much like my son with a stealth dyslexia diagnosis (except he is way high on achievement despite not being exposed). Did the tester have experience with 2E?

Yes, the tester has extensive 2e experience.

somewhere, did you receive a copy of the WISC subtest scores, and are they all within a consistent range, or do you see variations > 3 points among subtests or greater than 15 points between VCI/PRI/PSI/WM?

Can you also let us know how wide the discrepancy was between ability and achievement?

And - last question - I promise lol - when you look at the achievement tests is there a lot of scatter in the scores or are they consistently at the same level? If there is scatter, are the tests called "fluency" lower than the other test scores?

polarbear

somewhere, did you receive a copy of the WISC subtest scores, and are they all within a consistent range, or do you see variations > 3 points among subtests or greater than 15 points between VCI/PRI/PSI/WM?

I have a copy of the WISC subtest scores. IIRC, between VCI and PRI was a difference of 13 points (BUT - for PRI, DS hit the ceiling a few times on the subtests, so the difference was probably greater between PRI and VCI). There were also some great difference in the WM section. I remember the tester's reasoning, but can't recall the actual difference. (I will look at the paperwork and get back here.)

Can you also let us know how wide the discrepancy was between ability and achievement?

Between ability and achievement - ballpark figures were about a 15 point spread between verbal ability (higher) and achievement. But there was also about a 15 point spread between PRI and math achievement (higher).

And - last question - I promise lol - when you look at the achievement tests is there a lot of scatter in the scores or are they consistently at the same level? If there is scatter, are the tests called "fluency" lower than the other test scores?

I appreciate your questions, actually. Because if I am missing something, or if the tester is missing something - I WANT TO KNOW! Not too much scatter - the reading and writing was consistently lower than expected and the math was consistently higher than expected based on WISC (but as previously mentioned, DS hit ceilings on WISC and didn't do extended norms, so I don't know how high he would have gone on the WISC PRI). I am going to take a look and get back here.

Anything else I should be looking for?

This topic is hitting home for my third grade son and I need help in getting him the right tests to figure out what's going on.

He's bright (though his fifth grade brother is extremely gifted) and strong at math. This year his handwriting and spelling has regressed. The descriptions of dysgraphia and/or stealth dyslexia seem to fit what I have observed.

He was in speech therapy through first grade -- but 'graduated' at minimal aided levels when the school district had cut backs. His current teacher just had him observed by the school speech therapist but because he is bright, won't be considered for further speech testing.

In today's parent teacher conference the teacher and I started putting together a lot of the issues that have come up this year, including regression in handwriting to almost illegible, with basic spelling mistakes and very short answers. Even his math has hasty mistakes and illegible numbers. Rewriting assignments doesn't make it better. The other concern is missing assignments or not handing in his work, which I first thought was an issue of taking responsibility.

Then we started combining these issues with his toe walking (he still walks on his toes but not as pronounced), bites on his collar and doesn't realize he is, speech issues, and his wanting Mommy to read more at bedtime rather than him reading. While he does well at reading, he has always been reluctant to read and prefers books with lots of pictures. He is also not recording/taking the classroom tests for the books he is reading. When little he did have problems with backwards letters/numbers. Because he is bright I think he has been able to cover up any issues.

Something is going on and I would love any advice on how to handle this with the school district or getting our own testing done. Thank you in advance for any insight.

I think your gut is telling you something's wrong and you should pursue getting him an evaluation. Based on your and the teacher's observations, you can put in writing to the school that you suspect a learning issue with your son and you'd like him tested asap. The school is legally required to pursue testing regardless of how he is performing in class.

My son with dyslexia had similar issues to what you describe when he was that age (although he was diagnosed at 7, in 2nd grade). He sucked on his shirt, he couldn't say his "r"'s until the spring of 3rd grade year, his handwriting was chickenscratch (but it always had been), and he made letter reversals and he was good at math, but made errors mostly because of his poor handwriting. He never wanted to read, but loved being read to.

What is your son's reading level? If he's behind, I would pursue tutoring or intervention immediately, and not wait for the testing to be complete. It could be several months before the school has a plan in place and this is valuable learning time for your son.

FWIW, my son is doing great in school now-- advanced in all his subjects. But his handwriting and spelling are still terrible.

I agree with syoblrig, your gut is telling you something is up, and taken in combination with the things you've observed and mentioned in your post, I'd pursue an evaluation. You can request the eval through the school, or you can seek out a private eval - my personal advice is to get the private eval if you can.


The school is legally required to *consider* testing - they aren't legally required to test. As a parent you make a written request for an evaluation, and that requires the school to convene a team meeting to consider the request based on the parent's concern and input from teachers etc. It's possible that the team will agree and you'll receive the evaluation, but it might also be a very tough situation to successfully advocate through depending on the general attitude at your school on the part of the school staff or philosophy toward SPED evals, and you'll most likely need to provide work samples or data from observations and testing (state testing, classroom testing, or other types of testing) that illustrate your concerns. Our EG ds was in a school district which was stressed for funds and staffing to cover all the needs for testing and services when he was in elementary, and we would not have been able to advocate successfully for an evaluation through our school for our EG ds without having had a diagnosis already through a private neuropsych eval combined with a lot of research on our part re how to approach advocating (we most likely would not have been successful without the advice of a local advocate). It was really clear from the start of our advocacy that the SPED staff and school psychs were not used to seeing a child referred for evals who had such high ability scores, and we found the school staff was constantly trying to put the "reason" for lack of output in written expression back onto things such as lack of motivation or possible ADHD or "really he's doing fine".

The second (and ultimately most important reason) I recommend a private eval is that you'll (typically) get much more information from a private eval - you'll be able to talk freely to the tester and he/she will be able to share information and concerns with you freely without having to put them through a school-district filter. If it's a neuropsych eval your ds will go through not just the diagnostic ability and achievement testing but if an issue is suspected from those tests the neuropsych will administer additional tests to determine what's actually causing the issues. You'll also typically get a plan forward - recommendations on accommodations or remediation, suggestions or referrals for private therapists, and input on which local school programs are the best fit and what to watch out for when advocating at school. Those are all things you typically don't get from a school eval - the school is focused on what your child needs now to be educated in the typical classroom.

Best wishes,

polarbear

Somewhereonearth - I sent you a message a while back.

Please let me know if you have any questions. Wishing you and your DS the best!

I'm so glad someone posted this question because I have an interest in this topic also! I hope you don't mind that I grouped several of your posts together, but I realized our DD8 has many similarities to your DS7...and from the looks of it, others have some of these same issues with their kiddos.

We just received the basic information from DD8's psycho-educational testing (KABC-II and Kaufman Achievement) and are waiting on the full report. They reported to us that they don't think she has dysgraphia or dyslexia, but even when they gave her a spelling test she flip-flopped letters in some of her words - so as an example "people" was "pepole". She knows how to spell people and can verbally spell it. There were other things they noted, but since her comprehension was great they didn't feel there was an issue. So if this isn't some form of dyslexia then what is it? DD changes words when she is reading out loud and will sometimes just skip little words completely. When she does this, what she is reading still makes sense, it just isn't what is on the page. Like somewhereonearth's DS, our DD hit several ceilings and did not get extended norms so we don't know how high she can go, but her FSIQ is within the exceptionally/profoundly gifted category (depending on what chart you use). Her achievement scores were high, but not as high as we would have expected and we too were told it was because she isn't being taught at the level she needs to be. She loves to be read to, but doesn't like reading out loud. One difference - she doesn't really like to read for pleasure, and when she has free time, reading is never at the top of her list of things to do.

I read through all the responses that somewhereonearth received and it sounds like we should maybe start with an elaborate vision screening. If that doesn't give us some answers, then I guess we should start saving our money for a neuropsych eval instead of that trip to Disney World we had hoped for.

Being able to spell aloud but not in writing is also something I see in my son who is 9 and has stealth dyslexia. He makes similar spelling mistakes, for example, "bule" for "blue." High reading comprehension does NOT mean no dyslexia. Look online at some of he Eide's stuff online. Typical stealth dyslexia profile on reading tests is extremely high comprehension, with lower speed and accuracy. Many testers are familiar with stealth dyslexia.

Here is a slide share from a webinar that the Eides did a few years ago. Slide #26 gives a graphic representation of how dylexia presents differently in gifted versus non-gifted learners. I found it helpful when I was trying to understand why my kid didn't fit some of the standard dyslexia red flags.
http://www.slideshare.net/drseide/stealth-dyslexia-in-gifted-children-1565818

My DS is a lot like Gabalyn's. He also has stealth dyslexia, tests extremely high on MAP, reading comprehension, even spelling tests, but cannot write and spell at the same time. Tryangul is one of his recent gems! He told me the other day that he would probably get the word guess wrong on his spelling test "because I know mommy I am just going to put gess even though I know it is guess!" The Eides do a terrific job of explaining the difference in gifted kids.