Gifted Issues Discussion homepage Forums Twice Exceptional Possible Dyslexia/Dysgraphia

We have been struggling with my 9 year old son's testing and evaluation and finally on Wed we will have a possible IEP for him. He tested superior on the Beery VMI, and has no fine motor skill issues. But his handwriting is incomprehensible. I wish I could upload a picture. He confuses b and d regularly, puts no spaces between words, and his letter formation barely exists. He had a WISC-IV in 2nd grade (independent) along with one less than a month ago (school). Interestingly when I handed in the results 2 years ago they didn't set up a meeting within 10 days, it has now been 2 years. He was diagnosed with ADHD- inattentive type in 1st grade.
Verbal comprehension 110
Perceptual Reasoning 125
processing speed 94
coding 7
symbol search 11

any insight, experiences would be greatly appreciated.

Did he also take the two supplemental subtests of the Beery: Visual Perception and Motor Coordination? My DS took the Beery at 6.5 years and scored in the average range on VMI (39th percentile with an age equivalence of 6yr3mo). However, he also took the two subtests and scored in the 99th percentile on Visual Perception (age equivalence of 10yr3mo) but <1st percentile on Motor Coordination (age equivalence of 3yr6mo)! His overall Beery VMI score only looked average because his extremely poor motor skills are compensated by his extremely strong visual perception skills.

zoey, have you seen the subtest scores on his Beery VMI? My severely dysgraphic ds (fine motor dysgraphia) scored in the 82nd percentile total score on the Beery VMI, but his subtest score split was huge - the fine motor score was only in the 12th percentile. I don't have the scores at hand at the moment for my dd who has vision challenges (but not dysgraphia), but she also had what looked like an "ok" total score on the Beery VMI, yet tanked the subtest that depended more on vision instead of fine motor. Just like with looking at averaged total scores on the WISC, it's really not easy to tell the full story simply by looking at the one total score on the Beery VMI.

I am also curious - what is the basis behind saying he "has no fine motor issues"? I'm not questioning that he doesn't, just curious what kind of testing was done to assess them. It does sound like he may have some form of dysgraphia (there are different causes for dysgraphia). Dysgraphia is due to a neurological disconnect, so even children like my ds who have fine-motor related dysgraphia are still often able to perform other types of fine motor skills either correctly or even very well. My ds, for instance, tested as average-above average-superior on his initial OT assessment for handwriting OT even though he had a diagnosis of fine-motor related dysgraphia - the OT assessment was not looking at the neurological disconnect that takes place during handwriting, it was looking at the physical skills needed to make handwriting successful *if* your brain can tell your fingers what to do. He is also *very* talented at drawing even though he, as a teen, can't always remember how to form letters. Drawing is a different neurologic and physical process - your pencil rarely leaves the paper and you're creating what you are drawing as you draw it rather than expecting your fingers/brain to rely on any type of automaticity.

What you've described of your ds' handwriting, combined with his low score on coding, would lead me to look for more insight into what's going on with his handwriting. Did the school perform his evaluation? Can you ask them to perform any additional tests? The tests that were useful in diagnosing our ds' dysgraphia were finger-tapping - the results of the finger tapping tests combined with the Beery VMI will give you a clue re is it a fine motor issue or a visual-perceptual issue. You can also ask the evaluator to time your ds' handwriting and compare it to grade level expected speeds.

It's also possible, of course, that your ds had a low score on coding simply because he was distracted or moved slowly and it's a timed test. OTOH, if you're consistently seeing issues with handwriting I would be less likely to discount the coding test result. Did your ds show the same pattern of score scatter on his previous WISC? If he did, that would also indicated there is something more going on than simply moving slow due to distraction etc. Do you feel confident he has ADHD or have you had questions about his diagnosis? What types of issues was he having when he was originally evaluated for ADHD?

Let us know how your meeting goes on Wednesday - I hope you're able to get the help you're looking for for your ds.

Best wishes,

polarbear

ditto. DS has very good visual perception skills and on the visual perception test (a separate test) he was overall scoring like a 9 year old even though he's 6, hitting the ceiling on a few of the sub-tests. But motor coordination is very poor. Therefore on the Beery he scored 65th percentile. What really made the terrible motor skills stand out was a test the neuropsych did called the Grooved Pegboard test, which is timed and involves screwing pegs into a board. He had Z-scores that were literally like -5. Not sure what percentile that is, but it's very low (below the first percentile).

So I'm assuming he did Ok on the finger tapping? I think my DS would do poorly on that, just like screwing pegs into the board. If he has dysgraphia, it's the motor type and related to his Developmental Coordination Disorder.

blackcat, I'm not sure if you're asking the OP about the fingertapping or me - fwiw, my dysgraphic ds (who has DCD), had low scores on fingertapping, which indicates a neurological disconnect between the brain signals and fine motor function in the hands... which is why it's helpful determining if the dysgraphia is due to fine motor or not. You can sorta check finger tapping yourself at home if you want to try it - the "tapping" is just putting together different combinations of fingers with thumb (all on same hand) and asking the child to repeat what you do. It looks really easy - but my ds can't do it! When his neuropsych showed us the first time, I didn't believe her because it was something that just *looks* so simple. Turns out neither my ds or my dh can do it - they think they are copying what you show them but their hands and fingers are doing totally different things.

polarbear

Thanks polarbear, yes I was asking you. I think I'm confused because with DCD I thought everything with motor skills was pretty much poor. So how is it that your DS is able to do well on OT assessments?
My DS does well on any fine motor task that also involves visual processing...so for instance he can draw the state of Texas pretty well from memory (or any other random state). But anything that is purely physical and looks JUST at coordination, he does poorly on. The school is in the process of evaluating him and I'm worried that they are going to come back and tell me he is just fine for writing, whereas if they just asked him to manipulate small objects or tap his fingers he would tank it. So does that mean he is not dysgraphic, he just has DCD? When he writes, the main problem seems to be controlling the pencil and it goes in directions it's not supposed to go. I guess I'm confused about how this all ties together.

Maybe it depends on the type of assessment. The assessment I was referring to was an intake assessment - I'll look up the details later this afternoon and post them.


This is true for my ds too - he's really *really* good at drawing, and my take on it (from knowing him well) isn't that he's all that artistic but that he thinks in pictures. I've also been told that it isn't unusual for dysgraphic kids to be able to draw without problems even though they can't handwrite because handwriting requires a lot of picking the pencil up off the page and putting it down somewhere else, where drawing is more continuous flow - plus when you're drawing you're not having to replicate a specific set of instructions such as how to write a letter.


Everything you've posted sounds to me (again, just a mom lol!) like dysgraphia - and I've been in that same position where the school's evaluation says "everything is fine!". I'm going to come back in a few minutes and post some things we looked at and used to show the school that there was an issue with our ds - if I accidentally forget, pm me and remind me. I would do it now but I am out of time at the moment

polarbear

Forgot to mention - I find DCD confusing! It is a diagnosis that covers a *wide* range of physical issues, and when you read about it you'll find people who are all over the place in terms of how they are impacted. Some folks have just one tiny area (such as the fine motor coordination required for handwriting) and some folks are so impacted globally that they have a really tough time. You wouldn't know just by knowing my ds that he has DCD, but he is impacted in more areas than just fine motor. It's just that it's subtle and you don't necessarily see a challenge until it's really tested in real life, if that makes sense. A few for-instances for you:

1) Gross motor - my ds' OT assessment for gross motor was "near enough average" to not raise any red flags - but the testing situation was one-on-one with no time demands. He struggled tremendously with team sports in upper elementary and early middle school (things like soccer etc) where he had to use gross motor skills to kick/throw/etc when there was a time demand and lots of extra information to process at the same time (direction ball was coming from, where he needed to kick it toward, which teammates were where etc). Yet at the same time, his gross motor skills are a-ok for things like biking and skiing (individual sports) - as long as he's not racing against a same-age or same-size peer.

2) Speech - apraxia of speech is often found in children with DCD. We never really would have suspected this impacted our ds (although one of his diagnostic symptoms of DCD was his lack of early speech). Then in 4th grade, he started telling me that he had a tough time getting his thoughts out verbally (prior to that time he had been struggling tremendously with written expression and we didn't realize that it wasn't all about writing). He also doesn't open his mouth very wide when he talks - and that's something that didn't become obvious until he was a little older.

3) Sensory stuff, knowing when he's hungry, little things that don't seem like much of anything really when you are only looking at them in isolation.. also seem to crop up on lists of DCD symptoms.

More later!

polarbear

Also wanted to mention - although screwing pegs into a board was not a part of any of ds' OT assessment, it's one of the things his OT spent a lot of time having him work on, also things like pushing pins into clay, manipulating theraputty etc. So while he did "ok" on his OT assessment, he also clearly had a lot that the OT felt was worthwhile working on to develop fine motor strength... all very clear as mud, eh?

pbear

I would love to talk more about DCD and odd symptoms (and what to expect in the future)--maybe someone should start a new thread. DS is, strangely, acceptable with swimming. He's now in Level 3 and can swim across the deep end, do a kneeling dive, tread water, do the backstroke acceptably (although he has problems coordinating his arms and legs). He looks reasonable for his age (6), although he'll porbably never be on a competitive swim team. But he at least looks average. But then, if you throw a ball at him it bounces off his chest. LOL. I can't even imagine him in a soccer game or baseball game. So some physical things are definitely more challenging than others.

In terms of apraxia of speech, I do think this is an issue although all of the speech therapists we've seen swear up and down he does NOT have apraxia of speech. He is able to copy sounds and sound patterns, his articulation is now reasonable, most people can understand him. However his speech is SLOW and his prosody and pitch are odd. The speech therapists have NO IDEA how to treat this and they look at me skeptically when I say it's because he is dyspraxic.

In terms of sensory, if anything he is under-sensitive. As a toddler he would fall down an entire flight of steps and get up at the bottom and keep walking like nothing happened. He is a toe-walker on and off and also flaps his arms when he's excited. On the surface he appears like he has ASD just based on some of his mannerisms and I know there is some overlap. I am HOPING that some of this stuff resolves over time. Then I think maybe I should keep trying to get him to specialists who can actually deal with the problems and know what to do.