Gifted Issues Discussion homepage Forums Identification, Testing & Assessment Can speech/hearing eval catch dyslexia?

We still have concerns about DD8 reversing letters, flip-flopping letters within words, not capitalizing beginning of sentences, words not sitting on the lines, etc. For having such a high IQ and huge memory, she does some strange things. The other day she very seriously asked me if cheese had a z or an s. She knows the word cheese very well (one of her fav foods) and has seen and spelled the word a gazillion times. Then I caught her spelling family like this - faimly. I asked her to sound that out and she had a moment where you could tell she was thinking "oh yea, I've been told that before and I've got to remember the order of that one". She said she has always spelled it that way. It was like she was putting the order of the letters into her memory with all the other words she has memorized. I can see this being possible since she topped out the memory portion of her testing, so we know she has the ability to do this. This would also mean she would be able to hide this problem for a few more years until it really rears it's head.

I was researching options for a neuropsych eval since that seems to be the thing to use to tease out what may be going on that hasn't been discovered yet. So far I've found that to even get on a schedule we have to prove "medical necessity" and those schedules are into August already. I did finally get a code to check with my insurance and a guess-timate on fees if we paid ourselves ($1200).

While I was looking into neuropsych evals I found out our insurance might cover a speech/hearing evaluation and one of our state hospitals can do the eval (and they are a provider for our insurance). They told me that their eval could determine if there are certain issues like dyslexia (not sure about dysgraphia). They wouldn't be able to give us an actual diagnosis, but it would be a provisional diagnosis and a baseline. Has anyone gone this route and actually received the results they were looking for?

My DD19, had speech and language issues and saw a speech and language specialist from 2 year till she was 7. We used the fact that she was already getting tested for her speech & language to have the school test for her LD in 2nd grade. The school psychologist was the one who did these tests rather than the speech therapist. And it wasn't till I went to an outside specialist did we got the detailed information that ended up helping.

I suppose it's possible the speech & language therapist could give you a baseline. I do remember having the WISC administered quite young by the speech therapist. I'm just not sure this is really worth it unless having the speech therapist eval is enough to convince school to do the rest of the eval. Otherwise you will find yourself testing twice.

As to the spelling issues? I am a horrible speller and this sounds like exactly what I would do. I still to this day can't spell scissors without the help of the spell checker. And I am horrible about pronouncing words. I have always attributed this to my being a whole word reader, I taught myself to read very young and no one worried about a problem since I always read way above grade level. It never occurred to me that it could be a form of dyslexia but I suppose it's likely.

I always dread sentences that begin that way.

To the basic question, we face a very similar thing with DS8. He was a early whole word reader, but he seems to have a problem dissecting words in his head into letter pieces as well as forming consistent letters in a given space on lines and judging space needed. We've held off to see if having had his amblyopia (vision issue) corrected plus time would have it self-correct. But no luck and it is slowly becoming a barrier.

The best lead we have is for an occupational therapist test for issues related to handwriting. Hopefully we can get a pediatrician referral to leverage insurance.

Despite other flexibilities at school, this is definitely one "palm to the head" thing as I'd think an occupational therapist should be available for writing+spelling challenges despite giftedness. If he pronounced F as S, he probably would get in school therapy every week.

My recommendation is to make a firm appointment with the neuropsych, no matter how far out, and then ask that they put your dd on a waiting list to call in case of a cancellation. My gut feeling is that the speech/hearing eval might give you some helpful information, but you'd still be left with more questions.

Our youngest dd struggled with reading when she started school - she still does some of the things you've mentioned above. When we realized she needed an eval, we'd already been through neuropsych evals for my older two children (one 2e, one who we found out had vision issues) and to be honest, I didn't feel like paying the $ and going through an eval again with the same provider. So I opted for taking dd to a former school district sped employee who does educational testing for our local homeschooling community. She was able to give dd a full set of ability/achievement testing and a dyslexia screen for much less $ than the neuropsych eval and we came away from the testing with a good idea of the specific skill that was a challenge for dd, a long list of recommendations for accommodations and a plan to remediate reading skills. We didn't, however, have a diagnosis or a long-term plan or any of the typical follow-up testing that a neuropsych provides to determine the root cause of the challenge. And that was ok for dd - for about a year... and then we were back to the drawing board once more, needing more of an idea of what was really going on as well as documentation we could take to school that could be used for advocating. We did another round of testing with a reading specialist who was *terrific* - she gave dd just about every type of reading test under the sun and again verified both that dd's challenge was what the original tester had found, and also gave us a detailed game plan for remediation. That was all good - and still is - dd has worked with a tutor through this reading specialist for awhile and is making wonderful progress - which is great! But... once we had that reading eval, we started wondering and needing to know - how is the skill deficit that's impacting dd's reading also impacting other areas of academics or life skills? So... we did eventually end up taking dd in for neuropsych testing. Which is my round-about long way of saying - don't try to piece-meal testing here and there to get a little bit of info where you can to save time or $. The neuropsych testing (for us) has been worth both wait time and $. Once it's done, the neuropsych may in fact send you back for testing by an SLP or whoever, or if you want to do both, you could go ahead and have the SLP testing now and you'll have the results to share with the neuropsych. The thing I wouldn't do is to drop the neuropsych.

polarbear

ps - their is one scenario in which I'd consider dropping the neuropsych - if you want to test through your school district. They should do this if you request it, but we had a difficult time advocating to have our ds evaluated simply due to his high achievement that was related to high ability. We weren't able to successfully advocate for school district testing until *after* we already had testing and a report from the private neuropsych. The neuropsych testing gave us the data to show the school to prove that ds did indeed have a challenge.

p.s. It hasn't come up in a thread in a while; so, I'll mention the book Dyslexic Advantage as giving a great perspective. Dyslexia or not, they put together a clear picture of the sort of "big picture" mind that is tripped up on details like fine motor memory, spelling, phonetics, etc. It makes some rather seemingly disconnected issues aggregate nicely as well as wondering if it isn't such a bad trade-off.

This is something that is a very real issue in our school district too - and it impacts children who aren't necessarily gifted. It gets really convoluted here. To qualify for speech therapy you essentially *have* to have articulation impacted (I'm sorry I am not sure what the technical term is) - but children who have physical challenges forming correct sounds can get speech therapy through the school district and they typically get identified and referred by teachers and school personnel. Children who have expressive language challenges but can articulate ok - first don't get identified, and even if they are identified, they can't very rarely can qualify due to the way the guidelines for qualifying are written. The second gotcha here is students who need OT - the way our guidelines are written, you have to *first* qualify for SLP services before you qualify for OT.

Then the key "gotcha" - that is all written out as policy - but you *can* get past the "policy" issue by successfully advocating through the eligibility process - but it takes a parent who has a ton of time, energy, and savvy to figure out how to get there.

Sorry for the rant... it is just something that frustrates me as a parent, not so much for my own child any more, but for the students who are most likely going through school without having anyone realize they need help - when just a small amount of help could probably turn their world around.

Off my soapbox now!

pbear

bluemagic - DD8 was reading around the age of 4 and she also is very advanced and well above grade level, so no one is worried about these things but me (and DH). I'm just waiting on either someone to tell me what is going on or for this issue to become a real problem, enough for someone else to step in and say something. I would really like to figure it out before it becomes a problem.

When she had her psycho-educational testing done we asked them to specifically look into dyslexia and dysgraphia. Their results were that she has a very high IQ and huge memory, but they didn't see any major signs of dyslexia or dysgraphia that they were concerned about. They did note a few minor things they witnessed like she spelled a couple words wrong and mispronounced a word while reading. They readily explained these things away as words well above her level and tricky phonics. We also had her do some further testing and they too told us she is very advanced. The only problems they found were phonemic issues that could be explained away by her poor hearing due to fluid in the ears. Another thing we would hope a speech/hearing eval might tell us is if these phonemic issues they found are temporary or more permanent due to years of ear infections and tympanostomy tubes. Maybe her hearing explains more than we think. Could her ear infections be the cause of her not hearing the words sounded out correctly and therefore she didn't get the right phonics of the words in the first place and that is causing her to have issues spelling, etc? This might explain some of the issues, but not sure that would explain why she constantly forgets to put a capital at the beginning of a sentence. Something new to think about and talk to the doctor about!




Please don't take these words the wrong way - I know how they sound and I heard it myself when I typed it. I'm just trying to figure out if there is something more going on that we haven't pinpointed yet. When an exceptionally bright kiddo with through the roof memory can't recall how to spell cheese and family and that every sentence starts with a capital, then what is the reason? In fact that memory may be what is holding things together and masking a real problem.

One of the things on our list is a comprehensive eye exam from a vision center that does visual development testing, dyslexia testing, cognitive processing testing, and educational consulting services as part of their exam. Maybe it is her hearing and her vision causing her issues (all wrapped up in a pretty bow)!

polarbear - I've hemmed and hawed about the neuropsych testing for a while now. I think you may be absolutely right about us trying to piece together an answer by doing all these different evals and assessments. I just can't wrap my head around spending all that money and then what if we don't get any answers.

We've done IQ testing (KABC-II), achievement testing (KTEA), a couple forms of reading/writing assessments (TOWRE-2, GORT), ADD/ADHD scales plus the TOVA and the BASC, Wechsler Nonverbal Scale of Ability (WNV), and the school's STAR, MAP, DIBELS, etc. What more will a neuropsych give us?

The other issue I think I'm having is every single hospital, etc. that I contacted to ask about neuropsych testing acted like I was crazy wanting to get information when my child hasn't had any head trauma or injury. When I tried to explain what we were wanting the testing for I got put on hold while they checked to see if they would even do that. It was like they had never heard of someone getting a neuropsych eval for anything other than "medical necessity". I heard that phrase repeatedly! So I'd ask if they could recommend some place else to try and I got the same response from each place. I told them I understood that my insurance would probably not pay since it wasn't a medical necessity, but I still wanted some information about what their testing involved and how much it would cost us out of pocket. I tried to assure them that it has been done before and that it was my understanding that this is probably exactly what we need to tease out anything that we have missed so far. It was very frustrating!!!!

Reading these stories makes me feel really good about our school system. DS5 was evaluated and found to have a developmental delay in the social/emotional area, so he has a special ed teacher working with him in class and at recess 3 times a week to work on that. But he also has the SLP working with him on summarizing, because she noticed in her testing that he was consistently unable to summarize material of more than a sentence or two. He didn't qualify for services by "failing" any test, but she felt that the difficulty was significant and remediable, so she wanted to work with him to fix it.

frugalmom, have you looked for an independent tester, instead of through a hospital? It wouldn't surprise me much if the hospital ones really do only see head-injury cases.

I tried some "learning disorder" centers, a community health center, several mental health centers, 2 state colleges, and 2 dyslexic centers besides some hospitals in my state and a neighboring state. I can't find any individual psych on any website, etc. to even try that is within probably 500 miles. I'm in the middle of nowhere I guess when it comes to options.

It sounds like you have a good situation - count your lucky stars!!!!!