Gifted Issues Discussion homepage Forums Twice Exceptional Repeated Achievement and Worse

Hi! I've posted before. Short story is DS tested in EG/PG range last year before first grade. He also showed significant discrepancy to achievement on WJ-III ( though all above average). His lowest at the time was spelling and highest was calculation.

CTOPP was all high.

Beery was all average.

We've done a year with OG tutor and OT for handwriting and motor planning. We expected marked improvement!!!

School has assessed language and while we did not meet to review results I received a call saying he is off the charts in all areas and the assessment was a waste of time.

I do not have a dysgraphia or dyspraxia diagnosis but OT is confident there is enough testing data there to support.

We retested with WJ-III this month and things were worse in most areas. The two areas of big gains are reading fluency and spelling (go OG Tutoring!)

His results at bottom. Ed psych says no doubt now...mild to moderate LD . She said she's confident enough to call it stealth dyslexia. The common weakness is in anything with speed or motor graphia. She ask believes visual processing is weak and wants us to check teaming/tracking.
- he was 32% on visual processing Beery
- he cramped after 3 minutes of writing and samples deteriorated quickly.
- he clearly was not using ability while doing it

He is in public school. School thinks LD for him is hogwash and I'm getting bad advice from Ed psych. Laziness and immaturity is all that's wrong here. Because all his scores are average to above I am concerned I will not be able to advocate effectively.

I'm looking for:

1. Advice for securing accommodations for 2e child above grade level in achievement?

2. Advice for how to use technology to help compensate for his deficit in writing.

His scores generally compare to same time last year:

Globally: it is clear he has a mild to moderate learning disability. Anything dealing with graphic motor skills was an issue.
- overall he went from 94% to 95%.
- broad reading was exact same 93%.
- broad math up a point 97% to 98%.
- broad written went down 84% to 78%.


biggest gains in:
-reading fluency. 91-98%
- spelling 73-80%
- applied problem 82-93% (would have been higher but clocks and money issues)
- he had a drop it passage comprehension from 95-86%. Her thought was both implied text stumped him and she felt he is dropping comprehension trying to go for fluency.
- writing samples dropped a ton from 81-66%.
- math fluency dropped from 96-78%!!!!!
- he had to ask to stop the clock and break after three minutes of writing.
- all his writing samples start to deteriate after a bit...capitalization goes away; reversals pop up; some aren't even sentences; and letter formation was bottom to top on a lot.
- good news his confidence and self correction were both up a lot. Very big deal!!!

Sorry for typos on iPhone and must have fat finger tips

So he is going into second, tested EG/PG on IQ, but has lower achievement test scores, which were brought up with tutoring, but not as much as you hoped? And you suspect dysgraphia or stealth dyslexia?

I can't offer advice--just was trying to condense the issues, since you don't have any replies yet.

I would tend to agree with dysgraphia as a working hypothesis. You have a consistent pattern across subtests and time (a year) with regard to written expression: spelling, writing samples, I assume writing fluency, if he had to stop after three minutes to take a break, which made that score technically invalid, but clinically pretty clearly deficient.

Math fluency has dropped, which is also a motor task. This may partly be due to the fact that rising first graders are not expected to know any math facts at all, whereas rising second graders should know addition facts to 18. Consequently, his actual raw score may not be that different, but his normative standing would have fallen, as comparison peers picked up some math skills, while he did not pick up additional motor skills to compensate for the compression of the bell curve in math facts. That is to say, many rising second graders can do basic addition, which is largely what he would be doing on the math fluency subtest, so the ceiling on math skills is pretty low (the test doesn't have enough spread to separate him from his peers on the basis of math skill). This causes the test to become a measure of motor speed, rather than math.

1. Are you in a discrepancy district, or an RTI district? That will make a difference in terms of advocacy. Much easier in a discrepancy district. Another approach in an RTI district would be to argue that there is a failure to progress, as these normative results represent stagnation, or limited progress, in his absolute skills (you'll need to use W scores or raw scores from the WJ for this, which will involve your ed psych again). So his trend line year over year is excessively shallow, which, if it continues, would be projected to result in him eventually falling below normative standards. This would be the basis for instituting interventions for written language, and possibly reading comprehension, even though none of them are currently normative weaknesses.

2. Pretty much all fluency weaknesses have the same intervention: practice, practice, practice. A little every day is much better than a whole lot once a week. Do you have OT recs for increasing hand strength and stability? Get some. (clay, dough, rubber balls, writing with tactile feedback--such as with a finger on sandpaper or in finger paint, or on a chalkboard; writing while propped up on your arms, prostrate on the floor; Handwriting Without Tears, etc.)

Download a free Google or iPhone dictation app and use it to dictate rough drafts or written responses, then (if it's that kind of assignment) go back and edit, revise, or copy by hand. This separates language formulation from fine motor skills.

Accommodations (should you get them) should include supplementary oral assessment, items/problems sufficient to demonstrate mastery only (reduced workload), extended time, and no penalties for misspellings, unless the focus of instruction is spelling.

Hi. I am sorry I do not have a lot of time to post, but wanted to quickly help if I could. My son has dysgraphia as well as a dyspraxia diagnosis. He is also gifted. It doesn't really matter how much you "practice" or how much OT you get, when you have dysgraphia it just doesn't go away and you continue to fall behind until you get to show knowledge without having to do it through handwriting. Accommodations should include scribing and oral answers, ASAP. My son had to have a scribe. He does great now. He gets OT during which he is taught typing, the plan is that he will eventually type and use other assistive technology and he will not longer need a scribe. If your son has dysgraphia he will need a scribe and I would look into him keyboarding when he can and being taught typing. Sorry to say that it has been my experience that repeated "practice" only gets a kid with dysgraphia depressed, anxious and a very poor self-image.

Re No. 1, IN my state the courts have held specifically that above grade level achievement is not a reason for denying a child with an LD services. You just have to prove the LD. Where are you? I am in PA. Pursue the diagnosis. Get them in writing clearly. I got my son's privately (a neuropsych and a neurologist) and through school. School was tricker. When I first requested he be tested for dyslexia and dysgraphia they gave him IQ tests, achievement and a bunch of ADHD rating scales. Nothing was accomplished. Then I got smart. I made them give him very specific tests for writing (I can list them for you). I was very specific and I refused to give consent for rating scales, etc. I insisted they focus on writing and specific tests disorder of written expression. It worked, the results were undeniable. This kid despite a high IQ can not write. I got the Dx privately as well.

Re NO.2, I am getting my son a private "assistive technology eval" to answer this very question. I requested one from the school as well. Not sure how good the school's will be but that is why I am getting the private. I will share what I find out but I would encourage you to do the same. For now, DS gets scribes and gets to keyboard (his choice).

I hope to have more time to help you tomorrow! Do a search on dysgraphia here - it'll help you a lot!

Good instruments for dysgraphia and disorders of written expression include the TOWL-4 and the PAL-II. For younger kids with fluency/motor issues, I would lean toward the PAL-II, as it has measures of fluency and automaticity. (The PAL is only normed through elementary school, so you can't use it with older kids.)

OT and practice will not make dysgraphia go away, but it might remediate enough to provide better access to some handwritten tasks. The question of emotional impact will vary depending on the child, the clinician, the severity of the disability, and the strength of the compensatory mechanisms. You know your child best.

Depending on the nature of the fine motor, visual, or perceptual weaknesses (and although the Beery is technically in the Average range, it is apparent that something is going on from the extreme fatigue when writing), other accommodations might involve decluttering or organizing visual materials, e.g., by reducing the number of items on a page, using visual frames and guides, providing large square paper for math (to help line up numbers for accurate computation).

N., although you've titled this "repeated achievement and worse"... truthfully, I think you've seen great improvements, and the improvements correlate to the extra work your ds has had with OG tutoring. So that's all *really* really good.


Although these "drops" seem frustrating, I like to keep in mind what the WJ-III Tests of Achievement are and why they are used. Each subtest looks at one very isolated skill, and what you get from giving the range of subtests is a broad overview of where your child is at relative to same-age or same-grade peers. It is different from the types of achievement tests that are helpful in assessing where your child is at relative to your school's curriculum and - perhaps more importantly for a child who has any type of LD or challenge - they are typically given without accommodations - so a relatively low score *might* indicate an area that your child is weak in re the actual skill - or it might indicate that another challenge such as poor fine motor, vision, whatever - is impacting your child's ability to either show or learn that skill - and that's *good* information. The trick is to look at the tests in detail, correlate that with that with what you know about your ds, and then put it all together to understand why the scores are what they are. For my dysgraphic ds, it is *very* helpful to group the subtest results together according to response *type* - when you do that, the subtests that require oral response fall in the range of his ability level, the subtests that require handwritten responses fall about 30%iles lower, and the subtests that require handwritten responses and are timed fall another 20%th percentile or so lower. When you look at the list of subtest scores without that type of context (whatever the correlation may be), the scores just look wild and scattered - but thinking through what a students challenges might be and looking at how each subtest is administered as well as looking at what it is measuring, then grouping the subtests accordingly, can help the scatter make sense.


This is the mathematician in me speaking, but I wouldn't put much thought into analyzing or worrying over these broad scores. First, they aren't terribly statistically different across any one group (even the broad written). Broad math and broad reading could be something as simple as statistical range of error. More importantly, broad scores are averages - you'll get more info by focusing on the individual subtest results.


It does seem that there is more than enough reason to suspect either diagnosis, and there are a lot of good reasons to seek a diagnosis. You've also had a good series of tests - both earlier and again now after OG tutoring. It doesn't look like you've had a thorough reading assessment (but I could be wrong about that - maybe it's just not something that you've listed here). I'm not sure what the difference is, in this instance of an "ed psych" vs a neurospsych in terms of the type of eval, but it seems that you've gotten most of the tests my children had in their neuropsych evals. What you don't have is a diagnosis... and it's not clear to me if that's because the psych feels the diagnosis is not supported or not clear, or if you haven't seen a psych who can make a diagnosis (?). DId the ed psych give you any kind of DSM diagnosis? (comes with a code!).

Having the actual DSM diagnosis can be very helpful - this isn't the same thing as saying a student has stealth dyslexia, it's a very specific diagnosis defined in the DSM (hence it has credibility when advocating). OTOH, the DSM has specific sets of requirements for any given diagnosis, and it's possible your ds might not fit any one diagnosis but is still struggling. Anyway, I'm not sure if this is making sense, but my dysgraphic ds, for instance is diagnosed with Developmental Coordination Disorder and had an earlier diagnosis of Disorder of Written Expression. He's dysgraphic, but that's not what schools and/or the psych refer to - they refer to the DSM diagnoses.

Just occurred to me - was the "ed psych" private or through the school? Psychs through the schools do not typically diagnose via DSM but instead look for indications of LDs. It's all basically the same issue, just different terminology to fit the situation. I'm totally not explaining this very well (aeh is probably having a good belly laugh right now over a parent blundering through trying to explain it all lol!).


This is an area where it feels like your ed psych eval fell just short of what you need to tease out to understand what's really up - and you need to understand this in order to appropriately remediate or accommodate and know which you need to do. You've got indications that something is up - could be vision, could be fine motor, could be both - but it's all just "could be" at this point without more info. 32% on visual processing definitely sounds like a potential issue with how the eyes are working together and communicating with the brain. If you haven't had a *regular* eye checkup lately, I'd do that first, and if that's all ok (eyesight is fine and/or corrected adequately with lenses), then I'd get a Developmental Optometrist eval (assesses how well eyes work together to produce adequate vision).

Cramping wrist/hand is not unusual in dysgraphic kids - but it doesn't necessarily indicate fine motor challenges - it probably means he's holding the pencil too tight, which could be from a grip that's incorrect or it could be from frustration at the difficulty of forming letters etc. So I have no idea what's up with your ds, but suspect it could happen from just the response to difficulty with vision if that's the issue or it could be related to fine motor dysgraphia.

The reversals, wrist cramping, etc - all of that was present in our ds who has fine motor dysgraphia as well as in our dd who does *not* have dysgraphia but who had an undiagnosed vision disorder. These all disappeared for dd after her vision issues were remediated through vision therapy. DS' hand pain while writing was eliminated through OT - but - here's the gotcha - it has returned a few years after OT. Dysgraphia is not going to be fully "cured" or remediated - more on that later. If it's a vision issue, it *might* be something that can be fully reversed through remediation and accommodations (lenses etc). That's why it's so important to have an accurate diagnosis and understanding of what the challenge really is - so you don't put time and effort and money into something that's not going to help, and so that you don't miss opportunities to remediate/accommodate when you can.

I would look for additional clues as well as additional testing:

To determine if there is a fine motor dysgraphia issue: what does your ds' posture look like while handwriting? Does he hold his wrist or shift as if he's not comfortable? Is his pencil pressure on the paper uneven? Does he have an unusual pencil grip?

Signs of a potential vision issue: Does your ds hold his head or eyes at an odd position while writing? (My dd used to bend her head to the side or lay it on the table while writing). Does he stop and rub his eyes frequently while writing or reading? Has he struggled with learning to read as well as having writing quirks/struggles? When you are talking to him, does he look at you and make eye contact or does he look off to the side?

Some things you can do at home that are helpful in determining if it's dysgraphia:

Have your ds print the alphabet from A to Z, caps and lower case. Time how long it takes him to do this task and also watch while he does it. Does he form his letters consistently, does he have to stop to think to write letters, are any reversed? Does he make all the caps and lower case letters correctly? When he's done, calculate the number of letters per minute he wrote, then google "letters per minute + (whatever) grade" to get reference ranges for what is a typical handwriting speed at his grade level. Is it reasonably in range and did his letter formation look ok, or does he have errors in formation, did he pause and seem to have to think to form letters, and is his speed slow compared to grade level?

Collect and look at samples of your ds' handwriting from school and at home, current and from past years. Is his handwriting improving or stagnating? Are his papers neat or crumpled? Does he have reversals, lots of eraser marks, uneven spacing or size of letters, does he use the capitalization and punctuation skills that are expected for his grade level, does he run into the edge of the page while writing etc?

Give your ds two writing "assignments" at home - make them similar but not exactly the same thing. Have him complete one using handwriting, and one by telling you while you scribe. Compare the difference in output (number of words plus depth, detail, complexity of thought etc). There will probably be a slightly better story "written" by scribing for most kids at his age, but if there is a marked difference, that is a very strong indication of dysgraphia.

Observe how your ds acts when he has a writing assignment - does he try to avoid it, fight it, get upset? Does he sit and stare at it or start working on it right away? If he has hesitation or stress over writing, is it just "writing" (Language Arts) types of assignments, or does he have the same stress over completing math etc type of assignments when handwriting is part of the work?


Re school - some school districts and some schools (this has been my experience - it is absolutely not the same everywhere, but it *is* something to be aware of) - will give you pushback no matter how badly your child might need services or how obviously he will qualify. At one point in time, friends of mine here who work with and see many different students with different needs in their classrooms here in my district have told me quite honestly that to get the services the students need (and are legally entitled to) the parents have to go the route of suing the school district. We face a *lot* of in-your-face pushback from our ds' school staff when we advocated for IEP eligibility after his diagnosis, and when he was clearly struggling in school with written expression. It's easy when your child is working above grade level to listen to a school staff member say something like "he won't qualify because he's working on or above grade level" but you have to just listen and then ignore and move forward. That is *not* correct - and it's important to just keep the conversation focused on what your ds' challenges are and what he needs and what your goals are that you want the school to provide - and all the while be very aware of what your ds' legal rights are and what the school is required to provide.

SO - if your school is telling you "LD is hogwash" (in whatever words they choose to use), you listen, and then you submit a written request for an IEP eligibility review (if you are seeking individualized instruction) or a 504 planning meeting (if you are seeking accommodations only). The school is required by law to respond within a certain time frame - their is a time frame set by the Federal Govt. but there are also shorter time frames in some areas set by either the state or the local school district. Gather your data together, and be prepared to advocate. They have to at least hold a team meeting, and if they refuse to do that they have to give you a written reason explaining why. Every time you run into a road block, you think it through, and you write another request or summary or whatever to explain what you disagree with and what you request next. Does that make sense? It will take work, but you don't have to stop at the start by hearing the "hogwash" type comments and assuming you'll never be successful at getting help through the school. Just keep plugging away, and make all your requests in writing, and document all conversations in writing.


We had our school staff attempt to dissuade us from seeking help for our ds by talking down our neuropsych's advice and report. When you get these types of comments from the school staff, reply simply and concisely "Are you questioning the opinion of a respected local professional?" That puts the onus on the person making the comment to explain why they do not agree with specifics, and in turn gives you something you can address directly. It is also a comment that 99.9999% of the time immediately shut down that line of attack from the school in the team meetings we had.

The only caveat I'd add is - be sure the ed psych who tested your ds has credibility. If there's any reason for the school *not* to trust the credibility of the psych, then that's a reason to consider further testing, in addition to getting a defined diagnosis.

Best wishes,

polarbear

I'd second the suggestion to search the threads here for "dysgraphia" - both for advice on accommodations and assistive technology.

Success for both will depend on successful advocacy, and from what you've written, I think the key thing you need first is a better understanding of what the real issue is - vision, fine motor, both. It's hard to know from what you've written if you need more info on reading skills too but that's something else to consider - do you know for sure what the challenge was that the OG targeted, and have you attempted to determine if that specific challenge has been helped through the tutoring.

Once you know for sure what the challenges are - clearly - then you need to think through what your goals are - are you seeking extra educational (instructional, remediation) help or are you seeking accommodations only? That will help you determine whether or not you request an IEP eligibility review or a 504 planning meeting.

Next gather all your data, evidence, work samples etc. Also research your district policy and read up on wrightslaw etc - anything you can find to make sure you understand your rights as a parent and your ds' rights as a student. Collect any articles or research or advice from professionals that is relevant to your child's rights and to your child's diagnoses and needs - to prepare to meet with the school team.

Then you make your written request to the school (for either an IEP eligibility meeting or a 504 planning meeting).

Re assistive technology - we approached this in three directions. I definitely did a lot of research and reading online and it was very helpful. I also located a non-profit organization in our city that specifically helps people with disabilities learn about and try AT, which was also very helpful. Lastly, we advocated for and received an AT eval through the school, but in our situation that was a very difficult and prolonged process (just to get the approval for the eval) and it became evident quickly that the we were getting more thorough and up-to-date info from the non-profit and online research. That didn't mean the school eval wasn't worth doing - it was a necessary step if we'd hoped to have any of ds' AT funded through the school, and we did receive useful input, just not as much as we received elsewhere. So - moral of the AT story (and maybe all advocacy stories) is to spread your net wide and try to research as many sources as possible.

I apologize because that wasn't very *specific* advice - but each child is different and each situation is different. What works for my now-high-school student who relies on an iPad for all writing tasks might not work for your ds in early elementary who may or may not have the same challenges. Even if they have identical challenges and needs, the solutions we used for my ds at your ds' age are probably very different than the solutions you'll choose simply because the term "tablet" had nothing to do with computer technology when my ds was first diagnosed with dysgraphia Definitely ask here though, and dig through the past threads here - just spending time reading other people's stories helped me a *ton* in figuring out what to do re AT and my ds.

And... having a strong neuropsych report helped too. Our neuropsych gave us a very straightforward "this is what you need to do to support your ds" plan when he was diagnosed - we were told to remediate handwriting to the extent it was possible (and then leave it behind), scribe for him at school starting immediately, get him through one round of OT to get whatever benefits we could (it did improve his posture, gave him an ok pencil grip and improved legibility), teach him to keyboard, and that ultimately he would most likely rely on voice recognition. We didn't get into the nitty gritty details of software or devices (although the neuropsych did have advice on all of that) but the important thing was it was a PLAN forward that helped us know what his future would look like. It was also a series of steps, so we didn't feel like we had to solve it all at once - we started with step A moved on to step B etc, adjusting and flexing along the way. So try to keep it in perspective - read what you can about AT, but start with the diagnosis and understanding what really needs to be addressed.

Sorry for my very long-winded reply - hopefully it's helpful!

polarbear

I'd also add to aeh's observation that it's important to be sure that you don't get snagged by the "average range" concept - there are all sorts of potential gotchas with "average":

1) The Beery contains two types of tests to assess two different types of skills. Your child might have similar range but average scores on both subtests and those would average out to "average" or your child might have an above-average score on one test and a below-average score on the other and still average out to "average".

2) "Average" (as I've heard it referred to by school/etc) usually refers to anything between 80 - 120 Standard Score for a test with a normal distribution and a mean of 100 and SD of 15 which I think is how the Beery is scored, and kids can absolutely struggle and still have a Beery score down there in the lower end of average. OTOH, just to throw out a reference point - my dsygraphic's fine motor Beery subtest was down in the 20th percentiles, and my dd with the vision challenge scored lower than 1st percentile. Their scores are completely irrelevant of your ds' scores, I just threw those out there as examples of how widely scores can diverge, and you might be running into the expectation that they have to be that low to be meaningful.

polarbear