Gifted Issues Discussion homepage Forums Identification, Testing & Assessment what tools to assess dysgraphia?

Ok. I'm ready to try and deal with this again. I need to get my son 7 evaluated for dysgraphia and get some help with this! I suspect that he has slow processing speed and dysgraphia. He is homeschooled now. I contacted the special ed coordinator at his school, but did not hear back yet. I assume they can do a decent evaluation for this? (I hope)
What instruments would work to diagnose these problems in a gifted kid? When he was attending that school they did not address his giftedness well, nor recognize a specific writing problem. They only saw that he "didn't do his work".

If they do not do do a decent job of testing where should I look? I live in Madison Wisconsin and we could scrape together a few hundred dollars for testing if we need to.

I am the only one who really sees that this is something more than just him needing to practice. (Because I am the one teaching him most of the time!) I am feeling demoralized about it right now because my husband thinks maybe we should put him back in school. I don't see any reason to think that the school will do a much better job with him this year than last year. A less poor job maybe...

Anyway, what tools should I be looking for them to use?

I tried searching the forum, but my device is buggy and I can't find what Iam looking for. Oops, maybe I should have put this in the 2e forum... ah well, I hope you guys see it here.

I will be keeping an eye on this. My son will be undergoing further testing and this is one of the things I want him tested for.

LRS, there are a few things I'd do:

1) First, write down a list of all the reasons you suspect there is a challenge and all the things related to academics that you see as frustrating for your ds. Also list behaviors such as work refusal etc.

2) You have a gut feeling something is up with handwriting, so I would do a few tests at home just to have as data: measure his letter-writing speed - have him write the alphabet, upper and lower case, and time how long it takes him to finish it. Save the sample - note if there are any reversals or if he struggled to think through how to form any of the letters, or if the letters are sloppy or difficult to read etc. Calculate the # of letters per minute he wrote, and then google "letters per minute + (his age in years)" or "letters per minute + (his grade)". Compare his rate to the ranges of typical rates you find online. Is it in range for his age/grade or is it slow?

3) Gather recent handwriting samples from his classwork. Look for indications of dysgraphia - uneven spacing, issues with upper vs lower case, issues with caps, issues with spelling etc.

4) Watch him while he writes and make notes of things such as - does he form his letters the same way each time? Is he starting them at the top? Does he have to stop to think and remember how to form letters? Does he hold his wrist or elbow while writing? Does he have an unusual pencil grip?

5) Give him two or three writing assignments at home - each similar but not the same. Have him complete one using handwriting, one using keyboarding, and one using scribing. Time how long it takes him to complete each, or give him a time limit of five minutes - the idea is to see differences in both quantity of words/ideas that he writes using different forms of output, as well as differences in complexity of thought, details in descriptions, etc.

Put all of this together and make your request through the school for an eval - that's where I'd start if $ are a factor. I would also ask my ped, because we've had good advice from our ped re knowing whether or not the school district would be helpful and also re referrals for private evals. If your insurance will cover a private neuropsych eval I'd recommend that as another good starting point.

This is just based on my one family's experience, but based on that.... I believe it's better to start by requesting/seeking a "broad" eval - rather than going into the evals thinking "I think it's dysgraphia so how do we test for that" - look at it as "My ds is having issue x,y,z. I'd like to see how that relates to his overall academic functioning." I'm SO not stating this clearly - but the general idea is - you want a broad look, not a narrow-filter on where/what you look at. It's possible it's dysgraphia, but it could be that what you are seeing are symptoms of something else entirely. That's happened to us with 2 of our children - I was convinced I knew what was up with each, and I was way (WAY) off both times!

For a school eval, you'll want to request cognitive + achievement testing, possibly visual-motor integration, and an OT eval (for fine motor). I would also request a TOWL (Test of Written Language). Neuropsychologists will typically offer a few more neuropsychlogocial tests to help tease out details re diagnoses.

I have found private neuropsych testing to be an advantage over school testing (in *my* district - other districts may have very different circumstances!) - the things that have made private testing worth the extra $ (to me) were:

1) The neuropsych eval includes an in-depth parent interview and a detailed development history. These were *not* included in our school evals.

2) The school district has very low cutoffs for qualifying - i.e., tough to fall under, especially for HG/+ students, plus there are "rules" for qualifying that involve looking at and reporting only broad averages or generalizations for testing that can mean your child might have struggled tremendously with one speciic tie of skill, but you'll never see that one low score unless you know to ask for it (please note - this is my district and my experience - I'm not saying that every school district is like this!).

2) It's been very easy for us to schedule follow-up discussions with our neuropsych and easy to ask *any* question we have and the neuropsych will try their best to answer. School psychs don't offer the same type of access or an in-depth analysis of results (in our district).

3) In our school district, to get an answer we had to first ask the question. You won't always know what questions to ask. The neuropsych has no bias, no concerns about impact of identifying your child etc - it's easy to ask the neuropsych questions.

4) In our school district, school psychs seem to transfer in and out every 1-2 years... so you aren't following up with the same psych who initially evaluated your child when you run into questions as your child gets older and encounters new challenges at school.

5) School is just dealing with academics. Private neuropsychologists look at your child's full *life* - not just school. It's quite possible that a child who is having challenges with handwriting might be struggling with other types of tasks that don't involve handwriting specifically. You might not notice or put them together - that's what a neuropsych can do. The neuropsych can also give you recommendations for providers for follow-up evals (speech, OT, etc).

The last thing I'd add is - make your calls now. Don't hesitate. Go with your gut feeling - if something is up, you'll be glad you didn't wait to act on you hunch.

Best wishes,

polarbear

Polar bear Thank You! I feel more motivated already! I just needed to know what to do!

I get your bit about being open ended about what the problems are. Just document and describe the issues, not go in looking for a particular diagnosis. Got it.
I appreciate that you spelled out for me what I can do to gather information and document the actual issues. Very good ideas! I am going to do each step you suggest!
He does randomly use upper and lower case and often forms letters from the bottom up (mostly) the use of space on paper is bad and makes it less legible. He makes weird pained expressions when he writes, reverses the letter S often. His griplooks ok to me. He finally will draw a bit. He used to refuse. It looks like kindergarten drawings, and not good ones at that.
This from the kid who just finished the first Harry Potter book and has good comprehension. He reads obsessively. He does math in his head because he won't write it. There is a limit to that though!

I was told by a writing specialist who my DS7 is working with that there isn't a nationally normed assessment for dsygraphia (to her knowledge) but it is more of a behavioral observation diagnosis. For about a year after learning about dysgraphia, I have suspected that my DS has dsygraphia. The neuropsych who did a full evaluation diagnosed him with DCD, but he did not feel that he could make a dsygraphia diagnosis based on his time with my son. It has been the writing specialist who sees my son twice a week "in action" who has told us she believes he shows the characteristics of dsygraphia.

polabear makes a very good point about doing a full evaluation rather than looking for a specific disorder as your DC's difficulties may be caused by a number of issues, not just dsygraphia (as is with my DS). Also, based on my experience, you may need someone who works more closely with your DC on a regular basis who can make this sort of diagnosis for you rather than a neuropsych.

One other piece of advice that I have learned just in the last couple of weeks about my DS through this writing specialist is that accommodating dsygraphia can be a tricky thing. She feels that he may have been given too many accommodations this past school year which has lead him to believe that he can't do the work at all without help and thus he resists doing any writing at all. He doesn't have belief in himself, which he freely tells me. She absolutely gets that it is a tough thing for him and something he struggles with. However I fully agree with her after seeing her work with him that he is capable of more than he was doing. We are working to find that line for him where it is just the right amount of help.

Argh. I just had a whole post disappear!

Everything polarbear said, and,

Consider the PAL-2 writing fluency and accuracy subtests. Handwriting Evaluation Scale (optional holistically-scored legibility scale from the WJ-III, uses the product of the writing samples subtest).

Put plenty of detail about your exact concerns--needs, skills, behaviors--in your request letter, and ask for a call from the evaluator. Sometimes it's helpful (though admittedly I find this annoying myself when I get one) to get a note from the pedie with a list of example assessments. When the consent form arrives, you can add other assessments, like home assessment/developmental history, OT, PT, SLP, if you're not satisfied with what they've checked off. Ask for a call from the evaluator right on the consent form, which may be the only document they get to see. Wait a few days after returning the signed consent, and call and ask for the name, number, and email of the evaluator to whom it's been assigned.

While districts differ, of course, in every system I've worked, this would get me a call or note from the director, requesting that I contact the family prior to testing.

LRS, I mentioned a lot of things to look for, but that doesn't mean that each of them has to be occurring for dysgraphia to be an issue. I don't have a link I can recall at the moment, but if you google around you'll see there are different presentations/types of dysgraphia - one might involve a spelling challenge, or instance, while another doesn't. It's also important to separate the skills of drawing from handwriting - when you are drawing, you are creating objects rather than relying on automatic memory to be able to draw them, and your pencil also doesn't leave the paper anywhere near as often as it does with handwriting. Some dysgraphics (including my ds) can be quite talented at drawing.

Everything you've listed sounds a lot like dysgraphia. One additional thing you can add to your list is to ask your ds to describe his difficulties with handwriting, or you can ask him some very specific questions, such as "does your wrist hurt when you write".

polarbear

Here's the catch-22 though - if you'd started with the writing specialist, you wouldn't be aware of the DCD, would you? I'm not asking about this to be picking, just pointing out how difficult and complicated challenges like this can be to understand. My ds' diagnosis is actually DCD, with dysgraphia as a component of the DCD. DCD presents in many different forms, and I only really have my ds' experience to draw from, but the DCD impacts him in other areas of his life - and had I started with simply a writing specialist, he/she would not have seen outside the writing frame - which means we might not be seeing other impacts of DCD for what they really are - so many of the symptoms can be misinterpreted as laziness, lack of focus etc.


I also agree that finding the right place where accommodations are needed vs further work with learning is a very tricky thing - otoh, I think the "trick" is more in not letting ourselves press too hard in the direction of not accommodating. We all want our kids to learn how to use handwriting, and they will need some very basic skills with handwriting (how to sign their name, for instance). But it's really hard as a parent to notice at what point too *much* effort is going into learning letters and producing handwriting. For instance, my ds spent two years working on learning cursive handwriting at school, and yes, he learned how to write in cursive - but once it was no longer practiced daily in school (as in, no direct lessons for how to form each letter) - he forgot how to do it. The whole issue with dysgraphia is the lack of development of automaticity. Yes, they can learn to use handwriting - but it takes a *lot* longer and requires a lot more effort than it does for neurotypical kids. And when they are using handwriting, the act of using it takes up a significantly larger portion of working memory than is required for a neurotypical person, hence they are at a disadvantage in being able to do things like spell correctly, use correct grammar, and add detail and complexity to their writing.

Another tough wall that parents run into, not just with dysgraphia but with other LDs etc is - at some point, the effort put into remediating becomes so time-consuming that it takes away from the benefits of letting the child spend that same time pursuing their passions and things in their areas of strength. I've found this to be a really difficult line to walk - where do you push, where do you just drop something - but in the end, to be quite honest, with my two 2e kiddos, the answer was to push remediation as much as possible in early elementary but then let it go and focus on strengths.

Best wishes,

polarbear

Polarbear-
Thank you. Sincerely.
I knew you would reply

Thank you aeh too.
I have created a file folder and noted all advice. My son was diagnosed with aspergers at 3,and had been in therapy for years. Most people thought he was fine and loved to tell me so. Lots of work. Doing well. School screws up horribly. Lots of regression. Fights with insurance company.
Homeschooling. (That's my summary)

Now... We are moving on to thenext stage. I don't care what anyone calls it : gifted asynchronicities, aspergers, autism, splinter skills, dysgraphia, processing, expressive language delay, introversion, hypersensitivity....
I just want to do my best to help my unusual child grow and prosper.

Goodness gracious. My second appears to be the regular straightforward child for now. We could hope.

I am fully putting to use your advice. I will let you know. Our insurance compant has been forced to pay for the apsrgers treatment and is refusing to cover anything else developmental. I just want to do the best for him. We may start a " educational challenges" savings account!! Lol