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    #205260 11/09/14 10:19 PM
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    I've been giving DD my own assessments to try to figure out exactly how impaired she is, and compare how she is medicated vs. unmedicated. Dh was having her write down names of states and she seemed fairly fluent while writing. But then I asked her to write the alphabet in all lower case and she only wrote about 38 letters in a minute. I'm not sure if the problem is that she can't remember what letter comes next, she is getting mixed up trying to recall how to write letters in lowercase vs. uppercase, she's becoming unfocused (or what). It's was really odd to me how Dh asked her to write Pennsylvania (not copied) and she didn't seem particularly slow, but then kept hesitating when she was writing the alphabet from memory. Does anyone have any idea what would be normal for a 9 year old in fourth grade?

    I also had her copy sentences out of a book and she only wrote about 30 letters per minute. She spelled "appeared" like "appired" even though she was copying. There weren't really any other errors which surprised me because sometimes she writes over and over letters, trying to correct mistakes. She only did that a couple times.

    I guess I'm wondering how far "off" this sounds. I found some norms saying it should be about 50-60 letters per minute on average for copying sentences, so obviously she's lower than that, but how impaired it really is, I don't know. I timed myself writing lowercase letters in 1 minute and wrote 99 compared to her 38. But of course, I'm an adult, not a 9 year old. Tomorrow I will try it again when she is medicated.

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    Originally Posted by blackcat
    Dh was having her write down names of states and she seemed fairly fluent while writing. But then I asked her to write the alphabet in all lower case and she only wrote about 38 letters in a minute.

    Did your dh time her when she was writing down the names of states?

    Quote
    I also had her copy sentences out of a book and she only wrote about 30 letters per minute. She spelled "appeared" like "appired" even though she was copying.

    Copying is a slightly different skill than writing something you know, like the name of the state or the alphabet. I don't know how it's technically supposed to work, but I know that my dysgraphic ds has trouble with copying, and the way he describes the process is he has to look at what he is going to copy, remember as much of it as he can, and then write it down on his paper (or type it on his keyboard), and he complains that he can only remember three words at once so it makes copying really slow (and it is really noticeably slow for him).

    Re if the speed of writing states is faster (lpm) than letters, part of that might be that she is thinking about how to form the letters when she writes the alphabet but she knew she was being timed and was less focused on individual letters when she had to write out the whole words for the states.

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    I guess I'm wondering how far "off" this sounds. I found some norms saying it should be about 50-60 letters per minute on average for copying sentences, so obviously she's lower than that, but how impaired it really is, I don't know.

    One way to get an idea of how impaired is to google "letter per minute + 2nd grade" (or whatever other grade you want to compare to. Find the lower grade that matches your dd's lpm range. If it's two grade levels below her grade level, that's considered to be severely impaired.

    polarbear

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    We weren't timing her for writing names of states, I was just watching her and she looked so normal, for a few moments I felt silly that I put in a request for a special ed eval. But then I saw the alphabet writing which clearly didn't look normal. I think her copying speed is probably around a second grade level. But I can't find norms for writing alphabet letters.

    The school is saying that they would compare her to third graders since she should be in third grade based on her age, but she is very close to the cut-off and has been exposed to more curriculum than they have, so I don't really think that's fair to her.

    I also (a few weeks ago) had her do a story with a starter sentence, and she only wrote about 20 words in 3 minutes and it should have been more like 40. After the first 3 minutes I told her to keep going, but she had no idea what to write after that and only wrote a few words. I asked a college professor about this (who specializes in 2e kids and writing issues) and he said that it sounds like executive functioning issues related to her ADHD, not dysgraphia. Her handwriting is usually very neat unless she's in a big rush. I'm not sure what to think.

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    A few differences:

    Writing the names of the states from memory involves a meaningful retrieval task, where the letters are already in patterns.

    Writing the alphabet is also a retrieval efficiency task, but it's not all that meaningful.

    Near- and far-point copying involve not only fine-motor and visual tracking skills, but sustained attention, organization, and self-editing.

    Composing a story from a starter includes some retrieval factors, is meaningful, but also requires substantial organizational, working memory, and self-monitoring skills. (You have to have a mental sense of the structure of your writing, hold it in your head through the whole process; compose and organize sentences in your head, hold each one in working memory until you get it down on paper; manage self-monitoring of rote mechanics skills throughout.)

    People with EF issues, such as in ADHD, usually do better with meaningful than with rote tasks, which have insufficient intrinsic interest to keep them focused and organized. Organization, working memory, and self-monitoring are other EF skills, also frequently affected in ADHD.

    In dysgraphia, the ladder might look like: copying letters>copying words>copying sentences>generating letters>generating words>generating sentences>generating paragraphs+.

    So composing paragraphs is at the end for both causes of writing difficulties, but some of the earlier tasks may be in a different sequence.


    ...pronounced like the long vowel and first letter of the alphabet...
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    blackcat - I don't know if this will help, but I had a similar kind of odd experience with our DD8 (recently diagnosed dyslexia, probable ADHD-I).

    To set up our OG-type remediation program at home, we were putting magnets on a couple sets of letter tiles and putting them on the whiteboard. At one point, I had the whole alphabet laid out across, in order, minus about six letters. I suggested DD find the missing letters in the pile of tiles I had now added magnets to.

    Now I'd have sworn this child was practically born knowing her alphabet. I think the first time she wrote it out, she was barely two and appeared one day with it in hand - I had no idea she had the faintest clue how to write most of those letters. She taught herself cursive staring off at a border in the classroom (when one presumes she was supposed to be doing something else), and came home and wrote it out one night (when she was supposed to be doing something else).

    And yet - she had a lot of trouble figuring out which letters of the alphabet were missing (and I had left gaps), and where to put them. I was a little shocked, to say the least. Up to her diagnosis, we'd been making her read Percy Jackson to us at night. A week into remediation, and I am constantly boggled at some of the things I am now realizing she can't do, but has hidden so well.

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    Originally Posted by master of none
    That's a very interesting story blackcat. I wonder how she does if she is writing something spontaneously from her own head. Does she have to stop and think how to shape the letters?

    I'm not sure if she can't remember how to write the letters, or if she can't remember what letter to write next, as in "I just wrote an r, what do I need to write next?" Her working memory on the WISC was 127 (arithmetic and letter-number sequence) but maybe a completely different type of working memory is involved here. She said she was getting mixed up about keeping all the letters lowercase. She does have a history of making errors when she writes (esp. when copying I think) and then writing over the letters. I'm not sure if they are spelling/copying errors or if she is actually forming letters wrong, noticing they are wrong and then writing over. I think it's probably the former, where she is not able to copy words accurately, but does know how to form letters. I haven't seen any reversals, like writing a b instead of a d. Her writing is VERY inconsistent where sometimes she writes over and over every other letter and otherwise it looks very neat and adult-like with no errors. She presses down very hard on the paper and always wants to write with a pen. She said when she uses a pencil, it breaks all the time and it hurts to write. I told her that if she didn't press down so hard on the paper, that wouldn't happen. She said she has to write super dark or else she can't see it. She wears glasses and is nearsighted, and can read fast/fluently with or without her glasses so that makes no sense. Here's a story she wrote sometime last year, in third grade (handwritten in her notebook). Her handwriting is very neat. It's one of the only stories she wrote. I think she sat there most of the year and did nothing.

    "Once apoun a time there was a girl who went to the library. She borowed a book. The libraryian warned her not to fall asslep with the book open. But she did not listen to her. So that night she fell asslep with the book open. But when she woke up she could not breath so right when she woke up she died. The Libraryian mutered to her self "she should have listened." Her family also died, because the vines spread all over the house. The house had to be knocked down imedetly."

    I don't even understand this story--what do vines covering a house have to do with someone dying because they fell asleep with a book open? I don't get it. This story was done sometime last year but if she wrote another story now it would take forever (probably days) and it would probably be similar.

    aeh #205286 11/10/14 08:14 AM
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    Originally Posted by aeh
    Organization, working memory, and self-monitoring are other EF skills, also frequently affected in ADHD.

    So is this a different kind of working memory than what is measured on the WISC and if so, is there a way to test for it?

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    The story seems relatively clear to me. I would bet she had a visual of the story in her head, and her writing was more like reporting that vision. She just mis- or under- selected what to report on. Likely the book was about a magical vine, and the girl was drawn to it. The librarian's warning probably included something about it being a very special book. And when she read it she was so fascinated, she couldn't stop, despite remembering the librarian's warning.

    My DS does that, because of his writing issues, but the full vision is in his head. Any mild questioning and he'll tell the epic context of his story.

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    Originally Posted by blackcat
    Originally Posted by aeh
    Organization, working memory, and self-monitoring are other EF skills, also frequently affected in ADHD.

    So is this a different kind of working memory than what is measured on the WISC and if so, is there a way to test for it?

    The WM tasks on the WISC are done orally, so it's testing auditory processing->memory->production/manipulation. Visual WM can potentially be different, and some SLPs can test for it. I've monitored it at home with the game Simon with the sound off ("Crazy Copy" free iPad app).

    Both my kids have also struggled with copying, which is what had me probing for visual vs auditory WM, but to no avail. The issue seems to be one of an overwhelmed memory nevertheless, compounded by the fact that neither kid sees parts of words, but only the whole. So to copy the spelling, they would have to both be aware that their spelling was different and also to copy it letter-by-letter.

    On alphabet fluency, DS had a 143 second lower case alphabet writing speed as a baseline this last summer. It was very much a function of not knowing the alphabet from any arbitrary starting point. He would write it slowly, lose track of the song in his head, and then start over singing it from 'a' to progress. We've been doing AAS (thanks aeh!!), and one of the things that it works on is exactly that - being able to pick up the alphabet from any arbitrary starting point. I thought it silly initially, but DS has learned it, and we're finding all sorts of things now come more easily, including writing the alphabet in 30 seconds. His WM also tested in the high 120s (don't recall exactly the #).

    aeh: You said: "People with EF issues, such as in ADHD, usually do better with meaningful than with rote tasks, which have insufficient intrinsic interest to keep them focused and organized." This is the exact opposite of what I'm being told by the school - DS can't compose because of his attention issues (a diagnosis I do not have clarity on, BTW) as composition uses so much of the brain whereas wrote skills do not. Can you elaborate and clarify? DS certainly looks more like "generating letters>copying letters>copying words>copying sentences>generating words>generating sentences>generating paragraphs+" I've moved "generating letters" to the front of your sequence. Generating words is tough to determine as intermingled with resistance to do anything due to poor spelling.

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    Originally Posted by master of none
    Your story example is the kind of stuff my DS used to do when he was doing poor work. On better days, he'd write more detail, but always his only ending was death or explosion. He is still (at 14) challenged to have an ending that is not sudden death. How about a slow lingering illness? Nope, not happening here. Ever. How about more than one action than read the book leads to death? How about have a glass of iced tea? How about trim back those vines? Nope. One idea, and then you die.

    That's funny about sudden death, because 3 of the 5 "stories" (if you can call them that, they are about 4 sentences long) involve sudden death.

    "Once apoun a time, there was a home. One night when avery body was asleep, the attic, all of a suden, lit up. The house lifted off the ground. So, the house was never seen again. And, for the people in the house, well, they died. They went to heven, to live in heven. They were never heard from again."

    I took this to the IEP eval planning meeting and was almost embarrassed to pass it around--she looks like a kid with emotional issues even though she is usually happy/exuberant.

    I'm not sure if the teacher had odd pictures, and the kids were supposed to write a story based on the pictures, or what. I'm not sure that she even came up with these ideas without looking at some sort of picture or starter.

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