Gifted Issues Discussion homepage Forums Twice Exceptional Dyspraxia diagnosis

THANKS SO MUCH TO LORI H for info she has shared on this board - I had a pretty deep feeling that my DS5 had dyspraxia but his school based OT never said anything....he is not due for another OT eval on his IEP until the end of this year (his last will have been when he just turned 3)...so we went and paid for a full OT eval a few weeks ago - I just came back from a 2 hour meeting with the OT and I feel SOOOOOO much better. She stated he most definitely has dyspraxia and that it was as clear as day on all her assessments and was alarmed that the school OT never figured that out. She agreed with all the other assessments from the past that he is a true, clear cut case of Sensory Processing Disorder with no sign whatsoever of being on the autistic scale or Aspergers (which people want to so badly lump him into) and that he is very clearly gifted. she then shared that it was going to be extremely difficult if not impossible at this time to get an accurate IQ score on him because every time we attempt to test, the subtests that involve fine-motor skills or timed sections will always be extremely low and pull any high scores down....which is what has occured to date - he scored in the 99.9% on several subtests of the SBV but on the fine motor sections he scored extremely low so it pulled his score way down. She said because he is so gifted, he has been able to compensate to some degree but that this will just get harder on him over time...so I have NO idea where to proceed from there...she said we might have better luck with achievement testing? She did agree that dumbing him down was not the way to go - that in her opinion, we needed to start homeschooling him so that academically I can keep up with his intellectual ability and focus on intensive therapy to help teach him ways to cope. She also stated that he appears to have visual tracking issues as well even though he is a visual learner....I can't imagine the frustration that must be growing in this amazing little boy. So THANK YOU SO MUCH LORI for making me aware of dyspraxia - you are a star and you have helped a 5 year old!!

I'm glad you're getting some answers to your questions! YEAH!

If we can do anything to help you--finding resources, figuring out homeschooling, etc.--just say the word.

I'm so glad you got some things figured out! What a relief!

Hi Belle:

Wonderful news! Can you tell us what the tests were that the OT used and what they measure? I want DS to have additional eval and don't even know what to ask for.

DS is getting OT based on the observation of an OT who came to school the last day of school about 15 months ago and said DS "an awkward clumsy child with poor handwriting."

For assessments, we have had the SBV and the WPPSI - the WPPSI showed a pretty big gap between Verbal IQ and Performance IQ (which the OT shared is a very big indicator of Dyspraxia but of course the nitwit psych that we paid a fortune to do the test, never pointed that out to us). On the SBV my munchkin scored very high in many subtests but then scored really low in two that involved fine motor skills so it knocked his score down (the psych who did that stated that many states/counties should be willing to take his high subtests as placement into the gifted program because it clearly indicates his gifted range)

- the OT did a Sensory Profile, The Berry-Buktenica Developmental Test of Visual Motor Integration (VMI), The Preschool Developmental Profile, The Southern California Sensory Integration Test, the Bruininks-Oseretsky Test of Motor Proficiencey, neuromotor development observations during the assessment and she looked at his medical history.

We were thrilled with the OT but are about stressed out concerning the cost of everything - she wants us to do at least 3 - 60 minute sessions each week for OT, still allow him his 2- 30 minute school/IEP OT sessions that he qualifies for, and she suggested hippotherapy 1-2 times a week which is not covered by insurance. So anyone that has the winning lottery numbers and feels very generous and wants to share them :-)

Belle,
I've been meaning to get back to add my congrats on the diagnosis. It makes things so much easier when you have a name on something and know what direction to take.

It sounds like you have found a great OT. I'm not surprised that the psych didn't id dyspraxia. I have so many children that I see who are clearly dyspraxic before I even *begin* formal testing and am often shocked that a pediatrician or other professional has never spotted it. The truth is that many health care professionals just don't recognize it.

I am a bit surprised on the testing - only about the Southern California Sensory Integration Test (aka SCSIT). This is the older version of the assessment which is now updated to the Sensory Integration and Praxis Tests (SIPT). Perhaps the OT you are seeing was certified in assessment awhile back and hasn't gotten trained in the newer version of the test. The SCSIT will work just as well, but for others looking for SI certified OTs, you may be told that they are using the SIPT. This is the standardized assessment for sensory integration dysfunction and can help in identifying praxis issues as well as other types of SI dysfunction.

It sounds like your OT did a great job. I use many of the same assessments she did The three times a week treatment recommendation is appropriate for the intensity and frequency of OT that brings results. Many people are used to the once a week for 20 minutes that the school based OT can offer and don't realize how very little intervention that is. Using an SI approach takes 45-60 minutes per treatment session because of the therapeutic process that you take the child through in terms of sensory experiences and responses. It takes time to allow the child to process the information and formulate an appropriate response so that learning takes place in the central nervous system.

Does your OT use any adjunct treatment like Therapeutic Listening or Interactive Metronome?

Debbie and Belle:

Thanks for this information. I think this will be really helpful for anyone who searches for dyspraxia diagnosis on this site.

and for us

!

bk

Debbie - I asked her about a listening program because I about begged the private OT we had been seeing for about 2 years to do some kind of listening program with him because I knew how incredibly sensitive his hearing was...and he kept blowing me off and made comments that it doesn't really work or it's not suitable for young children...she said that she had already put that in his paperwork/write up and that she would like to do Theraeutic Listening...she said she wasn't a keen follower of subjecting children to some of the really intense listening therapies that required long listening periods over a 2-3 week period of time - and she did follow up that with the fact that she has heard about some good outcomes for some patients that have gone through intense listening therapy programs but that she really didn't want to subject my little guy to that and wanted to start out with something she thought he could tolerate...she then stated that her center has a check out procedure so we can check out materials/headphones to try them at home before buying them so that families don't put money down on something that might not be a good match for them...

she did not do the SIPT because we had already gotten an SPD diagnoses 2 years ago and she looked at the information from our old OT - we also told her that our insurance did not cover assessment so we would like to stick with using some assessments he hasn't already had in hopes of giving us a fuller picture of his strengths and weaknesses. Thanks so much for reassuring me! We had been going to the only OT in town that worked with sensory children and he did a lot of work with cp, downs synd, and autistic children and my son went to him for 2 years..the last 5 months of that time period became a joke for therapy. The main OT took on more patients than he could handle and it became a circus - my son's therapy session was pretty much whatever had been done with the client the moment before my son came in - it wasn't tapered to his needs at all...we began to stop seeing the OT in the sessions at all and instead were stuck with interns that spent more time gossiping with each other than paying attention to my son and the last thing that did us in was when they began to physically restrain him in a chair and forced him to complete coloring/writing worksheets while he cried hysterically that his hand hurt. He was SO traumatized after the first time they did that that we refused to go back. How in the world could you do that to a 4 year old at the time especially one who has weak muscle tone and has severe issues with even being able to sit upright and hold a pencil!!

I am happy to hear that you are finding some answers.

I just found the following statement in an article on Dual Exceptionalities in a resource guide:
http://www.doe.state.in.us/exceptional/gt/pdf/IAGResourceGuide.pdf

"In order for these children to reach their potential, it is imperative that their intellectual strengths be recognized and nurtured, at the same time as their disability is accommodated appropriately." A first grade teacher and mom of gifted kids who was working on her master's in special ed and who was the first person to tell me that she thought my son was highly gifted, said something like this and added that it was my duty as a parent to see that he got an appropriate education and that it would not happen in our public school and I would need to homeschool--even though I had no clue how to teach a child that learned very differently from me and had motor issues to deal with on top of that.

I have borrowed this military motto and find it helpful as I try to facilitate my son's learning:

Improvise, Adapt and Overcome

Another article I found helpful:

http://www.davidsongifted.org/db/Articles_id_10140.aspx

When the superintendent of our school told me that my son's learning differences were "a good problem to have" I think he was right for many reasons that I am slowly discovering.

One thing I found out recently was that my father's younger brother had asthma and severe headaches that kept him inside and prevented him from doing very much of the outside physical labor that my dad was required to do as a child growing up in a poor family. Their mother knew that the younger brother wouldn't be able to do jobs that required a lot of physical labor so she made financial sacrifices and helped him pay for college and he became an engineer. The other brothers, also very bright, had to work after school so they would have enough to eat and they didn't have as much time to do homework. They struggled while the less physically able brother came out ahead in some ways, so it certainly turned out to be a good problem for my uncle to have.