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    Joined: Apr 2017
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    I don't think they've done CELF. It was mentioned a few times, but I don't think it was ever actually done.

    They did tell us once his expressive language was poor and he needed a special group to learn how to express himself with his peers. But I think that was based on a less formal assessment, and when we pressed, the SLP said the only thing he was low on was code switching from formal to casual speech--he used formal speech too much, which really didn't seem an issue to me.

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    Just to note that DD did pull off a 98th percentile on block design (old WISC, so no other VS scores to compare) with some significant visual processing deficits. In his initial testing, optometrist did note that he had never before witnessed a child who could successfully "unsee" double vision by a sheer act of will. It was fascinating - and a tad unnerving - to watch her do it. It has been suggested (often by complete strangers in public places) that DD is a.... determined child.

    On an unrelated note, with respect to "I don't think a FSIQ of 133 accurately reflects his cognitive abilities", don't underestimate the impact of his extraordinary working memory, especially in younger grades. WM has enormous benefits in school.

    I have a DS with quite a few similarities to yours, including hypermobility and fine motor issues (and high WM/ low PS). I too was surprised at how high his early block design scores were - but have seen them drop over subsequent assessments. In retrospect, I think his VS skills are so strong that when young, sheer ability put him way over average despite his slowness. As he got older and the testing more complex, the timing had more impact compared to age peers. In his most recent testing (at 14), VS was his lowest index despite being his greatest IRL strength; the psych said that was a purely timed issue. Ah, I see further down that aeh predicts exactly this.

    DS has also always had math passion and ability many SDs beyond what his FRI would seem to predict (and language function way below what his VCI would predict). For lack of better explanation, I've assumed that his math skills came from the combo of extremely high VS and WM, despite much lower FRI (but his two WISC-IV assessments at ages 8 and 10 were also surprisingly inconsistent, and raised more questions than they answered). Interestingly, FRI scores are way higher on his most recent assessment with the WISC-V, for the first time looking more consistent with his real-life math achievement. Psych *still* (argh) did not find any data that supported - let alone helped explain - his enormous and obvious in-real-life writing deficits (the purpose of the last two assessments), but did eventually finally provide a formal diagnosis of language LD nonetheless, based on clinical observation and a whole lot of input from parent and teacher on what happens in the real world, regardless of all those high scores.

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    Thanks Platypus. Lots of good information there. How is your son doing in high school?

    Our meeting this morning went fairly well. The psychologist said he had never before encountered a child that didn't miss any items in the entire digit span test. He probably could have gone further on that, PS, and arithmetic, but the psychologist doesn't know of any way to test past the ceiling of 19.

    They agreed that because he's hitting ceilings in his strong areas, and his fine motor/processing speed issues are bringing down the weaker areas, the 133 is probably a low estimate of his ability.

    I feel like the elementary school team is finally starting to "get" the severe discrepancy between his mental ability and his output--just in time to start these conversations over again when he moves into middle school.

    It seems our issue with getting a specific learning disability in written expression diagnosis is that it says it can't be related to a health/motor problem, which is at least part of DS's difficulty. However, in the same breath, they say his health/motor issues aren't severe enough to warrant IEP eligibility for those. So we're still on the same 504 plan for now, awaiting yet another OT assessment--which will be his third since May 2017. They're also going to do a TOWL test to see if that brings anything new to light. We're meeting again at the end of November.

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    A TOWL would be good. That's probably the best measure of written expression currently available. I'm still a little curious about a real speech and language evaluation, but a genuine writing disability should show up on the TOWL, which is good enough. One of the handy aspects is that there are multiple subtests, breaking out various aspects of mechanics, sentence structure, and applied open-ended writing, so it should be possible to see if there are vulnerabilities in specific skills and/or when skills are combined.


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    Spent some time this afternoon looking into stealth dyslexia. The Davidson article here: (http://www.davidsongifted.org/Search-Database/entry/A10435) feels like it describes so much about DS. Would the TOWL test be able to parse out if he has some level of stealth dyslexia?

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    Originally Posted by Cnm
    The rapid naming is visual identification, right? So these results indicate that basically anything that he has to process visually or with writing is notably slower than the tasks he can complete using only his aural-oral connection?

    Which feels like it puts us back in the visual processing realm.

    How would a dyspraxia/motor planning diagnosis affect his visual processing? Would this be an expected consequence of that type of diagnosis?

    And yes, his spelling utterly falls apart when he has to use it in context. Even if he spells the word correctly orally before he writes it or has it written in front of him, he still frequently writes it wrong and erases multiple times. He even forgets spaces between words still.
    It's maybe not exactly visual processing. He also did well on the reading fluency measures, which require some visual processing, but are also language processing, and have minimal motor organization demands.

    Rapid naming has to do largely with retrieval efficiency, which can affect reading (and hence dyslexia), but specifically doesn't appear to be affecting his reading skills at this point, just his spelling skills. So in that sense, it does relate to stealth dyslexia, but probably, at this point, more accurately, the other name for that, which is compensated dyslexia.

    The rapid naming deficit relates to motor planning in that he is less efficient at motor tasks which are automatic for other people--such as letter formation, writing mechanics (spelling, punctuation, capitalization). He can spell in isolation because he can devote all of his cognition to it. In applied situations, his peers rely on automatically retrieving handwriting and spelling skills, while he is still using cognition for those basic skills, or inefficiently searching his memory stores for how to execute them, which occupies too much of even his prodigious working memory. Typical of dysgraphics: write, spell, or compose language--pick any one.

    And the TOWL is really best for identifying dysgraphia--but that's really top of mind at the moment. Any dyslexic traits appear to be largely remediated at this point.

    Last edited by aeh; 10/20/18 07:20 PM.

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    Thank you, aeh!

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    He said they pulled him out for the BOT-2 test--"Bot, like robot, mom!" He also told me "She kept saying I was doing really good, even when I wasn't. I wasn't good at catching her ball or dribbling it; and I was really, really bad at staying in between the lines in her mazes."

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    Here are his BOT-2 Results:
    Fine Motor Precision: Scale Score 9
    Fine Motor Integration: Scale Score 9
    Fine Manual Control: Standard Score 38, 12%-ile
    Manual Dexterity: Scale Score 13
    Upper Limb Coordination: Scale Score 9
    Manual Coordination: Standard Score 40, 16%-ile
    Fine Motor Composite: Standard Score 36, 8%-ile.

    The OT report states, "Decreased fine motor skills. Weakness in extremity and upper body. Visual perception/visual-motor deficits. [DS] demonstrates deficits in fine motor skills affecting performance in school activities. He demonstrates handwriting difficulties as he has problems with spacing and alignment when copying. He demonstrates problems with dissociating arm and hand movements, isolating finger movement, deficits in in-hand manipulation affecting handwriting, scissoring, and self-care tasks. He has weakness in trunk and upper extremity strength resulting in difficulty with sitting tolerance, difficulty remain in upright sitting position, handwriting problems."


    Still waiting for TOWL results. Our meeting is scheduled for tomorrow before school.

    Last edited by Cnm; 11/26/18 05:18 PM.
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    TOWL-4 Results

    Vocabulary: 9, 37%-ile (which is interesting because his WISC and KTEA Reading Vocabulary were both above average.)

    Spelling: 10, 50%-ile

    Punctuation: 9, 37%-ile

    Logical Sentences: 16, 98%-ile

    Sentence Combining: 14, 91%-ile

    Contextual Conventions: 13, 84%-ile

    Story Composition: 13, 84%-ile

    Contrived Writing Composite: 113

    Spontaneous Writing Composite: 121

    Overall Writing Composite: 116


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