Gifted Issues Discussion homepage Forums Twice Exceptional trouble following directions

My 3rd-grader hasn't been identified as having a LD, but I'm starting to wonder.

Although she is clearly very smart, she does struggle somewhat. Focusing has always been a big problem for her. For as long as I can remember I've had to remind her to "listen with both ears." Homework this year has been surprising--lots of skipped questions, directions not followed, problems half answered. She memorizes spelling words instantly, but has more trouble with math facts and has been so slow on timed tests that her teacher called her in for remedial work. Yesterday she complained (in a wistful way) that she has a hard time with directions.

Her WISC-IV scores were really erratic--very high VCI, but average WMI and PSI. Her PRI was all over the map, isn't useful. According to what I've read about score discrepancies, her spreads throw both the FSIQ and the GAI out the window.

The school psychologist who administered the exam hasn't said a word about her scores. If the scores were a major red flag, I'm assuming she would have. On the other hand, the scores make very clear to me that I have not fully appreciated the extent of my daughter's weaknesses. I thought her inattention was a simple developmental issue, something common and mild that she would grow out of. (And this is what her teachers all along have indicated when they brought it up.) But maybe this is something more? If she's noticing it now, as an 8-year-old, what will it feel like in a couple of years when her teachers aren't helping the class with directions and organization?

Part of me is afraid to pursue this with the school. I'm not confident about what their response might be, so I'd rather investigate this on my own before getting the school involved.

For parents with kids in this situation (by which I mean similar weaknesses but not receiving therapy/support for LD), what have you noticed over time? Do the kids "grow out of it" at some point? Is there a way to better help them focus on instructions etc, something more effective than simple reminders? Are there helpful books out there that address this? There are some great threads on this forum, but I feel I need a basic narrative. Just wondering where even to begin....

PS I'm wary about creating a disorder where there isn't one, which is why I'm looking for stories about these weaknesses before contacting the school.

A friend of mine raved about this book:

http://www.amazon.com/Late-Lost-Unp...g/dp/1890627844/ref=cm_cr_pr_product_top
I haven't read it yet but it's in my library queue.

Our ds8 has similar sounding scores, lower on psi than 'normal' but otherwise about the same. We had a full assessment done and for us the main take aways was: social awkwardness is leading to ds being a very sad lonely guy and the ps slowness was compounded by this depressed state - like working in a fog, unable to focus, restless, timed tests were not good.
If your child is getting along well with others, has friends and feels good about themselves in this regard, probably this is not an issue, but if there is also social awkwardness and fewer/no close friends, you might want to consider the social piece as part of the puzzle.
I would agree with further assessment being key.

Thank you all. These replies are helpful. The more I think about this, I realize that I'm not sure what my goals are. Truthfully, what I want is to find some stories about children who had similar weaknesses but practiced twiddling their thumbs while reciting numbers at home and brought processing speed up to speed.

:-)

Barring that, yes, your suggestion to get her properly assessed is a good one, and I will follow through. I'm not sure why the school hasn't initiated this, knowing what they know, and that makes me nervous. (Am I making a mountain out of molehill? or am I opening a can of worms?) I have called an outside psychologist and will pursue further assessment independently. I will also check out the book you've suggested, inky.

Our 9 year old has had Wisc IV. As far as we know, we haven't had the results yet, he scores off the scale in 'raw intelligence'. Like mmme's daughter, he can't focus and has poor concentration (motivation?). The EP said this scored in line with his age, so doesn't see it as an issue, just a disparity.

Any thoughts?

My DS8, is starting a gifted cluster program in August, but has many of these organizational issues too. Late, Lost and Unprepared mentioned above is really useful. Don't expect it to have all the 'answers', but it lays out the problems of kids with executive functioning difficulties (organizing/focusing), and puts out strategies to cope.
To be honest, I'm sure I was one of these kids myself growing up, and I'm delighted that it is now being recognized as a distinct difficulty that some kids have, rather than laziness.
One point it mentions is that all ADD/ADHD kids have Executive Functioning issues, but not all kids with EF problems have ADD/ADHD.

Has anyone tried "Brain Gym"? A psychologist informally recommended this as a way to help my daughter manage her attentional difficulties. I have not seen it mentioned re attention anywhere on this forum.

I'm willing to try anything, and wonder whether an at-home (buy a book about it) program will do, or whether meeting with an OT is better.

Not used it, but Ben Goldacre of Bad Science is eloquent about it here:
http://www.badscience.net/category/brain-gym/
- I'd read that first!

I have one piece to add to this. An evaluator will not raise a red flag as long as both of your child's scores on the WISC are normal or above. A trained neuropsych evaluator probably would, but the school evaluators are only concerned with whether the child can function in a normal classroom and whether they meet the criteria for Gifted.

That said, you should be concerned if the difference between the two scores is a standard deviation or more. That is a sign that your child might need to be looked at more closely. ADD might be one answer, since they need IQ tests broken up into smaller chunks. Another answer could be seeing a developmental optometrist and making sure that she focuses well and that she has good binocular vision.

My DS6 had similar issues on the IQ test. After some vision therapy and having the IQ test broken up, his scores are more even and very much reflect his capabilities.

Oh dear. Sigh. Glad I asked about Brain Gym. I had a feeling there was a reason I never saw it mentioned here.

Artana, I appreciate your response too. What you say makes sense and explains why I haven't heard anything from the school psychologist who administered the test, even though my daughter does have a difference of 2+ standard deviations. I'll need to be more of an advocate as long as my daughter is functioning in the regular classroom, which she is, albeit with distress that she conveys at home. The psychologist I consulted felt pretty confident that there are attention problems, so I'm trying to figure out how to address that without pursuing an official diagnosis leading to medication. I don't think vision is a problem, but I will absolutely have it checked. Like I said, I'm willing to try anything. :-)

What do you mean by "having the IQ test broken up"? Do you mean that the kids take different parts at different times?

Have you considered seeing a behavioral optometrist? For my dd the not following directions, half done problems, skipped problems were due to her inability of her eyes to track and other visual issues. The symptoms mimic so many other issues that it took us a while to get to this point.

We were fortunate to find a very good fit for us after seeing one who was not!

DD has done very well since starting therapy in January.

mmme,
Yes, I mean taking the test in smaller chunks over the course of several days. This gives a more accurate representation of a child who has attention issues.

Mamabear, what do you look for in a behavioral optometrist? Wondering what helped you determine a good fit.

http://www.covd.org/ - start here. The first Doctor we saw tried to "frighten us" into very expensive treatment. (I posted about it here sometime in January, I think.) Anyway, His testing was subjective and seemed random and his personality was very "hyper"- DD did not mesh well with his energy level. We later googled him and found that he had failed the licensure in two states.

The doctor she sees now is a well known DO in the area and I have yet to find negative information on her. Her testing is objective (computer driven). She is calm and confident and when dd "tested her", she called her on it with firm controled certainty. My dd didn't like it then, but she loves it now!!!

I would say ask the doctor for references, check the internet, read the "fine print"...check your mom gut!!!

Hope this helps!

The behavioral/developmental optometrist I take DS6 to was one of the heads of covd for a while. He is great and his vision therapy is doing wonders for DS6. I definitely agree with Mamabear that if you are getting odd scores on PSI you should look at this avenue as well.

This is very interesting to me b/c we are in the same spot w/ dd#2 who was also a 3rd grader this past school year. She's taken the WISC-IV twice (once at the end of 2nd and once at the end of 3rd). We really can't afford to do any more testing or anything at this point as dh just lost his job, but I still don't know what to make of her or her scores.

The first time she took the WISC, her VCI was in the 99.7th percentile, and the second it was in the 99th (no problem there). However, the PRI was in the 99th the first time and the 75th the second! The tester indicated that dd's abilities may have "fluctuated" although I don't know what the heck to make of that. Her WMI and PSI were average both times she was tested, although not identical (WMI was like 47th the first time and 75th the second and PSI was in the 66th the first and 42nd the second). The psych who tested her the second time did substitute the arithimetic test for one of the WMI subtests, though, so that accounts for the increase in WMI. Both dh and I noted attention issues to the psych, but dd's teacher did not and noted that dd was not gifted and "nothing special" according to the psych, so we were told that she did not have ADHD/ADD since it was only noted at home.

Overall, she had a FSIQ in the 98th a year ago and 91st now and a GAI in the 99.9th a year ago and 96th now. Her WAIS scores were 95th for reading, 98th for math, and 99th for writing and another reading achievement test (GORT) that she was given was in the 99th. These were all grade level percentiles, which probably would have been higher if they had used the percentiles for her age b/c she is very young for grade (late Sept. bd -- will be 9 a few days before Oct of 4th grade).

However, her school achievement tests say that she is reading just at grade level on the DRA assessment (nearly the same assessment at the GORT - oral reading) and her MAPS scores have ranged from the 53rd to 94th percentile up and down over and over in both math and reading.

I don't know if she'll qualify for TAG this next year when it starts. The psych told us that she didn't have learning disabilities, ADD, an anxiety disorder, or anything else wrong with her. However, the erratic and uneven scores were not explained at all.

Take a look at ADHD, and executive functioning. You can have one without the other or both. Either delays, or the distribution of strengths and deficits in a child's executive functioning can cause problems. The good news is that executive skills can be taught. It is not an over night fix, something to be worked on for years, but a necessary one. Smart But Scattered is the most recent book I've seen on this topic.

I am not familiar with Brain Gym, but there are programs that involve therapeutic listening, and ones that are computer programs set up like video games to increase listening skills, focus, and reduce impulsivity. We enrolled one child in a program, don't have the name, that helps with these issues and there was improvement. I've also heard of SIRRI being used.

My son has similar problems to your daughter and he is also gifted. There is a thread about it on 'need help with scores'.
My son has vision issues even though he has 20/20 vision. The latest info I received on his problems is this:

"I took my son to a vision therapist. He did 2 hours of testing. There is a problem with his vision. He is reading at a speed of 13th grade level, however his brain is turning on and off each eye rapidly. He is rarely able to use both eyes at the same time although he has perfect vision. When his brain changes eyes, it leaves gaps between letters in his writing, he misses words when copying things, and also when reading. I will get the full report on the 22nd, but it looks like his low processing speed is due in great deal to his eye problems. They gave him a test which had him see with his right eye the number 4 in line over a vertical dash, and his left eye saw a horizontal dash in line over a 2. If you see with both eyes it would look like 4 + 2 (vertically). However, he saw them separately and could not put the different dashes together to make a plus sign. Could be why he hates math worksheets, but is phenomenal in math as long as it is mental math. Things don't look like they should...maybe it is a minus sign, maybe it is a plus sign...columns don't line up.
Just thought I would update you in case anyone else has similar problems/test scores, with a child who has had strabismus/amblyopia issues."

He has had 2 surgeries and had seen a different vision therapist when he was 4-6 years old. My son was telling me he was seeing fine, which technically he does see fine. However, his brain turns off one eye and then the other. He leaves problems half done etc. Excellent speller but math facts/timed math papers he is horrible. He knows his facts but can't do them quickly when looking at them being flipped or on a timed test. He does all his math mentally. I hope you will consider a vision therapist to rule out vision problems that can't be seen by the regular eye exam. They can test your kid with goggles to measure where her eyes are tracking while reading etc. The fact that your kid can't focus or concentrate was the exact reason my kid was sent to be IQ tested. They thought he was ADD/ADHD. Turns out he isn't (he has had the test twice). My son also leaves problems half done, skips problems, leaves letters out of words when writing that he knows how to spell, all because he is not seeing properly. He actually tested >99% on spelling during the testing for ADHD (WIAT II). This year in 3rd grade my son had been going to the teacher for 'help' with his math immediately after she gave directions and told them to get started. He would tell her he didn't get it. She would tell him to read the directions out loud. As soon as he did, he immediately understood and could whip out the math paper. It turns out, my son is an extremely good compensator for his vision problems. He has learned to compensate by turning his visual processing problem into auditory process that he can understand, by reading out loud. He then doesn't have to rely on what he sees. Who would have known? He doesn't follow directions well and it drives me nuts. He too may have a LD. We will hopefully know soon.
Good luck to you!

By the way the optometrist/vision therapist told me that ALL but 3 of the signs of ADD/ADHD are also signs of vision issues.