Gifted Issues Discussion homepage Forums Twice Exceptional Identifying which (if any) LD a child has?

I'm in a strange place, and I could use a little direction regarding DS5 (nearly 6).

I'm pretty sure that he has 2E issues going on. I could be wrong, but his early testing by the school looks weird and doesn't reflect what other parents of gifted kids see when they look at him. (So it's not just me hoping to see something that's not there. The kid is testing at bright-to-MG, but he adds mixed fractions in his head even though no one taught him that. His math achievement scores weren't even in the gifted range.)

I feel in my mom-gut that something is wonky here. Visual issues or CAPD seem the most likely candidates, but their symptoms aren't even similar! Could he have both?

Honestly, I have no idea where to go from here. How do I figure out what the problem is? (Knowing full well that it could be something that I haven't even considered.)

Is there a one-stop shop for diagnosing LDs? How do I tease apart what is relevant from what is not, preferably without spending a fortune? We have a good relationship with a psychologist whom I had planned to have test him, as she tested his older brother. Is that my next step? Can she figure out what is going on, or is there somewhere else we should start first?

Any help would be appreciated. I'm feeling completely lost and useless to him.

Kriston,

You have given me such helpful advice here that I wish I had good information for you. I would hope that the pyschologist would be able to at the very least advise you on where to find the answers even if it is not with her. The school is testing DD7 to help me determine what is going on with her as I suspect some type of LD but her "symptoms" don't fit any one category.

I know one thing, your DS has a great and skilled advocate in you and you will make sure it all gets figured out.

Hope it is not too lengthy or expensive a process and it all gets uncovered.

Aw, thanks, Breakaway4. I really appreciate your kind words.

I just wonder if the bleah test results we got are an indication that testing isn't going to tell us much of anything right now.

The whole 2E thing is such a puzzle, isn't it? *sigh*

Please let me know what you find with your DD7 and the path you take. I read these 2E threads quite religiously these days...

Well so far they have only done achievement (WJIII) and I was present during testing. THAT was an eye opener. We still have a few more test for that since 45 minutes was the max she would/could cooperate.

1) She does not want to do it and gives up on items I know she knows.

2) She totally failed a section where you had to repeat an oral story. She said she couldn't remember even the simplest story. (I have been suspecting APD, is this a sign?)

3) She doesn't listen to directions and squirmed in her seat and avoided looking at the tester. (note: She is not shy and LIKES the teacher doing the testing)

4) She was really great at a section on pictures - and it seemed her visual skills overrode her poor listening/AP issues quite a bit - perhaps having the picture helped her visualize the directions e.g. First point to the biggest bear and then the bird in the tree but not if there is a rabbit near the picnic table etc.

All of it made me feel like there is more going on than I even suspected.

Keep me updated as well. Nice to have company along with the mystery. :-)

Breakaway

In my utterly unskilled and mostly clueless opinion, that seems like it might be CAPD. But like I said, what the heck do I know? The testing seems useful to you though, it sounds like? That's useful info to me, since I really am wondering if testing is even worth doing right now.

It's nice that you got to be present for the test. I was not, so I know zilch.

Kriston, I can recommend the full 'psychoeducational' assessment sort of route which we went with ds to determine what, if any, lds he had going on. This was close to $3000 but about 1/2 was paid by insurance as we were not just seeking iq/achievement info but help diagnosing an ld.
I think our dr was extremely thorough and did a good job pinpointing, as much as possible in this day and age, what is up with ds and, more to the point, what he needed in terms of therapy.

Best of luck getting this figured out~

Thanks for chiming in, guys. I appreciate the help!

Dottie: I'm jumping the gun a bit, which is why I didn't post scores. I have not yet seen the scores. The GT coordinator just called me quickly, so I have literally 3 numbers, one of which is the CoGAT score (which I frankly consider to be useless). I'm not even positive what they used for the achievement test. When DS8 was tested 3 years ago, it was the WJ-III, but I don't know if that's true anymore, and she just told me percentiles--no real data. None of it is at all useful yet, except to say that his reading score was higher than his math. That's clearly nonsense!

I'm not hung up on these scores, and I'm definitely not upset or anything. If he really were bright-to-MG, I would be ECSTATIC! But I don't think that fits. It just doesn't ring true. Something is wonky.

I suspect--and I have no real evidence for this other than my knowledge of my child--that in math he said that he can't do subtraction, so she stopped testing. Well, he CAN do subtraction, but it's not as breezy for him as, um, multiplication or adding fractions! Doh! So I'm betting the tester quit too soon. *sigh* But if that's the case I don't know if I'll be able to see it. This was the free testing done by the school. We don't get much of a paper trail...

I just feel very strongly that that this is further evidence that something isn't right here, you know? Now I need to figure out my next step.

I would love to treat the symptoms. I think that's great advice. But they're so nebulous, so vague. I feel like I see everything through half-closed eyes. What's normal? What's goofy, but not a real problem? What's a bonafide symptom? Where's the line between a bright kid and an HG+ one that has serious problems keeping him from succeeding as he could?

I have no idea right now.

BTW: It's APD? Not CAPD? See, I don't even know the current terminology! Gah!

Thanks, Chris. I'll take that under advisement. It really helped you?

The insurance note is helpful. I don't think our usual psychologist accepts insurance, but I'll be sure to ask. That might make a difference.

No Peripheral APD? LOL! Makes sense.

Here's how messed up I am: I read the Eide book a year ago and I was more lost after than I was before. Nothing jumped out, but I saw lots of symptoms of lots of things. For a good long while after that, I convinced myself that he was just a bright kid and I was crazy, looking for trouble--both in GTness that he didn't have and LDs he didn't have.

Then he did more out-there math and picked up chess like it was nothing, beating his dad, and my mom-gut started in on me again that something just didn't make sense.

I think he's VERY visual-spatial, so I suspect that might be clouding the issue. If he's VS and has visual issues so that he can't see things well, that might explain a lot. If he has some form of APD, too, well, that could cover pretty much everything I see.

But that's a lot. I worry that I'm hearing hoofbeats and thinking zebra instead of horse.

Augh! My brain hurts...

Hi Kriston! I'm following you over here today! I was totally confused about Eide's book or maybe just overwhelmed. I was looking for info for DS last year and came up having questions about his sister. 1)She's related to him 2)She had the early verbal milestones 3) She is WAY more intense 4)She is very VS, difficulty with math computation and spelling but strong reading, writing and drawing skills. 5) She had chronic fluid in her ears until 4 and has some hearing loss. At some point, she will have an evaluation as well. With DS our insurance covered most of the psychologist educational eval but the Eides, for a neuropsych eval, in our area were quite expensive.The psych eval could be a screener eval. I say trust your instinct, at this point, you're quite educated in assessing learning needs.

LOL about the editing. BTDT...

That very article is one of the things that made me think APD, actually. I've been noticing weird--glitches? I guess?--in his vocab for a few months now. Several times a day, he's been asking me for definitions of words that I use a lot. Not the $2 words that he wouldn't know--those he doesn't ask about. He picks out the pretty common ones, the 3rd or 4th toughest word in the sentence, you know? And his speech seems simpler than it should. He has some mild trouble picking the right word. It's not outrageous, but it's weird enough that I noticed it and have been keeping an eye on it. Both vocab issues have been bothering me for a while.

Then I read this article this week, and a lot of things he's doing look like APD: he doesn't take oral instructions well AT ALL (gets confused, stressed, lost, etc.), when he's given multiple instructions in sequence he loses the last one(s), he mishears words a lot, etc. And, of course, he's not yet reading well, even though is a chatty, extroverted kid. Which may be his normal...or he may be struggling. His hearing tests--the ones that test with tones--are normal.

I worry that I'm just highly suggestible. But I also worry that I'm not.

That "something not quite right" feeling is really strong.

So comprehensive testing? That's the next step to try to ID LDs/2E issues? What constitutes comprehensive testing? Which tests should we be looking for? More than IQ and achievment testing?

Kriston,

There are auditory specialists who can specifically do auditory processing tests if you feel strongly that this may be a fit. If you can do this and get it covered by insurance it might be worth it to more quickly rule out or in APD.

And don't worry - I often either feel like I am making a mountain out of a molehill with these things or that I am failing my child by not being more agressive in figuring out what is "wrong". (don't like that word much)

Hi Kriston, as the rest have pointed out, you can have a host of issues. I have a feeling my son's IQ score on the WISC was so high because the tester split it into 2 sessions and while the test time taken at each session was 30-35mins, he took quite a few toilet and snack breaks! But he has issues with achievement. All tests are snapshots only (mine seems to have performed well on 1 achievement test and then bombed the second one 9mths later. Unfortunately the gifted board only wants to consider the latest one).

My son has visual issues, mild SID, weak gross and fine motor skills, and mild ADHD. Talk about a bowl of walking alphabet soup! He's been proclaimed "cured" of his convergence/vision issues although we still have some remanant exercises to do.

The full neuropsych evaluation that we started but never finished is called the NEPSY II. It can be customised to be shorter and more targetted. Not sure if this is the one used over on your end.

Good luck!

What's the reason for wanting a child to be 7? Do you know?

I have to admit, not knowing whether there's reason to be concerned or not is making me a little crazy. But I also want to take action if there is something wrong. An ounce of prevention being what it is and all...

So there's a specific test for APD. I'll look for an audiologist for that. Good. A specific task!

Is a neuropsych evaluation recommended for LDs? I don't suspect ADD/ADHD or motor skills problems. I think this is one problem that's all in his head (if not mine!). Maybe his eyes, too, but since they're in his head...it's all in his head!

Keeping her sense of humor even in her confusion,

K-

You mean about being 7 for the APD test, Kriston? Think it's because their nervous system are supposed to be more developed by then, and they can more accurately measure the discrepancies between what is and and the norm. Son went through that as well. He's fine.

The neuropsych eval - the psych thought he might have ADHD. She thought the eval would be a good springboard into looking at how he thinks. We never got past the 1st segment cos he couldn't sit still, lol. Still, our psych thinks it's at worst mild cos he has good focus when he's interested.

I used to not believe in labels but have found them to be so useful insofar as looking for treatment was concerned. And don't worry - trust your gut - just find out what you can first. The manifestation can be mild, which makes you feel like you're being ultra picky about maybe even nothing. But I'm all for clearing the road so that life/learning can carry on smoothly. The worry is that if these issues are not dealt with, it could become more serious later on as other habits become ingrained.

Cheers!

Re age:


http://www.asha.org/public/hearing/disorders/understand-apd-child.htm

Did you see the Rosie O'Donnell interview yesterday on MSN about her son? There is a new book on APD also referenced in that interview.

Kriston, I am joining the party late but I am with you 100% on my DS7. We went the physical/occupational therapy evaluation route first. VERY helpful information. We also went to a behavioral optometrist who diagnosed DS7 with convergence insufficiency and tracking issues. Here's the catch-they very much look like dyslexia. So we went to a neurologist to confirm any of these diagnoses and he said DS7 has low muscle tone (contributes to all of the above). So we work on PT exercises at home but on an any given day one of the above 'symptoms' might rear their ugly head and DS looks ADHD. I guess around the age of 10 the nerves will be fully developed and some of this might get better but we have been working on coping strategies (IOW-treating the symptoms or heading them off). DS is highly VS but does not do achievement testing well at all!

So long story short, you could very well have several issues going on and several 'symptoms' mimic different diagnoses. I feel for you but several of us are in the trenches with you so you're not alone!!!

You're right on time, hkc. Thanks for joining the conversation.

I have wondered/worried about dyslexia for DS5, which is why we went to the developmental optometrist in the first place. But I worry about going to a specialist in one thing when he may have something else completely, or he may have an "alphabet soup" of stuff that we're not seeing, or he may just be a late-bloomer and not need treatment.

This is why I was hoping there was a one-stop shop where they would look at the whole kid and suggest the specialists required from there. This shop doesn't have to *treat* all the problems that a kid might have, but it would be nice if they could at least tentatively ID them, much as you'd see your family doctor if you had some general, vague, and varied symptoms. You wouldn't just go off and find a specialist for each individual symptom. I don't really want to see specialists for APD, dyslexia/vision issues, gifted testing, and maybe a neuropsych for good measure separately, when one or two or even *none* of those issues may really be DS5's issues.

Does that make sense?

Does this sort of place exist? Or is it all piecemeal?

I'm with you, Dottie, that I worry about getting the current "hot" diagnosis. I don't really like that approach. I feel like a place that sees the whole child is less likely to grab at what's popular in one field right then.

I just wanted to chime in with a comment on the idea that

"The worry is that if these issues are not dealt with, it could become more serious later on as other habits become ingrained. "

I live in NYC and face a different and opposite problem.

One of my kids is 8 and is a "late bloomer" on motor and related tasks (eye tracking, handwriting,...) just like older sibs, who grew out of those problems. Here in NYC we have to work like crazy to avoid having our children needlessly assigned certain LD labels (for things they will grow out of anyway).

My 8 yo was at a private, mainstream school last year where at least half of all boys were recommended for testing for purported attention problems and/or LDs, between grades 1 and 3. The kids had all been extensively screened before acceptance to K or pre-K there (kids with problems evident in preschool were never admitted). I found it remarkable the school thought so many kids could have attention or learning problems. I also found it interesting the school was not looking for neurological workups, but wanted us rather to take them to some nearby OT provider who endorses sensory based treatments. Several kids were referred for "upper body weakness" which basically means the teacher did not like the way these boys sat in the chair. Incidentally, there was no scheduled break for the kids other than a twenty minute lunch break at around noon (in chairs) and then a running-around recess at 1:30.

Quite a few gullible parents went in for these OT evals and then their kids were slapped with "special needs" designations which subsequently prevented the children from being accepted at other private schools later. One child was interviewed and allowed to spend THREE DAYS at a private Waldorf school in a new city where the family planned to move. The new school loved the kid (and the boy loved the school), and the school told the parents informally their child was accepted, but then upon receiving a school report describing "special needs" this child was then rejected by the Waldorf school. I also saw when kids applied out for high school, the consistent pattern was that the kids who had managed to navigate without getting labels attached, were accepted and had choices for high school. The labeled children were left with no options but to continue at the current school (not well respected for its high school) or to attend generally even less desirable public high schools. In NYC virtually everyone has to apply for middle and high school, EVEN if the intention is to attend public. The kids who "don't get in anywhere" can be stuck attending public high schools with graduation rates hovering around 50 percent. The special needs designations are not supposed to be a factor in public or private school placement, but it sure looks to observant parents that they are a very big factor.

Anyway, in NYC we parents of bright young boys (especially) worry about our children getting bogus "special needs" labels assigned to their school records, and subsequently being denied opportunities to attend appropriately challenging schools (in the future).

In this context especially, I personally am very, very uncomfortable with the culture of encouraging labels and seeking of new forms of LD, as I think despite good intentions on the part of parents these labels can so easily come back and haunt the children later. Maybe where the rest of you live it is not a problem, but in NYC I can tell you it certainly seems to be.

I'm homeschooling him next year. It's not a problem for us. But I'm not seeking a label so much as trying to figure out if something is going on here.

I'd prefer that this conversation not turn into a "don't label your kids" conversation. If you're interested in having that conversation, could we do it on another thread, please? It's a valid and worthwhile discussion, but it is not helpful to me. And I really need help! Thanks!

Kriston, I'm right there in the trenches with you as well.

I've long suspected possible dyslexia issues and/or CAPD issues for DS11. We do think he has ADHD-inattentive type and are medicating for that, but we're still not entirely convinced. He has a long history of ear infections and has specifically mentioned that all the sounds in the classroom are at the same level and that that makes it hard to concentrate. He also seems to have problems pulling words from his head when he's speaking. I thought the part of the Rosie article about hearing similar words the same way was interesting and I'm going to ask DS about this. When he was a baby he would leave off consonants entirely and I always had the feeling that he didn't really hear the consonants eventhough his hearing tests came back normal. (He only started using consonants at about age 2.5 when he started watching Between the Lions with it's emphasis on phonics.) We had the visual convergence and tracking issues as well and did vision therapy, which helped some but didn't take care of everything. And so, we too, are left with the feeling of something still being wonky. But we also still wonder if we're making a big deal out of nothing since his grades are good (not great, but good) and wonder if our perspective is just a bit skewed by our own giftedness experiences and those of our other kids. If he's ND, great! But if he has some LD's we don't want to ignore it.

This thread has been really helpful to me! So, thanks for starting it!

This thread has me remembering...DD at 4 singing her heart out that She was bein' eatin' by a boa "a-fictor" :-) or talking about the twirling Tomatoes - and then we said tornados and she says "THAT is WHAT I SAID!"

I also read some web sites re: CAPD and the constant "What?" happens here daily. Also when we read together she enjoys it but when I ask her a question about what we just read she often says "I can't remember." AND seems really stressed/annoyed with the question.

Lol! Yeah, it did help
Ds9 was diagnosed mainly with depression, but also anxiety (mostly about school and social issues) and also an actual but 'non defined' ld that shows primarily in sometimes excruciatingly slow processing speed. In the end I can't say it was 'incredibly conclusive' but did point us in the right direction with definite goals and he is much happier, even doing a bit better academically though he was always doing well there.
One extremely low cogat score is what finally threw us over the fence to just 'go for it' rather than continue to wonder about the timed math fact sheets etc -- I didn't want to wait too long and do more 'damage'.
Don't feel paranoid, in the end you probably do know your own kid! Turns out we knew something was up, just didn't know what or how to help.

We did have to pay up-front but then got reimbursed, miraculously, by ins. company...

APD - I have been wondering about that for a while, ds9 is still a guy who will say things like 'I won to her', instead of 'I beat her' at that game...odd things like that, but I have gotten no traction with the neuropsych, the school, the school psychologist or the audiologist/ent folks. So for ds9 I have to assume it is *not*, but it sure is ODD. The psychologist thought he was just wired differently.

For tests we did have iq and achievement in this big battery, some add/adhd stuff because for us that was a question, but there were tests of
'executive function'
some attention paid to auditory issues,
hand eye coordination
inhibition
dr's behavioral observations
mood screening
and so on.... Basically the neuropsychologist didn't say 'here is a list of tests, please pick' (so don't feel like you have to know it all, I tend to feel that way!), he had 2 types of testing - basic 'how smart is my kid' testing and this other level.

Our dr chatted with me for about 45 minutes on the phone and again for about 2 hours in person about ds (me and dh) and described the testing he recommended - sounds like you have someone already in mind, so that is some of the work out of the way. But I would think if some of these broad areas such as add are not a concern some of what we did wouldn't be needed, right? (makes sense to me) anyway, again, best of luck - this is a tough row to hoe but you will get to the end of it!

OOPS! just kidding - seriously, whoops, hope I didn't confuse anyone too much! thanks

Kriston,

We just did an OT eval this week for dd. She said it was really fun. I realize it doesn't cover exactly the issues you are concerned with, but thought I would mention that there is a "fun" test out there. In our case the evaluation is covered by our insurance. Last year's neuropsych evaluation was not...

It looks like Dr. Amend's office can do all kinds of diagnostic tests. I bet they can steer you toward other specialists near you for any other testing. (Dr. Amend is on our radar too...)

I hope you get some good news,
Chrys

Saw Dr. Amend in Feb. I had testing done by the school and he was able to go over all the testing that had been done. He agreed with what the others had come up with and was able to give me ideas and accomadations to take back to the school. He understood about the distance from our home so that is why testing was done in the school setting instead. Otherwise it can be up to 12 hours of testing at 250 an hour. It was well worth it for the 3 hour trip down to Lexington. If you can get into see him do it. It will reassure you that you are doing okay.

Kriston, my middle child is a puzzle too so I can totally empathize with you. The psych that we are using says he prefers kids to be at least 8 for evaluations. I have heard that kids outgrow some sensory disorders (?) so that may be a partial reason.

My 11 year old son went through testing and I really have more questions now than I ever did. We went through testing hoping that we could get a diagnosis so he could get OT/PT if he needed it and accommodations for testing if he needed them.

He was diagnosed with motor dyspraxia, but when I look at the symptoms now, few of them seem to fit. I watched videos of my son performing in 17 different songs with his musical theater group, and a lot of them required dancing. His timing was fine. I watched him at rehearsals. The only difference I could see was that his low muscle tone and low endurance caused him to need to rest after two hours when the other kids could keep on going for several more hours. He has to sit and watch sometimes while the other kids keep practicing so he gets about half the practice the other kids get actually doing the dances. He does look a little uncoordinated when he gets to the point that his legs and back start hurting and he just can't keep going, but until then I can no longer see a difference in how fast he learns the dances. The musical theater director can see the difference. One of the moms who is involved with the group told me he is one of the kids that can skip a practice and manage to get it by the time of the performance. She said some kids can't. He learned the song "Bare Necessities" quickly when another actor couldn't do it and practiced it only 3 or 4 times with his partner before the show. He had to remember which way to exit, stage left or stage right, 17 times so he has no left/right confusion. His balance is good now, he isn't out of sync with the other dancers unless he is tired, and he just took a typing test on typingtest.com and typed 38 wpm and he doesn't really touch type. He says he doesn't need to put his hands on the home keys, he can put them anywhere on the keyboard and just use whatever finger is most convenient to type a particular letter. Doesn't that take fine motor coordination? But he definitely still has dysgraphia and at least we got that diagnosis on paper. But I feel that I can't really tell people like the musical theater director that he has motor dyspraxia because if she looks up symptoms on the internet, most of them don't really fit now. His problems now are still the low endurance, low muscle tone, the brace and the migraines. He is good at tongue twisters and using different accents and will sometimes change accents like from a British, Australian, and Irish accents while he is reading out loud for fun.

My son was getting a migraine the day he took the test and I gave him Tylenol which doesn't work very well for his pain. We told the neuropsychologist about it and she said she didn't think it made any difference in the testing. I know that I don't think as well when I have a migraine. When we asked the neuropsychologist why he was able to do certain things that I would think impossible if he had dyspraxia, she said he could have splinter skills. If this is true, I think splinter skills can really make it hard to identify LDs. I wonder if gifted kids have more of these splinter skills than other kids with LDs.

..

Your PM's are full; so here it goes. I don't mind sharing, it's just long...so everyone else beware.;)

My DS5 has expressive language disorder. A few of the things you've said hit a chord with me. Large vocab, but not spoken; grammar problems; grasping for the right words at times (in my DS's case) especially when he's excited about something. Asking about the definition of 3rd or 4th difficult word. He (my DS) probably forgot the earlier ones.:) although, he has a crazy (weird-good) memory with some things. My DS prefers to figure things out by himself, usually; but just started asking definition questions. Here is a definition Of ELD from an article on it: ["Expressive language disorder (DSM 315.31) is a communication disorder which is characterised by having a limited vocabulary and grasp of grammar. It is a general language impairment that puts the person onto the level of a younger person and also a person can be as young as 2 or 3 years old with the disorder.
As well as present speech production, very often, someone will have difficulty remembering things. This memory problem is only disturbing for speech; non-verbal or non-linguistically based memory will be unimpaired.
Expressive language disorder affects work and schooling in many ways. It is usually treated by specific speech therapy, and usually cannot be expected to go away on its own."]

The time4learning we use is great for him...very visual and I'll then add a short worksheet or manipulative if he seems like he's not getting it. He also, as you've voiced on a different thread, like your DS, seems sometimes to not be trying; but in actuality he is taking a minute to absorb it. Then he knows it. One other thing about my DS is that since he doesn't always get the definition of the word due to context, he also takes some words more literally, if they have 2 or more meanings. eg. We were talking about chance/probability (math) and the unit asked which was more "likely" to be picked out of a bowl, one of the 10 blue blocks, or one of the two orange blocks. Well, he "liked" Orange; so that's what he picked. lol. When I changed the verbage he got it. This too is associated with the disorder.

If it doesn't seem to fit, we are all just more informed.:)

My DS has a crazy (good) memory, is reading at almost 2nd grade; but doesn't like to unless it's in his time4learning.com unit. He has over 250 sight words, which he prefers to phonics. He has a huge vocaublary; i.e., if you asked what something was that was a difficult word - he would know it; but wouldnt use it in his speech.

Okay, last thing, a good SLP would be able to pick out expressive or receptive language problems at this point, which covers a lot of your worries. And if they work in an office that has OT's and have specific specialties themselves in other things they would be able to rule out other things because they help kids with CAPD, etc. SLP's are instrumental in the therapy of CAPD.

Have to go. Hope it helped some. I didn't review this; so there may be errors.
Hugs!

I'm sorry! I didn't realize my box had filled up. I cleared some space. Thanks for being persistent.

This does sound very familiar! Thank you for sharing it. Sorry, but what's an SLP?

I'll look for more about this and definitely ask about it. Thanks so much, Michelle!

(And thanks to everyone else who posted. I'm behind, but catching up...)

SLP = speech and language therapist

I just sent you a PM

Kriston,I PM'd you.

Thanks, friends! I'm searching now, since this is really ringing bells for me.