Gifted Issues Discussion homepage Forums Twice Exceptional reading difficulties, dyslexia?

The other thing to add is that all his visual, auditory tests indicate that he should have difficulty with reading and language. Yet he has none. So in this regard, the tests have not been useful in terms of steps to take.

Hi Verona,

You are right � the Special Ed regulations and process in Canada are much different! The forum I suggested has a group of Canadian members, so when the time comes you might want to check in there for some guidance in terms of resources and laws.

You ask why test now. Given that you are already providing speech and language and OT support, you most likely have initial benchmarks in those areas and could put off testing. But, what you don�t have is an understanding of your child�s learning profile and a data for reading acquisition and other academic skills. You only have red flags that my gut (and I think yours) tells me might indicate an issue. But, without testing you don't know. The therapies you are using most likely will not address the reading difficulties, if there are some. If he has a language based learning disability such as dyslexia, he will need an explicit, systematic, multi-sensory, rule based reading program to learn how to crack the code. By waiting, you could loose precious time and perhaps allow your child to fall further behind. Given that remediation is much more effective when a child is young because their brain is more malleable, I would hate for you to lose this window of opportunity by waiting. If the testing comes back and indicates he is right where he should be, and there is no reading disability, you will have confirmation that you are addressing the priority areas with the OT and S&L, and you can relax and put your �wondering� about reading remediation to bed.

Note � if you do pursue more testing, be sure to get the names and versions of the tests that have already been used. Most tests are not valid if administered more than every 12 months. Your new evaluator will want to know the what tests to avoid and would most likely find the test scores helpful for background knowledge and developmental history. These domains are usually interrelated.

On another note, you write that you are considering vision therapy. When my son was 7 he participated in a year of behavioral VT. Initially the results seem to be positive, but they were not sustained over time. The therapy takes a large commitment and ongoing practice of the exercises. Over time, my very compliant son resisted. My experience is that the results were minimal and not sustainable. Additionally, the therapy does not address dyslexia � it only improves skills in the visual domain so that the child is more able to access the reading instruction. Here is a recent report on VT: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;102/5/1217 Again, you want to make sure that your resources (time and money) are targeted to the areas of priority. While VT could be part of the solution, I don't think you know whether it is the most important aspect of your child's remediation plan without data about cognition and academic achievement. You would get this important data via a neuropsychological evaluation.

Since you are in Canada, you may be interested in exploring the Arrowsmith School approach. I recently heard the founder, John Eaton speak. While I am not completely sold on the approach, it did seem interesting. And since I am fairly conventional, I tend to feel more comfortable with traditional approaches to remediation � you might be more open to alternative therapies. Here is the website: http://www.arrowsmithschool.org/. I'm not sure if there is a location nearby - I realize that Canada is vast!

Hope this helps � follow your gut � information is king.

Thank you Mich. I'm so glad to have your input on this.

I thought that the testing that the S&L therapist did was enough to diagnose dyslexia. She did tests for

working memory (OK)
verbal phonem awareness (ok)
rapid naming (not OK)
basic reading test (read this page of a book) (not OK)

She said informally that she feels he has some degree of dyslexia. And I agree.

I thought that the therapy she is planning to provide would be targetted at helping him learn to read and compensate for his difficulties. She mostly works with children who have language based LDs, so I thought this therapy would be what he needs. Are there other therapies/professionals I should be looking at for the reading program you suggest:

"If he has a language based learning disability such as dyslexia, he will need an explicit, systematic, multi-sensory, rule based reading program to learn how to crack the code."

I'd like to know more about this. He's not starting with the S&L therapist until February (waiting list!) so I have time to do some background research. Also, if I tell the school that I want something specific for DS during school hours, they might be able to accommodate (it wouldn't be a trained therapist, but they have a teacher who goes from class to class helping children who have difficulties).

I'm working at home with a book (in French)that the S&L therapist recommended that teaches phonems with pictures (like the sound "ch" is a little girl saying shhhh with the c as her mouth and the h as a finger). DS loves this approach and learned about 5 phonems in a week that we had been struggling with for a long time.

Yes, I've seen that vision therapy is sort of contreversial, and am not sure I'd do it with him. I'm pretty conventional too (and DH is even more so). I did try Padovan therapy (kind of a mixture of patterning and speech therapy, and song with some vision work as well) and didn't see a long term benefit.

A friend mentioned Arrowsmith also. I'll check out the site. DSs first language is French and this limits options as well.

I have seen posts over the years about multisensory/phonemic reading instruction in languages other than English, but I am not able to find resources right now - I'll do a bit more digging and if I find something I'll be sure to post.

As far as whether or not the speech and language pathologist can help - I'd say maybe. There are S&L in the US that are very well trained in both oral language and written language. In fact, a widely used reading for program for dyslexics was developed by a S& L Pathologist: LiPS. And there is a widely used writing program called EMPOWER that was developed by a Speech and Language Pathologist. The key is finding someone that is trained and experienced in using a proven reading program. The programs most often used to teach reading in English are: Orton-Gillingham, Wilson, LiPS and Project Read (at least in my area!). Again, I recall reading about a program for French, but can't remember/find it. (I actually was searching for my son to find out if there were a program for him to learn a second language!)

You may want to contact the International Dyslexia Association in Canada (specifically in Quebec, if this is where you live). They would have good resources on programs and practitioners.

It sounds like the testing that was given was more of a screen rather than a full evaluation. I would highly recommend that sometime soon you would get a full evaluation that looks at all areas of cognition and academics and uses standardized, normed testing. The evaluation should also look at the underlying skills for reading such as phonological memory and processing, overall processing speed, verbal and non verbal reasoning and organization. These are all important in understanding strengths, weaknesses and for diagnosing (or not) disabilities. In my area (Boston) the top evaluators schedule 4-6 months out. If it is the same in your area, you are talking about the end of the school year at best. Your Speech and Language Pathologist may be able to help you with referrals. The cost in my area ranges from $2500-$3500.

www.readingrockets.com is yet another resource that may help you understand the kinds of reading support he may need. It is encouraging that you are able to teach him the sounds using pictures. This is an example of multi-sensory. The programs I listed would use images, but also use fine and gross motor skills to help teach the rules. The idea is that if you use all pathways to the brain, the child will learn more quickly and will be able to recall the new concepts more fluently and accurately.

As far as help from the school - Straight Talk About Reading offers a number of approaches at the end of the book. This might be helpful to the school. My only concern is that if he truly has a problem, and eclectic approach may not be enough. His time would be more productive using a well -researched and proven systematic program that was developed by experts. But, as you wait, the ideas in "Straight Talk" are at least a start.

I checked a few Canadian/Quebec sites on dyslexia and the only approach I see mentioned is called EMS :�enseignement multisensoriel simultan� (EMS), bas� sur l�approche Orton-Gillingham" (a multi-sensory approach based on Orton-Gillingham). It also seems from these Canadian sites that most of the professionals providing interventions for dyslexic children are speech therapists.

I will call the S&L therapist and ask her for more details about what she is planning to do during her sessions with DS. If you don't mind, I might post again if I have questions about her approach.

Regarding a more thorough evaluation (WISC, achievement tests, etc), I am hesitant to do this. I found the process very stressful when I did it for DS10 -- I get focussed on the numbers and anxious. For DS10, I felt like the testing was needed because I was really confused about what was going on with him (still am). At this point, I think I have a good estimate of my younger son's abilities in my mind, and I'd rather assume that he is dyslexic and get him some help. I guess this might sound irrational, but there it is!

Verona - I totally understand about not wanted to test. In some ways I find it very invasive. I certainly wouldn't want anyone to look into my cognitive functioning in such a way and measure my competencies with hard numbers. And when I have had my children tested, it is hard to focus beyond the numbers and report and not get too caught up in it.

I'd say that if you are assuming he has dyslexia and are willing to address it, holding off on the testing for awhile would be ok. I did the same with my son as far as testing him for CAPD (central auditory processing disorder). I'm pretty sure he has it, I have an understanding of what type, and we are providing him the supports and interventions we would give him if he were formally diagnosed - so why put him through the testing?

I did a search on EMS and based on what I read with my very poor understanding of French - it is exactly the kind of program I was talking about. Using three senses (visual, auditory, tactile) it teaches the sound symbol relationship in a systematic way. It appears it was developed in conjunction with The Scottish Rite centers that are big providers of reading instruction in the US.

It looks like you are on the right track!

Dyslexia is complex and individualistic. The low scores in rapid naming and delayed word recall are indicative of the language processing problems of dyslexia and at his age it can be difficult to determine whether visual problems are memory/ processing problems or seeing problems. It is fairly common to have both to different degrees.

The low score of foreground / background maybe an indication of visual dyslexia. Not all visual dyslexics have poor depth perception but the rate is higher than the general population.

You may want to visit http://dyslexiaglasses.com for information about visual dyslexia.