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

My DS6 was recently given a test of visual perceptual skills (TVPS) to see if it is the cause of his difficulties with learning to read. Does anyone have any input on the results below? The OT who administered the test said that since he was in the average to low average range, he shouldn�t require any special accommodations in this area to be able to learn to read. She told me that average is anywhere between the 16th and 84th percentile. I find this confusing, as below the 50th percentile, more than half the children his age would do better than this � why is the 16th percentile considered average? Do any of these results point to a vision or tracking problem?

A. Visual discrimination (ability to recognize similar forms): average 25th percentile

B. Visual memory (ability to immediately remember characteristics of a form and be able to identify it when it is grouped with other similar forms: high average 63rd percentile

C. Sequential memory (ability to immediately remember a series of forms and be able to identify it when it is grouped with other similar series: low average (16th percentile)

D. Spatial relationships (ability to understand and use the concepts of spatial position such as above, below, beside, in front, etc): average (37th percentile)

E. Figure �ground discrimination (ability to distinguish the figure from the background and focus on an object): low average (16th percentile)

F. Consistency of form (ability to recognize similar forms despite changes in size and position): low average (16th percentile)

G. Visual closure (ability to mentally complete an incomplete form): average (25th percentile)

He also recently had a partial evaluation with a speech therapist to look at areas that might affect reading. He was above average on working memory, and average to above average on putting sounds together to form words verbally. The area where he was weak was on rapid naming (not sure of the official name as he took the test in French). This was a test where he had to �read� lists of colored shapes (e.g. red triangle, blue square, etc). He tested about 1.5 to 2 years below his chronological age on this test.

Background on DS: seems to be a bright child, likes math and has a good memory, vocabulary and understanding. He has motor dyspraxia (problems with fine and gross motor skills) and hypotonia. He reached all his motor milestones late. He is having a lot of trouble learning how to read. I have noted issues with word recall from an early age. It took him forever to remember the color �yellow� � he called it �the color of the sun� for a very long time. It�s like he has the concept in his head but can�t get the word out.

Any advice from those with knowledge of dyslexia and/or vision issues?

The lowest of those scores are certainly in the range where I would think further evaluation for vision and visual processing are in order. Have his hypotonia and dyspraxia been investigated further? There are neurological problems that can affect all of these functions simultaneously.

We have seen two different neurologists who both felt that he has "developmental coordination disorder" (dyspraxia, hypotonic type) and no other neurological issues -- but I would be very interested to hear of other possible neurological problems.

For vision issues, should I be looking for a developmental optomemtrist? Would my general optometrist be able to help?

He had an MRI that showed a slightly smaller than normal cerebellum which the neurologist thought DS was born with and could explain the dsypraxia. We've seen a geneticist who didn't suspect any type of syndrome. He has also had blood tests and muscle/nerve response tests that all came back normal.

He is a happy, bright, sociable boy, but I worry about whether he will be able to do well in school given his difficulty writing, and maybe reading too . . . He is currently in grade 1.

I think 16 to 84th percentiles are 'average' in that they are within one standard deviation of the mean. If you think of a bell curve, most of the population bunches up in the middle. That's why schools work in general.

You can try teaching him 'how to read' without reference to visual images. Just by talking about letters and what sounds they make and 'what word to you get when you put a 'c' with an 'a' with an 'r.' What if you put a 'b' in front of the 'ar?'

I guess you'd have to check that he knows the letters first, by asking 'how many letters can you name with no straight lines?' How many have no curves or circles?'

I would only try it if you can keep it 'fun' - perhaps while waiting in line at the grocery store, during car rides, as a way to pass the time.

Good luck!
Grinity

Thanks, that helps. I guess I wouldn't think of being one standard deviation below the mean as "average" but I suppose that is what they meant. 16th percentile seems problematic to me, especially when I am pretty sure his understanding and reasoning are above the mean.

He does know pretty much all his letters, and quite a few phonems (he is learning to read in French, so there are a lot of these), but seems to panic when they are all in a row in a long word.

For possible vision and visual processing issues in a child with that medical history, I'd suggest an evaluation by a pediatric neuro-opthamologist.

I think you are wise to stay on top of this. My ds now 13 and severely dyslexic had many of the same characteristics as yours at age 6. Things like poor sequencing skills that show up in his testing (16 th percentile is below average) and his slow development of motor skills come in to play with reading (think, keeping the letters in order, understanding that you need to go from left to right, letter confusion b/d, g/b etc). You also say that his rapid naming scores are low. This test may have been the CTOPP � comprehensive test of phonological processing or RAN RAS? (Although there are many different instruments). Low rapid naming is the single most consistent predictor of reading trouble. http://www.childrenofthecode.org/interviews/wolf.htm

The OT test is a good start, but since dyslexia is a language processing issue, I recommend that you get further testing including a full neuropsychological evaluation that looks at overall cognition (IQ, memory, organization) as well as receptive/expressive language, and academic achievement.) Let the evaluator know that you are concerned with reading so that they thoroughly evaluation reading, writing and spelling skills. Additionally, I would consider a speech and language evaluation that looks at how he processes and organizes language. There is often a link between oral language and written language.

In the meantime, I would begin to research reading disorders. The best book Is �Overcoming Dyslexia� by Sally Shaywitz. I also like Straight Talk about Reading by Susan Hall &Louisa Moats � my favorite when I started down the road. Here are some articles to get you started:

Is it a reading disorder or a developmental lag? http://www.readingrockets.org/article/32540

Resource for many good articles on reading http://www.readingrockets.org/article/c74/


Good resource for articles about LD testing http://www.ldonline.org/indepth/evaluation

The special ed process http://www.ldonline.org/article/Understanding_the_Special_Education_Process/20494

Great website about special ed law www.wrightslaw.com

Finally � if your child is in a public school it is important to understand the special ed process and laws governing special ed. If your child does have an LD of some sort, you will want to work with the school to insure he gets the right supports and instruction. Sometimes this goes smoothly, sometimes not. But outcomes are better for children with knowledgeable advocates. This forum is a good one to discuss the ins and outs of special ed as well as to get answers about how to recognize and treat an LD http://millermom.proboards.com/index.cgi? (Learning Disabilities, ADHD and Education Support).

Hope this helps � pat on the back to you for actively searching for answers.

Just wanted to add this resource that talks about tests for reading: http://concordspedpac.org/Whichtest.htm

And here is some basic information about dyslexia from the International Dyslexia Association:
http://www.interdys.org/FAQ.htm

Thank you Mich -- very helpful links, I've already looked at a couple of them. They made me think that I'm doing the right thing by not adopting a "wait and see" attitude to reading. The ones about special ed. process and laws might not be relevant for me though as we live in Canada.

I'm not sure about doing more testing right now (except maybe the opthomologist). The speech therapist only did a portion of the testing she usually does for language LDs and did not provide a written report -- she said that he does show signs of dyslexia (which I knew) and that we would be better to spend our money on therapy than on a complete work up with report, unless we need it for school (we don't this year as he is in Montessori and there are no IEPs or anything like that).

I'm open to hearing the other side of the argument though -- what is the advantage of more testing right now rather than just working on OT and speech therapy? To me he seems to have good organization, attention and social skills. His issues seem to be really dsypraxia/dyslexia.

Verona, fwiw, my son did the TVPS in July last year and had similar scores. We were told to remediate. Perhaps its because we're not in the Americas, so the standards are different. He has no problems with reading or math, but his physical skills are way behind, and I worry for his physical safety.

In November of last year, I brought him out of country to have his vision evaluated by a behavioral optometrist. Surprise- significant improvement across the board on a second TVPS. Seeing that he has been having vision therapy at various therapists on and off (mostly on) for 2 years prior, it must have been what went on in between july and nov that helped. This is what happened- I took charge.

I bought a balance board and did daily exercises with him. We each have one and we play ball this way.
http://www.balametrics.com/products/homekits.htm
I bought dr frank belgau's book as well- it's a good read and really helpful to understanding what's going on. The wider message to me is to focus on whole body improvement, in addition to visual improvement.

We also did a bunch of worksheet type exercises daily:
http://edhelper.com/visual_skills.htm
http://www.visuallearningforlife.com/visual-perception-worksheets.php

These 2 are subscription based. http://www.eyecanlearn.com/ is free but I didn't rely on this as much. I work closely with his vision therapist and speech therapist (he has CAPD) to implement the daily exercises they recommend.

I'm not spending more money on testing- my thinking is that experienced therapists can discover more along the way than any snapshot test. For eg, even though the recent TVPS looked great, I know that the improved skills haven't translated into significantly better physical skills. We've started working with a kinesiologist to help improve this area.

Good luck!