Gifted Issues Discussion homepage Forums Twice Exceptional Is it ADHD or Dyslexia or Both?

What were the scores on the TOWRE for pseudo word decoding and word reading? If the pseudo was significantly lower than word reading, this could indicate that he does not have a solid foundation of the decoding rules and word patterns and Wilson might be a good program. On the GORT, how was his accuracy vs speed? It will be interesting to see the results of the CTOPP and will give you additional info as to whether or not he needs to improve his phonological awareness skills and decoding skills or not. Also - how did he do on spelling? Often, poor spelling is a good indicator as to whether or not a child has a solid knowledge of the sound symbol relationship, word patterns and rules.

As far as the dysgraphia, what are the main issues? handwriting, written expressive language, spelling? What are the recommendations?

As far as the CAPD, virtually anyone with dyslexia has some aspect of CAPD. Often it is the inability to perceive all parts of a word, to hear the small differences between sounds, to be able to rapidly process sound or bits of language. Here are two resources that you may find helpful
http://kidshealth.org/parent/medical/ears/central_auditory.html
http://ocslha.com/Ferre.htm

As far as whether he needs a 504 or an IEP. A school is more reluctant to give an IEP because it comes with more procedural safeguards that protect the student. (more teeth so that the parents can monitor whether or not it is being implemented) An IEP also means that the student requires specialized instruction or related services in order to make progress.

Without knowing more about your child's difficulties in school and test scores, it is doubtful that a child that tests in the superior range on measures of reading will qualify for specialized instruction in that area. But, you say that he has a 3 standard deviation spread between ability and achievement. Perhaps this is in writing? If so, I believe you would have a case for services. Be sure that you bring work samples to the meeting - especially samples of INDEPENDENT work. If the SLP recommend S&L therapy, this would also be covered in an IEP. Often times students with oral expression difficulties such as word finding and formation also have difficulty with written expression. (if you can't say it, you can't write it). Often the SLP will work with the writing specialist to help.

Given his very slow processing and ADHD, he may need help with executive functioning skills. Sometimes kids with an IEP also have a study skills or academic support goal to help them learn to be a more active and efficient learner.

If he needs this kind of support, and IEP would be the best bet.

Based on the CCTOP the school says he does not meet the school's definition for dyslexia. I think we are headed for a 504 with modifications and no services unless he qualifies for a Tier II reading group. I can ask for an assessment under Special Ed., but I have heard that his school's special ed program does not serve 2e children very well. They don't seem to know what to do with them.

The dysgraphia is where he has the large discrepancies. His handwriting is terrible and he struggles with output. I have been working with him at home at composing on the computer and he is doing better. The Speech Pathologist says that an underlying weakness in his language skills are the problem as well as slow word retrieval. He had severely delayed language acquisition followed by an articulation disorder.

He is starting speech language therapy and Interactive Metronome has been recommended. Any comments about IM?

TOWRE Sight Word Efficiencies: 65 words in 45 seconds; score of 113(80%)
TOWRE Phonemic Decoding: read 32 pseudo words in 45 seconds; 73%; high average

GORT: Accuracy score 14; 91% and Fluency score 13; 84%

CCTOP: Phonological Awareness: 104 or 73%
Phonological Memory: 103 or 58% (scored 25% in nonword repetition - could this be indicative of the CAPD)
Rapid Naming: 103 or 58%

These scores are pretty solid. It's hard to make the case that he has a reading disability when his reading scores are mostly in the upper quartile. His CTOPP scores, which are the underlying reading skills are not as high - mostly dead average seem to be a solid foundation for day to day reading. It would be interesting to see the CTOPP subtest scores in addition to the index scores that you posted. Sometimes there is a lot of scatter within an index that could indicate areas of concern. (such as nonword repetition - although still in the lower end of average).

It is heartening that his rapid naming scores are so solid. Often, kids with retrieval issues have trouble in this area, and this results in poor reading fluency. But, your child seems to have decent skills in this area.

So - as far as needing an IEP for reading - these scores do not support this. Not sure if there are issues with comprehension - this would be an additional area to consider. It sounds like writing is the real issue, and it will be important to tease out what are the contributing factors: handwriting, language retrieval and formulation, attention, organization all or any of the above.

I have no personal experience with IM - but have heard of others with similar profiles that found it helpful.