I am becoming extremely frustrated and seeking any advice...
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My DD11 was tested with the WPPSI-III in kindergarten. Her IQ was 143.

Fast forward to fourth grade. Grades are not where they should be. Terrible speller, difficulty utilizing correct punctuation. Got her a tutor. She limped along. I began to suspect dyslexia, so she had a full psycho-educational eval. just before fifth grade.

Dyslexia was ruled out. She was diagnosed with ADD. I put her on Concerta. Another year of tutoring. NOTHING WORKED.

Beginning to suspect some kind of writing disorder. I am going to post test results to see if anyone could provide some insight. (I am getting a second opinion from another educ. psychologist, but this has been a two year struggle and I still do not know what is going on or what to do.)

FS IQ 125. This is obviously a big diff from WPPSI, but still too bright to be struggling.

Verbal Comprehension Composite 124
Similarities 15
Vocab 14
Comprehension 13

Perceptual Reasoning Composite 127
Block Design 16
Picture Concepts 16
Matrix Reasoning 11

Working Memory Composite 107
Digit Span 11
Letter-Number Seq 12

Processing Speed Composite 115
Coding 8
Symbol Search 17

She was all over the map on Woodcock Johnson, but mostly average.

On the Gray Oral Reading test, she was in the 50th percentile for everything tested. (am I wrong in thinking this is a pretty big mismatch with her IQ?)

And then this:

Beery VMI

Percentile rank 19
Visual Perception 39
MOTOR CO-ORDINATION <1

I honestly do not think she has ADD, and the last thing I want to do is give her stimulants to alter her brain chemistry if she does not need them!

Out of ongoing frustration and growing desperation, I have contacted speech and language pathologist to work with her.

If anyone has any advice or opinion, I would be extremely grateful. Her self esteem is suffering and it's hard to watch.

It seems like a familiar pattern. A number of us recently were comparing notes on the effects of visual tracking and convergence issues have had on our kids.

Slow and messy handwriting
Oral reading inaccuracies
Lowered coding score

I know personally, in addition to amblyopia related issues my eyes switched from far-sighted to near-sighted between 9 and 11.

So, from my near-sighted perspective, sounds like the symptoms fit a vision issue that may or may not be related to acuity.

Thanks for the suggestion, but she has had her vision checked.

I forgot to add that I rec'd her ERB scores, and she was in the bottom stanine (3rd percentile) for writing mechanics.

Our parenting co-ordinator has suggested this diagnosis from DSM 5: Specific Disorder of Written Expression.

This is beginning to drive me nuts after two years...

Just because of the similarities between her cluster of symptoms (average oral reading and exceptional comprehension and poor motor coordination and situation specific attention issues) andthose of us whose experiencing non-acuity based vision issues, hopefully she had her eyes checked by an opthamologist or developmental optometrist. A regular optometrist or pediatrician is likely to miss amblyopia, convergence issues, coordination issues, holding focus, and such. A couple of parents here have kids with connective tissue issues which lead to dyspraxia, dysgraphia, and general coordination problems; one possible symptom of that is exceptional double-jointedness. For us, the pediatric nurse when DS had his physicla was ready to dismiss his vision issues as being uncooperative but luckily the pediatrician referred us to an opthamologist.

I second Zen Scanner's suggestion to get her checked by a developmental optometrist. I have been going through a similar struggle with my son (age 7). He also has similar challenges as your little one - particularly low in motor coodination, visual -motor very low and handwriting issues... His codign score was deplorable. It has been suggested/hinted in the past that he is ADHD (tho it's, I guess it's 'subclinical,' b/c he doesn't quite meet the criteria so never formally diagnosed with that and I resist that Dx b/c I just know that it isn't the 'real' problem. And I do think there is a problem but I don't believe it is ADHD and I fear that a misdiagnosis like that (and giving him drugs) could be very detrimental in that the true problem would continue to go untreated and he would be inappropriately be given medicine, which I assume could cause damage if he does not really have adhd. Anyway, he was diagnosed with EDS (a connective tissue disorder) and it was suggested by the diagnosing doc that dyspraxia is often co-morbid. I am reading a lot on dyspraxia and DCD (Developmental Coordination Disorder - another name for it) and I really believe it's what he has. Why everyone (i.e., professionals) has been missing it, I have no idea because the more I read about it, the more obvious it is to me that that is what he has. He does have convergence vision issues but that is also really common with dyspraxia/DCD (I had no idea) and EDS. Have you looked into that maybe? It is an impairment in the development of motor coordination. With my son his gross motor skills are somewhat affected but his fine motor skills are very affected (hence the handwriting issues and dysgraphia). It can cetainly be co-morbid with adhd but it can exsist without adhd and, I believe, it is often mistaken for adhd. It affects more boys than girls, though. Anyway just some thoughts! I really know how you feel!

Yup this is us. My DS's hypermobility is relatively mild though... And originally DS's vision issues were dismissed as his simply being uncooperative by his pediatrician. Acutally DS became quite uncooperative evertime he couldn't see right. He felt stupid - he didn't understand why he couldn't do what was asked and what everyone else was doing. He wanted to "hide his stupidity" so he would end up saying whatever he was being asked to do was "stupid" and would become oppositional. Let me tell you how fast down a path of ODD and autism that was getting us. And I kept saying "I don't think he can see right... and I think he feels stupid." No one believed me. The Developmental optometrist not only believed me but proved me right.

It sounds like your dd has a fine motor coordination challenge. If you look at the WISC scores under processing, she has a lower score on coding - this is a subtest which has the student make marks in specific directions with pencil and it's timed. The *very* low score on fine motor on the Beery is another indication of a fine motor challenge.

Like Zen, I have a child who has visual processing challenges - but fwiw, she did *not* score well on the Symbol Search subtest - that subtest has you look for specific symbols in a randomly ordered highly scattered page of many many drawings. Since your dd performed really well on that subtest, I'm less likely to think it's a visual challenge.

My ds13 had a diagnosis of Disorder of Written Expression when he was in 2nd grade, as well as fine motor dysgraphia (and a misdiagnosis of ADHD, fwiw). He also has a dip in coding and a strong score in symbol search on his WISC testing, and a low score on fine motor on the Beery. I *think* he had a not-so-stellar score on the Beery visual subtest too, but can't remember for sure - when I have time later today I'll look it up. FWIW, he has been evaluated by a developmental optometrist and visual issues were completely ruled out. My ds did have some additional testing as part of his neuropsych - executive functioning, attention (can't remember the name of the test), and fine motor tests (called "finger tapping", part of the NEPSY) to tease out the results of the WISC and Beery.

The thing I'd recommend you do write away is to chart your dd's WJ-III Achievement subtest scores against the type of *response* required on each test. Some have oral response, some have written responses but aren't timed, and some require written responses and are also timed. For my dysgraphic ds, his WJ-III Achievement scores *appear* to be all over the place (and not so impressive) until you graph them that way - then a very clear pattern shows up - the oral response subtests track the percentile that his IQ is in, the written but not timed response subtests fall about 30 percentile points lower than that, and the written+timed subtests all track each other but at a very low score. Soooo... what you're really seeing with ds is the impact of his fine motor challenge, not his ability in the specific skills that are being tested. It would be interesting to see if a similar pattern comes up in your dd's achievement subtest scores.

Re the diagnosis of "Disorder of Written Expression" - my ds lost that diagnosis when he was reevaluated at 10 years old - even though he also has an expressive language disorder that impacts his ability in written expression. When I asked his neuropsych why she dropped that diagnosis, she said it was specifically because his scores rose in one of the writing subtests on the WJ-III. I can't remember which one, but if I have a chance I'll look back at his two sets of testing and let you know - I'm guessing that particular subtest score is going to be low for your dd.

Re the Grey Oral Reading scores - that's one I don't know what to think about. I've had some questions over the years re is my ds stealth dyslexic, even though he reads at a really really advanced level and seems to comprehend well. He's never had the Grey test, but he fits some of the other profile symptoms the Eides include for stealth dyslexia. I have a younger dd, however, who does not have a challenge with fine motor skills or written expression but has struggled to learn to read and has been identified as having a challenge with associating sounds with symbols. She's had almost every reading test under the sun, including Grey, but hasn't seen a neuropsych yet (she will this fall). Her scores on the Grey are a similar difference as your dd's percentiles between IQ and Grey. She is not dyslexic, and she scores well in some of her reading assessments, average in other areas, and really really low in that one bug-a-boo of sight-symbol association. She much prefers to listen to audiobooks over reading, and she does not like to read aloud. I only mention dd because, fwiw, getting to the root of what's impacting her in reading has been *very* challenging, and it's also been very challenging because we see what we think are impacts of it across the board in her schoolwork and testing now, yet nothing stands out as clearly obviously correlating with an obvious diagnosis like dyslexia. Determining what is up with our kids can be *tough*!

The other thing you can do (if you haven't already) is to simply write down every detail you can remember of your dd's developmental history (before school) as well as academic challenges. For my ds, some of the things we thought were just cute quirky things when he was a toddler etc were actually signs of developmental delays that related to the reason he also has a fine motor challenge - none of that was clear to us but his neuropsych put it all together for us and *then* it was "obvious"

Last note, difficulty with spelling and punctuation are potentially symptoms of dysgraphia, which I would strongly suspect based on the other test results and what you've written.

Hope some of that helps!

Best wishes,

polarbear

It's so neat she did so well on the symbol search. As polarbear said symbol search requires simpler hand motions than coding so that could be it, especially if she is a messy writer.

In addition to do really well on coding ideally one keeps multiple things in one's memory, and switches back and forth between them without mixing them up. Whereas in symbol search one doesn't have to use memory for such long stretches.

So the big difference between her scores on the two processing subtests could be due to several things or a combo:
1. Could be random such as chatted during the coding. There is not any time to spare on it.
2. Could be her actual hand control or her motor planning ability is poor. If so she would likely be either a uniformly slow printer, or not horribly slow but letters are sometimes illegible especially later ones as she tires. How is her motor planning or fine motor skills with other activities besides writing? Cutting with scissors, or tying shoes or lacing beads?
3. Could have trouble with memory, not memory for facts or events but the type of memory where you remember several things at the same time and manipulate them. Example: memorizing a list of what people are in what hotel room number and then being able to visit them in a particular order. But for the wisc it's a visually presented data.
4. Could have trouble switching. Perseveration is the extreme of this. Check out all the varieties of perseveration.
5. Perfectionism. If you worry you aren't doing it right you waste time checking or don't rely on your memory as much as you could. The amount of memory involved isn't huge but if you know you have a terrible memory (like me) you would probably waste a lot of time checking. It would take more time to check the coding and you'dbe more likely to lose exactly where you are, I think.

According to the wisc results it seems facile and easy use of memory, juggling memories in her head, is her weakest area. But maybe perfectionism or a fluid ability to switch back and forth complicates it?

Not sure how all that impacts spelling or punctuation.

PS... I have no training just read about the wisc processing because my DS has fine motor issues.

Thanks to all for your thoughtful responses. She was checked by regular opththamologist, so I will def. keep developmental doc in mind.

When I spoke with second educational psych over telephone about her, he said if her working memory lagged significantly behind IQ, it was a red flag. FSIQ of `125 but working memory 107. Am I correct in thinking that is one standard deviation below?
Is that red flag enough? and a red flag for what??

Isn't it fun trying to educate yourself about all this psychometric testing? I am grateful for the help on this board!

I second looking into developmental coordination disorder.