My son has hypotonia that was bad enough to cause a 50% delay in gross motor skills at 12 months and the doctors he saw at a military base never recommended therapy for it. He went for regular check-ups and saw different doctors through the years and I asked questions about the hypotonia and not one of them recommended therapy. It wasn't until my special ed teacher friend (the mom of one of my son's friends) told me that she noticed red flags for sensory issues and that we needed to take him back to the doctor that we started to get a few answers. I took my husband with me and we were able to get a referral to a developmental pediatrician who confirmed that my son did still have hypotonia and that it did contribute to his problems with writing and the low endurance and fatigue issues.
He is almost 10 now and has only been in occupational therapy (sensory integration therapy but the OT says she can't call it that because out insurance doesn't pay for that) and he is getting better in some things. His piano teacher noticed the difference, but there are still things I don't understand about this, like how he is sometimes able to play really well in piano (2/3 of the way through Level 3 where you have to look at the music and then move hands to different positions and look back up at the music and play both hands and sometimes he does this really well without having practiced very much and then other times he did practice and it doesn't look like it when he plays for the piano teacher. We used to joke that it must be "misfiring neurons." But lately, since he has had OT there are more of the good days and I am amazed at how well he is doing. Another strange thing though is that he still doesn't do jigsaw puzzles quickly and the OT says this is important but she didn't explain why. I don't think that it affects him academically in any way, but I do think it might cause his IQ score to be lower than his achievement scores.
I had some people tell me that you can't really tell by achievement scores if my child is gifted or how gifted. But I found an article written by Linda Kreger Silverman, Ph.D. "Using Test Results to Support Clinical Judgment" that said the highest indicator of a child's abilities at any age should be seen as the best estimate of a child's giftedness. She gives an example of a child with a reading achievement score of 160 but an IQ score of 125, and says that the IQ score must be an underestimate and it is impossible for a child to achieve beyond his or her capabilities and that "overachiever" is an oxymoron. In our case my son would be a twice-exceptional overachiever which seems even more ridiculous.
The article goes on to say that the measured IQ of parents or siblings, early achievement of developmental milestones, profound curiosity, deep moral concern, remarkable associations of generalizations, perfectionism,... should all be taken very seriously in determining the abilities of a child and that in the end the diagnosis of the degree of a child's advancement must be based upon clinical judgment, not just on psychometric data.
The certified educational psychologist that tested my son using the WIAT a few years ago took his achievement scores and his early reading and the fact that he has a half-sibling who tested highly gifted into account when he told us that he believed that my son was highly gifted but we needed further testing to confirm how highly gifted, but I don't think it really matters for us since we homeschool.
I know that my son seems advanced in everything except physical skills compared to a public schooled friend who tested gifted. The public schooled friend's gifted older brother (another of my son's friends) even noticed this and he also said that he thinks my son is smarter than he is in some ways and he is four years older.
I know that my son is very different from me in the way he learns. The energy he lacks physically is there in abundance mentally. IQ tests just don't tell the whole story.
