Overall, I think it is too early to be concerned; I think Dude's hypotheses have quite a bit of merit.
OTOH, there are things I would keep an eye on, such as the bilateral coordination--not because of any link with dyslexia (yes--since found to be bogus), but for purely OT/PT reasons. I would also be observant about what his actual level of reading decoding skill is, whenever he lets a hint slip out. With his oral vocabulary and cognitive language abilities, it is perfectly reasonable that his own decoding skills, even if they are, say, at a third-grade level, might feel too slow for the level of text that he wishes to access. At the same time, after two years of reading (though covert), some level of automaticity in word calling might be imagined to have emerged (i.e., faster, more fluent reading).
The occasions where he's let slip have been mostly in public-- reading things like, "exhibit closed for construction" when he saw a plain notice on a directory of exhibits near the main elevators of a museum, or "parking garage full" on an electric sign. I recall checking that neither of those instances had pictorial clues, because my initial reaction was that perhaps the meaning could have been inferred from context.
The time where he read words upside down and backwards was in a Berenstain Bear's book. I looked up the book last night and found it had a 500 Lexile rating, which is grade 2ish. He's sounded out words here and there from stuff like Curious George and Leo Lionni books. I'm inclined to think that there's quite a difference, though, between being able to read a book cover to cover and reading snippets. So K/1? TBH, I have no idea what the different levels entail.
I wouldn't bother with formal testing of the cog/ach/neuropsych type at this age, though, as you will most likely be assessing compliance and time-to-fatigue more than anything else.
LOL! Elegantly understated! I imagine buying $1,000+ of wine would be a better idea what with his tendency toward subterfuge and playful doubletalk in everyday situations. He spends at least half his time in wonderful, imaginary worlds of his creation. I can only cringe at the thought of his responses to a rather long series of questions that, to him, seem so comically obvious that they must be an invitation for fanciful answers.
I can just see a tester asking him to point to a picture of a teapot and him gesturing to, say, a lawn mower. If asked for his rationale, he might say that the commercial tea crops on planet Snorgbot have been poisoned by his archnemesis and, as a precautionary measure, all residents are cutting and brewing their tea directly from their backyard crop in a teapot attached to a mower, ironically also called a Snorgbot, but with the emphasis on the second syllable. And then he'd demonstrate a war cry or attack manoeuvre on the tester. Or just totally ignore the tester and do whatever he wanted, looking like he's 2 SD below the mean! (*Aquinas pulls her hair out*)
I would put the odds of a compliant test at less than 2%.
Waxing and waning: well, he's still in the age-range for which food jags occur among many NT kiddos. No reason that might not happen for other interests as well.
In any case, even if, worst case, there is something that needs remediation, it is highly unlikely that anything irreversible will happen in the next couple of years without him making you unmistakably aware of it by his distress first.
I think you're right. I'll run my observations by the ped to see if she thinks an OT eval is warranted, or whether I should continue watchful waiting. Thanks aeh! I'm much obliged for the informal professional opinion.
