katee564, I have a 2e ds who has a similar score profile on the WISC-IV and who struggles tremendously with slow output and written expression. He has expressive languages issues above and beyond what your ds has, but there are a few things I'd consider based on our experience with the gap in processing speed (ds is in high school now).
Does your ds have a 504 plan at school that specifies he can use keyboarding? If he doesn't, I would recommend pursuing one now even if everything is going well in school and he's allowed to type his assignments. He'll eventually be taking college board exams, and to get accommodations on those as well as in AP classes, it's much easier to qualify for accommodations if you have a record of having continuously used them for both classroom work and testing. Having a 504 plan or IEP with accommodations is the easiest way to prove that your student has continuously used accommodations. There's a bit more to it than simply showing he's used accommodations (he'll also need to be able to show that he needs the accommodations and that they are reasonable) - so you may want to consider having him re-evaluated either through school or privately.
If he is still struggling with slow output of written expression even when keyboarding or scribing, I'd consider an eval by either a speech language pathologist or the TOWL (Test of Written Language); both might be helpful in determining where the challenge is in getting his thoughts out/organized/written down. There's also a lot you can learn about his challenges by paying close attention to which types of assignments are more difficult.
Last note - when our ds was in upper elementary and middle school we focused a lot on accommodations to help him get his thoughts out faster. He made really great progress - for him. He didn't, however, truly keep pace with his peers in terms of output speed. He chose to go to a competitive high school program with high ability peers - which has been great for him in terms of keeping him interested in school, but there's been a downside in that he spends a ton of time on homework, sometimes as much as 3-4 times longer than his classmates. I only mention this because as middle school went by and we saw progress, I think I felt we were hitting some magic place where the gap in processing speed vs intellectual ability would become a non-issue... instead we found that ds made a lot of progress, he adapted to using accommodations, but he still struggles with the gap.
Last note - our ds also had some signs of rebellious behavior surrounding schoolwork when he was young, prior to having a diagnosis and accommodations for his struggles with writing. Once we understood what was going on and he had accommodations, the outward signs of behavior issues disappeared.. but he was still struggling with inner conflict. A lot of what had been showing up as lashing out turned into feelings that ds kept largely to himself. I hope that doesn't happen with your ds - but be sure to keep in touch with how he's feeling as best you can - it's not easy dealing with that difference in processing output vs intellectual ability.
Best wishes,
polarbear
