Gifted Issues Discussion homepage Forums Twice Exceptional Dyscalculia Alone, or Part of AS/NVLD (Revised)

***Edited to make it slightly less agonizing to read through.

So here's what I've been told about DS 9.

(1) Definitely PG
(2) Possibly mildly AS
(3) Possibly NVLD
(4) Convergence Insufficiency

It has never been suggested, but I feel almost certain after reading and reviewing lists (like this one), that he has DYSCALCULIA. He's "positive" for almost all of the symptoms.

I've always thought that ds leaned toward the NVLD side, but imo,a dx of dyscalculia, and possibly CAPD, would explain much of what makes him look like he has AS.

When I read this page , I don't see how AS with dyscalculia is any different from plain old dyscalculia *in how it manifests*. What am I missing?

The things which make me doubt an AS dx are that he has never even come close to doing ritualized things, as far as I can tell. The only time he has ever had any kind of outburts or uncontrollable (or inconsolable) emotional displays was when he was a toddler. Loud noises (like fireworks) elicited screams of terror. He would climb our bodies to try to get away from the sound. He still startles at unexpected loud noises, including shouting.

He can be passionate and intense from time-to-time, but not so much so that he causes a scene. He's didn't regularly have tantrums even as a toddler --I can only remember one, and that was when asked to leave the library. LOL He's very compliant and follows rules --when he can remember them! There are no obsessive tendencies I can think of.

When looking at the DSM list, this is what I see in regard to my ds:

A. Qualitative impairment in social interaction

• Failure to use non-verbal social skills (i.e. eye contact, gestures, body posture, facial expressions)
  
  He does avert his gaze at times; his face can be quite expressive, but when he's not smiling, he does seem 'flat'; I can pick him out on the playground by how stiffly he runs and walks.

• Developmentally inappropriate peer relationships
  I don't think so, esp. when you take the PG into consideration.

• Lack of spontaneous sharing of enjoyment and interests with other people
  Not at all

• Lack of social and emotional reciprocity
  Not at all

B. Restricted, repetitive and stereotyped patterns of behavior, interests, and activities.

• Preoccupation that is overly intense and narrow
  Never

• Inflexible adherence to non-functional or peripheral routines
  Never
  

• Stereotyped or repetitive motor movements
  I've seen this only during one period of time when we were all under a great deal of stress.

• Persistent preoccupation with parts of objects
  Never. Not at all.

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It seems to me that he wouldn't even qualify for an AS dx at present. To me, dyscalculia and many aspects of CAPD fit him well and I'm leaning that direction instead of autism in regard to pulling together a plan to help him. I'm just wondering what you all think, based on what I've written and your own knowledge or experience of these things.

Is there anything I've written which would still make you still tend to lean toward AS or NVLD, with dyscalculia being comorbid?

Thanks for reading.

I am a novice here so I don't have much to share but your last bit about head knocks puts me in mind of the neuro-psychiatrist Dr. Daniel Amen and his work doing SPECT brain scans in his practice. I find his work fascinating and we sought out one of his clinics in investigating our son's issues with good results. I like how he SHOWS the diagnosis in the SPECT pics and doesn't simply rely on subjective checklists. His website is www.amenclinics.org.

Thank you. I actually called the neuropsych earlier in the week to see if he thought a scan was warranted. Though thinking about it now, I'm not sure that knowing that we had a TBI issue going on would really change much.

I think I may be getting down to the nitty-gritty of the issues on my own, so maybe we'll just have to go with what we presently know and see if we can find things to help him ourselves. It's just been so difficult getting to this place because of the self-education that's had to take place and the ever-changing, multifaceted nature of ds' issues. I think that I was hoping to find someone who really understood ds' struggles and could say 'yea' or 'nay' --you know, something concrete, and something accurate. I just don't like the idea of assuming it's one thing and wasting even more time, but... you do what you have to do, I suppose, and keep moving forward.

Mom2MRQ, what standardized testing has he had so far? Has he had a neuropsych workup before? How recently?

And what symptoms are you seeing that concern you? You've told us what you don't see- what do you see?


I'd say the best way to get sure about this is to get standardized test results that seem to you to be accurate-- that is, they reflect the assets and deficits you see in real life.

In the meantime, I would treat symptoms by going to professionals who help manage those things.

DeeDee

I'm curious if he is positive on dyscalculia traits relative to his overall intelligence profile or is he particularly impaired when reasoning with quantities?

Like is he showing a 160 Verbal IQ but a 70 in mathematics?
Or is it more a question of standard deviations, like 160 verbal and 115 in mathematics?

Or is it more about secondary symptoms like losing track of time or visualizing mechanical systems?
Can he glance at 8 pennies and tell it's 8 without actually counting them? What about with one eye closed?

It definitely seems that there can be a cascade of symptoms all branching from convergence insufficiencies and other impacts on core visual processing systems. We have seen a ton of turn-around after DS's patch therapy for his lazy eye, but overall his visual system is delayed but catching up.

Mom2MrQ - you know what missing for the DSM? "Neurologically odd - not otherwise specified"...

Looking at your OP I want to put out there that when our DD was diagnosed there were criteria that we didn't think she met, but when asked the right questions in fact she absolutely did, and other things we thought were very aspie that the professionals weren't at all interested in. It was an interesting experience. And different professionals were interested in different things. I have a particularly vivid memory of telling a story about my three kids , trying to convey a particular point about my DD who has Aspergers, the paed wasn't very interested in my point at all, but went into a lengthy spiel of his own about how something completely different he pulled out of the story was a brilliant indicator of her issues.

Ok coding 5! When all those scores are so high that is quite a big red flag! go find the old thread about the coding 5 club. I'm on my phone or I'd find it for you.

For his PSI to be 123 with coding 5 the other PSI subtest (symbol search?) must have been high, making coding his only weak point in the whole test (??). And I can't see how a child with major auditory processing issues could score 141 for WMI either. Could that auditory attention test have been spoiled some how?

I'd be looking for a visual motor issue myself... And introducing an iPod or similar for time and task management.

That auditory attention line in red must have a typo, 97 is not the 3rd percentile? But all those others that are low (in assuming you only shared the low stuff) seem more visual or visual/motor than auditory? I don't know that much about the WJ Cog though.

I was part of that thread when it got going --and am still trying to get to the bottom of things. One thing that I recall coming up on the thread which was quite interesting was the fact that so many of the Code 5 Club had convergence insufficiency.


Cancellation was substituted for coding --I just threw it out there because it was so low.

(Edited: numbers removed)


Yes, I agree that it seems like something along those lines would be the way to go. I tried a watch with a timer, but... err... he has to remember to set it and use it and all of that. When I get the energy to start training again, I guess that's what we'll deal with next.


I'm so glad you pointed that out. I knew that didn't look right, but I just didn't 'see' that. So, I wonder where it would fall.

I agree with you on the visual/motor issue. I've seen that since his first IQ battery. However, an auditory component seems to keep popping up when they try to narrow things down. The thing I see at home is that he sometimes confuses similar sounding words. This happens a lot more when he's not used to the person's speech, and when there is a lot of background noise.

Thanks for your input.

It seems like you have a ton of data. I personally wouldn't be satisfied without most of his symptoms pointing to one main diagnosis. The slow walk, bent arm, and palilalia sure sound like primary symptoms that would fit together in some distinct way.

From my side I was fishing to understand if his distinct set of gifts and challenges fit mine or possibly my son's (but they don't so much.) For visualizing mechanical systems, I was thinking along the lines of being able to describe the connections in a motor or to know that if one cog rotates one way, then another rotates another way. Basically internal mechanical aptitude contrasted to what vision or dexterity might limit outwardly.

Numerical awareness seems to have a specific area of the brain associated with it. In addition to it's contribution to math, a basic guage of it is the ability to sight compare quantities and judge quantities without counting. As my son is slowly building out his visual associated skills; things he had problems with visually like judging quantities are coming up to speed. Since his impact was with eye coordination, his functionality was significantly better with his good eye than with his bad eye or both eyes together.