Gifted Issues Discussion homepage Forums Twice Exceptional Looking for advice on how to proceed...

My son (9) was diagnosed with ASD when he was 6. I have no doubts about this diagnosis at all so this is not about that. We have suspected for some time that he was gifted mathematically (was very good at puzzles early on, was doing mental math at 2, could add and subtract small numbers at 3, taught himself how to count above 10,000 and how to multiply at 4, etc), but I was advised to wait until he was older to test because of verbal difficulties.

He was tested by the school 2 weeks ago for that as well as a suspected learning disability with writing, here are his index scores (forgive me I don't have the breakdown of those scores):

VCI: 116
VSI: 132
FRI: 144
WMI: 91
PSI: 98

FSIQ: 120
GAI: 133

He had a meltdown while he was copying sentences during the test and refused to finish.

The outcome was that he was rejected for both a GIEP and an IEP. They said that "he gets all of the enrichment needed by small groups based on MAP scores". Small groups for math do not exist, they only exist for reading scores...he was also dropped down a level because of his behavior last year. They also determined that his writing problem is caused by "laziness" and being unwilling to do something he doesn't enjoy. The school wants us to accept a 504 which gives him nothing more than he already has (which is 30m a week to talk to a therapist not affiliated with the school). I am unsure how to proceed and would appreciate any advice given. Thank you.

are you able to use online programs to enrich and get him learning ahead? Then see how he responds. How motivated he is. Try and expose him to different things and see if he is motivated by special interests, like space, marine science, geology and then you can get a better gauge of his abilities. And in the meantime find someone who may test privately, at a university or somewhere.

Welcome!

Sorry to hear that your situation is not as responsive as one might like. Math enrichment can be challenging for elementary schools to manage (even though it should be easier, in some ways!), since "enrichment" in mathematics often involves grade advancement or cross-grade instruction.

I'm also wondering a bit about whether there are vulnerabilities in fine-motor skills or motor automaticity, given the history of suspected learning disabilities in writing, and the meltdown when asked to copy sentences. Behavior always means something. You may wish to investigate further evaluation by an occupational therapist. Also, while obviously you would have a better sense of the ASD diagnosis than I would, ASD-type presentation with writing/fine-motor challenges sometimes coexists or is a rule-out with other diagnoses, such as apraxias and dyspraxias. (BTW, how is his oral expression or dictated writing?) Especially since you mention early speech difficulties, which quite often are in the mix with dyspraxia. So also something that might be worth exploring--likely best done in a hospital/clinic evaluation.

Depending on your state of residence, you may be able to indicate that you are not satisfied that the evaluation addressed all areas of suspected disability, and request that the district contribute toward an independent evaluation. (Actually not that hard to establish, since they didn't fully evaluate writing.) Even if they do not, dyspraxia is a medical diagnosis, so evaluation of the non-academic portions may be covered at least partially by your health insurance, with a PCP referral.

Thanks for replying ^^ He's always avoided drawing, writing and coloring ever since he was little. He caught up with speech when he was three and I would say his oral skills are above average from what others have said to me (it's hard for me personally to hear it because I'm around him all the time, if that makes sense). We've never had him evaluated for a specific problem, but issues at school and over the past few years with writing are what prompted the evaluation. I do have a private evaluation being done by a pyschiatrist in December. I just don't want him to fall behind in his writing by the time I can have him evaluated again at school. I don't know if she can evaluated for a learning disability or not, but at this point it's all I have. Btw I live in PA, if that helps. I'm not familar with the laws when it comes to education, but we can't afford to pay for a private evaluation.

I really appreciate everyone's help and suggestions. It's just disheartening because he's always been borderline ever since he was little and we've constantly been rejected for services and programs because of it.

We've used Prodigy but he plays it when he wants to. In the summer we use workbooks, and he learns very quickly (although he hates memorizing facts and prefers to simply work them out). He's very interested in rocks and gems, space and building things. He started building adult lego sets when he was 5 and now we try to get him different types of building material so he can make robots and structures. He also loves different kinds of puzzles, especially 3D puzzles. He loves reading but mainly about non-fiction (although he does like bunnicula and stick dog). He also loves flowers and plants, and enjoys growing vegetables.

He wasn't an early talker or an early reader, so there's always been a big "if" about his educational needs. We've arranged private testing with a psychiatrist, although that won't happen until December. One thing I've already seen is that he feels bad about not being able to write as easily as other kids, and it worries me that he will only see the problems and not the things he's good at. We've already seen that some already, and it's not something I want him to grow up believing.

Here's some information on IEEs in your state:

https://www.elc-pa.org/wp-content/u...ation_revisedlinks_March2014.pdf#page=34

The psychiatric evaluation would look at the ASD angle, and any other emotional/mental health diagnostic considerations. For a learning disability evaluation, you would need a psychoeducational eval (like the one that should have been completed in your school) or a neuropsychological evaluation.

A neuropsych could also look at the apraxia/dyspraxia rule-out, and possibly tease out the differential diagnosis among ASD, dyspraxia, anxiety, etc. In addition to the question of dysgraphia/specific learning disability--written expression.

You could try places like CHOP:
https://www.chop.edu/centers-programs/psychology-services

Just make sure to bring all of your existing testing with you, so they don't administer duplicate testing, which invalidates the second administration.

You may be able to get a pediatrician's referral for this. Make sure to include the concerns with his delayed fine-motor development, so the appropriate areas of suspected concern are assessed.

Update:

The independent eval is complete and the psychiatrist said that my son is indeed twice exceptional and the school is not making enough accommodations for him to succeed in the long run. Because of that she wants to add a diagnosis of ADHD (which she said is stretching it but that the boredom he is experiencing at school is manifesting in inattentiveness where it's interfering with his work). She is hoping that this will force the school to take action. She also suggested getting in touch with an advocate (which I have) to help fight the school on his behalf.

Moving schools and homeschooling are not options at this point...I'm hoping we can come to a resolution that will help him overall. Thanks to everyone who have offered advice. If anyone still has advice on how to fight a school for an IEP/GIEP for a 2e child, I would appreciate it.

Thanks for the update.

Personally, as a professional I am a little uncomfortable with attaching diagnostic labels that are "stretching it" for the purpose of making the school take notice, especially when there is likely a legitimate second exceptionality. You only need one disability to trigger the child-find process and disabilities protections. She could just as easily have diagnosed him with Specific Learning Disorder--written expression, which would equally pressure the school to properly evaluate him in that area.

Also, I find that labeling inattentiveness due to instructional mismatch as ADHD contributes to school systems dismissing instructional mismatch as a genuine cause for inattentiveness in the future, which just perpetuates misconceptions about giftedness, and encourages school systems to view all symptoms of inadequate challenge through a disability lens. (E.g., suggesting that you should medicate him for ADHD, rather than that they should instruct him at his appropriate gifted level.) In any case, the standard menu of educational responses for ADHD would not address his gifted needs, nor would it fully respond to any writing disabilities, so this might result in sending the team down non-useful rabbit trails.

Not saying your evaluator isn't operating professionally, or with the best interest of your child in mind, but just adding some alternate professional perspective from someone with a deep pool of school experience.

A good, knowledgeable advocate can definitely be an asset. Make sure to interview any advocate you consider retaining regarding their views on and experience with twice exceptionality.

ETA: although it would be better to have SLD diagnosed by a neuropsych, technically it's in the DSM, so a psychiatrist is allowed to diagnose it.

I agree to some extent. The problem is that he does have some characteristics of ADHD...and we can't be sure whether it's caused by boredom at school because there's nothing to compare it to. He's never been properly challenged in such a way that we can determine it one way or another. The school won't move him into more challenging classes and the school won't help him out with his problems. So there's no baseline for comparison. Right now his behaviors match those of ADHD, whether it's being caused by a lack of stimulation or not, it's hard to deny it. No, there is no intent to medicate based on this.

The hope is that I can talk to an advocate (I have contacted a place near where I live) and go over my options for what to do. The plan is to hopefully get him into a proper classroom environment and then re-evaluate to see how it has affected his behavior and then see if there is a further need for a treatment plan. But until then, we need to treat it as ADHD behaviorally. That's how it was explained to me...I'm okay with that because I realize that there could be factors affecting it.

She did not evaluate for learning disorders because this eval was supposed to be in conjuction with the school (and the school said they would test for learning disorders, but instead used the IQ test and information from teachers to determine whether there was indeed a learning disability for written expression). I full intent to have him evaluated again for a problem with written expression, but I need a referral to do so.

There is NO PLAN to medicate. We have not done so up to this point and I have no plans to do so, nor is there any recommendation to do so. The diagnosis currently fits the criteria for ADHD...and there is an acknowledgement of mitigating factors and therefore the only recommendations are continued therapy and a change in curriculum.

To be clear, I had no sense that you had plans to medicate...I was more concerned that, in my experience with school systems, the knee jerk response of the school to this diagnosis is to hint either subtly or openly at medication, which sometimes is accompanied by resistance to seek any other solutions...but it appears that you are already rather near that point regardless.

I hope you are able to connect with an appropriate advocate, and to get a referral for an evaluation expeditiously.

And thinking back over your earlier post, it occurs to me that some of the school personnel might benefit from some additional inservicing on ASD, if they are that quick to label rigidity (a known characteristic of ASD) as defiance. And they have a history of responding weakly to behavior.

I would discuss with your advocate the value of adding a functional behavioral assessment (FBA) to a request for independent educational evaluation (preferably conducted by a BCBA or psych), given the testing behaviors, and the evaluator's interpretation of classroom-observed behaviors (writing problems, and being dropped down a level in math for his behaviors) in that light.

I think this is a pretty open and shut IEE request, actually. The referral question included writing difficulties. They didn't successfully assess his writing skills. He has a history of behavioral problems, and the evaluator ascribed additional academic problems to his behavior, but they didn't formally assess his classroom behavior. Based on the information you've provided, it seems clear that it is a defective evaluation, and the district should pay for (or contribute to, depending on your state) the independent eval as an appropriate remedy.