Advanced reader (with lots of mistakes), horrible speller. How to help?

[Heidi]

 

I just wrote this email and sent it to Susan Barton, but I wanted y'all's opinion too (because I think Susan is probably biased to her program).

 

I have a friend who wanted me to see if her son is dyslexic.  I explained that I am not trained to determine dyslexia, but that I would give it my best shot.  I am tutoring only one student, my first student, so I really do not have any experience at all.

 

My friend's son, Jacob, is in 2nd grade.  I gave him a reading level test (http://www.thephonicspage.org/On%20Reading/Resources/40L%20Test.pdf) and he reads at a 3rd grade level. 

 

He also reads very, very quickly, with lots of mistakes.  I gave him the Miller Word-Identification Assessment (http://www.donpotter.net/pdf/mwia.pdf).  He read the holistic I and phonetic I each in 45 sec.  So I had him read the holistic II page, which he read in 3'18'', making 26 mistakes.  I did not time him for the phonetic II page because I wanted him to slow down and be more careful in his reading.  I had to keep reminding him to slow down.  He made 36 mistakes.  I pointed to some of the words he missed on the phonetic II page and had him read them again, and he could read them just fine when he took is time and really looked at the word, sometimes sounding it out. 

The mistakes he made were exchanging letters, adding letters, saying a word that looks similar, and skipping words altogether.  I attached my copy of Phonetics II with my notes of his mistakes.

 

I gave him the Barton student screening, which he passed easily.  I read to him a story to test his oral comprehension, which is fine. 

 

Then I dictated a sentence to him and had him write it.  I cannot remember the sentence I dictated (I just opened a book and read him a sentence), but I also cannot figure out what he wrote!  I've attached his writing sample. 

 

His parents said that he has the most trouble with the little words, he skips them, misreads them, can't remember how to spell them.  His mother had a hard time reading when she was a child.

 

It sounds like dyslexia to me, but not the typical kind.  My current student has to sound out the three letter words and struggles with fluency; her reading is labored.  Jacob's reading is not labored at all, though inaccurate. I'm not sure what he needs.  I think Barton would help, but I'm not sure the entire program is necessary.  Being unfamiliar with what is in each level myself, what would you recommend for a child like Jacob?  Is there an efficient way to remediate Jacob?

Edited February 7, 2016 by Heidi

[PeterPan]

He's likely to get an ADHD label.  When they go to the psych for diagnosis, have the psych run a CTOPP just to be sure.  I would also get his eyes checked by a developmental optometrist, just to make sure that's not part of the explanation.  COVD is where you find developmental optometrists.  He could have some tracking or convergence issues going on.  Don't just go to a regular optometrist.  You actually want a developmental optometrist.

 

But no, I don't think he's going to get a dyslexia label, not with that ability to decode and that RAN/RAS and fluency.  My dd was like that (strong reader but terrible spelling) and she got an ADHD label.  The developmental optometrist found convergence, tracking, and depth perception issues, and the developmental vision problems had resulted in her visual processing not developing properly.  So, when she was tested at age 10/11, she had the visual memory of a *2 year old*!!!!  It's NO WONDER she was having spelling problems!  

 

ADHD involves executive function deficits (EF), and that's what they're going to chalk all that word skipping up to.  If his decoding is fine (which is why you want the CTOPP), then that's what they'll say.  He could even have a relative weakness with decoding, sure.  Dyslexia and ADHD used to be one diagnosis (minimal brain dysfunction), and there is that strong overlap.  60% of kids with dyslexia will get an ADHD diagnosis, and a lot of kids with ADHD will have some reading issues.  But the word skipping, not noticing details, that's all going to fall under EF and lead to an ADHD diagnosis.  

 

That can take a long time for people to wrap their brains around and get comfortable with.  I'm not sure I would tell them ADHD.  I would start by saying there are some other things that can explain it, that EF can affect the dc's ability to notice details, that it's something a psych sorts out by doing EF surveys and a CTOPP for the reading disorder, and that you recommend they pursue that AND get his vision checked by a developmental optometrist found at COVD.  Between the two, they'll get it sorted out.

[Heidi]

Thanks OhElizabeth!  I did read down a list of possible symptoms of Convergence Insufficiency and he said he sees double, so I recommended they go visit our local Vision Therapy clinic to get tested.  Your post helps a lot.  I will pass that info along. 

 

Heidi

[EKS]

Thanks OhElizabeth!  I did read down a list of possible symptoms of Convergence Insufficiency and he said he sees double, so I recommended they go visit our local Vision Therapy clinic to get tested.  Your post helps a lot.  I will pass that info along. 

 

Heidi

 

I was going to say to look at vision issues.  The reading quickly even with lots of mistakes doesn't sound like dyslexia to me.  Dyslexia is a processing issue, and my experience with dyslexic reading is that it is not quick.

[PeterPan]

Thanks OhElizabeth!  I did read down a list of possible symptoms of Convergence Insufficiency and he said he sees double, so I recommended they go visit our local Vision Therapy clinic to get tested.  Your post helps a lot.  I will pass that info along. 

 

Heidi

Oh my goodness, then he DEFINITELY needs his eyes checked by a developmental optometrist!!  It can be expensive, so they need to ask around, get feedback from people.  They might find they like one dev. optom. better than another.  Some optometrists do the appointment all in one ($$) and others do two stages, first with a basic exam (cheap) and then a developmental vision exam (more $$).  It's just frustrating for someone to walk in the door and realize they can't afford the services.  So they should ask all those questions upfront and call a number of places to ask about costs, how they do their therapy, who does the therapy (therapists or the eye doc), how much homework they tend to have, etc.  Practices vary, so they should ask lots of questions.

 

Yes, double vision is a HUGE flag.  No wonder he's having problems!  Well hopefully they can get that done.  My dd's reading got more comfortable within 1-2 months of VT.  They could see changes very quickly once they get started.  Even if it's a stretch, with such CLEAR indications of vision problems, it will be worth it.  Main thing is to make sure they have feedback on the eye doc, because they really will vary.

 

Oh duh, you're saying you've heard feedback on this clinic and it's good?  That's good.  But still, it's good for them to call around and compare.  

 

Well good, sounds like he's going to get some help!  :)

Edited February 7, 2016 by OhElizabeth

[PeterPan]

I just looked at your pics.  Do that same writing sample after a couple months of VT.  I think it's going to improve.  He doesn't have dysgraphia.  His letters are even on the lines and properly sized.  He's able to write and get his thoughts out. I think they're going to find the convergence issues glitched his visual processing, so that his visual memory, etc. was affected.  I just think it's reasonable to think a lot of that will improve just with the VT.

 

The CTOPP (commonly used in dyslexia diagnosis) is going to look at phonological processing.  So it's like if I say SPLAT and take out the /l/, what is left?  If I say SPLAT and change the /t/ to /g/, what is it?  There are fancy words for it, but that kind of thing.  Deletion, elision, blah blah, I have no clue what I'm talking about.  So you look at that spelling page and it actually seems like he's nailing things surprisingly accurately.  Like with "goes" the spelling actually was really close, kwim?  It wasn't this hyper phonological spelling.  It was more just his visual memory and noticing details didn't get him to noticing where the letters went.  

 

I think in that situation I would get the VT done and *see* what's left.  Some eye docs will run the BRIEF or another EF survey.  That really could be part of it, and it will be there hanging out, still an issue when the VT is done.  Sometimes VT will bring in EF skills and give kids this sort of overall bump, which is why people are like WOW I did VT and my kid started cleaning his room!  If the VT brings in EF work, it will bump that.  However it's really helpful to then say ok, let's get the EF issues diagnosed, let's get the right words for this and bring in more supports.  But I wouldn't do that before the VT is done, not when you have such glaring, obvious vision problems.  But I also wouldn't say oh, VT improved things a bit and now my kid is just BAD about the rest.  If there's more remaining, take that next step and get the psych evals.

Edited February 7, 2016 by OhElizabeth

[ElizabethB]

I was going to go with vision even before reading the other responses, too, the hive mind agrees!!

 

Try larger font and compare times, one of my students with a severe underlying vision problem read 20% faster eith 36 point font than 14 point font. I used similar words, for example, pig and ran on one list, pin and rig on the other. No Bs or D's.

[ElizabethB]

With that kind of error rate and guessing speed, though, you also want to do a few nonsense words and work on 100% accuracy with a big font, and do a lot of oral spelling and work on spelling rules until the vision piece is investigated. With students that race through, I have them spell and then read any word they miss and remind them to slow down and read every sound and every word from left to right.

Edited February 8, 2016 by ElizabethB

[sbgrace]

I was going to mention vision, but I see that's been covered. covd.org is the website for the developmental optometry. My son had amazing changes with vision therapy. It was hard and expensive, but so worth it.

[Barb_]

Reading with rapt interest as my youngest fits the OP to a T. I've been going back and forth on the "dyslexia or not?" for quite some time. My oldest two girls were here for Christmas and tried to convince me to have her evaluated since they didn't remember any of the rest of the siblings having issues like that.

 

BTW, that passage says, "After the queen goes out in a swarm, what do the rest of the bees do?" My daughter could have written that, lol

[Barb_]

Another hint that I can offer is to slow the child down and have him watch your mouth as you say sounds, then have him repeat them. Auditory processing can come into play here as well. I notice he is spelling queen as quing. It's likely that he actually hears it pronounced that way. By way of an example, my daughter still thinks the letter R is a vowel because she hears and tends to pronounce it as a schwa sound. When she's spelling I'll say, you need a vowel in the middle there...and she'll look at me and say "R?"

[Barb_]

With that kind of error rate and guessing speed, though, you also want to do a few nonsense words and work on 100% accuracy with a big font, and do a lot of oral spelling and work on spelling rules until the vision piece is investigated. With students that race through, I have them spell and then read any word they miss and remind them to slow down and read every sound and every word from left to right.

It helps them to slow down and sound out properly if you train them to count the sounds on their fingers. One finger up for each sound.

[PeterPan]

With that kind of error rate and guessing speed, though, you also want to do a few nonsense words and work on 100% accuracy with a big font, and do a lot of oral spelling and work on spelling rules until the vision piece is investigated. With students that race through, I have them spell and then read any word they miss and remind them to slow down and read every sound and every word from left to right.

Our VT had a word races exercise where they started with large font and worked down to small, having the student *read aloud* every letter and mark particular letters. So the row might have "pie cat dog hat up cow" and they were to read each letter and circle the middle letter.  They would do that for large down to small font with 3 letter words.  Then they'd start over with 4 letter words, large font down to small.  So for that there might be two markings (circle the 2nd letter, box the fourth).  Once they could do that from large fonts down to small, then they did it AGAIN with 5 letter words!  It was THE most arduous thing, oh my.  Worked though, lol.  For 5 letters I think we had three markings (circle, box, underline).  

 

So anyways, definitely something a good VT can help.

[PeterPan]

Another hint that I can offer is to slow the child down and have him watch your mouth as you say sounds, then have him repeat them. Auditory processing can come into play here as well. I notice he is spelling queen as quing. It's likely that he actually hears it pronounced that way. By way of an example, my daughter still thinks the letter R is a vowel because she hears and tends to pronounce it as a schwa sound. When she's spelling I'll say, you need a vowel in the middle there...and she'll look at me and say "R?"

Has she had a speech eval?  If this is a 7 yo, she ought to be pretty close to having that R.  Here's a chart.  http://mommyspeechtherapy.com/?p=754

 

And yes, at the most extreme, there would be enough issues that they'd get something like LIPS and really slow that process down.  That's what I had to do with my ds. You probably already know this, but you can do the free Barton pre-test to see if this is needed.  We have had (on the board here) some situations where a dc was farther along and actually needed to go back and do LIPS some more to get that connection solid.  

Edited February 8, 2016 by OhElizabeth

[PeterPan]

It helps them to slow down and sound out properly if you train them to count the sounds on their fingers. One finger up for each sound.

For the op, what's interesting about this is that most OG programs will have the kids do some kind of kinesthetic tapping of the sounds, whether it's fingers, on their arms, whatever.  It's a technique that works well for lots of kids.  One of the things it does is force them to slow down and S-T-R-E-T-C-H their working memory.  So a dc could actually *resist* when it would be really beneficial for him, because his working memory is low.  So if you decide to try the technique, I would begin with short words (1-2 sounds), build up, and REQUIRE it.  Like don't try and then let him say oh it's hard, oh it takes so long.  It's actually a really, really valuable step and that slowing down and forcing them to hold their thoughts is what stretches the working memory.  

 

If the dc resists, another thing you can let them do is let them operate your hand for the taps.  

 

Well anyways, that was your rabbit trail of the day, lol.  

[PeterPan]

Reading with rapt interest as my youngest fits the OP to a T. I've been going back and forth on the "dyslexia or not?" for quite some time. My oldest two girls were here for Christmas and tried to convince me to have her evaluated since they didn't remember any of the rest of the siblings having issues like that.

 

BTW, that passage says, "After the queen goes out in a swarm, what do the rest of the bees do?" My daughter could have written that, lol

You already have a family history of some challenges, yes?  And she may have some speech that could use an eval, yes?  So that would be totally reasonable to say ok, get the SLP eval, schedule that psych eval.  She's plenty old enough.  They're NOT going to diagnose dyslexia willy nilly.  If it is, you might as well know.  If it's not, if it's more like some working memory issues, some APD, whatever, you'd like to know that.  She's old enough to get all those evals now.  Our univ will run a basic hearing eval *with* the SCAN3 screening portion for APD for only $35.  That has become my new standard gig to recommend, because you can answer/eliminate so many questions with that, kwim?  Like when you're saying why some adhd, some phonological processing, some speech problems, but not all the way to dyslexia, not all the way to this or that, sure hearing could play a part. And for $35, it's easy for me to say eliminate it.  If it's more in your area or you have to go private, well, sigh...  

 

Anyways, yes, I'm with your dds.  If the girl is 7 and doesn't have her sounds, time for SLP eval.  And given the family history, there's no reason not to schedule the rest.  You'd rather know now than later.

[Storygirl]

I'll just chime in to say that DD10 would have looked a bit like the OP when tested this past summer. She could read on grade level, has excellent comprehension, and would read very quickly, skipping over some words, getting many wrong, but still being able to read the passage and understand it. Her spelling is horrible.

 

She has been diagnosed with dyslexia. And possible ADHD. The important piece of the dyslexia puzzle for her to get that diagnosis is that she has a phonological disability. Her phonological disability was what was preventing her from reading the bits of the words correctly (and the ADHD is what makes her read fast and dislike slowing down to sound things out).

 

So it COULD be dyslexia for the child in the OP, but they would need to have the testing to see if he has a phonological impairment. Did he have difficulty when learning to read? Can he sound out unfamiliar words? Has he been instructed in phonics? DD10 has had a ton of phonics, had extreme difficulty learning to read, and still has difficulty with phonological processing. (She does not have a vision issue).

 

Anyway, I agree that it would be good to have the child's vision checked by a COVD and also have him evaluated with a CTOPP and other testing. Is the child in school or homeschooled? Either way, they can request testing through the public school. The school may not tell them if it is dyslexia (they tend to just say reading disability), but they would be able to get the test scores that they need to determine whether there is a phonological disability.

[PeterPan]

And just to build on what Story is saying, you can have both vision problems AND dyslexia.  Our VT doc was actually screwball enough to say from their perspective dyslexia is a vision problem.  You can see how screwy this is, because in the DSM it's phonological.  So Story is so, so right that you have to pursue all the angles.

[Barb_]

Has she had a speech eval? If this is a 7 yo, she ought to be pretty close to having that R. Here's a chart. http://mommyspeechtherapy.com/?p=754

 

And yes, at the most extreme, there would be enough issues that they'd get something like LIPS and really slow that process down. That's what I had to do with my ds. You probably already know this, but you can do the free Barton pre-test to see if this is needed. We have had (on the board here) some situations where a dc was farther along and actually needed to go back and do LIPS some more to get that connection solid.

She has it now, but her tongue is lazy sometimes and she'll lose it when she's tired or talking too fast. It was striking to me that she spelled the Schwa with an R as well as pronouncing it that way.

[Barb_]

You already have a family history of some challenges, yes? And she may have some speech that could use an eval, yes? So that would be totally reasonable to say ok, get the SLP eval, schedule that psych eval. She's plenty old enough. They're NOT going to diagnose dyslexia willy nilly. If it is, you might as well know. If it's not, if it's more like some working memory issues, some APD, whatever, you'd like to know that. She's old enough to get all those evals now. Our univ will run a basic hearing eval *with* the SCAN3 screening portion for APD for only $35. That has become my new standard gig to recommend, because you can answer/eliminate so many questions with that, kwim? Like when you're saying why some adhd, some phonological processing, some speech problems, but not all the way to dyslexia, not all the way to this or that, sure hearing could play a part. And for $35, it's easy for me to say eliminate it. If it's more in your area or you have to go private, well, sigh...

 

Anyways, yes, I'm with your dds. If the girl is 7 and doesn't have her sounds, time for SLP eval. And given the family history, there's no reason not to schedule the rest. You'd rather know now than later.

Yes, I've thought about it, called the local Uni, they couldn't help me. During the course of the month that I was trying to figure out what to do next, she and I have both made some break throughs. I have to weigh what therapies would cost me in time and money against what I feel we would gain, and I've come to the decision that we're making enough progress on our own to keep pushing through without it. My three other students would suffer if I had to devote time to therapies and appointments. I'm sure it would help; I just don't feel like the cost-benefit ratio is favorable.

 

ETA She is without a doubt ADHD. More severe than my second daughter whom I've never medicated, and more physically impulsive but less mentally scattered and immature than the 16yo who is medicated. So I feel like we'll get there.

 

OP I hope you'll update when you get some answers

Edited February 8, 2016 by Barb_

[scoutingmom]

This sounds a lot like my son and daughter... they were reading at about a grade 3 level (depending on what reading test given...)  when in 'grade 1'.... but would miss words, suffixes, say the wrong word, etc.   Skip forward a couple of years, and they were still reading at about a grade 3 level.... well, again depending on the test.  My ds could do one test and it would say a grade 11 level (reading lists of words.... he would do great) - and another would say 'will struggle with grade 1 work'.)  I think most that included comprehension of some sort he would score at about a grade 3 level still.    And he couldn't spell.... as in he would fail 'inventive spelling'....

 

Yes, I'd check the vision for various things (including convergence, tracking, etc) - especially if he is seeing double....

But it could very much be dyslexia.

[PeterPan]

She has it now, but her tongue is lazy sometimes and she'll lose it when she's tired or talking too fast. It was striking to me that she spelled the Schwa with an R as well as pronouncing it that way.

You know me.   ;)  I'm gonna ask why they're using a moral term (lazy) for something that is motor planning.  So the motor planning is not automatic and she's having to work at it enough that when she is tired, etc. the process breaks down.   :)

 

That whole lifting the tongue thing has a fancy term in speech therapy.  It just slips my mind at the moment.  lingual separation?  I forget.  Anyways, there's both the ability to know the tongue is there, which is developmental, like it's even starting to go oh, I can make this motion, and then there's the motor planning of it, the praxis (not having the motor planning).  

 

Edited February 8, 2016 by OhElizabeth

[PeterPan]

Yes, I've thought about it, called the local Uni, they couldn't help me. During the course of the month that I was trying to figure out what to do next, she and I have both made some break throughs. I have to weigh what therapies would cost me in time and money against what I feel we would gain, and I've come to the decision that we're making enough progress on our own to keep pushing through without it. My three other students would suffer if I had to devote time to therapies and appointments. I'm sure it would help; I just don't feel like the cost-benefit ratio is favorable.

 

ETA She is without a doubt ADHD. More severe than my second daughter whom I've never medicated, and more physically impulsive but less mentally scattered and immature than the 16yo who is medicated. So I feel like we'll get there.

 

OP I hope you'll update when you get some answers

Sometimes an SLP can run the CTOPP.  I would at least get that.  Then you could say ok there's a discrepancy or there's not.  One hour.  And also do the Barton pre-test, just to see what happens.  

 

Not everything requires tons of appointments.  If you had that CTOPP to get that question sorted out, you could say ok, we're just going to handle this at home, and weave the targeted interventions into your day.  

[Barb_]

You know me. ;) I'm gonna ask why they're using a moral term (lazy) for something that is motor planning. So the motor planning is not automatic and she's having to work at it enough that when she is tired, etc. the process breaks down. :)

 

That whole lifting the tongue thing has a fancy term in speech therapy. It just slips my mind at the moment. lingual separation? I forget. Anyways, there's both the ability to know the tongue is there, which is developmental, like it's even starting to go oh, I can make this motion, and then there's the motor planning of it, the praxis (not having the motor planning).

Nah, it's not a moral term. It's descriptive. Lazy-tongue. Like lazy-eye. I tell her, "You must be tired because your little tongue sounds lazy. Where did your R's go, silly?" And then she'll giggle and roar at me like a lion. We just don't take it super seriously. I don't know if you were suggesting she should still have a speech eval but I think it's fine that she has to work at it for now. It's a new skill and will eventually be automatic. My 16yo had the same problem and will still lose her R's when she laughing hard about something, which makes her completely lose it.

 

Low outside-intervention with scaffolding has worked really well for us for the most part.

[Barb_]

Sometimes an SLP can run the CTOPP. I would at least get that. Then you could say ok there's a discrepancy or there's not. One hour. And also do the Barton pre-test, just to see what happens.

 

Not everything requires tons of appointments. If you had that CTOPP to get that question sorted out, you could say ok, we're just going to handle this at home, and weave the targeted interventions into your day.

I'll keep it in mind if I begin to worry again. That's where I was a month ago, but now I'm leaning toward continuing the interventions that seem to be working pretty well. As long as we aren't spinning our wheels or moving backward I'd really rather stay out of the system.

[PeterPan]

Nah, it's not a moral term. It's descriptive. Lazy-tongue. Like lazy-eye. I tell her, "You must be tired because your little tongue sounds lazy. Where did your R's go, silly?" And then she'll giggle and roar at me like a lion. We just don't take it super seriously. I don't know if you were suggesting she should still have a speech eval but I think it's fine that she has to work at it for now. It's a new skill and will eventually be automatic. My 16yo had the same problem and will still lose her R's when she laughing hard about something, which makes her completely lose it.

 

Low outside-intervention with scaffolding has worked really well for us for the most part.

I think it was just me being hyper-literal, sorry.  In that context, the way you described it working in your family, it makes sense. :)  If someone says that to my ds (and believe me, people DO), they get a stern something from me and they know not to do it again.  But ds CAN'T make a difference on it, can't just try harder.  Very mama bear.  :)

[Barb_]

I think it was just me being hyper-literal, sorry. In that context, the way you described it working in your family, it makes sense. :) If someone says that to my ds (and believe me, people DO), they get a stern something from me and they know not to do it again. But ds CAN'T make a difference on it, can't just try harder. Very mama bear. :)

It's ok! I understand. Serious issues can make you lose your sense of silly. Hugs :)