What needs to be appreciated about Dysgraphia, is the cognitive attention that is required when hand writing? Where a simple way to understand it, is to just write/ print a sentence. But when you do it, print each letter backwards? Where you'll soon recognize how much attention to letter formation is required. With little left over for what you are actually writing?

Having written about 'Adjustments' that can be made with NAPLAN tests? The govt just announced that from 2016, all NAPLAN tests will be done online. So that from an adjustment to use a computer to do the test? The adjustment might rather become an adjustment to not use a computer, and to do it in hand-writing?

Though perhaps you could rather see this as a step toward becoming an adult, and being totally responsible for taking the medication? Where she needs to have a reason for taking it. But as she has probably been taking for some time, she probably has no idea of what effect and difference it makes? So that her only reason for taking it, is that she has always taken it. Maybe you could rather get along side her, and help her to explore and understand what happens when she doesn't take it? In a supportive, rather than a critical way? Where perhaps you could develop a plan with her, to do a study into 'what would happen'? Which would be better to start, once the Christmas break has begun. Though you could take a sort of scientific approach, where she keeps a daily diary, and records her activities and how she went with them? Also do a comparative study, where the activities are done with or without the med? So that at the end of your study with her, she will be able to come to her own conclusion, and really understand why she takes the medication. Where this would address a major issue that occurs when a child suddenly becomes responsible for taking their medication? Which often occurs when a child heads off to board at college. So that it might rather been seen as an opportunity? Where as a scientific study into 'what would happen'? You need to have an unbiased position, and allow her to prove it to herself. A proof that she will carry through life.

You are paying the OG therapist to concentrate on phonics and reading fluency. So that this is precisely what they should be focusing on. As the paymaster, you don't have to ask her to agree to something. She needs to follow your verbal directions.

You wrote that school had a worry about him being able to handle the NAPLAN tests. But NAPLAN has 'Adjustments for students with disability'. "The following items are important to remember when considering the application of adjustments in the NAPLAN tests: Adjustments should generally reflect the kind of support and assistance provided in the classroom for assessment activities in order for students to demonstrate what they know and can do. Adjustments should allow students with various disabilities to access the tests. A student may have access to more than one adjustment in any one test, and adjustments may be different for different tests for a given student." They also detail possible adjustments, and specifically mention use of a computer, where the tests can be provided in PDF to be done on a computer. http://www.nap.edu.au/naplan/school-support/adjustments-for-students-with-disability/adjustments-for-students-with-disability.html

The label is rather an add on. Where the real value of an evaluation, is the insight that it can provide, to understand your daughters ways of thinking and learning.

Though the evaluator can only evaluate what they know how to evaluate? Where 'some sort of speech delay' might be the extent of their knowledge of speech difficulties? But it is enough of a confirmation to have an evaluation with an SLP.

Though working memory is actually a combination of 3 working memories, auditory, visual and spatial. So that each needs to be looked at individually.

Perhaps you consider teaching her to use 'sign language'? This is often used with children that have significant speech issues. Where it provides them with an opportunity to develop a way to fluently communicate and express themselves. Which then carries over into their speech, as it develops. Where you wrote that she verbalizes her needs by pointing. So that she might take quickly to adding sign language to pointing ? "Give apple to dad", might no longer be confusing for her?

Jenr, This make as much as sense as a child that needs reading glasses, being told to get an ed. psych evaluation. Where they might then be able to get more time to do standardized testing? Though the idea of accommodations needs to be put aside, where the focus needs to be with providing him with the tools to fully realize his potential? Which is only limited by his requirement to use hand-writing. Where given that the federal govt is rolling out a program, where all students will be provided with a laptop. If he was in one of schools where students have already been provided with a laptop, then hand-writing wouldn't be an issue. Where the laptop could also have 'speech to text' software, to use for scribing. But the requirement of an ed. psych evaluation for what is a 'fine motor difficulty'? Given that an ed. psych will have little or no understanding of fine motor difficulties, let alone access to tests for it? Is absurd, if not ridiculous? Where I have a great concern with schools limiting a students ability to demonstrate their learning and understanding, in the form of hand-writing. In our digital age. Where the key word is 'demonstrate'.

The critical issue is with your concluding words; 'being child lead'? Where the great value of self-directed project learning, is that it develops understanding, rather than just knowing. As it is more exploratory, as opposed to a directed learn this next approach. But on the other side of this, is that being self directed/ child lead? It is too easy to avoid the difficult and the unfamiliar? Where a child or an adult learner, needs someone else to take us beyond our current boundaries? Where the problem is that we don't know our boundaries, as we don't know, what we don't know? So that child or self lead, can be very limiting? Unless one is open to and regularly asking; 'Any thoughts or idea to share ?' Though perhaps it could be looked at from a Project perspective? With your child's education as the overall Project, with you as the Project Manager. Where you can allocate Sub-projects to your child a Sub-project Manager. Who will have some degree of autonomy, but still be under your direction. So that as your child demonstrates their self-management abilities, then they could gradually gain greater autonomy and control over their learning?

You wrote that: 'She doesn't seem to understand what words mean.' But perhaps you might consider 'what words mean'? Words are just abstract sounds and symbols, that we use to represent things and concepts. Where this abstraction is reflected in the multitude of spoken and written languages. Though we take for granted, the ability to understand this 'abstract use of sounds and symbols'? For example, I have been involved with a number of children aged 6 to 9 diagnosed with Dyslexia. Who still had a difficulty with knowing 'letters' ? But it turned out, that when they looked at a letter, such as B ? They couldn't understand why it sounded like a B? It doesn't look anything like the sound? Yet it suddenly made sense to them, when they understood that B is just an abstract symbol to represent a sound. Which came as a great surprise to them. Where it is difficult for most of us to appreciate how they didn't understand that B is just an abstract symbol. But spoken words are equally abstract sounds to represent 'things'. So that when you wrote that: 'She doesn't seem to understand what words mean.' ? Taking your example of her difficulty with colors? That color doesn't 'mean' yellow? It is rather represented by an abstract sound , that is pronounced as yellow. So that perhaps it is not so much that she doesn't understand what words mean? But rather, that she doesn't understand that words are just sounds that we use to represent things and ideas?

While it sounds loud to you, does it sound loud to him? We mainly hear our voice through bone conduction. Here's some simple activities, to explore hearing his own voice: http://chanteur.net/contribu/index.htm#http://chanteur.net/contribu/cSFenten.htm

Jenr, I was interested to read that you are here in WA. Though the major difficulty that your son is having, is with handwriting. So that if he was provided with a laptop, then most of his difficulties at school would disappear? Where he could use it to type, and also have a 'speech to text' program, to scribe for him. But a diagnosis of fine motor Dyspraxia, is done by an OT, not an educ. psychologist. Who would rather identify the symptoms, and then refer to an OT to identify Dyspraxia as the cause. Though fine motor Dyspraxia would come under the Schools Plus category of Physical Disabilty. Which qualifies for 'assistive technology' such as a laptop, from the Centre for Inclusive Schooling program. Though I have a great concern about the needless impact that fine motor Dyspraxia and Dysgraphia has on schooling? Where handwriting is becoming increasingly redundant, and by the time that today's children are adults. I wonder if writing by hand, will ever be used?

An important thing about vision, is that each eye uses its own side of the Visual Cortex. So that the left eye sends its image to its side of the VC, and the right eye to other side. Which are then merged together. But with convergence insufficiency, with the eyes looking at different points? They can't be effectively merged, which presents a problem for the brain? To cope with this, the brain learns to ignore the vision from one eye. Which in turn means, that the Visual Cortex for that eye isn't being used. Where the effect of this needs to understood in terms of Visualizing? So given that one side isn't being used for vision, then equally it wont be used to retrieve images from, when visualizing. But a further factor with visualizing, is that when we visualize? That we look around the mental image, So for example, when we visualize 8-6. We see the mental image from left to right in our mind. Where importantly, the brain uses these opposing points, to locate beginning and end points. With the left side having been identified as the brains 'beginning point'. Though the problem when only one side of the Visual Cortex is used for visualizing? Is that we cant locate an end point, if we don't have the opposing beginning point. So that with 8-6, 8 and 6 aren't visually located on opposite sides. But a crucial factor with convergence insufficiency? Is that while the brain has learned to cope with this, by not using one side of the Visual Cortex? Their is actually no problem with that side, as the neural connections had already been developed, before the brain stopped using. So that with the converge insufficiency being corrected. Then the unused side of the Visual Cortex can be reactivated. Followed by merging both sides, to form a full left to right visual mental image.

You wrote that he needs to shut down the opposite side? But both hands are controlled by opposite sides of the brain. Where they work in a master/slave relationship. Where the master is the dominant side, and the other slave side. Which always relies on the master side for direction, as it can't operate independently. While we can learn how to become equally skilled with both hands, as in ambidextrous. This just reflects a well trained 'slave' hand, which is still under the control of the 'master'. So that while we maybe ambidextrous with our hands, this doesn't apply to brain. As the brain can't operate with 2 opposing masters? Where they both work in a 'mirror' relationship with other. But we don't have a choice about the master/ dominant side, which can't be changed. Yet you noted that he had convergence insufficiency, where the brains way to cope with the mismatched images recieved from each eye? Is to ignore the images from one eye. So that if it was his left eye that was ignored? Then it would flow on from this, that he would use his right hand, to work more efficiently with his right eye? But having corrected his convergence insufficiency with the bifocals. He still continues to use his right hand. So that the solution could be for him to start writing with his left hand?

Though we have 3 different cognitive thinking processes, auditory, visual and spatial. While we use auditory and visual thinking to concieve of 'things'? A word or an image just represents a single thought. Where thinking involves bringing a collection of single words and/or images together? So that this collection forms understanding. But this is is not just a random collection, with everything dumped together? Rather, it involves forming a unique relationship and order of connections? Which is where Spatial thinking comes in, and forms a spatial connection between them. But a crucial element that Spatial thinking provides, is that it spatially locates a beginning and an end point. Where it actually uses the Parietal Lobes on each side of our brain for this. With the right lobe set as the beginning point, and left lobe as the end point. With these 2 opposing points located. It can then order auditory and visual thoughts in between them. But with Spatial thinking problems, their are no beginning and end points set in the mind, to order our auditory and visual thoughts in between them? Though 'follow directions', needs to be understood in terms of what is actually involved? Where as you follow a series of directions, you will have a sense of what comes next, within the series of directions. While 'now' sits at a mid-point. The brain actually locates 'before' on your left, and 'next' on your right side. Which extends to infinity in both directions. Though Spatial thinking doesn't just order thoughts in our mind, but also gives them a 'quantity'? So that as we recall a series of directions, we can give each step a quantity? Where it is not enough to just 'follow directions'? As most often they are set within a time-frame, where each step needs to prioritized and allocated a time? Within the overall time for the whole task. But with Spatial thinking difficulties, directions aren't ordered and prioritized in the mind? Rather directions are held in the mind as a 'verbal script'?

Amo, you wrote about this 'tiny abnormality' of 4 mm of the tonsil. But this 4 mm needs to be seen in scale to size of the area involved? Where we are looking at area at the juncture of the skull and spinal column. So that this 4 mm's occupies a significant space. The critical area, is the foramen magnum, which is a funnel-like opening to the spinal canal. So that this 4 mm lowered tonsil, is extending further than it should, into this 'funnel'. Where this 'funnel', funnels the neural wiring between the cerebellum and the muscles of the head and body. Though classic Chiari, is a result of an undersized bony cavity that contains the cerebellum and brainstem. With the result that, the cerebellum and brain stem are pushed downward into the foramen magnum and into the upper spinal canal. Which can also have a significant effect on the nerve tissue that connects both sides of the cerebellum. Yet Type IV Chiari, is specifically an incomplete or underdeveloped cerebellum, which would also include acquired injury, such as surgery, stroke, etc. While Chiari has so far been defined as 5 types so far, Type 0 to Type IV. This will no doubt be expanded, as the complexity is increasingly understood ? Where for example, their would be a differential impact of low lying cerebral tonsils of 2, 4 or 6 mm's? Where it has identified that the effect is not distributed throughout the spinal column? But rather descends, with C1 at the top being first effected. Where crucially, a comprehensive understanding of the nerves that emerge from each cervical vertebrae has already been defined. So that a more practical diagnosis, would be to identify the effected nerves at each cervical vertebrae? While the MRI identified that the tonsils were 4 mm's low, this also needs to be looked at as not just 'lower extension'? But also the associated 'lateral extension' ? Though what I am really suggesting, is that rather looking for labels such as Chiari? What would be more effective, would be to diagnose it in terms of the effect on the cervical vertebrae? Starting at C1, then onto C2, and C3, etc, But C3 plays a primary role in breathing, which he doesn't seem to have a problem with? So that a more practical diagnosis, would be to identify the specific nerves in C1 and C2 that are effected, and further to this, the effect on each nerve? Where a critical distinction that needs to be defined, is the difference between a nerve that has limited or no connection? Given that a limited connection has potential, but no connection is no connection. Yet more often it is a limited connection. But this would rather reframe a diagnosis as affected nerves within C1 and C2.