How to Assess for LD / Dyslexia

[Ramie]

I've been thinking about having my 3rd grade dd assessed. I can't quite put my finger on what the problem might be, but she has always struggled somewhat with certain aspects of reading and spelling, and there are signs that something isn't quite right with the way she sees what she is reading (she has had her vision tested by a specialist with normal results). So I go back and forth on whether or not she has a problem, but I don't want to regret not looking into it. I'm not even sure what the terminology is, or what exactly to look for - I guess things like dyslexia/processing issues/vision issues... Living in NY State, I imagine there is the possibility of being evaluated through the school district (??), but I'm not sure if I really want to include the school district in this issue (if she does get a label. I'm wondering if I can have her evaluated privately. What sort of professional does this, and what would I call the testing? Any advice on where I would start?

 

Edited to add (in case it is not clear), that dd IS homeschooled.

[sixpence1978]

You would have to go through a neuropsychologist. You may want to check if your doctor will refer you. Otherwise you will have to do it independently out of pocket, which can cost a lot.

 

What are some of the signs you are seeing?

[VinNY]

I've been thinking about having my 3rd grade dd assessed. I can't quite put my finger on what the problem might be, but she has always struggled somewhat with certain aspects of reading and spelling, and there are signs that something isn't quite right with the way she sees what she is reading (she has had her vision tested by a specialist with normal results). Was it a COVD Optometrist? So I go back and forth on whether or not she has a problem, but I don't want to regret not looking into it. I'm not even sure what the terminology is, or what exactly to look for - I guess things like dyslexia/processing issues/vision issues... Living in NY State, I imagine there is the possibility of being evaluated through the school district (??), Yes I have had my dtr tested through the school and privately. If you wanted to test through the school, you need to write to the Special Ed director and explain your dtr is having learning difficulties and would like an evaluation. Make sure you specify educational evaluation (psychological, language and OT)but I'm not sure if I really want to include the school district in this issue (if she does get a label. I'm wondering if I can have her evaluated privately. What sort of professional does this, and what would I call the testing? Any advice on where I would start?

 

I receive support through my local school district. They are Wilson trained. But my dtr needed Vision therapy in order to even address the page. All the reading help she received didn't help until that was addressed. She also has auditory and language issues.

[Ramie]

You would have to go through a neuropsychologist. You may want to check if your doctor will refer you. Otherwise you will have to do it independently out of pocket, which can cost a lot.

 

What are some of the signs you are seeing?

That's what has made this so hard. I used the tests here: http://homeschooling.gomilpitas.com/articles/060899.htm

and she tests at a 4th grade level.

 

First, her spelling is awful. She would memorize the words on her spelling lists (we would discuss the phonics of it), and score great on the test at the end of the week, but retained very little of it long-term. (We are using All About Spelling with her now, and hopefully that will help).

 

Next, I've always wondered if there was something wrong with her vision. She saw an opthamologist a little over a year ago, and tested fine in several measures (I don't remember exactly what he tested now). But when she tries to read numbers on a clock, or words on a page from a certain distance (that other people can read fine), she says she can't see it right. When she holds her reader to do a reading lesson with me, she holds it just a few inches from her face. She often loses track of where we are on the page, or goes back to the beginning of the same line instead of advancing to the next one.

 

When she was learning to read, she had to be heavily prodded (like prodded to the point of crying) to sound out words, and would regularly start the word then guess the ending. She often added sounds that weren't there. While she can read a lot of words just fine now, she still uses those same bad habits when she encounters words she doesn't know. I still have to prod her to sound words out, and she often chooses to guess before she will try to sound out. With the amount of focus I put on teaching her to always try to sound it out first, it doesn't make sense. Reading lessons are still a very difficult chore, even though we have moved beyond "learn-to-read" lessons.

 

When she completes her grammar workbook, she regularly "forgets" to read the directions before completing the task, and always prefers it if I read it to her. Social studies and science are both reading based. She is capable of decoding most of the words at the level they are printed in the books, but she would get lost in a reading assignment from those books if I had her do it herself. So I read to her, and she understands it wonderfully. Today I noticed that while she was reading a book to herself, she was moving her lips as she read.

 

And yet, when she was in a religious ed class last year at our church, with 20 other public schooled kids, she was one of the 2 best readers in her class. And this fall, she read the Lion the Witch and the Wardrobe to herself. Granted I don't know how well she read it (and it did take her a very long time), but she did say that it wasn't difficult, and she was able to tell me about the plot. I do believe though, that grade level performance doesn't necessarily indicate that everything is fine, because it doesn't take into account her potential (and whether she is meeting it or not), and it doesn't take into account how painstaking a process it might have been to get to that level (and that it is to continue) and the fact that she had a 1:1 ratio while being taught.

 

My judgement is informed or clouded (?) by my experience with her older brother, who is a reading wiz. I don't know if there is such a discrepancy between the way he learns, and the way she does because they are just different people, because he is simply more bright, or because she has a block than needs to be un-blocked. Of course, I try to compare her performance and habits to what I think is "normal" and not to him, but I don't really have much to go on in judging "normal."

[Beansmom2]

That's what has made this so hard. I used the tests here: http://homeschooling.gomilpitas.com/articles/060899.htm

and she tests at a 4th grade level.

 

First, her spelling is awful. She would memorize the words on her spelling lists (we would discuss the phonics of it), and score great on the test at the end of the week, but retained very little of it long-term. (We are using All About Spelling with her now, and hopefully that will help).

 

Next, I've always wondered if there was something wrong with her vision. She saw an opthamologist a little over a year ago, and tested fine in several measures (I don't remember exactly what he tested now). But when she tries to read numbers on a clock, or words on a page from a certain distance (that other people can read fine), she says she can't see it right. When she holds her reader to do a reading lesson with me, she holds it just a few inches from her face. She often loses track of where we are on the page, or goes back to the beginning of the same line instead of advancing to the next one.

 

When she was learning to read, she had to be heavily prodded (like prodded to the point of crying) to sound out words, and would regularly start the word then guess the ending. She often added sounds that weren't there. While she can read a lot of words just fine now, she still uses those same bad habits when she encounters words she doesn't know. I still have to prod her to sound words out, and she often chooses to guess before she will try to sound out. With the amount of focus I put on teaching her to always try to sound it out first, it doesn't make sense. Reading lessons are still a very difficult chore, even though we have moved beyond "learn-to-read" lessons.

 

When she completes her grammar workbook, she regularly "forgets" to read the directions before completing the task, and always prefers it if I read it to her. Social studies and science are both reading based. She is capable of decoding most of the words at the level they are printed in the books, but she would get lost in a reading assignment from those books if I had her do it herself. So I read to her, and she understands it wonderfully. Today I noticed that while she was reading a book to herself, she was moving her lips as she read.

 

And yet, when she was in a religious ed class last year at our church, with 20 other public schooled kids, she was one of the 2 best readers in her class. And this fall, she read the Lion the Witch and the Wardrobe to herself. Granted I don't know how well she read it (and it did take her a very long time), but she did say that it wasn't difficult, and she was able to tell me about the plot. I do believe though, that grade level performance doesn't necessarily indicate that everything is fine, because it doesn't take into account her potential (and whether she is meeting it or not), and it doesn't take into account how painstaking a process it might have been to get to that level (and that it is to continue) and the fact that she had a 1:1 ratio while being taught.

 

My judgement is informed or clouded (?) by my experience with her older brother, who is a reading wiz. I don't know if there is such a discrepancy between the way he learns, and the way she does because they are just different people, because he is simply more bright, or because she has a block than needs to be un-blocked. Of course, I try to compare her performance and habits to what I think is "normal" and not to him, but I don't really have much to go on in judging "normal."

 

Stealth Dyslexia

http://www.davidsongifted.org/db/Articles_id_10435.aspx

[sixpence1978]

My goodness. I can sympathize with a lot of what you are going through.

 

My DS was also a very early reader. It was just easy for him. In fact, he rarely needs to work hard at anything. It comes naturally to him.

 

My DD, on the other hand, struggles through most everything. She can do it, and is basically close to grade level. She can read words at a 5th grade level. But she has to really apply herself to get there.

 

I know you said you took her to an opthamologist, so I'm not sure what tests were given. A developmental optomotrist is who you need to see regarding tracking, convergence, etc. My DD went through 9 months of therapy. She still has dyslexia though, primarily visual issues that stem from problems with retrieving symbols in her memory.

 

Moving lips while reading is common in kids with dyslexia. It is called subvocalization. It is a way for them to "hear" the words using their auditory and kinesthetic input, instead of just relying on the visual input of reading. Also, even though she can read the words, a lot of times the physical effort of reading can affect their comprehension, which may be why she understands better when you read to her.

 

I would encourage patience. It has been the biggest issue for me. My DD requires so much more repetition and reminding than I think she should. In the meantime, you could look into a developmental optometrist test (COVD) to see if something like vision therapy would be beneficial.

[AHASRADA]

I would visit Susan Barton's website and do some reading, in addition to emailing her with your dc's symptoms. http://www.dys-add.com/

 

I didn't end up using the Barton system, never purchased any of her products. Still, she gave me very detailed info. re: my dd's symptoms, what they could point to, etc. It was a way of finding out, from someone with knowledge and experience, if I had reason for concern and if it would be worth testing her.

 

We ended up doing testing through our local university's educational psychology dept. It was much cheaper than a private clinician, but more thorough than a school-sanctioned test would be.

 

Best of luck.

[PeterPan]

Well with what you've said, you first need to get her vision tested by a developmental optometrist with COVD. An opthamalogist isn't' the same and doesn't look at the same things. What you've described are vision problems, and perfectly correctable. There may be some working memory or other things as well, but even that can be simply because of the vision problems. So get her eyes checked by a good developmental optometrist, then see what you're left with. If she still has issues when you're done with them, then go to the neuropsychologist. But there's no point doing the neuropsych eval first when she's telling you she has vision problems.

 

And yes, the whole stupid thing with the opthamologists slamming the developmental optometrists and telling people they dont need them is well-known.

 

BTW, she's not going to test as dyslexic because her decoding is on grade-level. I can tell you that upfront. She may be ADHD, but they're not going to call her dyslexic. She's going to HAVE to have the decoding or phonemic awareness problems to get the dyslexic label. What she's got is tracking, convergence, focusing, all the stuff a developmental optometrist looks at, and all easily correctable. Well easy is relative. Takes work and a couple months of therapy, but yes, it's extremely correctable. You can see astonishing, absolutely astonishing changes in as little as one month. You could start now and have a new child by spring. Then whatever is left you go to the neuropsych for.

 

Hey, could I briefly pause and say WOW that I have 10,000 posts now? Jimminee, I didn't know I had been rambling so long! :)

 

But seriously, if I sound more emphatic than anyone else, it's because my dd benefited so much. My dd never was willing/able to sound out words till we did vision therapy. At that point she started. I think you'd find if you checked her working memory that THAT is actually what is tripping her up and causing her to read the beginning, end, and jumble the middle. Try her with digit spans (auditory or written) and you'll probably see the same thing happen. That's why you know it's working memory, not a phonemic issue. And the working memory, visual memory, etc. can be merely held back as a result of the vision (ie. you correct how the eyes are functioning and the visual processing pops up) OR it can be an indication of ADHD. Don't blow off the label. Took me a year to understand what they really mean by it and deal with it. They're using it as this stupid alphabet soup thing where they throw everybody and their brother in. The label doesn't matter as a name. It's the fact that you start to see the REAL SYMPTOMS, what's really going on, and why. If she has poor working memory, low processing speed, etc., you *want* to know that. It's awfully stink in' hard to teach through, ask me how I know.

 

It was 10 when I took my dd to the COVD doc btw. It was when her strengths (she has a very high, or at least reasonably high IQ) couldn't cover over her weaknesses anymore. So you could say we're reading into it. I'm just saying I've btdt, very similar situation (to a T), and I would get her eyes checked first then do the np eval. The COVD doc will be faster to get into anyway. It can take 1-4 months to get into a np, depending on how busy they are. While you're researching and picking your COVD doc (get a Fellow if possible), also do some reading on ADHD, even if you don't like the label or agree with it. It's just good to start learning. These kids can think very differently from what you realize. Freed has a terrific book "Right-Brained Children in a Left-Brained World" but there are tons of others (No Mind Left Behind, all the stuff by Halloway, etc.).

 

Tell us when you find a COVD doc. We're gonna want to hear how it goes. :)

Edited December 15, 2011 by OhElizabeth

[Ramie]

Thanks for all of your replies. I am processing all of this excellent information. Dh read the thread too - he suspects that he is dyslexic, and learned to cope with it by himself as a child. Dd is due for a well-child visit soon, so I will discuss this with her pediatrician. Also, I know someone whose kids are doing vision therapy in my town, so I will ask her for a recommendation. This is a tough time of year for us. We are planning an extended vacation in January, so I'm not sure how quickly WE will be able to move on this. Maybe we can at least get the ball rolling before hand. I really appreciate your help and advice. :)

[PeterPan]

They usually give you homework with VT. Depending on how long the vacation is, you could do a month of therapy and be in the groove enough to just take your homework with you. Or if it's just a couple weeks, do the eval before and start therapy (if she needs it) when you get back. But I'm really serious that a MONTH, just one month, can make a radical change.

 

And I'll say something that is none of my business and suggest that if your vacation means there's no money for VT, you'd want to delay the vacation. It's *that* life-changing when they need it.

 

My dh is dyslexic btw. My dd I taught from the beginning (age 4) with SWR, WRTR, etc. because I wondered if she would have his spelling gene (didn't know there was a name at the time, hehe). If you read "The Dyslexic Advantage" by the Eides, there are actual brain structure differences they're finding in these kids, and yes my dd fits their pattern and is very, very similar to dh. But because she was taught from the beginning with good methods, she does not test as dyslexic. I'm just trying to be honest and tell you flat up, because we got our np (neuropsych) eval done last month. Your dd will NOT get a dyslexic label if she's decoding like that. What you've described is eye problems, working memory, and maybe ADHD or processing speed.

 

There are other people on the board who thought they and their kids were dyslexic and the kids didn't get the label. Your dh could be wrong about himself. Or it could be that *he* does and your *dd* won't because of how you've taught her. The np eval and the labels they use will be a snapshot. What we call dyslexia they specifically call reading disorder. So if she is decoding on grade level and has proper phonemic awareness, etc., she's NOT gonna get that label. The np isn't going to care that the Eides talk about this "dyslexic processing" or about what MRIs show of dyslexic brains the Eides have been studying or what it says on the web about mixing up left and right, etc. My dd had all that. All he's gonna look at is that CTOPP score and whether she decodes and has the phonemic awareness. And the pattern you're describing, exactly what my dd did, correlates to working memory, not phonemic awareness or an inability to decode. Try it. Give her a string of numbers (auditory or written), starting small (say 4) and increasing till she starts to stumble. Look at the patterns of her errors and see if they aren't exactly the same as when she tries to decode words.

 

The np is not a magic genie that rubs their heads and tells you everything inside. He's more like a brain function camera man who can take this really marvelous picture of where they're at right then and then extrapolate based on that. Our np is on a dyslexia board in our state, which is why I went to him, and he admitted flat up you can remediate out the appearance of dyslexia on those tests with enough remediation, the type of remediation we did. So I say it again. With that decoding, he's gonna see that working memory problem and find some other things and give you an accurate picture and some codes that fit the picture, but it's not gonna be what you're thinking.

 

I would get going on the eyes, only because it makes such a huge difference so quickly. I think we just had a post from someone this week who said in ONE MONTH her dd went from totally resisting reading to reading. Think how nice it would be if your dd did that and wanted to take along a Kindle or pile of books on that extended trip. Wouldn't that be cool? :)

[Tokyomarie]

I have a bit different perspective on the vacation thing than Elizabeth. This educational & remediation gig is a marathon not a sprint. Sometimes we get caught up in trying to figure it all out and NOW for our kids. While I certainly wouldn't wait long months or years, I think waiting 6 or 8 weeks until after what is probably a much-needed vacation is perfectly fine. It might be good to get appointments on the calendar, though. If you decide to get an evaluation with a neuropsychologist or educational psychologist, it can be a wait of 3-6 months or even more depending on location. It is usually easier to get in within 2-4 weeks with a developmental optometrist.

 

I, too, would have your daughter evaluated by a developmental optometrist. That is the one thing I regret not doing when my son was young. To be fair, there were few voices in my life at that time that were supportive of VT & fewer well-articulated professional descriptions of what VT can & cannot do for a child. If my son were 6-8yo today and having the same visual symptoms with reading that he experienced back then, I would be jumping on it big time. I now understand that VT doesn't make a dyslexic child non-dyslexic, but dyslexic children sometimes have difficulties with the control of the fine muscles of their eyes that can make reading a very unpleasant experience, thus leading to avoidance due to visual discomfort. Younger children cannot always articulate what kind of difficulty they are experiencing, so they simply try to avoid reading.

 

Wishing you the best!

[LaughingCat]

Next, I've always wondered if there was something wrong with her vision. She saw an opthamologist a little over a year ago, and tested fine in several measures (I don't remember exactly what he tested now). But when she tries to read numbers on a clock, or words on a page from a certain distance (that other people can read fine), she says she can't see it right. When she holds her reader to do a reading lesson with me, she holds it just a few inches from her face. She often loses track of where we are on the page, or goes back to the beginning of the same line instead of advancing to the next one.

VT helped my DD with problems like this. Not perfectly and we still have to keep practicing the VT exercises for tracking to maintain but still a big jump in her reading level. (FWIW others have said that once finished they did not have to keep practicing to maintain). The holding the book close to her face has gone away (and the double vision she was experiencing sometimes)

 

When she was learning to read, she had to be heavily prodded (like prodded to the point of crying) to sound out words, and would regularly start the word then guess the ending. She often added sounds that weren't there. While she can read a lot of words just fine now, she still uses those same bad habits when she encounters words she doesn't know. I still have to prod her to sound words out, and she often chooses to guess before she will try to sound out. With the amount of focus I put on teaching her to always try to sound it out first, it doesn't make sense. Reading lessons are still a very difficult chore, even though we have moved beyond "learn-to-read" lessons.

For us, the only part of these kinds of problems that VT helped with is that DD will now sound out words with minimal fuss. The rest was unchanged by VT. Using Dancing Bears (Fast Track) for reading has helped some with the word guessing - although I can tell when she's tired because she reverts to guessing. The adding sounds that aren't there still happens even when she sounds out each sound correctly - when she puts it together she adds or changes sounds. She is also very sloooow at sounding out too (also with math facts etc).

 

So for us VT helped dramatically but definitely did not resolve the problem. I know many recommend a neuropsych next but it's not clear to me where you find such a person. I've looked in my area and all that comes up is websites about ADD (which I do not believe DD has). Plus I've seen accounts on here of poor neuropsych evaluations. Of course there are also accounts of poor VT evaluations/results too - which is why it took me 6 months from first hearing of VT to finally decide to make the appt. But the neuropsych will be a much bigger $ loss if it's bad :sigh:

 

As an aside, I also believe that adding a Fish Oil supplement has helped. At least it appears to me that she does better when I get it down her daily and if we miss days she does worse. It would be an easy thing to try while you're making appts or deciding what to do.

 

LL

[Tokyomarie]

There are other people on the board who thought they and their kids were dyslexic and the kids didn't get the label. Your dh could be wrong about himself. Or it could be that *he* does and your *dd* won't because of how you've taught her. The np eval and the labels they use will be a snapshot. What we call dyslexia they specifically call reading disorder. So if she is decoding on grade level and has proper phonemic awareness, etc., she's NOT gonna get that label. The np isn't going to care that the Eides talk about this "dyslexic processing" or about what MRIs show of dyslexic brains the Eides have been studying or what it says on the web about mixing up left and right, etc. My dd had all that. All he's gonna look at is that CTOPP score and whether she decodes and has the phonemic awareness. And the pattern you're describing, exactly what my dd did, correlates to working memory, not phonemic awareness or an inability to decode. Try it. Give her a string of numbers (auditory or written), starting small (say 4) and increasing till she starts to stumble. Look at the patterns of her errors and see if they aren't exactly the same as when she tries to decode words.

 

The np is not a magic genie that rubs their heads and tells you everything inside. He's more like a brain function camera man who can take this really marvelous picture of where they're at right then and then extrapolate based on that. Our np is on a dyslexia board in our state, which is why I went to him, and he admitted flat up you can remediate out the appearance of dyslexia on those tests with enough remediation, the type of remediation we did. So I say it again. With that decoding, he's gonna see that working memory problem and find some other things and give you an accurate picture and some codes that fit the picture, but it's not gonna be what you're thinking.

 

I don't remember seeing a post with details of the results of your visit with the np. It sounds like you didn't get quite the answers you expected. What sort of conclusions did he draw?

 

Although our np stated that our son fits the dyslexic "profile," the head of our son's school is having a hard time believing it. I think that's because my son can read, and though not as efficient as a non-dyslexic, he is functional at grade level. My son's writing is laborious & lacks elaboration. It is littered with spelling, grammar, and mechanical errors until he's been over it several times to clean it up. However, what gets turned in is actually more mature in some ways than what a typical student of his grade in our public schools produces. Therefore, his teachers and the head of the school are not seeing the dyslexic process behind that writing.

 

Our np offered the diagnosis, not based on phonemic awareness, which is average because of his educational experience at home, but, I believe, on rapid naming, reading & other academic fluency measures, spelling, the major discrepancy on the Nelson-Denny between standard time & extended time, and measures of memory strengths & weaknesses which are consistent with a dyslexic profile.

[VinNY]

There is no evidence that dyslexia is an eye disorder or that vision therapy is a remedy for dyslexia. Dyslexia is a brain disorder, not an eye disorder.

 

I get so tired of reading threads about dyslexia where someone tromps in and offers up COVD as a solution for dyslexia. It is NOT RECOMMENDED by any dyslexia professional. Period. It is not recommended by the AAP as a treatment.

 

There is NO SCIENTIFIC EVIDENCE that vision therapy is in any way useful for treating dyslexia. Therefor it should MOST CERTAINLY NOT be your first step in treating your dyslexic child's LD.

 

http://aappolicy.aappublications.org/cgi/content/full/pediatrics;102/5/1217

 

 

 

 

 

 

 

What is recommended is PROVEN TECHNIQUES like Orton Gilligham based programs.

 

Please research the scottish rite dyslexia site and see if you can get FREE PROVEN TUTORING near you as well as a REAL evaluation from a scientifically minded professional.

http://www.dyslexiaconsultants.com/Scottishritedyslexia.html

 

http://childrensdyslexiacenters.org/

 

 

Totally get where you are coming from...but

my child is dyspraxic. We used LiPs, Wilson trained reading specialist, O-G etc and she could finally hear the sounds but would still not attend to the page and use her eyes correctly. VT was like OT for her eyes and her OT was the one who kept pushing me to try it. I waited 3 years to do it because I was a skeptic. Now my dtr uses her eyes correctly and is still being taught to read via O-G. She is language impaired and has a low working memory but all who work with her over the years and were just as frustrated as I was see her progress since VT.

 

Another son had convergence and tracking issues but I used Spalding to teach him and he began reading at 8. At 11, he did home VT exercises the Dr. gave him when he evaluated both. My son's standardized test scores leapt 20 points last year. At 12, he is in Catholic School on the Principal's List. He feels like a new kid, because prior to that he was lucky if he was a B/C student. He couldn't attend to the reading etc.

 

Best thing I did and I am a big O-G fan.

[peacefully]

.

[Tokyomarie]

This fascinates me, because I suspect that my ds also fits a "dyslexic profile," but his reading and several aspects of his writing (spelling, grammar, mechanics) is at least grade-level (or above). However, our np was emphatic that without deficits in phonemic awareness and decoding skills (he was too young at the time of the evaluation to have his spelling assessed), he did not meet any diagnostic criteria for dyslexia/reading disorder.

 

What kind of explanation did the np give for your son's difficulties?

 

In our case, our son's phonological speech delay for which he had speech therapy over two different 1 year time periods helped the diagnosis, I'm sure. His phonemic awareness per se was not specificially assessed when he was young, but we did Earobics and other phonemic awareness activities in addition to speech therapy from the time he was in pre-schoool. That targeted training from age 3.5yo on undoubtedly had an effect on his processing abilities.

[rafiki]

.

[FairProspects]

The NP can’t give an official Dyslexia (now called Reading Disorder) label unless all language skills are below age expectations. This includes vocabulary and verbal ability.

 

 

I'm just not understanding this reasoning at all. Some aspects of language skills may be remediated to grade level by using O-G methods, or other means. That does NOT mean the kid still doesn't have dyslexia or language processing issues. We are running into this issue as well and it is incredibly frustrating. Our COVD said he couldn't diagnose ds as dyslexic because he could read a list of grade level words (1st grade, I might add, not a very high bar by ps standards), but said with the Eide's evaluation ds would likely come back as dyslexic. I'm not even sure all NP's have the same criteria from what I've been hearing!

[PeterPan]

Marie, sorry, I wrote several people privately. It turned out the stuff I had known all along but not really KNOWN, if that makes sense: working memory, EF, extremely creative/artistic, low processing speed (compared to IQ), and enough remediation that she doesn't need a reading disorder label. I'm extremely happy with the results and got tons of information on how to handle each subject with her. He basically spent two hours with me answering ALL my questions, going through every single subject. I would tell him a range of options I have for science or history or math or whatever, and he would say where she thought she ought to be. And it's not even so very different from what we've been doing. It's just that I really felt I couldn't track her that way through high school without some clear evidence that what I was doing was right. Getting things quantified was a HUGE relief and has made a functional difference for us, giving words to her frustrations and helping me know how to react. There were so many things I had said all along ("smoke comes out her ears", etc) that we got explained via this. It was DEFINITELY worth it.

 

He didn't recommend any meds or even remediation (except some work on working memory), because the testing showed we've pretty much nailed it. So for us it was confirming we're on the right track. There were so many sticky wickets I was dealing with in my mind (textbook science, why she bucks certain non-fiction, etc.), and we got all that sorted through.

 

I'll repeat this again. He said the reading disorder label is only a snapshot of the current moment and that if he gets someone who has been through the dyslexia academy in town, they'll be remediated to the point it won't show except for fluency, and even that fluency score will come up with time. In other words, I don't think it's at all strange that Michele or I took our kids in, kids who have been taught from age 4 or 5 with methods meant for dyslexics (and never any other way, no incorrect or bad habits to undo) and VT and... and had them not need that label. I mean it's not rocket science: What we did worked.

 

So no, I'm not unhappy. On the contrary, it was about as good as I could have hoped for. :)

[PeterPan]

I'm just not understanding this reasoning at all. Some aspects of language skills may be remediated to grade level by using O-G methods, or other means. That does NOT mean the kid still doesn't have dyslexia or language processing issues. We are running into this issue as well and it is incredibly frustrating. Our COVD said he couldn't diagnose ds as dyslexic because he could read a list of grade level words (1st grade, I might add, not a very high bar by ps standards), but said with the Eide's evaluation ds would likely come back as dyslexic. I'm not even sure all NP's have the same criteria from what I've been hearing!

 

When I looked at the info on the Eides' website, it's pretty clear they use their term "dyslexic processing" pretty generously (by which they mean there are structural differences that would show up on an MRI, things that are a difference, not a defect), but that they still use the DSM reading disorder, disorder of written expression, etc. codings. In other words, I think they can only label with DSM coding what they actually see, since that's a snapshot. But they're probably going to be very generous at giving their additional head-rubbing of what they really think is behind it structurally in the brain (their "dyslexic processing") that clearly doesn't change with remediation. Look in DA at how many people they go back and retroactively label as having dyslexic processing just based on that pattern.

 

Personally, I found the advice I got very good: go in with an open mind and just accept whatever labels they toss at you. It doesn't matter anyway. The accommodations and changes you'll make are almost the same, no matter what label they give you. The point is to find someone you trust, someone who will take the time to explain things to you about how to APPLY the labels. That to me was the liquid gold, not the labels.

[rafiki]

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[Tokyomarie]

The NP can’t give an official Dyslexia (now called Reading Disorder) label unless all language skills are below age expectations. This includes vocabulary and verbal ability.

 

 

This does not seem to be at all correct. Diagnosis of dyslexia requires that written language difficulties be unexpected in relation to general cognitive ability, which includes verbal ability. While vocabulary and other aspects of verbal ability MAY test lower in older children due to reduced experience with academic language through reading, this is not a prerequisite for the diagnosis. If a child has had an enriched environment of oral language, read alouds and/or audiobooks, their oral verbal abilities may be very well developed.

 

This is the definition of dyslexia used by the International Dyslexia Association:

 

 

Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede the growth of vocabulary and background knowledge. [/Quote]

 

If it were necessary for a student to have below age-level oral verbal skills, how could it be that dyslexic students could achieve well enough to be accepted to and thrive at competitive universities?

[Tokyomarie]

Thanks for explaining, Elizabeth. How are your daughter's written expression skills? What is her spelling like?

 

My understanding is that, in the case of very bright & well-remediated dyslexics, written expression that lags behind the expected for ability level, especially dictated spelling, often provides information that can lead to a diagnosis. Of course, for school puposes, the student would probably get a label of disorder of written expression. But that label doesn't really explain the root issues in the cause of the disability. People can have difficulty learning to handle the writing process for different reasons.

 

In any case, the most important thing for homeschooling parents is to learn the details of how their students learn so they can better tailor the instruction to their specific needs. It sounds like you got lots of that kind of information, which is good!

[rafiki]

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[Tiramisu]

When I looked at the info on the Eides' website, it's pretty clear they use their term "dyslexic processing" pretty generously (by which they mean there are structural differences that would show up on an MRI, things that are a difference, not a defect), but that they still use the DSM reading disorder, disorder of written expression, etc. codings. In other words, I think they can only label with DSM coding what they actually see, since that's a snapshot. But they're probably going to be very generous at giving their additional head-rubbing of what they really think is behind it structurally in the brain (their "dyslexic processing") that clearly doesn't change with remediation. Look in DA at how many people they go back and retroactively label as having dyslexic processing just based on that pattern.

 

Personally, I found the advice I got very good: go in with an open mind and just accept whatever labels they toss at you. It doesn't matter anyway. The accommodations and changes you'll make are almost the same, no matter what label they give you. The point is to find someone you trust, someone who will take the time to explain things to you about how to APPLY the labels. That to me was the liquid gold, not the labels.

 

I just happen to have an MRI of a certain brain. I wonder who could read it for these things. ;)

[Tokyomarie]

ADHD and ASD's are medical Diagnosis with specific criteria which must be met. Dyslexia is interpreted multiple ways.

 

We've discussed this previously http://www.welltrainedmind.com/forums/showthread.php?t=318722&highlight=dyslexia+diagnostic+criteria

 

I do remember this discussion. The Great Schools article that was linked is a nice description of how different entities use different terminology.

 

Frankly, I'll go with the researchers and use the term dyslexia. Under the current DSM-IV, an elementary age child still struggling with reading, who can't write & who may have oral expressive difficulties, could end up with 3 different diagnoses (reading disorder, disorder of written expression, and, if oral language is impacted, expressive language disorder) to describe a problem arising from what is likely one main brain-based entity. Under IDEA 2004, the same child could get a label of "specific learning disability" which is a broad umbrella of academic difficulties that occur outside of a general cognitive disability, ADHD, or ASD. The child would be said to have a SLD in reading, writing, and/or expressive language. Again, 3 labels to describe what likely arises from one main difference at the level of brain structure & function.

 

What happens in schools is that the child must not only be recognized as having a disorder but they need to be recognized as having a need for specialized instruction & accommodations (IEP) or a need for "just" accommodations (504). A child who is remediated to the point where they can function at least within one standard deviation of average for their grade level on academic testing (such as the WIAT or WJ-III) is going to have a hard time getting services or accommodations, regardless of their actual performance on class assignments or tests. If their performance is grade level but significantly below their IQ, they'll have trouble getting help, even though they are at high risk fo developing emotional difficulties from the frustration of not being able to perform consistently at their level of reasoning.

 

In our case, at our son's age and level of performance, he wouldn't merit a "SLD in reading" or a "reading disorder" label because his reading is quite functional in the classroom and the real world. At age 7 or 8, he would have merited and probably received these labels because he could not read anywhere close to grade level, even with good instruction. The fact that he can read now doesn't change the fact that he is dyslexic- he still has dyslexic features to his reading process, which it appears as if the DSM-V will address.

 

What we are trying to address with the school this year is his disorder of written expression, which arises from the dyslexia. There appears to be a major disagreement between us (parents & private professionals) and the school as to what constitutes a severe enough difficulty to merit some level of assistance through at least a 504. The fact that he will be transitioning to a blended schedule of college classes & high school classes in January complicates matters further. The school's unwillingness to recognize our son's difficulties doesn't change the fact that his writing is moderately impacted by his dyslexia. It takes him many more hours than the typical student + professional help to complete a writing assignment which more often than not gets a grade of C or less. This is in comparison to his A grades for other assignments in the same class. In school he should be able to get a label of "SLD in written expression" but we are not there yet.

 

Ultimately, I think the schools & the DSM are going to have to catch up with the brain structure & function level of research. And the research needs to go even further to identify & quantify the "core features" of each diagnostic entity.

[peacefully]

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Edited November 20, 2012 by yllek

[peacefully]

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[Tokyomarie]

I think I can answer that one. My dh is dyslexic, and he did quite well academically. He went to a top-tier college, received scholarships, received academic honors, etc. But even today (he was evaluated by an NP about three years ago), his language scores (including oral verbal) are far below average. But since he has a documented learning disability, he received accommodations in school.

 

The IDA is an advocacy organization, and it offers its own definition of dyslexia (based on solid research, to be sure), but it doesn't determine the diagnostic criteria that most psychologists use. And then, as you've stated, schools systems determine eligibility for services with an entirely different model too.

 

Was there variability in language scores? Did he have some scores that were higher? Certainly, he functions much higher than average in some aspects of actual academics if he could go to a top-tier college.

 

My son does have variability in his verbal IQ subtests as well as his academic testing in reading & writing. Ds's vocabulary tests in the gifted range but one of the subtests was below average. His reading comprehension with extra time tests almost 90th %ile, but his spelling is <1st %ile. Phonemic awareness is average but rapid naming on the CTOPP & other similar testing shows a definite retrieval problem for verbal information generally, and especially the alphabet. We may be looking at doing some more specific oral & written language testing after the first of the year. I have a consultation scheduled with someone to discuss our situation.

 

I think our np has aligned himself with the current research on dyslexia because he brought up rapid naming as one key point in his discussion of ds's results. I think he is also very aware of how dyslexia presents across the life span & the differences between students who have had research-based remediation vs. those who have had only traditional educational instruction.

[Tokyomarie]

Anyway, I'm just very intrigued by your references to a dyslexic profile that does not rely on phonological processing and language scores as a measure.

 

I think I said this as I went around the bush, but in our case, there IS a strong history of a phonological speech delay, and his history includes difficulty with phonologically-based early reading tasks. *At this time* (age 15.5yo @ testing) his phonological awareness tests in the average range, most likely due to intervention.

 

If a person has never had a history of difficulty with phonological processing or a history of behaviors that might suggest a previously undiagnosed problem, then a diagnosis of dyslexia would be highly suspect.

[PeterPan]

What we are trying to address with the school this year is his disorder of written expression, which arises from the dyslexia. There appears to be a major disagreement between us (parents & private professionals) and the school as to what constitutes a severe enough difficulty to merit some level of assistance through at least a 504.

 

The IQ discrepancy is not in the current DSM standards, and Fletcher's book (that I've referred to numerous times and already returned to the library but found invaluable) says most research backs dropping the IQ discrepancy.

 

Next, you said it's his "dyslexia" causing his writing problems but he doesn't qualify for a disorder of written expression code from your psych. (Did you use a psych?) What label did the psych want to give? I would suggest to you that merely saying "dyslexia" is the cause isn't helping you narrow down the specific problem. What the DSM5 will code as dyslexia is now reading disorder, meaning you're still not explaining the *problem*. I'm nitpicking, but bear with me. Almost all these kids, no matter what label, turn out to have processing speed or working memory or EF or other problems. They also, if you read Freed's book, generally tend be right-brained and sometimes even VSL. In our case the VSL didn't start coming out until we did the VT. I think it was there and held back because of the physical problems.

 

So anyways, there may have been some other things your psych caught with the testing that DO explain the writing problems. For instance, our psych identified:

 

-EF--affects the ability to think logically, create structure, etc. I'll be really blunt here. If your dc has the EF of (pick an age, say 8), then HOW do we think he's really going to do the logical, ordered, structured thinking of a 12 yo??? He's NOT. EF is something the psych/neuropsych quantifies, so go look at your records. Ours was very blunt about how to use the scores to get realistic about where she's at with her ability to structure and organize. Once I started doing this, a LOT made sense. Her ability to organize is consistent with her EF age, even though she has a very high IQ for her actual age (ie. lots of meat to come out). That's why there's no lightbulb with writing structured stuff, even though the content is marvelous.

-working memory-kissing cousin of EF, it affects their ability to hold all that in their heads without going bizerk

-processing speed--like on a computer, it affects their ability to get it out before the working memory gives out from the rapid flood going through their heads.

 

The accommodations are all the same: less distracting environment, software to help with structure, typing to lessen the amount of motor control and processing needed, more time on assignments.

 

My dd did a writing class 1st semester that was quite challenging. She had 3-5 paragraphs a week or 2 5-paragraph essays. It left her utterly wiped and took a LONG time. I'm hoping that changing to Scrivener and using that for the research, drafting, and organization/structure will help significantly. We'll see. She LOVED the teacher and the teacher's quirky assignments, and of course that's half the battle. When they *want* to write, it's much easier to get something out of them, lol. At this point, my goal is to bring in supports for those components (structure, etc.) to lessen her strain and make it easier for her to get out what is inside.

 

I also switched her over to the Dvorak keyboard layout, which I HIGHLY recommend. It has (along with Mavis Beacon) basically doubled her scores in less than two months, nothing short of amazing. She's now typing comfortably and normally, where before she had regressed to pecking. Dvorak requires less crossing of the midline, making it much better than QWERTY for dyslexics or anyone with bilaterally issues.

[peacefully]

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