Trying to get a dysgraphia diagnosis...

[sherideane]

I'm new to all of this so bear with my lack of accurate terms and probable misunderstanding of various processes...

 

DS has had problems with handwriting since preschool. "Poor fine motor skills" they said. Kindergarten, he did okay, but it took him a while to write his newly learned letters. First grade (same public b&m as K) was a nightmare (for time's sake, I'm just going to leave it at that). Second grade we did virtual school... better, but writing was still a major pain in the booty. Now he's in third grade and I'm homeschooling with a local co-op (which I really like). He's an advanced reader and speller, and vocabulary is incredible (all about 5th grade level). Writing is still at a first grade level. SO. Did tons of research and I'm pretty convinced it's dysgraphia. I then had a meeting w/ our school district psychologist who informed me of the (way too lengthy) process of getting an IEP. (Seriously, it sounded like we wouldn't even get to see an OT until the end of the school year!) So I went through his pediatrician instead, who referred me to an OT for an evaluation - which we did today. My goal was to get some kind of determination/diagnosis, then take that to the school and begin their process mid-way through. So after eval today, the OT called me and told me DS didn't score significantly low enough to be considered as having a "fine motor delay" but that she really thinks it has more to do with poor tracking of his eye muscles (but she says his vision is fine). She wants to do one more evaluation called a "visual perceptual" test. If what she suspects is correct, we may still qualify (according to the school district) for some kind of IEP/treatment plan under a "sensory processing" problem.

Okay. I guess I'm a little frustrated... and confused. Because what I thought I discovered about dysgraphia was that it had more to do with a blocking of new information from one hemisphere of the brain into another (the newly-learned-info side, into the "automatic" side). Is this research super new... or not yet commonly accepted? Is it only a Dianne Craft thing? The OT seemed familiar with the term dysgraphia, but she didn't really use it herself, nor did she mention any brain processing functions. Maybe I'm just being a pre-emptive worrier? Maybe it's all the same thing being called by different names? (Dsygraphia = Sensory Processing Disorder?)

 

Anyone have any thoughts to share on this? Thanks for your time!

[Tidbits of Learning]

I just went down this path. You can not get a dysgraphia diagnosis from an OT. They will try to diagnose your child with lack of coordination, poor motor skills, and vision issues or sensory processing disorder. That is all they can diagnose. The OT will take your insurance money to treat something that may or may not be an issue and you will not get writing help. You have to go to a psychologist to get a dysgraphia diagnosis.

Look into Dianne Craft's book Brain Integration Therapy. http://www.diannecraft.org/

That is what we are doing after wasting 2 months with ds in a gym at OT and losing time and money with no help for his writing. They only worked on 2 letters with his HWOT that whole time. They were focused on what they could diagnose and charge treatment for instead of what we took him there for in the first place-writing issues. I was burned by the OT place here and I am very leery of using an OT place for dysgraphia with writing help unless they are listening and focused on the same issues that you are.

My pediatrician was able to write a 504 letter (not an IEP). Dysgraphia falls under 504 medical not special education. I took the results from the OT to my pediatrician and she diagnosed ds with dysgraphia and wrote us a letter for 504 accomodations.

 

ETA-sensory processing disorder is something totally different and not at all related to what you took him to be evaluated for...this was my experience with OT and asking for a dysgraphia evaluation. They did an OT eval and then tried to diagnose with something that they were accredited for and that he totally did not have and did not need therapy for while he still did not get any help for his writing.

Edited October 25, 2012 by OpenMinded

[ELITEANDLOVINGIT]

I am so lost..Dysgraphia is a learning disability, why in the world would they prescribe OT? I think you should pursue your IEP and request accommodation for written work, request that work be able to be completed on a computer, and in a different time frame.

 

Remember too...ANYONE that is any qualified educator or psychologist can verify dysgraphia, once the diagnosis is made, then the school must provide an IEP and accommodation - this is a federal law. It does not have to be the school psychologist, or even anyone that works for the district. The testing can be done privately through a neuropsycologist.

Edited October 25, 2012 by kerryfrank73

[sherideane]

ahh... that is what I was worried about. It almost seems (and it could just be ME and my frustration) that there is almost a reluctance to make a determination. How it was explained to me, was that first, DS would have to be "observed", **in the classroom**, "over the course of time" with regards to his writing. (Observed by whom, I failed to ask.) And if he only takes drama and spanish at the school (with no writing) how is that supposed to work?! THEN, one of his teachers makes a recommendation for some interventions (such as pencil grips?!) - which are put into place... THEN there is another observation period "over the course of time" with said accommodations... and it will be noted whether those are helping... and if it's determined that they're not helping and more intervention is needed, then they will call an OT to evaluate... blah blah blah.

 

I'm a cautious person who tries to look at things from all angles... so I haven't wanted to just make my own diagnosis. That's why I haven't jumped on the Diane Craft bandwagon yet - I'm not a psychologist! Do you think I should ditch the next OT evaluation - even if the OT strongly feels DS has a visual/sensory impairment? I don't think I can persuade the school psych to determine DS has dysgraphia (since she already told me they don't make diagnosis) so... do I demand a recount? (hahaha) Go back and tell his pediatrician, "No, I don't want an OT, I want a neuropsychologist"...?

 

This is so confusing. :(

[GoVanGogh]

You might cross-post this on the special needs forum. The ladies there are so amazing!

We just started down this road a month ago and I can totally relate to you saying it is frustrating and confusing!

We meet tomorrow with our third occupational therapist. :tongue_smilie:

It was my experience that OTs can dx dysgraphia, but you are using public school resources? I don't know how that changes the equation.

[1dawn]

My advice is to find a pediatric OT (private) and have him/ her evaluate. If the need is there, the therapist will provide therapy that will help your son. OT is VERY difficult to get in schools, and is usually given only when the student is failing (the disability interferes with academic success). I taught in public schools, and only knew of one student in the whole school that got OT services (besides those in MID and MOD classes), and that was only once a week.

 

I had my own dd evaluated for speech issues, and the speech therapist actually noticed some things that I, too, had questioned. She recommended that I get an evaluation. I had to go through my pediatrician for a referral. With that eval and a later visit to the neurologist, my dd was diagnosed with apraxia of speech, limb apraxia, and visual apraxia. She did OT/ PT therapy (with some visual exercises thrown in) once a week and speech therapy once a week. We paid a copay for every visit, and none was done through the school system. After a year and a half, my dd was dismissed from therapy because she had improved so much. I would highly recommend one on one therapy vs. most of the therapies offered in schools. At the school I taught at, it would take roughly 18 months for an IEP to be completed and started.

 

We also did therapy homework daily. My dd (now a fourth grader) went from writing like a preschooler just last year to writing beautifully on college rule paper this year when she really puts forth the effort. It is amazing!

 

Good luck, and keep seeking answers.

[MerryAtHope]

I would ask more questions. My experience is that OT can suspect dysgraphia but doesn't make the actual diagnosis--they can work on some of the strength/skills though. If she did a thorough eval., she should have noticed whether he showed muscle weakness for motor dysgraphia (and it sounds like she found some delays but not enough to qualify for an IEP, which would be 2 or more years behind). However, that's not the only type of dysgraphia, and it's possible that he has another type that is interfering (perhaps spatial dysgraphia, since his spelling is excellent).

 

Spatial dysgraphia could be caused by visual issues (where vision is actually fine but eye tracking and visual processing, which is neurological, are issues). So, it's possible that this eval. would actually be worth your while. (And she may know enough to suspect this and steer you in this direction, but for a real evaluation of vision processing issues, you would go to a developmental optometrist--not a regular eye doctor. www.covd.org). My hesitation with this thought is that his reading and spelling are advanced. Did you tell her this? I'm having trouble picturing a child who is an advanced reader AND advanced speller having visual issues. Maybe it's possible...I've just never heard of this. (My son went through vision therapy and it helped immensely.) I guess I'm having trouble understanding how that would add up, and that would lead me to call and ask more questions before spending time/money on her eval. (or a COVD one), and read on the COVD website to see if it could be a match.

 

When you say his writing is at a 1st grade level, do you mean the visual look of what he's writing, or are you referring to something else?

 

Was the school psychologist ONLY going to have your son do an OT eval, or was he doing other tests as well? I would think that there would have to be other tests to cover all forms of dysgraphia as well as rule out anything else (and yes, it does tend to take a long time to get in). You could do similar exams on your own through a neuro-psych evaluation, but it costs $$$ and not all insurance covers it.

 

Sorry, I know the process is frustrating! Merry

[Pen]

I'm new to all of this so bear with my lack of accurate terms and probable misunderstanding of various processes...

 

DS has had problems with handwriting since preschool. "Poor fine motor skills" they said. Kindergarten, he did okay, but it took him a while to write his newly learned letters. First grade (same public b&m as K) was a nightmare (for time's sake, I'm just going to leave it at that). Second grade we did virtual school... better, but writing was still a major pain in the booty. Now he's in third grade and I'm homeschooling with a local co-op (which I really like). He's an advanced reader and speller, and vocabulary is incredible (all about 5th grade level). Writing is still at a first grade level. SO. Did tons of research and I'm pretty convinced it's dysgraphia. I then had a meeting w/ our school district psychologist who informed me of the (way too lengthy) process of getting an IEP. (Seriously, it sounded like we wouldn't even get to see an OT until the end of the school year!) So I went through his pediatrician instead, who referred me to an OT for an evaluation - which we did today. My goal was to get some kind of determination/diagnosis, then take that to the school and begin their process mid-way through. So after eval today, the OT called me and told me DS didn't score significantly low enough to be considered as having a "fine motor delay" but that she really thinks it has more to do with poor tracking of his eye muscles (but she says his vision is fine). She wants to do one more evaluation called a "visual perceptual" test. If what she suspects is correct, we may still qualify (according to the school district) for some kind of IEP/treatment plan under a "sensory processing" problem.

Okay. I guess I'm a little frustrated... and confused. Because what I thought I discovered about dysgraphia was that it had more to do with a blocking of new information from one hemisphere of the brain into another (the newly-learned-info side, into the "automatic" side). Is this research super new... or not yet commonly accepted? Is it only a Dianne Craft thing? The OT seemed familiar with the term dysgraphia, but she didn't really use it herself, nor did she mention any brain processing functions. Maybe I'm just being a pre-emptive worrier? Maybe it's all the same thing being called by different names? (Dsygraphia = Sensory Processing Disorder?)

 

Anyone have any thoughts to share on this? Thanks for your time!

 

Do you see evidence of poor fine motor skills in other areas than writing? Or is he generally good with his hands, but has the writing trouble? (My son is super well-coordinated manually, but has penmanship troubles, which I've since come to realize is common in dysgraphia.)

 

What are you ultimately trying to get for him? Help with handwriting? Extra time on tests? Or????

 

 

Does he also have trouble with writing in the sense of composing sentences and paragraphs?

 

If you want help with handwriting, you might be best off trying to find someone on a private basis who can do that, if you can afford it. The chance that even if he got an IEP he would get the help that would solve the handwriting problem is slim. OTOH, if what you need is a paper trail for things like extra time on tests due to slow writing that is another matter.

 

Whatever else, I'd suggest you see if he can learn to type, and if that helps solve the handwriting problem by and large.

Edited October 26, 2012 by Pen

[ELITEANDLOVINGIT]

If you have private insurance, I would call and determine what level of benefit you might be able to seek a competent independent evaluation from a neuropsychologist or disabilities specialist. I don't necessarily believe you should scrap the OT, the memory and motor function are all considered facets of dysgraphia. My guess is the process is lengthy because IEPs mean time and money from the district, as well as long term accommodation, as things like dysgraphia and dyslexia do not go away. They just become more manageable.

 

You are likely to get some backlash from your insurance company, if you do, I wouldn't say much beyond he is having learning difficulty at school, if you could get a referral from his primary physician (if you have a good relationship) I would try to go that route. They may have you see a private psycologist first.

 

For us, our insurance covered all of Abby's neuropsych exam, but did not cover disclosure of findings...which is really stupid, but that's how it is. We had a lot of support to receive testing for deficiencies because Abby is a cancer survivor.

 

Hang in there.

[Guest trcohen1]

paffd

[Tiramisu]

Do you see evidence of poor fine motor skills in other areas than writing? Or is he generally good with his hands, but has the writing trouble? (My son is super well-coordinated manually, but has penmanship troubles, which I've since come to realize is common in dysgraphia.)

 

Great point. This is often misunderstood. It is very true for at least two of my children. Both are good with fine crafts and playing instruments, but have poor handwriting. Both have tested poorly on tests of visual motor integration. 

 

What are you ultimately trying to get for him? Help with handwriting? Extra time on tests? Or????

 

If these are possible needs for the future. It's not a bad idea to start a paper trail.

 

Does he also have trouble with writing in the sense of composing sentences and paragraphs?

 

If you want help with handwriting, you might be best off trying to find someone on a private basis who can do that, if you can afford it. The chance that even if he got an IEP he would get the help that would solve the handwriting problem is slim. OTOH, if what you need is a paper trail for things like extra time on tests due to slow writing that is another matter.

 

Whatever else, I'd suggest you see if he can learn to type, and if that helps solve the handwriting problem by and large.

 

I agree. Typing has been a life-saver here.

 

Great post.

[Tiramisu]

Dysgraphia is complex because writing depends on visual-motor interaction within a system of which any or all parts could be immature, disorganized, or uncoordinated.

 

I'll share the following experiences because my kids seem as though they may have similar issues to the OP's ds, and I now have the perspective to see how these issues show themselves and affect things over time. 

 

We also had pre-school teachers point out the gap between gross motor and fine motor skills in my children. All have turned out to be excellent readers and spellers, so, in us too, the visual-motor issues have not impacted those areas. However, they will drop letters when they are engaged in writing. It's  part of a processing glitch and can look like a spelling problem even though it's not.

 

They can write well when they type, once they get over the initial block. Getting started is especially difficult for those with processing issues. For some reason, it's harder for them to organize their thoughts. This can show itself in a reluctance to write but there are ways to help, however, such as talking about them before hand about what they'll write and how they will organize it, making an outline, etc. This is all so they don't have to do too much extra thinking and organizing while they write, if that makes sense. BTW, I like how WWE works on holding thoughts and writing in the early years.

 

Because OT can be covered in our insurance plan only if there's a muscle weakness, that has always been overemphasized in the reports. This was always confusing and misleading. I don't know how common this problem is, but, for us, only time and pulling in the help of other specialists put that to question to rest.

 

On the same note, because it's not covered by our insurance, the processing part was virtually ignored by our OT's, at least officially. So, if you have an OT picking up on the visual processing issue, bringing it to your attention, and wanting to test for it, that speaks well of your OT, IMO.

 

I didn't have a great experience in working with an OT for handwriting. Only a few minutes in our one-hour session were devoted to handwriting and in that time, there was a lot of coloring going on. Not that there wasn't a point to it, but we could have done it at home. There were also exercises with theraputty, which also could have been done at home (like a lot of the other OT stuff, actually).

 

The visual part is MAJOR and may be able to be improved through vision therapy, but first you would need to get an evaluation and see what the developmental optometrist says (see COVD.org). And yes, visual processing is completely different from vision. I have only had my oldest evaluated by a COVD doctor so far. He did find a weakness but it was primarily neurological and not of the type that could be helped very much by vision therapy.

 

We have tried to remediate through various activities and accommodate as we go along. My oldest is eligible for accommodations in college based on a neuropsychologist's report that demonstrates a speed issue. We also have an audiologist's report since she also has CAPD, which, I think, is part of the whole dyspraxia picture. We did not seek accommodations for standardized testing, so I can't speak about that except to say they generally want to see that a "disabilty" affects achievement to be eligible.

 

It is becoming clear that my next one's visual issues are frustrating some academics in junior high. She's the one who couldn't use scissors in pre-school. It just took the right circumstances for different aspects of the same issue to manifest. I'm mentioning this because processing issues sometimes seem to ebb and flow over time. There's a specific problem and you remediate it or accommodate it, by having them type, for example, but the underlying issue doesn't completely go away.

 

Anyway, these are all the reasons why I believe it's beneficial (1) to start a paper trail in case accommodations are ever necessary, and (2) keep our eyes open for areas of difficulty that pop up over time that could be rooted in that fundamental weakness so that they are addressed appropriately.

 

Wishing you the best as you make your decisions.  :grouphug:

[Heathermomster]

DS was diagnosed by a PhD. Neuropsychologist.  

 

Google around and try to find someone local.  Call them and ask about what needs to be done to get a dysgraphia assessment.  While you are performing an Internet search, maybe check out the College Board website and discover any testing required for ACT/SAT/AP testing accommodations.  The np can go ahead and address everything at once, and MAYBE your son will qualify.

 

If he's not typing yet, by all means, get him typing.  Handwriting practice is still important.  Visit the SN boards if you'd like more recommendations.

[thegeyser]

My son has a history with writing similar to your son. For lack of a better way to decribe it, I tell people he has dysgraphia. We've been trying to tackle this issue for close to a year now. We did three months of Dianne Craft plus many of the recommendations from her Biology of Behavior CD. It helped him gain some automaticity, but the exercises caused a lot of anxiety and meltdowns. He then started clinching his fists every few seconds (motor tic) and had to give up piano lessons. The tics transitioned to a chronic throat-clearing once we stopped all the writing 8 exercised. We decided that working with neuroplasticity is not the answer for him - not until we find the underlying cause. My son has a lot of sensory processing issues also. He does grip his pencil too tightly and craves deep pressure to help him relax. We then went to a neuropsych ed guy who gave us lots of numbers associated with what we already knew. Now we know he has 5th % motor speed and is borderline gifted in verbal AND math. He also has slow processing speed and poor working memory. Neuroed guy gave our son an ADHD diagnosis. He said he has difficulty writing because he can't focus long enough to do it. Somewhere along the way we started swimming on a competitive swim team to help with cross-brain activity. My son likes the feel of the water on his body (calming deep pressure). We then went ahead and paid more $$ for OT for the SPD. We were told by OT and neuroed psych doctor that OT would have little benefit for his writing. Now we use mechanical pencils, write on an angle, and have learned to type. If anything, the OT program we did gave him some tools to deal with his emotional levels until we can figure out how to get to the root of his issues. We went to another doctor who found some gut-related issues (low chymotrypsin {enzyme digests protein}, inflammation of the colon, low SIgA levels {poor immune system in gut}). So now we are chasing down a nutitionist who focuses on food sensitivites and intolerances. We started a very restrictive diet for him and only lasted for six days. We saw amazing improvement only to add back in a few items and have him lose all ability to focus and become an emotional basketcase. So we are enlisting the help of this nutritionist. I think we are onto something now. All in all, I share this say that you may have to run down a few rabbit holes until you find the right one. Your child may also have more than one issue or many issues that stem from the same origin.