Did our evaluation testing today on our youngest

[UCF612]

We had an assessment done on our youngest son to determine if he has dyslexia or if there is another reason for his reading challenges.  The testing showed a definite deficit between his IQ (near gifted but didn't cross the border into gifted) and his performance.  She noted that he is a very visual learner.  She also said that she thinks he has inattentive ADHD.  While he did have many of the markers for dyslexia he didn't have enough of them to be diagnosed.  She said she thinks his issues stem from the inability to focus and retrieve the knowledge.  I was a bit taken aback as I hadn't expected an ADHD diagnosis.  I was sooo sure he was going to get a dyslexia one!  I kind of had this sinking feeling like he's got the current in style label.  Now believe me I KNOW that ADHD/ADD are VERY VERY REAL.  But I just had not seen it coming with him!  But there are things that I've attributed to age or gender that I guess are truly ADHD signs.  Like many we don't want to jump straight to medication.  I'd like to try to work on his attention and focus other ways.  Any recommendations/tips/tricks/advice?  

 

She also thought he had poor handwriting which I hadn't expected at all.  Although after we left I realized that he spent all of K and 1st practicing cursive and he wrote in print for everything for her.  He has not had true print handwriting instruction.  His private school did cursive first.  His cursive is much better than his print.  So I'm going to order a few print practice books I guess and have him work on that.

 

ETA - We haven't received the full report yet since it was just done today.

Edited June 14, 2016 by UCF612

[wapiti]

What tests were run?  Usually the tests are numerous enough that more than one testing appointment is involved.

[Arcadia]

She also thought he had poor handwriting which I hadn't expected at all. Although after we left I realized that he spent all of K and 1st practicing cursive and he wrote in print for everything for her.

The poor handwriting is weird coming from a tester. My oldest write in print, cursive and also in chinese. When they were checking his motor skills at K and 1st, so drawing and writing, they don't care whether it was print, cursive, not english, or even a mix. My oldest have nice handwriting but is a slow writer. He used to draw every letter which contribute to the slowness.

 

How long was your child observed? My DS10 can be distracted easily. However the psychologist we saw as well as his pediatrician all consider his distractions normal for age. It is like if the phone rings, a normal young child would tend to look around the room for the phone so that does not imply anything other than a distracted kid. My kid was observed for three hours, first time by someone who don't usually encounter 2E and second time we went for someone familiar with 2E.

[UCF612]

We were there 2 hours. I'm not sure which tests she ran. I saw CTOPP and WISC on the table. I'm waiting for the full report to see. She had me complete a score for him that helped her reach the ADHD diagnosis. I just don't know what to think. I want to help him reach his full potential.

[UCF612]

I think I've attached a copy of some of his later 1st grade handwriting.  Does this look bad to you? Do I have mommy goggles on?  I know it isn't perfect by any means but I didn't think it was terrible.  This was an average page for him.  He had some way better and a few sloppier but this was pretty average work. I wish I'd brought samples in for her to see.  Regardless handwriting is the least of my worries.  I need him to READ successfully!

Edited June 14, 2016 by UCF612

[Arcadia]

His cursive handwriting is lovely. I don't see a need to teach print unless he wants to learn or it is a school requirement.

 

We received our kids' reports both times in two weeks after testing which was what was promised.

[PeterPan]

What I'm looking at in the handwriting is whether there's change over the page (indicating hand fatigue, drifting focus) and whether the spacing of the letters is normal.  He's too young to be worried about automaticity of formation.  To me I think what she's seeing is the ADHD.  I'd also just get his eyes checked, just your normal annual gig with a screening for the developmental stuff, by a developmental optometrist.  Some of the things that are a little wide on him tidied up when my dd got VT.  Is he complaining of hand pain?  Those are just little things in what I agree is overall nice writing.

 

Did she suggest meds to you or you assumed?  Because both times when my kids were initially eval'd the psychs were VERY opinionated about NOT using meds.  I think in some circles it must be a thing.  I think they think homeschooling has magical curative powers.  :D  I think meds are a choice and you don't *have* to feel you have to use them.  Now you just have the *choice*. And yes, many before you have gone in thinking one thing and come out with another label.  That's why you get evals, lol.  And it takes time to sink in and deal with and get ok with.  We've had some really good book threads, so maybe start there?  What things do you need help with or want to change?  What things are you dealing with that you think others would say you ought to use meds for that you don't want to use meds for?  If you get really specific, people can give you suggestions.  

 

Fwiw, we've done the no meds thing a LOT of years.  We've also done things some other ways.  I'm really agnostic on it, except to the extent that I think you have to get really real.  I think safety is important, and I think ability to be present and do some work is important.  But other than that, there's this HUGE range of what you can do and how much you can accommodate.  I know some feel doing more physical will make the ADHD better, and to a degree it does (exercise bumping dopamine levels).  It's not going to replace meds for some kids.  My children would say it only makes them more TIRED but that their brains are still distracted and revving inside.  I have my ds in 2-3 hours of significant physical stuff every day, and it's a *mild* calming benefit.  Mindfulness is helpful.  It's free (get a cd from the library), and it really is noticeable.  But even then, is it as good as meds?  No.  

 

One thing my people (psychs, behaviorist, etc.) tell me is they like to see kids go without meds long enough to develop *skills*.  I think there's some logic to this, because they don't always have meds and need to be functional/safe without them.  For some kids that's not reality either.  My ds is pretty astonishing, like really astonishing.  A mom who knows him pretty well asked me, out of the blue WHY I don't have him on meds.  It's really not a small thing when people start telling you you really ought to get him on meds, kwim?  But there's also a lot they CAN learn by having to wrangle with their bodies.  And I think we're sort of out of the school loop that only wants them medicated.  We're at home, and we're probably working on consistency with meds, consistency off.  But it's something you can think through, where you're at with that, how much you want him to be able to do without meds, and where you're like hello, we've really maxed that out and it's TIME.  

 

I think there are IN BETWEEN positions like that.  It's why I'm not agnostic.  To me it's incredibly obvious some kids need them and need them now (for safety, etc.) and for some kids there really is that room to think about it.  And sometimes you think about it a long time and have some hindsight that maybe you needn't have waited quite that long.  You don't have to live with regrets either.  ;)

 

So if you want to talk about what you're dealing with, people will give you ideas.  I just wanted to check, also, did the psych actually run a CTOPP?  Because I sure hope she wasn't just looking at profiles or something.  Please say she ran a CTOPP.  

[UCF612]

He does get a sore hand when writing.  I have to remind him not to push down too hard.  She sent me some strengthening exercises this morning.

 

I'm scared that meds will mess with the personality he has.  I'm sure that's a common fear among parents.  He's not overly hyper.  He has plenty of boy energy but he doesn't bounce off the walls by any means.  I don't feel like he's "running on a motor."  He can sit still very well, works quickly and quietly.   He's not a behavior issue at all, ever.  He talks quite a bit but quiets down when necessary.  He doesn't day dream.  I asked him if he has trouble paying attention and he said "no I can pay attention just fine.  I only have trouble remembering things later."  So possibly he IS having trouble paying attention but thinks he is doing okay?  I almost feel like if he has ADHD inattentive it is presenting more like they say it does in girls.   The time he spent in a classroom he was quiet and not at all a disturbance. At home he does wiggle A LOT when doing reading.  He'll slide out of his chair, kick his feet, etc.  But for other subjects, like math, he sits still and does his work.  He does sometimes like to circle the table when doing mental math.  He says it helps him think.  But that isn't something he does all the time, just once in awhile.   He is fairly disorganized, like the other day he just forgot to put on shoes before swim team.  If left to his own devices his bed is always disheveled and his drawers left open with clothes pouring out.  A quick reminder and he cleans that up.  He isn't naturally organized.  

 

 

ADHD Checklist I found online that was similar to what she asked.  But I feel like I might have given answers that were not so accurate during the evaluation.  My husband and I discussed it last night and we talked through each one thinking of things he does/doesn't do.  I feel like if I had been given time to really think about my answers it might have given a different result.  Although that might just be me making excuses or not accepting reality!!  My mommy gut though is just not seeing it yet.  Maybe given time I'll start to realize that it is an accurate diagnosis.  Here's what I would say after thinking about it.

• Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.  Not excessively, so I'd say rarely/sometimes.
• Often has trouble holding attention on tasks or play activities.  Not at all.  He can work diligently on things.  He plays games designed for 10-12 year olds and can sit for the entirety of the game with no trouble at all.  The only thing that doesn't hold his attention is reading.
• Often does not seem to listen when spoken to directly.  Nope, he listens.
• Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked). Sometimes
• Often has trouble organizing tasks and activities.  Sometimes
• Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).  Reading only.  
• Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).  Often, usually shoes!
• Is often easily distracted   Maybe? Sometimes? It isn't something that jumps out to me as being a real problem.
• Is often forgetful in daily activities.  Often usually if asked to do multiple things in a row.  

 

Ultimately our biggest troubles stem from memory, organization, and focus during reading.  He is not reading fluently, forgets things just learned or even a word that's repeated on the same page.   She said for his IQ he should be whizzing through school work and reading easily.  She showed me one page of one test where he was asked to write a sentence based on the 3 words given.  The first one he just wrote the 3 words.  Then she explained again.  He again just wrote the 3 words.  Then finally he understood and did it correctly for the last few.   Not sure what that means ultimately.  She used it as an example of lack of focus.   

 

I saw CTOPP on the table when we arrived laid so I assume she did complete it.  I was so flustered that I didn't think to ask specifically for names of the tests.    I imagine I'm in denial and someday will look back and think that was SO obvious!   

 

He was 7 years, 5 days on the day of the evaluation.

 

ETA: When I asked her what we could do to help him her immediate response was medication.  She gave me the name of a behavioral therapist that we could work with who could prescribe meds.  She didn't offer much else in terms of help but possibly will include more in her written evaluation.

 

Edited June 15, 2016 by UCF612

[Tiramisu]

In my personal experience, evaluators don't give out the ADHD label easily, even if it sometimes seems like the flavor of the month. There is subjectivity but they should be relying on objective evidence from their testing.

 

I have three kids that appear to be strongly affected by ADHD but the two who had in-depth, multiple visit evals did not get the label. Things aren't always what the seem.

 

The other thing to keep in mind is that smart kids can compensate for quite a while. Then they'd hit a wall. It might be in fourth grade, seventh grade, or in making the transition to high school. Not to be doom and gloom but it's worth addressing this now, not with meds if you don't feel they're absolutely necessary but on skills and strategies he can fall back on later.

[Arcadia]

We were given the SNAP questionnaire for ADHD. We were given three copies. One copy per parent and one to be given to a teacher (if in school) or instructor or regular caregiver. We were given days to do it as the psychologist told us to do the survey when we have a block of time to complete it in one sitting. Mine was 8 years old at time of evaluation.

 

SNAP example, very long questionnaire

http://www.crfht.ca/files/8913/7597/8069/SNAPIV_000.pdf

 

As for listening now and forgetting later, my kid can repeat verbatim what I said right after I said it but don't bother asking him later unless we tell him to remember. It doesn't go into his long term memory by default. I was surprised his working memory percentile was very high until I realised that was more of short term memory.

 

My DS10 who reads at a slower speed since preschool has tracking issues which aren't obvious. He is also my laid back kid so we didn't notice the tracking problem until this year. He is just leisurely about everything. His reading comprehension scores for standardized tests are quite high and a sharp contrast to speed. My fast reader is obvious about being near sighted. The opthamologist mentioned tracking, the vision check done during the annual well child checkup did not. So since your child is most affected in reading you might want to get a detailed vision examination.

[UCF612]

Thanks! This is a lot to take in and process. I'll definitely see to getting an in depth vision exam.

 

I remember one more thing she said. He still does occasional reversals letters and numbers. She said he's reached the top end of that still being "normal." How can I help him more with that?

[Tiramisu]

Thanks! This is a lot to take in and process. I'll definitely see to getting an in depth vision exam.

 

I remember one more thing she said. He still does occasional reversals letters and numbers. She said he's reached the top end of that still being "normal." How can I help him more with that?

Writing 8's?

[PeterPan]

So you need an OT eval for the hand pain.  Yes, the room stuff is his EF (executive function).  I mentioned a vision eval.  Sometimes kids get an EF bump with VT, and meds definitely bring some of those skills more in reach.  And yes, ADHD-inattentive is very tame, like you're describing, compared to ADHD-combined and the more physical presentations.

 

It took me a long time (at least a year) to come to terms with my dd's ADHD diagnosis and to realize all the ways it was showing up.  It's ok to ease into this.  You'll get there.  :)

[PeterPan]

Your explanation of his reading is vague.  You say he's not reading fluently or appropriately for IQ.  But he is reading CVC words or something?  It sounds like she ran the CTOPP and just didn't get there.  It is true that they are now supposed to use absolute lows, not just discrepancy for diagnosis.  Our state allows for discrepancy to be considered and some psychs still do.  I think discrepancy matters.  But it sounds like a lot of what you're describing is low working memory, where things are just dropping.  Working memory is the scratch pad of the brain, so to get things into long-term memory we need to have enough working memory.   And that, of course, goes back to the ADHD.

 

Really, they used to be diagnosed together (ADHD and dyslexia) as minimal brain dysfunction.  You'll still find that terminology in the law.  So it's VERY common for a dyslexic to have ADHD (60% comorbid) and for a person with ADHD to have their reading be somewhat affected.  They just occur together in varying mixes quite a bit.  

 

With my dd, I used SWR, which was explicit instruction in reading and spelling, based on Spalding, which is of course an OG spin-off meant for non-dyslexic kids.  I think at the VERY LEAST you could conclude from your test scores that you'd like to do something more explicit for his reading instruction.  What have you been using?  You could step it up without going all the way to Barton.  It wouldn't be a crime to use Barton either.  It would be interesting to see those CTOPP scores when you get them.  You're using AAR?  And he's newly 6 or newly 7?  And what level of AAR?  How is that going?  

 

With my dd I actually had to do some drill to get things to click.  That's not unheard of and it doesn't mean you're doing something wrong if he needs a bit more than what is in AAR.