2 questions: math and pencil grip for ADD,etc child

[arcara]

Hi,

 

My daughter is 7yo, but is at least a year behind academically. She has been tested through the public schools over the summer and shown to have poor working memory and slow processing speed. She scored VERY low average to below average on reading accessments. It was recommended that we have her tested for ADD, but we haven't yet.

 

My biggest problems this week as we started back to school are math and her pencil grip. First, math...we have been using Rod & Staff all of last year and continuing now. She is in Grade 1, book 1 (near the end of this book since it is continued from last year). I like how easy R&S is to use and how it includes review, but she hates it. It takes her forever to complete a lesson. Each lesson includes two workbook pages and I sit with her as she completes one early in the morning and the second later in the morning after at least an hour play break, or after lunch. But it's still painful for both of us. Any recommendations? I have 7 kids (8th due in Jan), and all the others have been above average, so this is my first experience with learning challenges.

 

As for her pencil grip...she puts her fingers in the right places on the pencil, but continues to hold the pencil very close to the tip. I remind her constantly to keep her fingers back on the colored part of the pencil. I've also put a rubber grip on the pencil with curves places for each finger and she still puts her fingers in front of the grip on the tip of pencil. I just feel this is a problem because it's difficult to see what you're writing when your fingers are that close, and your fingers continue to slip down the pencil because it's angled there. Should I continue fighting this battle (literally reminding her every 5-10 seconds, which is seriously testing my patience) or should I just let her be for the sake our our sanity? Any handwriting experts who know if this is actually a problem?

 

Thank you for your help!

Angela

[OneStepAtATime]

:grouphug:  :grouphug:  :grouphug:

 

1.  You may need to scribe for her for math, at least for maybe one of her math sessions for now.  Let her focus on the math itself, and not get bogged down in the writing.  Work on that separately.  You might also do work on a dry erase board for some of it.  Maybe an older child could copy the problems from the workbook onto the dry erase board for you.  Theoretically she should be able to get through math much faster that way and might retain better and be less resistant since she can focus on MATH not writing (since writing seems to be harder for her).

2.  You might want to look into an occupational therapy (OT) evaluation to see if she has physical or neurological issues causing difficulties with grip/writing.

3.  If she is struggling in reading/spelling then she may have dyslexia.  There are quite a few books you could read to understand dyslexia better. If you suspect that may be an issue please post and we can make recommendations.

4.  An evaluation through the school usually isn't terribly in depth so there may be comorbid issues that are tripping her up that were not caught.  If you ever had the option of a private evaluation through a neuropyschologist that might net more (depending on the evaluator).

 

How closely does she hold her paper when doing work?  Does she move her head when she reads or does math or does she mainly track with her eyes?  How is her letter and number formation?

[PeterPan]

It would be interesting to know the context of that pencil grip.  My dd wrote like that, down on the tip, and she turned out to have some fine motor and overall muscle tone issues.  Her core was weak, so she was slouching forward, struggling to hold it, etc.  Does it actually HURT for her to write?  Does she complain of hand pain?  And how is her coloring?  Scissor cutting?  How is the handwriting when she does write?  I'm saying I would be eliminating (or getting evals to eliminate) OT questions and vision questions.  My dd also turned out to have developmental vision issues.  Sometimes the funky grip is part of overall compensation because of stress of what their vision is doing.  You can go to a developmental optometrist (COVD) and have just a normal annual visit and screening.  It's a place to start, one of those things to eliminate.

 

If none of your other kids have ADHD, then that's pretty suspicious as an explanation.  She's plenty old enough for SLDs to be diagnosed.  With that much discrepancy and the failure of the ps to get any of this stuff identified (ALL of which they should have), you're relegated to private.  You have the legal right to file a dispute over your evals and have them pay for independent evals.  It's hogwash for them to say they can't answer on ADHD.  They can't tell you to take meds, but absolutely they should have done an ADHD screening and gotten it diagnosed.  The NOLO book from the library will have all the info on the IEP process, evals, and disputing.

 

You don't know if you have a correct diagnosis (ADHD vs. developmental delays) and you don't know if it's SLDs.  Did they do language testing?  Did they do EF surveys or any kind of questionaires? Do your other kids have ADHD?  That would be uncommon, imho, to have one be ADHD and not others.  And once you say the ADHD diagnosis is odd, then it makes you wonder what's REALLY going on.  

 

Evals are a hard thing, and I get that you're pregnant.  Deep breath, share what more info you've got, see what got missed and what you can make happen.  You can't decide curriculum when you don't have complete evals.  I wouldn't use R&S with a dc with SLD math.  I use Ronit Bird.  But you've just got outstanding questions to deal with like what's the explanation.  If say it's a developmental delay, then there could be a *language* explanation for academic delays.  That's why I'm saying it really matters, kwim? 

 

Is there anything else she does that's unusual or that she refuses to do?  

Edited September 3, 2016 by OhElizabeth

[arcara]

Thank you for your responses. I had not thought to scribe for her during math. I may try this.

 

There's so much I could say about this child. She had a difficult end of her pregnancy. She was breech with low amniotic fluid and was delivered early (38 weeks) via c-section due to signs of fetal distress. She ended up weighing 3-4 lbs less than my other children born naturally between 38-40 weeks. It seems that her cord was compressed for a while and I think this has resulted in her intellectual and behavioral issues.

 

I'll write here the tests that were done and the percentiles. I don't know enough to know if these were the tests you were asking about:

 

WISC-V

Verbal comprehension - 45th

Visual-Spatial - 90th

Fluid Reasoning - 42nd

Working Memory- 4th

Processing Speed - 13th

FSIQ - 37th

General Ability Index - 58th

Cognitive Proficiency Index - 5th

 

WIAT- III

Early Reading Skills - 16th

Math Problem Solving- 27th

Alphabet Writing Fluency - 13th

Numerical Operations- 14th

Spelling - 23rd

 

"Portions of" the CTOPP-2 test were given:

Elision - 25th

Blending Words - 50th

Phenome Isolation - 16th

Composite Phonological Awareness - 25th

 

The evaluator also had me fill out the BASC-3

which showed many problems. She acts immaturely for her age. She still throws fits like a 2yo. She has self-control issues.

 

I'm not sure if I can upload a picture sample of her handwriting. Her handwriting has improved, I think, but I would say it is still below age level.

 

I haven't paid attention to whether she moves her head or eyes when she reads to me. I'll try to pay attentions to this this week.

 

All of her siblings are developmentally normal. One of her older sisters does have concentration issues at times, but nothing like I'm seeing in my 7yo.

 

Thank you for your help.

Angela

[arcara]

I've tried to attach a handwriting sample from this week:

new doc 45.pdf.pdf

[PeterPan]

Will your insurance cover a neuropsych eval?  And, I'll just be blunt, but does she fit any of the criteria for autism?  If you think she meets DSM criteria for autism, then I would contact an autism clinic.  Otherwise, a neuropsych eval.  A neuropsych can tell which parts of the brain are affected or if there has been any damage.  You've got some big spreads there on the WISC, HUGE spreads.  I'm NOT a numbers guru, but I know those are big spreads.  I thought when the spreads were that big they wouldn't even calculate a full scale, because it's invalid.

 

So I'd get a 2nd opinion eval with a neuropsych.  Also get language testing by an SLP.  The neuropsych can typically do some, but I'd go ahead and go to an SLP.

 

While you're at it, get her eyes screened by a developmental optometrist.  In our area that would be less than $100 for a normal visit.  

 

Any oddities with her hearing or responding to people or complaining about noise?

[PeterPan]

The handwriting isn't bad, honestly.  I'd get her an OT eval, but they may or may not complain much about that.  The letters are formed correctly, and they're sitting between the lines on tri-ruled paper.  My ds is the same age, and with the new OT we just started with, those were the things she looked at.  She commented on his hold and was looking at tone, etc., etc., but I'm just saying as far as actual writing on paper, if that's how it looks, it's within the realm of considered developmentally typical for the age.

 

I'd want the OT for seeing that is going into this discomfort, the awkwardness, and what ELSE is going on.

 

Does she have any sensory issues or seem to like things tight or loose or reject certain types of foods?

 

Adding: How long did it take her to write that?  Can she write a short sentence from dictation?  The SLD reading can make writing harder, and for my ds he also adds SLD writing.  So for him to write that, oy, he'd need a model and we'd be there a LONG TIME and he'd be exhausted.  My dd, that age, only ADHD, could have written that, no problem, easy peasy.  So it's not just what is getting done but degrees, context.

Edited September 3, 2016 by OhElizabeth

[arcara]

Personally, I've thought she might need to be evaluated for autism for a while. I mentioned it to our pediatrician and they gave me a list of local psychologists. We live in a small town outside of Pittsburgh. Needless to say, I haven't found much support from local people who are supposed to be helping us. I just don't feel like these psychologist are the right people to go to.

 

That writing was done first thing in the morning. I wouldn't say it took too long. She sometimes does simple CVC word phrase dictation from All About Spelling 1. She can only do three phrases at a sitting with many repetitions of the phrase by me (Her 5yo brother can do 6 phrases and several single words in the same time).

[PeterPan]

Usually an autism clinic will do an intake eval or a long screening.  This is the kind of thing that is worth going into the big city for.  You want a multi-factored eval.  If you use a psych alone, then you still need speech (to look at language issues) and OT.  A clinic will have that all under one roof.  You can good to see who is well-respected in your state.  A psych alone can do it, yes, but you've got some pretty complex questions here.  You want somebody who specializes in autism.  My ds' first neuropsych specializes in ADHD, and he blew us off.

 

One of the hard things with homeschooling and autism is you don't have a lot of outside people to fill out the forms.  They want to see the behaviors occurring in multiple contexts.  The most important thing you could do, besides looking at your options for psychs and clinics, is to try to get her in some non-preferred situations where people make demands so OTHER people see what YOU see, so they can mark it on the forms.

 

We finally got good help from a psych who specializes in autism, then got more confirmation from a behaviorist who works under a psych.  The behaviorist came into our home for a fair number of hours, so she could see it for herself. So that's another way to look, by calling BCBAs in your area and asking who refers to them and where they suggest you go.  

 

Have you done any reading on NVLD?  I always forget the direction of the spread, but it causes big discrepancies in IQ.  The trick is NVLD is DSM4, not DSM5.  It went poof in DSM5.  So some of those kids move over to ASD and some don't.  Just depends.  But you've got reading problems and big spreads in your WISC.  Those were percentages or scores?  The standard deviation on the WISC is 10, so a discrepancy of 20 is considered significant.  Look at your scores, not percents but actual scores.  Yeah, you put percents.  Well go to your report and look at the scores and see.  

Edited September 3, 2016 by OhElizabeth

[PeterPan]

Fwiw, I think that the way her writing is so good reflects how much you've worked with her, not that it's not hard or not a problem.  :)  Like seriously, the practitioners come in, take a snapshot for a moment, and say see no story here!  Well it's not true, because you've clearly been doing stuff and doing it successfully.  I think it's really significant to know that progression.  It means that, if you're providing an unusual level of support, removing that support might cause her to regress or quickly fall behind her peers.  

 

So I don't think you have to take your success and go see, no story here.  You're not crazy.  If you think there's a problem and things are unusual for her compared to the other 7, they ARE.

[arcara]

I'm sorry, but I'm not familiar with the abbreviations you used: NVLD, DSM4, DSM5?

 

Here are her WISC scores:

Verbal - 98

Visual spatial- 119

Fluid reasoning - 97

Working memory- 74

Processing speed - 83

FSIQ - 95

General ability Index - 103

Cognitive Proficiency Index - 75

[arcara]

Fwiw, I think that the way her writing is so good reflects how much you've worked with her, not that it's not hard or not a problem. :) Like seriously, the practitioners come in, take a snapshot for a moment, and say see no story here! Well it's not true, because you've clearly been doing stuff and doing it successfully. I think it's really significant to know that progression. It means that, if you're providing an unusual level of support, removing that support might cause her to regress or quickly fall behind her peers.

 

So I don't think you have to take your success and go see, no story here. You're not crazy. If you think there's a problem and things are unusual for her compared to the other 7, they ARE.

Thank you for this! I do feel like the professionals are not taking me seriously. I have 6 other kids and none are like her.

 

The ps evaluator told me that she couldn't say that she qualified for services because of the possibility of ADD (which she said she couldn't diagnose) and because she was homeschooled and therefore she could not say that she had so far received "appropriate instruction." I asked what I was supposed to do if she continued not to progress, and she replied that we might consider putting her in school so she could work on her social skills and participate in their reading intervention program.

Edited September 3, 2016 by arcara

[PeterPan]

That's why it was SO frustrating when the first psych blew me off with ds!  We had done a TON of speech therapy, like way more than usual, trying to make sure he was intelligible for the psych.  Well our speech therapy time was like ABA.  With all that, he was so whatever that the psych was like what are you beefing about?  I'd say well he does this pteradactyl thing with his arms (flapping) and the guy blows me off.  I said he doesn't understand math and I'm using dyscalculia materials with him, and the guy goes well he did 1+1 for me...  It was a total blow-off.  He told me to get parenting help.

 

I brought in the behaviorist, after 9 months of no speech therapy and me trying to teach him, etc. etc., and he totally ignored her for hours then began hitting me.  She saw his things lined up.  She SAW it.  Best thing we did was bringing someone in the home.

 

So yes, the work you do is incredibly valuable and IS doubtless shifting things therapeutically.  Don't doubt yourself and the worth of what you do!  But it's important to let someone else see what you're seeing so other people can attest to it so you can line up funding to get help.  Because, without coherent explanations, without funding, without help, you burn out.  Just because you can do SOME doesn't mean you can do EVERYTHING or that you want to do it ALONE.

[PeterPan]

You're right on the line with discrepancy, but it's the opposite of NVLD.  

 

I think it's just one of those things where you need to start asking for help from private practitioners.  The only want to GET help is to ASK for help.  What is depressing the verbal IQ score and creating the discrepancy?  Was there a language delay?  What would an eval by an SLP show up?  They could do detailed testing and see.  My ds began reading when we bumped his language scores.  It's a huge deal.  I think it explains a lot of this "oh my kid started reading later but he was fine" stuff you read.  It's not mysterious.  If you can't understand what you're reading, are you going to read it?  

 

So you're just going to need to take some steps.  You took the first one, getting the school eval.  Pick whatever rabbit trail is most frustrating or what you can afford.  Like if the handwriting is the most pressing problem, then get the OT eval.  Honestly though, the school should have done that.  Did you mention handwriting problems?  Did they put that on the eval planning form?  It's hard because they sort of blow through it really fast and say here SIGN and don't really let you understand or fight back.  Sigh.  

 

If behavior is your biggest concern, then that's a different path.  I think you could also get that SLP eval going on the affordable (more affordable) end of things.  The neuropsych eval, even a 2nd opinion, is going to be pricy.  But call around, see your options, see what you can make happen.

 

My ds' issues have become more obvious over time.  That's why I'm saying it's ok to pick something.  It's not like everything is always smack you in the face glaringly obvious at a certain age.  Some things become more clear as the child ages and the peers pull ahead.  So the truth will come out in the end.  It's a matter of deciding what to tackle first, what you can afford, what your insurance will cover, what you can dispute and get the school to cover, etc.

[PeterPan]

Your girl is bright btw, very bright.  Look at that performance score.  The GAI is almost 20 points lower, well 16.  Look at it.  You're going to have highs and lows, things that she's really QUITE BRIGHT in and things that are crunchy rough.  

 

Me, I'd handle it like she's bright (that top score) and that everything else reflects disability.  Like see what you can do with her that feeds the bright part, while bringing in things that support the (probable) SLDs.  My ds' IQ was a little higher, honestly, but his CTOPP scores were pretty similar and he got labeled SLD Reading.  

 

So for instance on that math, why the R&S?  Did your other kids do R&S?  I wouldn't use that with her, not if she's that bright plus struggling.  I LOVE Ronit Bird.  I'd do doing math with her.  

 

Does she have anything she's really keenly into?  That can show things, both things you could harness, sure, but also maybe where brain energy is funneling.  

 

Have you thought about bringing in tutors to work with her?  That's what we're doing with my ds.  He has ABA tutors.  They use the materials I pick.  They're not super amazing on the really creative stuff, but (and this is just the reason I mention it) there's a lot to be said to just hours of interaction.  If you can't do that, could you rotate her on a schedule with your kids?  So like each kid does something with her 20 minutes a day?  And give her audiobooks during her down times when she's not with someone to keep building that verbal.  If you've got 4-5 kids who could give her 15-20 minutes a day, that would be 1-2 hours a day of intentional interaction.  Plus another 1-2 from you and 2 hours of audiobooks, that would be a LOT of input, kwim?  

 

And when I say interaction, like it could be they sat down and played a game with her that used turn taking or did a puzzle or colored.  Does she color?  Or make cookies.  Anything where they interact and talk.  If she's sort of flighty, maybe give her an assigned space and they come to her.  Make her a nook and set it all up with her audiobook device, headphones, sensory pillows, etc.  We finally set my ds up an office this year, and we do our work in there.  It's very calming to him to have the predictability of the space.

Edited September 3, 2016 by OhElizabeth

[PeterPan]

What does your gut say it would take for her to succeed?

 

I know that's kinda loaded, but I put a LOT of stock in mother gut.  You may have noticed things and put things together that you haven't verbalized yet.  Like I'll say things here on the board, and I'll think oh but I can't do that because what I'm SUPPOSED to be doing is xyz...  Then I'll talk with some professional, and they're like ACTUALLY that was EXACTLY what you should be doing!  

 

So maybe say things out loud that your gut is telling you and see what you see?  Like if you had no laws to comply with, no worries about college, no other kids to interact with, etc., what she REALLY NEED for where she is right now?

Edited September 3, 2016 by OhElizabeth

[kbutton]

Thank you for this! I do feel like the professionals are not taking me seriously. I have 6 other kids and none are like her.

 

The ps evaluator told me that she couldn't say that she qualified for services because of the possibility of ADD (which she said she couldn't diagnose) and because she was homeschooled and therefore she could not say that she had so far received "appropriate instruction." I asked what I was supposed to do if she continued not to progress, and she replied that we might consider putting her in school so she could work on her social skills and participate in their reading intervention program.

 

I'm sorry they told you this. Public school evaluations can be really helpful or a total bust. Part of it is that their priority is not to diagnose or explain anything--it's just to see what services the child is eligible for. They don't have to serve if the reason for the problems are educational neglect (it's in the determination document, and in the law), so some school districts like to throw that at homeschoolers. There are ways to counter, but not if the school is determined to be prejudiced. 

 

OhE has some great advice. I would say that if you've been wondering about autism, then you should research autism and learn what different things mean; for instance, learn what counts (besides the obvious) for repetitive behaviors and things like that. The manual that lists what you look for is called the DSM V. You can view the criteria online. 

 

OCALI has some great information. http://www.ocali.org/ They have videos, downloads, etc. 

 

Do not use a professional that doesn't put you at ease. Go elsewhere, no matter how qualified they are. 

[Tiramisu]

I think a neuropsych who understands girls with high functioning autism would be very helpful.

 

Due to the birth history, it is actually very possible that the neuropsych eval would be covered. One route would be to start at a pediatric neurologist and have them make the case for the insurance company. That's a route a friend took for a child with a similar history and challenges. Don't say it's for ADHD because that can keep insurance companies from covering it, and the reality is there's different things going on that affect her daily functioning, not just learning.

 

We also live in a state where a child study eval cannot result in a medical diagnosis. We were in the same position and it was frustrating. That DD had very big spreads (but in the NVLD direction) and she's like OhE describes. Very bright but some things are very crunchy. And over time, the real life stuff seems more of an issue than the other stuff.

 

By the way, that DD has an auditory processing disorder diagnosis and the neuropsych said she would have given her a developmental coordination disorder diagnosis if she had been younger. So I would definitely have your DD to see an OT like OhE said, and I'd also think about the possibility of auditory processing disorder. It just tends to go along with this stuff and one of the scores in her language testing got me thinking that way.

 

FYI, my DD found what she really loves and is in her last year of college. I think your DD will be fine, too, but your going to have to get creative, which is a hard adjustment after dealing with normal learners. OhE will have some great ideas to help you! Really!

 

I will also second OneStep's recommendation to scribe. Scribing is awesome and can take a lot of pressure off. I scribed for one kid for math through half of eight grade, until she had vision therapy and could handle writing better. I worried that I was accommodating too much but she is excelling in math in high school, so I know it really helps and is not something you should hesitate to do for any concern for enabling.

 

Another accommodation we used frequently was just reading and requiring no additional written work. I am absolutely convince that this preserved a love of learning and helped our relationship. Cuddle up and enjoy some subjects together without stress.

 

I don't know if this one will help you but I have one with a very good memory but writing stresses her out. I know Interactive Metronime would be brilliant for her but she's balking. So I use a lot of memory work with her that requires no writing. Poetry and flashcards for history, geography, vocab, etc. She's picking up knowledge in a way that works for her, that she enjoys, and it's also reinforcing her strength.

 

My general recommendation is little bits. So with your math problem I might limit the time to a twenty minute session. If scribing enables her to work longer, you can slowly work up paying attention to signs of frustration.

 

I also think giving her the support of your presence and encouragement while she does things that are hard for her can be helpful.

[PeterPan]

Ds' ABA tutor has him write for his math with her, but it's never more than a few numbers, not whole equations.  Sometimes I'll see a worksheet where she scribed.  When I work with him, we usually do "doing" math (manipulatives, games, exploring concepts) and I'll write anything where I want to explore the written form, usually on a whiteboard.  Sometimes he'll figure it out and want to take over.  I like that.   :)  But to sit down and do pages of a math workbook and write and write, we don't do that.  My ds is doing very well on math standardized tests so far, so to me the question is what writing that math would bring to her.  For some kids it might be a really good way to help them memorize.  But for others, it's really not necessary.  I want my ds to be able to write math eventually, but that's an eventually thing for us.  I'm not going to kill his enjoyment of math now over it.  That's my line.  If doing the writing will kill his love of it, I'm happy to separate the tasks.

 

My ds is, as the behaviorist politely puts it, not more than 2 years behind developmentally.  So for him, to say oh well 2nd graders write this amount, do it, that could really squash his soul!  I look at it and go ok, what would we be expecting K5ers to do?  Not as requirement but more like mental permission. That's more about where he is developmentally.  That's how he's functioning.  And it's ok that his intellect is in one place and his body is in another, kwim?  We can make that work.  

 

Fwiw, I also did a lot of whiteboard work with my dd, who is strictly ADHD, nothing else.  For her, the writing was not a dealbreaker.  The act of focusing and processing so much was fatiguing, but she could do the writing.  So using the whiteboard kept it spicy, kept her engaged.  She could take over for problems, take turns, and it was all good.  But with ds, even a little bit of that would just squash his soul.  So we do explorations.  We have a BIG board and we'll cover all kinds of advanced stuff in sort of a rabbit trailing, fascinating way.  He's actually more fun to teach, in that respect.   :)

Edited September 4, 2016 by OhElizabeth

[arcara]

Hi,

 

I really do appreciate all the replies. There's so much good advice here. I'm going to read through it several times and talk with my husband. I like the advice to choose what to investigate instead of worrying about it all right now.

 

All I know right now is that she's going to require a lot of patience and one-on-one work. My experience with the ps testing left me feeling like I'm on my own figuring out how best to help her. I'm focusing on giving her a lot of word exposure with read-alouds, discussion, poetry memorization, etc. The past week went well in that regard. The handwriting and math were still definite low-points of the week.

 

Thank you again for all of your advice!

Angela

[Heathermomster]

My son's most recent NP testing was covered by insurance because he was given an ADHD primarily inattentive diagnosis. OP, maybe call the mental health portion of your insurance and discover what they will cover. Since the public school has already suggested ADD, that might be all the info you need to justify the testing as far as insurance is concerned; however, you need to call insurance and ask.

 

An OT could evaluate your child and look at pincer/core strength, motor planning, developmental motor, static/dynamic balance, and visual perception. The eval takes about an hour. The OT could also determine whether they feel a SIPT sensory eval is warranted. Your child may need to be eval'd by an SIPT certified OT. 50% of kiddos with ADHD will have some sort of motor issue. Behavior may also be affected by underlying motor issues. When you call around for a local OT, be sure to go to a place with a SIPT certified OT on staff. You may need to get recommendations for OTs from the local dyslexia and/or Autism school.

 

You could also Google and discover whether there is a Scottish Rite Learning Center nearby. If there is one, call them and discover what they charge for dyslexia screening. My son was initially identified dyslexic by the local Scottish Rite for free.

 

One last thing, the accommodationa for handwriting are scribing and eventually typing. For some, typing will not work, so they use some combo of hunt and peck with speech to text sw. I scribed DD's math for about two years due to handwriting issues and her current math work is fine. We regularly move from white board, to paper/pencil, and back to oral answers.

Edited September 15, 2016 by Heathermomster

[Heathermomster]

One more thing.  Don't allow handwriting and math to become low points.  These issues are likely processing type issues that cannot be helped without some professional/appropriate curriculum type intervention.  Even with intervention, some accommodations will likely need to remain.  It's just a new normal that's all.  DS will be 17 yo in a couple of months and has been typing most of his work since 6th grade.  Honestly, handwriting accommodations are 2nd nature to us and working with an OT/ped PT helped him tremendously.

Edited September 4, 2016 by Heathermomster

[arcara]

Thank you for the info on the OT testing. I think I will look into this next.

 

Angela

[heartlikealion]

My son fights me on pencil grip so I'm not very helpful there probably, but we do own "the claw" which will hold the finger tips in place and you can slide it up higher on the pencil if you want her fingers higher. I am thinking that where we set our fingers might just be personal preference. I found the claw thing at a teacher supply store as I didn't want to order in bulk. Maybe that would help?

Edited September 15, 2016 by heartlikealion

[BlsdMama]

Angela,

 

Can we talk about behavior? 

I agree with OhElizabeth's last post -those scores, bright but struggling with a disability, but not an intelligence issue.  And that didn't look like a low working memory score to me, especially when realizing there is some kind of disability thing here.

 

Can we talk about behavior?  She's 7.  How is she with strangers? Is she chatty at all? What's it like posing as a family for pictures? What was she like as a baby - high needs/low needs, etc.?  Food issues?

That handwriting was nothing like what I was expecting at all.  Did she have direction for that?  What would her handwriting be like if you just handed her a three-four word sentence and asked her to copy it and gave her paper and walked away with no direction?

 

 

ETA: And I'll add that six kids and one different is unusual but not unheard of.  

My DS (#5) was the one who put LDs on my radar, like pick a label.  Up until then I was full of bliss and didn't recognize a far more mild LD (delayed reader in DS #2 that was also dyslexia but 2e, very gifted.)  

Then DD (#8) was born and I learned what "hyper" really meant on a psychological scale.

 

 

Edited September 15, 2016 by BlsdMama

[Tiramisu]

Angela,

 

Can we talk about behavior?

I agree with OhElizabeth's last post -those scores, bright but struggling with a disability, but not an intelligence issue. And that didn't look like a low working memory score to me, especially when realizing there is some kind of disability thing here.

 

Can we talk about behavior? She's 7. How is she with strangers? Is she chatty at all? What's it like posing as a family for pictures? What was she like as a baby - high needs/low needs, etc.? Food issues?

That handwriting was nothing like what I was expecting at all. Did she have direction for that? What would her handwriting be like if you just handed her a three-four word sentence and asked her to copy it and gave her paper and walked away with no direction?

 

 

ETA: And I'll add that six kids and one different is unusual but not unheard of.

My DS (#5) was the one who put LDs on my radar, like pick a label. Up until then I was full of bliss and didn't recognize a far more mild LD (delayed reader in DS #2 that was also dyslexia but 2e, very gifted.)

Then DD (#8) was born and I learned what "hyper" really meant on a psychological scale.

What's the significance of family pictures?

 

We've had so much trouble with this, when it should be so simple: get together, smile, click. But no. It's always grief or funny stuff in the early days.

[arcara]

I could speak volumes on her behavior, so I'm sure I won't completely represent it here.

 

She was a low needs baby. It was as a toddler that we noticed she was different. My husband and I kinda figured that we had become lax over the years and lost our parenting skills or something. She was intentionally disobedient and then would smile about it (still does this). She never seemed to feel sorrow after being scolded like our other kids. The most consistent way my husband and I have described her is by saying, "She just doesn't 'get it'." We would tell her things (this still happens) and then she she responds as if she didn't hear you. It has been as her younger brother, age 5, has gotten older and acted as the others that has confirmed our suspicions that she is "different."

 

With strangers she just smiles at them. Everyone says, "She's so sweet!" This is because she's quiet, calm, and smiles. She almost never speaks, though. She makes cards for nearly everyone she meets (another reason people describe her as sweet) - and I mean everyone - visitors to our house, teachers of classes she goes to (every week, not just once), the zoo, the doctor, the dentist, the public school psychologist who did her testing, etc. I know it's sweet, but to be honest, it seems a bit odd and immature to me. When visitors come to our house, she tends to monopolize them, bringing them bunches of toys and books, never imagining that they may NOT be there to play with her.

 

Whenever we are at a gathering with other children, she tends to play alone, or flocks to the younger kids, usually 4-5 years old.

 

Family photos- she's cooperative, as in, she doesn't act out, but she doesn't usually smile, sometimes has a scared look on her face, or just doesn't look at the camera at all (pretty common).

 

Her go to reaction in response to something she doesn't like is whining, yelling, or a full fit. She doesn't do this in public, though. We've NEVER had a 7yo still throw fits. She throws fits if my husband or I leave the house to go on an errand and tell her that she can't come. What 7yo does this?!?

 

Food...she's probably our least picky eater. But she's also our only over-weight child. She has no self-control, she eats super-fast and is asking for seconds when the rest of us have barely started eating (even though we all start at the same time because no one is allowed to eat until we've prayed). We make her wait now and try to limit her portions, but she whines and begs terribly.

 

Writing...she can't write a 3-4 word sentence. I tried AAS phrase dictation from book 1 and it took forever, lots of reminding her of the word she should be writing, and lots of whining. Yesterday she was writing the date for us, as we do every morning after discussing the calendar. I got up to do something while she was supposed to do it, but I stayed in the room. I came back over to her after a minute, and she had stopped writing. I asked how it was going, and she said, "Terrible!" Her last three letters were barely recognizable. I helped her fix the letters and told her letter-by-letter, number-by-number the rest of the date and she completed it.

 

There's more I could say, but I need to do some things now.

 

Thanks!

Angela

[wapiti]

Just throwing in my two cents to reiterate what the others said.  Your scores are a great starting point, clues for further exploration.  I'd be thinking OT eval, language eval with SLP (to look at language processing due to the spread between verbal and spatial scores - have seen similar things in our house), COVD (I would not skip this - too important, too easy to rule out developmental vision issues off the top though we have also seen where OT can help).  What I don't know, and you might do a little reading on, is what to do with that spread between spatial and fluid reasoning scores - I am not familiar with the WISC V (it is newer).  The more complicated issue would be the behavior and I'd take the PPs advice on looking at ASD spectrum stuff.  I'd probably want some form of psych to give an opinion on the scores and do further testing; I'm thinking neuropsych as an umbrella eval (whose office may do some of these evals in house?), though another possibility is an ed psych who refers out for the pieces.

 

For how you approach daily academics, I'd be inclined to treat this child as 2e (twice-exceptional, bright with learning issues).  In our house, development of strengths is at least as important as supporting weaknesses, very important for self-confidence.  I'd be thinking about input and output separately from what is going on in her head, and how you might treat her abilities for input and output as well as accommodate, depending on the situation.  So for example for math, I'd try to do as much orally as possible and then move to the white board when writing is needed.  I'd want to work on mental math/concepts to use spatial strengths to do more math mentally, less need for writing on paper.  I'd choose programs carefully - I don't know Ronit Bird but I'd probably start there!  I'd try to stay away from programs where learning relies on skills that are weak for her and then add in working on those weaknesses separately.  (For me, this is where it would help to mentally put things in "boxes" to keep my approach organized)

Edited September 17, 2016 by wapiti

[PeterPan]

Can you make private evals happen?

 

If you don't have money or insurance coverage for private evals, then you need to go through the dispute process with the school (using the NOLO book, using the law) and get them to pay for private evals.  She probably has more than ADHD going on.  I'd want the evals at a children's hospital, because there could actually be some other medical/genetic explanations for what you're describing.

 

[Tiramisu]

Can you make private evals happen?

 

If you don't have money or insurance coverage for private evals, then you need to go through the dispute process with the school (using the NOLO book, using the law) and get them to pay for private evals. She probably has more than ADHD going on. I'd want the evals at a children's hospital, because there could actually be some other medical/genetic explanations for what you're describing.

 

I think you're right, OhE, about the children's hospital. But I would start with the medical part because tgere's a big medical question in the birth history. I honestly think before evals, a pediatric neurologist at a children's hospital is in order. That will sort out the medical stuff and that *could* lead to better coverage for the other issues, including learning related evals.

 

Has she ever had an MRI?

 

For the school or anyone else to suggest or encourage an ADHD dx with this other stuff going on without a full evaluation is irresponsible and potentially harmful. I say that as someone who made that mistake twice, of thinking it was ADHD but it wasn't, or was more. I believe God has blessed my family and I fully accept how he has worked in my life and know it was all for the best, but, in a purely human level, if I had pushed harder for complete anserswhen they were seven, our path may have been much easier.

 

Whenever I've had my kid in for evals, one of the first things doctors/neuropsychologists ask is about the birth history. So I think it could be significant and justifies a medical evaluation in light of the behavioral stuff.

[Tiramisu]

Coming back....

 

Look up auditory processing disorder. She has symptoms of that in your description and seems consistent with the scores. That would be evaluated by an audiologist.

 

What are her motor skills like outside of writing? Is she well coordinated or clumsy?

[arcara]

She's quite uncoordinated. She runs awkwardly. We have to remind her to be careful a lot because she often falls. She fell outside and busted her nose on the house a few months ago (I know, who does that?). A week before she fell and busted her lip trying to show me something she learned in a ballet class.

 

I looked at our Children's hospital website today and the specialists we would need require a referral. She is due for her annual check up with her pediatrician in November, so I will do my best to push for these referrals then. I can probably find a decent SLP locally, so maybe we can do that in the meantime.

 

I do appreciate all the advice!

Angela

[Tiramisu]

Tough question to ask but I'll put it out there. Could she have mild cp? Has this question ever been asked?

[arcara]

No. I've not had that asked. Hopefully we will find someone who's willing to really look into things.

 

Angela

[PeterPan]

Get her eyes checked by a developmental optometrist, because that would be an *easy* explanation for the coordination and falling.  You can probably get into an OT pretty quickly too.  Will you need a referral for that?  Honestly, if you can get into the ped sooner, maybe bump up that appt?  Once you get the appt, you're going to need time for the referrals, time for insurance approval, and then you'll have another 3-6 month wait for evals.  That's a long time.  That's your whole school year with no answers.  

 

Our developmental optometrist practice will do just a normal annual exam (less than $100) but will *screen* for the developmental stuff.  That is what I'm suggesting you do.  My dd has some mild praxis (not enough to get her a DCD label) and is low tone, but for her the vision problems actually explained why she kept womping into things, etc.  So I'm not saying it's everything, but it's something you could eliminate, absolutely.  

 

For audiology, our state university can do that for $35, making it an easy thing to recommend.  I know someone is gonna say wow they just keep recommending stuff!  I think if you have symptoms, you have to start somewhere, do evals, scratch things off the list, kwim?  And these are less expensive, easier evals to make happen that eliminate the most COMMON explanations for symptoms.  Then you start getting into expensive things like a neuropsych eval ($2-3K private, more at hospital), etc.  An OT eval, same deal.  Around here you can get a private OT eval for $180 with a report.  You'd want someone with experience in ASD, ADHD, and sensory issues.  They're probably going to turn up some stuff.  It will get you info, and your next step, if they don't explain everything, is neurologist, neuropsych, etc., to put more on the table. 

 

If you have insurance coverage for a hospital, they could do everything under one roof, so long as you get all the referrals.  Make your list and really say stuff so the doc writes the referrals.  There's a lot of stuff that we sort of excuse when kids are little that is no longer in the range of appropriate as they get older. Make that list and get these referrals.  

[heartlikealion]

In my thread someone mentioned the COVD website so if you do need an optometrist maybe try that site. I don't think our kids took the same tests, but I wonder how your child would do on the Bender Visual-Motor Gestalt Test. That is the one my child struggled with and the optometrist I spoke to said that could affect handwriting.

[Tiramisu]

In my thread someone mentioned the COVD website so if you do need an optometrist maybe try that site. I don't think our kids took the same tests, but I wonder how your child would do on the Bender Visual-Motor Gestalt Test. That is the one my child struggled with and the optometrist I spoke to said that could affect handwriting.

I think one of my kids scored below the second percentile on that test. We had a lot of writing issues over the years and she struggled with pencil grip. And sensory was a part of it, too. She had VT and while her handwriting still isn't great, that and everything else just got easier with VT.

 

Also, if you combine low tone with lax joints, you can have problems with grip and writing. We have that as part of the picture, too. It all kind of goes together and it's a common problem.

[heartlikealion]

I think one of my kids scored below the second percentile on that test. We had a lot of writing issues over the years and she struggled with pencil grip. And sensory was a part of it, too. She had VT and while her handwriting still isn't great, that and everything else just got easier with VT.

 

Also, if you combine low tone with lax joints, you can have problems with grip and writing. We have that as part of the picture, too. It all kind of goes together and it's a common problem.

 

I'm sorry, what is VT?

 

[Tiramisu]

I'm sorry, what is VT?

 

Vision therapy.

 

Done with an optometrist who is certified member of covd.org.

 

ETA: The visual-motor integration testing was done by an OT first, before we ended up at the developmental optometrist. But an optometrist who does VT can also do this testing. Another DD had VMI testing with both the optometrist and an OT and the results were consistent. Her VMI was good but she had other visual issues (convergence excess, tracking, accommodative spasms) and other things probably related to executive function--not to mention the loose joints--that make writing hard for her. And there's also the sensory stuff that plagues us. Lol. Sorting this stuff out isn't easy!

Edited September 18, 2016 by Tiramisu

[heartlikealion]

Vision therapy.

 

Done with an optometrist who is certified member of covd.org.

 

ETA: The visual-motor integration testing was done by an OT first, before we ended up at the developmental optometrist. But an optometrist who does VT can also do this testing. Another DD had VMI testing with both the optometrist and an OT and the results were consistent. Her VMI was good but she had other visual issues (convergence excess, tracking, accommodative spasms) and other things probably related to executive function--not to mention the loose joints--that make writing hard for her. And there's also the sensory stuff that plagues us. Lol. Sorting this stuff out isn't easy!

 

Ahh, so complicated!