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What's dyslexia and what's normal for an almost-7 year old?

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I have a kiddo who seemed like she was making great progress reading around age 4. It was led by her, and we did as much or little as she wanted. Around the time she turned 5, she didn't want to do it anymore, and I didn't push too hard, but I did continue to cover phonograms with her 5-10 minutes a day. When she was 5.5, I started Spalding with her, and we've been doing that for over a year now. She is currently 6, almost 7, and I feel like she reads now about as well as she did a year ago, despite daily spelling and reading and phonogram practice. Lots of guessing, lots of rushing, lots of just making up her own sentence based on a picture or what she expects will happen. After two years of learning phonograms, she still struggles to remember which one is which when I tell her the sounds one makes, and she has absolutely no idea which one to use in most new words.

 

I know she's young, and I don't want to seem like I'm making a mountain out of a mole-hill, but the kid loves books and audiobooks and yet actual reading seems like torture for her (and me...)  And she's really smart - just obviously really smart. I posted on another thread and folks suggested I consider dyslexia. I took the dynaread dyslexia screening with her, and it gave us the following results *when compared with other struggling 6 year old readers*: 38 %ile in working memory, for common English words she had 71 %ile in accuracy and 77 %ile in fluency, for nonsense words she had 40 %ile accuracy and 60 %ile fluency.

 

It walked me through a little bit of what this means, but I still think I don't really understand what it means. Since the percentiles are among other struggling readers, and 6 year olds (while she's closer to 7 than 6), I feel like it seems she might really have a problem, but I'm not really sure how to put the numbers together in a way that my brain can understand what they mean or what to do. But another part of me says maybe it's just normal for a 6 year old? Some can read and some just can't at this age? Maybe I should've been pushier and done more than 10-15 minutes of spelling + 10-15 minutes of reading with her each day and it just reflects badly on me? Maybe she just needs more time and will take off reading in another year?

 

I'm sad that she dislikes reading more each week. We just took an 8 week break for travelling over Christmas, and coming back to it was just as bad as before. I'd really hoped that a break would help.

 

ETA I also just had her do the lexercise dyslexia screening, and on the z-screener score it said she reads simple syllables with less than 5% accuracy, but on the San Diego quick Assessment it said she was on target for words (real words, but simple ones) that a K'er should be reading. It's like she's memorized bunches of common words but can't sound out zac.

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She's at the age the IDA recommends testing. I had my ds diagnosed at 6, so I definitely don't think you're jumping the gun. On my phone here but go through Barton reading and do her student screening. It may surprise you. A 5yo should pass it.

 

Have you started connecting with dyslexia resources in your area?

 

Btw my dd was a little crunchy and I always wondered but she progressed. Turns out she's heterozygous and carrying a dyslexia gene where mother ds is homozygous and diagnosed. I think your focus on progress is good. You clearly need more powerful tools to get her moving forward.

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:grouphug:

 

First, don't stress out that you should have been pushing harder and her struggles are your fault.  Don't go there.  It isn't healthy and it isn't true.  If she has dyslexia then pushing harder at an earlier age would probably have tanked any desire on her part to EVER learn to read.  Even if she is not dyslexic but her brain needed more time then forcing her to march through more lessons would not have helped.  In other words, please walk away from putting this on your shoulders.  Children develop skills at different rates.  She is very young.  She has time and so do you.  Look forward, not back.

 

So now lets dig in deeper.  There are many reasons a child may struggle to learn to read.  Some are just not developmentally ready yet.  Others are going to need VERY explicit, very broken down pieces because reading is not intuitive for the way their brains work.  Others may have developmental vision and/or auditory processing issues that cause glitches.  And some will have all of those challenges plus possibly even more comorbid issues that combined make the whole process of reading at least a bit glitchy, maybe even near impossible until those other issues are addressed directly and intentionally. 

 

When the issues are tied to struggles with phonological processing that is what is typically meant by dyslexia (although definitions vary).  Since you aren't really sure what the problem is but your instincts are telling you that something is off, now is a good time to just start the process of digging a little deeper.  Before jumping into expensive evaluations, do some more targeted research and gather some more information, but because evaluations CAN take an enormous amount of time and sometimes money to get into place you can also start asking some questions that direction, too, but we will get to that in a moment.

 

Suggestions for right now, in the next two weeks:

 

  1. As PeterPan said, you could give your daughter the Barton Reading and Spelling student screening.  (You don't have to buy the program to administer the screening).
    • This is NOT a test for dyslexia but it does test for certain important basic skills, including sound discrimination, that are usually needed to learn to read effectively.  If those skills are not there or are glitchy than ANY reading program may not work well until those issues are dealt with directly. 
    • (Programs that frequently work well for addressing issues that can be revealed with this screening are the Lindamood Bell LiPS program and a newer program called Foundations in Sound.  Most people do not need that level of instruction but for those that do they can be a HUGE help.). 
    • You will need to pass the tutor screening first (not a test of knowledge but of sound discrimination) then you can administer the student screening to your child. 
    • The screenings are free and relatively easy to administer.  Since it is FREE and you can administer this test yourself I absolutely encourage you to do so.  Gives you more information about your child, regardless of whether she is dealing with a learning difference like dyslexia or not, and you can get that info quickly and at no cost.
    • Make certain you are both well rested, not hungry, there will be no interruptions, you won't have to rush out the door, and the area you do the screening is relatively quiet since hearing the sounds is PARAMOUNT to being able to accurately administer this test.
    • Ahead of time:  Play through the instructions first and kind of get your mind prepared.  It really isn't hard but if you have never done anything like this before it can take a moment to get mentally ready.  Also, there are a few things you need to print out/prepare before you can administer the screenings.
    • I am linking both screening links:  https://bartonreading.com/tutors/#ts   https://bartonreading.com/students/#ss
  2. Find resources to read up on Dyslexia.  Websites that might help:
  3. I wouldn't spend a ton of money on books yet.  Check your local library first.  There are a ton of books out there but books that typically have helped others that might be good to get you started:
    • The Dyslexic Advantage by Brock and Fernette Eide
    • Overcoming Dyslexia by Sally Shaywitz
    • The Mislabeled Child by Brock and Fernette Eide
    • Homeschooling Your Struggling Learner by Kathy Kuhl
  4. Take a break from heavy reading lessons right now.  Either drop formal instruction altogether for a couple of weeks or keep lessons really short and consistent but maybe only 4 days a week while you dig into this further.  
  5. Separate her ability to read from her ability to understand her native tongue.  The first is a skill set that can take a lot of time to smooth out.  It may take her time to be able to decode accurately and fluently.  She does have that time, especially if you are homeschooling.  Let her reading skill sets develop at whatever pace and in whatever manner works but keep her exposure to HEARING and DOING with language go at her intellectual pace.
  6. Focus on exposure.  Lots of read alouds and audio books and rich language as you converse with her.  Expose her to life.  DO things with her that expose her to a wide range of concepts/vocabulary.  Reading will come with time but if she has a richer background knowledge and larger vocabulary from the spoken language it will be easier to pair that with written words.
  7. If you continue your lessons, try to find a time maybe sandwiched in between two things she likes doing and keep that consistent so she knows she will get to do something more interesting right afterwards.  Be upbeat and positive.  Make eye contact and smile and try and infuse some humor if that helps (even if inside you are exhausted/frustrated/scared).  Don't put it off to the end of the day when you are both tired and honestly secretly trying to avoid it.  Some kids do better if you can knock out something tough but quick as the first thing of the day.
  8. Give yourself a pat on the back for caring and trying and working to seek answers. 

 

 

FWIW, I waited.  People kept telling me (including my reading specialist mother) that my daughter just needed more time.  Teachers told me she was just a bit unfocused.  No, in our case she really is dyslexic (among other challenges).  In 5th grade she was still not reading anything well at all and in fact still found Clifford books exceedingly difficult.  I started homeschooling her in 6th grade.  She could not spell or read past basically kindergarten level material and even that was not fluid.  We got evaluations, found a system that worked for her, and she was reading at grade level 2 years later.  Was it easy?  No.  The program worked brilliantly but this reading thing was HARD for her.  It took time and patience and understanding.  But it worked.  She and I both could see the difference within a month or so of starting.  Her brain needed a different way to learn to read.  Once we shifted systems (including starting further back in skills acquisition than normal reading programs typically go), things started to gel.  She reads well now.  She also spells well now.  I share this to reassure you that you really do have time to find what works for your child and to get answers on whether there really is something going on that would necessitate more specialized help than what she is getting now.

 

:grouphug:   Good luck and best wishes.

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There are some red flags for dyslexia in your description, so it would be worth considering having her evaluated. Testing that you do yourself may give you clues, but to be sure, an experienced professional evaluation is best.

 

To get the most thorough examination, you can go to a neuropsychologist. The drawbacks are that it is expensive and often not covered by insurance. You would need to check with your insurance company to see what would be covered. We found it to be worthwhile, despite the expense.

 

In some areas, you may find an educational psychologist who will do testing. The fees are likely less, but they may run fewer tests. If you don't suspect other issues, an ed psych may be sufficient.

 

If you are in the US, you can also request evaluations from the public school, even as a homeschooler. It's important to understand the law if you go this route, but there are books you can read, and you can find information online about federal law and your state laws. The big benefit is that the school will run tests for free. The drawback is that they usually will not give you a diagnosis of dyslexia. They would call it Specific Learning Disability in Reading. In other words, they can tell you whether the student has a learning disability, but they will not be able to give you as much information as a private ed psych or neuropsych would. They can tell you if a SLD is present, but they usually cannot explain the WHY. They also may not have insight into what you can do to help her as a homeschooler, since their focus is the public school classroom experience. But it's free and it gives you a place to start. You just need to understand your rights under the law and how the process works.

 

A third option is to see if there is a private dyslexia school near you. They often do reading screenings for the public. Just be sure to ask good questions about what kind of testing they do. They may not use a screening tool that is the best choice. I mention this because we ran into this problem ourselves. Where we lived before, the dyslexia school did some little 15 minute screener on DD that was not sufficient; they told us she likely did not have dyslexia. But she does. What you want is a test called the CTOPP.

 

The CTOPP is the test of phonological processing, and it is important to run, because dyslexia is a phonological disability. The fact that your daughter has had so much trouble learning phonograms suggests to me that a phonological disability (AKA dyslexia) may be present. However, reading problems can also be caused by poor working memory, inattention, and/or vision issues, so it is also important to have a thorough vision screening.

 

Working memory issues and ADHD are very commonly found along with dyslexia, so even though the CTOPP is an important test, there are other areas that should be investigated. A good psych can ferret all of that out for you.

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The important thing to remember is that these tests like the CTOPP are *not* looking at performance and saying merely oh he's behind on reading. There ARE legit differences in just when it clicks for kids. The CTOPP is looking at phonological processing, how the actual phonemic awareness and ability to manipulate sounds develops. So a typically developing child is going to have intact phonological processing, even if maybe they haven't quite clicked yet with reading. The CTOPP can let you discriminate that. A psych who sees a lot of dyslexia or a reading tutor trained to run the CTOPP and other tools can separate that. 

 

You don't have to worry, like oh will they diagnose my kid as dyslexic and it just needed another 6 months? Nope, the markers were there at 3, 4,5, and the tools are now available to recognize the patterns of the disorder and find them BEFORE the reading is a problem.

 

You do not have to wait for her to fail at reading to diagnose. The IDA wants these kids diagnosed before 1st grade. You are literally at the perfect time to get it sorted out and your gut is right. The OLD standard was to wait until 3rd and let them fail. Why would you do that? If the kid has fine CTOPP scores, then you know you just need more time and work. But really, it can be that easy to solve. 

 

Definitely get some testing, get it sorted out. She doesn't need to be frustrated. Early intervention for dyslexia can profoundly change their trajectory and their self-esteem. 

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Thanks for the advice, guys. My insurance actually covers neuropsych evals at 100% without a referral, but the facility itself requires a referral from my ped, and I've been reluctant to do that because I fear he'll think we're overreacting (we had an older child get a neuropsych eval last year)... But there have been other issues that I think the neuropsych eval could help us identify (questions of attention/focus/fixations, anxiety, working memory, etc.). 

 

I'll start by checking some of those book recommendations out from the library and doing the Barton screening and take some time to consider my other options, I guess...

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:grouphug:

 

First, don't stress out that you should have been pushing harder and her struggles are your fault.  Don't go there.  It isn't healthy and it isn't true.  If she has dyslexia then pushing harder at an earlier age would probably have tanked any desire on her part to EVER learn to read.  Even if she is not dyslexic but her brain needed more time then forcing her to march through more lessons would not have helped.  In other words, please walk away from putting this on your shoulders.  Children develop skills at different rates.  She is very young.  She has time and so do you.  Look forward, not back.

 

So now lets dig in deeper.  There are many reasons a child may struggle to learn to read.  Some are just not developmentally ready yet.  Others are going to need VERY explicit, very broken down pieces because reading is not intuitive for the way their brains work.  Others may have developmental vision and/or auditory processing issues that cause glitches.  And some will have all of those challenges plus possibly even more comorbid issues that combined make the whole process of reading at least a bit glitchy, maybe even near impossible until those other issues are addressed directly and intentionally. 

 

When the issues are tied to struggles with phonological processing that is what is typically meant by dyslexia (although definitions vary).  Since you aren't really sure what the problem is but your instincts are telling you that something is off, now is a good time to just start the process of digging a little deeper.  Before jumping into expensive evaluations, do some more targeted research and gather some more information, but because evaluations CAN take an enormous amount of time and sometimes money to get into place you can also start asking some questions that direction, too, but we will get to that in a moment.

 

Suggestions for right now, in the next two weeks:

 

  1. As PeterPan said, you could give your daughter the Barton Reading and Spelling student screening.  (You don't have to buy the program to administer the screening).
    • This is NOT a test for dyslexia but it does test for certain important basic skills, including sound discrimination, that are usually needed to learn to read effectively.  If those skills are not there or are glitchy than ANY reading program may not work well until those issues are dealt with directly. 
    • (Programs that frequently work well for addressing issues that can be revealed with this screening are the Lindamood Bell LiPS program and a newer program called Foundations in Sound.  Most people do not need that level of instruction but for those that do they can be a HUGE help.). 
    • You will need to pass the tutor screening first (not a test of knowledge but of sound discrimination) then you can administer the student screening to your child. 
    • The screenings are free and relatively easy to administer.  Since it is FREE and you can administer this test yourself I absolutely encourage you to do so.  Gives you more information about your child, regardless of whether she is dealing with a learning difference like dyslexia or not, and you can get that info quickly and at no cost.
    • Make certain you are both well rested, not hungry, there will be no interruptions, you won't have to rush out the door, and the area you do the screening is relatively quiet since hearing the sounds is PARAMOUNT to being able to accurately administer this test.
    • Ahead of time:  Play through the instructions first and kind of get your mind prepared.  It really isn't hard but if you have never done anything like this before it can take a moment to get mentally ready.  Also, there are a few things you need to print out/prepare before you can administer the screenings.
    • I am linking both screening links:  https://bartonreading.com/tutors/#ts   https://bartonreading.com/students/#ss
  2. Find resources to read up on Dyslexia.  Websites that might help:
  3. I wouldn't spend a ton of money on books yet.  Check your local library first.  There are a ton of books out there but books that typically have helped others that might be good to get you started:
    • The Dyslexic Advantage by Brock and Fernette Eide
    • Overcoming Dyslexia by Sally Shaywitz
    • The Mislabeled Child by Brock and Fernette Eide
    • Homeschooling Your Struggling Learner by Kathy Kuhl
  4. Take a break from heavy reading lessons right now.  Either drop formal instruction altogether for a couple of weeks or keep lessons really short and consistent but maybe only 4 days a week while you dig into this further.  
  5. Separate her ability to read from her ability to understand her native tongue.  The first is a skill set that can take a lot of time to smooth out.  It may take her time to be able to decode accurately and fluently.  She does have that time, especially if you are homeschooling.  Let her reading skill sets develop at whatever pace and in whatever manner works but keep her exposure to HEARING and DOING with language go at her intellectual pace.
  6. Focus on exposure.  Lots of read alouds and audio books and rich language as you converse with her.  Expose her to life.  DO things with her that expose her to a wide range of concepts/vocabulary.  Reading will come with time but if she has a richer background knowledge and larger vocabulary from the spoken language it will be easier to pair that with written words.
  7. If you continue your lessons, try to find a time maybe sandwiched in between two things she likes doing and keep that consistent so she knows she will get to do something more interesting right afterwards.  Be upbeat and positive.  Make eye contact and smile and try and infuse some humor if that helps (even if inside you are exhausted/frustrated/scared).  Don't put it off to the end of the day when you are both tired and honestly secretly trying to avoid it.  Some kids do better if you can knock out something tough but quick as the first thing of the day.
  8. Give yourself a pat on the back for caring and trying and working to seek answers. 

 

 

FWIW, I waited.  People kept telling me (including my reading specialist mother) that my daughter just needed more time.  Teachers told me she was just a bit unfocused.  No, in our case she really is dyslexic (among other challenges).  In 5th grade she was still not reading anything well at all and in fact still found Clifford books exceedingly difficult.  I started homeschooling her in 6th grade.  She could not spell or read past basically kindergarten level material and even that was not fluid.  We got evaluations, found a system that worked for her, and she was reading at grade level 2 years later.  Was it easy?  No.  The program worked brilliantly but this reading thing was HARD for her.  It took time and patience and understanding.  But it worked.  She and I both could see the difference within a month or so of starting.  Her brain needed a different way to learn to read.  Once we shifted systems (including starting further back in skills acquisition than normal reading programs typically go), things started to gel.  She reads well now.  She also spells well now.  I share this to reassure you that you really do have time to find what works for your child and to get answers on whether there really is something going on that would necessitate more specialized help than what she is getting now.

 

:grouphug:   Good luck and best wishes.

 

Thank you so much for your detailed response and encouragement!!

 

She can and does listen to lots of audiobooks of what I think are an appropriately good level for her (Secret Garden, Matilda, Ramona series, etc.) She's extremely verbal and has absolutely no problem having conversations with people in English, and only marginal difficulty conversing with people in German as well. She gets bored a lot and we've recently been dealing with that by giving her lots of audiobooks while she swings on an indoor swing for an hour or two... lol. So I think she's getting lots of good input.

 

Thanks again! I have two books you recommended on hold already at the library. :)

Thank you so much for your detailed response and encouragement!!

 

She can and does listen to lots of audiobooks of what I think are an appropriately good level for her (Secret Garden, Matilda, Ramona series, etc.) She's extremely verbal and has absolutely no problem having conversations with people in English, and only marginal difficulty conversing with people in German as well. She gets bored a lot and we've recently been doing 

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Start documenting.  Pediatricians usually respond better if you seem to be going on facts, not emotions.  Write down specifics of what you are seeing that concerns you.  Keep a journal for at least a week or so while you read up.  Bring in your notes.  Show him you aren't just having a knee jerk reaction because you read some blurb in a tabloid.  If he is a good ped he will listen to your concerns with an open mind and get you that referral.

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Yeah, I'd go ahead and get the referral and get it moving. You're seeing it, and by waiting all you're doing is delaying correct intervention.

 

See, here's the other thing you may run into. Say you wait 6 months and go ok, I'm tired of this, I'm certain. Then what? Then you wait a month for the ped appointment, another 3-6 months to get into the neuropsych (some are faster, but it can be common to wait that long), and then you wait for reports, wait to start with a tutor, etc. That means what you thought of as a little wait is actually going to be a full year.

 

So if you go to the ped, get the referral, get on the waiting list, and every single attention and reading disability symptom goes away before the appointment, boom you cancel. My dd has straight ADHD and we did a neuropsych eval for her. I'm pretty passionate about early evals though, because I didn't eval my dd till she was 12. I had thought about it when she was in 1st, made some calls, got the blow-off, and let it go. Lot of water under the bridge later, we FINALLY got evals. 

 

So you're not jumping the gun and you're probably going to have some waits involved in making things happen when you're finally ready. My ds (2nd dc, hindsite) was eval'd and diagnosed with all 3 of his SLDs at 6. I doubt your ped gives you a hard time with what you've described, honestly. 

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The boredom can be the ADHD thing, an executive function issue. They're having a hard time realizing their choices and organizing to make it happen. You might try helping her realize her choices, give her a bit of structure.

 

The audiobooks thing is FAB. Definitely definitely do that.  :hurray:  :hurray:  :hurray:

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Not all reading disabilities are dyslexia. My struggling reader actually has GOOD phonological processing skills. She can decode and spell in line with her physiological age (which is delayed compared to her chronological age). Where she struggles is with weak oral language skills, working memory deficits, slow processing speed, and rapid naming deficits. She will decode a word and then thereafter when she encounters it in the same paragraph will decode it EVERY SINGLE STINKING TIME as if it's a brand-new word. :banghead: She's in a class for language-based LD's and most of the other kids are dyslexic. Her teacher agrees that her struggles are different from the dyslexic students. 

 

I think having a neuropsych eval is a good idea because it should give useful information about your child's specific struggles (which may or may not be due to dyslexia).

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Bingo. That's why you run a CTOPP, because without something like that you don't know what is causing the issue.

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Crimson, total aside, but I again go back to my DSM is cr*p line. Take these teachers saying yes dyslexia, no dyslexia. That's not REALITY either. You've got genetics, so look at the dyslexia genes. https://behavioralandbrainfunctions.biomedcentral.com/articles/10.1186/1744-9081-10-23  There's a study that lists like 12, I forget. I went through them with my ds, and my ds trips *1* of their list and one other not on their list. So he has dyslexia, yes, but it's not AS SEVERE as someone who is tripping lots and lots of those genes, kwim?

 

So I'd be asking what genes are involved and what's really going on, rather than giving a rip about what the DSM says. DSM is such an under-powered tool for complex kids.

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Thank you all for your very helpful feedback. We have an appointment with a nueropsych for next week to do an initial consultation and discuss our concerns.

 

Any suggestions on what tests to request, besides the CTOPP? I was thinking of something for working memory, processing speed, and attention, and I considered a WISC while we're there anyway and insurance is covering the testing. But I don't know if there are other tests that would be more helpful?

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You won't need to suggest what tests. The neuropsych already has a mountain of them, and they'll decide what to do as they dig in. They'll have basic ones they know they'll run (IQ, achievement, CTOPP), and then as they see things they'll go various directions. They'll also give you a pile of questionaires to fill out, which will be more diagnostic tools. They'll combine what they see plus what you put on those forms and get some conclusions. 

 

Well that's good you found someone to get evals going!  :thumbup1:

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The main thing you can do is make your list of CONCERNS, so you're telling them what you want investigated. Make a list, write it out, so you don't forget. 

 

If you have a list of questions you need answered by the end of the process, this is the time. 

 

Like for me, when I had my dd eval'd, I actually made video and I said BY THE END I WANT TO KNOW WHY SHE'S HARD TO TEACH LIKE THIS. For real. LOL And he actually did explain it by the end. And I told him what he was worried about, and he ran tests and excluded things. It was a good process.

 

The psych process is interesting, because they often look for STRENGTHS, not just weaknesses. They'll spend time, hopefully, talking about how you can nurture positives, where there are strengths you can work with, etc. It's interesting to get that kind of whole perspective and an outside perspective.

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You won't need to suggest what tests. The neuropsych already has a mountain of them, and they'll decide what to do as they dig in. They'll have basic ones they know they'll run (IQ, achievement, CTOPP), and then as they see things they'll go various directions. They'll also give you a pile of questionaires to fill out, which will be more diagnostic tools. They'll combine what they see plus what you put on those forms and get some conclusions. 

 

Well that's good you found someone to get evals going!  :thumbup1:

 

 

The main thing you can do is make your list of CONCERNS, so you're telling them what you want investigated. Make a list, write it out, so you don't forget. 

 

If you have a list of questions you need answered by the end of the process, this is the time. 

 

Like for me, when I had my dd eval'd, I actually made video and I said BY THE END I WANT TO KNOW WHY SHE'S HARD TO TEACH LIKE THIS. For real. LOL And he actually did explain it by the end. And I told him what he was worried about, and he ran tests and excluded things. It was a good process.

 

The psych process is interesting, because they often look for STRENGTHS, not just weaknesses. They'll spend time, hopefully, talking about how you can nurture positives, where there are strengths you can work with, etc. It's interesting to get that kind of whole perspective and an outside perspective.

 

Really? This was not my experience with our last neuropsych eval at all!! But I also felt like that neuropsych eval was (almost) a complete waste of time. They asked me what I was looking for, and only did the bare minimum that I asked for, because I didn't know what all was available. The report answered almost none of my questions, and discussed almost exclusively a small number of my son's strengths - but they were strengths I had already highlighted during our initial consultation, so that wasn't super helpful. I felt like the doctor discounted most of what I said, and despite working specifically in pediatric neuropsychology, she didn't not have a child-friendly way of working with my son at all. But, that's why we're seeing someone else this time around, so hopefully this experience will be a lot better! :)

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I think it would be a good idea to get testing (either by the NP or by a Speech & Language Pathologist) of more advanced language skills. Things like figurative language, making inferences, retelling narratives, etc. Sometimes kids who appear on the surface to speak fine can have funky holes and that can cause reading difficulties. I came across a statistic in one of my textbooks that weak narrative language skills at age 5 predicted poor reading achievement at age 9.

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I would do the Barton screening and the free phonological assessment test here: 

 

https://www.spelfabet.com.au/2013/02/free-phonological-awareness-test/

 

Depending on how she does, you may need to do some phonemic awareness work.  LiPS is the most comprehensive, but there are some cheaper, lower level materials that can work if there is a small deficit, here is a good thread for them:

 

http://forums.welltrainedmind.com/topic/582944-phonemic-awareness-resources/?hl=phonological+awareness&do=findComment&comment=6784102

 

Here is my blending video which explains why it can be a challenge, as well as a link to my blending page that explains it:

 

https://www.youtube.com/edit?o=U&video_id=6Q4KTyqpg5o

 

http://www.thephonicspage.org/On%20Reading/blendingwords.html

 

After that, I would do a lot of work with nonsense words directly, my syllables page has those resources built into the program as well as files with additional words to work on after completion.  You should be able to read nonsense words with the same rate and accuracy that you read regular words, there are also age norms in the files about the nonsense words.

 

http://www.thephonicspage.org/On%20Reading/syllablesspellsu.html

 

Here is the test with the age norms for nonsense words:

 

http://www.thephonicspage.org/On%20Reading/Resources/NonsenseWordTest.pdf

 

 

 

 

Edited by ElizabethB
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Really? This was not my experience with our last neuropsych eval at all!! But I also felt like that neuropsych eval was (almost) a complete waste of time. They asked me what I was looking for, and only did the bare minimum that I asked for, because I didn't know what all was available. The report answered almost none of my questions, and discussed almost exclusively a small number of my son's strengths - but they were strengths I had already highlighted during our initial consultation, so that wasn't super helpful. I felt like the doctor discounted most of what I said, and despite working specifically in pediatric neuropsychology, she didn't not have a child-friendly way of working with my son at all. But, that's why we're seeing someone else this time around, so hopefully this experience will be a lot better! :)

Do you have another option for a neuropsychologist? Sounds like this one isn't worth much.

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Do you have another option for a neuropsychologist? Sounds like this one isn't worth much.

 

Ha ha. There's one other option in town, and we have something scheduled with him, but I'm a little skeptical, because he said he expects the appointment to last 4-6 hours. Not spread out over a few days - just 4-6 hours. That doesn't seem like long enough to run a variety of tests to me, but he said they usually just like to get kids in and out in a morning... I'm trying to withhold judgement until I see what he actually tests and how it all shakes out...

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That's a normal amount of time to test. If a psych is suspecting something like autism, they might want to see them over more sessions to see the range of behaviors, etc. However if it's dyslexia, etc., sure they could bang out the testing all in a day. Psychs usually have how they roll in their practice. Like I think some psychs do evals in the morning and write reports in the afternoon, that kind of thing. They have their routines. So if that's his routine, he makes it work.

 

So yes, in general, barring finding something exceptional, the 4-6 would be pretty normal. It's just common for them to spread it over 2 days to make it less fatiguing for the child.

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That's a normal amount of time to test. If a psych is suspecting something like autism, they might want to see them over more sessions to see the range of behaviors, etc. However if it's dyslexia, etc., sure they could bang out the testing all in a day. Psychs usually have how they roll in their practice. Like I think some psychs do evals in the morning and write reports in the afternoon, that kind of thing. They have their routines. So if that's his routine, he makes it work.

 

So yes, in general, barring finding something exceptional, the 4-6 would be pretty normal. It's just common for them to spread it over 2 days to make it less fatiguing for the child.

Oh! That’s good to know. At some point in the past when I was asking what to expect from my sons evaluation, I was told it should take 6 to 12 hours spread out over 3 to 4 sessions. And it wasn’t, it was only six hours spread out over two or three sessions and I found that somewhat concerning. But there was autism There.

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I would do the Barton screening and the free phonological assessment test here: 

 

https://www.spelfabet.com.au/2013/02/free-phonological-awareness-test/

 

Depending on how she does, you may need to do some phonemic awareness work.  LiPS is the most comprehensive, but there are some cheaper, lower level materials that can work if there is a small deficit, here is a good thread for them:

 

http://forums.welltrainedmind.com/topic/582944-phonemic-awareness-resources/?hl=phonological+awareness&do=findComment&comment=6784102

 

Here is my blending video which explains why it can be a challenge, as well as a link to my blending page that explains it:

 

https://www.youtube.com/edit?o=U&video_id=6Q4KTyqpg5o

 

http://www.thephonicspage.org/On%20Reading/blendingwords.html

 

After that, I would do a lot of work with nonsense words directly, my syllables page has those resources built into the program as well as files with additional words to work on after completion.  You should be able to read nonsense words with the same rate and accuracy that you read regular words, there are also age norms in the files about the nonsense words.

 

http://www.thephonicspage.org/On%20Reading/syllablesspellsu.html

 

Here is the test with the age norms for nonsense words:

 

http://www.thephonicspage.org/On%20Reading/Resources/NonsenseWordTest.pdf

 

What do you think are pros and cons of starting all of this before her appointment next week to test for dyslexia? Or would you recommend postponing that appointment to see if this just fixes things?

 

ETA:She flew through the TAAS with flying colors (she missed one early on and then the last one) and on the Barton Screening she got the max wrong on all three tasks, but not more, so maybe that's a good sign?

Edited by 4kookiekids
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What do you think are pros and cons of starting all of this before her appointment next week to test for dyslexia? Or would you recommend postponing that appointment to see if this just fixes things?

 

ETA:She flew through the TAAS with flying colors (she missed one early on and then the last one) and on the Barton Screening she got the max wrong on all three tasks, but not more, so maybe that's a good sign?

One week is not enough for full remediation if it is dyslexia, but is is enough for some improvement. If it is something else, it could also fix things, you could try and see your progress. You could do two lessons a day and lighten everything else (separate the lessons with a break and other work). By the time you get to lesson 6 or 7 you should see improvement if it is going to help. Someone with dyslexia will see very slow improvement, my other students have fairly rapid improvement. But, the syllables do help my students with dyxlexia. They need a lot more repetition and generally gain .1 or .2 grade levels and 2 to 4 WPM on nonsense words vs my regular average of .5 to 1.5 grade levels of improvement and 10 to 30 WPM increase after each set of 10 lessons, I repeat the course for students that need more work.

 

I would keep the appointment, the working memory and other tests are helpful for any child, more knowledge will help you in every subject.

Edited by ElizabethB
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I would do nothing more than normal school work this week. Why screw up your baseline? Then you'll just be left wondering. Continue your normal routine. Begin intervention after the CTOPP is done.

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Is the CTOPP the only valid measure for dyslexia? Despite my concerns and my stated desire that they give her that, it appears that they didn't. They gave her the 21-item test, Grooved pegboard, judgment of line orientation, developmental test of visual motor integration, stroop color/word test, Woodcock-Johnson III Reading subtests, Gordon diagnostic system, WRAML-2,  and some emotional stuff like depression and anxiety scales. Should I request that they go back and do that, see someone else, or is this enough information to rule out dyslexia? They basically said that her reading is fine, but if it's because they gave her a bunch of words she's already memorized (she's a bright kid....), then I'm not sure that it was a fair assessment. I'm just not sure how to tell. Any thoughts?

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Was there a nonsense word reading section on the reading test?  She wouldn't be able to have memorized nonsense words, and so if the reading test has that, then it would show up that way.  I don't know enough about it to know if it would or not, but that is included on some things.  They also could have a test of phonemic awareness as part of the reading test.  I think google the name of the reading test and see what it includes, if it gives a list of sections or anything like that.  Phonemic awareness or nonsense words would both be good things to see. 

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https://images.pearsonclinical.com/images/products/wrmt-iii/WRMT_III_Interpretive_Sample_Report.pdf

 

I googled this. I am just guessing but I think the sections for phonological awareness, rapid automatic naming, and word attack would be sections where it would be good. But I don’t know what word attack really is. It was a lower score for my older son though iirc, so I think it is something.

Edited by Lecka

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Or they had the CTOPP but didn't bother because the WJ scores were good? 

 

WJ is open-ended, so you're kicking out actual grade levels with it. 

 

Took me a long time to wrap my brain around the idea that dd could be crunchy but not dyslexic. Turns out she's heterozygous (a carrier, one gene) for dyslexia. So it's there, floating, hiding, but she reads fine. 

 

Not everything gets a label. Some kids will be a pain in the butt and no label. And if there's no label this time, that can change in a few years. But sometimes, yeah, the answers are dissatisfying. "Pain in the butt to teach" isn't quite a nice sounding as dyslexic. ;)

 

Dd ended up with an ADHD label, btw, and needed VT.

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Edited by PeterPan

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You're getting testing done and so maybe this isn't so important - but I thought I'd toss it out b/c it doesn't seem anyone else has touched on it - 

 

There are often non-reading  issues/signs of dyslexia - directional confusion (esp. left/right but also up/down and front/back), coordination, especially with bilateral stuff - shoe tying, riding a bike, jumping jacks, and I'm blanking on the name - but having trouble watching and then doing when it comes to big motor (or even fine motor) activities, it's likely a procedural processing issue in the brain that also makes reading/learning to read difficult. 

 

The Barton website hits on all this, so maybe you are up on it. But if your dd has other signs that are not reading specific it might lead you to a stronger suspicion, especially given her age and the 'she's just not ready/motivated enough' conventional wisdom that's out there. 

 

If you are at all a book geek person - I liked "Reading in the Brain" a lot - but that was more for me and my interest in what's going on in there, not really immediately helpful for the (more important!) teaching my dyslexic kid to read part!  :tongue_smilie:

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Is the CTOPP the only valid measure for dyslexia? Despite my concerns and my stated desire that they give her that, it appears that they didn't. They gave her the 21-item test, Grooved pegboard, judgment of line orientation, developmental test of visual motor integration, stroop color/word test, Woodcock-Johnson III Reading subtests, Gordon diagnostic system, WRAML-2,  and some emotional stuff like depression and anxiety scales. Should I request that they go back and do that, see someone else, or is this enough information to rule out dyslexia? They basically said that her reading is fine, but if it's because they gave her a bunch of words she's already memorized (she's a bright kid....), then I'm not sure that it was a fair assessment. I'm just not sure how to tell. Any thoughts?

 

 

There are a number of different tests that can be used to diagnose or rule out dyslexia.

 

Did they run the "Woodcock Reading Mastery Tests, Third Edition" or just administer the reading subtests of the "Woodcock-Johnson Tests of Achievement"? 

 

If they used the WRMT-III, this would cover the same areas as the CTOPP.

 

If they used the WJ-Achievement, it does include a subtest called "Word Attack", which requires the student to decode nonsense words. If your daughter did well on this subtest (along with the other reading tasks), I can see why they might not feel the need to run the CTOPP. If this is the case, though, it still might be worth having them run some kind of test of phonological processing. 

 

Where are you in the assessment process?

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There are a number of different tests that can be used to diagnose or rule out dyslexia.

 

Did they run the "Woodcock Reading Mastery Tests, Third Edition" or just administer the reading subtests of the "Woodcock-Johnson Tests of Achievement"?

 

If they used the WRMT-III, this would cover the same areas as the CTOPP.

 

If they used the WJ-Achievement, it does include a subtest called "Word Attack", which requires the student to decode nonsense words. If your daughter did well on this subtest (along with the other reading tasks), I can see why they might not feel the need to run the CTOPP. If this is the case, though, it still might be worth having them run some kind of test of phonological processing.

 

Where are you in the assessment process?

We had the initial consultation, we had a four hour eval, and I just got a letter in the mail With the doctors report. But I have no actual score data And to know details on which subtests were administered. So I think my first step might be to email the office and ask them to send me a full listing of everything that was actually done along with all of the scores. After that I might make an appointment to go in and discuss the results. Edited by 4kookiekids

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PS. We did have a developmental a vision exam, and the doctor said they were definitely flags there and things that she would be concerned need either glasses or vision therapy. But my daughter is so eager to get glasses, but the doctor is concerned her troubles with vision might have been exaggerated. So we bought glasses with clear lenses off of Amazon and they’re going to give her another vision exam next week with her new “glasses†to see if they help her vision And see if she does any differently on the vision exam.… I know it might be considered sneaky, but I don’t want to get her glasses her vision therapy if she’s just exaggerating with What she cannot see because she wants glasses.

Edited by 4kookiekids
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They sent you a letter, not an actual report?? There should have been a multi-page report and it should have had a list of the tests and some scores.

 

 

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They sent you a letter, not an actual report?? There should have been a multi-page report and it should have had a list of the tests and some scores.

It had a few scores, Like overall I Q, working memory, and processing speed. Maybe One or two others. They listed the tests, but not the subtests. They just said some subtests were given. I like specifics numbers however… :-)

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Was there a nonsense word reading section on the reading test? She wouldn't be able to have memorized nonsense words, and so if the reading test has that, then it would show up that way. I don't know enough about it to know if it would or not, but that is included on some things. They also could have a test of phonemic awareness as part of the reading test. I think google the name of the reading test and see what it includes, if it gives a list of sections or anything like that. Phonemic awareness or nonsense words would both be good things to see.

 

So the WJ-III subtests they did were Letter word identification, reading fluency, and passage comprehension. Can I rest assured she would’ve gotten flagged by those if she were dyslexic? Her scores in those areas were 31, 12, and 17 (respectively) and there is no percentile score.

Edited by 4kookiekids

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It's been a while since I looked at WJIII. Are those standar scores? I thought I remembered WJIII kicking out actual grade levels. Standard scores have mean 100, standard deviation 10 or 15, depending on the test. So figure out what you're looking at or call and ask. 

 

If those are standard scores, they look crazy low. 

 

Can you find someone who specializes in dyslexia? Even some reading tutors (Barton ,OG) will have the CTOPP and run it. They might have a different psych to refer you to. It's true there are clinical psychs who just run achievement and IQ and read everything from there, but it's not very thorough or helpful.

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No, those are raw scores. It did not give me grade levels or percentiles Or standard scores.

Edited by 4kookiekids

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We did follow up with the optometrist though, who says she does have some convergence and tracking issues. They’re going to start with glasses to help with the convergence and then in a few months see how she’s doing and probably start vision therapy then.

 

I will look up someone to actually give the CTOPP here. One other thing that I think could be affecting her reading is that her working memory scores are a full 40%ile points lower than any of her other scores.

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So the WJ-III subtests they did were Letter word identification, reading fluency, and passage comprehension. Can I rest assured she would’ve gotten flagged by those if she were dyslexic? Her scores in those areas were 31, 12, and 17 (respectively) and there is no percentile score.

 

IMO, no. The subtests administered measure her ability to read a list of words, to read sentences, and to understand passages. I think difficulties with phonological processing and decoding could easily be missed.  

 

It is very odd that the psychologist provided raw scores rather than standard scores or percentiles. Usually, raw scores are never reported to parents. 

 

I also think it's odd that they used the WJ-III (rather than the current edition, WJ-IV) and that they didn't administer a full academic achievement measure, or at least some spelling or writing measures. Perhaps this neuropsychologist doesn't usually assess for learning disabilities, and you might be better off seeking further testing from an educational/school psychologist? 

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Agreeing with Meg. The whole thing is odd. Your optom wants to do prism glasses? Why not go directly to VT? Glasses can make convergence issues WORSE. What you actually want to do, since you've found you have vision issues, is test for retained reflexes (did the eye doc? often they don't), work on the retained reflexes, then do VT. Unless the glasses are prism glasses, I wouldn't even bother. Is there a scrip needed too? 

 

My dd started with reading glasses and it made the convergence issues WORSE. Prism glasses are very expensive. That's why I'm saying you want to check through the logic of this. A slight scrip can be a tool, giving them a way to relax their eyes when they feel strained. But as far as solving convergence issues, they won't. 

 

And yeah, that's totally, totally weird to give raw scores. You have no way to interpret them, so why would they do that??

 

Maybe you need to drive farther for evals? Learning Ally (the audiobook people) have a list of tutors, psychs, etc. They self-list, so it's not like they're necessarily awesome. But they're at least people saying they know something about dyslexia. You might see if someone shows up there. Around here, I can get a reading tutor to do the CTOPP for $75 as part of an intake eval. It's fast and not affected by vision. 

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So I reached out to a place that specializes in dyslexia, even though it's an hour away. They said the same thing about the raw scores and suggested it was just an oversight and I should contact the psych office to ask for grade equivalents, age equivalents, standard scores, and/or percentiles. So I emailed the neuropsych and will see what they say.

 

The glasses script is super mild, I think. Just some basic bifocals to relax her eyes when reading (and plain glass for outside the reading area), the doc said. She asked us to come back in 8 weeks. On the off chance that it's enough, she said that it's an easy fix. She said she doesn't expect it to be enough, but she'd rather only change one variable at a time, so glasses is the first one to try, she said. I'll do some more reading on it before I follow up with her... By the time we get the glasses, there will only be 6 weeks before her follow up appointment with the eye doc. I don't think she's suggesting we not do VT at all - but she wants to see how the glasses affect her reading at least, she said, since that was our main concern.

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Yup, that's what the regular doc did with my dd. Made the convergence headaches worse and wasted time.

 

I'm just cynical about docs. Get burnt enough and you'll get cynical too. I've had so many "professionals" screw up that it's just wearisome to the bone.

 

Think about it. Your eyes have to work, pulling the eyes in, to convergence. Or does she have over-convergence? There's insufficiency (struggling to converge) and excess (over-converging). Convergence insufficiency is the more common issue, so that's what I was assuming was going on.

 

Either way, your dc probably has retained reflexes if you do the tests for them. Visual reflexes and visual midline issues develop AFTER the primitive/neonatal reflexes get integrated. So that's why you have to work on the retained reflexes for the rest of the body (ATNR, Palmer, blah blah) before you work on vision. So you're seeing the fruit problems of the tree, but you have to dig to the root.

 

So you're saying you want to see if improving the vision improves her reading? Well it might, sure. Won't change a CTOPP score, but it will help if she's fading out and not attending or not tracking well.

 

My dd's work with VT for convergence took 3 months total. The 6-8 weeks you're waiting seems like a long time. We had noticeable improvements in one month and DRAMATIC changes in 2. If you want to see what improving the convergence could do, you could just improve the convergence. It doesn't take that long.

Edited by PeterPan
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Think about it. Your eyes have to work, pulling the eyes in, to convergence. Or does she have over-convergence? There's insufficiency (struggling to converge) and excess (over-converging). Convergence insufficiency is the more common issue, so that's what I was assuming was going on.

 

Either way, your dc probably has retained reflexes if you do the tests for them. Visual reflexes and visual midline issues develop AFTER the primitive/neonatal reflexes get integrated. So that's why you have to work on the retained reflexes for the rest of the body (ATNR, Palmer, blah blah) before you work on vision. So you're seeing the fruit problems of the tree, but you have to dig to the root.

 

So you're saying you want to see if improving the vision improves her reading? Well it might, sure. Won't change a CTOPP score, but it will help if she's fading out and not attending or not tracking well.

 

My dd's work with VT for convergence took 3 months total. The 6-8 weeks you're waiting seems like a long time. We had noticeable improvements in one month and DRAMATIC changes in 2. If you want to see what improving the convergence could do, you could just improve the convergence. It doesn't take that long.

 

 

Well, this part about how quickly you saw improvements with VT is good to know!

 

I really have no idea if she's dyslexic or not. It was never on my radar until someone here mentioned it here when I posted about reading struggles, and then we took some online screenings and they flagged her, so we started pursuing it. If she's got dyslexia, then I'd like to know. If she's got issues with vision, I'd like to know. If she's got neither or both - I still want to know either way, so I'm just pursuing all my leads right now! :) So I'm still looking for someone to run the CTOPP one way or the other (just waiting for folks to respond to emails!!), but I'd be thrilled if she came back as non-dyslexic and just needed a bit of VT!

 

Her issues are with convergence excess. The doc had her face me while she'd take turns covering and uncovering one or the other eye, and you could see her eye have to pull outwards each time it was uncovered to focus on the thing in front of her. It naturally wanted to roll in more towards her nose. She did have tracking issues as well the doc said. They were't noticeable during the normal eye exam, when her eyes had to go about ten inches back and forth between things, but when the doc who did the developmental vision exam held pen tips just 2-3 inches apart, dd's eyes had a very noticeable "jump" in the middle (she showed me, and I wondered how I'd never noticed it before, except that I'd never looked for it!).

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That midline jump can indicate retained reflexes.

OK. I will read up on that, Since I have no idea what retained reflexes are, and then ask the eye doctor next time I see her! Thanks!

Edited by 4kookiekids

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Is the CTOPP the only valid measure for dyslexia? Despite my concerns and my stated desire that they give her that, it appears that they didn't. They gave her the 21-item test, Grooved pegboard, judgment of line orientation, developmental test of visual motor integration, stroop color/word test, Woodcock-Johnson III Reading subtests, Gordon diagnostic system, WRAML-2,  and some emotional stuff like depression and anxiety scales. Should I request that they go back and do that, see someone else, or is this enough information to rule out dyslexia? They basically said that her reading is fine, but if it's because they gave her a bunch of words she's already memorized (she's a bright kid....), then I'm not sure that it was a fair assessment. I'm just not sure how to tell. Any thoughts?

 

No, there are other tests of phonological processing. There's the TOPA and the PAT. I don't have enough assessment experience to give an opinion on these vs. the CTOPP.

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