DS with new IEP -- would appreciate comments on test results

[ceratops]

My DS (age 11, summer birthday so he's close to turning 12, was in grade 5 in the just-completed school year) has had various issues with school since about grade 1, and, although he has gotten OK grades throughout, I finally made a referral and asked for testing in May. I gave the school a lengthy and detailed description of my concerns. DS has a fairly recent (early 2013) diagnosis of ADHD, following an evaluation by a psychologist. Many of his organizational issues do seem to fit in with ADHD. Some other things I mentioned, which don't look so ADHDish, at least to a lay person, were his problems with reading (decoding problems; not enjoying reading on his own even though he has always loved listening to books read aloud), writing (he hates writing, avoids it like the plague, and is below grade level in writing), and trouble with sequences and rote memorization (days of the week, months of the year, finding words in a dictionary by knowing the alphabet, math facts such as multiplication table, etc.). He also seems to find it difficult to hear information when there is competing sound/noise -- e.g. always turns the TV up louder than anyone else in the family, even though he doesn't have any hearing deficit on the kind of simple test performed in the pediatrician's office. Homework is a huge problem -- takes him way too long, and is a source of a lot of conflict and stress at home. Anyway, I could go on (and did, at length, in the referral).

At the initial team meeting (the team is called a PPT here) my concerns, plus some concerns from DS's classroom teachers, were taken seriously, and the school agreed to do several tests with DS, and to try to get the whole process wrapped up before the end of the school year, so that DS would have something in place when he heads to middle school next year. Overall, the staff were helpful and concerned, although I had the impression that they thought my worries were a bit overboard. For one thing, they showed me measures of DS's classroom performance over the school year, and pointed out that he was really doing fairly well in many of the evaluations. His math teacher said DS was strong in logic, but had weaknesses in calculation and basic math facts. His classroom teacher held up a writing sample, to show his progress over the current school year -- yes, he wrote an entire paragraph, and filled up the available space on the paper (!!)  Overall, I got the impression that they were very receptive to the idea that DS was negatively affected in school by his ADHD traits. However, I thought there was a slightly dismissive vibe about the other concerns I was raising. For example, when I brought up DS's trouble with sequences, someone volunteered that lots of kids at this age don't know the months of the year, and that teachers don't worry about this as long as the kids know which are the summer months and which are the winter months. I responded that if mixing up the months were DS's only problem with sequences, I wouldn't have bothered mentioning it -- it was only one example of a more pervasive issue.

Anyway, the tone of the meeting set me off an lots of Internet reading over the next several weeks, and I eventually came upon descriptions of dyslexia, which seemed to match many of DS's characteristics. That gave me another hypothesis to think about. During this same time, the school administered tests, and we (parents) also filled out several psych rating scales (Connors, BASC), as well as completing a developmental history. DS's classroom teacher also filled out the rating scales.

Anyway, finally getting to the point of this post, here are the results of the testing done by the school.

WISC-IV   (scores and percentiles for the composite scores, just the scores for the subtests):

VCI   136   99
similarities          15
vocabulary         18
comprehension    15

PRI   104   61
block design        11
picture concepts    11
matrix reasoning    10

WMI  102  55
digit span        10
letter number sequencing    11

PSI     83   13
coding    6
symbol search    8

FSIQ was calculated at 111, but the report properly noted that this was not interpretable because of 'extreme variability between composites.'


Woodcock-Johnson III Cognitive, various subtests administered (standard score, percentile):

clusters:
long-term retrieval   87   19
auditory processing   106   66
phonemic awareness   113   81
cognitive fluency   88   20

individual subtests:
visual auditory learning   86   18
retrieval fluency   98   44
sound blending   112   80
incomplete words   107   67
auditory attention   92   30
decision speed   86   18
rapid picture naming   91   28


WJ-III Achievement (standard score, percentile)

broader categories (I think these are all composites of subtests, although the report isn't crystal clear on that):
oral language   124   no percentile given
broad reading   102   55
broad written language   87   19
broad math   96   40
academic skills       33 (percentile only, no standard score given)
academic applications      64 (percentile score)
academic fluency      15 (percentile)
math calculation skills      17 (percentile)
written expression      36 (percentile)

subtests:
story recall   119 (standard score only, no percentile given)
understanding directions   121 (standard score)
letter word identification   106   66
reading fluency   90   24
passage comprehension   105   62
spelling   81   10
writing fluency   90   26
writing samples   101   53
spelling of sounds   96 (standard score only)
sound awareness   98 (standard score)
calculation   93   32
math fluency   77   6
applied problems   107   67


I'll also mention that DS has received reading intervention repeatedly, starting in grade 2. Upon request, I was given a report describing his reading interventions over the years. His comprehension has generally been decent, but fluency has been a problem. His scores seem to show that his fluency went up following each intervention... but then another intervention is called for a year later, due to low fluency...


The BASC and Connors scales, not surprisingly, came back with elevated scores consistent with ADHD (both the inattentive and the impulsive sides).


I'll only briefly describe the follow-up PPT meeting (a meeting to discuss test results, and plan accordingly). Again, the ADHD and executive function issues got a lot of attention from the school staff. I asked if I was correct in assuming that the large spread in the WISC scores (50+ points between the highest and lowest composites) was unusual -- they agreed that it was. The summary suggested by the school psychologist was that the verbal area obviously was a strength for DS, and that this should be helpful to him. The other 3 composites were lumped together as being fairly average. I pointed out that processing speed (PSI) was over a standard deviation below the other 2 scores, and suggested that this was probably significant. They didn't disagree, but didn't offer any further insight or comments either. There was some conversation among staff as to how DS got such a good vocabulary -- independent reading in his areas of interest was suggested. I pointed out, again, that, up until the last few months, DS has never willingly read on his own, even in areas of great interest. Public television programs, and home conversation were then mentioned. All in all, it seemed that they were almost dismissing the VCI score as an outlier -- certainly useful to DS, but otherwise not all that significant.  I asked whether, in their opinions, the large spread between scores was adequately explained by ADHD -- there really wasn't much of a response to this question.

After all the tests were reviewed, as well as reviewing DS's school performance measures this year (those measures basically show he is hitting or exceeding their 'average' goals for the most part, with the exception of writing, where he has a lot of 'below basic' evals; spelling and math facts are also weaknesses), the team members agreed that DS should have an IEP next year (with goals and interventions, as well as accommodations). I won't go into the details of that for the moment. For one thing, since this whole process was done unusually quickly (squeezed in at the end of the school year), there wasn't really enough time for the team to work together on the IEP -- another meeting to revise/review the IEP is planned for the fall.


Sorry this has ended up so long... I would very much appreciate some feedback on these test results. My concern is, if DS does have some learning disabilities, concurrent with the ADHD, perhaps it is important to identify those issues, in order to better target interventions.

Another bit of information (relevant also to the other thread I started, about one of the current IEP goals -- getting DS to school on time in the morning), is the fact that he has sleep issues. He is a night owl, has trouble getting to bed at night, sometimes sleeps restlessly, and has trouble getting up in the morning. I don't think that has anything to do with test results, but just mention it so you have a more complete picture. Sleep issues was one of the key concerns mentioned by the psychologist who did testing with DS last year (the testing that came up with the ADHD diagnosis).

[bros]

1. Why did the district not provide you with all of the information necessary?
2. How are his motor skills?
3. You state that he hates writing. Ask him why he doesn't like it. Tell him that any reason is fine even if he thinks it sounds weird.
4. What does his handwriting look like?
5. It sounds like he may have dysgraphia, or something affecting the motor skills.
6. Were there any problems at or surrounding his birth?

[ceratops]

Jul 3, 2013 9:50:36 GMT -5 bros said:

1. Why did the district not provide you with all of the information necessary?
2. How are his motor skills?
3. You state that he hates writing. Ask him why he doesn't like it. Tell him that any reason is fine even if he thinks it sounds weird.
4. What does his handwriting look like?
5. It sounds like he may have dysgraphia, or something affecting the motor skills.
6. Were there any problems at or surrounding his birth?

1. Which necessary information do you think is missing? Do you mean the fact that the standard scores or the percentile rank were not given for some of the WJ-III Achievement tests? That may have been because the person administering that particular test had some distractions while preparing the report (family issue which, very justifiably IMO, demanded her attention). As I've mentioned, the school staff were really trying hard to get all this work done in about 30 days, which, as far as I understand, is unusually quick turnaround on this process.

2. Motor skills seem normal (gross and fine). He's not an outstanding athlete or anything (not the greatest at catching and throwing balls, for example), but there are no glaring motor issues.

3. All aspects of writing cause misery. Planning, organizing, physically putting text on paper, spelling, editing and revising. DS much prefers to write on the computer now (use of keyboard alleviates problems with the act of writing, and spell check helps somewhat with spelling problems). It also helps if he can dictate (he talks and I type).

4. Handwriting is messy but legible (not a total disaster, at least in my non-professional opinion). Technical details like capitals at the start of sentences, and punctuation, are forgotten more often than not. DS himself thinks that his writing is messier than that of many of his classmates.

5. Maybe. Again, haven't noticed motor troubles in general. No specific testing was done in that area. DS was very late to choose a dominant hand (after age 6), in case that is relevant.

6. Normal, full term pregnancy; healthy baby; no particular illnesses in early infancy.

[michellea]

Quick observations and questions-

Does the report indicate whether the WJ tests are based on grade norms or age norms?
What areas does your son enjoy in school, what areas does he struggle?
Could share the BASC results?
Did they conduct reading tests beyond what you posted? How about in the past when they began the reading services?
Did the TEAM discuss any assistive technology at the meeting? Things like keyboarding for written responses, on line graphic organizers, text to voice software such as Kurzwiel?
When your son speaks, does he sometimes have difficulty finding the word he is looking for?
How are his handwriting skills?
What goal areas are included on the IEP?

Observations -
Looks like your very bright son has fairly significant glitches in his processing speed. Although this thinking ability is very strong, the pace in which he takes in and spits out information is much slower. My son is very similar - and the slower processing can be very frustrating. Think about having a high powered Ferrari engine, stuck in morning rush hour traffic...

I think this is part of the difficult with his ability to quickly and accurately recall rote information such as math facts and even reading at a fluent pace. You see this in the subtests that are timed and have anything to do with fluency. My guess is that it takes him longer to do things, and he probably poops out by the end of the school day.

It looks like your son has a language based learning disability that affects his ability to read (decode and read fluently), write and spell. Some of the issues spill over to math - especially when the complexity increases, rote recall is needed and there are time constraints. In any subject that requires writing to demonstrate his knowledge, I bet he struggles - compared to when he can engage in a discussion or do a project.

When you add the ADHD on to the language, you probably have a student that struggles with pulling together all of his skills and working to what his teachers see as his potential.

There are accommodations and modifications that can help your son navigate the school day more easily AND learn the strategies he needs to overcome his weaknesses. I would be interested in hearing more about his IEP, the answers to the questions I posed and the types of support he has had in the past. He absolutely could be successful - but as he heads into middle school and high school, it will be critical that he has a strong IEP to help him become a more active learner.

BTW - your concern about sequencing is a very important observation. People w/ Dyslexia very often have trouble with the days of the week, months of the year etc. I do think it is a red flag of an underlying LD in addition to the ADHD. How long did it take for him to learn his telephone number? Did he have a difficult time dialing the phone? My profoundly dyslexic son had trouble with all of this. (if you asked him what month comes after June, he would have to start at January and recite each month until he got to July. AND sometimes, he would (and still does) mess along the way).

[healthy11]

Your son's elevated scores for inattention and impulsivity likely mean he's dealing with the "Combined Type ADHD," which is the most common. My son also has ADHD Combined Type, as well as dyslexia and dysgraphia (specific learning disabilities in reading and writing, to use "school terminology.") Your description of your son's sloppy writing and reading avoidance doesn't surprise me at all. Even the math teacher saying DS was strong in logic, but had weaknesses in calculation and basic math facts can be explained by difficulties in having to write out steps to solve a problem, and not paying attention to things like sign changes, etc.

In case you didn't know, the PSI subtests on the WISC are both "pencil to paper" portions of the test.
• Coding - children under 8 mark rows of shapes with different lines according to a code, children over 8 transcribe a digit-symbol code. Time-limited with bonuses for speed.
• Symbol Search - children are given rows of symbols and target symbols, and asked to mark whether or not the target symbols appear in each row.

It would be helpful for your son to be evaluated using the TOWL (Test of Written Language), since it is considered a better indicator for identify writing issues than the WJ.

I'm not sure if you've ever heard the term "2e" or "twice exceptional," but given your son's strong verbal scoring on the WISC, you might want to look at some of the information I've compiled at millermom.proboards.com/thread/9972/twice-exceptional-gifted-adhd-resources

[momfromma]

OK, I' ll jump.

Aside the ADHD issues that you were already aware off, what strikes me is the difference between the Perceptual Score and the Verbal score, as well as the WJIII Cognitive on the same topic which is lower. Given these results, it is not necessarily surprising that the PSI is low, because it is also a highly visual task.

I think the most urgent is to have an OT eval to see what are the issues there.

Have you ever been told about NVLD or NLD. You may want to look into it as well. www.nldontheweb.org.

Other than that, obviously, a lot of things look like ADHD, but I seriously would have an eval by somebody familiar with non verbal disorders. There are a lot of people who can talk about this better than I can, so I hope they will chime in this thread.

[SharonF]

ceratops--

You've got a good understanding of what's going on.

As you probably know, ADHD is not a behavior disorder. It's a cognitive processing disorder due to a chemical imbalance in the brain. Research shows that in ADHDers, there is a shortage of chemicals (neurotransmitters) used to transmit messages from one brain cell to the next. Clinical research repeatedly shows the levels of dopamine and norepinephrine are lower in the brains of ADHDers than the levels of people who do not have ADHD. Also in some ADHDers, the protein that the neurotransmitters use to travel on is in short supply. The result: in people with ADHD, many messages being passed from brain cell to brain cell often disappear on the journey.

This is important (to me, anyway!) because it explains why willpower isn't enough to control ADHD. Or that behavior issues associated with ADHD are simply the visible part of the ADHDer's largely invisible struggle.

Your son's low scores in Processing Speed (WISC) and the various measures of fluency tell me your son is probably struggling with the "invisible" cognitive processing issues caused by ADHD.

The AWOL brain neurotransmitters can cause huge problems with the ADHDer's working memory, recall and application of learned information, sequencing, attention, organization and what's commonly called executive function.

But looking at his scores, I'm guessing there's more to it than ADHD alone. Like michellea said, there are some signs of language processing issues. (See a pattern with the word "processing"?)

Writing difficulty (written expression, not necessarily penmanship) are very, very common in people with ADHD. Compared with other academic tasks, written expression requires more aspects of the brain and body to work together smoothly.

Looking at his verbal/language abilities, there is some big scatter. Some of that might be explained by the early intervention he received in reading. With Phonemic Awareness at 113, Sound Blending at 112 and Letter-Word ID at 106, he's good at those fundamental skills, at least in isolation.

Schools have found that providing solid instruction in sound-symbol association and phonics can help many struggling readers become good readers. But the harsh reality is that, for many, it is not enough.

Your son's Sound Awareness (98), Spelling of Sounds (96) Rapid Picture Naming (91) and Visual-Auditory Learning (86) indicate his basic reading ability may not be as strong as believed. Especially when compared to his Verbal Comprehension Index (WISC).

I'm guessing that his processing speed is slower than his brain's ability to "read" the letters or words. When he has to read for very long or has to read something complex, his brain gets overwhelmed and shuts down. That's probably why he doesn't like to read.

Another interesting comparison. His Vocab on the WISC is one point below the highest score possible. But his Rapid Picture Naming is relatively low, given some of his other scores. I realize they are two different subtests from two very different tests. But it makes me wonder. If someone gives him a vocabulary word, he may be able to quickly define what it means. But if he sees a picture of something, it takes him a little longer to recall the name of that object. That may be very important. Lower-than-expected Rapid Naming scores are often a sign of language processing problems. For me, Rapid Naming can be a "canary in the coal mine" when the other test results are not consistent.

You didn't mention how he's doing in math. But based on his WJ-Ach, I'm guessing math can be difficult and is becoming more so. He was probably able to get by when he was doing just an isolated skill at a time. But like reading, math is getting harder by 5th grade. If his math fluency and memorization of key math facts are not solid, he may start to have bigger problems in math.

My advice: push for an IEP as Other Health Impaired (OHI) due to ADHD. OHI can cover any learning issues. Not all IEPs cover all learning issues. Then develop goals and strategies around each area of weakness. The weaknesses (as I see them) include reading fluency, spelling, written expression and math fluency. Sometimes goals in organization and self-advocacy can help kids like this.

One last thought: we often use the term "dyslexia" on this board. And it's commonly used in society and on the web. BUT--be careful using it at an IEP meeting. There is no IEP category for dyslexia. Most of my kids' teachers had misguided understandings of what dyslexia is and is not. I learned the hard way not to ever say "dyslexia" at an IEP meeting. I used the term "Language Processing Disorder." Or to describe the specific difficulty my kids were having.

I hope this is helpful. It sounds like your son's school cares and is trying to work with you. That is huge!!

[SharonF]

momfromma--

Good point about Nonverbal Learning Disorder. I toyed with mentioning that. Some red flags I see that might indicate NLD: he appears to be an auditory learner, stronger verbal than performance (not always an indicator of NLD but worth exploring), low-end math achievement scores and the low Processing Speed which I attributed to his ADHD but could be caused by fine motor problems or both.

Reasons I didn't mention NLD: he doesn't like to read, doesn't read on his own, doesn't like to write and has relatively weak rapid naming. His VCI was pushed up, in large part, by his high vocab score. His day-to-day output in school does not match his VCI. So that makes me wonder about the depth and breadth of his language processing skills.

Another thought: he may be a "bits and pieces" kid like my daughter.

ceratops: my dd was diagosed with ADHD-inattentive, Nonverbal Learning Disability (significantly affecting math, abstract reasoning and fine motor), Auditory Processing Disorder (affecting auditory learning, competing sounds, attention) and Language Processing Disorder (affecting reading comprehension.)

That's a hodge-podge list of often opposite diagnoses. Because of that, she didn't fit the textbook case for any of the disorders. And we had to fight like mad to even get her qualified for an IEP. But you should be aware that some kids do have bits and pieces of several different diagnoses.

The eval scores for these kids are scattered and sometime baffling. Kind of like blind men touching different parts of an elephant, experts looking at the eval scores see what they are trained to see. Some might focus on the ADHD. Some might focus on the reading. Others might focus on fluency. The key is finding someone (or someones) who can see the whole child, not just through the lens of a single diagnosis or single IEP category.

[bros]

Jul 3, 2013 12:14:54 GMT -5 ceratops said:

Jul 3, 2013 9:50:36 GMT -5 bros said:

1. Why did the district not provide you with all of the information necessary?
2. How are his motor skills?
3. You state that he hates writing. Ask him why he doesn't like it. Tell him that any reason is fine even if he thinks it sounds weird.
4. What does his handwriting look like?
5. It sounds like he may have dysgraphia, or something affecting the motor skills.
6. Were there any problems at or surrounding his birth?

1. Which necessary information do you think is missing? Do you mean the fact that the standard scores or the percentile rank were not given for some of the WJ-III Achievement tests? That may have been because the person administering that particular test had some distractions while preparing the report (family issue which, very justifiably IMO, demanded her attention). As I've mentioned, the school staff were really trying hard to get all this work done in about 30 days, which, as far as I understand, is unusually quick turnaround on this process.

2. Motor skills seem normal (gross and fine). He's not an outstanding athlete or anything (not the greatest at catching and throwing balls, for example), but there are no glaring motor issues.

3. All aspects of writing cause misery. Planning, organizing, physically putting text on paper, spelling, editing and revising. DS much prefers to write on the computer now (use of keyboard alleviates problems with the act of writing, and spell check helps somewhat with spelling problems). It also helps if he can dictate (he talks and I type).

4. Handwriting is messy but legible (not a total disaster, at least in my non-professional opinion). Technical details like capitals at the start of sentences, and punctuation, are forgotten more often than not. DS himself thinks that his writing is messier than that of many of his classmates.

5. Maybe. Again, haven't noticed motor troubles in general. No specific testing was done in that area. DS was very late to choose a dominant hand (after age 6), in case that is relevant.

6. Normal, full term pregnancy; healthy baby; no particular illnesses in early infancy.

Look into getting him an OT eval, such as the Beery Buktenica, Wold Sentence Copying Test, and the TOWL

[ceratops]

Thank you to all who have posted so far, and I hope more people may yet chime in. I'll start responding to additional questions that have been asked, but may not be able to get to everything in one sitting.

Also, I'm not sure how to do multiquote on this forum (i.e. quoting and answering several posts at once) ?

Jul 3, 2013 13:11:55 GMT -5 healthy11 said:

Your son's elevated scores for inattention and impulsivity likely mean he's dealing with the "Combined Type ADHD," which is the most common. My son also has ADHD Combined Type, as well as dyslexia and dysgraphia (specific learning disabilities in reading and writing, to use "school terminology.") Your description of your son's sloppy writing and reading avoidance doesn't surprise me at all. Even the math teacher saying DS was strong in logic, but had weaknesses in calculation and basic math facts can be explained by difficulties in having to write out steps to solve a problem, and not paying attention to things like sign changes, etc.

In case you didn't know, the PSI subtests on the WISC are both "pencil to paper" portions of the test.
• Coding - children under 8 mark rows of shapes with different lines according to a code, children over 8 transcribe a digit-symbol code. Time-limited with bonuses for speed.
• Symbol Search - children are given rows of symbols and target symbols, and asked to mark whether or not the target symbols appear in each row.

It would be helpful for your son to be evaluated using the TOWL (Test of Written Language), since it is considered a better indicator for identify writing issues than the WJ.

I'm not sure if you've ever heard the term "2e" or "twice exceptional," but given your son's strong verbal scoring on the WISC, you might want to look at some of the information I've compiled at millermom.proboards.com/thread/9972/twice-exceptional-gifted-adhd-resources

Yes, he scores clinically significant for the combined type ADHD.

I've been doing a LOT of reading in the last month or so, and had come across some of these descriptions regarding WISC subtests. I've also been reading (since seeing DS's test results) about the 2e world, and have already read the thread you mention with rapt attention . Thank you for listing all those references, and thanks to the other posters who added further relevant information to the thread!

Regarding TOWL, at the last PPT meeting, I did ask if it would be worthwhile to do some additional diagnostic testing of DS's writing, with a view to getting a closer look at his difficulties, as well as establishing a baseline that would allow measurement to see if IEP goals were being met in the future. The school staff all shook their heads -- they clearly saw no need for further testing. I guess they were satisfied by the combination of the WJ-III and their own in-house measures of writing performance (e.g. the 'writing prompts' that all the kids have to do several times each school year). I let it go for the moment, but still had it in the back of my mind. Hearing several people here suggest the TOWL as a logical additional test is interesting. I realize (from the reading I've been doing) that WJ-III is not considered a great test of writing, since it requires fairly short responses. DS's writing difficulties are definitely worse with longer and more complex writing tasks.

[ceratops]

Jul 3, 2013 13:24:09 GMT -5 momfromma said:

OK, I' ll jump.

Aside the ADHD issues that you were already aware off, what strikes me is the difference between the Perceptual Score and the Verbal score, as well as the WJIII Cognitive on the same topic which is lower. Given these results, it is not necessarily surprising that the PSI is low, because it is also a highly visual task.

I think the most urgent is to have an OT eval to see what are the issues there.

Have you ever been told about NVLD or NLD. You may want to look into it as well. www.nldontheweb.org.

Other than that, obviously, a lot of things look like ADHD, but I seriously would have an eval by somebody familiar with non verbal disorders. There are a lot of people who can talk about this better than I can, so I hope they will chime in this thread.

Thank you for taking the time to comment!

I noticed the rather large difference between VCI and PRI (32 points) and wondered about that. That did lead me to do a little reading about NVLD, but a number of the described characteristics didn't really seem to fit DS, so I didn't read very much. And, I confess, I don't even remember now why I thought it didn't fit... duhhh -- my memory ain't what it used to be... On your suggestion, I will take another look. Thanks!

[ceratops]

Jul 3, 2013 14:00:53 GMT -5 SharonF said:

ceratops--

You've got a good understanding of what's going on.

As you probably know, ADHD is not a behavior disorder. It's a cognitive processing disorder due to a chemical imbalance in the brain. Research shows that in ADHDers, there is a shortage of chemicals (neurotransmitters) used to transmit messages from one brain cell to the next. Clinical research repeatedly shows the levels of dopamine and norepinephrine are lower in the brains of ADHDers than the levels of people who do not have ADHD. Also in some ADHDers, the protein that the neurotransmitters use to travel on is in short supply. The result: in people with ADHD, many messages being passed from brain cell to brain cell often disappear on the journey.

This is important (to me, anyway!) because it explains why willpower isn't enough to control ADHD. Or that behavior issues associated with ADHD are simply the visible part of the ADHDer's largely invisible struggle.

Your son's low scores in Processing Speed (WISC) and the various measures of fluency tell me your son is probably struggling with the "invisible" cognitive processing issues caused by ADHD.

The AWOL brain neurotransmitters can cause huge problems with the ADHDer's working memory, recall and application of learned information, sequencing, attention, organization and what's commonly called executive function.

But looking at his scores, I'm guessing there's more to it than ADHD alone. Like michellea said, there are some signs of language processing issues. (See a pattern with the word "processing"?)

Writing difficulty (written expression, not necessarily penmanship) are very, very common in people with ADHD. Compared with other academic tasks, written expression requires more aspects of the brain and body to work together smoothly.

Looking at his verbal/language abilities, there is some big scatter. Some of that might be explained by the early intervention he received in reading. With Phonemic Awareness at 113, Sound Blending at 112 and Letter-Word ID at 106, he's good at those fundamental skills, at least in isolation.

Schools have found that providing solid instruction in sound-symbol association and phonics can help many struggling readers become good readers. But the harsh reality is that, for many, it is not enough.

Your son's Sound Awareness (98), Spelling of Sounds (96) Rapid Picture Naming (91) and Visual-Auditory Learning (86) indicate his basic reading ability may not be as strong as believed. Especially when compared to his Verbal Comprehension Index (WISC).

I'm guessing that his processing speed is slower than his brain's ability to "read" the letters or words. When he has to read for very long or has to read something complex, his brain gets overwhelmed and shuts down. That's probably why he doesn't like to read.

Another interesting comparison. His Vocab on the WISC is one point below the highest score possible. But his Rapid Picture Naming is relatively low, given some of his other scores. I realize they are two different subtests from two very different tests. But it makes me wonder. If someone gives him a vocabulary word, he may be able to quickly define what it means. But if he sees a picture of something, it takes him a little longer to recall the name of that object. That may be very important. Lower-than-expected Rapid Naming scores are often a sign of language processing problems. For me, Rapid Naming can be a "canary in the coal mine" when the other test results are not consistent.

You didn't mention how he's doing in math. But based on his WJ-Ach, I'm guessing math can be difficult and is becoming more so. He was probably able to get by when he was doing just an isolated skill at a time. But like reading, math is getting harder by 5th grade. If his math fluency and memorization of key math facts are not solid, he may start to have bigger problems in math.

My advice: push for an IEP as Other Health Impaired (OHI) due to ADHD. OHI can cover any learning issues. Not all IEPs cover all learning issues. Then develop goals and strategies around each area of weakness. The weaknesses (as I see them) include reading fluency, spelling, written expression and math fluency. Sometimes goals in organization and self-advocacy can help kids like this.

One last thought: we often use the term "dyslexia" on this board. And it's commonly used in society and on the web. BUT--be careful using it at an IEP meeting. There is no IEP category for dyslexia. Most of my kids' teachers had misguided understandings of what dyslexia is and is not. I learned the hard way not to ever say "dyslexia" at an IEP meeting. I used the term "Language Processing Disorder." Or to describe the specific difficulty my kids were having.

I hope this is helpful. It sounds like your son's school cares and is trying to work with you. That is huge!!

Thank you so much for the insightful comments!

Regarding math, he generally does OK, and usually says he likes math. Calculation (basic number facts) is a misery, and he still counts on his fingers when doing addition or subtraction. He still is unable to come up with many of the facts from the multiplication table. And you are right about the skills in isolation thing. If DS is given a set of problems which call for review and application of the relevant skills from various previous areas of study, he gets frustrated and even angry -- he doesn't know which study 'unit' each problem is supposed to be from and has trouble bringing the relevant skill to bear. Learning new skills is also often a real struggle. He often resists learning something new (at least when I try to go over the new skill with him at home, while helping him with homework).

Regarding reading, I do have the feeling that the various interventions have helped, but that DS continues to be a slow and inefficient reader. The rest of the team members were apparently not concerned with DS's reading at the moment, probably because his most recent fluency scores looked passable (right after the most recent reading intervention) and his comprehension is generally good. However, when I see him reading the assigned language art books at home, it is a slow and painful process, even when he likes the book in question. I know, for example, that DS never finished at least 4 of the books assigned this year, and that's even with me reading parts of the book out loud to him as nightly bedtime reading. I had the impression that his classroom teacher was unaware of this (I didn't get a chance to talk about this during the PPT meeting, though, so never got her take on it). The other weird thing, of course, is this RTI model that helps guide the thinking of the school staff -- as was explained to me, since DS has responded to reading interventions in the past, one must therefore conclude that he doesn't need reading help as an element of his IEP... Did I really understand that correctly? At least there is a note in the IEP that I (as the student's parent) remain concerned about DS's reading and reading fluency. Hopefully we'll get another chance to talk about reading when the IEP is reviewed next fall.

I had heard of this attitude toward the word 'dyslexia' and was cautious about using it with the school people. I did mention dyslexia as a concern in an email to the school psychologist, and it was pretty clear this wasn't going to lead to fruitful discussion, so I said I was happy to use whatever terms they preferred to describe DS's problems.

Oh, the IEP we now have is indeed based on OHI -- ADHD. The ADHD was clearly the only issue the school people were willing to pull out of the information they currently have about DS.

[ceratops]

Jul 3, 2013 14:41:52 GMT -5 bros said:

Jul 3, 2013 12:14:54 GMT -5 ceratops said:

Look into getting him an OT eval, such as the Beery Buktenica, Wold Sentence Copying Test, and the TOWL

Thank you.

Several people here have now suggested OT eval... interesting...

Are Beery Buktenica and the Wold test both considered part of an OT eval?

How would I (in a non-ideal world) get these tests done?

[ceratops]

Jul 3, 2013 14:23:33 GMT -5 SharonF said:

...

Another thought: he may be a "bits and pieces" kid like my daughter.

ceratops: my dd was diagosed with ADHD-inattentive, Nonverbal Learning Disability (significantly affecting math, abstract reasoning and fine motor), Auditory Processing Disorder (affecting auditory learning, competing sounds, attention) and Language Processing Disorder (affecting reading comprehension.)

That's a hodge-podge list of often opposite diagnoses. Because of that, she didn't fit the textbook case for any of the disorders. And we had to fight like mad to even get her qualified for an IEP. But you should be aware that some kids do have bits and pieces of several different diagnoses.

The eval scores for these kids are scattered and sometime baffling. Kind of like blind men touching different parts of an elephant, experts looking at the eval scores see what they are trained to see. Some might focus on the ADHD. Some might focus on the reading. Others might focus on fluency. The key is finding someone (or someones) who can see the whole child, not just through the lens of a single diagnosis or single IEP category.

How does one find such a someone?  I'm not even sure where to start looking. Certainly the school staff, well meaning as they are (and I know we are lucky to have that helpful attitude from them), do not seem qualified to see the whole picture. Heck, they don't even seem particularly interested in looking for the whole picture.

[ceratops]

Jul 3, 2013 12:27:10 GMT -5 michellea said:

Quick observations and questions-

Does the report indicate whether the WJ tests are based on grade norms or age norms?
What areas does your son enjoy in school, what areas does he struggle?
Could share the BASC results?
Did they conduct reading tests beyond what you posted? How about in the past when they began the reading services?
Did the TEAM discuss any assistive technology at the meeting? Things like keyboarding for written responses, on line graphic organizers, text to voice software such as Kurzwiel?
When your son speaks, does he sometimes have difficulty finding the word he is looking for?
How are his handwriting skills?
What goal areas are included on the IEP?

Observations -
Looks like your very bright son has fairly significant glitches in his processing speed. Although this thinking ability is very strong, the pace in which he takes in and spits out information is much slower. My son is very similar - and the slower processing can be very frustrating. Think about having a high powered Ferrari engine, stuck in morning rush hour traffic...

I think this is part of the difficult with his ability to quickly and accurately recall rote information such as math facts and even reading at a fluent pace. You see this in the subtests that are timed and have anything to do with fluency. My guess is that it takes him longer to do things, and he probably poops out by the end of the school day.

It looks like your son has a language based learning disability that affects his ability to read (decode and read fluently), write and spell. Some of the issues spill over to math - especially when the complexity increases, rote recall is needed and there are time constraints. In any subject that requires writing to demonstrate his knowledge, I bet he struggles - compared to when he can engage in a discussion or do a project.

When you add the ADHD on to the language, you probably have a student that struggles with pulling together all of his skills and working to what his teachers see as his potential.

There are accommodations and modifications that can help your son navigate the school day more easily AND learn the strategies he needs to overcome his weaknesses. I would be interested in hearing more about his IEP, the answers to the questions I posed and the types of support he has had in the past. He absolutely could be successful - but as he heads into middle school and high school, it will be critical that he has a strong IEP to help him become a more active learner.

BTW - your concern about sequencing is a very important observation. People w/ Dyslexia very often have trouble with the days of the week, months of the year etc. I do think it is a red flag of an underlying LD in addition to the ADHD. How long did it take for him to learn his telephone number? Did he have a difficult time dialing the phone? My profoundly dyslexic son had trouble with all of this. (if you asked him what month comes after June, he would have to start at January and recite each month until he got to July. AND sometimes, he would (and still does) mess along the way).

Thank you for your comments! Your description of DS's likely troubles is really on the mark -- kind of spooky.

Yes, it took him forever to learn his phone number. The 'start at the beginning and go through the whole list' approach is exactly how DS looks up words in the dictionary -- for each letter in turn, he chants the 'A B C D' song under his breath to figure out where that letter goes, compared to the matching letter in the two guide words on the dictionary page. It is painful to watch. I really couldn't believe that the school staff people didn't think this was indicative of SOMETHING -- quite a lack of curiosity on their part.

I will answer your specific questions later (running out of time at the moment)...

[dihicks6]

As far as requesting more evals, you are well within your rights to do so. Couple of ways to handle it; you can write an email to the sped chairperson, explain what you want and why (testing must be done in ALL areas of suspected disability) and specifically request the evals you want. In that letter/email, you can also include some wording regarding requesting an IEE (independent educational evaluation) if that is the only option left to you (translated means either they do the additional testing or you disagree with their results, (as incomplete), and request the IEE). Post if you need/want help writing the letter/email. They'll get the message....

[bros]

Jul 3, 2013 18:38:40 GMT -5 ceratops said:

Jul 3, 2013 14:41:52 GMT -5 bros said:

Look into getting him an OT eval, such as the Beery Buktenica, Wold Sentence Copying Test, and the TOWL

Thank you.

Several people here have now suggested OT eval... interesting...

Are Beery Buktenica and the Wold test both considered part of an OT eval?

How would I (in a non-ideal world) get these tests done?

I would suggest requesting that the district perform one ASAP, then get an IEE from an OT

[healthy11]

On the topic of tests, the GORT (Gray Oral Reading Test) is considered one of the better ones to look at various reading components (rate, fluency, accuracy, and comprehension.) Like your son, mine had reasonable comprehension, but his rate, accuracy, and fluency were poor (5th to 25th percentile.) That "flies in the face of logic" to most educators, who assume a student needs to have decent decoding and basic skills before they can comprehend well, but many "2e" kids seem to display uneven/unexpected performances compared to "the norm." My son NEVER liked reading books "for fun," (Legos were his only "fun" thing to do when he was your son's age) but one of his evaluators commented that shorter-length articles/magazines, particularly on non-fiction topics that interested him, along with listening to TV, etc. were still helping to develop his strong vocabulary, and so we should encourage that, and not expect him to "be like all the other kids." To this day, he prefers reading articles on his computer about cars and science (his favorite subjects) and he turned those interests into an engineering major in college, but he STILL CAN'T easily tell you the order of all the calendar months!

[empeg1]

Your ds is a very bright child. And, his cognitive profile is one of peaks and valleys. It looks like there are issues of storage and retrieval of information, affecting fluency across subject areas. Given his very, very strong VCI scores, I would look at some of the academic scores and make the point that your child can also qualify as a child with a specific learning disability. Take a look at his math scores, a very low fluency score and still quite discrepant calculation score when looking at that 136 VCI score. I wish the assessment took a closer look at memory, like with the WRAML and the writing subtests of the Woodcock-Johnson are not a good sample of what is expected in the classroom for writing. I would like to see the Test of Written Language given to your ds. And, it looks like he is strongly an auditory learner. Yes, rapid naming is often associated with language based learning disabilities, but your ds has difficulty with fluency across the board. I suspect difficulty with association and retrieval of symbols, numbers and letters, hence the poor retrieval difficulties across the board. BTW, retrieval difficulties can make writing quite difficult.

Interesting that your ds has difficulty getting up in the morning. He many have difficulty with sensory integration, i.e., difficulty filtering out noise, which can also be associated with sleep difficulties. My youngest has long standing sleep problems for which melatonin did not work. Like your ds, she has difficulty falling and staying asleep. Theanine, thank you, Jisp, has been more helpful than anything to relax her enough to sleep. I am also wondering if your dd's difficulty in sequencing information might also be present in sequencing actions, as in getting ready in the morning. Does your ds show any difficulty in motor planning? My oldest, for instance, struggled for years to lear to type and even to learn the sequence of actions to dial phone numbers.

For one, I would make sure that your ds has a clear accommodation on his IEP. This is a very bright child. No way should retrieval issues slow him down in math. He gets to use a calculator (which is what we are all doing anyway). it is his math thinking that needs to be fostered. Your son also needs work on reading fluency. And, written language should be addressed now, as the demand for writing goes way up in middle school. There are strategies for writing that can be taught for a child who has retrieval and organizational difficulties. My oldest was taught to use a tape recorder, which she used to talk an essay before she wrote it. She was extremely articulate. A program called Inspiration may also be helpful or Kid Inspiration. Today, assistive technology can also help your ds. And, maybe this summer he can learn to type? Make sure he gets to use a program in which the speed can be turned down. Watch what he does to see if you notice motor planning difficulties. If your son likes to listen to books on tape, go for it and then give him a book to read along with the tape. Finally, a program called Making Math Real might be a very good match for your ds- it uses language along with other cueing to teach math facts, operations and concepts.

Finally, routine that does not vary in the morning may help your ds. The backpack must be ready and set by the front door before he goes to bed. All clothes, shoes, etc are selected the night before and are left out in plain view, ready to be put on. You may need to wake your little ones a bit early and get them ready then sit them down to watch a short TV program. At that time, turn your attention to your son, to get him ready.

What does your ds like to do? If school is hard for him, it is as important that he gets to pursue his interests and an activity in which he can excel as any remediation he may get. Finally, if your family can afford to do so, hire a learning specialist to work with your ds 1:1 outside of school. Your son has an unusual cognitive and learning profile-one that will not fit the often one size fits all Resource programs at school. That and the relationship between a specialist and a child can go a long way to make academic tasks more palatable, especially if the specialist can adapt what he/she does specifically to your ds. The above is far more likely to occur in a 1:1 situation. Finally, do impress upon your ds that he is very bright. Sometimes it is how our brains process and store information that can make learning hard but that does not mean that our brains are not smart about thinking!

[ceratops]

Jul 3, 2013 12:27:10 GMT -5 michellea said:

Quick observations and questions-

Does the report indicate whether the WJ tests are based on grade norms or age norms?
What areas does your son enjoy in school, what areas does he struggle?
Could share the BASC results?
Did they conduct reading tests beyond what you posted? How about in the past when they began the reading services?
Did the TEAM discuss any assistive technology at the meeting? Things like keyboarding for written responses, on line graphic organizers, text to voice software such as Kurzwiel?
When your son speaks, does he sometimes have difficulty finding the word he is looking for?
How are his handwriting skills?
What goal areas are included on the IEP?
...

Does the report indicate whether the WJ tests are based on grade norms or age norms?
I asked about this specifically, and the tests are all based on age norms. This isn't clearly stated on the reports, though -- kind of odd IMO not to include that information. DS is older than most of his classmates -- we delayed his start in Kindergarten by a year, as we thought he wasn't ready, socially or academically. It's interesting that those early concerns probably correlate to the difficulties he still experiences. We still think that delaying his start at public school was a good idea; however, it clearly wasn't a panacea.

What areas does your son enjoy in school, what areas does he struggle?
DS likes science and technology, and has done well in these areas. Science teacher commented (at first PPT meeting) that DS is much more comfortable giving his answers verbally, and that having to write answers, even short ones, slows him down. He has wide background knowledge and high interest in science. He also enjoys social studies, with the exception of the writing assignments. Math is an area that he sometimes enjoys and sometimes complains about, depending on the topic. His math scores sort of reflect this -- lots of ups and downs in his scores over the year. Language arts is his least favorite academic subject, and he struggles with all kinds of writing assignments. Not very enthused about doing the assigned reading either. For spelling, he does OK on the weekly tests, but continues to spell badly when writing. As for other subjects, he enjoys music and art (not highly talented in these areas, as far as we see, but he enjoys those activities); he does not like phys ed class. Outside school, DS loves to take things apart to see how they work. He is very interested in technology, machinery, electronics, and computers. He also enjoys gardening. Several people in this thread have suggested possible motor problems. Maybe I'm not understanding what this means exactly, but it doesn't jibe with how DS takes things apart, and, in general, puts them back together successfully. He is not an inspired tinkerer (like his father), but he does well with mechanical stuff. I would also say that he is a hands-on learner.

Could share the BASC results?
Unless you really think it's necessary to give all the numbers (?), I'll quote from the summary in the report. "D is currently exhibiting high levels of problem behavior and low levels of adaptive behavior in both the home and school settings... Ms. M [teacher] reported that D exhibits behavior in the At-Risk range in most areas and in the Clinically Significant range in Atypicality and Withdrawal. Adaptive behavior seems to be a particular area of concern, as all adaptive scales are elevated... [parents] also observe behaviors of concern in several areas, some of which differ from those reported in the school environment. While his parents report higher levels of Hyperactivity, Aggression, and Attention Problems, they do not observe concerns in the areas of Withdrawal and Leadership..."

Did they conduct reading tests beyond what you posted? How about in the past when they began the reading services?
No other reading tests were done as part of the evaluation. The summary report prepared by the reading specialist (summarizing DS's history since Kindergarten) did contain some test information. I'll describe the tests done during the most recent school year, in case that's useful. DAZE (Dibels Comprehension Measure) Universal Assessment -- he scored 9 in September 2012 ('intensive support' category), 9 again in December, and 19 in May 2013 ('strategic support'). There are also scores for DORF (Dibels Oral Reading Fluency Measure) Universal Screen. In September DS had WPCM numbers of 82, 101, 118 (3 different stories), with 50%ile goal at 110. His accuracy ranged from 90% - 94%. In December his WCPM numbers were 91, 113, 84 (goal was 127) with accuracy 97% - 99%. In May, his numbers were 155, 146, 135 (goal was 139) with 99% accuracy. During the team meeting, people were scratching their heads over the big change from December to May. Another thing that was actually confusing in that regard was that one of the tests done as part of DS's evaluation in response to referral (in other words, a test done in early June) involved having DS read a story and write some responses to questions. Come to think of it, this test wasn't included in any of the written reports, but was described verbally by the tester during the meeting -- she timed DS at 113 WCPM (goal was 130). So, there he was with lower fluency again...

Did the TEAM discuss any assistive technology at the meeting? Things like keyboarding for written responses, on line graphic organizers, text to voice software such as Kurzwiel?
As I've mentioned, the team, unfortunately, did not have much time to work on the IEP together. Most of the time at our second meeting was taken up with reviewing test results and academic performance. Then there was talk about whether the circumstances called for an IEP (all team members agreed they did), and under what classification. We talked about placement, and briefly about accommodations. We did, at some point, talk about the fact that DS much prefers to do his writing on the computer (i.e. keyboard entry) when given the choice, and access to computers is one of the accommodations mentioned in the IEP. 'Graphic Organizer' is another thing mentioned under accommodations; I didn't even know what that meant, until I asked one of the school staff during a later conversation we had to review the draft IEP. There was no mention of speech-to-text AT. I did mention in the referral that DS does better with writing when he can dictate (I type at the keyboard while he talks). However, you said text-to-voice, not speech-to-text -- do you mean the type of software that reads on-screen text aloud to the computer user? If so, that was not discussed either.

When your son speaks, does he sometimes have difficulty finding the word he is looking for?
I don't really have that impression. I'll have to listen more closely, to see if there are any such problems. If there are, they probably aren't blatant. DS often talks a mile a minute.

How are his handwriting skills?
His handwriting looks messy and immature, but generally legible, in my unprofessional opinion. Capital letters at the beginning of sentences, and punctuation in general, are omitted more often than not. DS himself thinks that his handwriting is messier than that of many of his classmates. He dislikes writing by hand, and does little of it voluntarily. I haven't looked at his pencil grip for a long time, but perhaps I should take a careful look.

What goal areas are included on the IEP?
I will list the goals as they currently appear. These were drafted by the case manager, after the second PPT meeting, so there really was no opportunity for the team to work on them together. I'm not real impressed with the goals as they stand, but would certainly welcome comments from you and from the other knowledgeable posters here. Maybe I just don't understand what I'm looking at. In any case, there is supposed to be another PPT meeting next fall to review/revise the IEP, so, if the goals are inadequate, maybe they can be further developed then.

1) 'D will come to school on time and be prepared with all the required materials...'  This is the goal I questioned in another thread on this forum -- it seems to me that this is an at-home goal, and it is not at all clear to me what the school can or will be doing to help DS implement this goal.

2) 'D will complete homework and classroom assignments for all his classes.' Short term objectives under this goal mention the use of an agenda to record assignments and to keep track of due dates. Nothing else is mentioned about implementation.

3) 'D will maintain his attention on task during class lessons and assignments in order to complete assignments on time.' A short term objective mentions refocusing, with prompts, when distracted.

4) 'When presented with narrative text and/specific informational text... on the sixth grade level, D will answer questions about the text that test for understanding...'  A number of short term objectives are described, giving different details that would be required in a proper written response.

5) 'D will write an informational/explanatory text with facts and quotations to develop points, including linking phrases... to connect ideas, precise and domain-specific vocabulary and a logical introduction and closing statement, all grouped within appropriate paragraphs, headings and sections.' Again, there are a few short term objectives giving more details about what is expected in the written work.

I don't know... much of this doesn't sound very individualized to DS's specific issues, particularly in terms of how to get from point A to point B... or is that sort of detail not supposed to be in the IEP? I guess a lot will depend on the skills of the particular teachers who try to implement this plan next year. I would like to see some goals about self-awareness and self-advocacy -- both areas that DS needs to get better at in order to deal with his difficulties. I would also like to see something about reading... but the school staff didn't perceive much of a problem with DS's reading at the moment, probably because of his improved fluency numbers in May (DORF). Also, as I mentioned in another post, the RTI model seems to have the effect that, if a previous intervention has been effective, then that particular problem doesn't warrant mention as a major concern or finding on an IEP??? At least that's how I understood what some of the school people were trying to explain to me... I'm also uneasy about goals where measured progress rests exclusively on teacher assessments, as the writing goals in particular do.

A number of accommodations are listed on the IEP, and I'm happier with those than with the goals. These include access to a computer, use of calculator, a second set of texts for home, extra time on tests, help with pacing long term projects, study guides and study outlines (DS does not take good notes), alternate (quieter) seating if needed for tests, use of planner/graphic organizer, cuing of expected behavior, positive reinforcement, making sure DS has all needed materials before heading home at the end of the day, and checking that DS understands instructions that have been given.

You also asked about
the types of support he has had in the past
In addition to various reading interventions over the years (starting in grade 2), DS has had some extra help with particular math topics, from time to time (also under the RTI approach). His classroom teacher last year apparently made some informal accommodations -- e.g. reducing workload on some classroom assignments that were particularly difficult for DS, and also working more in small groups with him (he does better with individualized attention and encouragement). There was also informal communication between teachers and parents last year (mainly by email) -- that way I was better informed about what assignments DS was supposed to be doing at home, and the teachers were better informed about how he was doing on them, and what his difficulties were.

[SharonF]

ceratops--

Where do you find someone who can diagnose "bits and pieces"? We didn't find ONE person. A pediatric neurologist diagnosed my dd's ADHD-inattentive and prescribed meds. A developmental audiologist diagnosed her CAPD. Then a developmental neuropsychologist took the school's evals, the neurologist's report/diagnosis, the audiologist's report/evals, did a LOT of additional testing and added the LD-NOS (Nonverbal Learning Disability) and Language Processing Disorder.

We took THAT huge pile of sometimes contradictory scores and the neuropsych's detailed summary back to the very reluctant IEP team. The first IEP they wrote (for Speech-Language Impaired) was useless. It took a couple more years before we finally got an OHI IEP with meaningful goals in all areas of need. By the time dd got to college, she found consistent and meaningful success in the classroom.

Your description of your son loving to tinker, use his hands, get involved with the machinery or the dirt...so TYPICAL of bright kids who struggle in school.

Linda Kreger Silverman is my favorite researcher in the area of visual-spatial learners. www.gifteddevelopment.com/Visual_Spatial_Learner/vsl.htm

I shared this article with my dd's IEP teams for several years: www.visualspatial.org/files/appenda.pdf My dd did not fit the entire description. But the things she did fit, it was a 100% match!

This cartoon is typical of my dd. www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=t5OZ97m3aR3_zM&tbnid=rzcrJaMlKE4OeM:&ved=0CAgQjRwwAA&url=http%3A%2F%2Fwww.visual-learners.com%2F&ei=IczVUd6qJffH4AOLtoHgBw&psig=AFQjCNHcCgAuOsc1Dby11LJb-IaVx2EY0w&ust=1373052321671522

School rewards those like the child on the left: those who follow the written instructions sequentially. But my dd looks at the pictures and avoids the words to assemble anything!

Even though she has much stronger VCI than PRI on her WISC IQ, she is not a verbal learner. She is a hands-on learner with almost a photographic memory. To truly learn, she needs to feel it, touch it, interact with it. Despite her strong VCI, words are not enough for her.

I strongly agree with those who recommend an OT eval, GORT, TOWL, NEPSY and other tests that are far more specific and in-depth than the WJ. Bright kids, especially those who've had some remediation or good teachers, can often get an acceptable score on the WJ and similar broad tests of achievement. It's when you drill down deeply into their executive function, various aspects of reading, their written expression, their fine motor...that you start getting a clearer picture of what's holding them back and how to help.

That process took us a couple years. The school kept playing down my dd's issues or telling me her scores were in the average range so it was okay. (And we were also trying to get an IEP for our son during that time. He also has a complex profile that didn't lead to any quick answers, even from the doctors.)

You are a WONDERFUL mom for being so involved and willing to advocate on behalf of your son. Years ago, I had days when I truly wondered if it was worth it. My 21-year old dd has now graduated from college with honors and hopes to go to grad school to get her doctorate in physical therapy. (Talk about a hands-on profession!) I say that to tell you there IS hope. You must be persistent. You must be knowledgeable. And it really, really helps to have a community of others cheering you on--like here on MillerMom. These people have been my sanity and my salvation for years!

[ceratops]

Jul 3, 2013 19:48:58 GMT -5 dihicks6 said:

As far as requesting more evals, you are well within your rights to do so. Couple of ways to handle it; you can write an email to the sped chairperson, explain what you want and why (testing must be done in ALL areas of suspected disability) and specifically request the evals you want. In that letter/email, you can also include some wording regarding requesting an IEE (independent educational evaluation) if that is the only option left to you (translated means either they do the additional testing or you disagree with their results, (as incomplete), and request the IEE). Post if you need/want help writing the letter/email. They'll get the message....

Thank you for the comments!

I wonder whether you (and other posters) have any comments on the wisdom of demanding more tests at this point.

The school, so far, has been very cooperative and helpful in responding to my referral. They worked hard to get something together in a short timeframe. DS will be going from one school to another next fall (middle school grades are in a different building), with different teachers, different school psych, different special ed staff.

On the downside, I don't think the school has shown much acuity or curiosity at getting at the root causes of DS's difficulties... and that's where further testing would come in. Also, they weren't the ones to make the referral in the first place -- as long as the child is showing generally average achievement, the school establishment is satisfied, which is unsettling. In our state, discrepancy between ability and achievement is explicitly NOT supposed to be considered when making decisions about placement for special ed. On the other hand, I think it's that discrepancy that is behind DS's growing dislike of school, his falling self-esteem in school, his oppositional behavior regarding homework, and his growing conviction that he is 'dumb'.   It seems that bright kids are still in the 'wait to fail' category, as far as getting help in school for their learning problems.

I'm wondering if it's worth meeting the people at the new school first, and getting a feel for whether their interactions with DS are helping him? In many ways, the success of the plan may depend on the skills of the teachers and their sensitivity to what a particular student needs help with... Or is it very important to get more information about the nature of his problems first, even at the risk of getting adversarial with these people before we've even met them?

I'm really new to this process, and am wondering what those who have been through it would counsel at this point.

[ceratops]

Jul 4, 2013 1:36:27 GMT -5 empeg1 said:

Your ds is a very bright child. And, his cognitive profile is one of peaks and valleys. It looks like there are issues of storage and retrieval of information, affecting fluency across subject areas. Given his very, very strong VCI scores, I would look at some of the academic scores and make the point that your child can also qualify as a child with a specific learning disability. Take a look at his math scores, a very low fluency score and still quite discrepant calculation score when looking at that 136 VCI score. I wish the assessment took a closer look at memory, like with the WRAML and the writing subtests of the Woodcock-Johnson are not a good sample of what is expected in the classroom for writing. I would like to see the Test of Written Language given to your ds. And, it looks like he is strongly an auditory learner. Yes, rapid naming is often associated with language based learning disabilities, but your ds has difficulty with fluency across the board. I suspect difficulty with association and retrieval of symbols, numbers and letters, hence the poor retrieval difficulties across the board. BTW, retrieval difficulties can make writing quite difficult.

Interesting that your ds has difficulty getting up in the morning. He many have difficulty with sensory integration, i.e., difficulty filtering out noise, which can also be associated with sleep difficulties. My youngest has long standing sleep problems for which melatonin did not work. Like your ds, she has difficulty falling and staying asleep. Theanine, thank you, Jisp, has been more helpful than anything to relax her enough to sleep. I am also wondering if your dd's difficulty in sequencing information might also be present in sequencing actions, as in getting ready in the morning. Does your ds show any difficulty in motor planning? My oldest, for instance, struggled for years to lear to type and even to learn the sequence of actions to dial phone numbers.

For one, I would make sure that your ds has a clear accommodation on his IEP. This is a very bright child. No way should retrieval issues slow him down in math. He gets to use a calculator (which is what we are all doing anyway). it is his math thinking that needs to be fostered. Your son also needs work on reading fluency. And, written language should be addressed now, as the demand for writing goes way up in middle school. There are strategies for writing that can be taught for a child who has retrieval and organizational difficulties. My oldest was taught to use a tape recorder, which she used to talk an essay before she wrote it. She was extremely articulate. A program called Inspiration may also be helpful or Kid Inspiration. Today, assistive technology can also help your ds. And, maybe this summer he can learn to type? Make sure he gets to use a program in which the speed can be turned down. Watch what he does to see if you notice motor planning difficulties. If your son likes to listen to books on tape, go for it and then give him a book to read along with the tape. Finally, a program called Making Math Real might be a very good match for your ds- it uses language along with other cueing to teach math facts, operations and concepts.

Finally, routine that does not vary in the morning may help your ds. The backpack must be ready and set by the front door before he goes to bed. All clothes, shoes, etc are selected the night before and are left out in plain view, ready to be put on. You may need to wake your little ones a bit early and get them ready then sit them down to watch a short TV program. At that time, turn your attention to your son, to get him ready.

What does your ds like to do? If school is hard for him, it is as important that he gets to pursue his interests and an activity in which he can excel as any remediation he may get. Finally, if your family can afford to do so, hire a learning specialist to work with your ds 1:1 outside of school. Your son has an unusual cognitive and learning profile-one that will not fit the often one size fits all Resource programs at school. That and the relationship between a specialist and a child can go a long way to make academic tasks more palatable, especially if the specialist can adapt what he/she does specifically to your ds. The above is far more likely to occur in a 1:1 situation. Finally, do impress upon your ds that he is very bright. Sometimes it is how our brains process and store information that can make learning hard but that does not mean that our brains are not smart about thinking!

Thank you for the comments and suggestions!

DS does seem to have some difficulties filtering out noise (I may have mentioned in the first post; don't remember for sure). He's always turning up volume on the TV to hear better. Also, he's VERY annoyed by anyone else making noises while he's trying to concentrate on something. I had no idea this might be associated in some way with sleep difficulties. Interesting.

Thank you for the list of possible accommodations. DS is already a reasonably good typist -- he was very motivated to get better at typing, since he much prefers writing on the computer to doing it with pencil and paper, and his keyboard skills have improved a lot during the past school year.

Yes, we need to focus more on encouraging areas where DS can excel. From some of the material I was reading about 2e (I don't know if DS falls in this category, but it looks like a possibility) it seems that it is very important, even in the school setting, to focus on the child's strengths, not just on the areas that need remediation. I actually asked about this in a conversation with the school psychologist -- i.e. whether a focus on DS's strengths shouldn't be part of the IEP somehow -- she did not think so...

As far as impressing on DS that he is bright -- yes, we probably have some work to do there. I'm afraid that, at this point, there is already damage to be undone in terms of his self-image and self-esteem.

[bros]

He needs an OT and an AT evaluation, seems like there might be a written expression disorder in the works.

[ceratops]

Jul 4, 2013 14:45:26 GMT -5 SharonF said:

...

I shared this article with my dd's IEP teams for several years: www.visualspatial.org/files/appenda.pdf My dd did not fit the entire description. But the things she did fit, it was a 100% match!

This cartoon is typical of my dd. www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=t5OZ97m3aR3_zM&tbnid=rzcrJaMlKE4OeM:&ved=0CAgQjRwwAA&url=http%3A%2F%2Fwww.visual-learners.com%2F&ei=IczVUd6qJffH4AOLtoHgBw&psig=AFQjCNHcCgAuOsc1Dby11LJb-IaVx2EY0w&ust=1373052321671522
...

Thank you again for your comments, and for sharing your own experiences.

That article is very interesting, and lots of it (not everything) does remind me of DS.

I had to laugh at the cartoon -- I'm the one on the left, and DH (and probably DS) is the kid on the right. Very different approaches. We always joke here when assembling or installing something new -- DH will just start working at the task (usually with very good insight and results) while it is my job to read through the printed instructions, just in case there are some essential bits of information lurking in there (and there often are).

[ceratops]

Jul 4, 2013 16:03:27 GMT -5 bros said:

He needs an OT and an AT evaluation, seems like there might be a written expression disorder in the works.

Sorry, I know what OT is... but what does AT stand for?

[healthy11]

AT = Assistive Technology.

Is the middle school considered part of the same elementary school district that just did his testing?
Did you have any kind of IEP transition meeting with representatives of the elementary and middle school together?

Since he's transitioning to a different school, where your son won't have any administrators/support staff around who know him, and he won't have just one homeroom teacher anymore, it will be all the more critical to have an effective IEP plan in place. In order to have an appropriate IEP, one has to have a thorough understanding of what a student's issues are. Clearly, ADHD is a part of his difficulties, but whether he has other LDs is unclear. I know it's not an easy topic to discuss, but one of the sagest pieces of advice that we got was that when a child is known to have ADHD, it really should be addressed first, before spending a lot of time, effort, and money on specialized instruction, etc., because even the best tutors in the world, using the best remediation strategies and methodologies, won't be as effective if a student isn't able to pay attention to what they're trying to teach.

Medication can often make a huge difference in an ADHD child's ability to focus, and if you read past postings here at Millermom, you'll see a number of parents who have found that their child's homework can be accomplished more efficiently, handwriting is significantly neater, and even things like remembering to put in punctuation, and noticing sign changes in math problems also improve. ON THE OTHER HAND, medication will NOT "magically make LDs go away." What we found with my son was that he continued to have significant trouble with reading and written expression, and so at that point, we were finally able to convince the school that his problems were more than just ADHD, and they finally did additional testing, which confirmed his exceptionally high IQ, but also the SLDs in reading and written expression. I guess what I'm trying to say, is that you already know your son has significant ADHD issues, that appear to impact him not just at school, but also at home, and so I'd recommend trying to talk to his doctor this summer, and/or have your son working with a psychologist to come up with an approach to better manage his ADHD, so he doesn't continue to have falling self-esteem in school, oppositional behavior regarding homework, and a conviction that he is 'dumb'. (What was your son's reaction to finding out that he has ADHD? Some kids feel a sense of relief, because it affirms that they aren't just stupid or lazy, but other kids may not want to hear about being "different" than their peers. At nearly 12, he's old enough to where he ought to become an active participant in discussing strategies that can help him to deal with it. You might want to look at some of the books/ resources at chrisdendy.com/products.htm and www.amazon.com/Keeping-Head-School-Abilities-Disorders/dp/0838820697?tag=533643275-20)

[bros]

Jul 4, 2013 16:10:44 GMT -5 ceratops said:

Jul 4, 2013 16:03:27 GMT -5 bros said:

He needs an OT and an AT evaluation, seems like there might be a written expression disorder in the works.

Sorry, I know what OT is... but what does AT stand for?

Assistive Technology

[ceratops]

Jul 4, 2013 16:21:04 GMT -5 healthy11 said:

AT = Assistive Technology.

Is the middle school considered part of the same elementary school district that just did his testing?
Did you have any kind of IEP transition meeting with representatives of the elementary and middle school together?

Since he's transitioning to a different school, where your son won't have any administrators/support staff around who know him, and he won't have just one homeroom teacher anymore, it will be all the more critical to have an effective IEP plan in place. In order to have an appropriate IEP, one has to have a thorough understanding of what a student's issues are. Clearly, ADHD is a part of his difficulties, but whether he has other LDs is unclear. I know it's not an easy topic to discuss, but one of the sagest pieces of advice that we got was that when a child is known to have ADHD, it really should be addressed first, before spending a lot of time, effort, and money on specialized instruction, etc., because even the best tutors in the world, using the best remediation strategies and methodologies, won't be as effective if a student isn't able to pay attention to what they're trying to teach.

Medication can often make a huge difference in an ADHD child's ability to focus, and if you read past postings here at Millermom, you'll see a number of parents who have found that their child's homework can be accomplished more efficiently, handwriting is significantly neater, and even things like remembering to put in punctuation, and noticing sign changes in math problems also improve. ON THE OTHER HAND, medication will NOT "magically make LDs go away." What we found with my son was that he continued to have significant trouble with reading and written expression, and so at that point, we were finally able to convince the school that his problems were more than just ADHD, and they finally did additional testing, which confirmed his exceptionally high IQ, but also the SLDs in reading and written expression. I guess what I'm trying to say, is that you already know your son has significant ADHD issues, that appear to impact him not just at school, but also at home, and so I'd recommend trying to talk to his doctor this summer, and/or have your son working with a psychologist to come up with an approach to better manage his ADHD, so he doesn't continue to have falling self-esteem in school, oppositional behavior regarding homework, and a conviction that he is 'dumb'. (What was your son's reaction to finding out that he has ADHD? Some kids feel a sense of relief, because it affirms that they aren't just stupid or lazy, but other kids may not want to hear about being "different" than their peers. At nearly 12, he's old enough to where he ought to become an active participant in discussing strategies that can help him to deal with it. You might want to look at some of the books/ resources at chrisdendy.com/products.htm and www.amazon.com/Keeping-Head-School-Abilities-Disorders/dp/0838820697?tag=533643275-20)

The two schools are part of the same school district. However, there was no transition meeting; we just had meetings (at the elementary school) that served to order evaluations and to set up an IEP from scratch. There was an intention to have a middle school representative at the second meeting, but that didn't work out, due to time constraints.

Yes, we do plan to see a doctor over the summer to discuss possible medication for ADHD. I've been hyperfocused on getting the IEP process going before the end of the school year, in order to finally start addressing those concerns (which have been nagging at me for years). I had also hoped to have a more complete picture of DS's difficulties, including possible LDs, before talking to someone about meds for ADHD. Unfortunately, the school testing, so far, hasn't given that complete picture, so I'm frustrated and trying to figure out what to do next. The psychologist who diagnosed ADHD wanted us to gallop off in multiple directions at once -- family therapy, individual therapy for DS, seeing a psychiatrist for possible medication (for DS's sleep issues as well as for his ADHD), and having the school do testing for possible LDs (since she herself didn't do any testing in the educational realm). I don't do that well with doing multiple things simultaneously, so I've been working mainly on getting the school testing going before summer vacation.

I'm wondering whether to request additional tests from the school promptly... or to first try ADHD meds, see how things go for a while in the new school, and then request additional testing at that point. Ideally we want more precise information about DS's strengths and weaknesses (all those additional tests that various posters have recommended). Practically, maybe it's best to let things float a bit, address the ADHD alone, and see how the new school situation looks in the fall?

DS is actually asking for medication; he has several friends who are on ADHD meds, and has been talking to them about ADHD since hearing about his own diagnosis -- he is hopeful that meds will help him to focus better and to be able to get homework done. He doesn't seem to have any qualms about being 'different' -- in fact, he blurts out comments about ADHD and meds for ADHD with total disregard for his own privacy .

Part of me just wants to line up private testing to get these LD questions answered NOW, and to heck with trying to push the process through the schools. However, A) I don't know whom to go to for private testing, so getting recommendations will be another research project; and B) the cost is a problem.

[ceratops]

Jul 4, 2013 16:29:32 GMT -5 bros said:

Jul 4, 2013 16:10:44 GMT -5 ceratops said:

Sorry, I know what OT is... but what does AT stand for?

Assistive Technology

Thanks. I guess I have seen the abbreviation before -- the context threw me off -- are there specific evaluations that should be done to see if someone would benefit from assistive technology?