Question about test results....

[bairnmama]

I posted quite a while back that I had to get a psychological eval for my dd before we could pursue dyslexia testing for her. We just got the results back and the psychologist that did her eval said he would advise us not to pursue dyslexia testing because the tests didn't show any language problems (phonological processing was low avg, speed naming was avg, and oral comprehension was well above avg). However, her visuospatial testing put her only in the 2nd percentile and visual memory was below the expected level as well - both immediate and delayed recall being tested. Would this explain her significant problems in learning to read? Would you suggest I pursue dyslexia testing anyway?

He also wants to get an OT eval to rule out Kinesthetic Dyspraxia and Developmental Coordination Disorder. Would the problems evidenced by these disorders give us the trouble with handwriting that I was attributing to possible dyslexia? She was given a developmental age of 5 yrs, 0 months to 5 yrs, 5 months according to the House-Tree-Person Technique and Bender Gestalt Visual-Motor Test even though she turned 7 in June.

Besides the above she was also diagnosed with ADHD - combined and Cognitive Disorder, NOS. I didn't really expect either of these since she's not one to be bouncing off the walls, just a bit impulsive and figidty mostly. Although I do admit it's very hard to keep her focused on her schoolwork, I mainly attributed that to her reading difficulties and ds interrupting her a lot.

Any insight you ladies would have would be greatly appreciated!

[Laurie4b]

Was a WISC-IV done? (an IQ test) Was an achievement test such as the Woodcock Johnson done? The low average phonological processing combined with above averge oral comprehension does fit a dyslexia pattern, but isn't enough in and of itself to make a diagnosis.

The visual processing problems certainly could affect reading. Handwriting is only indirectly affected by dyslexia. A child with dyslexia will often have handwriting problems when doing self-generated writing, but their handwriting looks fine if they are simply copying something. The other kind of dysgraphia involves fine motor problems. Some kids have both types.

An evaluation by an occupational therapist and a developmental vision therapist seem in order given the test results. It's very possible that dd's eye movements don't allow her to track when she is reading. Symptoms of visual processing issues can look exactly like ADHD. (She also could have ADHD. A lot of times it isn't as "wide-open" in girls as in boys.) If she has ADHD, there is a strong probablility that she also has sensory integration issues. The OT can evaluate the fine motor skills, dyspraxia, coordination disorder, sensory integration, and to some extent, the visual-spatial stuff. The vision therapist will evaluate dd's ability to coordinate her eye movements and her visual perceptual ability.

Does your dd have age-appropriate social skills?

[bairnmama]

Thanks for commenting so quickly! No, they didn't do an IQ or achievment test. When I asked he said that generally, the schools around here use those basically as a way to deny services to children. That basically the IQ tests are generally harder than the achievment tests given so we are setting the children up to "pass" when the difference between the scores is not great enough to warrant services. He was glad that we were not in the local school system when it came to that point.

I don't think I will be able to get an eval by a vision therapist as our insurance doesn't cover it at all! We certainly can't pay for it. Is there some other way to find out if this is a problem?

As far as social skills... I don't see too many kids her age, but she does seem a little immature (to me) for her age. However, I do know that at church, she has several friends that keep asking when they can get together to play and race to greet her when we arrive - some are a couple yrs older and some younger. When we visited a new homeschool group, she instantly made friends with the kids there and just seemed to fit in seemlessly. One of the other mothers even commented on how easily she just folded herself into the mix almost instantly.

I would love to hear other opinions, too. However, I won't be able to check the boards for about a week as we'll be traveling to see family before my dh starts his next three schools.

[Kathy in MD]

I don't think I will be able to get an eval by a vision therapist as our insurance doesn't cover it at all! We certainly can't pay for it. Is there some other way to find out if this is a problem?



Does your insurance specifically exclude VT under any circumstances or does it just say it doesn't cover eye care. It's an important distinction because **certain** eye problems, such as convergence, are typically under major medical and surgical even when most eye care isn't covered. Our insurance didn't cover eye care, but because my ds had a convergence problem, the insurance partially paid for VT and VT exams because the standard treatment was more expensive surgery. We did have to pay for ds's glasses, but that was minor by comparison. (Don't opt for surgery first, because scar tissue will develop that can make VT more difficult or even impossible.)

If it still isn't possible, a good OT experienced in SPD might catch *some* vision problems. If she's an older OT, she might even have some training in treating dev. vision problems, however her tools and techniques will not be as advanced or thorough as those of a dev. opt. Laurie4B's OT was able to improve one of her ds's dev vision problems.

[Laurie4b]

That is a totally bogus reason not to have done the WISC or an achievement test. It has me steamed and it isn't even my kid! Both IQ tests and achievement tests are scored based on the scoring of a very large group of kids on whom they were tested.

What does the school system have to do with it? Absolutely, they will deny services when they can. If a child is on grade level, they will say that their disability isn't interfering with their achievement, even if it's clear the achievement isn't commensurate with ability or it's clear they're going downhill fast. Some call it the "have to fail to get services " approach. But what does what the school system would do have jack diddly to do with the info you need as a homeschool mother?

The subscores of the WISC tell you so much. For one thing, it would be good to know if her score in phonemic awareness is low average, but her IQ is quite high. That is a totally different picture than if it's commensurate with her IQ. Additionally, achievement tests like the Woodcock Johnson, with several reading subscores, give you an opportunity to analyze the pattern of strengths and weaknesses which can support (or not support) a diagnosis of dyslexia. If your child has any learning anomolies, you want a WISC. Unfortunately, they are expensive, but it's likely that the school system would do both the WISC and the achievement test for free. You need to write to the head of special services and state that you suspect that dd has a specific learning disability and request an evaluation. Some states allow the school to deny these requests. Most don't.

A vision therapy evaluation is not terribly expensive--probably a couple hundred dollars. Most insurance will cover the eval, but not the treatment. The Brainware Safari mentioned just down the board works on visual-spatial skills, but my guess is that any problems with the control of the eyes by the brain would need to be dealt with first.