Reply to Low score on the Beery-Butanka VMI test

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[quote=Anonymous][quote=Anonymous]I'm OP - didn't mean to start a thing re: ODD - when we last had DS evaluated, and got the "one criteria short of ODD" reference, it was stil DSM-IV.

11:03 - I'll come back with a breakdown when I have our exact scores with me.[/quote]

11:03 here.  I really wanted to echo what you and another PP said about the torture of writing.  Our DS really hated to write from the very earliest age.  He never was into "coloring" or "painting" in pre-school, to a degree which was really different than others.  When he did engage in these activities, his "product" was really just immature scribbling compared to peers.  But, of course, that isn't really considered a "problem" in pre-school.  Fast forward to preK and K, and DS was very resistant to writing activities.  Of course, that was dismissed as his being an active boy, and "boys don't like to do those things".  By first grade and second grade, DS began to act out in order to avoid writing.  The final straw was when he actually broke down crying in class when his second grade teacher asked him to share what he wrote.  He could see by then that he could not write like other kids, and the idea of being forced to reveal that in front of the whole class was just too much.

Fortunately, he had one teacher in 2nd grade who didn't think he was dumb or a behavioral problem.  She took my concerns seriously and advocated and adjusted for him at school.  We have a family history of language-based learning disability, so after the school refused to give him an IEP, I took him to a private neurospsych and had him evaluated.  Here are the tests that, altogether, resulted in the diagnosis of specific learning disability/dysgraphia --

low average and significantly discrepant WISC Processing Speed Index -- (approx. 3.5 standard deviations which is huge)

diagnosed Mixed Expressive Language Disorder

low average and significantly discrepant TOLC-1 Oral Expression score

low and/or significantly discrepant scores in the following:

WIAT--III Alphabet Writing score in 8 %ile (compared to GAI in 99.8 %ile)
WJ-III Writing Fluency Score in the 24 %ile
WIAT-- III Spelling and Sentence Comp in the 70 %ile
WIAT --III Math Fluency and (61 %ile) and Numerical Operations (77 %ile)

Poor VMI score -- already mentioned above 
Tower of London -- 17 %ile (testing executive function)

IVA -- Attention Quotient -- 4 %ile

TEACH Score Subtest -- 2 %ile (auditory attention)

All of this added up to a diagnosis of ADD/Inattentive w/ executive dysfunction, developmental coordination disorder and dysgraphia.  DS' separate complete language assessment also showed difficulty with word finding, syllable segmentation and sound/symbol correspondence which made spelling and reading more difficult.  Although he was significantly discrepant, he did not fall below average at that age. Language assessment also showed age discrepant problems with mastery of grammar, syntax, semantics and pragmatic language, all of which can impact writing (and reading).

Writing is a very complex process.  It takes coordination and practice to write by hand quickly and neatly enough o be functional at school.  It takes a certain amount of mastery of the sound/symbol correspondence to learn to spell quickly, and a certain amount of memory.  Then there is mastery of grammar, syntax and semantics, which are necessary to write fluidly and to generate ideas based on the writing prompt and think in terms of categories and organization, as well as for editing.  All of these different tests explained, together, how my child's "dysgraphia" was more than a simple problem of that could be cured by using the "Handwriting without Tears" program.

Here are the types of remediation that have been helpful to DS, most of it outside the public school system:

-explicit instruction in handwriting, with extensive practice and support, include gross motor activities
-Brain Gym activities to reinforce left/right
-explicit instruction in spelling patterns 
-explicit instruction in sound/symbol correspondence 
-explicit instruction in the organization of writing 
-explicit instruction in editing -- including grammar, punctuation, and capitalization
-speech/language therapy, particularly in semantics and word-finding strategies 
-accommodations including -- extra time, use of computer, use of spell check, use of graphic organizers (paper or on computer), use of text to speech programs for editing, Franklin Speller (not very useful) and AlphaSmart (also not very useful). 
-a lot of "talk therapy" from us as parents about his LD and his high ability and reinforcement of success and effort.  This has really helped mitigate low self-esteem and real anxiety about writing at school.

Not all kids with dysgraphia have ADD or executive dysfunction.  Some kids with dysgraphia have coordination issues, some don't.  Some have language disorders, some don't.  Every student's individual testing profile will be quite different than our DS' even though the overall diagnosis of dysgraphia might be the same.

Watch your child carefully, both at home and at school when it comes to writing and drawing.  Also look at math work (because writing affects the ability to write calculations, draw representative math pictures, and write math explanations).  Observe in school if possible (our parental observation and that of our advocate and a central county staff person revealed quite obviously the ADD/Inattentive and the social masking of the writing problem).

Compare neuropsych testing results with observation and you will have a pretty good guide to your child's unique dysgraphia profile.  [/quote]

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