NVLD and ADD (very long)

The WISC looks a lot like my own son’s. That can be deceiving, though, because the categories have more than one potential area of weakness. Let me think on this for a while. I’ll be back to you.

Did you ever have your child seen by a developmental optomotrist? I know it is a scary proposition because there seems to be a wide range of results from different perspectives on this board.

Sounds like my friend’s son who had a problem with the focusing. Read my post below. Interesting that my son and my friends son both had problems with visual perception yet the TVAS that I did showed a different problem with each.

My son would just draw the shape in the wrong place on the graph and had difficulty drawing a diagonal line, her son would leave out parts of the shape but drew the diagonal line just fine. I will have to ask my friend if her son had problems in the area of picture completion on the wisc. Her son corrected with the glasses, my son didn’t.

My son was fine on picture completion but had alot of trouble with block design (scored a 4)

The authors of PG say that children who do not succeed with PG should be tested for problems in binocular control.

My son has been through vision therapy. He started vision therapy before he ever had PG training. We saw improvements in his ability handle worksheets and the like but I would not say it was an overwhelming success. I think that was partly the therapist. My son’s vision problems seem to rooted in sensory integration issues and the therapy was, for the most part, “flat”. We have continued work with vision in Neuronet therapy but so far have not seen big changes with reading from that. The therapist says that is because his system is still being taxed on multiple fronts. It is true that when the text is easier to decode, his tracking issues disappear.

I took him to a second developmental optometrist who told me that my son’s fixating and tracking do not hold up when there are cognitive demands. That, I think is the problem for him. If he did not also have auditory processing problems, his visual processing would be adequate.

Beth

Please do let me know what you think. I have been impressed by your posts—a knowledgable teacher who also has that voice of experience.

Beth

Interesting, sensory integration certainly seems to affect visual perception. I was just reading the other day about how visual perception is affected by all the senses working together. The book I was reading said that when there is a breakdown in the lower brain functioning the higher brain is taxed to perform tasks that in most people, are automaticaly performed through the lower brain. It made alot of sense to me. Sounds like what you described with your son’s problem. I have to wonder if he is tracking with some part of his higher level brain that is needed for cognition thus making it difficult to do both at the same time.
My son has sensory integration issues as well.

Still, I am curious to see how your son would do on the TVAS (test for visual analysis skills) test. It is such a simple little test.

I think you are right—that higher levels of his brain are being used to do lower brain type activity. I actually have been told that by the Neuronet therapist with whom he works.

Is the TOVAs available generally? I am curious too.

Beth

of PG have, shall we say, a very small number of reasons which they accept as reasons for students not to succeed with PG. They are far from objective on this matter.

Your son deals with many of the same issues as my dau-she too deals with SI, CAPD and visual processing (with test scores very similar too). While she was in ele. school she was evaled by a reading specialist who has a lot of experience in brain functioning…what she told the school district is that because my dau is using her senses more intensely than the rest - she goes into sensory overload which can look like ADD. So her suggestion was to allow her to move around the room in between lessons which did help her regroup her senses. She is in middle school now and they changes classes so the problem is not as evident…she is also in co-taught classes and her extra teacher knows the signs of overload. If you need more ideas, I would be happy to check through that eval and see what else would be of help.

I just sent you a few pages from my book that I scanned. Have your child draw those shapes. If she gets through all of them I will send you the next harder group.

Let me know how she does.

The name of the book is Helping Children Overcome Learning Deficits by Jerome Rosner.

It has a very specific rather simple plan for remediating this deficit that seems to be working well for my son.

That sounds like what has happened with RObbie’s speech dysfluency. The more complicated his ideas are, the harder time he has expressing himself. We haven’t figured out what to do about that yet either, since he seems completely unaware of the problem.

Karen

That’s interesting. My son clearly wears out easily. One therapist thinks it is because he has to exert so much energy integrating his senses. The result is that he does better often the first time he does somethng than the second or third. I told the neurologist about this and his comment was it was attention. Sometimes I think everybody has their paradigm. The therapist thinks it is this and not attention. Frankly, I suspect it is both.

Beth

With my dau, her third try is her most successful because with both the visual and auditory by the third time she has it all put together and scores very high…after that it is downhill because she is 1) tired 2) bored 3) both and just wants to move on or quit! Believe me he is paying attention (more than most) and when asked to repeat the task may begin to question their own ability and chances of getting more right the next go-round. My dau now unfortunately questions every answer even though she knows its right. Before the district finally had the specialist in to eval my dau, (in 5th gr.) we had teachers starting back in 1st grade telling us the same thing…SHE HAS TO BE ADD…but they were wrong…and after 4 evals in the beginning of 3rd gr. and another in the beginning of 4th - it still took till the beginning of 5th with this specialist’s eval for the district to understand what this child has been dealing with…heaven forbid they should listen to the parents!
Homework is also a huge issue-when she gets home from school she is fried so doing homework is a battlefield! Her co-teacher does homework help after school so that has been very helpful because my dau is still in school mode at school (even though the reg. day is over) and works easily with this teacher.
Sorry to be so long winded here!

Beth - I’ve noted the similarities between our kids before in your posts. We had a neuropsych done this year b/c the school thought dyslexia and ADD. The only thing we feel confident about saying at this point is its NOT ADD based on the neuropsych, and his subsequent work with a psychiatrist. My son too gets overloaded with emotions and sensory input in certain situations (when reading, and novel social situations) and checks out. We are working on the sensory/motor by doing IM right now. His former speech therapist recommended it , says she thinks it will help his eye contact . We also have a diagnosis of a right hemisphere neurologically based problem . Some people have said NLD to us, some don’t think it fits him. Some have floated the aspergers idea, but if he’s AS its so mild that the label is irrelevant.

What I’ve come to accept is that he’s a little of alot of these disorders, but no one disorder really describes him. Go with your gut here, I think you really know your child. If a neuropsych will give you peace of mind you could do it, but I suspect your already know enough about his deficits based on what you’ve said before.

One more thought: our son’s psychiatrist is willing to try medication if we want. He’s not pushing it, in fact thinks its a shot in the dark. We’d be looking at alleviating the anxiety (which mimics ADD by the way) . But I mention it because we may try it to see if we get an “aha” - the theory being that it might actually aid in diagnosis. If it works then we know some of the behavior is anxiety and not hardwired .

Since the WISC has more than one skill required on each subtest, you cannot be completely sure of the precise skill weakness without some other testing, observation, etc. (This is also true, remember, because one subtest isn’t as as statistically reliable as a cluster of them!)

Picture Completion—Factors affecting outcome:
Ability to visually conceptualize
Ability to organize information perceptually
Memory
Visual Discrimination
Concentration & Attention
Time Element
Cultural experiences and background :-)

Object Assemby—Factors affecting outcome:
Visual-motor coordination and integration
Spatial relationships and orientation
Visual and perceptual organization
Gestalt (Global/whole) awareness
Time element
Body imagery
Problem-solving techniques
Concentration & attention

Because he did well on his Block Design, we can be 70-80% sure that he does these things fairly well:
Visual-motor integration and coordination
Spatial orientation
Perceptual organization

This, most reliable subtest and (some say) predictor of visual fluid reasoning requires different visual skills, as you know, than the PC or OA. It is whole-to-part and part-to-whole, timed.

I’m suspicious of visual discrimination, but feel that there may more. I need to think some more. What are your observations?

Back when I dig out some more stuff…or maybe one of the PhD’s psych’s will look in. (They usually don’t post, though, darn!)

I suspected ADD years ago with my daughter..but I too didn’t want to see it in her nor myself, once I saw the light and realized it wasn’t just CAPD it was ADD comorbidity…we got her on meds and it’s made such a difference in her life. We also just discovered that she has an astigmatism and she is nearsighted so she is wearing glasses and her reading is much better. She finally said, “Mom, I am SMART!” What music to my ears…

It sounds like you have a great neurologist who is wiling to work with you. Your son is a special young man who has many gifts and some deficits, we all have strengths and weaknesses that is what makes us unique. I wouldn’t bother with a Neuropsyche. All the Neuropsyche would do is to put all the puzzle pieces together like the Neurologist did and come up with a similar answer with a different twist… I would put the funds to Rehabilitation. Good luck you are a great mom and you have done so much to help your son over the years… patti

JMHO, but I think I would agree and spend my money on the remediation. You have all the subtests that I have on my daughter. We did go to sensory integration therapy which proved very helpful with the visual motor problems and motor planning.

I don’t thnk more testing is going to do a lot of good. I would find a tutor who could customize a reading program for him and BY ALL MEANS use the accommodations the school offers, ie., books on tape, etc. for lengthy assignments. Again, JMHO

He has been very weak in visual discrimination. We have done some therapy and I think he is much improved, although maybe not age level. I am not sure. He now likes to do those “Where is Waldo and Where is Pokemon” books. He can now do them faster than his 5 year old brother. They used to be the same speed.

The only visual test I have observed him take was PACE’s nonverbal reasoning. He did terrible on it—both before (5 year old) and after the program (6 year old). He was 8. In contrast, his then 10 year old sister scored as an adult. She spent a long time on it and saw it as a big puzzle. He whipped through it very quickly. When it became harder, he just guessed. I am sure that her underlying skills are much better (she is the only one in the family who can put the hampster cage together) but it seemed like she approached it much differently too.

I think he has a hard time seeing things that aren’t right there in front of him. He doesn’t put the pieces together very well. This is actually true for verbal tasks as well.

Beth

This test helps pin point problem areas better than the WISC (which isn’t difficult to do.) Neuropsych evals are the best, though, I’m not saavy enough to pick through the small details without help. Most of the PhD’s don’t post anymore—they did when the board was first begun. There are some professional constraints and liability involved, even here.

I’m not suggesting you get a Woodcock-Cognitive. Sometimes we just test kids to death when we could spend time in learning activities. But, sometimes we test so little that we don’t know what they need, either. You, as mom, are the final decision maker in that process.

Beth,

I was thinking about this last night. It seems that the neurologist is right, going to a neuro psych wouldn’t give you anything more specific just another person’s overall view. If this neurologist is good why don’t you ask him about more specific vision perception tests since the overall view seems to be pointing in that direction. I know these tests exist, the one I mentioned before is a pretty basic one, there are others.
It seems that moving from general to specific is the way to get to the problem.

Regarding the higher level brain/lower level brain thing. This is interesting. Karen’s child has this related to speech. The higher brain is forced to do the work that should be done automatically by the lower brain to form the words.

My son has this same problem but with writing. He can form the letters very nicely when we do HWT but when he has to write down his thoughts his writing, spelling and punctuation slips. I know he knows that sentences start with capital letters, yet, he has alot of trouble doing this when he writes down his thoughts. Is this because he is using his higher level brain to control his spacing on the page, something most do automatically with the lower brain?
I think my son’s specific problem that causes the handwriting issues is related to his kindergarten level visual perception as demonstrated by the TVAS. This is why I believe my best spent efforts is to remediate this specific problem.

Doesn’t this also explain to us why these kids get so tired? They are working so hard to do that which comes automatically to most.
This has all been very interesting and helpfull to me in formulating my plan.

Emailing the test didn’t work. I never used the scanner for this before. I am going to try to copy some of it into a file later today as my other friend has asked me to do. I will see if I have more success emailing the file.

Linda

Yes. 2 years ago. I didn’t find it that enlightening which is why I didn’t post it.
% standard score
Long term retrieval 8 79
short term memory 22 88
processing speed 60 104
auditory processing 44 98
visual processing 77 111

Said that visual processing without fine motor involvement as an area of strength for him. Said that long term retrieval skills are weak. Don’t know what this tests because his long term memory is fine—remembers what happened in the past very well. He has some word retrieval issues though.

The school psychologist explained low picture completion scores in terms of long term memory problems. That doesn’t make sense to me.

Beth

My son actually does worse by the third try. He does best on his first. It is very queer (to me) and even he is aware of the fact that things become more difficult for him as he keeps doing it.

Beth

You kept talking about ADD and CAPD and after awhile I had to wonder. I have had some mixed responses from professionals with him—some think he is and some do not. I think there are multiple things going on which makes it hard. But there are behaviors at home—lack of ability to organize and carry things through that are hard to explain any other way, although I wonder if we have coddled him too much. But I really think I coddle him because otherwise nothing gets done. My other two kids are very independent.

I am hopeful that we can see some positive change with treatment.

Beth

I think all these threads are causing visual/spatial issues with me, too! I see this stuff on email, read all of them, and then answer on-line. (Might not be the most effective way of moving about…)

What did you think of the tester (or better, what did you child think of the tester) who have the WC? Maybe you’ve got one of those kids, like I did, who just didn’t fit anyone’s definition completely.

Didn’t you say a few weeks ago that reading is your main concern and that you tried LiPS for about 3 weeks. The tutor didn’t think he’d make progress. (I should have said then, how the heck does he/she know that quickly???) My child didn’t make fast progress, but he did make steady progress. I see both auditory and visual issues of some kind—maybe true, maybe not. Combo LiPS and OG (plus fluency and comprehension skill building) brought my son to H.S.-level reading. Doesn’t like to read, but can read.

Hope I’m not mixing you up with another poster.

Yes, my child is the one you are thinking of. I didn’t think much of the Woodcock Johnson tester. She was a school psychologist, employed by the district. At the time, I had hired an advocate and she too thought she talked but never said much. The advocate liked the same people I did.

I am encouraged to hear about your son because you said there were similarities. I think our experience with LIPS was due to 1. the tutor who had a fixed approach 2. my son has small motor issues and this includes his mouth. He doesn’t seem to get much information this way—and thus the labels in LIPS became one more thing to memorize rather than helpful to him.

Beth

You have had a ton of testing but if it ever comes up again you might ask for the WJII achievement and GORT III to give you standard percentiles to compare to the WISC III. I would not put my money into more testing, it’s better spent on remediation. I have found the schools do an adequate job testing, but have trouble interpreting the data. Keep hoping, our son improved a lot in 4th and 5th grade(with huge parental input and tutoring).

Linda F wrote:

>> I was thinking about this last night. It seems that the neurologist is right, going to a neuro psych wouldn’t give you anything more specific just another person’s overall view. <<

I guess my view is just about opposite. If I had a child with a brain tumor, or some other disorder that could progressively get worse, I’d definitely need a neurologist. If I even suspected that there was the slightest possibility, I’d go to a neurologist. (sometimes it’s worth it just to rule that sort of problem out, particularly if problems come on suddenly or increase with time) The trouble is that many of these problems are so subtle on the biological level, that they are not definitively detectible by any non-invasive means currently available to the medical community.

Besides my son’s speech dysfluency, he is also extraordinarily one sided. We knew he was left handed at 3 months. He NEVER reached for anything with his right hand as a baby. He doesn’t even use his right hand to stabilize his paper when he writes, and it took a year of intensive training to get him to keep both hands up on the keyboard for keyboarding.

About a year ago, I was discussing my son with a woman who I later found out was the head of pediatric neurology at a major metropolitan hospital. This was a person who was tops in her field. I told her that we had known my son was left handed at 3 months. She questioned me further, and said that in her opinion, barring strong evidence to the contrary, a child who showed strong handedness that early almost certainly had at least minor brain damage. She was surpised that he hadn’t had a functional MRI at some point. But as we talked about it more, she also told me that an MRI it wouldn’t necessarily show anything, because the damage could easily be too small for the sensitivity of the machine to pick up.

I went home and my husband and I mulled over what she’d said. We had asked whether what we did for him would in any way change based on knowing, specifically, what part of his brain was affected. She said probably not. And there’s certainly nothing that could be done to “fix” it. We decided that we wouldn’t gain any useful knowledge by pursuing a definitive answer to why or where his brain worked differently. All we would do would be to stress him out with a test that might lower his self esteem if he started to view himself as “damaged”, without any offsetting benefit.

OTOH, a good neuropsych eval might not tell you WHY your child’s brain works the way it does, (although an educated guess might be made) but it will tell you HOW it works. With a good neuropsychologist, test scores will probably be the least significant part of the report. A good evaluator will have the training and experience to watch carefully and see how a child approaches and manages each task. If they need to test further to figure out why a child’s processing speed went down and reduced the score in a particular area, they will.

A good neuropsych eval may or may not be able to put a specific label on what is going on with a child. What it will do is give you a road map for educating your particular child. What are his strongest points? How successful is he in using them to compensate for weaknesses now? Are these compensating strategies good ones, or are they heading him toward a dead end? (we found through neuropsych testing that our son, who “seemed” to be able to multiply and divide single digits quite accurately in 3rd grade had actually learned to count, forwards and backwards, very, very quickly… not a useful strategy when you need to do long division in 4th grade!) What are his real weaknesses? Are these remediable? What SPECIFIC interventions make sense for this particular child?

Neuropsych evals are expensive for good reason. A good one takes a long time to do, as well as a lot of training to administer properly. But I consider it the best money we ever spent for our older son. Now our younger son is starting his tomorrow. My husband gulped when I told him last spring that we needed to do it. I said to him, “We’re paying $5000 to straighten out his teeth. Can you really tell me his brain isn’t worth less than half that amount?”

I know you can get a bad neuropsych eval. I know several people who have gone to major hospitals and universities and come away with a report full of psych-jargon, maybe a label, and no useful information to help the school help the child. I think that people should be very careful and get good references when shopping for a neuropsychologist. Look for someone who has a reputation for writing a good, understandable report with specific, concrete suggestions for the child’s education. Also pick someone who will go to school with you and explain their findings, in person, to the school staff.

I can tell you for sure, if we didn’t think we’d gotten our money’s worth the first time, we wouldn’t be doing it again with a second child!

Karen

Linda F. wrote:

>> Regarding the higher level brain/lower level brain thing. This is interesting. Karen’s child has this related to speech. The higher brain is forced to do the work that should be done automatically by the lower brain to form the words.

My son has this same problem but with writing. He can form the letters very nicely when we do HWT but when he has to write down his thoughts his writing, spelling and punctuation slips. I know he knows that sentences start with capital letters, yet, he has alot of trouble doing this when he writes down his thoughts. Is this because he is using his higher level brain to control his spacing on the page, something most do automatically with the lower brain?<<

My son has exactly the same trouble with written expression. He knows perfectly well how to use capitals and punctuation in isolation. He will happily correct any typos a teacher hands out on a test or work sheet! He is in the 98th %ile for spelling in standardized testing. Yet, when he has to write anything, He doesn’t use a capital or punctuation anywhere on the page. He mis-spells words that I KNOW he knows how to spell, and his handwriting (printing… he doesn’t write cursive at all) becomes close to illegible.

It was explained to me exactly the way you suggest. None of these processes are automatic for him yet, and because he has to use the higher brain function to keep too many balls in the air, it doesn’t work, and something has to go. That’s why it was strongly recommended that he be taught to keyboard well as soon as possible. The idea was that the motor part of keyboarding is much simpler than writing by hand. good programs will help with spelling, capitalization and punctuation as they go along. Certainly, kids need to learn these other skills too, but it will take a lot longer for these skills to become automatic enough that they don’t interfere with the written expression part itself.

And yes, it is the oppinion of most of the professionals we’ve consulted that his speach problems AND the problems with written out put are both part of the same basic issue.

Karen

Boy, I wish our schools did good testing. In both my son’s cases they said there was “nothing wrong” and refused to test. With the older one, I didn’t know I could insist on it until later. With the younger one, I have just lost faith in them doing an adequate job, skipped that phase and have gone straight to a private evaluator that I have confidence in to do both a good eval and write good recommendations.

Karen

When my son (then age 7, about 1990) went through LiPS (then called ADD), he found the labels revolting, too. Fortunately, our tutor wasn’t hung up on that part (we got lucky) and moved on when he could feel how the sound is produced and describe that in his own words/labels. Since then, I’ve learned from NICHD reading-research that the ability to segment, blend, and move sounds around is the part that, we believe, truly helps reading. In fact, the Torgesen longitudinal study indicates that using letters to move sounds is best: so I move from block tracking very, very quickly and into letters with CVC and CVCE pattern. Back to blocks intermittantly, but mostly letters.

My son’s issues were both visual and auditory. He was very late to speak in phrases and sentences and had articulation problems. Difficulty reading social cues (non-verbal) and moderate fine-motor issues, mild gross-motor issues (poor balance/coord). Great vocabulary and excellent syntax/pragmatics so reading comp was a relative strength. A very average memory on some things, great on others. Difficulty in math. Flip Kid—issues on both sides. “Oh, my!” they would say at posh private schools when I would fax test results for possible summer or school year placement. They weren’t even sure they could teach him—at that time they liked the language-based LD kids because they generally lack the behavior/social issues. No one really believed that this kid would learn. This was before FastForward, Earobics, and any other supportive software. Stone ages.

Fortunately, my son had strengths on both sides, too. I think he used them to wire new pathways. I just kept plugging away and finally gave up that I would really understand the full diagnosis.

Thankfully, I met Wilson Anderson. He helped me take my son into multi-syllable word reading beginning at age 13. He was still at 3rd grade level. Couldn’t make sense out of LiPS multi-syllable segment. “Seeing Stars” was still just gleam in Nanci’s eye then. I was tapped out from tutors, psychological testing, and the myriad of other expenses we parents endure. I had to learn to teach reading. I couldn’t afford to pay tutors for years & years due to my son’s learning pace.

After dinner, I’ll post who I like to study now. Lots of learning & the brain stuff, in addition to reading lit. So much to learn…so little time!

I hope you’ll email me so that I’ll have your address.

Why don’t you post with your response information? You can tell me about that privately.

> % standard
> score
> Long term retrieval 8 79
> short term memory 22 88
> processing speed 60 104
> auditory processing 44 98
> visual processing 77 111
>
> Actually this is pretty enlightening I think- it tells you that it isn’t necessarily the individual pieces of the processing that are hard for him- it is the integration of the auditory and visual stuff… Long Term Retrieval is probably the most misnamed cluster I can think of… It really is more of an associative memory assessment than a long term memory assessment and is valuable for teasing out kiddoes who will find new learning somewhat difficult to acquire. At your son’s age Beth, many learning tasks reqire strength in associative memory- learning letters and sounds is probably the most striking example of an associative task- but math facts and a bunch of other stuff fall into this category too. He also has what I would call a small desktop for new information- that is the short term memory cluster score- especially information he hears since this test is all listening.

Instructionally scores like this suggest that he needs information to be presented in small increments with lots of opportunity for overlearning- but that once he has it he should be able to get at it without a gtrreat deal of trouble. This is what you see as good memory BTW- recalling what he KNOWS. It is acquiring the learning that is a little tough. This may or may not be part of the CAPD- it is certainly on the list of possible behaviors- and it may be related to other attentional issues- these are just numbers I am looking at and not a whole child after all:)

Robin

Karen,

I agree that keyboarding will certainly help to circumvent this problem. Have you tried to teach your son cursive? I read that some children have an easier time with cursive than they do print. (I don’t have the article anymore but it is dependent on where the breakdown in the writing problem is) This is why we are doing HWT cursive this summer. If this doesn’t work we will move to keyboarding.
Also, I believe that the problems you are describing are related to dyspraxia. Does this term sound familiar? The brain knows what it needs to do yet the motor part is inefficient.

I was told by my son’s Occupational Therapist that interactive metronome helps with dyspraxia. We will be starting in August.

It surely sounds like you found a wonderful professional to help pin point your childs problem. Congrats!

Linda

Wow, a therapist we have worked with for some time told me the same thing about his processing. This is what we have been working on for some time now. But what you said, which rings true, is nothing like what the school psych said. This is why I took his scores to a independent psych. who wasn’t much more help. So, you don’t always get what you pay for!!!

Now this same therapist thinks this is his core problem—not ADD. It manefests itself with him having trouble keeping his performance going. It takes so much effort to integrate that he can not maintain it. I told the neurospych about this characteristic of him but he thought it was attention. It is in one sense but it is because the underlying processing is so difficult. Do you have any experience with kiddos like this? Does medication help?

I think you are on to something with associative memory but I don’t understand it still. Could you expand a little? I have never heard of it. Could you give me maybe a little more information on what the test is?

He has had trouble learning math facts as well as as sounds and letters. And yes, once he knows something he really does. He still knows the continents from the beginning of third grade–now he had to bounce on a ball and call out the continents by name by looking at pictures he drew to remind him of them…….But he knows them!! The struggle has been to automate information for him. Motor activities seem to help (he could do that darn LIPS circle as soon as he started bouncing on a ball doing it).

Beth

Hi Linda,

Yes, we did try cursive… briefly. Total disaster. In my son’s case, it’s not just a motor issue. He also just doesn’t “see” how the letters are formed. His visual/spatial issues combined with his motor problems made cursive an exercize in frustration. He could _not_ remember what direction to move the pencil in. An added problem was just plain muscle fatigue caused by his motor problems. While he also has fine motor issues, the big one here was gross motor/upper body weakness. When printing, your muscles have a very short “break” between letters. In cursive, you have to have the stamina to keep going. After even a short time trying to do cursive, his hand and arm were cramping to the point that he couldn’t continue. He is also a real perfectionist, and tends to get perseverative. He’ll get caught up in making one word perfect, and erase it until there are holes in the paper. (with printing, he only needs to re-do a single letter, not the whole word if he makes a mistake!) His frustration level turned to anxiety that made it impossible to get him even to put the pencil on the paper.

Also, his printing is quite legible, it’s just slow. With an NLD kid there are so many areas of deficit, that you have to pick and choose what areas you’re going to focus on. The biggest long-term problems for NLD’ers are anxiety/stress/depression issues, brought on by being overfaced and pushed too fast. So one of our main goals, as we plan his education, is to work on strategies that allow him to get where he needs to go as efficiently as possible. I think we can get him to the point that he can sign his name in cursive, but for other purposes where any sort of lengthy written response is required, I think that keyboarding is really the best alternative for him. (we had an assistive tech assessment done this spring, and they were of the same opinion… they said that he should really be working on a laptop most of the time next year in 6th grade)

Karen

We certainly saw improvements in the dyspraxia part of my son’s handwriting issues with IM. Mostly, that his output improved a lot and he stopped whining about how tired he is. Now he still doesn’t capitalize or punctuate so that must have some other cause.

Beth

Did you find the neuropsychological evaluation helpful? Did you get more specific information other than a right hemispheric disorder? In one sense, I already knew that. Two professionals who have worked with my son have said the same thing—although as audiologists they certainly weren’t in the position to diagnose (and made sure I knew this was outside their professional boundaries).

My son has some traces of NVLD on the social end. Sometimes he speaks in a monotone—but not usually so I didn’t even notice it until others mentioned it. His teacher at school told me he read his lines in a play without varying his voice at all. Sometimes he doesn’t have eye contact—like at the pediatrician’s office when perched on top of the table quizzed by the doctor. Interstingly enough, he looked right at the neurologist when he spoke to him. It may have been sitting in chairs which is more normal. He does not suffer from anxiety.

Beth

What terrific insight you have in synthesizing the CELF results to other teaching & learning situations. I know some good S/L’s, but they seldom articulate it as you have done.

I’m going to post some brain & memory stuff from Eric Jensen & Pat Wolfe—not to be discrepant with your information, but to shed some light on different types of memory and retrieval.

Who is Wilson Anderson? Your son does have many similarities to mine. I am encouraged to know that he is doing well, even if he doesn’t like reading! I read everything but I certainly could live easily with that.

Beth

I meant I told the neurologist (not neurospych—we have not seen one) about his difficulties sustaining performance.

Oh, I didn’t mention the IM business. In our son’s case, as I mentioned, there was a LARGE upper body component to his writting difficulties in K. His writing actually became immediately more legible when the OT reduced the size of the lines he was writing on by 1/2. The OT said that upper body strength was a bigger issue in writing problems than most people recognize. It is also the source of a lot of fatigue issues in written work, and just plain being in school.

She suggested either Karate or gymnastics to improve balance, timing and strength. Since I’m leery of Karate, (having had my son regularly trounced by an older cousin who took Karate and used it inappropriately) we chose gymnastics. He did 4 years of gymnastics, ending at the pre-team level. He was never competitive, of course, but his teachers were supportive and understanding, just encouraging him to do the best he could. He got a huge amount of physical benefit out of it, and never even realized that it was therapeutic.

When he stopped gymnastics, we moved him into his current gym-based social skills program, where they know that upper body strength and visual/motor coordination are issues. (they work with LOTS of NLD and AS kids) So they continue to address those needs along with working on social skills in a fun setting.

IM sounds like an intriguing program, and it’s one of those things, like vision therapy, that we considered. But because we didn’t really understand what all his issues were until 4th grade, we were already caught up in the stress of just keeping up with school work and homework. We have to really be careful when choosing therapy options that the added stress doesn’t outweigh any possible benefits. So with the things that “might” help, but we’re not sure, we are reluctant to add them to his already full schedule.

Karen

Karen,

We have seen really nice improvements with IM—and mostly related to the right side of the brain (I think anyway—I always errored on the social science side in college). Besides the handwriting progress, my son now sings. He never has. He even has made up songs. He also was talking to his puppy in an animated conversation in which he was the dog and then himself. He has never done that ever—even as a young child.

I think it is worth doing but with your child, given what I know of him, you’d have to be careful. I know he is sensitive to stress and so you’d want someone who was really good at working with kids.

And you can’t do everything—but it is worth putting into your maybe pile.

My son has done gymnastics and karate as well.

Beth

Wil is an Orton-Gillingham trainer and educational consultant. He taught me lots & lots about reading. He’s been around for ever and knows all the different programs (OG & not): what they do, what is their basis. He is a past president of IDA and, I think, is the current Pres of the O-G Academy.

One of the most important things Wil ever said to me is, “When children fail to learn, always remember that it is *never* their fault.” True, true, true.

My son has his share of other problems—but he can read! (He brought tears to my eyes one day recently when he told a student of mine, “Don’t worry. My mom will teach you how to read. She will never give up finding different ways to try.” He knows me too well…) I hope I never lose empathy for what families experience.

It is just about time for me to begin preparing for next school year. I won’t be checking in as often then. I have more time in the summer, actually.

Books for you on learning & the brain:

Wolfe, Patricia. (2001). “Brain Matters: Translating Research into Classroom Practices.” Alexandria, VA: Association for Supervision & Curriculum (ASCD)

Jensen, Eric. Several titles—all wonderful. “Teaching with the brain in mind” is the title I have—loaned out right now or I’d give you the info on it. He has a website, too. Incidentally, will be the keynote speaker at the LDA of Missouri annual conference. Now aren’t they on top of things!

Your observation about your son’s ball-bouncing to retrieve continents was very important to understanding how he gets things out of memory and what part of memory seems to be working.

Pat Wolfe would be an excellent guest on this website. Someone should suggest it.

Sorry, but have to do other things today. Have enjoyed making your acquaintance!

You guys are just wonderful. So many things to think about. I appreciate it so much. And I must say I no longer feel like I am the only one who has the LD child who hasn’t read the book–can’t even be an “average” LD child.

Beth

Yes, we got our very most useful information from the Neuropsychologist. Until then, no one knew how to deal with him, and just kept pushing and pushing beause they “knew he was bright”. Now we know that pushing him is counter-productive. He has plenty of internal drive IF he has the space and time to learn. But he has a slow processing speed with novel material, (which sort of sums up the whole school experience) and if you push him, you only add stress, which drops his processing speed even lower, and becames a vicious, downward spiral.

Actually, the “social” stuff you mention with your son is not what I’d call “typical” of NLD kids… it’s stuff that you sometimes see in some of them. My son does not speak in a monotone. (he’s just really, really disfluent, but that’s not a typical NLD thing either) And eye contact varies tremendously from one NLD’er to another. The Aspergers-ish ones might avoid eye contact, but not all do. My son has what might be called “inappropriate” eye contact, where he will not drop or vary his gaze at all, which people often find unnerving, or view as insolent. The funny thing is that I think this is learned behavior. His SPED teacher in first grade made a big deal about teaching the kids to maintain eye contact when she spoke to him. His mind might be a million miles away, but his eyes never leave your face.

The expression of NLD social issues come in as many different “flavors” as there are NLD kids. The basis of the problem is that due to their visual/spatial difficulties, they don’t pick up on the non-verbal cues of others. The also don’t learn by watching others. So they don’t acquire social skills by observing other people the way NT kids do. They can be taught these things, but each individual step needs to be taught separately, by rote. With my son and the eye contact thing, he was “taught” to look people in the eye, but not to moderate it. (with autistic people, my understanding is that they purposely avoid eye contact because it is uncomfortable for them. That’s not usually the case with NLD kids, they just don’t know any better)

Interestingly, theater is often really good for NLD/AS kids because they CAN learn, by rote, to imitate expression in their tone of voice. Sometimes (though not always) these skills start to seep over into conversational situations as well.

Karen

I guessed that ;-)

Karen

I know it has worked well for many people. (vision therapy too) But we didn’t know about his issues until much later than you did. At this age, (he’s 11 now) he really has to buy into something or it doesn’t work. We dropped straight OT for that reason.

Karen

How true. Socks’ boys did it at that age and maybe older. Not sure how she managed the buy into it issue. It is a program of limited duration which is attractive as opposed to OT which can go on forever.

I can still tell my son that he is doing something. But at 9, eleven is not that far off!

We did vision therapy as well. I would take IM over vision therapy. If nothing else, it is standardized so you are much more likely to get the same treatment as someone else.

Beth

Yes, we did. But that’s also because it was the first comprehensive testing we undertook. He had been seen by speech therapists and OT’s in his younger years, and even taken the Stanford Binet at age 4. (which interestingly enough shows some gaps consistent with the VIQ> PIQ we found on the WISC, but doesn’t really raise any red flags. He apparently was “well related ” back then, which makes me think his lack of eye contact is somewhat a learned response as in Karen Randall’s case …)

But the neuropsych was just the beginning of our understanding. Either b/c it wasn’t complele enough , or I just needed to do my own research, I now feel like I have a handle on his root issues. Here’s my theory: Poor internal timing/planning and lack of automaticity. Sound familiar? His patterns of strengths and weaknesses are suggestive of many disorders, but that’s what I think it really boils down to.

Also curious about what other parents of kids like these think about meds.

You are just that much farther down the road than I am, and I have learned alot from reading your posts. And about IM . I am also less wary of IM, than VT. Several people I respect suggested IM for my son, and he began this week. I do see him squinting and moving his head when he reads, but only when he doesn’t want to be reading. If its voluntary (rarely!) I don’t see that behaviour. Anyway - wish us luck!