Making Sense of Cognitive Assessment - Dyspraxia/Dysgraphia

[artichaut27]

Hello,

I've just got back from my DS1's (private) cognitive assessment. He had been assessed for Dyspraxia by physio/OT in August and I wanted to check how he was doing on the cognitive level.

My suspicions have been confirmed but it was still a shot across the bows. I'm feeling a bit fragile and dreading the struggles of the years to come.

His speed of processing was the lowest with 16th percentile and his working memory was around 30th percentile I think (full printed report to come).

His Verbal was 115 on WISC and his Perceptual was 121.

Ed Psych said that he will struggle at school with anything auditory sequential. She also thinks he is dysgraphic, which I didn't realise.

Does dysgraphia fall into dyslexia?

She said, although 'very spiky', his profile was a bit different from most kids with Dyspraxia. For example, he scored in the gifted range for Block Design and another subtest. She said something like 'pockets of giftedness'.

Does it make him Twice Exceptional?

My DS1 is very creative and visual spatial. He has a very good photographic memory, but terrible auditory memory.

He was building big boxes of Lego at age 4 on his own, but he has poor pen control.

Although, I understand his profile, but it is so paradoxical at times, that it is very difficult to wrap my head around it.

Anyone else has had a similar 'spiky' Cognitive score?

Thanks!

How old is your son OP? Is he having difficulties at school?
My son (6yrs old, Yr1) scored extremely low (1st percentile!) for processing speed but got average or high average for everything else. Although he is bright, he struggles to focus in class and hates writing. The school has applied for an EHCP and has provided him with 1:1 TA support for written work. The psychologist speculated that his dislike of writing is linked to his poor processing speed (ie - it’s all there in his head but he struggles to put it into written form).
The frustrating thing about my son is that he can write quickly and well when he’s in the mood for it. It’s therefore sometimes difficult to believe that he has an ‘impairment’ with his writing. He’s also excellent with spellings and picks new spellings up very easily (he’s always happy to do spelling tests because they are one word at a time... he just hates writing sentences)

He's 7 and a half in YR2. Considering his difficulties with handwriting and processing, he's doing ok. He works really hard, he's very 'gritty', persistent and a perfectionist. So he has good standards for himself (his choice, we're not pushy obviously). All non-cognitive skills that make up for his cognitive weaknesses.

His teacher told me this week that she's not surprised about speed processing. He needs a lot of time to think.

He struggled a lot in reception and YR1, but made leaps and bounds since entering YR2.

Does your DS have a photographic memory and strong visual skills? My DS is good at his spellings and learns them photographically.

I wouldn’t necessarily say my son has a photographic memory but he knows how to spell a lot of words because he remembers them from reading books (he’s exceeding at reading at school - the only area that he’s performs well in at school).

He has a fantastic memory for learning and picks up new complex concepts/ideas quickly. He just doesn’t like writing at length and finds it difficult to sit still/be quiet in class (although the knowledge still somehow goes into his brain) - it’s really holding him back at school. The biggest problem is that he sometimes refuses point blank to do his work... whereas at other times he’ll be really enthusiastic and take on additional ‘greater depth’ work that is set for him. The unevenness means that he’s not currently meeting age-related expectations for writing and maths... even though he finds the work to be (in his own words) ‘easy’. Argh 🙄! Hoping his attitude will improve with age 🤞

www.understood.org/en/learning-attention-issues/child-learning-disabilities/dysgraphia/understanding-dysgraphia

I have leaned a lot from this website.

I would ring the OT and ask about great lego skills vs poor handwriting. Try to pin down his handwriting problem - you'd think if it was fine motor he'd have problems with lego.

We have issues with processing speed and working memory - can't recall off top of head any strategies but understood.com will no doubt cover. Its USA based but great practical stuff on there in great detail. We do play a memory game - 'I went to the café and ordered....'(each take turns to add an item to the list and see how many can be remembered)

Processing might just mean he needs more time to register the question and think about it and maybe some visual prompts would be useful to remind him (picture might go in quicker than auditory if he has better visual skills).

Dyspraxia ADHD dyslexia and dysgraphia often hang out together.

Start write stay right, write dance - lots of stuff you can do for handwriting, sooner the better as optimum age to help is up to around 11. Low pressure approach so he doesn't resent it. Air writing, vertical (blackboard/white board), multisensory like sand/glitter/wooden letters/goop/shaving foam or sandpaper can help muscle memory embed.

Pintrest is your friend here. Type in multisensory writing and off you go. Try writing patterns too. Write dance good for this, they use her materials in lots of European countries. She's Dutch I think. Books and CD's are published in English by Lucky Duck.

writedancetraining.com/about-write-dance/

I really like it as it's not just fine motor but gross motor, music and movement and its fun - aims to make writing as enjoyable as art. More holistic approach to pattern and letter and the flow of writing.

When we do practice (and at school - DS has handwriting intervention 30 mins x2 a week I think) we choose one thing to work on - finger spaces, aim for the line (use a sharpie to make a thicker black line, and a colour/highlighter to indicate small letter spaces and upper/tall area for where the stalk of a h, d ,b goes up to, or descenders go down g, y's)

Just focus on one aspect at a time - otherwise its overload/failure. Or look which particular letters are hard (a's for us) and work on those.

Sitting still/moving - try weighted lap pad (1kg for younger kids) and deep pressure movement breaks, great for proprioception. Squeeze yourself in a hug, wall press up, press down on your head - gentle but firm etc

These reassure the bodt about where it is/give it sensory feedback which is calming.

The Out of Sync Child books are good too.

Thanks a lot for all the suggestions KisstheTeapot14

I love the Understood website and I have been reading about Slow Processing there. I've now understood why making decisions is such a tough one for him.

Great suggestions for the SPD. I've made him a weighed blanket last year, which helps a bit with sleeping issues. A weighed lad pad is a great idea.

We have a private OT once every 6 weeks, because NHS discharged us instantly.

The OT helps with handwriting exercises. We've been doing the 2 minutes a day method. 2 minutes patterns, 2 minutes letters.

His handwriting has improved tons since then. He has now just started to write for 'fun' and he's doing alright.

In hindsight, the WISC was always going to be a problem for him, as he freezes with anything timed. Given his difficulties, test conditions are stressful and exhausting.

I'll see what the Ed Psych says in the report, I hope it won't be all gloom and doom. She sounded quite worried about his low WM and PS scores.

She mentioned that he needed breaks during test because of attention issues. I've asked her if she thought he could have ADD. She replied that he was well-behaved so probably not.

It annoyed me, as ADD and ADHD kids show different patterns of behaviour. The ADD kid is more reserved and 'off with the fairies' type.

I had the same issue with a GP who said my DS1 didn't look like he had ADD.

I'll guess we'll never know.

You've got a great point about Lego and Dyspraxia. This is one of the paradoxes that still bugs me.

DCD kids have all kinds of profile though. DCD (500 articles) is very under-researched as opposed to Dyslexia (15,000 articles). So there is still tons to discover on these quirky individuals (in which I count myself!).

Yes, totally. No-one fits in a box. Its just understanding the strengths and room for improvement bits for your own child to help them along the way.

ADD - ours has just been assessed. Ed psych sent report to paediatrician who reviewed with connors3. No hyper activity just dreamy etc etc diagnosed straight away.

It has to be med diagnosis so go for 2nd opinion - connons you can see online so use as basis of your ticklist to show GP to get referral. Can take some time to be seen, but if you think it is relevant then push for it to be properly looked at.

Not a GP's job to say yay/nay. That's why paeds have a mega ton of training. Always go for the 2nd opinion. Good Luck Arti x

Thanks Vasillisa.

I suspect ADD is very under-diagnosed.

My DS1's paediatrician said his attention issues are part of his DCD package. I can see it, but at the same time, it's not 100% put my mind at rest.

Seeing now that his processing speed is that low, I wonder if his DCD (and SPD and secondary APD) is his only LD. There's always been a bit of ADD in him. But given the Vrenn diagram intersection for all these issues, it's difficult to tell the hay from the straw.

What stood out in the ADD diagnosis for your DC?

Is that your DC's only LD or is it co-morbid with another?

I'm just curious. At this stage, I'm not really keen on another label on him!

We have DCD then possible dyslexia, writing bad but DCD issue we think.
ADD most recent diagnosis 2 and half years after DCD diagnosis.
Also mild speech issues and bladder probs.

Will have a look at connors and tell you the stand outs later

May have poor concentration/attention or
difficulty keeping his/her mind on work.
May make careless mistakes. May be
easily distracted. May give up easily or be
easily bored. May avoid schoolwork.

Restless (but this is more DCD related) and interrupts people.

OT said he needs so deep pressure movement breaks during sitting still time in class as proprioception needs are distracting his attention

Exec function
May have difficulty starting or finishing
projects, may complete projects at the last
minute. May have poor organisational/time concept/planning
Add to this learning problems - 3 years behind peers

Not aggressive at all, not hyperactive as in always on the go, up super early/late to settle, moves from one thing to another (ours can focus on play/film but less so in busy classroom on tasks he finds hard anyway and lots of stimuli drawing attention away)

Ours can be impulsive (still can't cross road safely at 9 years) but not wildly so in general just have to watch safety aspects.

Not angry/destructive or verbally argumentative more than average kid. I would say inattention and exec are the two high scorers from this test. Basically he's a dream boat.

Very loving, happy kid but attention all over the place - constant reminders to stay on task - OT and ed psych both commented and speech and lang said he did OK once focused.

Due to attention/learning difficulties and poor writing and reading he has a TA most mornings and we have just asked for EHCP as school have gone as far as they can with time/money input.

Ed psych suggested weighted lap pad 1 kg and maybe timers and other tools to help him to learn to self monitor/meta cognition skills as he grows. So adults showing him how they monitor their behaviour by talking it out loud/doing the same for him. 'Ok so we got distracted by youtube videos but we need to focus on maths homework. Let's crack on with that for 15 mins then we can have a reward break for our hard work. '

Paed agrees we should try this for a year then look at meds - she did say that as kids grow that frontal cortex develops so we might see a quite different picture as he gets to say 11 or 12 (just in time for hormones) and he will mature to have better self control and focus.

Must say that I look at myself these days and think ah wonder if he got this from me. I am Mrs distracted, but has never stopped me getting what I want done. Nor an issue at school for me.

Hope this helps.

Thanks a lot for the description vasillisa

I can see a lot of my son in it. He's always struggled to fall asleep. He's always on the go, except when he's in the 'zone' and then he hyper-concentrates. Since age 4 has been able to sit on task for up to 4 hours on something he's really engaged in (lego, audiobook, etc.).

His attention issues always come up at parent's evening though. At home, he tends to talk over us, and interrupt us a lot.

He can't manage street-crossing either and I need to remind him to wait for me to cross the street. Sometimes it feels like having a giant toddler on the street :)

Funny what you say about Mrs Distracted. As a child I would go to school with my sleepers on. Complete space-cadet!

DD2 has DCD but is very good with things like lego and putting fiddly playmobil people together. Her handwriting is dire though - it's the motor memory and sequencing of the physical letter shapes and spatially orientating them on the page that she struggles with. Her attention seems poor as well - but actually it's picking one stimulus out among the chaos that she struggles to do, and she's like me - needs to fidget or doodle to be able to focus fully so usually looks like she isn't paying attention when she is.

She is terrifyingly determined though - announced today that she was GOING to ride her bike without stabilisers or help and she's about 90% of the way there! Her balance is actually pretty good - but again, it's the motor planning of circling the pedals that she struggles with.

Yes Pantsy think you have hit nail on head in describing handwriting vs lego. DS really struggles with these, though short handwriting lessons are helping. Problem is when he has to think and write as opposed to just concentrating on sitting letters on a line etc. Drunken spider all over again. Still, small gains.

We are looking into bike riding lessons this summer with a teacher with SEN experience to help with the pedalling bit. FB dyspraxia groups often have heartening videos of kids who have fledged on their bike skills. Brings tear to the eye. Swimming too, quite possible. Just takes specific teaching and time. Good luck DD2.

Off to buy knee pads and elbow pads now.

That's amazing Pantsy about the cycling! Determination seems to take these kids wherever they want. I once heard a French Neuroscientist specialised in LDs and G&T who said that you're better off having a bright kid with LD than a G&T. Kids with LDs know how to work, a lot of G&T don't have to work. It's a biased generalisation but there's a lot of truth there. I'm a mum with poss DCD/Dyslexia and I did ok considering.

My youngest learns very easily and acts out in class because everything is too easy. He tends to give up when effort is needed.

My DS1 rides the rage of his frustration pretty healthily. He relinquishes a challenge and complexity.

We've been meaning to get a bike. It's all been so difficult with Speech and writing this year that I've been half-hearted about bringing a new beast to tame.

DS1 is getting there with swimming.

I have a neighbour on my street who is a retired SALT and mother of a DCD grown-up son. She told me that DCD tends to be compensated/outgrown by age 25. They then make leaps and the penny drop for a lot of things.

She recommended Rugby and sea sports like sailing, surfing, windsurfing. She said they are excellent for DCD kids. Big no-no on tennis though!! haha!

Other very interesting thing that she told me in that working memory can be worked and improved. I naively thought it was a set trait.

So that's good news.

You can definitely be very well behaved and have ADD.
DS is a very compliant, hardworking child but has ADD. He has a very spikey profile but medication for ADD led to an improvements across the board. Even things like cycling. I had been trying to teach him for years. Once his ADD was being treated he learnt very quickly.

DD2 also can focus for hours on something she wants to focus on but appears to be away with the fairies the rest of the time - but actually when you figure her out she has missed absolutely nothing and is pin sharp and very very deceptive to the extent she's learnt to read all the road signs and routes around here and played grandad for an utter sucker the other weekend making him drive them between parks and navigating perfectly for him for 6 hours in one day! (She's not long turned 6)

She comes out as just under the borderline for inattentive ADHD - but I was reading one of the Lois Addy books recently talking about perceptual issues linked with dyspraxia and it does explain a lot of her quirks... but she's placid, desperately eager to please and compliant - so you can imagine the amount of time and energy she gets in terms of support within a classroom setting (hint it's a number that is equal with "fuck all").

I've never even looked for assessment scores (they tend not to give you them around here from NHS services and school haven't bothered to do any formal assessments since the diagnosis was all done via the health service related agencies). DD2 has verbal dyspraxia as well (had virtually no intelligible speech when she started school) so I focus my energies on the speech therapy side of things to try to get that up to scratch (although a lot of the programme the SALT does also is very beneficial for her working memory) and in just trying to embed strategies to help her with things like writing on an iPad in terms of recording a sentence and then she can play it back as many times as she wants while she's trying to get it down. I take a lot of flack from school for not pushing the handwriting angle at home - she's already distressed enough about how it's being handled in school this year... I'm bloody well going to let her practice her spellings by typing and they can piddle off if they have a problem with that!

Swimming - don't get me started - we moved from one set of lessons where they just yelled at her for not trying (pre diagnosis though so although they were shite they really weren't being openly intolerant - just shit) to another much better setup, but she's still been right at the border of being a bit too good for beginners, but not up to stage 1 for a year and a half now... her confidence has come on no end and she's a lot better than she used to be - but for things like jumping into the water she can't quite process jumping up and forward together and just ends up landing back where she took off from, plus her low muscle tone makes holding a shape to float hard for her - and those are the two skills she's lacking to be able to move up!

In some ways because she's a slightly less conventional profile for DCD (and I have to say, because she's a girl as well) everyone's struggled a bit - school tried to just go into "struggling boy" mode initially and it's taken a lot of me pointing out repeatedly that she has these difficulties but they do manifest in her own particular style for them to start to get the picture, and this year we've had a very disinterested class teacher who very much made the assumption it was going to be "dyspraxia=shit handwriting and will fall over a lot" and hasn't wanted to listen to anything else.

As for sport - she does (with varying degrees of success) - karate which she's dire at but has really benefited from things like the warm up activities and hopefully it'll give her a chance of walloping the little shite who's bullying her some day, swimming, dance (but we moved her from one set of classes which were proving a bad fit as she got older and her difficulties came to light into another setup with a lady who teaches in the church hall but went off and researched DCD and adapted how she delivered the class just to help DD2 fit in), and when we can get there she is amazing at one of those climbing wall places - and the strength benefits it gives her core and arm/shoulder muscles is brilliant.

Ah! Bless the dancing teacher. We need a few more people like her in the world (and a few less like the teacher who makes lazy assumptions). Climbing is ace for building dyspraxia related skills up. Drumming too (there's been research on this)

Pantsy Your DD2 sounds fantastic! I admire her attitude, it will get her a long way.

I'm very possibly the one with the DCD curse and I was a complete 'off with the fairy' child. I still can't really swim that well, dancing has always been a problem because I needed to memorise series of instructions and I don't know my right from my left.

Drumming is a good idea. Reading music isn't fun for a lot of dyspraxics. I always learnt music by ear which obviously has its limitation as a compensation device.

The good news is I'm learning how to drive at age 47, which I thought would be utter disaster. It really fries my brain but it's going pretty well. So all is never lost, even later in life.

Do any of you have invested in a WII Fit for your DCD kooks? DH read something about that type of video games and coordination, so we're looking into it.

I'm also looking into learning how to teach Kids Yoga which OT recommended. I have a personal theory that Yoga helped rewiring my brain. It sounds a bit too enlightened to be true, but it definitely helped tons with body awareness. It created a mind-body that was definitely not there!

I think yoga would be excellent for any child to learn, but especially one with DCD. Well done on the driving. I passed a good few years ago but never been very brave at practice. Scared will cause crash. Be good to get over it as such a useful skill.

Can anyone recommen OT in bristol