We have some answers

[Malika]

Okay, been and come back in one piece from our trip to the big city to see the neuro-psychologist. She is yet to send me the detailed report, which will go into some emotional/behavioural components that she didn't go into with me, but basically:
J has something called visual-spatial dsypraxia NOT dyslexia as I was beginning to be certain. His scores on the WISC were

131 on the memory tests
116 on the verbal reasoning tests
103 on speed/performance tests
86 on visual-spatial tests

Which is a HUGE discrepancy between top and bottom scores and what, she said, pointed to the presence of this "dys"... she said his reading problems were actually more related to visual/spatial factors (she said that b,d,p and q all look more or less the same to him) than some innate difficulty with reading.
So... I've very often read about dyspraxia in relation to ADHD (she specified that he does not general dyspraxia but just this visual-spatial kind) but don't know so much. Another steep learning curve coming up!
Anyone have any personal knowledge/experience?

 

[InsaneCdn]

Sounds a bit like "developmental dyspraxia"... which was an older term for Developmental Coordination Disorder (DCD) (developmental coordination disorder).
And Developmental Coordination Disorder (DCD)... can affect just a single aspect - a kid can be a fantastic athlete, but have major problems with writing, for example.
And writing is one of the most challenging tasks we learn.

www.canchild.ca has a whole section on Developmental Coordination Disorder (DCD) (not on the top menu, I think its to the left on the main page, haven't been there lately - if you don't see it, I'll go look it up).

 

[Malika]

Hi IC. No, the problem is in the translation, I think. The neuro-psychiatric was at pains to point out that this was nothing to do with co-ordination. And J has indeed had good fine motor skills and reasonable co-ordination. This is what I found on good old Google:

[h=2]Dyspraxia Type[/h] The three types of dyspraxia are:

1. Dyspraxia gesture: it is a deficit of motor acquisitions and gestural coordination
2. Dyspraxia constructive: it is a lack of planning an executive function task and production task .
3. Dyspraxia visual space, which seems to be most common to date. The dyspraxia could also be classified into three groups, perhaps more difficult to identify.

• The first type of dyspraxia : is the association with disorders of praxis difficulty of verbal expression
• The second type of dyspraxia : is dissociated impairment of motor skills with particularly praxis conducted on the orders more successful than others initiated as part of an imitation. They present and syntactic difficulties spatial dyscalculia
• The third type of dyspraxia : a deficit of the system for attention deficit and a representation of visual cues.

So J has the third type.

​

 

[Ktllc]

I think it is reffered as visual and spatial perception issues. It is part of motor planning which I think is equal to dyspraxia if I am not mistaken. A child can have good coordination and still have visual and spatial issues. It is the case for V.
It is definetly an Occupational Therapist (OT) related field. So in order to better understand how this visual spatial dyspraxia affects J and how to help him, the best course of action is probably to contact a good Occupational Therapist (OT). Keep in mind that Occupational Therapist (OT) do work on things related to writing and reading.
I'm glad you have some answers. It will guide you even if it seems a bit confusing right now. I would assume the neuro-psychiatric can direct you to good professional and even school recommendations. There is a few French websites on dyspraxia "dyspraxique mais fantastique" is the one that comes to my mind. Even if J does not have general dyspraxia, it might be a good starting point.

 

[Malika]

Thanks, Ktllc. Yes, the neuro-psychiatric said Occupational Therapist (OT) and speech therapists worked with this and that in Toulouse there were specialists in the field... of course we are about to go to Morocco, where it looks like I am going to apply to the French school. Interestingly, I have just been in touch with an association in Marrakech for parents of kids at the French school with learning difficulties and she sounded REALLY helpful.

The neuro-psychiatric made the interesting point, of which I'm already aware, that actually a very conventional school with a lot of structure is good for kids like J. If it weren't so boring...

The thing that puzzles me about his test is the very high memory score, called working memory in the English translation (she explained that anything from 130 to 85 was considered within normal range). I had always understood that ADHD REALLY affects working memory. I will have to ask her about this - we will have a telephone consultation after she sends the reports.

Honestly, it's good to have some definite information.

 

[Malika]

Actually, I am now really confused. A little internet research (how reliable?) tells me that ADHD always involves impaired working memory. Now, a score of 131 is classed as "very superior" in the WISC grading scale and is the highest available category.

It simply does not add up. A very quick reading up on dyspraxia seems to list many of the symptoms of ADHD and also lots of the sensory stuff J has. Is there any possibility the ADHD thing was a red herring and he is "just" dsypraxic?

I feel like I'm swimming in soup, a little. Alphabet soup... or are all these things just overlaps of each other anyway, just labels we have given to identify a part of the brain that doesn't work as well as it could??

 

[InsaneCdn]

Sorry. ADHD does NOT always involve impaired working memory.
Mine happens to be superior... and I'm over-the-top on focus issues.

The alphabet soup? you'll get used to it.

How about... statistics?
Half the kids with ADHD also have Developmental Coordination Disorder (DCD)... no one knows how many kids have Developmental Coordination Disorder (DCD) without ADHD, but that is also known to exist.

This is a Canadian take on things... based on our years of working through the system.
ADHD is a "spectrumish" condition, and is related to Autism Spectrum Disorders (ASD).
However. ADHD kids typically are not nearly so severe in their social skills issues.
But like Autism Spectrum Disorders (ASD), ADHD is a whole spectrum. And the two kind of run together.
So... you can be mild ADHD, or next-thing-to-Autism Spectrum Disorders (ASD) and still be "just" ADHD... or be Autism Spectrum Disorders (ASD) but so mild that you're closer to ADHD than to most Autism Spectrum Disorders (ASD) kids...

The Sensory Stuff? goes with ADHD, Autism Spectrum Disorders (ASD), dyspraxia/Developmental Coordination Disorder (DCD)... basically, any of the "developmental" issues along that spectrum, tend to also have some level of sensory processing/integration issue. It all involves the same parts of the brain, I'm told.

All of these labels and ratings are just lines in the sand as we try to define levels and types of "disabilities" but... it's really a very fluid spectrum of conditions.

I CAN tell you that Occupational Therapist (OT) is a big help on both sensory integration and on motor skills challenges... label or no label.

 

[Malika]

Hmmm, just as I thought it might actually start getting more straightforward

You'll be interested to know, IC, that the neuro-psychiatric. specifically mentioned Canada (NOT America!) as being streets ahead of France in terms of knowlege and understanding and implementation about all these things...

The visual-spatial dyspraxia totally makes sense. J regularly asks in the evening "is it still morning?", has absolutely NO sense of months or years, cannot tell the time and cannot seem to learn, etc, etc. And it is obviously the clue to what is partly making reading so hard for him. I've noticed how his eye jumps ahead and back and he seems to get confused by the lines of type. I bet if words were bigger, more separated and maybe accompanied by images more, he would find it all less of a struggle.

The neuro-psychiatric. is going to list a series of accommodations in her report and this of course will be very helpful.

 

[InsaneCdn]

Create a reading ruler for him... a piece of thin cardboard, with a thin square hole in the middle, about the height of the text in his book. He will then read just THAT line, then move it down to the next one.

McMasters' (canchild) is a Canadian University... and yes, they are among the leading researchers on Developmental Coordination Disorder (DCD), among other things.

 

[Ktllc]

ok, now is the time for you to look into Irlen syndrome (also called scotopic sensitivity syndrome).
Yes, you will get used to the alphabet soup. It is a bit mind blowing, but keep in mind that you are identifying issues/challenges. Wether there are part of x,y or z is relevant but not vital. If you see what I mean.
Funny thing all this talk about Autism Spectrum Disorders (ASD), adhd, and others. Just had this conversation at the school today! It overlaps so much.
I think you need to focus on the new piece on info, try to tackle it and then decide if there is improvement or not. It is a process that I fear never really ends when dealing with kids with "real" issues. You can't just say: ok, now I have the answer(s)! But you can say: now I have some more answers.
Yes, it is exhausting but that is part of raising a difficult child...

 

[Malika]

ok, now is the time for you to look into Irlen syndrome (also called scotopic sensitivity syndrome).

Naughty, naughty, Ktllc! I do NOT want any more possible syndromes to look into!

 

[buddy]

Malika, guess what? Q scores well on some subtests for working memory. Deep testing on that one area shows more deficits. (and indeed he sometimes has crazy good working memory and he has had direct therapy to work on this...., other times he will stop and say, it's to much, you know i can't remember , lol)

All memory depends on many factors. If a child is having attention problems you can imagine scores going lower. If they are having a really good (one on one, no distractions etc?) attention day or for that time anyway.....well?

Just like there are different kinds of attention, I think in real life, there are different "types" (that is not a good word for it) of short term and working memory. Not to mention all the things that affect all types of memory.

Sort memory sub tests are to me, not all that valid (not testing the skill that we are concerned about in real life). Just mho. There are more specific memory tests that obviously are better.

I've given standardized memory tests to kids....using chips, games, unrelated words....and I always wondered of they really showed the big picture. Memory clinics and programs I'm sure have much better tools.

As a stand alone task, he may be able to do well. But if hungry, distracted, if the information is brand new versus familiar, or is able to be related to prior information, if it is language based, visually based, etc......all those factors can affect real life working memory (and all memory).

Anyway, just a long way of saying he may have good skills for the kind of task he was tested on (which is a subtest of a bigger test, not a dedicated memory assessment, right?)....

Or not.....but just a thought.

As for the other information, really interesting and very cool that it really validates what you are and have been saying for a long time!

Yay!

 

[Malika]

The thing is, buddy, I really have so little true knowledge about this (ie absolutely no wider context to put this newly gleaned information in) that really I'm not formulating any very serious comments. I just don't know, is the truth... it just seemed to me odd according to that I've read about ADHD, but actually really fits in with what I see of J day to day which is an incredibly bright kid on the practical level - not intellectually gifted - with a phenomenal memory and grasp of practical details of life, things that have just happened, that happened long ago, etc. He is seriously more organised than I am - and I defy anyone to say that is not difficult
Anyway, knowing about this visual-spatial dyspraxia is quite exciting because it TOTALLY explains everything to me about his reading and why it's been such a struggle and gives clues to ways to help him. Eg, different coloured lines or syllables, hiding other lines of texts, etc. It is also is a start of explaining things to teachers and finding ways to help him. Gives me more confidence in the future. J is clearly bright, nothing exceptional but able to learn and do well in school if only he can be accommodated. This feels major to me.

 

[InsaneCdn]

My difficult child has an incredible memory too... except when he needs it for school... (times tables, history...)
If he can relate it to HIS life, he stores every detail.
If not... there's nothing to "hang it on" and it gets lost.
This is just another aspect of "working memory".

 

[BusynMember]

One of my main issues is a spatial orientation problem. I don't know if this is the same thing. I have very little understanding of where I am in time or space and often run over curbs because I judge space wrong, etc. I have face blindness which may or may not be a part of it. Time is a problem, so I make sure to always be very early. Time is evident to me only by looking at a clock. I can't judge it well. I have many visual memory deficits. Again, I don't know if this is what J. has or not, but it's the spatial arena and I've got it BAD. I'm going to Google spatial dyspraxia. Bet it's another name for one of my biggest problems :/ I hope J. gets the help he will need.

While my visual memory is almost non-existant, I can almost recite books I've read by rote and have had many people stare at me and ask how I can remember. I stopped doing it because people gave me such odd looks. So my auditory memory is outstanding. With these neurological glitches, you get a very unusually developed person who is hard to figure out, even to the person. Can you imagine a poor kid?

IQ is rather insignificant with a differently wired person. Their performance seems to defy the numbers and the IQ test can change too. I've had IQs of 94 and 120 and neither meant a whole lot in the big picture. I excel in certain areas in ways some geniuses don't...and in some very simple areas I can't do squat. The world is confusing.

On the other hand, I was a bit slow at learning to read, but once I learned I exceed at it. Math was a much, much bigger problem.

The French aren't that crazy about Americans, I hear, but Canada and the US are pretty much the same as far as mental health and different types of wired kids. France is definitely behind most of the developed world if most have not even heard of ADHD!!

Glad you're getting some help...finally

 

[BusynMember]

Just looked it up. Yep, yep, that is likely what they meant when they told me I had spatial orientation problems some twenty years ago (not bad for being twenty years ago, if not longer). The clumbsiness...yep. The short term memory...yep. The difficulty with space and time. Check. There is a lot more. Life is not easy...never was. I'm sure there is way more help now.

Any questions? J/K, but very interesting to me in a personal way.

 

[InsaneCdn]

When the spread between sub-tests on the IQ testing is too large, there is NO composite score possible... The normed standards don't allow for those spreads. But most testers don't read the fine print, and assign a number anyway... and it's wrong. Because they could say 105 and it's really 150.. or 95. The people who created the tests can't capture these cases.

In reality... performance should align with the sub-scores.

 

[Malika]

That's interesting, MWM. Or not so much interesting for you, as debilitating. J too has phenomenonal memory of what he hears (rather than sees). The neuro-psychiatric. said that the brain compensates for areas that are under-performing by becoming very strong in others.

She also said she would not give an overall IQ score because it was meaningless and that she was not interested in a mere number. It seems things have come on a lot since the days when a simple IQ figure would be assigned... this is a more a way of discussing strengths and weaknesses that is much more revealing, it seems to me.

I'm so glad we got this testing done. Though sorry for J that it means all the work and difficulty ahead for him, of course, but at least now we have a reason and the way forward for help.

Oh and as for why she talked of Canada - in fact, Canada is generally in the shadow of its big neighbour here as elsewhere... I assume she mentioned it because it is genuinely ahead in its work and implementation in the field of these disabilities.

 

[BusynMember]

Malika, I don't think Canada is ahead. I think we are about the same. But immaterial.

Spatial orientation problems really impede a child and adult's ability to know where they are. I think that may be partly why we are klutzy. I often step on the shoes of somebody in front of me, not knowing how close she is. Since being an adult, this is less of an issue, but as a kid I often bumped into the child in front of me in line. I was also that kid who got laughed at in the cafeteria for dropping my tray of food (that usually evoked sarcastic and embarassing applause). I had trouble learning to drive, as an older person, and have compensated by making sure I way far behind the cars in front of me just to be sure. It's automatic now, but I really had trouble learning to gauge space when first learning to drive. I struggled with anything that required coordination, including sports and shoe tying. But I had a real memory for doing plays and learning songs (I had and still have a tremendous ear for music...again that superior auditory memory while my visual memory failed me).

On the extreme end, I do have face blindness, but more. I get lost going around the block as I don't understand where I am...space and time. If I take a new route someplace, I get totally thrown. I need consistency and repetition for anything requiring visual cues. It is also hard for me to concentrate visually while somebody is talking to me. I do better with one sensory issue at a time and am very sensitive to particulary loud noise and smells. I can smell if my dog had an accident if I am in the kitchen and my dog had an accident upstairs on the far other side of t he house. The only other person with that sense of smell in my family is Sonic...lol.

I always felt I had acquired brain dysfunction at birth. My mom did take medications during the birth. I don't know. Do you have any records of J's actual birth? Was he full term? No foreceps? Easy delivery?

Keep my posted. I have a vested interested in J. Not only do I think he is the definition of "cute", but since he has some issues I have, I would love, love to see how he gets help and how that help works out. And, of course, I wish him and you all the very best. He is a neat kid and deserves this chance to learn compensation skills. There are plenty.

 

[Malika]

Thanks for sharing your experience
As in all things to do with the brain, we are in the area of the complex, not the simple... In fact, if I reflect about it a little, I see that - unlike you - J's problems with space seem to be on the level of the abstract rather than the concrete. In other words, he is not particularly clumsy, doesn't have a particular tendency to drop things or bump into people, and has an excellent sense of direction and memory of place, as long as you do not ask him to codify it into left or right... but if he has to copy a geometric pattern that is in front of him, it will take him ages and parts of it will be wrong and/or very slipshod. That is both concrete and abstract?
This is a very unknown area to me and I confess I do not understand it at all well. I know that he has, and has always had, absolutely no notion of time, far or near, and cannot tell the time on a watch or clock. I've given up trying to teach him.
How all this impacts on school needs the experts to tell me...