Expert: Norm Bishop - 9/10/2008

Question
QUESTION: My son is 8 and in 3rd grade.  At the age of 6 he was diagnosed with Tourette Syndrome, ADHD, OCD, and Sensory Processing Disorder.  He has been telling me a lot lately that he sees things different than anyone else.  That he is one of a kind.  I have been trying to figure out what that means but have been unable thus far.  When reading with him last night, I noticed that he would add letters to a word that were not there when reading, he would switch a s for a h in a word or vise versa.  He would read a large word perfectly, but mess up on a 3 letter word or less.  He also has extremely bad hand writing, completely blending words and spelling them incorrectly, far worse for his grade level.  Do you have any suggestions about what might be going on?

ANSWER: None of those disorders would be that related to what you describe with the reading.  Tourette's would cause him to tic, (repetitive movements or verbalizations that he has no control over).  ADHD would cause impulsiveness and organization problems.  OCD is a condition where a child is very defiant and Sensory Processing is not clearly defined within the educational community.  Therefore, from what is described there are two possible scenarios going on here.  Between the ages of 5 and 8 children's visual integration systems between the eye, hand and brain are completing development.  It is not uncommon for 5, 6 and sometimes 7 year olds to struggle with what you describe.  Typically when it carries over to 8 or older, then the brain may not fully integrate in this area.  We label this dyslexia, which is an extreme form of a reading difficulty.  I would suspect that this is the problem.  In that case he would need a really well trained reading specialist or special education teacher to help him learn to read.  Dyslexia doesn't go away, but the right techniques can teach students to compensate for it.  

If he is not already diagnosed as a student with a disability (special education), then you should ask for his school to conduct an evaluation to see if he is eligible for special education services.  (That is if he attends a public school).  (If he attends a private school, the district which the school is located within is responsible for evacuating him).  This evaluation is free to you and part of the Individuals with Disability Education Act, finding and providing service for all students with dualities.  

I would not panic at this time, great things can happen.  I have taught one particular student who could only read 11 words half way through 3rd grade to read at grade level within two years.  She graduated high school with honors a year of so ago and is in College becoming a teacher.  Definitely follow up on the special education evaluation.

Norm

---------- FOLLOW-UP ----------

QUESTION: I was doing some research on Dyslexia and it said that flipping letters is not necessarily a defining characteristic of the disorder.  He does that some times but not all the time.  The biggest issue is he will either take letters off the word or add letters to a word that should not be there.  He also said that he will sometimes see pop like pp.  This affects his reading and also his spelling.  For a while his blinking tic was really bad at 6 and 7, so I thought he would be just losing his place in the story, but I see now that it is much more.  Do you think that Visual Processing Disorder or Dysgraphia could also be an issue or do you think that this could all fall under Dyslexia?  I have been fighting for some time for my son to have an IEP and he finally has his meeting on 9/30.  I am really trying to get to the root problems so that I can have a better idea of what suggestions to present to the school to help him.  IE: Therapies, special education, and more detailed evaluations.

Answer
Flipping letters and syllables isn't always the clear symptom, although the older the student is, (further from six) the more more it might be an indicator.  Without a good evaluation, it is hard to know if it is connected to the visual processing disorder, however, I would suspect that it is all connected in one way or another.  The terms, dyslexia, dysgraphia and visual processing disorder are not defined in the Individuals with Disabilities Act, so what they will be looking for is a discrepancy between his ability to read and his overall abilities or whether or not he responds to a systematic series of interventions.  

If they do a special education evaluation, ask that they do a reading assessment that measures all 5 areas of reading (phonemic awareness, phonics, comprehension, fluency and vocabulary).  Also ask that they test for his visual processing disorder.  Many school districts use the same battery for all potential disabilities, and miss many because of it.  

The reading problem also may be connected to eye tracking...it would be interesting to watch him read, see how his eye tracks...is it smooth, does it jump periodically...

Good luck with your meeting on 9/30...if you have further questions don't hesitate.

Norm