How does a medical diagnosis affect LD services?

[miranda]

I'll helping one of my scout's mom through the process of requesting learning disability testing. Her experience has been eerily similar to mine. Her kid goes to another very high achieving school in our district. He tests very well on standardized tests, but his handwriting and spelling is awful. So much so that he has been invited to summer school each year since kindy. He's in 4th grade now, and his teacher allows him to type everything. His mom is convinced he has dysgraphia (or perhaps dyslexia), and she's troubled that the school has him typing instead of giving him services to help his handwriting. She has been relentless; she has called meetings with the principal, social worker, teacher, and school psychologist. All of them have basically told her she's crazy for wanting to "put her son through learning disability testing when clearly he is so smart and doing so well." They painted a picture for her that the testing was tortuous and embarrassing for her son. So she thought that was the end of the road at the school, and has an appointment with a neuropsych to undergo private testing. She is very worried about the cost.

So I met with her and introduced her to Wrightslaw, and explained the Child Find laws. I told her to ask again for testing and cite the federal law requiring them to test. I pointed out that Child Find specifically requires testing even when a child is passing through grades academically. I showed her the time frames for their response and told her to cite them. She did, and the principal called her today. The principal told her flatly that even if they tested her son, they are "100%" sure he wouldn't qualify for services. They again discouraged her from doing so. But in the end the principal said she should contact the school psych for further direction. She mentioned that they were pursuing a private diagnosis and the principal replied that a private diagnosis would help matters along.

I've tried to paint two pictures for her: first, yes, they have a legal obligation to test him. But also, no, he probably won't qualify. Is the reason he won't qualify because he doesn't qualify under General Learning Disability (because the school doesn't have to test for Specific Learning Disability?) I'm trying to recall specifics from when DS was tested a couple years ago. It's hard for me to parse out because he had his triennial testing at the same time, so there were a ton of tests and I'm not sure which ones were specific to LD. Is it the WISC that they give? I remember when DS was tested them telling me he was far above everything for LD testing, although his reading comprehension was closer, but still didn't qualify.

Does a medical diagnosis add anything to the party here? The unspoken elephant in the room that I've gently tried to explain to her is that his typing accommodation is likely the best he'll get. Some kids can't even get that. But I can understand her desire to get him handwriting assistance. I told her she should also request OT services. I think that's less appealing to her because she doesn't see this as a "physical" impairment. DS was discharged from OT long ago because he can hit all the matrix for aging out, but can't write freely when given other tasks unrelated to testing.

Any other advice I can pass along to her? Am I off mark in what I've passed on to her thus far? My gut tells me this kid would never qualify for services. His handwriting is better than DS's and he's very bright, socially aware, emotionally stable. He's in sports and lego league and all kinds of stuff. He just has lousy handwriting.

[waverly]

I can’t speak with a lot of authority here just our experience.

A medical diagnosis and outside testing helped DS obtain hearing services and speech. Academics did not play a role here.

It appears that our district has higher standards for OT than private practice or even than one might think. Despite an outside OT eval they still refused services. His academics are good and the teacher said she was fine with his writing because it was first grade and she has low standards for first, so academics did play a role here. He does not have a medical diagnosis that would have anything to do with his writing from his pediatrician.

He is similar to your friends child in that he is bright. He is not great in gym/ sports but not so far behind as to be thought of as disabled. He would be considered uncoordinated or clumsy is my guess.

In another forum some people say their school district takes medical diagnosis into consideration and some don’t. This forum is nationwide and also includes Canada.

I am not sure how schools test for dyslexia but given the large number of students going undiagnosed - I am not sure they are doing a great job in the dyslexia area.

[savan]

I have a child in the same scenario. We have a family history of dyslexia and by the beginning of 3rd grade it was very clear to me that DS was at the very least dyslexic. I tried approaching the school and they kind of laughed at me. He wasn't in the lowest reading group, he was doing just fine in school, there was no reason to test for anything. Also, they explicitly said they could not diagnose dyslexia. I chose not to fight the school and delay help to DS any longer so we sought private testing. DS was diagnosed with dyslexia and dysgraphia. The psychologist agreed that he probably would not qualify for services but encouraged us the seek out a 504 to get him some classroom accommodations.

The private testing did help because I was able to bring the report to the school and show that he had a diagnosed learning disability. They still weren't all that nice or helpful but they couldn't brush me off. I was able to get the 504 but not before they made it clear they thought I was crazy.

I will say that the diagnosis helped me tremendously because I was able to narrow down his needs. As soon as we heard he was dyslexic we enrolled him in a OG tutoring program which was life changing for him. He could read before the program but it was really labored and now it is quite a bit easier for him. His biggest struggle is with his dysgraphia and the 504 is largely for that purpose.  I am confident that there is no way we would have gotten that 504 without the diagnosis.

[auntie]

Apr 10, 2018 16:09:26 GMT -5 miranda said:

I'll helping one of my scout's mom through the process of requesting learning disability testing. Her experience has been eerily similar to mine. Her kid goes to another very high achieving school in our district. He tests very well on standardized tests, but his handwriting and spelling is awful. So much so that he has been invited to summer school each year since kindy. He's in 4th grade now, and his teacher allows him to type everything. His mom is convinced he has dysgraphia (or perhaps dyslexia), and she's troubled that the school has him typing instead of giving him services to help his handwriting.


There could be something related to mild dyslexia going on with the spelling. The one niece I thought escaped the dyslexia curse in DH's family was identified as having mild dyslexia at about 35. She's always worked hard and gotten decent grades- a career diplomat with a masters. Another niece on that side of the family is a teacher with a masters and her sister is a grad of the USAFA. Assuming he reads well, maybe this isn't a huge deal in a world that includes spell-check. A therapeutic setting might redirect time away from learning other critical subjects for something his computer can already do. 


If his dysgraphia makes in trend into a disorder of written expression, a program like Kidspiration or Inspiration could help him find his voice. A graphic organizer or rubric might be useful for written assignments. 


The ship has likely sailed on cursive. OT is not generally successful for handwriting past age 10 unless it is to regain skills lost for medical reasons like accident or stroke. His writing might improve on its own as DS's did. He's probably better served teaching proficiency on the keyboard and with other adaptive tools like Smartpens. Other options include a scribe (way stigmatizing for a kid with an invisible disability) or a set of class notes as he gets older. 


She has been relentless; she has called meetings with the principal, social worker, teacher, and school psychologist. All of them have basically told her she's crazy for wanting to "put her son through learning disability testing when clearly he is so smart and doing so well." They painted a picture for her that the testing was tortuous and embarrassing for her son. So she thought that was the end of the road at the school, and has an appointment with a neuropsych to undergo private testing. She is very worried about the cost.


He's the thing, a school district is not going to do the same sort of rigorous LD testing a pediatric developmental clinic or lab school will do. Dyslexia is a medical dx and needs to come from an MD. And, yeah, it's hella pricey. DS didn't find it particularly upsetting or torturous. The 3 day testing DS did cost about $10K these days. My insurance picked up half when we did it, but most don't. 

So I met with her and introduced her to Wrightslaw, and explained the Child Find laws. I told her to ask again for testing and cite the federal law requiring them to test. I pointed out that Child Find specifically requires testing even when a child is passing through grades academically. I showed her the time frames for their response and told her to cite them. She did, and the principal called her today. The principal told her flatly that even if they tested her son, they are "100%" sure he wouldn't qualify for services. They again discouraged her from doing so. But in the end the principal said she should contact the school psych for further direction. She mentioned that they were pursuing a private diagnosis and the principal replied that a private diagnosis would help matters along.


In this situation, it would make sense to buy a private eval first from a very reputable source- I got DS's first from CHOP. It's hard for a district to discount the findings of one of the top pediatric hospitals in the world. 

I've tried to paint two pictures for her: first, yes, they have a legal obligation to test him. But also, no, he probably won't qualify. Is the reason he won't qualify because he doesn't qualify under General Learning Disability (because the school doesn't have to test for Specific Learning Disability?) I'm trying to recall specifics from when DS was tested a couple years ago. It's hard for me to parse out because he had his triennial testing at the same time, so there were a ton of tests and I'm not sure which ones were specific to LD. Is it the WISC that they give? I remember when DS was tested them telling me he was far above everything for LD testing, although his reading comprehension was closer, but still didn't qualify.


WISC is an IQ test. Certain subset patterns can be suggestive of SLD- like a <1 std dev result between PIQ and VIQ. Or they can compare WISC to something like WIAT which tests achievement. If a kid has a 130 IQ and tests average, that too is suggestive of a SLD.

Does a medical diagnosis add anything to the party here? The unspoken elephant in the room that I've gently tried to explain to her is that his typing accommodation is likely the best he'll get.


A dx from an MD can be a powerful tool.


Typing? It is the best. The real world best. He isn't likely going to get better with more OT and she'll just sour his attitude towards academics. If she's hell-bent, she could spend the summer doing HWT with him and see if it makes a difference. If it does, she'd have a stronger argument that OT would be helpful.


Some kids can't even get that. But I can understand her desire to get him handwriting assistance. I told her she should also request OT services. I think that's less appealing to her because she doesn't see this as a "physical" impairment. DS was discharged from OT long ago because he can hit all the matrix for aging out, but can't write freely when given other tasks unrelated to testing.

Any other advice I can pass along to her? Am I off mark in what I've passed on to her thus far? My gut tells me this kid would never qualify for services. His handwriting is better than DS's and he's very bright, socially aware, emotionally stable. He's in sports and lego league and all kinds of stuff. He just has lousy handwriting.


See above.

[miranda]

Thanks all.

auntie, ITA that typing is best, which is why I have chosen not to pursue this same path for my own kid. It seems like a shame to pull the kid out for services on handwriting when he's so bright in math, science, etc.

The other problem is that she wants an IEP and not a 504, so they are going to test everything from speech language to large motor. I told her to find out exactly which tests they are administering. The psych said that even a medical diagnosis of dyslexia wouldn't guarantee services because the medical definition of dyslexia and the school's definition are different.

[auntie]

In the past I have led local folks to resources, but I always stay in my lane. I don't want to be painted as that mom who aids and abets other parents. I feel it's best to be seen as an equal and collaborative member of the CSE rather than be associated with another parent whose behavior I can not check. From your description, she seems extra and that could reflect badly on you.


I feel badly for her, but assistive technology could really help her son access his education. Unless he has a career in calligraphy ahead, this probably isn't a hill upon which to die. Were he in kindie? Sure. But at 10. NFW.