I have a 16-year-old son who is really struggling in school. He has severe dysgraphia and is doing little to no writing in school. He has an IEP for SLD in writing but he keeps falling through the cracks because the teacher doesn't realize his needs until after things fall apart. When I read information about ‘twice-exceptional’ students, it fits him perfectly except I cannot prove the high scores. I know his verbal skills are quite high. His conversation and reasoning is far superior to the rest of the family.

He has classic signs of dyslexia like excellent 3D visualization and visualizing buildings from the sky view as we drive past them (first noticed around 3 years old). He was identified with dyslexia at seven years old but always read with average ability so there has never been acknowledgement of dyslexia from the school. Would a standard score of 77 on phonological processing be enough to throw off reading? He can read novels, but my feeling is that he does not read worksheets, handouts, or textbooks. All school information is coming from auditory and visual (non written) input. How do I prove this to the school?

Dr. Pierson's Response: 
First of all, yes, a standard score of 77 on phonological processing is indeed enough to affect reading and spelling -- that score falls at the 6th percentile. Historically, we have considered anything below the 10th percentile as clinically disordered. Phonological processing includes phonological awareness, phonological memory, and rapid naming. We need to know where the breakdown is in order to determine what course of action would be best. For example, if it's memory, then he may not be able to hold what he wants to put on paper in his head -- he starts writing and then it's gone. Challenges with any of these could be impacting not only reading, but spelling and writing as well.

Writing requires deployment of a variety of cognitive and linguistic resources, and if any are deficient (e.g., reading, spelling, memory), less is available to be allocated to the actual content (including the organizational structure, style, sophistication of sentences and vocabulary, and depth or creativity). In your son’s case, his phonological processing difficulties most likely are contributing to his challenges with writing. As a result, he is most likely not able to demonstrate his understanding of curricular content and his products that are not what one would expect relative to his oral expressive skills.

A good, comprehensive assessment [1] of strengths and weaknesses is in order. When diagnosing dyslexia, we look at spoken language comprehension, particularly receptive vocabulary and listening comprehension, and compare that with skills in reading (including phonological processing), spelling, and writing. Dyslexics have strengths in listening comprehension with weaknesses (or relative weaknesses) in reading, spelling, and/or writing skills [2]. This can be a challenge, particularly with twice-exceptional kids, because they are so smart and learn to compensate. A good diagnostician will help you sort this out.

Relative to intervention, I've got a lot on writing here [3]. He might benefit from speech-to-text software so he can get his thoughts down and then edit and revise. Graphic organizers also help these students. Inspiration is one that many like. I've got others here [4]. I've also got text-to-speech options on that page. He might benefit from audiobooks. He could benefit by understanding how to write for different purposes, learning narrative versus expository structure.

Now, given that he has an IEP, you will want to ensure that his goals and objectives are measurable, and that his program is targeting his individual needs. He should be making growth. I’ve got information about Annual Goals and Short-term Objectives on this page [5].

I know it can be a challenge, but your son needs you [6] to continue to be an advocate for him. Successful dyslexics talk about the one person who believed in and supported them, and for many that person was/is mom. As I say, the squeaky wheel gets the grease, so don’t give up. He will succeed with the proper intervention and your support. Please let me know if you have other questions. And, good luck!