Thomas Madsen (age 7½)

Dear Dr. Levinson,

Thank you for agreeing to see Thomas. We are located in Camarillo, CA. Thomas has been treated by Dr. Kumar for his ADHD. I mentioned to him in passing a few months ago that the stimulant medication was helping him focus. However, he was still having a hard time academically and I wondered if he might also be dyslexic? Although reading that 7 was too early to tell, I really see him struggling. And I didn't want to wait till he was years behind before doing something about it.

At that point, Dr. Kumar, Thomas' psychiatrist, gently suggested I research your work. So I went home, looked up your name, and started reading. After starting Smart but Feeling Dumb I was truly amazed. Suddenly it all came together! Everything that you mentioned in the first chapter about dyslexia and listed within your Self-test was exactly what Thomas is prone to. I had mistakenly believed that — many of his "symptoms" like his severe motion sickness, dyscoordination and anxiety were independent and separate from his learning disorder. I now realize that dyslexia is much more complicated than just a reading or academic problem.

Below are some of the symptoms from your self-test that Thomas is showing:

• Loud noises bother him. He covers his ears.
• He is VERY prone to motion sickness. He gets carsick on our 5-minute drive to school in the morning almost every day. He tends to vomit very easily if we do not stop to take a break. He recently got sick on a bike-ride with the boy scouts.
• Lately, he has been getting more anxious with crowds. During his seventh birthday, as the cousins and uncles came over, he got under the table to hide from them. Although it just seemed like he was being funny, I've been noticing that he is doing it more often. Seems he's becoming more easily overloaded.
• Hard time reading. It is slow and forced. When I read the story to him once or twice, he can memorize the book. And only then does he seem to be able to read it.
• Sounds out each and every letter within a word — having difficulty blending sounds together and linking them to sight words.
• Inconsistent remembering of sight words.
• Guesses while reading.
• Loses his place while reading.
• Tends to reverse b, d, m, w and a few numbers.
• His writing is VERY messy regardless of how much we practice; and we practiced a lot. Examples of his writing are included.
• Hard time remembering spelling words, left from right, and days of the week in order.
• When spelling out words, will miss hearing some of the sounds. (Example: spells Grandpa as 'Gap.')
• Stuttered for about 1 year (around the age of 3).
• Repeats word-sounds many times before being able to finally get it out correctly.
• Difficulty following verbal directions or completing tasks, especially off the Concerta.
• Tends to hear words differently. If I say a word, he might hear a completely different word.
• He has a very hard time concentrating, is hyperactive, and tends to be impulsive without medication.
• Uncoordinated and constantly getting hurt — accident prone. When we placed him in soccer, he would just stand in the middle of the field and not really run or focus on the game. Literally, as other kids were running and chasing the ball, Thomas would just stand on the starting line. We would have to scream... RUN! Then he would run in the direction of the kids, and again stop.
• Anxiety in the dark.
• Easily overstimulated and overloaded. His kindergarten teacher mentioned that he gets overstimulated during recess and will sit on the bench and cover his ears & rock.
• Impaired self-esteem. Recently, I asked him if he thought he was smart. He said, "No… I think I am dumb." I asked him, "Do you think you are dumb right now as I am talking to you." He said, "No… only when I am at school."
• Very sensitive to medication. For a time, he was obsessed with picking at his nails to the point of them bleeding. It occurred more frequently at school than anywhere else. It stopped after changing from Vyvanse to Concerta.

Let me provide you with you with the other facts you wanted:

When kindergarten started, I noticed his efforts were not progressing as expected. As we worked with letters and sounds, he would have a hard time remembering them.

During our first conference, his teacher recommended a two-year kindergarten program. She felt Thomas needed a bit of time to develop.

Even during kindergarten — year two, he was still struggling. He would mention how he is the "worst one" or "worst reader." As time went on, his confidence was decreasing more and more. Most all of the kids, now a year younger, were doing better than he was in reading, writing… Although his grades were good for kindergarten, he really was behind the other kids. So I had him tested for ADHD. I got two separate opinions, one from a Psychologist and one from a Psychiatrist. They both confirmed that he did have ADHD.

Dr. Kumar has been treating him for about one year now. He first started him on Vyvanse. For a time, I thought he was going to do very well. It seemed to help, but he started losing weight and would seem to zone out — even on a low dose. He was switched to Concerta. That has been working well enough for focus, activity and impulsivity without side-effects.

Medical Clearance:

Our family doctor was very responsive when we explained our need for medical clearance and Thomas' pending appointment with Dr. Levinson for a possible inner-ear problem underlying his symptoms. When I mentioned the depth of Thomas' motion sickness (car, swing, bike rides, overstimulation around people) he suggested a few referrals as well as Dramamine and Zyrtec.

Response to Dramamine — the first two weeks

The last 10 days have been amazing in so many aspects:

On Tuesday, August, 13, 2013 I gave Thomas 25 mg of Dramamine 2x/day. That same day we went to an amusement park with lots of big rides. To my surprise, he wanted to get on all of them — all day. He usually doesn't do well with roller coasters at all. He had no sickness, headache, or nausea all day. We had a great time.

On day two, when I asked him to write in his journal, he took 10 minutes vs. 30 minutes. Thomas was about to verbally translate his written journal sentences to me, as he usually needs too since they were previously illegible. But for the first time I was able to make out what his writing intended to say. The next day (day three) he wrote even better. His writing became much neater and legible. The sentences were now lowercase and started to appear phonetically recognizable. His carsickness has subsided — which was huge! We also noticed other improvements immediately too. His speech and thought process was smoother (noticeable on day two). He is now able to stay on mental track and does not repeat or stutter his words.

Physical improvements have been seen as well. He's had a skateboard for over two years. He usually rides it on his stomach. On Wednesday (day three), he asked his Dad to help him ride. By Friday (day five), he was skating down ramps at the skate park, going down vertical inclines and balancing back and forth for about 30–40 feet.

School started on Monday, after seven days on Dramamine. He's happy. His reaction to school has been very good. He really likes his teacher. He comes home recalling the things he learned. And he says he's "the third best in his class." This is a huge improvement since he has always said he is the worst, and he is in the same group of children as last year. I'm a little nervous because he is still having a hard time sounding out words and hearing certain sounds.

I keep asking him how he is feeling with the Dramamine. To my surprise, he said: "Great, the words have only blurred twice since I have been on the medicine." I was also very surprised by his use of this word because I had never previously mentioned nor asked him specifically about blurriness.

The thing that pleases me the most is how well he is doing with this medication. No side-effects. Although usually very sensitive, he does not feel sleepy, sick, or anything bad. We even went to 'Sky High', which is a trampoline fun warehouse for kids. He was fine and was jumping like a pro and landing on his feet.

I'm just amazed and a little anxious. Although his physical and social abilities are getting stronger, he is still having a hard time sounding out words and reading. He is better at staying on track and not getting lost as much when tracking. But he still reverses words and often guesses instead of sounding the words out.

We are very eager to see what further progress Thomas will make.

Thank you so much,

— Edith Madsen (Thomas' mom)