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help with *huge* discrepancy in son's subscores


Guest Mommof6
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Guest Mommof6

I have gleaned from the WTM boards for years, but today I received information that is leaving me reeling - and I would love some thoughts from the wise ladies here in this forum.

 

Our oldest son is 16.5 years old and was formally diagnosed with Central Auditory Processing Disorder (CAPD) when he was 5. He has been homeschooled since kindergarten. Learning to read was a long, slow process - but at age 8 he took off and became a voracious reader with good reading comprehension. He has had some quirks in his development that has lead us to believe he had some learning discrepancies challenges/LD but didn't see the need for formal testing until this year - his sophomore year of high school.

 

We suspected: slow processing speed, poor memory, and continued CAPD. We realized that as our son got closer to college age he might need accommodations in college courses and on SAT/ACT testing. We brought him in for testing and we received the results today. I did my master's research and testing requirements in the Education department - so I have a decent working knowledge of the instruments used. But I am finding myself reeling from the data. It looks so very hopeless and 'odd'. The disparity is huge on the WAIS! And every memory test is at the very bottom of the barrel (most are .1%)

 

Scores:

 

WAIS: General Intellectual Ability

Verbal 141 (99.7%)

Perceptual Reasoning 98 (45%)

Working Memory 86 (18%)

Processing Speed 81 (10%)

 

Full Scale: 104

_____________________

 

 

Weschler Achievement Test:

 

Reading comprehension 108 (70%)

Word Reading 115 (84%)

Pseudoword Decoding 112 (79%)

Numerical Operations 100 (50%)

_______________________________________

Memory was an area of concern so the Psychologist did the Adult Wechsler Memory Scale (WMS)

 

Auditory Memory: 43 (<.1%)

Visual Memory: 50 (<.1%)

Visual Working Memory: 67 (1%)

Immediate Memory (49 <.1%)

Delayed Memory (40 <.1%)

 

Retention of Information: .1%

 

Auditory Memory and Visual Process Scores less than 2%

Designs I and Symbol Span are his high scores at 5%

______________________________________

 

Can you help me out with any of this? He is a well-spoken young man who loves to learn, read, is coordinated, has strong people skills, and works slowly through his schoolwork. He felt well on the day of testing and gave it his best - so I feel quite comfortable with his performance on testing day. He desires to be a physical therapist - - and sooo many of the sciences in college are uber heavy in the memorizing department. He likes Algebra and the Sciences. He took forever to learn his letter sounds, his spelling was atrocious until about 8th grade, math facts took forever to learn. Once something gets into his 'head/brain/memory' it stays forever. But it is a slow arduous process to get it in there. He manages to 'pass' as a regular college-prep kid who needs to study a lot and who takes a long time to get things done. My husband who is a MD who is a slow processor with auditory learning issues (but my husband has great memory skills). I have a Master's, am a 'quick' processor, have good auditory skills, but struggle greatly with memorizing.

 

 

Thoughts? Helps? Career ideas? Further testing? Any other suggestions? Resources?

 

I am literally sitting in a puddle of tears. And lest you think I am easily daunted: I have two kiddos with ADD, a non-speaking smarty pants who has severe cerebral palsy, and another kiddo with mild Aspergers. So I deal with lots of reports and 'bad news'. But somehow this testing has blindsided me. I'd love any insight anyone might be able to offer.

 

Thank you!!!

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Did the examiner have any ideas? I have one with wide variations but she has a mental impairment and ADD. Her subscores were preschool all the way to post highschool at age 13.

 

Does he have trouble focusing? Could ADD play a part in that he can't focus long enough to get the stuff into his memory?

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Guest Mommof6

He seems to focus well and does better with longer periods of study. I don't think ADD is part of the equation. He has a large vocabulary, grasps complex ideas, and has been able to get 86%-94% across the board in almost all of his high school course grades. He utterly failed in Spanish - in spite of trying 3 diverse curricula. We decided to drop the foreign language for high school.

 

I'm trying to wrap my head around how he can learn/memorize anything with memory scores as poor as his. (Less than the 1%)

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Wow! I can see why you're feeling out of your element in trying to understand this profile. Just the amazing gap between verbal and nonverbal scores on the WAIS is daunting, and that doesn't even take into consideration the low working memory and processing speed scores. Given the working memory and processing speed scores, the full-scale is invalid and a GAI should be used. (Rather, I would expect the FSIQ to be rendered invalid, but I am not a qualified evaluator- just need to make that clear).

 

I, too, wonder what the evaluators thoughts were.

 

My son has fairly weak short-term memory abilities- especially for information with less context. For instance, he is better at recalling a story than he is at recalling a list of items. He was given different tests of memory, but his scores were more varied- from extremely low to mid- average. I have found, as I am sure you have, that repetition is the key to getting things into long-term memory. I only learned rather late, that it's not just repetition, but short spurts of study several times a day are better for memory work than one long spurt. And heaven help us if we take more than a day off at a time. Like your son, once something is in long-term memory we're good, His long-term memory seems to be pretty iron-clad.

 

As a for instance, we dropped Japanese language study over a year ago when he enrolled in a school that doesn't offer Japanese. We recently started up homeschooling Japanese again, and I am finding that he is remembering well what he had already learned, either without review or with minimal cueing. But what he knows took a very, very long time to get into memory. I am hopeful that we'll be able to move a little faster this time since I'm feeling more confident about structuring lessons that makes use of strategies I now know are effective for him. My reason for picking it back up is that I am hoping to get him far enough that we won't have to worry about foreign language in college. Each college is so different about how it handles accommodations for foreign language and he may or may not be exempt. For various reasons, sign language is not any better an option than other languages. Japanese is his best option because due to living in Japan for his first 5 years, his brain has lots of experience with the phonology and prosody of the language even though he never learned to speak.

 

Are you familiar with Cogmed? This is one brain training program for working memory that has some decent research behind it. Our neuropsychologist doesn't general get on these kinds of bandwagons but he now recommends it for the right client. You might investigate it, given the severe memory weaknesses.

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He seems to focus well and does better with longer periods of study. I don't think ADD is part of the equation. He has a large vocabulary, grasps complex ideas, and has been able to get 86%-94% across the board in almost all of his high school course grades. He utterly failed in Spanish - in spite of trying 3 diverse curricula. We decided to drop the foreign language for high school.

 

I'm trying to wrap my head around how he can learn/memorize anything with memory scores as poor as his. (Less than the 1%)

 

 

Here's what my son's report says. Not sure it will help.

 

It is remarkable that even though ***** has significant learning difficulties, his verbal

crystallized intelligence (knowledge and skills that call on past learning and experience)

is measured as significantly stronger than nonverbal-fluid intelligence (which involves

novel problem-solving abilities). This suggests he is able to use compensatory strategies

in order to learn material.

 

I feel like your child is my child, only 3 years older.

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The gap between verbal and perceptual reasoning could indicate something like non-verbal learning disorder. Does the description of that fit at all?

 

FWIW, the general pattern of your ds's WAIS is somewhat similar to what we had on the WISC years ago. The testing done by a school psychologist who just gave a description of strengths and weaknesses. We did not have memory tests. We got a full scale, too, like you, but we shouldn't have because of the discrepancies. So things we not done the way they should have been. Because we went through this, I'm also concerned if things were done the way they should have been in your case. Since you didn't say what the evaluator suggested about the scores, I can't really judge.

 

I would push for a clear dx if there is one, even if you have to take the scores to someone else, because of your plans for the SAT and college. You need as much evidence and documentation you can get. It's great that you're starting now. The scores may be odd and your son may have challenges, but what you've said about how well he's doing in real life gives every reason to hope for his success in the future with the right accommodations.

 

I'm sorry you have so much to deal with. :grouphug:

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If you feel that the testing blindsided you, listen to that feeling, because it means that the answer given by this particular evaluation is incomplete at best and wrong at worst.

 

Since I am unfamiliar with the WAIS, these ideas are based on what I'm thinking might be similarities between it and the WISC.

 

Has he ever had a developmental vision exam? A vision problem might explain the relatively low perceptual reasoning score.

 

Has dyslexia ever been mentioned as a possible diagnosis? CAPD often goes with dyslexia, and in fact, my son was diagnosed with CAPD well before he was diagnosed with dyslexia. Also, I was surprised that you were able to get a CAPD diagnosis at such a young age. I thought they wouldn't evaluate kids until age 7 or so.

 

Does the evaluator have experience with twice exceptional kids (gifted with a second diagnosis, usually learning disabilities)? If not, you might want to get an opinion from someone who does (and there aren't many of them out there).

 

Take a look at the book Overcoming Dyslexia. It has lists of symptoms at various ages and you might see your son in them.

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The processing speed should qualify you for some extended time, so that is a positive at least. Did they give you a GAI? With those discrepancies in subtests I don't think the FSIQ is valid. Did they mention possible LDs?

 

I agree with determining the GAI. His verbal scores are very, very high. Who did the testing? Are they going to go through the results with you? Will they be qualified to diagnose? I think getting more information from a professional will be really helpful.

 

In the end, he is still the same kid. He clearly is doing well....To quote you: :-)

" He has a large vocabulary, grasps complex ideas, and has been able to get 86%-94% across the board in almost all of his high school course grades."

 

I think seeing the actual numbers is severely painful. (I know it was for me...my ds had HUGE discrepancies, much like you are seeing btw verbal and processing speed). It feels very frightening.

 

However, I think your son will find a way.....he clearly already has. I am SURE my dh has profoundly low processing speed and another friend's husband, also. They are both HIGHLY successful in their fields (computer programming and ophthalmologic surgery...2 fields that require careful, focused work is important).

 

And so you know, waiving foreign languages for dyslexic/CAPD students is a common accommodation.

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Guest Mommof6

Ladies - Thank you so much for your encouragement and ideas! Everyone is correct - His full-scale IQ number is invalid and the psych will need to put together a GAI for him. She stated that he should 'never' have a time restriction for any testing. I do think the general results were what we expected - but I was surprised at how high and how low his scores were (which sounds like a classic LD compensation that fooled even teacher-mom). My husband (a pediatrician) was a bit more rational - he laughed at the memory scores. :001_rolleyes: He thought it might be helpful to retest or look at other testing in the memory realm. He was was like, "Really, this kid is scoring is down at the worst memory scores out of 1000 cross-section of adults" He helped me to remember a test is just a test.

 

My son and I met with psychologist yesterday - and I have the 'interpretive report' for each of the instruments. The psych is finishing her report and will send it via email tonight. My husband and I want to meet with her again after we digest the report.

 

Kai - I have wondered about dyslexia ever since he was little. He still struggles to use a clock face to tell time (he loves to wear watches and I just found out last month he doesn't use them to tell the time) and uses capital B and D within his writing. He still struggles with basic punctuation. At the age of 9 - when he was inhaling books and reading for pleasure hours every day - he didn't know what paragraphs were. I had him bring me the book he was reading to show him the paragraph breaks. He literally didn't notice them before I showed them to him :huh: . I think I ignored dyslexia signs thinking his CAPD was at the root of the issues. It just doesn't seem 'fair' that someone could have both auditory and visual processing issues.He does well with narration, but his writing (content, not handwriting) is atrocious. He has had a fabulous writing tutor - after 6 months with 4-6 hours of weekly tutoring he is finally writing at grade level.

 

In computing a GAI in the WAIS-4 they use the Verbal Comprehension Index and the Perceptual Reasoning Index. I was struck by the particularly low score on the Matrix Reasoning subtest.

 

Subtest scores within VCI:

Vocabulary: 18

Comprehension: 14

Similarities: 18

 

Subtest Scores within the PRI:

Block Design: 13

Matrix Reasoning: 6 *****

Picture Concepts: 10

 

When I looked at Matrix Reasoning it looks like classic challenges for our son. It looks at visual processing maps, puzzles, and visual abstract reasoning. (I'm guessing this is why Geometry was such a struggle for him. He loves Algebra - though he struggles with careless errors/computation errors.)

 

Thank you for the reminder that he is still the 'same kid' he was before testing. I do a good job remembering this with our other children's reports - somehow I hadn't prepared myself for this meeting with the psych.

 

Ramona: Thanks for the reminder that slow processing speed doesn't mean he cannot have a demanding career. My husband is a bit of a slow processor as well - and yet has excelled as a physician. Thanks too for the info on the possibility of waiving foreign language requirements.

 

Heather - Thanks for sharing. Have you found anything particular strategies that have worked well for getting information into your son's memory??

 

Marie - Thank you for sharing your thoughts - I greatly appreciated them!

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On foreign language, you might want to check out colleges of interest to better understand their policies on foreign language- both with respect to foreign language on the high school transcript as well as requirements for foreign language to graduate in the majors your son is considering. Though most colleges will waive the foreign language requirement for students with supporting test data, some are a bit more picky. I learned that one highly selective university on our list of potential schools would consider lack of foreign language in high school to be a liability in the admissions process. I have heard in a few cases that a student has been unable to get a foreign language graduation requirement waived but has been able to use ASL, or even-surprisingly- a computer programming language to qualify. Many dyslexic students (and others with memory challenges) are able to learn a foreign language but only with individualized pacing and liberal use of multi-sensory instruction. These are the reasons why we are pursuing foreign language the way we are doing it now.

 

Your husband may have a point on the memory testing. If you really wanted to know, you could consider doing some more testing using some other assessment tools to see if they confirm the original scores. I do know that the various memory weaknesses my son has- both auditory and visual- made teaching him basic academic skills such as reading decoding, math facts, memorizing days of the week and months of the year, etc., excrutiatingly painful. Now that he is older and more complex reasoning is required in his schoolwork, he is actually experiencing greater feelings of success as a student. Even now, a teacher that emphasizes memory work over conceptual understanding can make a class difficult for him. He had this difficulty in pre-calc/trig when the teacher taught trigonometric functions as a memory exercise. Bad match for my son. Only after his dad taught him the concepts underlying them did his test scores improve. Thankfully, so far he is expressing that Calc I seems easier than Pre-calc. and he says it's because the teacher explains things in several different ways.

 

The matrix reasoning score is a definite outlier, and I think your reasoning on it is likely going in the right direction.

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I agree with the PP about trying CogMed. It's expensive and unfortunately not covered by insurance, but with that big a discrepancy between intellectual potential and memory/processing, I think it would really be worth the investment if you can at all swing it. If it's not in your budget, you could try Lumosity but be aware that's designed more for general "brain fitness" rather than remediation.

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We work in shorter increments, try to go slowly, and review, review, review. We use mnemonics. Hands-on learning is great. Some subjects come quite easily to him...

 

I rest upon something particular that Dr. Shaywitz mentioned in her book Overcoming Dyslexia. Dyslexics become subject matter experts. I expect that as my son gets older, he will pursue something that he loves as a professional and be really, really good at it.

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I wonder - does your son have a typical recall pattern of a dyslexic? Does he remember stories or information within a context well?

 

I'm unfamiliar with the Weschler Adult Memory Scale, but most memory tests focus on how the brain remembers unrelated items, like a string of numbers. His verbal comprehension score of 70% though, and his very high verbal scores suggests that he does remember facts well, but within a context that his brain can make sense of. Maybe that's why, as Heather quoted, dyslexics become subject matter experts.

 

ETA: I'm jumping the gun to imply that your son is dyslexic. Ds also has CAPD as well as VPD. I think this is the root of his issues. He reads very well but skips letters and lines all the time despite heavy VT in the past. His primary mode of comprehension is inference. He has a dx of Stealth Dyslexia, and while he reads all the time, I can see that his learning/memory profile is exactly that of a dyslexic - he has zero rote memory. He also has very poor spatial abilities, which has led to dysgraphia.

 

Cogmed has been a life saver! And looking for high interest curriculum has been necessary, or nothing (and I mean nothing!!) gets in.

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Guest Mommof6

The Psych said she would be finishing his report and sending out on Thursday evening. I've heard nothing from her. I've emailed her twice (she prefers email to phone calls) but not a word. I would have no issue with a 'been busy/I'm ill' email letting me know the report will be delayed.

 

At this point my husband and I want to pursue more testing for our son. Should we start making inquiries now or wait until we hear from her?

 

Oh - -and she runs her own practice. So she handles all contact with clients...

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