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Help me interpret these WISC-IV scores, please


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We *finally* got dd9's testing done through her virtual academy. It's been an arduous process, to say the least, and we will NOT be continuing with them for next year. However, these results were the whole point of enrolling this year, so I'm glad to finally have something on paper.

 

Anyway, due to spelling and writing difficulties, as well as number sense issues, I have long suspected dyslexia. I broke protocol with the VA and started using Sequential Spelling a few months ago, which has helped tremendously. Some of the number sense issues are being passively remediated thanks to the fact that dd is at the table while younger dd is doing RightStart math. The underlying issues, though, are still there, and I'd like some help interpreting these scores. I meet online with the school psych tomorrow to discuss the report. The psych did note in the report that she did not have confidence in the Full Scale IQ score, due to the large discrepancies.

 

It's also worth noting that I have a son who is autistic, and I have suspected for a while that were dd to be evaluated, she might land on the upper end of the spectrum. We have never pursued that line of testing, however, as it wouldn't impact her education the way an LD/dyslexia dx might.

 

Please don't quote the scores portion of the post, as I will delete them later. Thanks!

 

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Just a quick thought - have you ever ruled out developmental vision issues with a covd optometrist?  Thinking out loud, I'd be wondering what could account for the huge difference between VC and PR.  I'd want to rule out vision before looking into something like NVLD.

 

What person performed the testing?  Was it a psych?  I'd plan on taking the results to a neuropsych for analysis and consultation.  Eta, I just noticed you haven't had the conference yet.  In my experience, it's unusual to have results prior to the consultation (as much as I would prefer that).  Be aware that quality of school psychs varies widely when it comes to analyzing complicated sets of scores.

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The psychologist employed by the school district did the testing. I am not exactly sure how a neuropsych differs.

I asked for the results to review before the meeting, so that I could come prepared with questions rather than being hit with all this info during the meeting.

She has not been evaluated by a COVD, but two separate ophthalmologists have told me her convergence and tracking are fine after examining her. She does wear glasses, fwiw.

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Were additional testing instruments used?  I would agree with the large discrepancy would not be a vailid indicator of intelligence.  I had one w/ similar scatter although much higher Verbal Vision Therapy helped tremendously.  Additional the w/ the other testing instruments used he was dx as dysgraphic, dyslexic and ADHD -- using Wilson Language Fundations program and meds for the ADHD were the final piece for our puzzle/

 

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Were additional testing instruments used?  I would agree with the large discrepancy would not be a vailid indicator of intelligence.  I had one w/ similar scatter although much higher Verbal Vision Therapy helped tremendously.  Additional the w/ the other testing instruments used he was dx as dysgraphic, dyslexic and ADHD -- using Wilson Language Fundations program and meds for the ADHD were the final piece for our puzzle/

 

She was also given by the OT:

 

Beery Test of Visual Motor Integration
Test Date: 3/6/14
Test Results:
The Beery VMI helps assess the extent to which individuals can integrate their visual and motor abilities. The test presents drawings of geometric forms arranged in order of increasing difficulty that the individual is asked to copy. Supplemental tests are included for visual perception and motor coordination. {dd}'s results included standard scores of 83 for Visual Motor Integration(13%), 83 for Visual Perception(13%), and 76 for Motor Coordination(5%), with an age equivalency of 7 years.

 

On the Beery Test of Visual Motor Integration, {dd} scored below average at the 13th percentile for her age group. {dd} demonstrates weaknesses in visual perception skills as demonstrated by her performance on the Visual Perception supplemental task of the VMI scoring at the 13th percentile. Her lowest score was on Motor Coordination supplemental task, scoring at the 5th percentile. During the assessment {dd} was impulsive with choices, not looking at all options. When replicating designs she had difficulty visualizing the whole picture, often making separate linear strokes to form the design and lifting her pencil between each line segment. All of her extremity motor tasks are influenced by poor postural strength/stability and cocontraction at the upper extremity joints. Core body strength is weak, specifically extension as noted when assuming total body extension posture against gravity (maintains prone extension for 4 sec).

 

Test Administered: McMaster Handwriting Protocol
Test Date: 3/6/14
Test Results:
{dd} is writing at a speed of 30 letters per minute when copying a near point sample and 23 letters per minute when copying a far point sample. Based on the McMaster Handwriting Protocol, she is writing at a third grade speed. Errors are noted in spacing between words, letter placement on the line and consistency in letter size, influencing legibility.

 

 

It's also worth noting that she scored "Exemplary" on the state reading test at the end of 3rd grade, and her Scantron Results at the beginning of 4th grade were "High Average" for 4th grade. She is an excellent reader, using only sight. It's when she has to decode that everything used to break down. She's made great strides in the past year, using ElizabethB's methods. :)

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Okay, first of all, I agree with those who posted previously. 

 

I think wapiti may be right about the possibility of a developmental vision problem. It might be helpful to get that eliminated as an issue with a covd specialist who you can trust. I know you said you saw two ophthalmologists but I'm wondering what instruments they used and if their testing was specialized enough because developmental vision isn't their field of expertise. The covd doctor will help you understand what's behind the visual weakness and what you may be able to do about it.

 

momtotkbb is also right about asking about additional testing instruments. You will need to have a test of visual processing, though I think seeing the covd specialist should come first. Ideally, the findings of both should support each other. 

 

Okay, say the ophalmologists are right and there is not developmental vision, or ocular motor, problem. Then you are likely dealing with a deeper visual processing weakness.

 

Do you have any processing scores? They should be there, too.

 

You mentioned her writing difficulties. I think you're talking about a physical issue, right? A difficulty with fine motor skills and coordination, possibly? That goes along with the visual weakness that shows up in the scores. Coordination is something that influences everything. Dyspraxia or developmental coordination disorder even affects sensory processing, or sensory processing affects it. Whatever it is, it's tied together and affects learning and real-life functioning.

 

I think your mommy instinct is right about something. There's a big gap between the visual and perceptual scores. You may want to read about nonverbal learning disorder. I'm not saying that's what it is, but the scores fit that profile. It's associated with having some of the same weaknesses you will find on the spectrum. So as you said, the upper end of the spectrum, or perhaps the far end of NT. 

 

Your scores remind me of one of mine. We also had vocab stand out among relatively high verbal scores, interestingly. She did see a covd doctor who did find a visual issue which couldn't be helped by the therapy he does. Her problem comes down to dyspraxia too mild for an actual dx but certainly enough to effect visual, auditory, and visual-motor processing. No specialist has ever suggested AS and she's seen lots, but her processing is similar to the processing of AS.

 

Hope this helps!

 

P.S. And with those working memory scores, I would suspect ADHD type difficulties.

 

 

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LOL. I see you posted the VMI test while I was typing away.

 

Yes, it all fits together. 

 

Are you against getting an eval for AS for the sake of ruling it out? Would that interfere with the dysgraphia/dyslexia dx that you see as being more helpful now?

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I appreciate all the input.

 

 

Okay, first of all, I agree with those who posted previously. 

 

I think wapiti may be right about the possibility of a developmental vision problem. It might be helpful to get that eliminated as an issue with a covd specialist who you can trust. I know you said you saw two ophthalmologists but I'm wondering what instruments they used and if their testing was specialized enough because developmental vision isn't their field of expertise. The covd doctor will help you understand what's behind the visual weakness and what you may be able to do about it.

 

I am honestly not sure what instruments or methods they used. I will look into how our insurance handles this. Hopefully, we may be able to get it covered when she is due for another eye exam in August.

 

momtotkbb is also right about asking about additional testing instruments. You will need to have a test of visual processing, though I think seeing the covd specialist should come first. Ideally, the findings of both should support each other. 

What sort of testing instruments, specifically? I'm sure I won't get any more out of the VA, so anything else will have to be pursued on our own.

 

Okay, say the ophalmologists are right and there is not developmental vision, or ocular motor, problem. Then you are likely dealing with a deeper visual processing weakness.

 

Do you have any processing scores? They should be there, too.

 

This is all I could find regarding processing:

 

A direct assessment of {dd}'s short-term auditory memory, performance on the Digit Span subtest requires attention, concentration, and mental control and can be influenced by the ability to correctly sequence information. Mental control is the ability to attend to and hold information in short-term memory while performing some operation or manipulation with it and then to correctly produce the transformed information. This weakness may impede the processing of complex information for her and slow new learning. Solving mathematical problems without pencil and paper also requires mental control.

 

{dd}'s ability in processing simple or routine visual material without making errors is in the Low Average range when compared to her peers. She performed better than approximately 16% of her peers on the processing speed tasks (Processing Speed Index = 85; 95% confidence interval 78-96). Processing visual material quickly is an ability that {dd} performs poorly as compared to her verbal reasoning ability. Processing speed is an indication of the rapidity with which {dd} can mentally process simple or routine information without making errors. Because learning often involves a combination of routine information processing (such as reading) and complex information processing (such as reasoning), a weakness in the speed of processing routine information may make the task of comprehending novel information more time-consuming and difficult for {dd}. Thus, this weakness in simple visual scanning and tracking may leave her less time and mental energy for the complex task of understanding new material.

 

{dd}'s performance was significantly weaker on the Matrix Reasoning subtest than her own mean score. Her weak performance on the Matrix Reasoning subtest was below that of most children her age. The Matrix Reasoning subtest required {dd} to look at an incomplete matrix and select the missing portion from five response options. This subtest assesses fluid visual information processing and abstract reasoning skills; (Matrix Reasoning scaled score = 5).

 

Unfortunately, it's not really anything I didn't already know. I was hoping that the testing would reveal exactly the nature of the "beast" we're dealing with. Perhaps the psychologist might fill in those blanks in the meeting.

You mentioned her writing difficulties. I think you're talking about a physical issue, right? A difficulty with fine motor skills and coordination, possibly? That goes along with the visual weakness that shows up in the scores. Coordination is something that influences everything. Dyspraxia or developmental coordination disorder even affects sensory processing, or sensory processing affects it. Whatever it is, it's tied together and affects learning and real-life functioning.

 

She has always had fine and gross motor delays. She received OT when she was in PS for kindergarten, but met her goals and was released by first grade. My son also is severely apraxic. I hate to think that maybe his severe deficits made dd's seem less concerning, but I have to admit that's a possibility. :(

 

I think your mommy instinct is right about something. There's a big gap between the visual and perceptual scores. You may want to read about nonverbal learning disorder. I'm not saying that's what it is, but the scores fit that profile. It's associated with having some of the same weaknesses you will find on the spectrum. So as you said, the upper end of the spectrum, or perhaps the far end of NT. 

 

Your scores remind me of one of mine. We also had vocab stand out among relatively high verbal scores, interestingly. She did see a covd doctor who did find a visual issue which couldn't be helped by the therapy he does. Her problem comes down to dyspraxia too mild for an actual dx but certainly enough to effect visual, auditory, and visual-motor processing. No specialist has ever suggested AS and she's seen lots, but her processing is similar to the processing of AS.

 

Hope this helps!

 

P.S. And with those working memory scores, I would suspect ADHD type difficulties.

 

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LOL. I see you posted the VMI test while I was typing away.

 

Yes, it all fits together. 

 

Are you against getting an eval for AS for the sake of ruling it out? Would that interfere with the dysgraphia/dyslexia dx that you see as being more helpful now?

 

I'm not really against it, but I'm pretty sure it would be all out-of-pocket for us. Since any accommodations she'd need in school or testing would be based off of the dyslexia/dysgraphia/LD diagnosis rather than ASD, we just figured why go through all that for a label? Not to mention that the wait to even get seen (say, by ds's dev ped who dx'd his autism) around here is 6-8months.

 

If anyone can give me a good reason, I'd honestly like to hear it. I freely admit that perhaps we are so used to being flexible and meeting our kids where they are, thanks to ds's needs, that maybe we don't fully recognize a need for a label. For ds, it was different. He clearly needed and benefited from services that his autism label provided.

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Oh wow. This describes dd to a tee:

 

 

  • Process at a very concrete level and interpret information quite literally.
  • Significant weakess processing nonverbal communication such as body language, facial expressions, or tone of voice.
  • Unable to intuit what is not specifically stated.
  • May present as uncooperative.
  • Tremendous difficulty with fluid or difficult social interactions.
  • Lack "street smarts" - can be incredibly naive.

 

I've posted before about how she is so literal that when a randomizer algorithm for a Discovery Education quiz had all correct answers, but put choice "C" as all of the above, rather than "D", dd argued and argued with me for over an hour and refused to click C because the one underneath was also correct! The facial expressions aspect is intriguing. She can't fake any expressions, other than a mild smile. If you ask her to look angry or confused or sad, unless she is really experiencing that emotion, all you get is a Mona Lisa smile. That was my biggest tipoff that she may be on the spectrum.

 

She tends to prefer to socialize with girls a couple years younger than her own age. Sometimes, I've joked that if we just let people believe she was a giant 7yr old, she'd be just fine.

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I appreciate all the input.

 

Among other things, the important testing the covd doctor did with both my girls was to test their tracking with googles hooked up to a computer. That indicated one dd did have some difficulty tracking, but it showed that the other's eyes moved very slowly though she tracked well. So that device was particularly helpful for that dd and the information it gave us was completely in sync with what the np found, relatively low fluency.

 

The WISC processing speed index should include results for coding and symbol search subtest.  

 

Our np did extensive visual memory testing, though I don't know what the test was called. There was a rather long list of results for the different types of visual memory, I remember. She also did an executive functions assessments. I think there were two different types. I know there were other tests that she could have done and did not do, because I consulted another np about the scores and she was interested in doing different tests to get around the visual issues to help determine if there was anything else going on.

 

I also find it really frustrating is that there's not always an easy label. You can have a collection of weaknesses that have different labels or aren't severe enough IN TESTING to actually get a label but the problems are still very much there IN REAL LIFE. It would be so nice to have a nice, neat explanation that covers the whole picture. Maybe SPD in the very broad sense that includes dyspraxia. Our only official dx is CAPD, even though that's likely really just a symptom of the underlying issue. 

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Ok, I found the other scores.

 

Processing Speed Subtest Scores Summary (Total Raw Score to Scaled Score Conversions)
Subtests
                              Raw Score          Scaled Score     Percentile Rank
Coding (CD)               36                           8                    25
Symbol Search (SS)    15                           7                     16

 

 

She was also given the WIAT-III. Those scores are even more disparate, with ranges from <1st grade in addition fluency to grade 3.4 equivalent for essay composition. Multiplication fluency is grade 3.1. She still has to count on her fingers to determine 2+1, but she can tell you right off what 8x7 is, thanks to Times Tales!

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Good news. I found a COVD doctor only 4.2 miles away! Now...to see if she is included in our insurance network...

 

Usually, the evaluation isn't horribly expensive. Ours were each about $200. It's the therapy that's really pricey. 

 

ETA: I was really impressed by our covd doc's knowledge of brain quirks. Perhaps you will also find someone who can help you sort it out. It was interesting that ours did not recommend our np, but he did recommend an educational psych. He felt this particulary educational psych had a better long term understanding of how the different issues will come into play over time, and he thought this would be more worthwhile in the long run than np testing. But he's not a hser.

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