My 8-year-old child is being assessed for difficulties in school related to following verbal directions, math word problems, and reading comprehension. He has no "hyperactive" issues, although teacher has observed what's being labeled as "inattentiveness" at times while doing his work. I am concerned that his slow processing speed is being misunderstood for inattentiveness. Moreover, I am concerned about scatter both within subtests on the WISC IV, as well as the significant discrepancy in scores between Verbal, Perceptual Reasoning, and Processing Speed. His WISC IV scores are as follows: Verbal 102 (Similarities 14, Vocabulary 10, comprehension 8) Perceptual 129 (Block 14, Picture conc 11, matrix 19) WMI 110 (Digit Span 12, Letter -number sequ 12) PSI 88 (Coding 9, Symbol Search 7) FSIQ - 112; GAI 119
The Woodcock Johnson achievement tests were given - scores ranged from 102 (reading comp and written expression) to 115 (broad reading and broad written). Does the scatter tell us anything about any kind of pttential LD? He was also given the CogAT as part of gifted testing at school. He scored in the 99th percentile for quantitative reasoning, 88th percentile for nonverbal, and 48th for verbal. I would greatly appreciate any feedback, as well as guidance on how to interpret the Woodcock Johnson with the WISC.
Significant subtest scatter on the WISC is almost always an indication of learning disparities, and further evaluation is needed to figure out what they are. You say that your son is being assessed for difficulties in school, but is the testing being done by a public school psychologist, or a private evaluator? Did the person give you a written report with recommendations yet?
I'm not sure how much you know about the WISC subtests, but those for processing speed (coding and symbol search) are "pencil to paper" tasks. Some children appear to have slower processing speed, when it may be related more to a hand-eye coordination issue. I'm guessing that may not be the main problem in your son's case, since you didn't mention writing problems as a concern. (Out of curiosity, how is his spelling?)
Usually, children with attention deficits score poorly in Digit Span, and that doesn't appear to be a problem with your son, either. The fact he's scored so well on the perceptual reasoning part of the WISC leads me to think that he prefers "hands-on" interactive learning, rather than classroom "lectures." A very good site to find out more about these types of learners is www.visualspatial.org
What I'm really thinking, and would like to see done, is an evaluation by an audiologist who specializes in CAPD/APD (Central Auditory Processing Disorder.) It's different than just having a hearing test. It can "look like" a child is inattentive, and not following directions, but it might be that the auditory messages are "garbled" on their way to being interpreted. It stands to reason a child with APD issues may also show weaknesses in verbal areas. There's a good book called "When the Brain Can't Hear," and I also recommend that you look at this information from CAPD expert Dr. Jeanane Ferre: http://ocslha.com/Ferre.htm
If you'd like more feedback about your son's scores, there are a lot of experienced parents at www.millermom.proboards107.com who can give you additional insights.
Thank you for your replies/links. Healthy11, in response to your questions, his spelling is good, handwriting (and general artistic abilities) is excellent. His writing lacks detail in terms of its substance, and he has extreme difficulty organizing his writing. His reading comprehension is fair. He has to take his multiplication tables tests orally, as he cannot finish them fast enough when writing is involved. He has several classroom accomodations including preferential seating, written instructions, extra time to respond to questions. He was given an auditory processing evaluation. It showed "mild difficulty in the presence of nonverbal backround noise; some variance on dichotic listening tasks, with below average skills for competing two syllable words; and a pattern of errors on the SSW indicating difficulty integrating auditory information." However, the audiologist ultimately concluded he did not have an auditory processing disorder because his performance was "not consistently below average in any skill". She further concluded that because he was struggling with written directions as well, his problems were beyond audiotry. She recommended continuing with his accomodations (he is not coded). However, he is extremely distracted by noises, and will often startle/cry out with loud, unexpected noises. I am at a loss at this point as to what further tests we should be suggesting - do you have any suggestions? He is often frustrated with homework, school and has begun experiencing low self esteem because he can't do the work. He is excellent with Legos/building, loves science, and my guess is he is a visual/spatial learner - thank you for the website link. My concern is if there is a an LD going on. The school evaluated him, but we're more than willing to pay for private - we just don't know what kind of testing to pursue at this point. No one has noticed any hyperactive issues. He did receive speech language therapy as a preschooler for language delays. The CELF they administered was mostly in the average range, but there was a large discrepancy between between language content (125) and language structure (108). He did perform below average on the rapid naming subtest of the CELF. He did appear to struggle more with syntax than semantics measurements. What do you suggest?53596
How old was your son at the time of the CAPD testing? Was the audiologist affiliated with the school, or a private person, and did they give the SCAN-C, or more? If you haven't looked at the Dr.Ferre link, please do.
In terms of ADHD, the DSM -IV (Diagnostic and Statistical Manual) identifies 3 subtypes (Hyperactive, Inattentive, and Combined ) but most people incorrectly assume hyperactivity is present in all of them. ADHD-Inattentive is often characterized by a "daydreaming, in his own world" sort of demeanor, and NOT the "bouncing around the room, distracting other people" sort of behaviors. You can find out more at www.help4adhd.org Studies seem to show that many students with ADHD-Inattentive often have dyscalculia (math disabilities) but your son sounds like he "gets" math, he just can't put it on paper easily. Only once have I heard about a child who scored well in digit span on the WISC, and still had ADHD; it's definitely not a common occurrence, which is another reason I'm leaning more towards processing difficulties.
As far as writing difficulties, the WJ isn't considered the best measure; it could be useful to have the TOWL (test of written language) given.
I need to point out that I'm not a psychologist or speech/language path, or audiologist, just an experienced parent who has been advocating for a child for many, many years (He's highly gifted, but also has ADHD-combined, dyslexia, and dysgraphia, and is now in college.) I highly recommend joining and reposting your son's scores/background data at www.millermom.proboards107.com, where I'm sure you'll get additional "seasoned parent feedback."
Thanks again - I really appreciate your feedback! His auditory processing test was performed about 1 year ago (when he was 7). They had previously tested him at 6, but said he was too young to reach any conclusions. By "they" I mean the school audiologist. His scores on both tests were almost identical. She did do the SCAN -C - his score was SS 7. When the school first brought up auditory processing, I thought we had found our diagnosis - it seemed to explain so many of his problems. He will literally be looking at me, I'll have his undivided attention, but if I give more than one direction at a time (multi-step), he'll either only follow one of them, or in his attempt to follow them, do something completely different altogether (not correctly follow any - it's as though they're all jumbled up). He cannot work with any backround noise, whatsoever. He says he can't focus on his tests at school because the other children finish before him, and they talk when they're done. We hesitated on an ADD diagnosis, because his teacher also reported at times she would have his complete attention but he wasn't following directions. At home, his attention is excellent - it just appears he's not listening - does that make sense? In your experience, can kids with ADD look like that?He has struggled with math, and we've had to provide private tutoring. That's why we were shocked to see he scored in the 99th percentile for quantitative reasoning on his CoGAT. We received gifted information on math extenstion activities which are typically provided for kids in this score range at his school. I thought it seemed just so far out there, since he has struggled to get average grades in math - and then only with significant supports from us at home. Once he gets math, he does get it. It just doesn't come quickly. he is fine with math facts, just can't write them - don't understand why. I will join the site you mentioned, as I would appreciate direction from experienced parents. I will approach the school regarding TOWL. The IEP meeting to discuss the results is next week. I wanted to make sure I had a good understanding of everything beforehand, as there is not alot of explanation in the evaluations.53604
The reason I asked about your son's age at the time of the CAPD testing was precisely because testing of younger students is less reliable. As far as ADHD, I've heard lots of different parent descriptions over the years, and so nothing is a complete surprise.
The only other thing that I remember one person mentioning, where it looked like their child was paying attention, but they weren't following directions consistently, and all the "routine" tests didn't seem to identify the problem, resulted from some kind of seizure disorder. I'm forgetting the details, but I think they ended up consulting with a neuropsychologist and having a sleep-deprived brain wave study done, and it turned out to be some mild form of epilepsy, where the child had brief periods of "zoning out" even though they still looked awake.53613
In addition to checking for seizures, you may also want to do more in depth testing in the area of language. I believe a speech and language evaluation is in order and might include some of these tests: OWLS, CELF, PPVT. Generally speaking, although very solid, his verbal skills are a relative weakness (VCI 102 vc PRI 129). Perhaps there is a language processing difficulty that would certainly impact his ability to organize his thoughts for writing, possibly follow along for lectures or directions etc.
I'd also want to see some testing in the area of memory and executive funcitoning. While his working memory is strong - (a very good thing!), there are other types of memory that could be weaker and tripping him up. Executive functioning are the skills that helps one organizae, plan and integrate information. He may have difficulties in one or more aspects of EF that is causing problems.
Finally, the Woodcock Johnson isn't the best indicator of a child's ability to perform academic tasks in the classroom. Most of the tests are very brief, untimed and very structured. A child may be able to peform well in these circumstances and show a strong scored. But, when the same skills are being tested under a time constraint, with less structure and in a more complex manner (such as school work), the child may not be able to sustain the level of performance. It would be helpful if additional tests were given in areas of concern to gather more info about how he performs in circumstances more similar to school. Here's a great article on writing tests that illustrate my point: http://www.wrightslaw.com/info/test.written.lang.htm,
Finally, don't underestimate your child's slow processing. He has amazing perceptual reasoning skills and solid verbal skills. His reasoning and thinking skills are excellent. But, his ability to process: take info in, churn it around and make sense of it and then demonstrate what he knows either verbally, in writing or some other way, may be much much slower than his overall intellectual horsepower. This can be very frustrating for him and for his teachers. It's like driving a Ferrari during bumper to bumper traffic. The power excell is there, but there are barriers in performing.
Many kids with ADHD-in have either slow processing, low working memory or both. This could be part of the problem/solution. My son has very low processing yet his other 3 index scores are above average. Stimulent medication helps him with his concentration - but he is still very slow with his verbal and written output.53616
I just re-read one of your responses and see that he has had the CELF. In addition to the quantitative scores, did the evaluator note anything about how he processed language qualitively? While his scores were in the average range, what did the overall pattern tell you? Would you feel comfortable posting the scores?
You mention that his rapid naming scores were low. Was this the CTOPP rather than the CELF? Did they do any other subtests? Could you post the scores?
Lower rapid naming can be an idicator of reading difficulties - most often with fluency (rate and accuracy). They are also related to memory and processing difficulties. I'd love to see the other scores, because "average" is a wide range and there might be other scores that are notable.
Did they do any other reading tests? TOWRE, GORT, Gates McGinity? This might help us to understand more about reading in general and how this could affect comprehension.53634
pajeka, if you want to copy/paste what you've already posted here, along with the additional test info that Michellea asked about, at www.millermom.proboards107.com, Michellea and I will both be able to see them there, along with other experienced parents. (Unfortunately, Greatschools forum has only been in existence two years, and most parents here are younger, so you probably won't get much more feedback.)53639
His CELF scores are as follows: Core language - 104 Concepts/directions - 11 Word Structure - 13 Recalling Sentences - 8 (he often substituted several words here - mother for mom/students for children/ a for the, etc, the speech pathologist is saying it's because of lack of attention to detail, even though he has a history of word retrieval problems since age 3) formulated sentences 11 Word Classes - receptive 12 Word Classes - expressive 16 Word Classes total - 14 Sentence Structure 13 Expressive Vocabulary 17 Number Repetition - 10 Familiar Sequnence 14 Receptive Language Index - 113 Expressive Language index - 103 Language content - 125 Language structure - 108 Working Memory 112 Rapid Automatic Naming - slower than average/accuracy above average To answer your other questions: The Rapid Naming was a CELF subtest They peformed NO other subtests, nor did they do any further investigation of some of his lower subtest scores on passage comperhension and math fluency. There was no note on her report regarding the sifnificant 17 point discrepancy between language content and language structure I am not sure what is meant by "qualitative speech"? I do know his speech has always lacked fluidity, but not sure how this is measured. It seems that many of the tasks on the CELF are rather basic, and do not involve speech as it would occur in the classroom? Thank you for your help! What further evaluations would you suggest?
I am going to try and post of millermom as well.53651
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