Gifted Issues Discussion homepage Forums Identification, Testing & Assessment Testing on a 5 year-old girl

My 5 year-old daughter is in Kindergarten and she has been seeing a Social Worker for anxiety issues. Recently, the Social Worker referred our daughter for a Psychological Evaluation and the intelligence portion of the evaluation showed the following results:

Composite Percentile
WPPSI-IV Summary Score Rank
Visual Comprehension (VCI) 135 99
Visual Spatial (VSI) 132 98
Fluid Reasoning (FRI) 114 82
Working Memory (WMI) 121 92
Processing Speed 103 58


Subset Scores Summary Score Percentile
Verbal Comprehension
Information 16 98
Similarities 16 98
Visual Spatial
Block Design 17 99
Object Assembly 14 91
Fluid Reasoning
Matrix Reasoning 10 50
Picture Concepts 15 95
Working Memory
Picture Memory 14 91
Zoo Location 13 84
Processing Speed
Bug Search 11 63
Cancellation 10 50

Composite Percentile
WRAT-4 Score Rank
Word Reading 124 95
Spelling 126 96
Math Computation 122 93

The psychologist said it didn�t make sense to calculate an overall IQ due to the disparity between the individual results. She also speculated that the disparity between my daughter�s processing speed and other intelligence components, combined with perfectionist tendencies, may account for some of her frustration and anxiety. She also recommended that we look into outside enrichment programs for our daughter (particularly during the summer), but didn�t recommend actually placing our daughter into a full-time gifted program, as these can be competitive and might increase her anxiety level.

Could anyone explain these test results to me and let me know if my daughter is truly gifted, or just above average in intelligence? Do these test results mean anything at such a young age and can they change significantly as she gets older? Assuming the test results are significant, could anyone suggest supplemental type enrichment programs we might want to consider? Our daughter seems happy at school, and her report cards indicate that she is doing well (but not exceptionally well). We want to do what�s best for our daughter, but also don�t see a need to push her into more stressful situations. Providing her with a happy childhood is our most important consideration.

I would appreciate any advice that others might have.

Welcome!
Yes, these test results are considered in the gifted range. I will note that among her lowest scores was Matrix Reasoning, which is a measure of fluid reasoning and adaptive thinking. Sometimes I see children for whom adaptability is a relative weakness struggle particularly with anxiety, especially when they are in settings (or at developmental levels) where they experience life events as largely outside of their control or prediction. Such children often benefit from consistent, predictable environments, with clear expectations for adults and children alike, and ample preparation for changes in their routines.They do mean something at this age, but they may also change significantly over time. Testing is usually considered to be more representative of adult intelligence after about age 8 or 9. One does not generally assume that it will fall into the average range, though, absent some neurological trauma. I would agree.

Did your daughter have any additional testing from the psych to look at things such as visual-motor integration? I'm not as familiar with the WISC-V as the WISC-IV, but fwiw the degree of discrepancy of your dd's test scores (PSI vs everything else) is very similar to the discrepancy in my 2e ds who has Developmental Coordination Disorder. There are a few signs that suggest to me (just a parent, not a professional psych, so take what I say with a big grain of sale )... that suggest it's worth looking into the reason for the discrepancy in scores: you've noted that your dd is seeing a SW for anxiety, and you've mentioned perfectionism. Have you noticed what you think is perfectionism in your dd's school work or at home? If so, when does it occur, what type of activities? When did her anxiety start - has she always been anxious, or is it something that ramped up when she started school? Is there anything at school that she worries about or complains about? The reason I ask those questions is that it's possible the anxiety your dd is experiencing is occurring because she's faced with a challenge that is related to the discrepancy in processing speed and the other scores. The discrepancy could be due to *many* different reasons, so checking into it further, in the light of having the anxiety, is worth pursuing.
What looks like perfectionism can also be a sign of a challenge. For instance, maybe a child who has a relatively low score on Bug Search is a perfectionist and just wants to make sure he/she has the right bug circled each time. Or maybe the child has a hard time drawing a circle around the bug. Or maybe the child has a hard time seeing the differences in the bug vs other bugs. Or maybe the child has a tough time focusing. There can be so many different reasons for behaviors that look like perfectionism - so if you've got a questionable test score (I'm not saying the test score is potentially incorrect, but questionable in that it doesn't line up with others), a child with anxiety, and a child with what looks like perfectionism - my first priority would be to try to test further to really understand that dip in scores.

Again, I'm not a professional, just a 2e parent who's child had similar scores like that at the same age, we chalked it up to a gifted kid with perfectionism, and two years later when he was finally diagnosed, I really wished I could have gone back in time and figured it out earlier.

It's possible there's nothing at all up with your dd's psi score - but testing to be sure won't hurt anything and may give you some peace of mind.

And I also agree - a happy childhood is the most important consideration

Best wishes,

polarbear

Dear aeh & polarbear,

Thanks so much for your feedback. I hadn't really noticed the Matrix Reasoning subscore, and it makes sense to me that a relative weakness in this area may be causing some problems. We do try to create a calm and predictable environment for her, but the problem is that she is the one who makes things un-calm and unpredictable. We have always tried to give our daughter choices, as the experts suggest, to give her the illusion of control. That may have worked 3-4 times when she was 2 years old, but she quickly realized that she didn't like any of the choices we gave her.

There wasn't any additional testing done about visual-motor integration, but I will ask if it would be helpful. "Perfectionist" was actually the psychologist's term. My wife and I would probably say that our daughter "gets stuck" or obsessed with something, and she has a lot of trouble stopping or transitioning to something else (even when that something else is preferable to her current activity).

Do you know if there are any games or other activities that we could play with our daughter to improve her matrix reasoning and processing speed? I'm wondering if improving these abilities would also help her improve her coping skills.

Forrester, even if the title doesn't seem to describe your child, I would recommend that you take a look at The Explosive Child, by Ross Greene. You can read the book, or you can get 80% of the way there by watching the videos at http://livesinthebalance.org/walking-tour-parents . Specifically, the solutions he suggests to "getting stuck," and of looking at your kid as having lagging skills in that area, really changed (for the better) the way we parent.

Elizabeth, thanks for the advice. I actually have that book sitting in my pile of books to be read. I'll be sure to move it to the top of the pile.

I have a few more questions for anyone who might be able to offer an informed opinion:

- My daughter is being raised to be bilingual in English & French. I read somewhere that being bilingual introduces an additional layer of processing in the brain. Could this be slowing down her processing speed somewhat? If so, any idea how much this might be?

- The Social Worker initially referred my daughter for evaluation on "sensory issues" (aversion to noise, cutting labels off of her clothes, not walking barefoot in the grass, etc.). These and other factors, always had me concerned that my daughter might be mildly autistic, but she keeps them well-hidden in public, and the SW was the first one to pick up on some of these issues. The Psychologist used GARS-3 and Vineland-II questionnaires filled out by me (which indicated that my daughter was in the Probable range and might need minimal support) and the teacher (which indicated no problems). Overall the Psychologist said she didn't think my daughter had any autistic issues. It doesn't appear to me that she did any independent testing on her own, and she never really addressed the sensory issues raised by the SW. Should I push for additional testing on this?

- The more I look into it, I can see why my daughter received a relatively low score on Matrix reasoning, which I believe measures the ability to read non-verbal communication and adapt to changing circumstances. It seems to me that this may be causing some of her anxiety. Is there a way to build her skills in this area to help her overcome some of her anxiety issues. I've seen a book on this subject, but it seems focused just on helping kids improve their test score, to help them get into a good private school. I really don't care about test scores, but just want to understand if there is anything we can do to help her in this area.

- Finally, I would like to understand if my daughter's relatively low processing speed and matrix reasoning scores indicate that her relative weaknesses in these areas are fueling her anxiety problems, or is it the other way around (her anxiety problems are driving down these test scores). Similar to my last question, I'm just wondering if trying to improve her skills in these areas would be a helpful adjunct to her current treatment (which focuses on improving her coping mechanisms).

Thanks for your help.

Forrester, with this additional information, I would rather strongly recommend that you get her tested by someone who is actually an autism expert, rather than a regular neuropsych, probably using the ADOS (ask specifically about this test - they may not actually use it for your child, but they better know all about it and have a reason for not using it, because it is the gold standard test for identifying autism). The inflexibility, sensory issues, anxiety, and low processing speed are all issues that my daughter had, and she was finally diagnosed with autism at 11 (after her brother was diagnosed at 7, and we started talking to the psych who saw him about what autism looks like in girls). Her middle school counselor told me that the "unholy trinity" of ADHD + anxiety + sensory issues pretty much causes her to assume undiagnosed autism until proven otherwise. She may not be autistic, but trust me, you really don't want to wait until she's almost a teenager if you don't have to.

I would agree with Elizabeth, that the addition of sensory processing/sensory defensiveness to rigidity and anxiety does make additional eval for ASD more advisable. The GARS-3 is a decent indirect instrument for ASD; I use it myself, and find it informative. It does not, however, replace direct assessment by an experienced multi-disciplinary team using the ADOS-2 (it should be a team of specialists, including, preferably, psych, speech/language, and OT (or at least psych and one of the others), and not an individual).

And, BTW, Matrix Reasoning isn't exactly a measure of social perception, although individuals with deficits in social perception may also score poorly on it, possibly because of the fluidity of social situations, and possibly because individuals with perceptual weaknesses often have difficulty with reading facial expressions and body language (but this is distinct from weaknesses in theory of mind and social perspective taking).

If you're not sure where to start looking for an autism specialist, you may have an NICHD autism research center or autism center of excellence site in your area somewhere. Check "current sites", and also try googling "autism center of excellence" in your area, as some of the centers are not engaged in current research projects (and thus not listed on the site), but still have many resources:

https://www.nichd.nih.gov/research/supported/Pages/ace.aspx#current

If you happen to be in the Northeast, there's the National Autism Center:

http://www.nationalautismcenter.org/

Also, check your regional Children's Hospital.

Thanks everyone for your feedback. I've been slow responding, as I wanted to get some feedback from the Social Worker who has been doing art therapy with my daughter.

First, going back to polarbear's point about visual-motor testing, a Bender Visual-Motor Gestalt Test was administered. This showed a Copy score in the 93rd percentile, Recall in the 70th percentile, and 76-100% range on the Bender Motor & Perception tests. They also administered a Grooved Pegboard test, which fell within the average range on her dominant hand. She had some problems with her non-dominant hand (placing pegs in the wrong direction and dropping a peg twice), but they thought that it just showed less dexterity with her left hand. Overall, they don't think my daughter has any issues with visual-motor integration.

As mentioned above, our SW originally wanted some sensory testing done, but it seems the place we went to doesn't administer this. Our SW recommended that we go to a place with an Occupational Therapist who is qualified to administer a Sensory Integration & Praxis Test.

As I mentioned earlier, the Psychologist had ruled out Autism based on the Teacher's GARS-3 & Vineland II questionnaires, even though my questionnaires indicated potential problems. When I questioned why no independent testing was done, the Psychologist said that if our daughter was truly autistic, then there would be signs of it when she is out in public. Our SW initially agreed with this assessment, but then researched the subject a bit further, and found that almost all Aspergers research had been done on boys. After looking into it a bit more, she said that some newer studies show that girls with mild Aspergers may actually be able to hold everything together during the day, and then let everything out at home in the evening. She agreed that an ADOS test would be the only way to truly rule out any autistic issues.

Finally, the Psychologist diagnosed a General Anxiety Disorder, based largely on the fact that my daughter drew a family picture with only herself in it, and because her coloring was chaotic & heavy. Our SW who has done a lot of art with our daughter said that she's drawn plenty of pictures with other people in it, and that she's never seen the heavy, chaotic coloring the psychologist mentioned. I don't dispute the overall anxiety diagnosis, but wonder if the drawing showed that my daughter wasn't really comfortable in the psychologist's office.

We will definitely find a place to have an SIPT administered. Would it make sense to start a complete Autism evaluation as well, or wait to see the results of the SIPT first?

I still have a number of other questions as well, and would appreciate any input that others might have:

- I understand that a FSIQ doesn't make sense in this case, as my daughter's scores vary somewhat. The psychologist didn't give a GAI though. Should I ask for this?

- I've read some comments online, where people have said that processing speed shouldn't be included in the WPPSI, as young children have incomplete motor development. These people recommend the Stanford-Binet test instead to get a true measure of a child's intelligence. Do you agree with this, and should we consider getting this test done as well?

- Are there any type of activities or therapy we could get to improve, our daughter's Matrix Reasoning skills? Also, could her relative weakness in this area be a potential sign of Aspergers?

Thanks for your help.

GAI--this probably won't add any information, and likely won't raise the global measure, as FRI is heavily weighted in the GAI (2/5 of the contribution), and that's one of her weakest areas.

SBV--this test has motor tasks too. Also, VSI was among the highest areas. I don't know that moving to a motor reduced test (even if the SBV were that much less motor-involved) would necessarily provide a more comprehensive picture of her abilities. Though it is true that the Stanford has no processing speed cluster. The most likely reason for getting an SBV done at this point would be for access reasons. I don't think you'll get a lot of additional information.

Matrix Reasoning--not really, other than the ordinary activities that are part of healthy childhood. You are correct, though, that weakness in this area is not an unusual finding in individuals on the autistic spectrum.