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    Thank you so much aeh, this was very helpful! Excuse me while I pour over it all for hours with my likely low working memory wink

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    smile


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    Does anyone know if there is a substitute for block design on WISC V for kids who have challenges with motor skills? DS did the WISC IV a few years ago and his block design was much lower than the other two PRI scores (13 vs. 18-19). Other testing done the same day was below the first percentile for fine motor coordination. I don't know if he will be tested again, but we already know his block design score is affected by the motor skill issue (which the psych put in the report). What if we want to measure visual spatial ability without it being confounded by a fine motor problem?


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    aeh Offline
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    There is a motor-free spatial reasoning measure (Visual Puzzles) that comprises the other half of the Visual Spatial Index. A single substitution may be made in the FSIQ. Since only one VSI subtest contributes to the FSIQ, that would be an option for the composite score. No substitutions can be made for VSI, so both subtests would be retained at the index level. This also means BD would have to be used in the GAI. Keeping all of these substitution rules in mind, it may not be most beneficial to him to substitute VP for BD, depending on how Cd comes out. If you are attempting to capture his ability without significant fine motor confounds, subbing SS for Cd in the FSIQ probably makes more of a difference, since I would imagine Cd is far below his other scores, including BD.

    If the examiner has access to it, there is also a supplement to the WISC-V, the WISC-V Integrated, that includes a motor-free version of Block Design, using multiple choice responses. Although this cannot be used as a substitute, it can provide valuable clinical and normative information regarding performance on similar tasks with and without motor demands.

    Either way, a skilled clinician will be able to provide some information on his spatial ability with and without motor demands based on the primary subtests of the WISC-V.


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    Thanks aeh. The primary care doctor wants me to take him back to the university neuropsych and I don't know if they'd even want to re-test IQ but if they did I would probably ask about the point of doing the block design subtest again. They gave it to him before, knowing fine motor was impaired, so they would probably do it again unless I ask about it. Of course, they weren't trying to find out if he was gifted, they were trying to find out info about the TBI (I think? I didn't even know they were going to do an IQ test when I took him in).

    Do schools normally test IQ as part of a re-evaluation? Obviously the old school was happy just giving everyone the CogAT but not sure what current school does. It is possible for "physically impaired" they don't need to assess cognitive ability anyway. For his last school eval they mentioned the University results but did not do their own cognitive testing, just the WJ-Ach (strangely, they did the whole test, or at least broad math, reading, and writing).


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    They probably do not need to do cognitive for physically impaired, but typically schools do re-test cognitive on re-evaluations. For the TBI, giving BD was probably important diagnostically, as it is one of the subtests that can be sensitive to brain injury.


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    Originally Posted by aeh
    giving BD was probably important diagnostically, as it is one of the subtests that can be sensitive to brain injury.

    Wonder why that is.

    His coding score was actually a 10 or 50th percentile but I doubt it would be that good now. I had him write the alphabet and it took him twice as long as it should have. (26 letters in 60 seconds, I think it should be 30). I would actually be really interested in seeing how he does on coding again, even if it brings down the FSIQ. I can't figure out if he actually has dysgraphia or if it's just a coordination issue (or both). Anyway, sorry if I'm hijacking the original thread.


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    There are a number of visual organizational and visual integration tasks that are closely correlated with extent/presence of brain injury (RCFT or Rey-Osterreith is another one, beloved of neuropsychs).

    Another instrument for assessing motor-free visual spatial ability is the MVPT-4, usually given by OTs.

    His alphabet fluency may or may not parallel his Cd performance, as it includes retrieval fluency/automaticity, which is one of the core deficits of dysgraphia, as distinct from actual fine motor coordination. If measures of motor coordination (which may include Cd) are good, but alphabet fluency is below average, that would suggest that it is not (or not only) motor coordination per se that is the challenge, but automaticity.


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    Interesting. Thanks aeh. When I had him write the alphabet, he started off looking good but got really spacey and slow in the middle of it, and left out a string of 3 letters in the middle.

    He did some sort of visual perception test after the brain injury, given by an OT. The OT could not get his eyes to track moving objects. I think it was the Test of Visual Perceptual ability or something like that. I think he was close to hitting the ceiling of the test for visual memory and visual spatial ability at the age of 6.

    I wonder if it's worth it to get an actual dysgraphia diagnosis or it's not going to make a difference to the school anyway in terms of how they deal with him. The current school is hopeless (they tried to drop OT from his IEP, and seem to have no concept of what dysgraphia even is), but if I get detailed instructions for the school in a neuropysch report I'm wondering if it would help.

    I have already rejected 2 proposed IEPs and nothing is signed. I'm not sure what is going to happen at this point.

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