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    Joined: Sep 2018
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    I was tested by a psychologist four years ago as part of an evaluation for ADHD. I know that the vocabulary and information subtests of the WAIS-IV are high, but everything else is significantly lower. Is this an unusual profile? Does it suggest ADHD or a possible learning disability? Is there anything specific I should bring up with my therapist? The psychologist also gave me some attention/working memory subtests from the WJ-III and the Brown ADD scales. I can post those scores as well if it would be helpful. Here are the results from two of the assessments:

    WAIS-IV
    Verbal Comprehension: 141
    Perceptual Reasoning: 123
    Working Memory: 114
    Processing Speed: 114
    Full Scale IQ: 130
    General Ability Index: 136

    Similarities: 13
    Vocabulary: 19
    Information: 18
    Block Design: 12
    Matrix Reasoning: 16
    Visual Puzzles: 14
    Digit Span: 12
    Arithmetic: 13
    Symbol Search: 12
    Coding: 13

    Nelson-Denny Reading Test:
    Comprehension: 101
    Reading Rate: 77

    I was diagnosed with depression and social anxiety in high school. Even though the psychologist who evaluated me diagnosed me with ADHD, I�ve had other mental health professionals dismiss the diagnosis. Two different therapists have looked at the report and said they�re �not convinced� that I have ADHD.

    I am thinking about going back to university and I�m wondering if my scores explain some of the struggles I�ve had in school. It�s hard to tell because my therapists tend to attribute all of my problems to mental health issues. I was a good student until I started taking college level courses in high school. I had trouble managing my time, staying organized, meeting deadlines, and sustaining attention long enough to read a textbook and take notes. I would go to the library to try to read my textbooks and end up falling asleep. I didn�t understand the material in my math classes at all so I could not take calculus despite passing all of the prerequisites.

    In university I always felt like I had to work harder than my peers. It took me significantly more time to complete the assignment compared to the other students. It takes me a long time to answer questions. I also feel like despite passing most of my classes I didn�t understand the material. I could give the correct answer on the test but I really didn�t understand it and how it all fit together. At my current job I feel completely lost and I feel like I�m performing badly because I am missing foundational knowledge. I�m afraid that if I go back to school I won�t pass the classes because I won�t be able to understand or retain the material.

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    Welcome!

    You have some very strong cognitive scores, especially in verbal knowledge and abstract reasoning, but your reading scores raise some significant question marks, which I would say go beyond the question of ADHD, if these are consistently where your reading performance falls. For someone with the depth of vocabulary and general knowledge that you showed on the WAIS, one would expect much stronger reading comprehension (stronger than the average score you have), and certainly much stronger reading speed (which is markedly below average on this testing).

    Have reading disabilities ever been discussed with you?

    One of the other striking results is the significant gap between your ability to demonstrate verbal knowledge, and your ability to demonstrate verbal reasoning, as represented by the extremely high scores in Vo and In, vs the high average score in Si. It looks like you work better with concrete language than with concrete visual-perceptual materials, but better with nonverbal abstraction than with verbal abstraction. If that's the case, then you likely think and problem-solve better visually (nonverbally) than verbally, yet retain information better verbally than visually.

    That may explain why your oral vocabulary is so strong, yet you find reading and comprehending text to be laborious.

    Measures of working memory and processing speed look appropriate, in the upper end of average to high average, which is often observed in individuals even with your high overall cognition.

    I'd wonder what other aspects of memory and executive function look like, to generate the mixed interpretations you've received regarding ADHD. I'm curious about any measures of fluency, rapid naming, retrieval efficiency, etc. if you have them.


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    Thank you for your interpretation, aeh. I really appreciate it.

    Originally Posted by aeh
    Have reading disabilities ever been discussed with you?

    Reading disabilities have never been discussed with me. The psychologist wrote in the report that my history is not consistent with a Specific Learning Disorder. She attributed the lower reading scores to ADHD. My math/writing scores have always been lower than my reading scores on school standardized tests, so I had assumed reading was an area of strength.

    I don�t believe I have any measures of fluency, rapid naming, retrieval efficiency. The only other measures from the report are these subtests from the WJ III NU and the Brown ADD Scales:

    Woodcock-Johnson III Normative Update
    Working Memory: 117
    Broad Attention: 113

    Numbers Reversed: 111
    Auditory Working Memory: 121
    Auditory Attention: 98
    Pair Cancellation: 99

    Brown ADD Scales (T-Scores)
    Activation: 68
    Attention: 53
    Effort: 53
    Affect: 86
    Memory: <50
    Total: 63

    From what I understand, Activation (task initiation and timeliness) and Affect (e.g. frustration tolerance, irritability, impatience, sensitivity to criticism) are the only scales with clinically significant T-scores.

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    My apologies; I didn't see this until just now.

    When I mention your relatively lower reading skills, what is most striking is the gap between verbal cognition (extremely high) and assessed comprehension (average); it's not actually below average, so some psychs would not consider that SLD (in the DSM-5, the criteria have led to some controversy about whether ability/achievement discrepancies alone can constitute an SLD if the level of achievement is at least average; in your case, the SLD Dx would require the use of ability/achievement discrepancies, as you do not display below average reading achievement, with one exception). Your reading speed is actually below average on the Nelson Denny, which, if reflective of your typical reading pace, would suggest that your reading efficiency is far below that predicted by either your verbal cognition or your visual-motor processing speed.

    It is possible that inefficiencies in reading speed and comprehension are related to dysregulated attention, rather than an underlying reading disability, but it's generally worth asking the question. When the cause is attentional, what generally happens is that the reader reads slowly because of losing track, or because of backing up and re-reading due to having trouble maintaining continuity. Comprehension weaknesses are related to how fluctuating attention interferes with making cause and effect connections across lengthier text selections.

    In your case, I suspect that some of your struggles in college reading were related to a) slow reading speed (of whatever cause), and b) the gap between your concrete and abstract verbal abilities, which means that you are much better at soaking up facts than at generating interpretations. This might look like feeling as if you understood what you read, but then struggling to explain, integrate, and extend meaning from literature selections. Because repeating back facts is easier for you than articulating the higher-level concepts, it will probably be important for you to learn and use some specific active reading strategies, especially those that involve narration (restating/retelling in your own words). You might want to take a look at some of these. I like SQ3R:
    verbal description: https://www.nhti.edu/student-resour...-solutions-lab/reading-and-learning-sq3r
    bullet point pdf: https://www.weber.edu/wsuimages/vetsupwardbound/StudySkills/SQ3Rmethod.pdf
    video:

    video w/more visuals:

    But you can also google "active reading strategies" for other methods. You might, in the past, also have been dealing with factors interfering with your focus on extended reading selections, the details depending on what mental health issues were in play (e.g., people with thought disorders, like schizoaffective disorders, or with anxiety disorders, like GAD or OCD, often struggle with intrusive thoughts, which can make it quite challenging to sustain continuous concentration for a long or complex reading passage).

    Your ADD rating scale suggests mild to moderate vulnerabilities in activation, and significant concerns with affect. It does not, however, suggest dysregulated attention, poor motivation, or working memory deficits, which is likely why you have encountered professionals who disagree with the ADHD diagnosis. The indirect measures are consistent with the direct measures, that also found your attention to be at least average, and your working memory to be high average/above average. The at-risk score in task initiation does suggest some kind of executive dysfunction, while the clinically significant affect score doesn't specify the source; these symptoms could arise from other conditions, including mood disorders, or specific (temporary or environmental) stressful circumstances. I would not be surprised if the executive dysfunctions are indeed related to the mental health history you report, as that is not unusual.

    To return to your original key question of your likely success on a return to post-secondary education: What you've reported and described appears to be a learning profile that is capable of success in college coursework, as long as you surround yourself with supportive structures, routines, and persons for managing your mental health and task organization (cloud-based calendar/reminder systems will become your best friends, if they aren't already--GoogleCalendar, GoogleClassroom, etc.). If you choose to take courses, make sure you have a good conversation with your college's disability services, especially campus mental health providers, regarding accommodations (consider extra time, separate test setting, course notes provided/lecture notes) and tutoring supports.


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    No worries, aeh. All of my posts must be approved by moderators so it takes a few days for what I've written to show up on the forum.

    Originally Posted by aeh
    In your case, I suspect that some of your struggles in college reading were related to a) slow reading speed (of whatever cause), and b) the gap between your concrete and abstract verbal abilities, which means that you are much better at soaking up facts than at generating interpretations. This might look like feeling as if you understood what you read, but then struggling to explain, integrate, and extend meaning from literature selections.

    I feel like this is something that I have experienced but I was never able to articulate it. Thank you so much for your suggestions. I will review the information about active reading strategies. I feel more optimistic about returning to school.

    Do you think further testing (e.g. in the area of reading) is warranted or unnecessary? I would probably qualify for college disability services with just this report for the ADHD evaluation.

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    Further testing is probably not critical. Functionally, you would receive the same accommodations from disability services with your existing evaluation.

    I applaud you for continuing to pursue your college goals. If you take a moment to look back at the path you've taken to where you are now, I think you'll see that you've overcome a lot already. The evidence of your strength and capacity to reach forward is there.


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    Originally Posted by aeh
    I applaud you for continuing to pursue your college goals. If you take a moment to look back at the path you've taken to where you are now, I think you'll see that you've overcome a lot already. The evidence of your strength and capacity to reach forward is there.

    Thank you, aeh. This made me cry. School has been really difficult and it's often hard to see things in a positive light.

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    {hugs}

    Last edited by aeh; 04/08/19 03:18 PM.

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