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    #247858 - 12/21/20 05:46 PM Re: Conflicting test results, 3 year gap [Re: LazyMum]
    aeh Offline
    Member

    Registered: 04/26/14
    Posts: 3803
    Hm. What you are describing sounds more and more like executive function weaknesses, which also fits the questioning about ADHD, in addition to the existing EF results on the ENFEN and CAS. Aspects of EF that these behaviors would align with:

    1. planning & organization: odd mistakes on layout when copying text, as well as difficulty inferring directions.

    2. cognitive shift: adjusting slowly to changes in format or task demands.

    3. sequencing: not knowing where to start from or what she should do first. This could also be from weaknesses in another EF skill (initiation).

    4. inhibition (which is the positive skill that is impaired when we talk about impulsivity): inconsistencies in performance, especially on multiple choice tasks.

    5. probably a combination of EF skills, but likely resulting in impediments in cause and effect thinking, which often shows up in inferential reading comprehension.

    Some of these would have impacts on visual working memory, which (of the kind we've been discussing) is sequential, but not on simultaneous visual spatial memory.

    Along those last lines, I also wonder whether she is a simultaneous or gestalt thinker, rather than a sequential thinker. That might explain why she did so much better on visual spatial tasks when young (when the designs are much smaller, and don't require as much part analysis), and was only average a few years later (when you need some part-to-whole thinking to efficiently reproduce the designs). Note the Rey-O results describe her as starting from the big picture and trying to work her way down, but missing some detailed elements.

    And yes, the behavior with card-flipping memory games and with scripts (as well as the Rey results) suggests that she is extremely efficient at transferring to long- or mid-term memory, which isn't necessarily reflective of any working memory issues that might exist. Retrieval, on the other hand, may not be as efficient for every method of accessing from long-term storage, which may result in inconsistencies in her ability to demonstrate learned knowledge and skills, such as those you report.

    I wish we could do some more fine-grained item analysis, and see if her Matrix Reasoning performance was slanted toward errors in the sequential items or the gridded items. Or see how she does on some of the other cognitive tests, like the KABC-II or CAS, which explicitly assess simultaneous vs sequential thinking. I'd also be interested in more thorough assessment of her memory structure, such as through an instrument like the WRAML or CMS.

    As far as skill-building: well, EF happens to be one of the cognitive skills that can be taught explicitly (perhaps because it's actually a relatively late-developing skill, so the window for brain plasticity is longer). Not so much through an overpriced "braintraining" computer program, but through everyday parenting and classroom strategies, modeled, explained, scaffolded, repeated, and reinforced over time. For example, she might do well with mind maps or graphic organizers to scaffold the organizational process for longer writing assignments. Or scripts and flow charts for specific problem solving algorithms or procedures. Or visual models for the first few times she does a new task-type (or format for written assignments, etc.). Or explicit instruction for strategies for getting unstuck, such as "backing up", asking oneself framing questions (e.g., "what am I trying to find out?" "what do I already know?"), turning the problem around (various ways of looking at a question from a different angle, sometimes literally, such as with math problems that have diagrams).

    If you haven't seen it before, I'd highly recommend Peg Dawson's "Smart but Scattered." (US Amazon page: https://www.amazon.com/Smart-but-Scattered-Revolutionary-Executive/dp/1593854455/)

    FWIW, my lowest-EF kiddo is now (after years of parental scaffolding) a very organized young adult, with sufficient self-regulation skills. Still not exceptionally strong sustained attention or working memory, but compensated by long-term memory and high conceptual thinking. DC has also learned that having to organize and understand information enough to teach it to someone else is what transforms new learning into permanence. Which also makes them a popular classmate!
    _________________________
    ...pronounced like the long vowel and first letter of the alphabet...

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    #247859 - 12/22/20 06:30 AM Re: Conflicting test results, 3 year gap [Re: LazyMum]
    LazyMum Offline
    Member

    Registered: 06/09/15
    Posts: 119
    Wow, aeh, this was a bit of a revelation for me. I had never heard of gestalt/simultaneous thinkers. I had to google it. But it makes a lot of sense. Some thoughts:

    * I used to comment when she was little that she seemed to learn by osmosis. I never saw evidence of direct learning, and most times I tried to directly teach her something it failed. Somehow she just absorbed information and skills. Oh, and she literally never stopped moving (another reason I thought she had ADHD). She never seemed out of control though, it was just constant motion. If gestalt learners need to move when incorporating new information, then this would explain a lot.

    * She's nearly 8 and still has trouble knowing what time of day it is, eg will ask me if it's the afternoon yet when it's clearly dark outside. Took her a very long time to learn to read a clock. Follows a learned process to solve time/clock questions in maths, but doesn't really 'get' it.

    * Good with graphs, fractions (the visual kind not the 'a over b' kind), but still doesn't know addition and subtraction maths facts by heart and will use her fingers.

    * Weak in lots of sequential-thinking skills but, thankfully, is good at learning processes. Follows processes to do long addition, subtraction, algebra, etc. Follows processes to get dressed in the morning, get ready for bed etc. Also really great at following a process to construct and arrange entire songs using loops and samples, (makes chorus first, then makes verse, then makes intro, middle 8, etc., then copies/arranges the sections and adds in 'ear candy', sound effects, etc.).

    * Reads a book or watches a show/movie but cannot tell me what happened. Struggles a lot with explaining order of events, or even distinguishing between important information/events in a storyline vs random facts.

    * Good at learning choreography. Sees a dance move that might have arms, legs, torso all doing different things at the same time, and can just DO it, without having to break it down constituent movements. Likewise, good at most sports without having to breakdown movements.

    * Always moving and often doesn't look at me when I'm trying to explain something (and I'm guilty of always telling her to sit still and look at me - but I'll stop now!)

    I think I have a lot more to google on this topic.

    Very glad that if DD's oddities turn out to be the result of EF weaknesses and gestalt learning style, that she can be taught skills to deal with both.

    Can I ask you for one more huge favour? If you had to make a list of things to investigate further based on what we've covered in this thread so far, what sort of order would you put things in?


    Edited by LazyMum (12/23/20 01:46 AM)

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    #247860 - 12/22/20 07:10 AM Re: Conflicting test results, 3 year gap [Re: LazyMum]
    LazyMum Offline
    Member

    Registered: 06/09/15
    Posts: 119
    Oh, I just thought of another thing. In high school, my husband was diasgnosed with what he calls 'lateralidad', which I haven't been able to find much about but sounds like something to do with brain function and lateralization. I don't know how much of this is genetic, but if gestalt thinking is about right brain dominance, maybe there's something like my husband's diagnosis going on with DD. Hubby, however, still tested PG despite his 'laterality'.

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    #247863 - 12/23/20 05:15 PM Re: Conflicting test results, 3 year gap [Re: LazyMum]
    aeh Offline
    Member

    Registered: 04/26/14
    Posts: 3803
    Mm. I think your DH's lateral-thinking profile does have relevance to your DC. And remember he was identified as an adolescent, by which point he had probably developed better strategies for maximizing his own profile.

    As to next steps--well, there are multiple ways to prioritize these. I'd probably start with the possibilities that are the simplest to eliminate, such as some of the vision and convergence/tracking considerations that Portia raised, and then tackle more angles on executive function. Although it sounds like she already had one of the more available EF measures in your region. Maybe a little more thorough clinical explanation from the evaluator? I would also strongly consider having your DH sit down with DD (or maybe not sit still!--whatever way of spending time together is most conducive to open communication with or without words), and see if he can elicit or identify any insights into her thinking and learning process, and how she experiences the world. If they are actually more similar in this domain, some things may resonate or feel familiar for him that others might not perceive as readily.


    Edited by aeh (12/23/20 05:15 PM)
    Edit Reason: typo
    _________________________
    ...pronounced like the long vowel and first letter of the alphabet...

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    #247864 - 12/24/20 01:13 PM Re: Conflicting test results, 3 year gap [Re: LazyMum]
    LazyMum Offline
    Member

    Registered: 06/09/15
    Posts: 119
    Thanks a million aeh! I've learnt so much in this thread. Even though my head is swimming with all the new info I've smooshed into it in the last few days, I feel like I have a much better idea of the possible ways that DD's head works, and what directions to explore further. I'll be sure to let you know how we go!

    Happy holidays and the best wishes for the new year!! smile

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