Gifted Issues Discussion homepage Forums Identification, Testing & Assessment Help understanding recent testing results

OK, I have some other threads about this, but long story short DS7 was recently tested by the district due to my concerns about reading fluency and difficulty with writing. They surprisingly went ahead and did a full assessment including cognitive testing (this is the first time DS had a cognitive test where he was medicated and actually was cooperative.)

I do not have the subtests right now, maybe I won't be getting them or maybe they will come in with the written report, but this is all verbal from a phone conversation as of right now. I am mainly concerned with whether this test shows any real areas of deficit. DS was given the Celf 5, the Wisc 5, the WIAT, the Beary, and the BOT 2.

Celf 5

Core language 118
Receptive 123
Expressive 118
Highest scores (average is 7-13):
Recalling sentences 16
Following Directions 16
Weaknesses:
Formulated Sentences 10
Pragmatics 7

There was also an observation score for social skills where he got 11/32 and she (apparently (thanks aeh)) said that 9 or lower is considered normal.

WISC

Visual Spatial 151
Fluid Reasoning 155
Working Memory 155
Verbal Comprehension 118
Processing Speed 100
FSIQ 144

WIAT

Math 160
Reading 141
Word Reading 127
Pseudo Decoding 134
Fluency 127

One thing worth noting is that on the WIAT he was able to go until he couldn't go any further on math, but on the reading sections he was only able to be tested on 1st grade level material which is below his reading level. I would say he would have performed just as well on the reading section at age late 4/early 5 as he did during the test, which is one of the main reasons I am concerned about reading, lack of progress over the last few years. I was really hoping for a test that would check his fluency on something at his actual reading level. He scored a 207 on his map test in January for reading and the lexile level with that was like 6 hundred something to I think 770ish? I would have much preferred if they had him read something at that level for the test, because it would have been very slow and choppy and I doubt recall would be adequate.

He was also given rating scales and meets criteria for ADHD (which he is already diagnosed with and which I think is his main disability), came up as "elevated" on the autism rating scale, and has executive functioning challenges. The school has his primary category listed as autism and secondary as gifted. I still am not 100% on board with the autism thing and experts tend to be split on whether they see it or not. His diagnosis of ADHD is combined type, severe. Many of us who know him best think that ADHD explains his symptoms best, especially since he does not have some of the core deficits of autism (but he does have bits and pieces of it).

He was also given fine motor testing. On the Beary his visual motor integration was 123 and visual processing was 140. On the BOT 2 his fine motor was 62. They determined his slowness and reluctance to write is not an OT concern. They did find sensory differences and a lot of deficits in self regulation and recommend OT for those areas.

So, overall I was somewhat expecting that he had to be smarter than prior testing had shown based on his academic performance, especially in math. I was honestly not expecting scores in the 150's and I'm feeling slight panic. Of course his FSIQ came out 1 point below DYS cut off, lol. Not sure if it was something we were interested in anyway, but I just think it's funny

I'm mainly concerned with how much lower Verbal Comprehension is than the other scores. I'm assuming this is why he is not keeping up with the other students in his gifted class in reading and writing. He also was totally average in formulated sentences. I was there during that test and it was painful. There is not a time limit, but DS was taking up to 10 minutes to make sentences even for the easiest questions. It's hard to say if he was having trouble coming up with something, had too many ideas to choose from, was suffering from analysis paralysis, was overly concerned with determining the "right" answer, etc. But I can see how he might hate writing if even coming up with the sentence "The boy is holding a jar" takes 10 minutes of agonizing thought. I missed the end of the test, so I don't know if he got to a point where he could no longer answer, if he gave up, or if he hit some discontinuation criterion. I could definitely see that there was a problem for him in this area.

I guess I am less concerned about the processing speed. I pretty much guessed this would not be an area of strength for him and it's totally average, so not really a deficit I guess and pretty typical for ADHD and, based on what I have seen on this board, it's totally common for gifted kids to be average in this area.

The district is going to get me an official written report sometime next week which may have more info in it on the subtests. We will also have to schedule an IEP meeting where I will find out the placement recommendations and proposed accommodations. If anyone has any advice or ideas on what I should bring up at that meeting I would really appreciate it.

Overall I am very happy with the job the district has done, and I didn't have to fight for any of it! I do wish that we had done more to tease out the exact nature of his reading and writing challenges/reluctance, but at the very least we did rule some things out. I was especially amazed at his pseudo decoding score as he was never even taught phonics and I thought that was what this was based on. And here I have been so worried that I failed him by not teaching him phonics and feeling guilty that it might be the reason for his slow reading. It's nice to lose a little chunk of parental burden

Any advice or help understanding what is going on here would be greatly appreciated, especially with understanding what it means to have verbal comprehension so much lower than the other main areas of cognitive functioning. I'm also curious what the kid is asked to do on the tests that make up that score. Thanks everyone for all your help so far

Did they calculate a General Ability Index (GAI)? If so, is it higher than the FSIQ? Might the GAI meet the DYS Qualification Criteria?

For what it's worth, my DS8 also has lower verbal comprehension, and he is autistic.

Also, I think that you actually meet the Davidson criteria another way, by having both Visual Spatial and Fluid Reasoning over 145.

They did not give me a GAI, but maybe it will be in the written report?

As far as the ASD thing goes, DS was diagnosed at age 2.5 and we have been working for years to have him properly reevaluated and get rid of ASD if he in fact does not have it. But it's just on everything and causes everyone to look at him through ASD lenses and, IMO, you see what you are expecting to see. No test has ever definitively shown ASD. Even at 2.5 he was borderline on 2 of the 4 tests they gave and came up as not on the spectrum on the other 2. He was mostly diagnosed based on observation and parent interview. I will freely admit he was one weird 2 year old!

The lower verbal scores are very much what I am most worried about. I know that most gifted programs are so focused on high verbal kids and writing and that is likely to be a problem for DS going forward as he needs gifted services to be happy and those same services focus primarily on his weakest area. I'm thinking these results explain why DS is such a math beast though. I'm thinking you couldn't get a much mathier profile!

I have been considering auditory testing for a while, just don't have the money right now to pay for anything insurance won't cover. Maybe over the summer when we don't have the school payments each month I will be able to swing it. DS does often seem to have a hard time understanding what we are saying. I get a lot of "what?" when I talk to him, but that could also be an attention things with the ADHD. He does often say new words incorrectly when they are introduced to him. I can figure out which word he is trying to use, but only because he has a lot of the sounds right and using the context of the sentence. I'm not sure if this is a memory issue or if he's hearing us wrong to begin with.

I had always considered verbal skills to be an area of strength for DS. He started talking early, around 5 months, phrases around 1, complex sentences by 2 (I want to take a walk in the forest just like Harold and the Purple Crayon ((22 months)), over 400 words by 18 months (yes, I kept a list :P), knew letters around 18 months and started reading and spelling cvc words by 2, reading very early readers at 3, chapter books (MTH) late 4/early 5, seems to have great fact retention from text that he reads, follows written instructions well, has an extensive vocabulary, etc. I didn't expect a 155 on verbal for sure, but I thought high 120's to low 130's would be pretty accurate. At 118 he is going to have a really hard time in gifted language arts as it's honestly a whole standard deviation below gifted range!

I would be curious about expressive language, both oral and written, including word retrieval efficiency, idea generation, organization.

Diagnostically, another consideration based on what you've presented would also be social pragmatic communication disorder (new to the DSM-5), which includes the social communication and interaction aspects of ASD, but not the restricted/repetitive behaviors or sensory processing differences. His classification for special education purposes would then be communication, rather than autism. His pragmatics score from the CELF supports that. My understanding of the pragmatics activities checklist is that lower scores are better, so that a score of 9 or below would be within normal limits, and score in your DC's range would indicate a mild social skills deficit, consistent with his pragmatics subtest score.

Overall, the lower VCI and CELF-5 language scores are also consistent with a communication disorder.

You do not have written language data, timed or untimed, nor do you have oral (word retrieval) fluency data, both of which might be more sensitive to the fluency issues you suspect. It is possible these are in the subtest numbers that will be in the written report, as they cannot be used to obtain a written expression composite at this age (the written subtests would be alphabet writing fluency--thus a writing fluency measure--and sentence composition). If not, I would request additional assessment of written expression, since this is also an area of suspected need, based on his struggles keeping up with writing expectations in his GT placement. The WIAT-III and the CELF-5 both have written expression measures, though only the WIAT has even a rudimentary fluency measure. At his age, you could also consider the OWLS-II for additional oral and written expressive language, or the PAL-II, for written language and fluency. A supplementary assessment that might provide the kind of reading fluency data that you note may be missing would be the GORT-5, which is focused mainly on fluency, and secondarily on accuracy and comprehension, and uses basal and ceiling rules, rather than age/grade-based item sets.

Wow, that gives me a lot to think about. I will wait until I receive the written report and see if there is any of that sort of data there and then ask them about some of those items specifically if not.

One other interesting thing is that when being evaluated for autism at 2.5 DS was given a speech eval and scored around a year ahead for receptive language and 2 years ahead for expressive, exactly the opposite of this current test. A 2.5 year old with the speech of a 4.5 year old I'm guessing would be more advanced than a 7 year old with the speech of a 9 year old and if so this would indicate that DS is performing worse over time in this area. Plus the receptive and expressive flip flopped and that doesn't seem quite normal.

DS does have a lot of ASDish symptoms. But he does not have lack of empathy/theory of mind deficits, lack of interest in sharing or showing, insistence on routine, restricted interests, common ASD behavioral problems like tantrums, etc. He is very socially oriented and wants to be with others all the time. He is more focused on friends at school than anything else and his favorite times are lunch and recess, often less preferred times for spectrum kids.

He does tend to be rigid/have trouble with transitions and get stuck on things, he does engage in pointless and repetitive behaviors (like paging through books or arranging things instead of playing with them appropriately), he does have a lot of trouble appropriately regulating his behavior and emotions. He is diagnosed with ADHD, TS, and ASD, but his school psych thinks a lot of behaviors are related to anxiety. I have done research and learned that there is something called Tourettic OCD which, along with his ADHD, totally explains his symptoms better than ASD ever did. Maybe he really does have a very mild ASD things going on, but it hardly seems like his primary area of concern educationally or behaviorally vs the severe ADHD and TS.

Overall he is one complex kid. I'll never forget our last district who wanted to put him in full time autistic support with "a bunch of kids just like him!" There can't be more than a handful of kids just like him in the world, let alone 8 of them in one low performing school district! Nevermind the fact that most of the kids he would have been attending school with were minimally verbal

SaturnFan, you've received great advice above from aeh.

I have a few suggestions - for background info, my 2e ds has an expressive language disorder.


I'd suggest asking for what you are interested in now rather than waiting for the written report since you are dealing with the school district. They may be planning to send along what you want anyway, but they might not, and you'll save yourself time by asking now rather than waiting. Just send an email to the team lead and school psych asking for the subtest score report and any other testing data details you want to see. Let them know you'd like to be able to review the data before your IEP meeting.


I'm not a professional so this is speculation on my part, but based on our experience I'm guessing that the difference you're seeing is due to differences in what the test is looking for in terms of ability - what is expected of a 2 year old in expressive language is much different than what is expected of a 7 year old. Another consideration is that challenges aren't necessarily directly related to an obviously low scores. Large discrepancies in subtest scores can be as much of a clue as a low overall score. Observations by the person administering the test can also play a key role. My ds, for example, scored in the 99th percentile on receptive language and somewhere in the 60th percentile on expressive language on the CELF at 10 years old. If you just look at those scores thinking of baselines, there's nothing remarkable about them - other than thinking perhaps he's a kid who was highly capable with receptive language and capable enough to fit in with everybody else re expressive language. Yet give him a grade-level open-ended writing assignment or ask him an open-ended question and he was completely lost, couldn't respond. The SLP who administered his CELF noticed something that was key to his challenge while administering the test - he took forever to be able to put together two words into a sentence. He completed the tasks eventually and the test wasn't timed, so he hit the 60th percentile - but he only hit it after an unusually atypical amount of time working through the thought process.

FWIW, my ds went on to work with the same SLP who administered the CELF and additional sessions with the SLP outside the standard testing cofirmed and helped define what the challenge was.

There are also layers to expressive language. My ds was not an early talker, but when he did start talking it was in long, complex, complete sentences expressing advanced thinking. No one would have guessed at 3 years old that he had an expressive language disorder because no one in his world was asking the kind of questions or expecting the kind of verbal output that would have clued us in on the challenges he has.


There are other diagnoses which have symptoms that are shared with ASD. Our neuropsychologist has a chart that shows overlap in symptoms specifically between ASD, ADHD and Developmental Coordination Disorder. My ds has DCD, and in addition to his expressive language disorder he has a pragmatic language challenge. The one thing I would caution against is making an assumption that behaviors that look like ASD (or other challenges) are gifted behaviors. They *might* be but it's really easy with high-IQ kids to overlook or pass off a behavior that we don't want to belong to a diagnosis as being due to giftedness.


While we hear every now and then on this board that it's "common for gifted kids to be average in this area" (processing speed), I don't think we've actually seen an abundance of non-2e kids' scores posted showing that it's common among gifted kids. It might be more common than in non-gifted kids simply because there's more room for spread in scores, but most of the posts I've seen on this board that reflect large discrepancies in processing speed vs other subtests are scores from kids who have something causing the discrepancy.

My ds' has a similar processing speed score (around 100), and while it's an "average" score it's highly meaningful for him in terms of representing a challenge. The key isn't the actual score, but the discrepancy between it and other subtest scores - anything above 1.5 standard deviations is considered to be a potential red flag for an LD. I'd recommend that you ask for a copy of subtest scores, as those scores will help you clue in to why his averaged processing speed score is 100. Once you've seen those, you might have more of a clue if there might be an issue with vision or with fine motor or with something else - and if you think you see a hint of any of these, there is additional testing you will want to ask for prior to writing the IEP.


Anxiety can be a huge issue for young children with undiagnosed, misunderstood unremediated or inappropriately accommodated challenges. It's wonderful that you were able to get a thorough evaluation through your school district - I hope you're able to make sense of it and the school will work with you in order to support your ds.

Best wishes in advocating for your ds -

polarbear

All of your responses really helped me a lot. This whole communication disorder idea is totally something I had never considered due to DS having such great speech so young, but it makes perfect sense that the expectations for the types of ideas communicated change a lot with age and could make a problem become more apparent as he gets older.

Looking back at prior testing it seems like he may have had a gradual decline in this area since that first test at 2.5 where he was at the 99%ile in expressive communication (score of 142) to the WPPSI at age 5 where he got a 17 on Information (the only verbal subtest he was compliant with during that failed testing session) to the SBV, also at 5 (because we needed a valid and completed IQ test to apply to current school), where he got 132 verbal IQ based on subtests ranging from 12 to 18 (although I'm not sure how much sense subtests that measure things like verbal visual spatial actually make). This 118 definitely has me concerned though!

I did email the psych and mentioned that I would like to have the subtest scores written in the report, but she didn't get back to me yet. If and when I get them I will post them as hopefully they will be useful as far as figuring out what might be going on. I really hope we can figure out what is going on before the end of the school year as we still haven't decided what to do with DS next year. We have a meeting in 2 weeks with his current school to discuss our plans for next year and the more info I have for that the better.

I am not so sure that an all gifted school is a great fit for a kid who is barely above average verbally as so much that they do at that school is based on reading and writing. OTOH, I'm not sure how he could be accommodated in the public school for math and science. Even without great verbal skills he has an amazing memory and strong reasoning abilities that would probably make grade level social studies pretty boring too.

And then there is the issue of true peers. He has actual friends at his current school whereas when we tried public school last year the other kids just flat out ignored him because he was always making up rules and trying to get kids to play complex games they couldn't even begin to understand. At his current school the kids all just add more and more complex rules to their play and seem to enjoy building on each others ideas. This doesn't even get into the financial difficulties and some of the issues we've had with the private school.

What to do? I'd at least like to get a handle on what is going on with DS as we go into this decision making process. Somedays I really envy parents who have perfectly normal kids. I love my son so much and truly appreciate his uniqueness, but a little easy would be nice every now and then!