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Posted By: Lupine High VCI, Low PRI on Wisc4 / Dyslexia - 12/13/13 07:15 PM
We just got the "official" diagnosis and test results for DD7 after 3 years of steadily increasing educational supports.

Verbal Comprehension (VCI) 150 (>99TH)
Perceptual Reasoning (PRI) 94 (34TH)
Working Memory (WMI) 97 (42ND)
Processing Speed (PSI) 112 (79TH)

The school is offering a dyslexia diagnosis and an IEP. They seemed a little surprised by the VCI ("I have never tested a child who scored that high on verbal comprehension in 20 years.") and I'm looking at them thinking, "Did you think I was lying or delusional when I told you she likes me to read Harry Potter out loud to her and that, yes, she follows the story and can extrapolate larger themes if asked?" I realize it's unusual for a child to comprehend at a level so far beyond her decoding level but it isn't unique!

I suspect the scores of parts of the test that required pencil and paper work are depressed because she has fine motor control issues. Not truly awful but noticeably below that of her peers. The school offered no ideas as to why they thought there was such a large scatter between her VCI and PRI scores other than some tepid "maybe she was getting bored" throwaways. I suppose, the dyslexia diagnosis is their answer though, honestly, they were not clear on how they had gotten to that point. It wasn't a wholly satisfactory meeting in that it was clear they had some to their conclusion, which conveniently was the one I wanted them to come to, and were just going to read the reports to us .

At this point I have her scheduled with a developmental optometrist to do a thorough vision workup, not just a nearsightedness screening to rule out physical eye issues. I'd feel a bit awful if she were struggling with visual distortions that can be compensated for and I didn't check into it. I admit I didn't bother mentioning this to the school as things like the colored overlays are not wholly accepted.

Twice-exceptional, here we are.
Posted By: KADmom Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 11:56 AM
I'm not an expert but how is her vision?
Posted By: gabalyn Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 12:47 PM
Well, I am not an expert either, but I do have a dyslexic child, and I have never, ever heard of making a dyslexia diagnosis based only on a WISC. I believe that is not standard at all, and doubt it could be done. In fact, many claim that dyslexia does not affect IQ scores. A dx of dyslexia is usually made after an extensive battery of tests -- my son was tested over five afternoons, and was given tests of reading and phonemic awareness in addition to IQ.
Posted By: Lupine Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 01:30 PM
There was also a WJ achievement, a battery against town standards and an elaborate phonemic testing. I have spared you the 25 pages of results smile
Posted By: Lupine Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 01:30 PM
She is not nearsighted We will be doing a more comprehensive vision screening next Tuesday.
Posted By: Irena Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 02:58 PM
My son had a similar scatter between PRI and VCI. And he only scored as high as he did on PRI b/c he worked sooo hard he really wanted to give up. He has/had in my opinion a lot of dyslexia symptoms. But he reads over a grade level above and comprehends several grade levels above. He has a visual perception disorder and receives vision therapy. Dyslexia was ruled out ( though I worry he has stealth dyslexia). He also had dysgraphia.
Posted By: Pi22 Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 03:14 PM
I am also not an expert, but here are my thoughts...

Originally Posted by Lupine
I suspect the scores of parts of the test that required pencil and paper work are depressed because she has fine motor control issues. Not truly awful but noticeably below that of her peers.


There are two subtests that require pencil and paper (Coding and Symbol Search) and both are within the PSI. Coding requires the greatest fine motor skills. The Block Design subtest (within the PRI) also requires some fine motor skills to manipulate the blocks. Since Block Design is only one of three subtests within the PRI, fine motor issues shouldn't have a 'huge' impact on the PRI composite score. There are only two subtests that go into the PSI, so fine motor skills can have a dramatic impact here.

Do you have the scaled scores for each of the 10 subtests? If not, you may want to request them. The scatter within the subtests can be as useful as the scatter between the four indexes when trying to figure out what is going on. For instance, is Block Design the lowest PRI score? And is the Coding score much lower than Symbol Search?

Originally Posted by Lupine
The school offered no ideas as to why they thought there was such a large scatter between her VCI and PRI scores other than some tepid "maybe she was getting bored" throwaways.
I assume this comment was given by people who didn't administer the test? As I understand it, the subtests are intermixed when they are administered. That is, the Block Design subtest (from PRI) is given first, followed by Similarities (from VCI) followed by Digit Span (from WMI), followed by Picture Concepts (from VCI), etc. So getting bored shouldn't have an impact on just one of the four indexes. The tester should have provided notes about the test behavior if he or she saw any indication that the scores may not be a good representation of the child.

If you don't feel like your questions are being answered by the school and the tester, there are psychologists with experience in gifted and 2E that will re-interpret the scores for you. Another reason to try to get the subtest scores if you don't have them already.

Pi22
Posted By: Lupine Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 04:19 PM
I do have the subtest scores and, alas, the person who offered the bored option was the test administrator.

I actually think the dyslexia diagnosis is dead on; I've had suspicions of it for years and was told "it's too early to tell". I just suspect motor control issues lowered scores that required writing and plan to check out whether eye sight is an issue.

The whole meeting was not exactly useful except in that they are offering exactly the supports I want the child to have for the reading issues and we can now move them from non-mandated supports to mandated supports.

I live in CT so they have no mandate to address the gifted part of the 2e equation at all. MathQuest starts in 4th grade and until then it's up to the teacher to differentiate at will. My son's teacher does differentiate math for him. I had no idea DD was unusually good at math (in comparison to her brother she is not, especially. They are twins.) so to be told she had finished the grade 2 curriculum and was the best math student in the class was a bit of a surprise. However, they don't have to accommodate that or challenge her in that area at all. Gifted education is not an exceptionality that CT schools must meet.

I'm a bit unsure how to challenge her in the areas she excels. She's NOT a fan of audio books so the school's suggestion that I offer her audio books so she can continue to explore ideas at her interest and comprehension level without needing to read them while a reasonable suggestion isn't going to help. I don't want her to feel totally overwhelmed with the academic support work for the areas she struggles AND with enrichment stuff.
Posted By: blackcat Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 05:20 PM
DD is very slow with written work (and slow in general with ADHD) and it was processing speed that was below 100. She has been tested and doesn't have fine motor issues, but I'm not convinced that she doesn't have dysgraphia. DS actually has developmental coordination disorder and is getting an IEP for fine motor and his processing speed score is about the same as your DD.

Does anyone think dyslexia would cause a lowish Perceptual Reasoning score or a gap? I guess i haven't seen anything about that one way or the other, but it might make some sense if a child is looking at complex patterns. My kids have both displayed traits of hyperlexia (the neurological opposite) and they are both higher on PR than verbal.

One test you could ask about is the TVPS which tests visual perception. I don't understand their "she must have gotten bored" theory because I think testers usually alternate tests, for instance do a PR one, then a verbal one, then working memory, etc. rather than doing all verbal together, then all PR, etc.
Posted By: Lupine Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 05:24 PM
It's a very large gap and went wholly unexplained other than "she's just very strong in one area".
Posted By: blackcat Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 05:54 PM
Have you looked into non-verbal learning disability? That's the only other thing I can think of. DS's scores were similar in that everything was around 110-115 EXCEPT for perceptual reasoning which was in the 140's. On achievement testing, he is advanced in everything, but esp. math, which is over the 99.9th percentile. So he is the opposite in that verbal is much lower than PR.

No explanation for our WISC gap either, and the neuropsych didn't seem too concerned.
Posted By: Pemberley Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 06:41 PM
My DD has similar scatter. Her verbal did not test as high as your DD but she has 40+ points difference between verbal and visual perception and 50+ to both working memory and processing speed. She also has a significant fine motor deficit. I endorse blackcat in suggesting you look at non-verbal learning disability as my DD was labeled "NLD-ish" with this profile. My DD doesn't have the social component but the neuropsych said it was "a useful diagnostic concept" and "easier than saying super high verbal along with dyslexia, dysgraphia, dyspraxia, math disability, etc."

You are not alone. My DD loves, loves, loves audio books though and finished all 7 Harry Potter books by the time she was seven. In second grade we started her on "enrichment/anxiety breaks" to listen to high level texts like Dickens, Twain, etc. She loves to discuss books at a higher level - character development, motivation, references to Greek mythology or comparisons to other texts, etc, but she didn't have the opportunity. She would just listen in the resource room and head back down the hall to her 2nd grade classroom where she was treated as "the little special ed girl". So sad. She is now in an out of district placement, though, and as part of her 3rd grade curriculum she gets to join the 8th grade reading group for her comprehension component. She is so much happier...

I will send you a PM. Click on the flashing envelope on the top of the page.
Posted By: polarbear Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 07:15 PM
Originally Posted by Lupine
I actually think the dyslexia diagnosis is dead on; I've had suspicions of it for years and was told "it's too early to tell".

If you've suspected dyslexia for years, I'd suggest following up this eval with a reading specialist. As gabalyn mentioned, dyslexia is not typically diagnosed from ability/achievement testing alone - when my dd with reading challenges was assessed (more than once by different professionals) there was a checklist of criteria that included different types of tests/assessments and a certain # of criteria had to be met to be diagnosed. There are many different types of reading assessments that can be very useful in determining how to approach remediation for the reading challenge. If your dd has a reading challenge (which it sounds like she does), you'll want to know as much about the root causes as you can in order to make a plan forward for remediation and accommodation.

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She's NOT a fan of audio books

I don't know anything about audio challenges, but I wonder if there's a reason related to comprehension while listening to books that makes her not a fan? So so so very many kids I've known really love audiobooks, and they opened up the world to my dd who has a reading challenge.

I wonder if there was an issue with auditory processing if that might have impacted her PRI score also? One thing that was helpful for me in understanding the scatter in my 2e childrens' WISC scores was to look at how each subtest was administered - what type of question, was the question oral or did they have to read or look at the question, did they answer orally or have to write, was the subtest timed etc. It's possible if you look at that you may see a pattern that might help understand what's going on with the scores and with reading.

I'm also just curious if you saw scatter in the PRI subtest scores and if so how much and which were higher vs lower?

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so the school's suggestion that I offer her audio books so she can continue to explore ideas at her interest and comprehension level without needing to read them while a reasonable suggestion isn't going to help. I don't want her to feel totally overwhelmed with the academic support work for the areas she struggles AND with enrichment stuff.

When our 2e children were young, it was *really* important to focus on the challenge part of the e for awhile, and it came at the expense of some of the enrichment they could have received for their strengths had they not been 2e. I am not saying *don't* push for academic challenges in your dd's areas of strength - push for all that you can - but wanted you to know that it's (jmo) very important to get the challenge figured out so that it can be remediated/accommodated appropriately so that your child will be able to "take off" once they get past the early challenge. It really did happen for my ds - all the focus on his challenge in elementary made it possible for him to be in a position to be successfully accelerated once he was in upper elementary and middle school. Had we changed out the balance and not put in the large effort on the challenge, I doubt he would have been able to keep up with the workload demand (not the intellectual piece, the part of each class that calls on the areas he was challenged in (written expression for ds). Had that happened, he would have been thousands of time more frustrated than he was in elementary school dealing with not having fully appropriate academic enrichment in elementary school.

Best wishes,

polarbear
Posted By: puffin Re: High VCI, Low PRI on Wisc4 / Dyslexia - 12/14/13 07:54 PM
My kids aren't a fan of audio books either. They like to be read to however so I think it is more that they feel fobbed off with audio books. Have you tried listening with her while snuggling on the couch?
Posted By: Lupine Re: High VCI, Low PRI on Wisc4 / Dyslexia - 01/29/14 02:58 PM
So I wanted to come back and touch base on this.

Thank you for all you input.

We had her vision checked and she is farsighted, has convergence insufficiency and sees double. She now has glasses and a weekly appt. for vision therapy and after about a month of treatment there is some mild improvement in her eye turnout.

I showed the scores to my shrink, who is also a pediatric and adolescent neuropsych, and he said something like, "this is classic non-verbal learning disability but the school can't diagnose it because all they have is a school psych and you need a clinical psych to make a diagnosis" along with "anyone who knows what they are looking at seeing these scores knows this is not a normal brain. Brains are not supposed to work like this." and "long term you are probably going to need an advocate to sit in on meetings with you." The good news is he confirmed my town is one of the best in the area for meeting needs of special needs kids; it's the gifted portion that we're going to have to fight for when we get there.

She is on the wait list for the developmental pediatrician.

Audio books are apparently acceptable if they are Harry Potter. It's non-stop Harry Potter all the time in our house now.

So we are making slow and steady progress.
Posted By: cathy m Re: High VCI, Low PRI on Wisc4 / Dyslexia - 01/30/14 06:12 PM
What kind of test is Perceptual Reasoning? I have a Concept Formation category from the Woodcock Johnson test. Is this similar? Just wondering what that means.
Posted By: polarbear Re: High VCI, Low PRI on Wisc4 / Dyslexia - 01/30/14 07:05 PM
Lupine - did you see a large scatter in your dd's PRI subtests? I'm wondering if the relatively low score might be related to a vision issue. Our dd who has vision issues had a really *really* low score on one of the PRI subtests before we knew she had vision issues (that low score, combined with a really *really* low Symbol Search score under Processing Speed) were what keyed the neuropsych into her issues with vision. I'm sorry I can't remember which PRI subtest it was!

DD hasn't been retested on the WISC since her vision therapy but if she was retested, I suspect that the two subtests that were dramatically impacted by her vision issues came up to the range of her other subtest scores (that weren't heavily dependent on vision), and that in turn would most likely bring her PRI and PSI scores up into the range of her VIQ. I'm sorry I don't have her test results in front of me at the moment so I can't tell you the extent of the difference in subtest scores, but I believe it was almost 4 SD.

Best wishes,

polarbear
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