Welcome!
These are very strong achievement scores across the board. I do notice, however, that there were no written expression subtests at the sentence or passage level (depending on whether he is in 2nd or above grades), and no reading comprehension. With the exception of math problem solving, most of these scores are in basic skills, which, at this early grade level, are easier to top out (score very high in) than reasoning and comprehension tasks are.
A few factors should be considered in thinking about whether the difference and direction of difference in the academic and cognitive testing are significant.
1. Is this difference within the standard error? Generally speaking, if the cognitive test was the WISC-V, the correlation is between about 0.5 and 0.8 between the two tests. From that standpoint, the difference between, say, a 130 cognitive score and a 140 achievement score, is not that significant.
2. Are there differences between how comfortable he might have been with academic vs cognitive testing? It is possible that the achievement testing felt more familiar, which allowed him to demonstrate more of his range, while the cognitive tasks, which are intentionally novel, for the most part, may have been less comfortable. Including the social perception and attention results, the verbal high/nonverbal low cognition, and the anxiety, brings in the possibility of other diagnoses as well. For example, these data are sometimes consistent with an NVLD or high-functioning ASD profile, both of whom generally are more challenged by novel situations.
So in answer to your questions:
1. Unusual discrepancy: not necessarily. But it may still be meaningful, since there is a fair amount of information missing. If you have other data that you are comfortable sharing, we may be able to provide additional feedback. Or if you prefer to pm me, feel free to do so.
2. Fine motor: again, not necessarily. NEPSY fine motor testing is not only about pure fine motor coordination. It can be affected by other factors as well. Also, it depends a bit on which task or tasks were actually low.
3. Social perception/attention: possibly, but there are several other diagnostic considerations as well, including NVLD and ASD. Really, lots of things affect face reading and executive functions.
This isn't, perhaps, as helpful as you may have been hoping! There really are just too many possibilities to say anything definitive based on the limited data available. One hopes that the neuropsych had good reasons for making the formulation given you.
