Did the neuropsych talk to you about the results yet, or is this next appointment your first follow-up? I'm guessing it's the first chance you'll have to discuss the results?
These are the things I'd ask about (plus, fwiw, I usually find that our neuropsych has tons of new info for me to take in at that first follow-up meeting, and that's when I *really* have questions - after that meeting!).
1) I think it's a good think you're following up on the behavioral optometrist, especially since your regular eye dr noticed muscle concerns. I have a dd who has 20/20 vision but has had significant challenges with her vision due to muscle weakness, and she was helped tremendously by vision therapy. OTOH, I don't think vision challenges explain everything you are seeing in the scatter on the WISC. When my dd took the WISC (before we knew she had a vision challenge), her subtest scores were very consistent across categories *except* for the processing speed tests (symbol search in particular), and matrix reasoning (I think, if I remember correctly - it was one of the PRI subtests, but not all three).
2) I would ask about possible reasons the scores are scattered (the neuropsych will probably want to discuss this anyway). Ask if any follow-up tests (executive function, fine motor, vision etc) were given during the neuropsych eval to clarify what possible reasons might be causing the scatter.
3) I would think through my child's academic strengths and weaknesses and ask how that relates to the scores. Ask if there is anything that you need to put in place at school and home - accommodations etc - to help support your child.
4) I would ask how your child behaved during the testing - was he tired, distracted etc. Also ask which tests were given first/last.
5) Do you have the subtest scores from the 2009 WISC? The average scores were more consistent, but were the subtest scores also consistent? Although they don't bounce around quite as much, my EG 2e ds13 had scatter in his total VCI/PRI scores... and the higher/lower flipped from testing at 8 to testing at 10 ( I can't remember which flipped which way). In his case, his neuropsych didn't have concerns about it because the change in #s was within 1 SD. Your ds' drop in PRI from the earlier test is larger than that and I would want to know more details about the earlier subtests to see if it is a specific test that was really high before that drove the high # or if they were all somewhat even before (like they are now) and the average went down that much.
6) I would ask which subtests are most impacted by vision.
You didn't mention here why you had your ds go through neuropsych testing but I am guessing something was going on at school (or home) that you're trying to understand better. If you tell us a little bit about why you sought out the testing, we might have more suggestions for things to ask the neuropsych.
Best wishes,
polarbear
