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    #172978 10/28/13 06:06 PM
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    Hi All,

    First post...long time reader. We have been waiting to have our DS tested until he turned 7. He finally got tested recently and I'm still trying to understand the results. The past 3 years I have been researching giftedness/Sensory Processing/Asperger's--now ASD/Visual Spatial Learner/ADHD. SIGH! I guess we have answers? I'm still confused!

    Story in a nutshell: we have had a wonderful 7 years thus far with my DS. He has always been different in a cool way. Teachers, friends, family--everyone notices if they know him at all. He has had OT now for several things, but mainly sensory issues like proprioception and vestibular issues. He was extremely weak in the area of fine motor, so he worked on that as well. He responded wonderfully to OT.

    He has also always been nutty smart. The most observant child I've ever known...down to the detail. How that relates or connects to something else he's seen. Sort of pattern-making. He never has to study for a spelling test. You tell him the word once, he's got it. Same with basically anything memory. It is just all super easy to him. We've been told a ton he's gifted and after research for the last 3 years as mom I agree. We had him tested at 5 for ASD (Asperger's Syndrome in particular). Turns out he is not. He does walk the line, but he is too social with whom he chooses to be social. They recommended full battery at 7. We just got results back.

    So, turns out he's ADHD. I can see it at home b/c he does have a total lack of self-control. Very clumsy. Climbs and hops from furniture piece to piece. Cannot follow 2 or 3 step directions often over easy things like putting clothes in dirty hamper. I'd always ruled this out b/c he's well behaved at school and does really well. He's only in first grade but the test the school gave him for the gifted program came back with him scoring in the 3 percentile. INSANE. As in awful awful score.

    Here's my ?: Doc said his IQ test was too scattered due to the ADHD. His processing speed was apparently really impaired. On the non-verbal part he did better but only showed giftedness in one area: Matrix Reasoning. He scored in the 99.6 percentile with a scaled score of 18.

    I still think my child is gifted. In fact I pretty much know. I know I sound crazy, but now that I know he has a disability how do I ever figure out if he really is? Or do the scores not lie? Is he only gifted in one little area? Does ADHD only hinder scores in some kids?

    I'm so confused. I feel helpless. I know he sees and manipulates things very spatially and rote is boring and torturous for him. ;-) I truly believe he's visual spatial with a side of ADHD. I'm so scared school is going to be a nightmare, yet I know he's crazy smart. Any help/advice/wisdom is GREATLY appreciated.

    Does one high scaled score mean anything?

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    What were the rest of the scores like?

    And did the examiner feel the testing was accurate? My 6 yo is suspected of having ADHD. Apparently during testing he was pacing around the room, seemed very whipped up (which isn't his normal personality) and needed tons of breaks. But they felt he was engaged when he was actually paying attention. Since I know him better than they do and he is not normally hyper, my guess is that he was anxious and acting out, and therefore some of the scores are probably not very accurate. For the non-verbal section he scored 18-19 on Matrix Reasoning and Picture Concepts and 13 on Block Design. They felt that Block Design was an underestimate because his fine motor coordination is very poor, and Block Design is timed and involves manipulating little blocks. For the rest of the subtests he scored in the 10-14 range...it was just those two in the 18-19 range that didn't go along with the rest. Those two high scores brought his GAI up to 133. Full scale IQ shouldn't even be calculated if there are huge discrepancies.

    My DD has more obvious ADHD--she is extremely unfocused. I have no idea how she would do on WISC testing unmedicated but I don't dare try it (at least not in terms of seeing if she is "gifted" or not). I do think the scores can be affected--probably some more than others. For some of the subtests, the kid just has to answer short questions, like "What does the word X mean?" In those cases I doubt that ADHD would get in the way much, unless the kid decided they just don't want to deal with the questions and they aren't going to try. But then it should be pretty obvious to the examiner.

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    Thank you for your reply. My son seems to get hyped up like you said whenever we're at a doc apt. It must make him really nervous. The more I've read about ADHD the more I do see it at home. He just does not display much of the traits at school thus far. I'm guessing he's exhausted from holding it all in by the time he gets home!

    Here are his full results which are very scattered as the doc said. They said his processing speed was very impaired making anything timed inaccurate.

    WISC 4:
    Verbal: 106 Percentile: 66.0 (yikes)
    Perceptual Reasoning: 121 percentile: 92.
    Working Memory: 99 Percentile: 47. (again, yikes)
    Processing Speed: 80 Percentile: 9 (yowza!)

    Full Scale: 105
    GAI: 116

    If you know my son at all you know that this is in no way his potential. AT ALL. I'm not saying this to be mamabear that thinks my son is smart. I'm saying this b/c I know my son. He is extremely smart in an outside the box kind of way. Wacky smart!

    Here are subtest scores:

    Verbal
    Similarities: 13
    Vocab: 12
    Comprehension: 9

    Non Verbal:
    Block Design: 9 (said this was timed, therefore he had trouble)
    Picture Concepts: 13
    Matrix Reasoning: 18

    Digit Span: 12
    Letter-Number Sequencing: 8

    Coding: 5
    Symbol Search: 8

    So, really scattered. Is there a chance he's still gifted and ADHD hindered it altogether or am I way off in thinking he's capable of a lot more than tests show?

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    To also answer your question, the neuropsych's report said that the test is NOT a good estimate of his overall intellectual ability.

    Since I'm not a doc I'm just trying to understand if one high subtest can mean anything in getting my child gifted services. He is gifted--I know. The program at our school is total research/project based which he does at home on his own already. It is RIGHT up his alley. Is there any way I can make a case for him being gifted with such awful scores and ADHD to boot?


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    Welcome Researchmamabear - can you let us know what type of dr did the evaluation that included IQ - was it a neuropsych or other? If it was a neuropsych, was there any additional testing of executive functioning or to tease out why the processing speed score was impaired etc? Were there any other things noted about the IQ subtests? Would you mind posting the processing speed subtest scores, or if that's not something you want to do, can you tell us if the processing subtest scores were similar to each other or was there a discrepancy (high vs low)?

    It can be so tough to figure out what's going on with our 2e kids - especially because often there can be more than one challenge, and it takes time and observation and testing to unpeel all the layers and truly understand what's up. For a child that has ADHD, for instance, perhaps the low processing speed score is due to simply having trouble focusing while taking the test... otoh... there might be something other than ADHD behind the processing speed low score that you aren't going to recognize while the ADHD is overwhelming the ability to get a good test reading. And there can be so many different reasons that any on specific subtest is low relative to others. For instance, my dd tanked the symbol search subtest on the WISC and didn't do much better on coding. At home, she was hyper, couldn't sit still, and couldn't follow a multiple step direction if her life depended on it. We'd send her to her room with a pair of socks to put in her drawer, and by the time she got up the stairs she'd forget what she was doing. Her drs were all convinced she had ADHD... but the low score on processing speed combined with her neuorpsych's observations during testing clued the neuropsych in to guessing there might be a vision issue.. and there was... but we'd had no clue!

    Do you have a copy of the test results from his school's gifted program testing? If you don't, I'd try to get a copy. It's clearly not a valid result - but it may help down the line in advocating to have had a chance to really understand what the test was and why your ds might have done poorly on it - you might have to explain it at another school meeting sometime in the future when advocating to get your ds gifted programming, or you might find your ds is required to take another similar test and understanding what happened the first time might help prepare to make sure it doesn't happen again. This is just one tiny example, but for instance, if he had to fill in bubbles to answer, it's possible he got off-track on the answer sheet. Or if he just didn't care about answering maybe he didn't answer most of the questions. If you know the test, you can also find out information about what that 3rd percentile really means - was it compared to children his age, same grade, higher grade etc.

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    Originally Posted by Researchmamabear
    To also answer your question, the neuropsych's report said that the test is NOT a good estimate of his overall intellectual ability.

    Since I'm not a doc I'm just trying to understand if one high subtest can mean anything in getting my child gifted services. He is gifted--I know. The program at our school is total research/project based which he does at home on his own already. It is RIGHT up his alley. Is there any way I can make a case for him being gifted with such awful scores and ADHD to boot?

    I would probably try to get a different test. I don't think you could make a case for getting gifted services because of one high subtest score on an IQ test. A person would probably have more luck if a child had either a high non-verbal or a high verbal score but not on just one subtest. I know the Stanford Binet is not timed so a kid with ADHD or processing speed issues might do better on it. But I don't have personal experience with it.

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    Originally Posted by Researchmamabear
    To also answer your question, the neuropsych's report said that the test is NOT a good estimate of his overall intellectual ability.

    Since I'm not a doc I'm just trying to understand if one high subtest can mean anything in getting my child gifted services. He is gifted--I know. The program at our school is total research/project based which he does at home on his own already. It is RIGHT up his alley. Is there any way I can make a case for him being gifted with such awful scores and ADHD to boot?

    Ask yourself this-- is there any reason to suspect that any of the values associated are HIGHER than they legitimately are?

    Probably not, right? So those are baseline values, obtained without controlling for his (now known) adhd. Your expert has already stated that the values are NOT a good estimate. I'd say that they do tell you one thing, though-- that your child is ABOVE those levels, whatever else may have been true.


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    Thank you guys! All wonderful help. Background to clarify: DS was in classically based private school for Pre-K and Kinder. We are now in public 1st.

    The original test given at his last school was using the TONI-4. When I showed the Neuropsych who most recently did the full battery using the WISC-4 he found that to be a strange test to use for a gifted program placement. He was tested b/c the teachers at that school thought him to be gifted. I was going to take those scores to our new school district this year but upon seeing them--um, no! ;-)

    When he entered our new district they screen every incoming new student. He was screened. Apparently you have to have 4 high markers to move on to testing. He had 1 or 2 but not 4. He is apparently on some watch list. Now that I know he might have difficulty with processing speed and working memory I'm thinking all these tests are just really difficult for him to show his true ability.

    Polarbear--you asked such great questions and had great info...thank you! He was given the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT). Apparently his results were very impaired and his symptoms are "severe." From what I'm reading on his results the coding and symbol search were the processing speed subtests, specifically.

    Where I'm confused is that he's well behaved at school and always has been? Thus far none of this has any effect on school.

    Thank you guys for your help. While I was excited to see that one really high scaled score for Matrix Reasoning--18--I'm thinking just that one doesn't tell us much. Frustrating!


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    It sounds like your DS would fit into the gifted program based on how he appears in person. I agree that the one subtest score is not going to get him in unless they have a category of qualifying in alternate ways (portfolio for example).

    Three things to say. One is medication. I am not personally a proponent of medication for children who are pretty functional, which it sounds like your DS is at home and school. ADHD runs in my family and I have a diagnosis of ADD and I have not found the need for medication. Except when I go bowling. It makes an enormous difference in that one setting, where I can't take back the gutterballs that otherwise spring out of nowhere. So I would just throw out there that if he tries medication beforehand and it has a consistent and useful helpful effect that it may be a way for him to show his strengths on the next IQ test.

    In that same vein, a recent study showed ritalin also helped motor skills in children diagnosed with both developmental coordination disorder and ADHD. http://www.ncbi.nlm.nih.gov/pubmed/23584172 .

    It doesn't sound like the neuropsych had any doubts at all about the diagnosis. That he doesn't find the need for meds in day to day life is wonderful, but IQ testing is a very expensive moment in time when he really needs to focus.

    Apart from that, it may be helpful to go back to the tester (just you) and discuss more in depth each subtest and how your DS did and what behaviors they showed. The tester probably did not know your DS well enough to be sure they were tanking a subtest while it was happening, there's always the possibility they just are at that level. They also see only the physical types of behaviors that indicate distraction. There's also a whole second level of distraction where performance is impacted without behaviors that whop the tester over the head. So while they said they felt it wasn't representative they may not really get the depth of that. Given that they didn't know at the time exactly where he should have excelled versus what was truly the highest level he was capable of, their comments are only going to help you so much. But it would be useful to know specifically if he gave one word answers in similarities or in picture concepts. Was he getting full points on questions and then just missed a bunch in a row entirely. Or was he giving minimal answers all along. Did he give up entirely on some of the block designs, did he make them inaccurately, or did he take too long?. Did he have a break and then was unable to settle down before the next subtest started? Etc. Get a very long detailed breakdown of exactly what his demeanor was like and exactly how he was responding to questions that lost him points, on every individual subtest. You can learn a lot more from this experience.

    We really lucked out with the tester we went to. She turned out to have 3 teenage sons. Therefore not only experienced with hyper boys and the movie/lego characters they know, but also wistful for their younger selves and therefore particularly maternal to cute little boys. She got my DS warmed up to the point of hugging her before ever starting testing. I had told her he needed lots of breaks and she started that way, but after the first one apparently he had trouble settling down enough to begin the next subtest so she intuitively realized not to have him try to change back and forth from focused to running around. In order to get him through the test she let him fiddle with stuff while he was answering questions. It could have backfired with a different kid but she was just that in tune with his needs.

    So that brings me to the next issue. Is there a way to make the testing environment better attuned to your DSs needs next time? Maybe one tester is fine for diagnosing ADHD, but for a young child to really continuously put forward their most conceptually perceptive thoughts for over an hour they need a personal connection with the person. Did your DS connect on that level with the tester?

    And then other factors. What about doing it over two days... that is allowed for the wisc I believe (not sure about the others), just seldom used by testers because often the test doesn't take very long (for example if the child doesn't score well). But ideally it will take a long time. Are long breaks or short breaks better. Is a snack good or does that just set off a mental rollercoaster. Would it have been better if your DS had met with the tester for an hour a week ahead of time for weeks so they were used to going to their office every Friday at 9 am, is routine or complete novelty better for getting their best performance. What specific things make your DS feel like happily (but not hyper-crazily) expounding on what they know?

    And then my last recommendation is practice, and I know there are going to be some that find I'm awfully close to the prepping line here. But I don't mean practicing making patterns with blocks. I mean practicing fundamental test taking skills that come much harder to kids with ADHD.

    As an example I would say practice guessing. School does not teach or reward guessing, at school there are specific answer, and the easiest strategy is often to say, "I don't know, what is it." That is also the fastest answer which if you have ADHD makes it attractive. But in an IQ test that is a terrible strategy. Good guessers spend a lot of time thinking about what they know about stuff, maybe say some things to try them out, retract some of it, go slightly but not too far off topic, finally summarize, etc. And that all has to happen in front of a pretty silent audience in a test situation, unlike at home where the parent is a more active listener or even adding in info. So one can practice guessing to a silent audience.

    Another thing I wish I had practiced with my DS was just simply not getting to find out the answer right after answering a question. At home and at school often you find out immediately and you are so used to that that not knowing can leave you hanging and unable to move on (at least it does for my DS, who tends to obsess).

    Another thing to practice is simply having a timer on for an activity (eating lunch for example, just to get to the point one is not distracted by it). My DS tends to see a timer and try to go extra fast which backfires, but another child might be so lax about a timer they don't really get the idea that it means go fast at the expense of neatness. As a side note if your DS is typically ADHD and distracted by beeping or ticking of any kind you will want to confirm ahead next time about the characteristics of the timer used, and if it beeps or ticks request they get one that does not (it is supposed to be silent).

    Another practice item especially for an ADHD type is just practicing at keeping on topic when someone asks a question. Testers may be tightly bound by the rules of what they can and can't say and what type of help they can give, sometimes they may be unable to say "you are getting way off topic here". They are very limited if a child gives an answer to something else: they may not be able to say, "well weren't you supposed to tell me about how bees are similar to books and not insects and books?" There may be a maximum number of times they can remind the child about the rules or aspects of each subtest.

    Along the same lines the tester may not be able to repeat the questions in some subtests. For example if it's to test memory then it would be an unfair advantage to repeat it to some kids but not others. If your child has ADHD then they are likely even more used to hearing questions or instructions repeated than other kids, and it may come as a total shock that this time, out of the blue, there is no second chance at hearing the question. It's almost the definition of ADHD that this will be a problem on an IQ test. But it is something you can practice in a fun and reward based way, the skill of listening for very short periods on cue, with no second chance.

    I'd summarize but it's gotten so long I can't recall what the beginning was.

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    Interesting study. I printed it out to show the neuropsych. I'm taking DS in for more testing in a week. My DD does not have DCD but does have ADHD and her handwriting is significantly improved when she is medicated properly. Last spring she was on the wrong medication and her teacher said her work is extremely sloppy. We changed her meds over the summer. She just brought home a cursive packet with handwriting that was so perfect it almost looked like calligraphy. Her teacher who is so critical of everything wrote on the top "ABSOLUTELY BEAUTIFUL!" This is a girl who is a total slob in every other aspect of her life. It probably took her 5 times longer than everyone else but hey, at least she wasn't sloppy!

    DS has some aspects of ADHD (not sure yet if he has it) and I would love to see if his motor coordination improved on medication. He does seem to rush through writing and not put much effort or concentration into it.

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