Gifted Issues Discussion homepage Forums Twice Exceptional Just came back from meeting with the nero-psyc

I'm a bit overwhelmed, just had a conversion with psychologist about my DS15's testing results. The psychologist doesn't have a written report for me yet. Partly because she has another test she wants to do, but DS is at camp so I can't get him back to her for a few weeks. Her overall take is that he clearly is a 2-E kid, and that he has severe anxiety problems that get in the way of schooling and testing.

One thing I was surprised by is how low his overall WISC-IV results came out. I don't have all the numbers at this time, he had what she called very superior scores for the math/visual part. (137) And very superior scores of most of the english/language part. But Average scores in social comprehension, working memory and processing speed. These are 2 standard deviations lower than everything else enough she thinks we should qualify for an IEP based on this. He also did very well on the achievement tests doing a 98% in math, and above 90% in reading comprehension. But as expected fell apart completely when asked to write an essay. And surprisingly when she did more tests on his memory skill, did very well on all the sub-tests.

The testing still left the written language disorder still a possibility. But because of his high anxiety around writing she wasn't able to tease that detail out. Along with the anxiety it's clear that interest makes a HUGE difference and clearly significantly affected the testing. His Executive Skills were surprisingly very high, but she suggest this is only when the task is for very well defined tasks. But his did have problems with Pragmatic Judgement. The other big issue was his social skills and emotional stability. After looking at all the tests she considers him borderline ASD, and want to do another test to see if she can get more information. It's not clear if certain symptoms were a result of his anxiety or symptoms of ASD. He meets just enough that she could write such a diagnosis if it's what we really want.

One suggestion is we look at talking with a psychiatrist and look into the idea of medication for his anxiety/depression. I need to talk with his psychologist before we go that route. (I have someone else doing this testing.) Last week while on vacation, I talked with a friend who has a kid with severe school anxiety and medications have really helped them. I'm going to have to look at this further I must admit it makes me a bit uncomfortable.

She also had a LONG list of what would be helpful for him, working with his psychologist, working with the education therapist, more social skills class, cognitive behavior therapy. Honestly there isn't time to do all this, and classes and homework, and his fun/social activities like band and robotics, and Aikido. At some point we are going to have to pick and choose.

A few questions that I can maybe figure out by googling. Can anyone explain more what working memory is? And more detail about what Executive Skills are?

A significantly lower score in working memory is one indication for calculating General Ability Index (GAI) as a supplement to Full Scale IQ (FSIQ). Find each occurrence of "working memory" in the 49-page PDF for info.

National Center for Learning Disabilities (NCLD) is one of several websites with information about Executive Function.

EF: Peg Dawson's website and books:

http://www.smartbutscatteredkids.com/

In short, mental regulation and organization skills.

Working memory can be compared to your mental scratch paper--how much data a person can hold in his/her head, manipulate, and then either send to long-term storage or use to produce an external product.

Thanks I've seen the book before but not read it, I will put it on my list. There is just so much to read. The odd thing is the testing showed his executive skills as excellent, despite the anecdotal evidence. This is why the tester thought that he was good at things that were limited in scope.

I am posting as a fly-by at the moment, so quick without time for detail - and I hate to suggest something that remotely seems to add anything else to what probably already seems like an overwhelmingly long list of to-dos… but… you might want to consider adding in some further testing to help understand the root of the writing issues. An SLP evaluation (for expressive language) and the TOWL (Test of Written Language). You can probably ask the school to provide both of these.


Just out of curiosity - how was the tester able to clearly determine it was interest? I find with my ds that many times when he appears to not be interested it is actually rooted in his learning challenges and resulting anxiety. Unless it's something as totally clear-cut as he's passionate about subject A and totally doesn't care about ever learning about subject B. On testing like this, though, I think it's a real possibility that something that looks like disinterest or disengagement might actually mean there's a hidden struggle there and detaching is the way the student has learned to cope.



Prioritizing will also help - and you can ask for input on this from the person who did the testing. I think it's really important to leave room for fun and also for academics that *aren't* challenging in an LD-way but are interesting and challenging intellectually. It's also possible that the school may be able to provide some of what is recommended (maybe some overlap with what the educational therapist would provide, for instance).

Last thing I'd suggest - be sure the tester provides a GAI in the report (this is the number that leaves WM and PSI out of the calculation, and is an important # to have when you're advocating for advanced classes/gifted services etc.

I'm glad you have the testing (so far) completed, and that you have information and data now - I hope you'll find it helpful as you move forward and advocate!

Best wishes,

polarbear

polarbear you quotes in your above post is missing an end ] making it hard to read.

The one case she gave that was clearly disinterest was a test where she read a passage out loud, and then asked him questions about it. She did this with two different passages, the first one he was clearly uninterested in and got a very low score. When she did the test with another passage (I think this was normal) and it was subject he was interested it, he did extremely well.

I don't really have the report yet, so I'm going by my notes and memory and I'm not sure what subtest this was.

Sorry I missed that! I edited it - hopefully it's clearer now

pb

That makes sense - I'd just be careful not to extrapolate that to other subtests where you don't have a clear comparison.

pb

That would be a classic aspergian move.

I hope you have good answers soon!

DeeDee

From your description, it sounds like a story re-tell/recognition task from the in-depth memory testing, such as the WRAML-2.

A day later and I think I have a bit better grip on my reaction. I am a bit disheartened that I don't have one thing to hang onto and say THIS is the problem, and if we do X everything will magically be better. Even though I know rationally that wasn't what to expect and wouldn't have happened. The problem is I'm struggling to balance what he needs socially with what he need academically.

Breaking it up there are really three issues. His anxiety/depression that we have to work on first or we won't get anywhere with the other issues. The underlying LD the working memory, processing speed, pragmatic judgement, and possible written language processing issues that are the cause of a lot of the anxiety to begin with. And the social, mild Autism behaviors that make it hard for him socially.

Makes him seems more non-functioning that he really is.. This is my kid who happily went off to two weeks of wilderness camp? The teen who happily wanted me to teach him to cook this summer. Who is looking forward to marching band camp? The teen that walked into an unfamiliar house last week, and to my surprised had a normal conversation with someone he hadn't met in years and didn't remember?

You are on top of this, processing a lot of new information.

Your son is fortunate to have you as a supportive parent, focused on his obvious strengths, and gaining assistance for other areas.

Hang in there bluemagic. It will take awhile to process all the info, but you'll get there and as you think it through you'll come up with a plan that makes sense for your ds and your family. One thing that is hopefully going to be helpful for you is your ds' input - he's old enough and has enough self-insight that he should be able to help somewhat in setting priorities.


One of the things that's been toughest for me as the parent of children with LDs is seeing the amount of time that the LDs take out of their lives - both in time spent remediating and in the impact the LDs have on the amount of time they spend on their homework compared to nt peers. I look back at how their childhoods have played out relative to what I *thought* their childhoods would be like prior to diagnoses and it's very different - but that doesn't mean it's either sad or bad or that they've missed out on anything. It's just different. The time spent on remediation was well worth it, and the time they've invested in their homework helped make them successful students which built their self-confidence. The toughest point to be at is really the starting line - when you first know there's a problem and you're looking at how to get from point A to point Z. Once you've jumped in and started moving forward, you'll see progress and the journey forward will seem less overwhelming.


I know I'm beginning to sound like a broken record on this, but the anxiety may very well be a which-came-first chicken-or-egg issue. It was for my ds - we landed at a neuropsych initially because his anxiety was so sky high he was having panic attacks and imagining horrible things were going to happen to him. We went in thinking it was all anxiety, found out he had undiagnosed LDs, and once those LDs were accommodated the anxiety went away. Completely.

You may have to deal with medication to help decrease the anxiety so he's able to take advantage of the work he's about to move into, but otoh, you might also find that knowledge of the challenges and getting along with helping through accommodations and remediations may in and of itself help resolve the anxiety.


This sounds to me *totally* like a kid who's anxiety is wrapped up in school - which may by pointing back to his learning challenges.

Best wishes,

polarbear

Thanks this is very helpful, it's one of the reasons I keep posting here. You have such good insights. In the past and it's what I need to hear. I know.. I have to get the formal report, hear why DS has to say, talk with his psychologist and education therapist to form a plan. Figure out how to prioritize.

The one thing I'm struggling with is if I should purse the medication for anxiety angle or not. This old friend who told me the story of her son (I will not repeat here since it's not my story to tell but he is a rising senior and fell apart sophomore year) and how what she just told me she regretted was not starting medication sooner.

I consider the social aspect very important. When my DD (who has LD's) was in middle school I demanded that they find a way to accommodate her while leaving her in choir. It was very frustrating that the very thing that helps kids with LD's self esteem, art classes, and music are often dropped in junior high/high school to make room for their special ed.

Although one thing I am considering is dropped DS's private music lessons. We love the teacher, but it's a bit of a drive and I don't feel DS's is getting much out of it at this time. During the school year he is in band almost every day.

So how would one help a child with this sort of issue? My DS does not have a diagnosis at this point but has difficulty with certain things. Anxiety is one problem with testing him, but he also shows much better results when motivated in some way. So how does one help a child get better at doing tasks that he or she finds uninteresting!

Hope no one minds the slight side track, but I'm curious.

We have tried to broaden DS's interests, with mixed success. Starting with things *next to* what he's interested in -- physics is close enough to astronomy, chemistry close enough to physics, biology close enough to chemistry-- and also things that others in the family are interested in-- Mom LOVES the art museum, would you please go with her for an hour?

Sometimes he finds a new enthusiasm, sometimes he participates somewhat grudgingly-- but always he is gathering expertise and familiarity with things that helps him have more of a context for new information and therefore muster a little more interest.

It is tricky to manage the anxiety/disinterest issue-- we have persuaded DS to care about grades somewhat, which helps with motivation, but we don't want him to tip over into thinking grades are a life-or-death issue, either.

apm, with my 2e ds it was really difficult teasing out whether or not anxiety was the issue, lack of motivation, or actual learning challenge. The thing that worked best was to look at a wide range of situations over time - what type of assignment is causing the symptoms that look like anxiety? Is it truly random, or if you pay attention over time do you see any pattern? With my ds, the "pattern" was open-ended writing assignments - he appeared to be zoning out in class, "lazy" (according to his teacher), lacking motivation etc. Other times he was able to complete writing assignments. It took looking over a full year's work, plus a lot of other thinking about what was going on, but we eventually realized it was the open-ended nature of the questions. He was eventually diagnosed with an expressive language disorder by an SLP - I noticed on your earlier posts you'd mentioned early delays in speech but also mentioned you'd anticipate his scores on a speech eval now would come out in the average range. FWIW, my ds' scores on the CELF *did* come out in the average range - some were actually very high - but the diagnosis came from observations on the part of the SLP related to how long it took ds to come up with the answers to the questions.

Sorry that probably veered a bit OT too!

My last piece of advice - I think it's really important to listen to your gut feeling as a parent - you are the person who's spent the most time with your ds. If you feel like there is something going on, it's worth looking into. If you find out it was all for nothing and everything is a-ok. that's ok! And if you do find a challenge, you'll be so glad you found out now instead of later on.

Best wishes,

polarbear

Thanks, polarbear and DeeDee. It's the open ended questions that DS has the most trouble with; he missed every one of them on his last testing, I think. His speech therapist doesn't seem to think more speech would be helpful and the school won't help with anything because they don't offer anything to kids who are academically advanced (DS is working two grades ahead of grade level). Maybe I need to insist on a speech appointment with his private therapist, who is usually very helpful. No one seems to know what is making things difficult for him.

Thanks again!