Gifted Issues Discussion homepage Forums Twice Exceptional Drastic change in IQ scores over time?

I don't know if anyone has info but I'm dealing with a child that went from WISC IV PSI of 109 (2nd grade) to 78 (9th grade) and a 40 point drop in VCI on the WISCIV (144 to 104) after a long term illness (Lyme Disease 3yrs post-treatment). There was a 26pt decline in WMI (123 to 97) while PRI remained stable (129). I have read some medical literature and this is exactly what was observed in a small scale study of post-Lyme teens. I have also read there is a slight dip in IQ during puberty. I wonder if there are multiple issues going on. Both sets of scores were an accurate reflection of the child at that time. Currently, I see performance like when he was younger - during those times he says the fog clears but most of the time, he's in this fog of slowed thinking. The 2nd grade testing was performed by a psych specializing in gifted kids. The current set of tests were performed by a neuropsych. I do think my son has significant anxiety issues. He deals with chronic fatigue and was exhausted that day.

I guess I'm wrestling with what do these numbers really mean and how best to help him succeed. He has been homeschooled but is now in public school for 9th grade.

Belana

Hi Belana, it looks like his processing speed has been most drastically impacted, and his working memory. I've just finished reading a book mentioned in another current discussion here "bright kids who can't keep up", I have mixed feelings about it but you may well find it very useful.

Chronic illness certainly impacts cognitive function, I have a chronic degenerative condition that i know has an ongoing impact on me. I imagine focusing on his health is the best way to help him? And putting in place the sort of supports mentioned in the book I suggested.

I saw that thread, MumofTHree, and ordered but haven't started reading it yet. That will be on the list for tomorrow.

Yes we are still focusing on improving his health, dealing with the chronic fatigue and nausea. he doesn't eat enough and was very underweight due to pain and nausea.

I wonder what the research is on chronic fatigue syndrom after lyme disease? I would not look for other reasons at this point as this ones staring you in the face, as it were, and you say it is what you see and what he describes. I vaguely remember that sometimes, when you think lyme disease is gone, it actually isnt and you need another lengthy course of antibiotics before rebuilding the immune system through probiotics, diet and supplements. But there mus be forums out there specializing in this?

I just did a quick survey of the literature as well, and it appears that the areas that are usually most impacted in children are working memory/executive functions, processing speed, and perceptual reasoning. Also increased anxiety and mood disorders. Granted, all of the research consists of small-scale studies, from what I can see.

Adult research suggests that the deficit is a higher-level one, of integration and organization.

I would also encourage you and your DC to look into some of the Lyme Disease forums, support groups, etc.

Also, regardless of the long-term prognosis (I am not suggesting one way or the other), there is a kind of grieving process that individuals and families go through when the temporary or permanent loss of a prior level of cognitive function occurs. For resources on managing those kinds of feelings, I would suggest looking up TBI (traumatic brain injury) groups:

http://www.biausa.org/brain-injury-community.htm

BTDT - although in my DS' case, the medical basis was not up for debate or speculation. Anyhow, assuming that the brain functioning issues are due to damage to the brain from his illness/treatment, there is still hope that you will see some improvements over the next few years. Doctors often use the three year window but in my DS' case as well as that of a couple of people we know, there can be observable improvements for a few years beyond that time-frame. By the way, I think that you are absolutely right to wonder about the other reasons. In my experience, they are valid. At least as I was told, that is one reason why a very high IQ is far more impressive in a teenager/adult than in a young child and that IQ numbers are more reliable (from a long term perspective) as the child gets older. Extreme fatigue and high anxiety can certainly lower test results but they can also clue you in on his practical functioning ability as well as the necessary IEP accommodations in a school environment. In a couple of my DS' WISC IV administrations, he had to rest (even nap) during the testing in order for the tester to even get responses. Anyhow, I would make sure that your DS has extended time, reduced work, and unlimited breaks (DS used to walk the halls often and even go to the nurses for brief naps) especially during his first year back in a school environment. The drop in VC appears to be the highest and I may be wrong but I think it is possible that an additional cause there might be limited academics during the years of his illness and home-schooling. At least that was the case with my DS as speculated by a couple of his testers. I know that it is suppose to be an IQ test, but two of the three VC components on WISC are vocabulary and comprehension, which are highly dependent on exposure to new words and social conventions. Even though my DS' recent IQ results are accurately low (technically in the average range except for PS), there are still flashes of brilliance on rare occasions. It is almost like he has swiss cheese brain - there are just so many holes. My best thoughts are what you already appeared to be doing - accept and meet him where he is now.

A friend of mine has TBI and runs a few support groups. It didn't occur to me to mention all of this to her, but I will now, thank you.

Currently this is all being classified as post-lyme infectious disease syndrome. Beyond that, there is so much unsubstantiated claims that it is hard to know what is real.

Unfortunately, after a great 1.5weeks at school after being out sick for 1.5weeks, he is sick again. He's very congested and the nausea has ramped up probably from the congestion.

Belana

Certainly fatigue was a HUGE factor in his testing as he was exhausted that morning before the test. And for a kid who never, ever naps especially not in the car, he napped all the way home.

Yes, missing the social conventions lowered his VCI this time.

I have the same here - flashes of brilliance. He came up the idea of using two magnets w/ same poles facing each other. He then put a screw in the middle and said he wondered if this would work for a suspension system in a car b/c you could vary it. He then researched it on the internet and found a company that had designed that very thing.

Or he read a math problem and instantly said the answer is 4. Now I had to do write an algebraic equation to get the answer and he was right. Now it wasn't terribly complicated, but when looking at him on days when he can't tell me 8x6=48, the contrast is striking that his brained solved it so quickly and near instantly.

Thanks for your insight, Quantum2003.

The tester said she will discuss the results with me when she returns. Her conclusion was that there is organic disease causing his issues.