Gifted Issues Discussion homepage Forums Identification, Testing & Assessment Thoughts on Language Impairment Diagnosis

Can a person have an expressive receptive language impairment and still score HG the verbal section of the WISC?



Thanks

It's somewhat unusual, but, yes. Three tasks comprise the VCI of the WISC-IV (only two in the new WISC-V). Two of them can be answered quite successfully with one- or two-word responses. The third (knowledge of social conventions--the Comprehension subtest) requires a little more language, but not as much as you would need to do well in social communication. Impairments in social communication and abstract language are most likely to show up on speech and language measures, like the CELF-5 or the CELF-5 Pragmatics. High auditory working memory translates to high Digit Span scores on the WISC-IV WMI.

The WISC looks at verbal reasoning, rather than communication, which is what an expressive/receptive language impairment describes. There is overlap, of course, but it's not 100%. Hence, cases like this. (I've also seen occasional cases where the CELF scores were average, but the WISC VCI was much lower.)

Thanks- I think the CELF was one of the tests that he took. Verbal Comprehension was 15, Similarities and Vocabulary were both 18.

Interestingly, digit span on the WISC was a 13, but letter number sequencing was 18.

I think that DS reasons well (verbal and non-verbal reasoning) when the task is intellectual (esp. math or logic/analysis), but does not understand higher order social thinking or how to read social cues. It may impact some later writing and reading comprehension tasks (so I'm told). Right now, he's reading about two years above grade level.

Hi cammom,

Not exactly the same diagnosis, but fwiw our EG ds scored very high on the verbal section of the WISC yet had a large discrepancy on his CELF subtests, and has an expressive language disorder diagnosis. I don't know if it's relevant or not, but fwiw when ds was first tested with the WISC at 8, his VCI was higher than his PRI by around 11 points (if I remember correctly - I don't have the #s with me at the moment), and his expressive language issues at that point in his life were really only noticeable when he was tasked with writing assignments. Within the next few years he stared telling us that he also had issues with verbal expression (knowing what to say) and we started realizing the impact of his challenges went beyond written expression. When he was given the WISC again at 10, his VCI (still high) came in lower than his PRI, again by around 11 points.

polarbear

Thanks polar bear-- this has been a hard one. DS also took the WJ achievement test about six months ago and came in between the 99th and 99.9th percentile in broad reading and broad written scores. He's also had a barrage of school standardized tests that have put reading, language, etc. at 99th percentile.

The abstract language bothers me a bit, because my experiences with him aren't supportive of a delay in abstract language. He often makes connections, inferences, etc. that I think go well beyond his age. I may see more academic issues with abstract language as he gets older that will cause me to revise. I would also add that these connections/inferences do not extend to social situations. He needs a lot of intervention to help with social skills.

Interestingly, his IQ evaluator thought that his PRI might go up (it was 133) as he gets older- polarbear this might sync with what happened with your DS. I'm noticing that mine is becoming heavily resistant/impatient over language homework, and is accelerating rapidly in math.

Why was he assessed with the CELF? What was the concern going in? Was he healthy and engaged for that testing?

I'll echo the questions from geofizz. Our DS10 has significant writing issues, and one of the things I am trying to pursue is expressive language disorders, given some interesting parallels from polarbear's experience. The fit isn't exact - but I still haven't found any descriptions of what expressive language disorders might look like when mixed with gifted, so it's pretty hard to measure for fit!

cammom, DS fits your description almost perfectly. He took the WISC at both 8 and 10, and both show a big discrepancy between Comprehension and the other two sub-tests, though all his scores rose significantly between the two assessments. At 10, his VCI was 99.6th percentile, but that blends Comprehension at 91st with Vocab at 99.9th. At age 8, his VCI measured much lower, at 95th percentile, with Comprehension - aka "Practical Social Reasoning" - at 50th! (Like yours, also high WMI: 99.9th at age 8, and 99th now). Like you, I would say he's very good with abstract language and reasoning. I would describe him as very aware of social and emotional cues - but not so clear on what he should do about them.

So please do tell us more about what prompted the assessment, and what you see in real life. If this diagnosis doesn't feel right, what doesn't work, and what might make more sense to you? I'm hoping to learn from your journey here, and the CELF sounds like something we may need to pursue.

I think your observations of his language comprehension are still consistent with delays in abstract language, as two years above his age level is still a fairly concrete level (early middle school). I would find the inconsistency between testing and life more significant if he were comprehending on a high school literature level. Reading for pleasure at a high school level does not necessarily mean that he is grasping the inferential and social-emotional aspects of the books. (I read Anna Karenina when I was twelve, and enjoyed it, but had no idea why Anna would want to leave her husband--thus missing the central conflict of the story.)

School-related language tasks do become increasingly inferential, and reliant on perspective-taking and social comprehension, as you go up through the grades. A lot of the writing in the primary years is personal narrative, which can be challenging for students with relative weaknesses in social comprehension, as one needs a certain amount of perspective-taking skill to be able to communicate internal experiences to an outside reader. Factual writing is probably much easier for him--is that often the focus of his areas of interest? I'd watch for the variance in quality and ease of writing products to increase as the years go by, as literary analysis really goes after the areas of weakness.

aeh- Thank you. I appreciate your perspective on this matter. The evaluation results were overwhelming and confusing. I think having a 2e child is confusing to a newbie like myself anyway, because it's a world of contradictions.

Yes, I think the books that DS most enjoys are non-fiction or heavy on plot. He reads fiction and non-fiction equally, but loves books books filled with facts.

Actually, it was difficult for me to understand why a kid would prefer Theordore Gray over JK Rowling if given the choice-- but he likes science, particularly books on space or physics/chemistry, weather, etc. I thought that was "smart" but kind of different.