Gifted Issues Discussion homepage Forums Twice Exceptional Not gifted only anxiety?

Hi there,
I apologize ahead of time for a long post here. I have a bunch of questions as we just received DD8's test results. I'm a bit overwhelmed by them. I am perplexed by her WISC-IV scores too.
For a bit of background, she took the NNAT fall of last school year (1st grade) and the CogAt this last fall (2nd grade) as part of the schools district's screening for their full time GT Centers. She scored 140 on both and was accepted into the center. Her teacher even mumbled that she thought DD had the highest CogAt of all the second graders in the school. Because of some significant issues such as refusing to do her work (usually writing), difficulty transitioning and with flexibility, screaming, hiding under her desk, and running from the classroom, we started testing for special ed. She's got perfectionism issues and avoids activities she's not sure she'll be good at. She is on meds for anxiety and is doing much much better (I still feel guilty for her multiple anxiety attacks per day).

So, she had the:
Beery-Bukteinca VMI 108 70th
BASC-2 - anxiety, maybe depression
BRIEF - some executive function issues

WISC-IV
VCI 106 66th
Sim 15
Vocab 15
Comp 4
PRI 135 99th
Block 17
Picture 15
Matrix 15
WMI 123 94th
Digit 14
Letter number 14
PSI 97 42nd
Coding 7
Symbol 12
FSIQ 121 92nd

Kaufman test of educational achievement
Reading composite 98th
Math composite 86th
Written 39th
Sound 82nd
Decoding 93rd
Oral fluency 58th

Does any of this make sense? I thought her FSIQ would be higher given her CogAt (all that she seems to understand). I don't understand her math composite feel her strong suit is STEM as she gets concepts quickly and she not challenged at all (virtually any incorrect answer she makes are "dumb" ones because she wasn't paying attention). Her favorite shows are NOVA and Cosmos; she can watch both without it going over her head. I could go on but I feel like maybe because I think she's so special I thought that the tests would show how special she was but in fact she's not gifted. She's just a bright-ish kid with anxiety (and still so very special in that way).
She's accepted into the gifted program and I should be okay with that but we're thinking of moving to another state and I'm worried I have to start all over to get her to a good place with learning.
Any thoughts will be much appreciated!

Did the psych compute a General Ability Index? That is just the PRI and VCI and does not include processing speed and working memory. It's a better measure of reasoning ability and when there are large gaps, many psychs do not calculate a FSIQ, and use the GAI instead. Do you think it's possible she got a couple low scores (like verbal comprehension or processing speed) because of anxiety? Maybe she just didn't want to answer the questions, or gave really short answers. I wouldn't conclude that she isn't gifted, if you take out the PSI, for instance, her percentile would be higher. DD had similar scores (but her verbal score was quite a bit higher and processing speed was lower) and there was a 15 pt. difference between her FSIQ and GAI.

It looks like it's possible she's 2e (gifted and potentially LD or other challenge). I'm just a parent so take what I have to say with a grain of salt, but fwiw I'm a parent with 2 2e kids. So here's what I see:

1) Her PRI score is close to her NNAT and CoGAT scores. If you don't have a copy of these test results I'd request it from the school. I think the NNAT is non-verbal, and therefore more likely to match PRI than VCI. The Cogat has both verbal and nonverbal, and it would be helpful to know which parts were administered (our school district only administers the verbal), and what her sub-scores were for each on the Cogat, to see if a pattern there reflects the pattern of high/lower scores on the WISC.

2) Did the person who administered the WISC note any anxiety or fatigue? I don't have time to google for it right now, but the WISC subtests are given in a specific order, so you could look for that order and see if her subtest scores decline with the order administered (indicating fatigue).

3) Her coding score is very low - my EG ds who has DCD and dysgraphia also had a coding score of around 7 when he took the WISC. While mixed in with other strong scores it might not seem like anything, it is actually hugely meaningful for him - not because he has a weakness with processing, but because it is indicating he has a neurological challenge impacting fine motor skills. Both coding and symbol search subtests are timed, but the symbol search only requires a child to circle a repeated symbol from a random field of symbols. The coding subtest requires the child to make a specific type of mark, hence fine motor challenges can impact the score. If there is a fine motor issue, that might be the reason you see a lower score in a broad achievement test category such as math when you aren't expecting it - if there is a timed test that requires written output for instance. If the fine motor challenge is significant, fluency tests (timed) often measure the inability to produce quick handwriting rather than measure knowledge for a child with a fine motor challenge.

3) The Beery VMI usually contains two subtests that differentiate between visual and motor integration skills - do you have the subtest scores? Looking at these alongside the WISC processing speed scores can provide insight.

4) You dd's score on the WISC VCI would have been much higher if she hadn't scored a 4 on Comprehension. Is this Picture Comprehension? I would look for a description of what is required on that subtest, as well as ask the psychologist who administered it specifically what she thinks happened with the test. It is so far off the other subtest scores that unless you can pinpoint some specific skill weakness that might be impacting it, I might doubt it's accuracy. The other VCI subtest scores are very close to her PRI subtest scores, which would fall somewhat in line with the NNAT and Cogat.

5) Lastly, I would take the anxiety seriously, and not assume that anxiety is the root of anything, but consider that it may be a symptom secondary to an underlying issue. There is a lot of variability in her test scores, which may be a sign of an undiagnosed LD.


My EG ds has an expressive language disorder which impacts written expression. He appeared to "refuse" to do writing assignments in early elementary - but he wasn't really refusing, the reality was he had no clue what to do, but because he was very bright his teacher thought he was being lazy and just not doing his work on purpose. As his parents, we knew he was very bright, and thought what was happening was perfectionism. As a result of none of us recognizing he had an actual learning challenge, he became extremely anxious and was on the verge of clinical depression when he was finally referred for testing at the end of 2nd grade. So - fwiw, my recommendation is that you find a neuropsychologist or educational psychologist or a school psychologist who will look at the overall bank of data you have - the ability vs achievement testing, classroom behavior, classroom academic work, developmental history, and additional testing, and try to put the puzzle pieces together to determine what is driving the issues with written work and behaviors at school.

When you talk to the school, I'd also request further testing of written expression - the TOWL (Test of Written Language) is what is typically used in our school district. I'd also request an OT eval if that wasn't included in the testing. I don't know if it's an issue or not, but google dysgraphia symptoms, and see if any of that fits anything you are seeing with your dd. At home, try giving her different types of writing assignments and see what is easier (or compare to school) - can she summarize a story? Can she write about factual info but is lost when you ask her to make up a story? Is the length and complexity of her writing significantly different when she uses handwriting vs telling you orally?

Put together any notes you have from your own observations and see how hey correlate with the test results you have. You most likely won't get it all neatly figured out overnight, but you have a lot of info already to start with.

Best wishes,

polarbear

I am also struck by the significant range of subtest scores. In particular:

1. The Comprehension score of 4, in contrast to the other VCI scores in the Superior range (more consistent with a VCI in the upper 120s than in the 100s). Although this is not the only skill associated with it, social reasoning is one of the skills connected with performance on this subtest. Social perception is often notably impaired in individuals with anxiety disorders. Another possible angle (and I don't enough from your description to suggest how likely this is) is that the anxiety and the putative social reasoning deficits are both related to an autistic spectrum disorder. It sounds like there may be other symptoms that could be consistent with ASD, such as inflexibility/rigidity, and sensory regulation issues.

2. The combination of low Coding, relatively low writing, and anecdotal writing refusal all would concern me, wrt written expression, including mechanics, as polarbear already stated. The VMI was in the upper end of the average range, which is less significant, from an OT standpoint, but as it is untimed, there could still be fine motor issues.

3. The math composite score is not as concerning per se. It's within the range, statistically. I would like to know if both computations and problem solving were at the same level, though, as that could be more significant. The math computation subtest involves written work...

4. Did they do the reading, math, and writing fluency subtests? I notice that her Oral Fluency (mostly retrieval fluency) is average, and comparable to Symbol Search, which suggests that the challenge with Coding is specifically fine motor speed, as opposed to untimed fine motor, or motor-free speed. Her perceptual reasoning skills are quite good, so this is more data that suggests pursuing the OT end of things. Fine-motor speed can be connected to deficits in developing automaticity, which can affect writing (lack of automaticity in letter formation and/or spelling can become major obstacles to written expression), reading (using phonetic decoding strategies on novel words), or mathematics (lack of rapid access to basic computations interferes with higher level problem-solving and multi-step computations). The latter two usually become more noticeable in later grades, for high cognitive individuals.

5. I second (third?) more in-depth writing assessment, such as with the TOWL-4 or PAL-II (I give a slight edge to the latter for this age).

My DS has ADHD/anxiety/depression dx and 504 for those (old stuff--awaiting updates). I don't have all those sub-scores or know anything about them, but his only FSIQ was 126 and psych stated in report anxiety may have affected and should be considered in interpretation (again, those scores are five years old).

GAI has been tested at 146, 132, 136. Processing speed was big issue in FSIQ but I have nothing to add as far as the sub-tests. The lowest of GAI was when he was extremely phobic, anxious, and basically freaked out about the testing (and still remembers how much he disliked the psych--he was scared of him). I would definitely want further info especially before deciding "not gifted." I don't know much about IQ testing but 99th percentile in PRI and also 97th in WMI look like clues to me.

Thanks so much, I'm going to have to go back through the test scores and narratives with all this advice. The school psychologist did note that she tended to not answer rather than guess. With the meds attenuating the anxiety, we're seeing some things like the depth of her perfectionism and self-doubt. So, I think she'd rather not answer than to guess and be incorrect. She thinks she's the slowest learner in her class and the worst at math. Her teacher and I are floored as she gets stuff no other kid gets in her class. So, we're both trying to show her how much she knows. She just got beast academy books and LOVES them. Hoping that will help build interest in taking on challenge and help her feel good about it.

polarbear - your DS sounds like my DD. She goes completely blank with writing assignments, especially ones where she can write whatever she wants. Pre-meds, she would fall off the emotional cliff. She loves to draw though and one way to get ideas flowing is for her to draw pictures then write about the pictures. Her drawings are not that different from any other second grader except for the incredible amount of detail. They just started writing poetry and she likes doing that - something to explore.

aeh - the psychiatrist and another psychologist said she has a combination of behaviors that are associated with ASD but didn't think she was ASD. The psych thought maybe ADHD-inattentive in addition to the anxiety but wanted the psychiatrist to have a look (and give a medication consult). Psychiatrist wanted to get a handle on the anxiety before further examining for ADHD. She also wasn't sure if rigidity was leading to anxiety or anxiety leading to rigidity. I think it's the latter. DD became more and more rigid as her anxiety amped up. On the meds, she is calmer and more flexible (but still won't eat anything green 😝).

I have her CogAt report but can't find the NNAT. I can get that from school. Tomorrow is therapist appt for the anxiety, so more calculations such as GAI will probably wait for the weekend. As a side note, my kiddo very much reminds me of me and seems to be wired like me. I was identified as gifted as a kid and so in my shock of a lower than expected FSIQ, I asked my dad if I had an IQ test. It was highly likely SB (from the mod-1970s) and my dad said I scored in the 150s-160s. DH wasn't labeled as gifted but his sister skipped a grade sometime in early elementary. It made me feel better to think that I'm not crazy or "that mom" to think DD is gifted.

Thanks again and I know I'll be back with more questions.

Hi again,
I have an update and more subscores.
DD8's therapist also thought an OT evaluation of fine motor skills is a good idea. And it looks like she'll qualify for an IEP AND the full time GT center isays they are prepared to support her needs.

DD's CogAt subscores are:
Verbal 133 98th age percentile
Quantitative 137 99th age percentile
Nonverbal 132 98th age percentile

Kaufman subscores
Composite 130 98th
Letter & word recognition 126 96th
Reading comprehension 127 96th

Math composite 116 86th
Math concepts and application 122 93rd
Math computation 102 55th

Written language composite 96 39th
Written expression 94 34th
Spelling 99 47th

Sound symbol composite 114 82nd
Phological awareness 106 66th
Nonsense word decoding 115 84th

Decoding composite 122 93rd - no subscores - note says this is derived from letter & word recognition and nonsense word decoding. Y
Oral fluency composite 103 58th
Associational Fluency 109 73rd
Naming Facility (RAN - I don't know what this means) 97 42nd

Still looking at the narrative from the school psychologist. The recommendations are in the behavioral realm plus a comment on needing more time to complete work.
The WISC-IV was administered pre-anxiety medication and the Kaufman was administered while on medication.
If anyone has more insight, that would be greatly appreciated.

Hm. I'm seeing a pattern of relative weaknesses in the retrieval fluency areas and possibly phonological processing, with some indications that retrieval fluency/automaticity is starting to impact academics, in the form of math computations and written language. I'd agree with the IEP eligibility.

It is not unusual for cognitively intact or strong children with learning differences to experience themselves as much less capable, which feeds anxiety, which in turn distorts perceptions further. And, incidentally, differentially depresses the demonstration of math skills. You may find that appropriate academic instruction, and supports, contributes significantly to the moderation of her anxiety symptoms.

RAN is rapid automatic naming, and is a form of retrieval fluency

I think this is similar to what DD had on the D-KEFS in terms of the letter fluency score (I think the kid is supposed to name things that start with a certain letter)...she was in the below average range. He said she has slow proc. speed even though her latest WISC-IV processing speed score was in the above-average range.

The OT last year had her do a similar task (name animals that start with letters of the alphabet) and she basically freaked out and couldn't name much of anything. She also has anxiety issues.

There's a difference between acting quickly on information presented to you (which is more speed of information processing/processing speed as it is usually assessed), and retrieval fluency, in which one needs to access and produce information that one already has stored away. The latter has a lot of EF implications. I've used the messy closet analogy before. It's all in there somewhere, but the filing/organization/retrieval pathway is so inefficient or disorganized that finding it on demand is difficult. Often, cued or recognition recall will be much better than free recall.

I usually recommend that students learn to attach memory "hooks" or personally-meaningful mnemonics to information, so that there will be a "fishing line" attached to a group of related content or skill standards. Or you can think of them as links or beads on a chain/thread. Using mental walk-throughs or narratives can help, too. E.g., you memorize and later retrieve your grocery list by standing in front of the refrigerator (IRL or mentally) and looking at each shelf for the item that you need to buy. Or tell yourself a story that involves all the pertinent steps of a process/skill, with vivid sensory, relational, or emotional (including humorous) cues connecting each step.

This doesn't, honestly, help that much with retrieval fluency, because it's not that fast, but it can be helpful as a compensatory strategy for retrieval weaknesses in general. And I figure it can't hurt for fluency purposes, as it minimally gives one some sense of control over the effort to pull up facts and skills.