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Hi,
I posted a few weeks ago about WISC V results and low processing speed. Here were my child’s scores.

Verbal-136-99%
Visual Spatial-126-96%
Fluid Reasoning-128 99%
Working Memory-132-98%
Processing Speed-80-9%
FSIQ 129 (137*) 97(99*)
*Prorated score because of processing discrepancy

The subtests for processing speed were:
Coding-7
Symbol Search-6

We had follow up achievement testing done, and the results were worrisome to me. The Woodcock Johnson IV, WIAT III and Gates-MacGinitie tests were administered. The scores were in the 73rd percentile for age and 77th percentile for grade on the Woodcock Johnson.

Areas of broad math, math calculations, broad, written language, academic skills, academic fluency, and phoneme-grapheme knowledge were all in the average range.

There were numerous scores in the advanced range, but none in the very advanced range.

My son has a lot of trouble with spelling and apparently he is struggling with math calculations, despite high fluid reasoning skills. His writing construction was strong, but apparently he is having trouble mixing up sounds when spelling. Reading scores were all very strong, although not quite as strong as I thought they would be, knowing how much he reads and how good his comprehension is.

The psychologist wrote “relative dysgraphia” in the report, but she really wants to focus on anxiety issues and wants to put my child on an SSRI. I agree that there are some anxiety issues, but the differences between achievement scores and IQ scores seem very concerning to me. My child took the Stanford last year and had some similar achievement results, so I don’t think this is a one off.

Any suggestions for follow ups with the psychologist? His school is very supportive. Any suggestions? I think he was tested for ADD/ADHD.
Thanks!

Full Scores on Woodcock Johnson-based on age
Broad achievement 73
Broad reading 86
Basic reading skills 83
Reading comprehension 91
Reading fluency 79
Reading rate 78
Broad math 51
Math calculation 43
Math problem solving 84
Broad written language 66
Basic writing 66
Written expression 78
Academic skills 64
Academic applications 90
Academic fluency 60
Academic knowledge 84 (strong in science, average in social studies and humanities)
Phoneme-Grapheme knowledge 57
Reading vocab 84

WIAT III
Sentence composition Percentile 34, grade equiv. 4.2
Essay composition Percentile 97, grade equiv. 12.9

Gates Macginitie
Vocab 95%, GE 10.5
Brief story comprehension 98%, GE Post high school

Also, his school does not use grades, so it's hard to measure how he is doing in school. They see him as being ahead of grade in science and reading and on grade level for math and social studies. This appears to be true, but the difference between IQ and achievement is really concerning to me, especially because my child is so forgetful.

What type of psychologist is this? My suggestion is that if this is not a psych who specializes in either neuropsychology or educational psych evaluations, seek out another psychologist or request follow-up testing through school. You have IQ scores, which show the gap in processing speed, reading achievement tests (Gates-MacGinitie) which show reading comprehension in the range of his ability, and you have achievement testing showing a large discrepancy between ability and achievement, which most likely correlates to the dip in processing speed on the WISC. What you don't have is additional testing to determine what is causing that dip in processing speed.

I haven't heard the term "relative dysgraphia" before, but can tell you that neuropsychs typically use additional tests and data to confirm that a child has dysgraphia and to determine what the cause is (same for other types of LDs, dysgraphia is simply the easiest for me to explain lol!). For dysgraphia, a neuropsychologist will look at handwriting samples and observe the child while he is writing, plus administer tests that assess visual motor integration as well as tests such as the NEPSY which measure various neurocognitive skills. A neuropsych eval will also include recommendations for remediation and accommodations if a challenge is uncovered, and often will include specific recommendations re where to seek different types of help (private vs school).

I also noted in previous posts that you mentioned your ds has good fine motor skills - dysgraphia isn't directly a measure of fine motor skills. Many children with dysgraphia are able to draw incredibly well or complete fine motor skills tasks easily - my fine-motor dysgraphic ds was drawing amazingly detailed pictures at an early age and creating life-like tiny clay figures even when he was in pre-school. Dysgraphia is a glitch in the ability to develop automaticity of handwriting.

I don't look at tests such as WJ Achievement tests as measures of actual achievement, I see them as measures of independent skill sets compared to typically developing children. It's quite possible to appear to be achieving at an average or above average level in the classroom yet be extremely challenged in one specific area of functioning, especially in early elementary. My dd who has a reading challenge went undiagnosed for years because her strong abilities allowed her to compensate for the one very specific area in which she was challenged.

You've noted that your ds has anxiety - I wouldn't be surprised if the anxiety is secondary to any challenges he may have that are reflected in his relatively low achievement scores (relatively low compared to his ability scores). My ds had extreme anxiety prior to his dysgraphia diagnosis and receiving appropriate accommodations at school - but once those accommodations were in place and we were able to explain to him the reason he was struggling, the anxiety went away. Same thing (sorta) happened with my dyslexic dd. Neither have needed meds to control anxiety - they needed testing to determine what was going on re the challenges that impacted them in school, and advocacy to get appropriate accommodations and remediation in place.

Best wishes as you sort through this -

polarbear

Thank you, Polarbear. I'm feeling a little overwhelmed with this. We went to the psychologist to discuss social issues, but then this popped up. It is a neuropsychologist who is well regarded by our pediatrician. That was what I was frustrated about. I expected to hear about practical things we could do to address these issue and the psychologist just kept focusing on the anxiety and very "big picture" ideas about encouraging our child to take risks and develop more motivation. It's not that I'm opposed to that, but I didn't understand how to implement those things or how they related to the gaps in achievement test scores vs. wisc score. I'm not really sure what to do now. The testing was quite expensive, so I don't want to start all over with someone else.

Okay. I specifically followed up about learning disabilities, and I will wait to hear back. I was very overwhelmed when we had our discussion about the testing, and I don't remember what I asked! But now I am asking.

The anxiety is not related to school, specifically. He is very risk averse and afraid of things like insects, the dark, heights, etc...These are things that many kids are afraid of, but he is more afraid than normal. He also gets concerns like what is a meteor hits earth, we are all going to die, etc...He's also very dependent on us and not very social. He has few friends and does not want any more friends. He was displaying some ASD behaviors like lack of eye contact, but ultimately I do not think he is on the spectrum. The neuropsych was not sure either. She thought more likely anxiety. But he is very different at home than at school. He's much more gregarious and happy and silly at home. But I switched his school so he would be happier, and I think it is a better environment for him. The anxiety is there, but it's certainly not all the time. Most of the time he's very happy.

Anxiety is often tied to intelligence, if you can come up with more solutions to a problem, you can also come up with a million ways that you can die….imagination is a double-edged sword. You can also look into separation anxiety/ocd and see if any of that fits… obsessively thinking about scary things can mean he has a bit of OCD. But perhaps taking him to a developmental psychiatrist might be the easiest place to start. OCD and/or anxiety can be treated with Cognitive Behavioral Therapy.

Also just remembered something my son's doc said.. he said that anxiety can often be a result of the fact that they understand at a higher level but that they cannot cope emotionally with what they know. NT kids learn about the world and learn to cope around the same time- gifted kids are asynchronous, so you can learn that meteorites can kill you and understand what that means, but not have the emotional ability to deal with the fear that results. So as a parent, you have to ramp up teaching him coping skills (or finding someone who can) to compensate.

It may be that the neuropsych is not downplaying the LD (since she did give the diagnosis, granted with a low-incidence label), but just viewing the global anxiety as being the more debilitating of his issues at the moment. From your description, that is not an unreasonable position to take at the moment.

He's probably much different at home, because he feels safe there, around his family. You've established that you are trustworthy, and will protect him. New settings can't prove that right away, and if they break trust, it can take a long time to re-build (if ever).

I think LAF makes an excellent point. And yes, CBT, RET, or DBT.

It does look like all the deficits are in basic skills and fluency, mainly calculations and spelling (that likely affected the sentence composition score, too). But his math problem solving and written expression appear to be otherwise intact.

I would disagree that he is on grade level for math. He is on grade level for math calculations, and above for math reasoning. But the calculations are holding him back from demonstrating (or accessing) higher level math problem solving skills.