Gifted Issues Discussion homepage Forums Identification, Testing & Assessment Finally got the full report/scores

Hi all, this is an update to my previous thread. I'll repeat some stuff just to have it all together.

Basically we are concerned about DS7's much lower VCI in comparison to his other cognitive scores. He has shown weaknesses in reading and writing at his gifted school and we are trying to determine if he has a disability that can be treated/accommodated to help him do his best, what additional tests might help us to determine that, or if he just has a perfectly normal (for him) cognitive profile with personal strengths and weaknesses. I already got some good suggestions on the prior thread, but with sub-test scores now available maybe something more specific will stand out? DS is diagnosed with ADHD, Tourette's, and (contested by me) ASD. Well, on to the numbers:

Wisc V

VCI_____________118____88th%ile____High Average

Similarities_____11____63rd%ile____Average
Vocabulary_______16____98th%ile____Significantly Above Average

VSI_____________151____>99th%ile___Extremely High

Block Design_____18____>99th%ile___Significantly Above Average
Visual Puzzles___19____>99th%ile___Significantly Above Average

FRI_____________155____>99th%ile___Extremely High

Matrix Reasoning_19____>99th%ile___Significantly Above Average
Figure Weights___19____>99th%ile___Significantly Above Average

WMI_____________155____>99th%ile___Extremely High

Digit Span_______19____>99th%ile___Significantly Above Average
(Picture Span)___19____>99th%ile___Significantly Above Average

PSI_____________100____50th%ile____Average

Coding___________12____75th%ile____Average
(Symbol Search)___8____25th%ile____Average

FSIQ____________144____>99th%ile___Extremely High
GAI_____________143____>99th%ile___Extremely High

(Nonverbal Index Score=158)

WIAT III

Reading Comp____141____>99th%ile___Superior
Word Reading____127____96th%ile____Above Average
Pseudoword______134____99th%ile____Superior
Decoding
Oral Reading____136____99th%ile____Superior
Fluency
Basic Reading___137____99th%ile____Superior

Math Problem____160____>99th%ile___Superior
Solving

(Of note is the fact that the entire reading portion was based on 1st grade level reading and would not have found any relative deficits because it was so far below his level)

The school then went on to do their gifted eligibility matrix in which DS did qualify for the gifted program, but with no help from his own mom! He got 0 points for the GERRIC scale that they had me fill out (which I thought was full of questions that had little to do with giftedness, such as early motor milestones and leadership abilities). As I was totally honest on it he got a 44/60 and 0 points towards the gifted matrix. I find it interesting that even a kid with an IQ below 120 can get into the gifted program with enough points on the matrix... especially since a kid can get 3 points just for having parents that rate them highly on the GERRIC. His teacher also filled out a CHUSKA scale for which he also received no points. I'm gonna guess these scales aren't very helpful for determining giftedness in special needs kids

DS scored at clinically significant levels for Executive Functioning problems (79 parent, 74 teacher on the BRIEF 2), at risk or significant all over the BASC 3, very elevated for the vast majority of items on the Conners 3 (ADHD), and average (59) by parent rating and slightly elevated (60) by teacher rating on the ASRS (autism).

CELF 5

Sentence Comprehension_____Raw: 25___Scaled: 12___%ile: 75
Word Structure ____________Raw: 31___Scaled: 13___%ile: 84
Word Classes_______________Raw: 25___Scaled: 13___%ile: 84
Following Directions_______Raw: 27___Scaled: 16___%ile: 98
Formulated Sentences_______Raw: 27___Scaled: 10___%ile: 50
Recalling Sentences________Raw: 60___Scaled: 16___%ile: 98
Core Language Score _______118_______%ile: 88
Receptive Language Index___123_______%ile: 94
Expressive Language Index__118_______%ile: 88
Pragmatics Profile_________Raw:143___Scaled: 07____%ile 16

It was noted that pragmatics language deficits primarily fall in the area of following conversational rules. Pragmatic strengths were noted in giving/asking for information, awareness/use of prosodic cues, and sharing/responding to reactions. Also noted was that for some items on formulated sentences he took more than 5 minutes to come up with a sentence. He asked questions such as "What is the right answer?" and "Are there more or less than 50 right answers?". This did not affect his score as the test is not timed. Throughout the evaluation he had a hard time guessing or accepting that he did not know an answer. He became most upset during Formulated Sentences and Word Classes, presumably because they were hard for him/he did not feel like he was doing well. No articulation problems noted.

On the Pragmatics checklist DS had 11 items checked as follows (9 or more out of 32 is a deficit):

Did not maintain appropriate eye contact
Did not look where speaker pointed
Did not look at object/person named by speaker
Did not coordinate gaze with speakers gaze and ongoing talk
Did not use gestures to identify person or object
Did not point to distant object or person when appropriate
Used too much non specific language
Repeated things that listeners were already aware of
Talked repeatedly about topics he was interested in but others were not interested in
Talked even when no one was listening
Responded but did not extend the conversation to offer further information (unless related to topic of interest)


Beery VMI 6th edition

Full Form___________________Raw: 25____Standard: 123 High
Visual Perception Subtest___Raw: 23____Standard 112 Average
Motor Coordination Subtest__Raw: 21____Standard 104 Average

(it was noted that he would have performed better at visual motor integration had it not been timed)

BOT 2

Fine Motor Precision______Scale Score: 24_____Above Average
Fine Motor Integration____Scale Score: 17_____Average
Manual Dexterity Skills___Scale Score: 20_____Average

Fine Manual Control_______Standard Score:62___Above Average

Test of Visual Perceptual Skills

Visual Discrimination__________18____99th%ile High
Visual Memory (short term) ____19 ___99th%ile High
Spatial Relations______________19____99th%ile High
Form Constancy_________________15____95th%ile Above Average
Sequential Memory______________17____99th%ile High
Figure Ground__________________19____99th%ile High
Visual Closure_________________19____99th%ile High

Overall_______________________140____99th%ile High

SPM (sensory processing measure, teacher report)

Social Participation: Some Problems
Vision: Some Problems
Hearing: Definite Dysfunction
Touch: Typical
Body Awareness: Some Problems
Balance and Motion: Some Problems
Planning and Ideas Definite Dysfunction

Some other things noted by the OT for writing and in general:

Mature grasp
Fair line adherence
Legible
Letters not always fully ascended
Irregular bottom up letter formation
Decreased writing speed
Extra time to initiate writing
Wrote with minimal details
(When asked to write 2 sentences about his favorite animal, wrote "My favorite animal is a cat. Her name is (omitted).")
When engaged in tabletop tasks DS was observed to sit on his legs and bend over so his face was close to the paper.
He also wanted to turn his body instead of adjusting crayon strokes when coloring in a simple picture.
Cutting skills were good, but he incorrectly donned the scissors and cut while holding the paper close to himself.
In the classroom he was slow to respond to teacher and peers when spoken to.
It was noted that he also sat on his knees at school when seated and on the floor and leaned over his desk when he worked.

My favorite thing in the evaluation, because it is so DS: He hid under the table at one point when he perceived the evaluator had given him the answer. He stated "You ruined the test, I can't go on." He's so ridiculously dramatic sometimes! It also mentions that he demonstrated awareness to minute details and had difficulties filtering out things that were not important.

At the end the report determines that "overall his academic skills are commensurate with his ability." I can see how reading and writing are commensurate with a verbal IQ of 118, but I kinda think that such a huge disparity between verbal and nonverbal IQ might mean something?

I know that it is already causing difficulties at his current school placement (6 gifted kids k-1) and this is causing us to reconsider gifted school for next year.

OTOH I am not seeing how public school could accommodate him academically. He's pretty much done with elementary math so he could not go to a higher class. And even with his reading weakness he is still way above average and would potentially be bored with 2nd grade reading. He already knows a lot of science and social studies just from car conversations to and from all of the therapies over the years. And even if the material is new, he learns so quickly he would likely be annoyed at the slow pace.

Well, I guess that's it. Any ideas or advice would be greatly appreciated. I want to come up with a list of additional ideas to run by the school before we finalize everything. Thanks

A couple of notes:

Actually, his achievement scores really are commensurate with his nonverbal ability. Regression to the mean is one of the concepts that can be hard to grasp. The predicted achievement in all areas of academics, based on his nonverbal ability, falls largely in the mid 120s to upper 130s. It's actually his higher math problem solving score that approaches being above predicted levels (though not by much). I agree that the large difference between verbal and nonverbal is worth keeping an eye on, but it isn't that surprising that there is no apparent impact on academic achievement at the primary grade levels. Expectations are low for this age, especially for the high-level, abstract, inferential verbal reasoning that is likely to become more of a relative challenge for him down the road (possibly quite a long way down, and possibly not at all, since he has exceptional fluid reasoning).

We've already discussed ADHD, and I think someone brought up the fine-motor/dysgraphic category of learning differences. I think, whatever the etiology, the OT testing pretty clearly demonstrates fine-motor delays, which are sufficient to explain challenges in reading and writing, and the speech language eval documents pragmatics delays, which are likely to contribute to social and behavioral presentation, and may even impact reading and writing performance (because of the inferential aspects--though not so much at this grade level). Writing for obvious reasons, and reading because many teachers assess reading comprehension through written products. Unfortunately, your final eval report confirms that no norm-referenced assessment of written expression was done.

Granted, the OT data should be sufficient to stimulate an occupational therapy and a writing goal, and classroom accommodations to provide access to demonstration of skills in a variety of academic areas (including reading comprehension) without being gated by handwriting. If the school can be flexible about letting him use, for example, a variety of oral and visual presentations instead of purely written products, then he might have some other avenues for accessing ELA instruction. I would want to separate working on handwriting and mechanics from working on language expression, reading comprehension, social studies and science content areas. So don't grade for spelling (except as it impacts intelligibility) unless spelling is the instructional objective. Allow speech-to-text for writing longer than a sentence in length, and oral assessment in content areas and for demonstrating reading comprehension. Extended time. Items only sufficient to demonstrate mastery (graded on starred items only). (By the way, this would actually serve a dual purpose of helping with his slow writing speed, and, as a side benefit, reducing boredom from repetitive drills.)

He sounds very similar to my DS who is now in 4th grade, except DS has very obvious issues with motor coordination. He had the same gap between verbal and nonverbal ability. But achievement testing shows reading/math both above the 98th percentile. His pragmatics profile showed some of the same deficits. He is NOT diagnosed w/ autism, we had him evaluated several times and he just doesn't meet the critiera. But he definitely has something else going on that is causing his issues (doctors note something is probably going on w/ his cerebellum because his motor skills are also really poor and he has hypotonia).

He does much better with written expression when he types and the same was true of my daughter, who had similar writing issues. the TOWL wasn't even scoreable because she didn't write enough words for the story. Now that she is 11 she is doing much better with her writing. Her issue wasn't linked to verbal ability (which scored 99th percentile on the WISC), it's linked to her executive functioning issues and ADHD. She uses keyboarding and speech to text as needed but the problem seems to be diminishing now that she is getting older. Even though she didn't have any obvious motor deficits she also had very slow handwriting. She would trace over and over letters practically ripping through the paper.

Thank you both so much.

aeh: Interestingly the OT report says no fine motor concerns and writing problems are not motor based. Is there something specific in the testing I could point to to try to argue otherwise? Also, given this data, which norm referenced assessment of written expression would you recommend I ask for? I feel like I already got a lot and for free, so I don't want to burden them with a bunch of additional requests, but if there is maybe just one more measure that would really give us useful info I'd love to have it done.

blackcat: I find it interesting that ADHD used to be called minimal brain dysfunction, because I find that a much more accurate way of thinking about my DS. Nothing is so far off he can't function, but most things seem to be at least a bit off. DS has been assessed as low tone in the past. He has qualified for PT at various points. He does have poor coordination on many gross motor tasks. He has the ADHD. The TS. Emotional and behavioral regulation issues. Various mild sensory issues. I do often wonder if just one part of his brain just isn't working right. I am very happy to hear of another kid with a similar pragmatics profile who is not autistic. I don't think we will ever shake that diagnosis now that we have it, but any little bit to help me feel more confident really helps

One really funny thing about DS is that his verbal skills seem to be at their highest when he is angry/fighting. He can reason and scream out the most amazingly complex and vocabulary rich things when he is mad at us. Which makes it really hard to stay mad at him! I wonder if he does it on purpose? Maybe I should suggest to the school that they work him into an angry frenzy and then ask him to come up with a story?

He's just so variable in general. Last year he wrote some beautiful poems and he used to dictate huge stories to us when he was 4 that often had very creative elements (and totally crazy ones). His art teacher says he is a very talented painter, but I haven't seen him paint at home in years (in fact I was convinced for quite awhile that she must have me confused with another mom). He hates to write, but he will happily draw and solve mazes for hours. Just a very inconsistent and strangely amazing child

You received great information above. I'll just add a few quick thoughts -

Is your child a Davidson Young Scholar? With WISC-V scores of VSI 151 and FRI 155 I believe you could apply to the DYS program; The DYS Qualifications are listed here.

Pearson provides some general background on WISC-V scores here, showing how the various scores relate to each other.

You mentioned "variable" and "inconsistent". Are you familiar with the concept of Asynchronous development of gifted kids?
- Link to NAGC description here.
- Link to book "Asynchrony and the Gifted Child" here.
Beyond the 2e diagnoses, asynchrony may help explain some of the variability/inconsistency that you see.

You might want to delete the score detail from your post(s) to help preserve your child's anonymity (consistent with this post and board rules).

Don't quote me because I'll probably come back and delete, but DS has a dx of developmental coordination disorder. I think he may actually have a more serious issue like a mild case of ataxic cerebral palsy. His "motor coordination" score on the Beery VMI was like .02 percentile. So that's pretty bad. Yet I saw him do a game on the ipad yesterday where he had to press squares in order as they ran quickly across the screen (to play a song) and I think he did that as well as I could have which didn't make a lot of sense to me. His handwriting looks like preschool writing and never seems to get much better. Anyway, everyone thinks of the "cerebellum" as just having a motor function, but it goes far beyond that, it controls social skills, speech, hyperactive, inattentive or immature behavior, etc. I was reading about a kid who had damage to one part of his cerebellum and he developed speech issues that are very specific and rare that sound like DS's issues. It also controls things like eye contact. If you don't have a well functioning cerebellum eye contact is impossible. I think there is research showing ASD involves an underdeveloped cerebellum but other disorders are linked to it as well. DS was just run through a 3T MRI scanner to try to get a better look at it, so far all that we have found is a mild chiari malformation with a quick 5 min. scan. There are so many disorders that can cause some ASD type symptoms but the question is are there enough of those symptoms to warrant a diagnosis of ASD or is it something else. Have you ever seen a genetcist? There is all sorts of testing that can be done now that couldn't be done before. I was just reading our policy and it looked like testing on kids with ASD is covered.

edited to add, this comes from wikipedia. "They reported that patients with injury isolated to the cerebellum may demonstrate distractibility, hyperactivity, impulsiveness, disinhibition, anxiety, ritualistic and stereotypical behaviors, illogical thought and lack of empathy, aggression, irritability, ruminative and obsessive behaviors, dysphoria and depression, tactile defensiveness and sensory overload, apathy, childlike behavior, and inability to comprehend social boundaries and assign ulterior motives.[5]" Sounds like autism, right? But they are describing injury to a specific brain part.

I don't have much time to reply at the moment, but there are different types of root causes of dysgraphia - one is fine motor, the other is related to visual motor integration. I don't have the knowledge to tell you if either of these is an issue here, but fwiw you might want to google "types of dysgraphia" or something like that and see if any of the symptoms of a specific type line up with what you're seeing in your ds.


This really isn't atypical for dysgraphic children - my ds is a talented artist and can draw amazingly well. He's also able to take one look at a complicated maze and draw the solution with no mistakes. He can't write. There are very different processes in the brain controlling each of these - drawing is free-form, figure it out as you draw, every drawing is new and unique, the pencil rarely leaves the paper while drawing. Usually when you're drawing your head can be totally in it and doesn't have to be thinking about things like spelling, capitalization, grammar etc. Handwriting involves (in neurotypical children) the development of automaticity when learning how to form letters, and when that automaticity doesn't develop, forming the letters takes up all of a child's working memory to the extent that they can't focus on those things.

My ds also has Developmental Coordination Disorder... and it has symptoms that overlap with ASD.

Re asking for further evaluation etc from the school - one thing I'd seriously consider is seeking a professional evaluation outside the school. With the testing and data you already have it wouldn't have to be as extensive and costly as a full eval, but being able to review the results and ask for recommendations from a professional who has no ties to the school might be helpful both in terms of reaching an up-to-date diagnosis, and in terms of understanding what therapies/remediation/etc could be useful, as school evaluations are going to somewhat limit that information based on what they are required to provide and what will help in the classroom at this moment in time. An outside professional can help you provide a long-term plan and understanding, as well as provide references for outside help should it be necessary to add additional remediation outside the scope of what your school district is willing to offer. Please know I'm not knocking schools at all in saying this - just think that sometimes when a parent has unanswered questions an additional review from a professional not tied into what the school is capable of offering can help with clarity and a plan forward.

Best wishes,

polarbear

Thanks so much for everything guys, I am keeping track of all of these ideas for all of the meetings we have had (and will have). I have also been doing lots of research! We have an IEP meeting scheduled for Monday and I am reviewing all of this again as well as my other thread just to make sure I am totally ready to advocate!

One thing I am not sure about is how much to emphasize his academic needs vs the average learner or even the average gifted learner. Since his scores aren't very uniform it makes it harder for me to think of him as highly gifted (or whatever you might call it). Does it make sense with his scores to bring up the fact that the gifted program alone may not be enough for him (it's a weekly pull out)? I'm guessing we would advocate for subject acceleration in math and maybe sticking with his age mates for language based stuff, but what about science and social studies? He loves complex concepts and I anticipate he will be really bored learning lists of facts (what schools call history) and really basic science concepts. Do I go into the meeting thinking of DS as standard gifted or should I make it clear he has needs beyond what they are used to accommodating? How many kids with his abilities are they likely to have at the school?

I got an email from his current (gifted) school today about how great DS is doing on the current unit on thermodynamics. His teacher says he is able to understand and explain very difficult concepts, such as the idea of the universe as a closed system and that all energy that ever existed or will ever exist came from the initial singularity of the big bang. She was particularly impressed with his ability to come up with examples of the second law of thermodynamics, including putting an ice cube in a glass of water and waiting for it to melt before the glass of water achieves equilibrium. On the car ride home today he talked about entropy and some ideas about absolute zero and asked some questions I couldn't answer until I was able to consult with Google. I'm not sure what the public school is doing for science in first grade, but I doubt it is anything this interesting.

DS is really into the conceptual stuff and the big ideas, especially in math and science, but also in history. He loves learning about the evolution of humans and how the early people developed and spread throughout the world. I am pretty sure he knows more about these concepts than many adults. He also loves chemistry and genetics and anything to do with math theory, especially infinities.

With the IEP next week I'm totally freaking out about what it might actually mean for his education if we can't afford the gifted school next year. We don't hear about our financial aid for a few more weeks and if it isn't pretty significant we won't be able to use the gifted school again next year (tuition is over 26k with no aid). We had to sell our second car and have a strict budget (that only includes food) just to send him this year. If we end up getting less aid I'm just not sure we will be able to make it work. The fact that we are also paying over 7k in school taxes doesn't make the situation any easier to swallow. DS's happiness is our number one concern and he loves his current school, but realistically we need to consider all the options at this point.

So, a lot may or may not be riding on this IEP meeting and I need to treat it very seriously. I have multiple Google docs going with lists of ideas/concerns and important information about DS, much of which has come directly from the very helpful people of this board I guess what I still need the most help with is how to present his giftedness and what to push for academically. Based on conversations I have had with the people involved with the testing it sounds like they are quite willing to accommodate his areas of weakness (mostly writing), so I don't think I will have a battle there. I might also want to ask for adaptive PE, or to at least have it as an option if regular PE isn't working out. I'm pretty sure they won't have coding (his favorite subject) and if he wants to continue learning to read music we will have to do that at home as well. And obviously no Mandarin (and that's something we can't teach at home, lol!) This is getting scary, I hope we get the financial aid decision soon, I'm going crazy here

In answer to your much earlier question about fine motor: while it is true that all the scores are at least within normal limits, there is a huge disparity between his average motor coordination and fine motor skills and his very high visual perceptual skills, which suggests that there is some impediment to his demonstration of his exceptional perceptual skills when fine motor output is required. Perhaps this is a more nuanced interpretation, and one that some OTs would not accept as justification for supports, since they tend to see relatively narrow slices of a child's functional profile.

On additional writing assessments: I like the PAL-II for this age, as it distinguishes between various levels of writing complexity, including fluency.

The good thing about his interest in the big ideas of science and history is that these are relatively easy to supplement, with educational videos, books, and fun science websites. Coding and reading music actually aren't that hard to do for fun, either (don't know his level of coding, but Scratch is fun and age-appropriate). Reading music is just a matter of practice. If you can find middle C between the staves, you can figure out everything else. Rhythm notation is simple fractions.

The hardest thing to accommodate outside of school (without going full home/after school!) is probably the level of math instruction he'll need. My personal inclination would be to prioritize (among academic needs; obviously his holistic happiness is more important than any one academic subject) appropriate math instruction, and let the other chips fall where they may. He's only going to be in second grade, so there's plenty of time for higher-level structured science and history instruction in the future, just as long as the current level is not so low it frustrates him. At his reading level, he has access to a pretty rich range of books on any topic that interests him.

Hold on to your sanity...I think you'll all be fine!

Thank you so much aeh. It turns out I had the date wrong for the IEP meeting, it's on Thursday, not Monday. On Monday we have a parent teacher conference with the current school. For that meeting I am going to continue to advocate for reduced writing requirements (but I'm not expecting to get anywhere, it's pretty obvious they are not going to budge on the issue).

I definitely don't want to after school. I want DS to have a lot of free time to pursue his interests and to play, especially after spending 7 hours at school already. It's a little hard for me to work with him on things like programming, math, and reading music, because those are all weak areas for me (well, I've never tried programming, but it doesn't look particularly interesting). DS has already passed me in all 3 of those areas, but whether it's because he is exceptional at them or more because I have some sort of serious deficit is hard to say. Probably some of both. I am the one who still adds on her fingers, hasn't memorized multiplication facts, still has to say FACE to figure out what the treble clef notes are and can't even remember the mnemonic for the bass clef (despite years of playing piano and good ability to memorize songs), has poor handwriting/horrible pencil grip, can't spell even a lot of extremely common words correctly, took over a decade of practice to learn to type, and am entirely unable to learn another language (except, oddly, sign). I don't feel like I make a very good teacher

He has already seen all of the science videos I am familiar with, he's seen Cosmos, Bill Nye, and Magic School Bus. Are there any other good educational videos? I'd love to show him nature programs, but for some reason people seem to think the most interesting thing animals do is mate and we have not had that conversation yet. DS also loves everything I've told him related to anthropology and I'd love to hear of any resources for that as well.

I will definitely ask about the discrepancy between visual perceptual skills and motor output. They may not be willing to address it in any way, but it certainly doesn't hurt to bring it up and see what they have to say. I will request we do the PAL-II to better place him next year and to allow me to address weaknesses over the summer (hopefully that will get them moving, as me addressing concerns over the summer could potentially save them money in the long run.)

I'm also wondering if I might be able to convince them to give the optional verbal subtests in order to figure out if verbal areas in general are a weakness or if it's a weakness just in similarities. Right now I don't know if similarities or vocabulary is the verbal outlier for him. I also noticed that he scored similarly on word classes to similarities and I think they are measuring about the same thing. As much as I hate to say it, as a person who worked many years with autistic kids it makes me think about the weakness a lot of kids on the spectrum have with FFC's.

I'm also curious about the coding score. This was the only section of the IQ test I sat in for (I was trying to convince DS to squeeze in one more subtest as he wanted to be done for the day) and I noticed that DS quickly memorized the key and no longer looked up by the second row. I suspect that if he hadn't done this his coding score would have been much lower. I'm wondering if it is expected that the kid will memorize the key? The lady who did the test noted he made no errors on the processing speed tests and when I was there she commented that his symbols he drew for coding looked as perfect as the printed material he copied from. Just watching the coding test it was hard for me to understand how it could relate to intellectual ability. It seems to reward fast and sloppy writing and memorization of the key as well as an aggressive approach to timed material. DS appeared calm as could be and didn't appear to rush at all (not that DS has ever rushed, I think he has a congenital lack of ability to understand time constraints.) Plus I'm sure I would do terribly on it, so of course I'm not going to believe it is a good measure of intelligence :P