Gifted Issues Discussion homepage Forums Identification, Testing & Assessment Another thread on discrepancies in scores?

I have test results for a kid that leave me just about as confused as I was before we did the testing, because the things that the neuropsych told me should be correlated just don't seem to be.

E.g., WISC: working memory: 42 %ile, Processing speed: 99.3 %ile
WRAML-2: Story memory recognition: 95 %ile, Verbal memory recognition: 9 %ile (yes, single digit 9)
WRAML-2: Story memory: 95 %ile, Picture memory: 16 %ile
ELLA: Phonemic awareness/processing: 6 %ile, Random automatic naming: I haven't gotten a %ile score yet, but she did it in roughly half the "typical" time, so I'd wager pretty good %ile ranking.

We initially sought evaluation for concerns over reading struggles and possible affective mood disorders. The evaluator commented in the report that the child's anxiety was palpable and the affect was "mildly dysphoric," so I'm almost certain they underperformed overall - but not enough that I can make sense of these discrepancies.

I guess I'm just trying to figure out how to understand this child and serve them better, in light of their reading and mood struggles. There has been concern over ADHD as well, and brother is ASD-2, but we haven't pursued further testing yet. I will confess that I was relatively surprised by the WISC scores. While I had nothing concrete to base this on, but I've always had a "gut" feeling that this child is considerably brighter than my older child, who had a FSIQ in the solid mid 130s (though also containing a range from 50-99%ile in scores, the few scores <80 %ile were clearly outliers in that case, in contrast with my younger child, whose report is characterized by these vast discrepancies). I'm not concerned that the results weren't what I expected them to be - I'm more concerned about figuring out what this means, since the professionals I've spoken with thus far have indicated that this is a fairly unusual profile, and have not offered me much of an explanation regarding what it actually means.

Thank you very much!

ETA: For what it's worth, she is homeschooled, so I have considerable latitude in changing things up in order to help her better. My main constraints are just my other kids (two younger kids the older ds8 with ASD).

I'm responding primarily to bump to those with greater expertise, but I will say that wildly scattered scores are pretty normal around here. That extreme unevenness probably brought quite a few of us to this board seeking help. So welcome!

I'll leave interpretation to real experts (whatever would we do without aeh?), but I will just note that my kids have many similar extremes, including one with an even larger working memory/ processing speed split (but in the opposite direction). I'm guessing yours can use that amazing processing speed to compensate for a whole lot of things, and will hook into other kinds of memory to do certain kinds of tasks.

My DD (who is dyslexic and ADHD) also had wildly divergent memory scores, depending on what exactly was being tested. My understanding is that it's pretty common for kids with ADHD to be far better at retaining meaningful information (like story details) than disconnected data, and we could certainly see patterns of notable strengths and weaknesses across her results. If you want to dive into the memory weeds, the first main section of the Eides book reviews many types of memory in detail, what they do, what it looks like if they are impaired, and how to compensate. It's fascinating (albeit like reading a dictionary), and available in a lot of libraries (https://www.amazon.com/Mislabeled-Child-Solutions-Childrens-Challenges/dp/1401308996).

I can't comment on the test scores, although I am eagerly awaiting hearing from those more experienced.

Being unable to express oneself academically, being unable to participate fully - such as not reading well - can be extremely difficult for children to cope with. I have a nephew with probably dyslexia which is still not properly diagnosed at age 10 (but parents are working on it). His lack of reading ability has been emotionally devastating, and if one wasn't aware of his academic and related social difficulties, he would appear to have a mood disorder, or oppositional defiant disorder, and certainly an anxiety disorder. His parents are withholding judgement on that until his academic issues are addressed, although he is receiving supportive therapy to help him cope in the meantime. I would suggest probing the discrepancies in these reports before coming back to a mood disorder point of view.

Once a mood disorder is noted, it can be very difficult for a person's health to be properly managed. I was victim to this phenomenon. I was misdiagnosed with a mood disorder without proper evaluation and was tossed around the mental health care system for 14 years with a dozen or so diagnoses. Turned out I have a *physical* health problem that affects the autonomic nervous system. I happened to stumble across it on google, then was lucky enough to convince a doctor to refer me for testing.

Mood is often a product of circumstances and overall health. I can't help interpret what the test scores mean in terms of your child's abilities, but I would suggest there is a good chance that they mean your child's anxiety and affect are only a symptom of the underlying problems that the test discrepancies indicate.

Thanks for the recommendation. I'll check my library for it!


These are all good thoughts. Thank you very much. We are not eager to diagnose a mood disorder. I only wanted to mention them in light of why we decided to do some testing. We have been keeping notes on her various mood struggles over the years, but really only pursued testing for the reading struggles and possible dyslexia. Bipolar does run in our family (three of my siblings, both parents, three aunts, and two grandmothers), so I don't want to be naive that it might affect my children, but my husband and I are absolutely only going to consider an actual mood disorder evaluation as a last result. We will be starting OT for sensory issues and some other stuff over the summer, and I'm hopeful that might improve her mood issues, or at least give us some insight into what's going on with her.

I guess now I'm even more interested to hear what others might have to say about this, because I have no idea what kind of underlying problems could result in either the above discrepancies or her mood issues. We are seeing a psychologist who does CBT, but after 3ish years of therapy, the most consistent thread in our sessions is that (a) DD must have learned these behaviors as a way to get what she wants, and (b) I seem to be doing everything right (every time I bring up a situation, say how I responded, and ask how I should've, the response is usually that that's exactly how the psych would've suggested I respond). It's unclear to me, as of yet, how (a) & (b) can simultaneously be true, since I feel like she couldn't have learned these behaviors if I was doing things right... But that's perhaps a conversation beyond the scope of this current thread.

4KK, I'm going to organize my response into a few categories:

1. Dyslexia: the classic three legs of effective decoding are phonological processing/phonemic awareness, phonological memory/working memory, and rapid naming. Your DC appears to have exceptionally strong skills in one of the three legs (RAN), average skills in another (auditory working memory), and significant weakness in the third (phonological processing). This is a profile that would quite frequently be found in learners with word-level reading difficulties (aka, dyslexia). So on that level, the evaluation findings do answer the question of whether there is evidence for a genuine reading difficulty. The good news is that phonemic awareness is the easiest of the three legs to remediate. As you are homeschooling, you are in a good position to intensively remediate. On my go-to list would be:

-All About Learning's reading and spelling curricula, which are designed for open-and-go homeschooling, and are comparatively affordable. Intended for 20-minute individual lessons 3-5 days a week, they are also easy to adapt for individual needs, by either accelerating or slowing down specific lessons.
https://www.allaboutlearningpress.com/
-Logic of English's integrated reading, spelling, and writing curriculum, also designed for homeschooling, with options for schooling multiple levels at once.
https://www.logicofenglish.com/

2. Memory: the memory measures exhibit a consistent picture of strength in narrative memory, and weakness in most other areas of memory. Your DC's verbal list recognition score suggests that encoding and retaining a list of disconnected words over a 30-minute-plus delay was much more challenging than encoding a retaining verbal information in presented in a meaningful narrative context. Immediate memory of visual elements, even in a familiar visual context, was similarly challenging, probably because the images weren't in a narrative context.

3. Thoughts on your gut feelings, and other comments: you haven't posted the other evaluative data (nor do you have to if you prefer not), but I would suspect that this child's verbal cognition is quite high, based on the story memory numbers. To platypus's comment on types of memory, it seems likely that your DC has been using strengths in narrative/associative memory and processing speed to mask challenges in fundamental decoding skills. The combination of the two strengths makes it easier for some learners to read by guessing from context, and by rapidly retrieving memorized words as whole words. This works up to a point, but is highly inefficient long term, and diverts substantial mental energy away from comprehension.

To address the (a) versus (b) issue, a more appropriate viewpoint is "children do well if they can". A fabulous resource for working from that point of view and identifying lagging skills is The Explosive Child book and corresponding website livesinthebalance.org

I have also found the Boys Town parenting hotline gives advice that is not carrot/stick or reward system.

I would also suggest the book "Why Bright Kids Get Poor Grades" because your child may have risk factors for underachieving. (And underachieving is a cause for mood problems and poor outcomes )

If you are looking for CBT for kids that is actually CBT, the workbook "Think Good Feel Good" is a good one. It is best for tween years because there are examples of dating, spending time together in boy/girl pairs. With a little parental editing it can be used for younger children.

Thank you so much for all your input!

On Dyslexia: we previously used Spalding's program (which was initially one of the reasons I couldn't figure out why she was testing as if I had taught her with a whole-word method, since *everything* is done phonetically there, except the word "eye"...), but in hindsight, I think it was too taxing on her memory to start a program by learning all the phonographs and all their sounds. Thankfully, we are friends with a certified educational therapist / dyslexia tutor, and when she found out about dd's struggles, she offered to start tutoring her with an Orton-Gillingham based program for dyslexics twice a week at no cost to us. She'll start this next week, and I'm cautiously optimistic about it! I have looking into both AAR and LoE in the past and will talk with the dyslexia tutor about what she recommends after they have some time to work together for a while.

On Memory: What aeh said makes sense. So, in the interest of figuring out "what comes next", it seems then that my teaching needs to incorporate context to a greater extent. We do everything in context, usually, because it just makes sense to me that that's how kids learn - but it seems even more vital for her to have things in context, so I should be more conscientious about this, if I want her to remember things.

On Mood: We did read the Explosive child, and I remember being really blown away regarding the "kids do well when they can" concept. Before we started her dyslexia eval, we would've checked all those "bad-attitude" tick marks for her: lazy, doesn't try, doesn't pay attention, rude for no reason, etc. It started to make sense once we really understood how frustrated she was over not being able to read, and how discouraged she was in feeling like she was never going to be able to read. I feel like I could laugh at the title "Why bright kids get poor grades" because that's exactly what I thought when I initially got her WISC scores back! I mean, I *knew* she couldn't read well, but I thought she was going to blow the test out of the water, otherwise! I will try and see if our library has it.

On other things: What tests make up verbal cognition, exactly? I didn't see something with that specific title on our score reports, and I don't have a ton of experience, so I'm not really sure how to judge if her verbal cognition is high. Verbal comprehension was only 113 (not surprising, because she often zones out when others are talking or just blows right over them with what she has to say), and her Verbal Learning and Verbal Learning Recall were both exactly 50th %ile. She made no errors on the Environmental Symbols, Letter-Symbol Identification, and Word Reference Association subtests of the Ella, and scored well on Word Associations. On her CELF, I have standard scores of 13 on Understanding spoken paragraphs and 14 on Formulating sentences, but all I know is that the average is 10, so I don't have percentile rankings or know what the standard deviation or anything is. But I don't know if any of these are actually part of what makes up verbal cognition.

PS. Everything else you said regarding her memory and processing speed trying to compensate for fundamental decoding skills is exactly on point and why we pursued an eval, aeh. She tried so hard to figure things out based on context and pictures on the page, and she'd just throw out any number of words that might "fit" the sentence instead of actually reading the words in front of her (even when they were simple 3-4 letter words). It was just such bizarre behavior for me to witness after doing nothing but phonics with her every day for 2 years! lol. Silly child. I'm only glad, at this point, that we had all that phonics for that time. I can't even begin to imagine how bad her reading struggles would currently be if we had done anything with less phonics in it... The idea actually makes me shudder a bit...

AAR and LoE are both OG-based reading programs, but if you have an OG-certified interventionist, that's even easier. (And no-cost, to boot!)

Verbal cognition would be what the WISC-V VCI assesses, with some overlap with the CELF-5 measures. So it appears that she is testing in the high average range in verbal cognition, which is strong, though not as strong as her narrative verbal memory. One of the confounds, though, depending on where her reading stands in comparison to age and ability peers, is that most learners with high verbal cognition also have high reading skills (obviously not all, or we wouldn't be having discussions about dyslexia!), which affects verbal knowledge skills, especially vocabulary. It's not possible to measure pure verbal reasoning ability without including some acquired/achievement skills. You may find that, if her reading is sufficiently remediated in the next couple of years, that her assessed verbal reasoning/cognition goes up as she develops better access to text and the verbal knowledge that it contains. Also, her personal weaknesses in rote and working memory for information that is not contextualized may be affecting her listening comprehension, which also affects verbal knowledge and vocabulary.

I would suggest that, as you are trying to increase the context for her instruction, that you start with personally-relevant application scenarios and big picture previews of new concepts, skills, and knowledge. She may also do well with literature-based curricula or videos as the backdrop for specific history and science content, as it will help give her a narrative context. (My kids loved the animated Liberty's Kids originally aired on PBS, for example, and others have enjoyed Drive through History, or the many animated Magic School Bus vids.) (And of course, you will have to do many as read-alouds, at this point.) You may also find that pre-reading/-listening strategies that activate comprehension may be helpful, such as KWL (know/want-to-know/learned) charts. Search "active reading strategies", and you should find a number of techniques of this kind employed by experienced teachers.