My daughter was given the WASI-II at age 7 years, 9 months for admission into the school's gifted program. She scored

Verbal 136
Performance 129
Full Scale 138

In the two years since, she has thrived in the program, which is pull out one day/week. We have been noticing some attention and maturity issues, more at home and in her regular classroom than in the gifted program, and wanted to get a full evaluation.

I got very upsetting WISC-IV results last week, at age 10. She got:

Verbal Comprehension 112
Perceptual Reasoning 110
Working Memory 113
Processing Speed 85
Full Scale 109
General Ability Index 113

Verbal Subtests:

Similarities Scaled Score 14
Vocabulary Scaled 14
Comprehension Scaled 9

Perceptual Reasoning Subtests:

Block Design 13
Picture Concepts 10
Matrix Reasoning 12

Working Memory Subtests:

Digit Span 13
Letter-Number Seq 12

Processing Speed Subtests:

Symbol Search 8
Coding 7

The tester was very dismissive, saying IQ is very fluid before age 10 and not being concerned about a 29 point FSIQ drop. The pediatrician, on the other hand, said that is a huge difference and they are actually pretty stable at nearly age 8, so one test must be wrong. He asked what her dad and my IQs were, and upon hearing that they are pretty close to her original score, said the higher score must be right because heredity plays a huge role. I realize this is dismissive the other direction.

The tester also said she does not have ADHD, although she scored quite distracted on his test, she still got enough answers right to be in the average range. My instinct says that she got so many right because she's bright, and that she really does have ADHD.

My daughter says she was not stressed at all on the day of the exam, although she did have trouble falling asleep the night before (this is not super unusual, though) and the morning of the exam was very stressful for me because we could not find the office at a large university because they were not answering their phones because, as it turned out, the building had been evacuated for a natural gas leak. The building smelled strongly, and we were re-evacuated, and when we returned, the building was still airing out and had a slight smell and the windows were open, making it somewhat warmer than usual. However, she says none of this bothered her. She was unaware that she was being timed or that there were any stakes at all to right or wrong answers, for better or for worse.

What do you think is going on?

Here are some considerations:

1. Your daughter's lowest (and in some cases, discrepant) subtest scores on the VCI and PRI were also the subtests that have no equivalent on the WASI-II. Of course, this applies even more to the entire WMI and PSI clusters. So, on some level, this is not exactly an apples-to-apples comparison.
2. The truth is somewhere in-between early IQs being so fluid that the first one is entirely wrong and heredity being so important that the second IQ is entirely wrong. Obviously.
3. There are other possible diagnoses that can manifest as difficulty with attention and wise decision-making. ADHD is one of them, but so are nonverbal learning disability, any of the sleep disorders, and even depression, anxiety, or allergies. You mention that poor sleep is a regular occurrence. I would start from there.
4. That is a marked relative weakness in processing speed, and ought not to be ignored. Did the evaluator give you any feedback about it? In a moment, I'll bring up some bigger issues about PSI, but I should also mention that it can have effects on the PRI, because Block Design is timed. One of the big differences between a 7 yo and a 10 yo on block design is the extent to which bonus points for speed factor into your ultimate scaled score. A 7 yo is not expected to get many of the designs correct, therefore any correct design within the overall item time limit will get maximum credit. Any 10 yo should be solving more of the designs, so bonus points for speed begin to figure into spreading the upper part of the curve.

On to PSI in general: Her PSI would be considered a normative weakness, in addition to being a personal weakness, and suggests further investigation for a learning disability of some kind, which then has implications for the impact of an unidentified 2e. The relative weakness in Comprehension tends to support this thought, as it differs from the other two VCI subtests in having substantially more language, and drawing on a certain amount of inferential learning from daily life and experience. Without knowing anything else about your daughter, I can't say exactly what the difference might represent for her, but it is definitely unusual.

If she does have a 2e, that would be another possible explanation for the behaviors; children who sense that they are underperforming, but can't figure out how to remediate it themselves, sometimes have difficulty paying attention, and may attempt to mask deficits with silly behavior.

Processing speed is particularly important to fluent written expression and automaticity in calculating. Fourth grade in many schools marks the transition to a significant increase in expectations for lengthy or analytical writing and math problem solving (which is much easier to do if one is not bogged down with calculations that should be automatic, like multiplication facts). Is it possible that the behaviors are symptomatic of difficulty meeting academic expectations, not necessarily because of intellectual reasons, but because of learning difference reasons?

I do not know if there is anything to this, but I'd read that:

"For girls, in particular, early IQ scores are more reliable than those obtained after they have been socialized into hiding their abilities.

At the Gifted Development Center, we have found that the optimal time to test gifted children is between the ages of four and nine. We find that at the age of nine, test scores for gifted children usually decline, sometimes as much as 20 points, due to (1) ceiling effects (test items not being sufficiently difficult to measure the full range of abilities); (2) perfectionism (particularly in girls), leading to unwillingness to guess when uncertain; and (3) the increased emphasis on crystallized (learned) knowledge and skills rather than fluid abilities (purer forms of abstract reasoning, considered innate)."

http://www.malonefamilyfoundation.org/whatisgifted_assessing2.html

This is why I have no plans (unless absolutely necessary) to obtain a second IQ test for my son.
aeh is the expert.

1. It sounds like she is performing well in her gifted program at school. That would have been my first question.
2. Has she had an achievement test and do her results more closely match the first or second IQ score? We had our son take the WJ III achievement because we wanted to see if there were significant differences between his IQ and performance.

If this were my DS and I had suspicions of ADHD or something else, I would consider a more comprehensive evaluation. If my DS were doing very well otherwise, I might chalk it up to a bad test day.

I don't know enough about IQ or gifted programs to say this with certainty, but if your daughter is doing well on achievement testing and in her school program, I would find the second IQ score to be suspect.

In 3rd grade, my daughter scored in the 99th percentile on the Terra Nova portion of the state testing. We are still waiting for 4th grade scores, which should come in September.

How long were you in the building while it smelled of gas? It's possible that the gas affected her cognitive abilities (it does that).

I was gassed once in college and went to a language table for dinner right afterwards. I was pretty good at this language, but literally could not put three words together correctly that evening. I think I went to bed right after dinner and slept all night.

I wasn't aware of how I'd been affected until the next day.

We were in the building for about 10 minutes while the smell was strong, and then were evacuated for another half hour to 45 minutes. When we went back in, the smell was faint and the windows were open.

aeh, I think the evaluator described it as a personal weakness. He said that because she worked very slowly but made no mistakes, he attributed it to anxiety. Even when I called back later after doing some research, he did not think anything was wrong. He even said during the follow-up visit that that he was looking for major problems during the IQ test, and that since she was average/high average, he didn't see any reason to worry. He said on the later phone call that because the WASI is abbreviated, he places less weight on it (true, but four of the subtests are identical, and those scores were dramatically different, as well).

He is a psychology resident who has just completed his residency, but his work was still being reviewed by faculty until his title change was official.

Some other things I didn't love about the evaluator--he cut and pasted a lot of the report, leaving "his" instead of "her" and some grammatical errors (subject/verb agreement) that made it obvious he was recycling reports.

One test he administered involved DD looking at pictures and telling a story about them. When she left the test, she told me that she was well aware the last picture had been bunnies, but she pretended they were cats because she is obsessed with the "Warriors" series and wanted to tell a story about that.

At the follow-up, he said that the story had been unusually well-crafted, and that he had been surprised that she admitted that she had based it on characters from a book. He interpreted this as her being eager to please and get approval from an authority figure, so she plagiarized a story from a book. It's true that she loves praise and approval. However, she also just really loves to talk about those books. I asked her later if the whole story was from the books, and she said not at all. She based the characters from the book, but made up a new story about them. It was basically "fan fic", although she doesn't know that term. So, while he was right that she craves approval, he was completely wrong in assuming that the whole story was plagiarized and that she wasn't capable of making a story like that up on her own. And he didn't ASK her if the story was original; he just assumed that "based on" meant "stolen".

You may wish to raise your concerns with the test center.

My daughter is a fluent writer, with good handwriting. She is a poor speller, and can spell the same word wrong more than one way on the same page. However, she is still one of the better spellers in her class, so maybe standards are just low these days.

In math, she does have to work a bit harder. Multiplication tables do not come naturally, and she makes some mistakes. Even her better IQ score does not have her as HG, so I'm not sure what level of math performance is normal for a bright/MG child and what is a processing issue.

I do not know about underperforming. Most of her attention issues come from executive function--she has difficulty staying on task for undesirable or tedious tasks.

I do think there's a 2e situation, but the evaluator diagnosed General Anxiety Disorder and not ADHD. She was very distracted (as low as the 4th percentile) on the PIA, but because she still answered accurately in about the 50th percentile, he said no to the diagnosis.

Just a few random thoughts for you:


It could be that the reason you notice the attention and maturity issues in her regular school program vs in the gifted is due to the way the class/day is structured and the types of material covered, not just due to academics - this is a total *guess* of course, but the instructional approach and the types of projects, and amount of noise, activity, free-thinking etc that was allowed in our school district's gifted elementary school pull-out was extremely different than much of what went on in the classroom and it was in many instances an easier environment for kids who had ADHD or similar challenges to cope in. The activities also focused a lot on brain work, experimenting and discussing rather than the rote types of worksheet, repetitive exercises, etc that went on in regular class - so sometimes for kids who had LDs even (like my 2e ds) it was an easier place just to be, much less anxiety provoking than a regular classroom.


How are you making the determination that she's one of the best spellers in class? Based on what you see in written paragraphs/stories of other kids etc, or based on spelling tests? Memorizing words for a spelling test is a bit of a different skill than spelling while writing - when you're in the middle of the act of writing there are quite a few other things to pay attention to such as grammar, punctuation, neatness, and of course, the ideas you are trying to put into the written words. I don't think it's terribly uncommon at your dd's age to spell better for tests than while writing. One thing that was different in our elementary school today than when I was in elementary school is that our kids' teachers didn't make them over-think spelling while writing, they wanted them to focus on ideas. Judging growth and ability in spelling accuracy was left for spelling tests. When they had writing assignments, the teachers usually had them circle two words that they found that were spelled wrong and correct them and that was it, no worries about the rest. When our kids were doing writing assignments for homework we (parents) were specifically told not to stop them while writing to correct spelling.



If you make a list over time of the specific tasks she has the most difficulty with staying on task, do you see any trends re the type of task? Any ideas of what makes the task undesirable or tedious?

With both symbol search and coding relatively low scores for your dd, I'm wondering - is there any possibility she might have a slight vision issue? Those tasks both depend on vision.

Was there any kind of behavioral survey completed by parents/teachers included as part of the eval? Was there any executive function testing other than the ADHD test?

It sounds like you had an inexperienced, disinterested tester. If the degree to which you're seeing attention issues in your dd seems large to you, or if it's interfering at school, it would be helpful to have a more in-depth eval which would look into specific issues such as why the processing speed scores (both subtests) seem low relative to the others, etc.

I'm also just curious what the test was where the tester asked your dd to make up stories - it doesn't sound like anything I've heard of before, so just curious!

Best wishes,

polarbear

Multiple spellings of the same word, especially multiple unique misspellings, is a clinical indicator that I would not ignore, even if she is one of the better spellers overall in her class. Most poor spellers use the same misspelling repeatedly in any given session of writing. (As a result of weak spelling strategies.)

Does she understand multiplication, but struggle to memorize them to the point of automaticity? Those are two different situations (poor conceptual grasp of multiplication vs poor fluency with multiplication).

Anxiety does have impacts on attention and working memory, and certainly is a reasonable hypothesis. There are also some indications from MRI data that it has some negative interactions with mathematics.

Additional information I would look into would be spelling skills: Phoneme/Grapheme Knowledge on the WJIII, Spelling on the WIAT-III, KTEA-II/III, WJIII/IV, or TOWL-IV would be some options. Academic fluency skills: Math Fluency, Writing Fluency, Reading Fluency on the WJIII/IV or KTEA-III, or Math Fluency, Oral Reading Fluency on the WIAT-III, or various dimensions of oral reading on the GORT-5.

Basically, I think you need more information to be able to meaningfully reconcile the two assessments you have had so far. This information should include academic achievement testing, including some of the areas I've listed above, and probably slightly more in-depth social-emotional assessment and executive function, given the Dx of GAD. Whether you pursue additional assessment depends largely on how unhappy or stressed the existing schooling situation is making your daughter and your family as a whole.

I'm a bit embarrassed to admit that I'm basing my opinion on her spelling compared to peers on school spelling bees. She's usually a finalist or runner up in her class of 25 (mainstream class).

Just realized I missed a couple of posts.

To the story-telling task: this may have been a projective social-emotional measure, which would then explain a bit better why he felt that GAD was a better Dx than ADHD. Keep in mind that the majority of apperception tests (TAT, CAT, SAT, TEMAS, Roberts-2), with the exception of the Roberts, have no objective scoring scheme, so they rely solely on the clinical skill of the examiner.

Alternatively, it could have been an expressive language test, which would relate to his comment on the complexity of her response.

Which one of the above it was should be evident from the list of assessments administered.

Reflecting on what you've posted so far, I also wonder what you would see if an SLP looked at her expressive language versus her receptive language, as that can be a factor in the difference between the Vocab/Sim and Comp subtest scores on the WISC. And could factor into the reported inattention.

And finally, the cut/paste reports are one of my pet peeves. That, and computer-generated reports. I write my narratives from scratch, for each student.

It was the Children's Apperception Test.

The undesirable tasks include stopping reading to get ready or do chores, or even have a conversation if she's not in the mood.

She also is very impulsive and has difficulty reading social cues. At this point in her life, she is socially affected much more than academically. Socially, she's struggling. Academically, she's been doing fine, although I'm obviously concerned about latent issues that would cause trouble in the future.

Multiplication problem is fluency. She gets the concept, but can't always recall them quickly and has to figure them out manually.

Ah, that would explain the relatively lower Comprehension and Picture Concepts scores (which also happen to be the subtests not on the WASI-II). Comprehension draws largely from non-academic, experiential knowledge, and thus has a lot of overlap with social reasoning. Picture Concepts is also an every-day life kind of task, and requires examinees to make connections between visual images of common objects. The two together suggest that she currently is not as skilled at reading nonverbal cues (largely visual in nature) in social situations, or at the related skill of translating such social information into language. Weaknesses in social perception or social problem-solving are not all that unusual in children with LDs or ADHD (although we usually associate this with ASDs).

I would still be concerned about her academics, as she goes into the next stage, especially with automaticity in spelling and calculating, which sound vulnerable to me, from your description. At some point in the very near future, when all of her classmates have mastered multiplication facts, her lack of fluency will begin to hold her back in her cohort, as problem-solving and multiple manipulations become the rule, rather than simple calculations. Something similar often happens with spelling. Although she is the top in her class, if she continues to make unusual spelling errors, whether due to lack of automaticity, lack of effective spelling strategies (there is only so far you can go with rote memory), or weak self-monitoring (characteristic of ADHD/executive dysfunctions), teachers will begin to judge her on her spelling rather than the content of her writing, or she will begin to self-censor her vocabulary to reduce the chance of spelling errors. Neither is a desirable outcome.

You might consider having additional evaluation in executive functions done. There are children who are not ADHD, because they don't have clinically dysregulated attention, but do have deficits in inhibition (impulsivity). If you do pursue further eval, make sure to mention that impulsivity is a concern as distinct from ADHD.

Do you think that the test was scored/administered accurately, then, and the lower numbers really are indicative of her true score? Because I still can't grasp why, at the very least, the four sections that parallel the WASI wouldn't have been fairly equivalent to her WASI scores of 136/129.

If she does have these deficits, are they treatable?

I don't see any evidence that suggests the test is invalid, but that doesn't mean the results are necessarily indicative of her true ability. I think what you may be looking at is a 2e situation, where some of her gifted-type traits are being masked by her (I'm guessing) executive dysfunction-type traits, whether the latter is ADHD, disinhibition, or possibly another dx, like NVLD or ASD. (Obviously, I can't diagnose her over the internet. ) And vice versa.

Oh, and yes, she can learn compensatory strategies for her relative weaknesses, like all functioning adults eventually do. She may just need more explicit instruction in reading social cues and self-monitoring. Fluency, unfortunately, comes only by practice, but she can certainly improve there too.

Update: I met today with her regular psychologist, who had reviewed all the papers. She spoke with a colleague who is a supervisor in the university program that provided the testing, and he thought the evaluator was just inexperienced enough not to see the "gray" areas in her responses. She feels that ADHD is as much on the table as GAD, and agrees that her abilities are masking the symptoms on the VAI.

We are going to wait and see how she does with more cognitive therapy for social and attention skills, and be ready to jump into more testing when we have a better idea what's working and what's not.

Thank you so much for all your help.

DD8 has ADHD and also had processing issues. It's not necessarily obvious in a 1 on 1 situation like an IQ test. There is a person right there keeping the child focused and on task. DD's main problem in the classroom is all the distractions and activity. The difference between her processing speed and GAI on the WISC was something like 60 points. Which in many/most cases is probably not normal. She also has problems with math fluency and remembering the math facts. If you ask what is 9+5 she may very well give you a blank stare for a few seconds even though it's not a hard question. Her working memory was fine, 96th percentile I think so those are two different issues. Some neuropsychs do computerized testing for ADHD which you could look into. It seems more objective to me than someone's random observations. It measures how long a child can sustain attention and how impulsive they are. DS had this testing and he tended to slow way down in his responses after a while, indicating possible inattentive ADHD. Since medication has been so helpful with DD we are doing a trial of meds with DS as well. If they don't help much or at all, then I will assume his issue is something other than ADHD.