We are getting ready to undergo another round of testing for my DS8. I was reviewing his WISC IV results from 2.5 years ago and his VCI stood out as needing further explanation from the knowledgable folks here.
VCI
Similarities 13
Vocabulary 15
Comprehension 11
Word Reasoning 19
To my layman eyes that looks like a significant intra index spread. Why comprehension so low? Why Word Reasoning so high? The tester didn't explain anything. IRL we see a highly verbal kid and a voracious reader who struggles with EF and has ADHD like qualities. WIAT III achievement reading scores were all 140+.
Because I didn't have confidence in the tester (long story) he took the DAS II 8 months later. His Verbal T scores seem to be the opposite?
DAS II
Verbal Comprehension 78
Naming Vocabulary 56
Any insights would be appreciated!
thank you.
Not sure I'll be much help but I found myself with a similar [but not identical] question a little while back. On the WISC-V we had VCI subtest scores of 19, 19, 18 and a 12 [might have been 11?] on Comprehension. It was really odd. Our child's alphabet soup includes: E/PG, ADHD, Anxiety and Stealth Dyslexia.
I then found the document linked below which sent me down a rabbit hole I'd thought we'd ruled out - ASD+LD.
http://images.pearsonclinical.com/images/assets/WISC-V/Q-i-TR11_WISC-V_ADHDAUTL_FNL.pdfBut we had previously ruled out ASD so this really threw me for a loop but our clinical psychologist firmly insists that we are not dealing with ASD at any level on the spectrum [rationale: TOM and perspective taking are in-line with cognitive age which means it is years ahead of actual/chronological age].
Ultimately, the psychologist feels that the low comprehension score is symptomatic of the ADHD and Dyslexia ... the neurobiology of those differences combined with age [6] and extreme asynchrony make for delayed development of this skill. The psych believes that once the dyslexia is treated the comprehension will follow [yes, even though the comprehension subtest is presented orally, the psych believes it is all tied together somehow].
I'm not sure that will help but thought I'd share in case you notice any similarities. Have you read much on Stealth Dyslexia? If not, this will get you started ... I know you said your child is a voracious reader but that does not rule out Stealth Dyslexia so definitely check it out! Just in case
http://www.davidsongifted.org/Search-Database/entry/A10435
Oh, and a DAS II Verbal Comprehension score in the 78th percentile is fairly consistent with the WISC-IV score. If I remember correctly an 11 or 12 on the WISC-V [not IV but I assume they are similar] VCI Comprehension subtest is around the 75th percentile.
ETA: errrr ... just realized I don't know if the 78 you reported was a percentile or not! So just ignore me if I'm totally wrong!! Hope I'm not confusing things ... hopefully someone much more knowledgeable than me will respond!
Thank you MinuteByMinute. I appreciate your thoughtful reply. And thanks for the link on Stealth Dyslexia. After reading the article, I am more confused than ever. The kid reads constantly, way above grade level with comprehension.
The 78 is a t score from the DAS II which I think is 99%?
Hence the confusion. The two tests seem to give opposite results? DAS comprehension at 99% WISC IV comprehension at 63%?
To further muddy the waters he had a 140 on WIAT Reading Comprehension and is an excellent speller. Definitely struggles with fine motor and writing is a disaster. Can do it when forced but hates it,
Definitely struggles with fine motor and writing is a disaster. Can do it when forced but hates it,
It's possible that the scores are reflecting your ds' ability to take in information or output information, rather than measuring the actual skill that the subtest is designed to measure. If you google WISC-IV + subtest name + description you should be able to find a specific description of each subtest. I found it really helpful to make a chart of subtest score vs type of output (and type of input) - you've mentioned that your ds struggles with fine motor and writing. See if there's a correlation between lower scores on timed subtests or subtests that require written output. You can do the same for reading vs verbal questions.
Best wishes,
polarbear
Re the WISC vs DAS:
First off, DAS subtest scores are usually reported as T scores (x = 50, SD = 10), which would make the verbal comp score 2.8 SD above the mean, or equivalent to about an 18 on the WISC, and the naming vocab score equivalent to about a 12.
Secondly, your child appears to have been given the Early Years version of the DAS (which was appropriate at age 5), which is quite different from the WISC. While this is the standard battery for five and six year-olds, in the case of suspected GT, I might have used the out-of-level norms (which are legitimate original norms) and administered the School Age battery instead, for its higher ceiling. The verbal tasks from that battery are also more directly comparable to those of the WISC.
Naming vocab is a picture vocabulary task, consisting only of nouns (obviously), whereas the WISC vocab is an oral task requiring verbal definitions of a range of words, including both concrete nouns and more abstract concepts.
Verbal comp is more like a task of following verbal directions, using toys and objects likely to be familiar to a first-world kindergartner. Many responses involve simple motor manipulations. Comp on the WISC is another pure verbal task drawing on knowledge of social conventions. A certain amount of life experience generally is necessary to score very high on this.
Re WISCIV VCI intersubtest scatter:
There are three verbal reasoning tasks (Similarities, Comprehension, Word Reasoning) listed here, and one verbal knowledge task (vocabulary). Similarities is a task of verbal concept formation--take two words and identify their commonality or category (e.g., three and four are both numbers). For comprehension, students are given a brief scenario, societal practice, idiom, etc., and asked to explain what it means, what expected behavior is, or the purpose of the convention. Much of this is learned from life, not books, and is strongly culturally-bound. Word reasoning is like progressive riddles. You try to guess a word (it may be an object or a concept) from a verbal clue. For most of the items, you can test your guess a couple of times, receiving additional clues after each guess.
It looks to me (totally blind, of course, since I didn't see it happen, and I don't know your DC!) like receiving feedback was extremely beneficial to your child's ability to demonstrate verbal reasoning skills. I also wonder if the low WISC Co score reflects the challenges in picking up cause-effect relationships in everyday/social situations that are often observed in individuals with ADHD/EF deficits. ASD is not the only profile that manifests as social skills weaknesses. ADHD does too, though for very different reasons.
To give a "for instance" on what aeh is saying - - - -
It's helpful to note that the WISC-IV Comprehension test is not what most of us would think it is. The sub-title is actually "Practical Social Reasoning". Once we figured that out, it made sense for this sub-test be a major low outlier in my DS's verbal index. His Comprehension score did in fact increase quite a bit as he gained life experience between the two times he was tested (ages 8 and 10), but still remained lower than his other verbal scores by a couple of standard deviations. The challenges that undoubtedly feed into the lower Comprehension scores just get more apparent as he grows older (12 now) - extreme inattentive ADHD, anxiety, weak social skills, and probably expressive language deficits.
For comprehension, students are given a brief scenario, societal practice, idiom, etc., and asked to explain what it means, what expected behavior is, or the purpose of the convention. Much of this is learned from life, not books, and is strongly culturally-bound.
I also wonder if the low WISC Co score reflects the challenges in picking up cause-effect relationships in everyday/social situations that are often observed in individuals with ADHD/EF deficits. ASD is not the only profile that manifests as social skills weaknesses. ADHD does too, though for very different reasons.
The sub-title is actually "Practical Social Reasoning".
This makes a ton of sense for my DC. Limited social experience due to asynchrony, ADHD, anxiety and extremely limited social experience [circumstance and choice]. I had not truly bought into the ADHD diagnosis until very recently so it was not a substantive part of my research to understand the low Comprehension subtest score [although AEH did respond to a post of mine on this topic and explained that the Co subtest could be affected by life experience]. Very interesting. And, for us, the best explanation of test results!
I just thought of something else that I thought might be helpful. Our clinical psychologist recommended reading lots of fables [Aesop, etc.] and then discussing them with DC as a means to help further comprehension.
Thank you MinutebyMinute, polarbear, Platypus and aeh. It is so wonderful to have a resource like this forum with people who are so knowledgeable and willingly share their knowledge.
Meanwhile, I am more confused than ever! I think what everyone is saying is that comparing these two tests is not apples to apples since they are measuring different skills.
The one takeaway (I think) is that the scoring may be consistent with ADHD which we see in flashes in real life but I am not totally convinced.
On the dyslexia angle, can a child love reading (8 hours a day if I let him), have high scores on reading comprehension, be an excellent speller and still have stealth dyslexia?
This one threw me for a loop since dyslexia was the one thing I was sure he didn't have... He does have Visual Processing Disorder and I think there is an overlap.
Should dyslexia be part of the diagnostic work up? What other tests besides ADHD, Cognitive and Achievement?
Mulling over this...I think I'd consider speech and language testing, too, as there is some suggestion of a difference between expressive and receptive language, with a possible relative weakness in expressive language (naming vocabulary, comprehension, writing vs vocabulary, verbal comprehension, and reading comprehension). How'd he do on the the oral language subtests of the WIAT? Your description does suggest a lower probability of dyslexia. The overlap of dyslexia with visual processing disorders is mainly in presentation, not in underlying deficits.
aeh - thank you for your help. Here are the WIAT Scores:
Oral Fluency 135
Word Reading 146
reading Comp 140
Pseudoword decoding 126
Spelling 124
Sentence building 112
Do these scores along with cognitive scores suggest a need for a dyslexia workup in a voracious reader?
I don't want to miss anything when we test but I also don't want to spend time chasing something that is likely not the source of his struggles.
I am thinking he is more likely ADHD with VPD and maybe dysgraphia. What throws me on the dysgraphia is that he can write just fine (cursive and print) when he is motivated which is rare. Prefers typing.
I am so dizzied up right now. The more I probe the more confused I am. Hoping the Neuropsych testing can give us clearer answers. I want to make sure the psych administers the right tests.
Thank you!!
I am thinking he is more likely ADHD with VPD and maybe dysgraphia. What throws me on the dysgraphia is that he can write just fine (cursive and print) when he is motivated which is rare. Prefers typing.
I'd be careful about this. You will hear it said that the only consistent thing about 2e kids is their inconsistency. And it is very, very common to have real disabilities dismissed as a lack of motivation. It must be even worse to have that coming from your parent than from your teachers if there is actually a disability.
In the absence of any other noted concerns regarding reading, I would tend not to reach for dyslexia as an explanation in this case. His phonetic decoding (pseudoword decoding), reading fluency, and spelling scores are quite good, which are the main things I'd be checking for compensated/stealth dyslexia. Writing, on the other hand, might bear some more investigation, as the sentence building score is on the low side compared to his reading skills (though still at the upper end of the Average range). This is also consistent with the hypothesis either of some kind of expressive language concern, or a dysgraphic concern. Are there oral language achievement scores? (Listening comprehension and oral expression)
Regarding his handwriting: if you observe when he writes "just fine", there may be other patterns. For example, depending on the dysgraphic, a student might be able to write beautifully when composing text very slowly, or when copying text, or when writing individual words, but not when composing lengthy or complex analytical or creative writing. Many dysgraphics can spell, write neatly, or generate meaningful language, but not all at the same time.
ElizabethN you are spot on. Thank you for the reminder. It's just so hard to know what is a disability and what is a choice by the child. The school believes it is a motivation issue. That is why we are doing a fresh eval. To understand him better.
aeh - no other language achievement scores. He says he knows what to say but needs to say it verbally or have someone scribe for him. The school won't allow accommodations.
Thanks again for your wisdom. Will use it with our neuropsych.
Thinking of Paul Beljan since he is close and specializes in 2E.
I am always highly suspicious of "motivation" issues. No child instinctively prefers to do badly. We are almost all born with a desire to succeed, to feel good about ourselves and proud of what we do, and to make the adults around us proud, too. When a child "chooses" to fail, it usually means there is a problem for them with the alternative. The challenge, of course, is figuring out what that problem is.
Telling the difference between "won't" and "can't" is extremely hard. Especially as kids get older, and unrecognized issues compound and have more complex and diffuse effect on seemingly unrelated behaviours. However, if you step back and make an assumption that it really is "can't", and then stay with that assumption for a while and hunt hard for possible barriers, it's amazing what you may find. I find I need to let go of the discipline/ behaviour lens before I can really work with my kids to figure out "why are you struggling with this seemingly simple task? What skills/ resources/ support/ time do you need that you do not have?" And I learn a lot. There's almost always a hole between what what they are being asked to do, and what they believe they are capable of doing. Sometimes the hole is due to anxiety or missing social skills, sometimes it's LD (usually all of the above mix together). Sometimes it's meaningless repetitive rote-work that sends the ADHD into hyperdrive. Always, the hole makes the task difficult, and sometimes it makes the task seem impossible.
As others have noted, the critical question with twice-exceptional children is not whether they can do the task, but whether it just seems much *harder* than it should. They can usually - through super-human efforts and perhaps the right alignment of the stars - pull it off at least occasionally. But they can't sustain it. They may not be able to control it. And when simple tasks, like writing, don't become automated, they are using all their brain resources and working memory simply to produce the letters, crowding out their ability to think about spelling and what word is next, let alone more complex questions like what they want to write, or what the teacher is asking at the same time.