Gifted Issues Discussion homepage Forums Identification, Testing & Assessment Very slow processing...?

Okay, so my son does have separation anxiety that we've been making progress on, but in general he does not appear to be an anxious child. The psychologist who assessed him said she didn't think he had ADHD even though he was zoning out (daydreaming) and needs to move (fidgets in class, and at home he paces etc.) He moves whether he is nervous or happy/excited. His grades are fine, and he reads a lot, likes math etc. but not begging for acceleration. He doesn't appear scattered and can focus, and after really observing and talking to DS I think zoning out is from boredom and the pacing is psychomotor excitability.

However according to his test he has very low processing speed (21st percentile), and the psychologist said it was a combination of perfectionism and anxiety- if we fix the anxiety she said his PS would likely increase. She recommended keeping everything calm in the household, working on the separation issues and otherwise building his confidence. To me though, he doesn't seem anxious or insecure as long as he's not alone. When kids were picking on him at school last year he says he just got angry, he wasn't nervous or scared. In general he said he was just bored. Anyway, just wondering if anyone else has any thoughts on his scores?

If the processing speed wasn't so low, I would just shelve it, but I don't know if it indicates a 2e situation that I would need to address...for instance I don't think he has dyslexia as he loves to read, but my brother had undiagnosed dyslexia and he suffered from it so I just want to rule out anything else to make sure I'm not missing something.

WISC IV

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Anyway, I'm just not sure what's going on. I know that's it's just an IQ test, but something just doesn't makes sense to me yet. There is anxiety going on but it doesn't appear to affect him unless he's alone and he's never alone at school and he wasn't alone during the test. If he just has slow processing that is fine but if there is anything else I should be looking at, please let me know.

Thanks again for your help, and I am grateful for the support and these forums.

1) That is a sizable difference between VCI and PRI, suggesting a strong verbal preference/relative perceptual weakness. And the subtests within the indices are fairly consistent, so it looks more like a pattern, and not a fluke score in one area. It is not uncommon for children with NVLD (which this would raise questions of) to be misdiagnosed as ADHD, often due to motor restlessness (associated with greater challenges with motor coordination & organization) and relative difficulty focusing on visual stimuli. Granted, every one of those scores is strong, so it could just be a marked verbal preference, without reaching for an LD explanation.

2) I don't see a subtest score for symbol search or cancellation. Did you accidentally omit those from your list, or did the examiner estimate the PSI from a single subtest score? Because if the latter, the relative weakness is specifically in fine motor copying speed, and not necessarily in processing speed overall. Same question for working memory, as the only WMI subtest I see is digit span (no arithmetic or letter-number sequencing). Not discounting the index differences, but just noting that real index scores, based on multiple subtests, are much more reliable than subtest scores alone. It kind of looks to me like these are prorated scores, as the raw scores you report for the WMI and PSI are exactly twice the scaled scores for their respective subtests. Assuming that they are prorated, you don't actually have a legit WMI, PSI, or FSIQ. Did the evaluator give an explanation that would justify using only one subtest instead of two for each of those index scores?

Do you see evidence of functional difficulties with fine motor/fine motor speed, such as in writing or drawing? Or working memory/attention, for that matter? Anxiety/perfectionism can affect both speed and working memory. Or maybe rote tasks (which both of these were) are really just too boring to fully engage his attention and intelligence.

To be fair, children (even many PG children) don't have as broad or as nuanced a vocabulary or self-awareness for their emotions, and may generically label everything as boredom, when closer investigation might reveal anxiety, depression, withdrawal, anger...or actual boredom due to inappropriate instructional level.

Interesting about the nvld- I feel like I fit a lot of it..is it inherited? He doesn't seem to have a hard time with humor though. But great verbal and grammar, poor math, clumsy and overly worried about offending people is very true of me. He seems to enjoy math more than English though, and both of us are artists.

I will ask psychologist- I put in all the scores that were included on the report. Thank you so much!!

I would seek out some follow-up on the lower scores - it might be nothing more than perfectionism or anxiety, but it also could be an indication of an issue that is impacting his ability to perform tasks requiring fine motor coordination or it could be related to an issue with visual processing. A complete neuropsych eval would typically include some type of visual-motor integration test to help determine what was the root cause behind the relatively low coding score, as well as other tests that would help tease out issues with fine motor coordination, executive functioning, etc. Were there any other tests included with your ds' psych eval?

There are two reasons I recommend further testing - first is to understand what caused the lower scores in PSI and WM, and also as important - it's possible that the anxiety your ds is experiencing might be *caused* by whatever is driving those low scores. My ds has a similar discrepancy in PSI (coding specifically). When he was in 2nd grade we had *no* idea it was due to developmental coordination disorder and dysgraphia - we were referred for a neuropsych eval by our pediatrician because our ds had really really *really* severe anxiety and because his teacher at school was convinced he had ADHD because he stared off in space during class and wasn't producing any work. His DCD and dysgraphia diagnoses were a complete surprise to us - but once we'd set up accommodations and were able to help him understand his challenges, his anxiety essentially disappeared. He's still a kid who is prone to worrying as a first reaction to stress, but what we were seeing and thinking was anxiety as a primary issue in 2nd grade was in fact anxiety that was secondary to an undiagnosed LD.

polarbear

ps - if he has a challenge with either fine motor or vision, it can also impact one of the subtests under PRI (I can't remember which - sorry!)

And if he didn't do all the tests don't pay the full amount. If that is what he did it is unacceptable. Would you expect a diagnosis of cancer based on 1/3 of the tests required?

Well I just looked at my daughter's report and she did include Arithmetic so maybe she just forgot to list it on DS's results? Regarding prorating a score, why would someone ever do that? Especially if it creates an inaccurate score?

I will ask her if she forgot to include Arithmetic on my DS's report, maybe it was an oversight...

She ran the following tests:

WISC-IV
Projective Drawings
House-Tree-Person, Family Drawing, Draw-A-Person
Children's Apperception Test

She states in the report he preferred the subtests of the perceptual reasoning component of the WISC-IV.

Polarbear, those are excellent points..the anxiety could be caused by an LD.

Yet he did markedly better on the verbal tasks.

It is actually not that uncommon for neuropsychs to prorate scores, or give partial clusters, as their training encourages cross-battery assessment (to which I have no intrinsic objection; it can be a good approach for some questions). Typically, though, I would see that kind of result presented as an analysis of functional domains, rather than as an actual Index or IQ score. There are two subtest scores missing here: arithmetic or letter number sequencing, and symbol search or cancellation. (I list two options for each because either one could be the second subtest in an Index score.)

The usual reason for prorating is when there are "spoiled", or invalid subtests, and you don't have enough valid ones to derive a regular index score. Sometimes you see prorating when assessment is part of a university study, and they don't need a comprehensive cognitive, just enough for their data to be clean. (E.g., when they need IQ-matched subjects)

I see that she did a number of projective social-emotional measures. Interpretation of these kinds of measures is highly dependent on the clinical skill of the evaluator, as they are rather subjective. Especially projective drawings, including HTP, etc. (Again, not that I don't employ my fair share of them.). I prefer to view these types of tasks as frameworks for clinical conversations, and opportunities for observing task approaches, with less weight placed on the interpretation of figure size, placement, features, etc. I would imagine that these were part of the basis of her emphasis on anxiety as a concern.

I looked on my daughter's scores (assessor did both kids) and hers were

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So she didn't do two subtests for Processing Speed on DD's test either. Apparently assessor has been doing this for 20+ years so I don't want to second guess her- but I do want to make sure that the scores are an accurate picture of what's going on, and we did pay for these tests.

Alternatively I can wait for the school's test, because he was also tested with a group timed test by a psychologist (I am assuming Raven) and see what that score is before deciding whether to go back to the assessor on it.