Gifted Issues Discussion homepage Forums Identification, Testing & Assessment Is a neuropsych assessment warranted? Please help!

Hello all,

I would really appreciate some input. My DS9 was diagnosed with Aspergers by Kaiser when he was 7. This was after years of us worrying about his obsessive behaviors when he was young, such as fascination with fans, wheels, etc. He has outgrown many of these behaviors, but still rotates through obsessive interests. He does have issues with eye contact, but I find myself wondering the last year or so, if his diagnosis is correct. He can be pedantic and extremely black and white, but he understands social cues most of the time and sarcasm etc.

I had him tested on the WISC IV by a Hogies listed Pysch late last year and his scores went up quite a bit from the DAS II scores. He is definitely a late bloomer. The tester did not feel he is on the ASD spectrum. Meanwhile, he has vision processing issues and we are in OT for that currently.

Here are his scores (please don't quote as I will delete scores)

GAI = 146
FULL SCALE IQ = 135
Verbal Comprehension = 132
Perceptual Reasoning = 143
Working Memory = 123
Processing Speed = 106


Similarities 18
Vocabulary 16
Comprehension 12

Block Design
19 (14 when timed)
Picture Concepts 16
Matrix Reasoning 16

Digit Span 15
Letter-Number Sequencing 13

Coding 9
Symbol Search 13

He can take forever to do his homework sometimes and can get distracted. If I tell him I am going to time how long he takes, he can really hyperfocus. He is slow with work but has an incredible memory, such as memorizing Pi digits to 150 after two days of studying it for approximately 10 minutes. He still remembers 6 months later. Most of all, he is extremely disorganized! He did recieve all As in his gate magnet school this year, but some nights he was up very late doing homework. Does the slow processing seem to be a result of the visual issues or is there something else going on? He acts like he has inattention ADD sometimes. Do these score indicate a learning disability? We have an appointment scheduled with a well respected neuropsych (on Hoagies) but it will be very expensive and wondering if it is worth doing. I am hoping they will also be able to really determine if he is on the spectrum.
Sorry for the rambling questions, but money is tight and I just really want to see the benefit of doing more testing. Thank you!!

DD's scores were similar and she has ADHD and executive functioning issues. She can be very slow to complete work. I guess the main reasons to pursue more testing would be to get more definitive answers in terms of ASD as well as recommendations for modifications/accommodations at school. If you think he could have ADHD and would consider medication, it would help to get more information about that as well.

DS did the WISC IV with his eyes literally looking in different directions due to a traumatic brain injury (one eye wasn't tracking to the right), and I don't think there was any obvious result of that on the WISC. Other posters on this forum seem to have different experiences though. I find it odd that block design was done timed and untimed? I thought it was always supposed to be timed. One of my DS's lowest scores was block design because he is slow in terms of motor ability (he has developmental coordination disorder).

Was the tester knowledgeable about ASD, or just about giftedness? Many of the other issues you mention are consistent with an ASD diagnosis - pedantic, black and white, ADHD-I, disorganization, hyperfocus. Remember that ADHD is almost always part of the picture for an ASD kid.

Good luck!

Welcome to the forum, wander


I'm not familiar with the DAS-II, but I believe it's a much briefer test than the WISC. What you might be seeing might not be "late blooming" but difference in tests or difference in testing conditions, or simply the difference in testing a child that is slightly older.


FWIW, our dd who had vision processing issues didn't make eye contact when talking until after her vision issues were remediated. Our DO told us that not making eye contact can be a symptom of trouble with vision.

I won't quote your block design score so that it can be deleted ... but... did they use the non-timed score in calculating his FSIQ/GAI or the timed? I'm only asking out of curiosity.

His coding score (and processing speed total score) is low relative to his other scores. Did they feel coding was related to fine motor or his visual challenges? His symbol search doesn't seem to have been impacted by his visual challenges, and that's one of the subtests I'd expect to see the largest impact from vision issues on."


Was this last appointment with a neuropysch or was it just focusing on determining if he was on the ASD spectrum? A typical neuropsych eval will include testing to determine if things like the low score on coding are due to fine motor vs visual processing, tests of executive function, etc. Symptoms can overlap between ASD, ADHD and Developmental Coordination Disorder, so it's tough to put together the pieces without some type of comprehensive eval.

It's possible you can pursue some of what you'd get through neuropsych testing through your school district (if you haven't already gone through eligibility testing for an IEP). It's also possible a neuropsych eval wouldn't have to be the full-blown full-price eval if you're able to find someone who can start with the ability and achievement testing your ds has already had. It's also possible that medical insurance might cover part of the neuropsych eval. If the Hoagies neuropsych is extremely $ relative to other neuropsychs, I might consider instead going with a neuropsych that is considered competent by your ds' pediatrician but not feel you have to go with a neuropsych that specializes in gifted children.

I do think more testing would be helpful if your ds hasn't had testing to tease out why he has the lower score in coding, combined with your observations that school work seems to take a long time to complete, and your observations that sometimes he looks like he has ADHD, as well as looking further into whether or not he is on the ASD spectrum. This is all *IF* he hasn't already had more testing that isn't mentioned here

Best wishes,

polarbear

ps - the latest tester that didn't feel your ds was on the spectrum - did he do any kind of assessment to determine that, or was it just "a feeling"?

FYI: Block Design can be scored with and without the bonus points for quick execution. That's what timed and untimed means. They are both timed (wrt item-by-item time limits), but one score is based only on accuracy at the time limit, while the other includes extra points if completed well before the time limit. They are alternate ways of obtaining a scaled score for the same administration.

ETA: Looks like the Block Design-No Time Bonus was used for the GAI.

I'll add that he may be showing some lingering relative weaknesses in social comprehension on the VCI, as his lowest score (though still well into the Average range) was on Comprehension, which, among other things, has some association with knowledge of social conventions. It is not unusual for high-cognitive individuals with social communication deficits to use cognition to compensate for social perception, by consciously learning the rules for social engagement to the point that it becomes "good enough." In fact, I encourage my students in this category to study people like an anthropology or wildlife behavior experiment, as a compensatory strategy.