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    Joined: Jun 2014
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    I received my son's psych report today and was hoping for any further insight. He is 5y9m, bright but quirky, and has recently been through a psychological assessment for ASD at a local university centre. The assessors determined that he does not fit the criteria for an ASD diagnosis (not even close, apparently), but noted that on his cognitive assessment that his processing speed was low. They were fairly dismissive of this low subtest score in the verbal feedback, they thought that he didn't enjoy this part of the test/was perfectionist and thought the low score reflected that. They suggested we should retest (cognitive) in 1-2 years to see if the processing score was still low. However I didn't realise quite how low it was until I got the report today, now I'm concerned.
    They used the WPPSI - III which I understand has been superceded, so his scores may be inflated. These are the results we were given, they only included percentiles, not actual scores:

    Information: 91
    Vocabulary: 99
    Word reasoning: 95
    Block design: 84
    Matrix reasoning: 99
    Picture concepts: 98
    Coding: 16 (eek)

    Composites:
    Verbal: 99
    Performance: 99
    FSIQ: 98

    Can anyone shed any light on this type of scatter? Thanks in advance!

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    Yeah, his fine motor isn't great, if fine motor is part of block design it doesn't surprise me that that's lower. His writing does lag well behind his reading. As far as I know it's not been an issue at school, he's only started kindergarten this year though so I don't think there's huge demands in terms of handwriting etc yet.

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    squishys is correct. The two lowest scores are the ones that involve fine motor. Although expectations are admittedly low in kindergarten, I would still keep an eye on this, and possibly seek additional evaluation by an occupational therapist, as the Coding score is two SD below the next lowest score (Block Design), which is, in turn, a relative weakness within the Performance Index (1 and 1+ SD below the other subtests in its cluster). The remaining subtests are all clustered fairly closely (depending on where in the 99th %ile Matrix Reasoning and Vocabulary fall).

    Late developing fine motor may or may not be purely developmental.

    These are also the two timed tasks, so a highly conscientious or perfectionistic task approach, or anything else that interferes with speed, might also lower the score. Though you note IRL fine motor delays, so that seems like the more likely explanation.


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    Thanks for the input aeh, I really appreciate it. I hadn't really considered that his fine motor might be actually delayed, I definitely noticed that it is a relative weakness of his compared to his performance in other areas, but I guess it looked normal enough compared to other kindergarten kids. I will have to have a bit of a closer look at how he's going there I think, and whether it warrants further investigation. He definitely has issues with perfectionism so that may be a factor as well.
    I have read into symptoms of processing speed deficits today, and I do see some potential symptoms there as well. He's an interesting little thing, a bit of a mystery to me! At the moment he is coping and performing quite well at school, the only issues have been that the academic level is far below what he's capable of/interested in, but I'm a bit nervous about how he'll go into the future.

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    Just to give my experience with motor skills and processing speed, DS did the WISC IV when he was just over 6. He had had a traumatic brain injury and his eyes were looking in slightly different directions (resolving from when it first happened when one eye was actually stuck). He also has a developmental coordination disorder diagnosis and had issues with motor skills before he was in an accident. His lowest score on the WISC was coding at 50th percentile, so it wasn't as low as what you experienced. He was given a Grooved Pegboard Test the same day, where he was timed putting pegs into a board, and tanked it with a Z score of -4.8 with one hand and -3.69 with the other (these are well below the 1st percentile). It's possible that he could not figure out how to get the pegs into the holes if his vision was bad, but there are parts of the WISC IV which require vision and like I said, his lowest score was 50th percentile. So even though his fine motor ability at that time was atrocious, it didn't show up as an obvious deficit on the WISC (it showed up more as a "relative weakness") and the neuropsych didn't seem all that concerned. He did recommend OT though because of the awful pegboard test. DS had been in OT about 6 months earlier and they had exited him because he improved into the normal range. Then a few months later he was in the accident. All of this being said, if you are seeing fine motor issues in real life, or issues with processing speed, I'd definitely keep an eye on it. DD has slow processing speed (I think she was at the 34th percentile overall on the WISC IV for PS) and it shows up in school as being exessively slow with work and fluency tasks, like math fact fluency, and slow writing.

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    Just something to note... although DS (almost 5) did not show any "delays" in any fine motor areas, we decided to have an OT eval anyway because we were concerned that the gaps between his intellect and motor skills were bigger than I would have liked, and the NT we saw also said although they did not see any motor skill issues, if there is a gap and his skills slips below age-level, it would cause frustrations (the younger these can be addressed, the better). And although the fine motor skills were very good, what it exposed was slight delays in bilateral coordination and core strength - nothing major but could use short term work, and the OT also said even at his age, she could see he would learn so fast how to compensate for his weakness that she has to be really careful to make sure he was not figuring out how to compensate right on the spot.

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    napanangka, I noticed in a previous post you mentioned your ds was given the SB-V previously. I am not familiar enough with the SB-V to know how to examine the scores, but you might want to have someone look at the previous testing to see if there is a subtest that correlates to BD and coding or relies on fine motor, and look for a similar pattern there. If you see a pattern of low scores related to fine motor on the SB-V, that would be another reason to not assume that perfectionism caused the low scores on the WPPSI.

    Best wishes,

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    Thanks for the ideas everyone. He did have one relative weakness on the SBV, which was knowledge. I don't believe that is related to either fine motor or processing speed, although I don't know enough about the tests to be sure. Having read into it, I do see possible signs of a processing speed problem in real life, so I'm definitely not dismissing it or assuming it's inaccurate. Correct me if I'm wrong, but I think the SBV doesn't include an assessment of processing speed? I know his working memory on SBV was a relative strength.

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    There are no specific measures of processing speed on the SBV, and nothing like coding. The closest subtest to block design is the nonverbal visual-spatial task, which is timed at some levels. At this young age, speed would not come up on the SBV.


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    Non-verbal visual spatial on the SBV was 99.6th percentile. But as you say, it would've been untimed.

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