Gifted Issues Discussion homepage Forums General Discussion diagnosing 2E

Hi. I am new to the forum! I have an 8 yr old daughter that may be 2E and I would just love some input. From a very young age, people have always commented on how smart and precocious she is. This always is the case when somebody first meets her. She has always been very verbally expressive. I noticed that she had difficulty memorizing her letters when she was in a Montessori preschool. Now, as a third grader, she is just below grade level with spelling and punctuation and simple math. She is excelling in other areas of LA, but we read a lot at home. I feel like she should be reading much faster by now. It seems like she is slowly having a more difficult time in school each year. Her teacher is great this year and understands her, so it has been good for her. She is an only child and has always been fairly difficult with a TON of energy. When she was in 2nd grade, she took a test to determine whether or not she would qualify in the gifted program, and she tested in the 99th percentile for the intellectual giftedness part. So they did further testing (WISC-V), and she ended up in the 94th percentile, and so did not qualify for the gifted program. They don't actually do anything for the gifted kids at her school anyway due to lack of funding, and I don't think she would do well. (unless it was in the performing arts!) So this year, I discussed my worry about a potential LD with the school psychologist. In December, she gave my daughter the WoodcockJohnson Tests of Achievement, Fourth Edition.

her results:
reading 57th percentile
math 32
broad math 39
math calc skills 32
written language 53
academic skills 47
academic applications 69
brief achievement avg.
letter-word id avg
applied problems avg
passage comp. avg
calculations avg.
writing samples high avg.
math facts fluency low avg.

After seeing these results, I feel like there is major disconnect between the two test results. Regardless, she does not qualify for help, even though I see her struggle. Her math teacher said it is strange how she can understand fairly complex ideas and then a math fact like 12-7 blows her mind.

I don't know where to go from here. Should I have her evaluated by an educational psychologist? Do they have another name? because I can't seem to find one in my area. I appreciate any feedback as to whether or not you think she might be 2e. I feel like the second test makes it look like she has an LD and might not be gifted at all, but I obviously don't know how to interpret these tests. Thanks.

Welcome!

Did the school psychologist have access to the WISC-V results from 2nd grade? Because it seems likely that combining the WISC and WJ results would present a picture of some kind of unaddressed obstacle to learning, such as a learning disability of some kind. The WISC profile alone may also suggest additional insights into the possibility of twice exceptionality. If you feel comfortable with posting the WISC-V results, that might allow for additional input. If you'd prefer not to post it publicly, feel free to pm me.

Since both the cognitive and achievement portions of her testing are fairly recent, you may already have sufficient data to explore learning difference questions.

In the event that additional evaluation seems called for, the kind of clinicians you are looking for would typically be school psychologists (you have one in your school, and s/he might be able to identify your daughter's needs; this also costs you nothing beyond what you already pay in taxes for public school), neuropsychologists (typically available in private or hospital-associated clinics, through private pay or, sometimes, primary-care physician referral; going rates vary, but start from about $2000 and head north of $6000), and clinical psychologists (similar in venue and cost to neuropsychs, but may be less specialized for learning disorders). While many families find the school psych in their community school sufficient (full disclosure, I am one), sometimes low-incidence learners, such as the twice exceptional, find a neuropsych to be a better fit.

In your case, you may be able to reduce the cost of going outside your school by having a neuropsych review the existing testing, and keep additional testing to supplementary instruments. My bias (for obvious reasons) is usually to start with the school, but if you don't feel that this route is productive at the moment, then the next step may very well be a neuropsych consult to review existing data.

Thank you very much for the feedback. Her school psychologist did have both test results as she administered them both. She seemed dismissive of the disconnect that I noticed between the tests. I thought based on her WISC-V results, that she should be working above grade levels in some areas. She just told me that she didn't qualify for help. She also mentioned that test anxiety plays a role, but my daughter said she actually enjoyed the achievement test.
I don't have the complete results of the WISC-V, but I imagine I can get them. I will do that and post results.
So, based on these test results, do you think I should take her to a neuropsychologist if the school is not willing to help her in any additional ways? Obviously, if it's really unnecessary, or if it is going to cause self-esteem issues, then I wouldn't want to take her. But if she has a true LD, I need to know about that, correct? Will the school be able to help her if a neuropsychologist says that she has an LD and needs extra support? I obviously want her to be able to work at her full potential. But I'm not sure that is possible in the public school systems of Oregon. We are majorly underfunded. Thanks for your help.

I see. One of the factors is that you are in an RTI state, where the emphasis is on performance compared to grade level expectations, rather than compared to individual expectations. Not all practitioners would end the process after grade-level achievement scores, but many would. So yes, it will likely be more challenging to get special education services.

In that case, I would request all testing records, and take them to a neuropsychologist for consult. Alternatively, if you have already been through a formal IEP eligibility process, wherein she was found not eligible, you can also dispute the finding, and request an independent educational evaluation, which would would have the advantage of being at district expense, but the disadvantage that you would have to pick from their list of approved providers, which gives you less control over who does the testing.

I'd reassure you that taking her to a neuropsych (or other professional) for testing isn't going to cause self-esteem issues - my 2e kids found testing not that big of a deal. We explained that the person who was giving them the tests was interested in helping us learn how their brain works, and also that it would help us (parents) know how to help them out at school. Even if you go through neuropsych testing and find that there isn't an LD or any type of challenge, you'll still come away from the testing with a wealth of knowledge re where your child's relative strengths and weaknesses are, and if you just approach it as data rather than something that carries weight in terms of self-esteem, it's interesting. If it *is* an LD or challenge of some type, chances are your dd is already somewhat aware that she's struggling and knowing that it has a name and a definition was, for our kids, like taking the weight of the world off of their shoulders - before the diagnosis they'd internalized that struggle to be something that was "wrong" with them and meanwhile at school were getting the message that they weren't trying - all of that was a huge challenge for self-esteem. Knowing the name of their diagnosis, knowing that there are other kids on the planet that also share the diagnosis, and knowing that there was a roadmap of how to get over, through, and past their challenges based on having a diagnosis all *gave* them self-confidence.

Whether or not you'll be able to get farther with your school or should seek a private evaluation is really dependent upon your school and school district. I can share my experience, but it was only my experience in my school district. My first recommendation is to see if you have a parent advocate's group in your area that you can ask questions of at no charge. At the point we were advocating several years ago, there were groups that were federally funded in most states, but I don't know what the current status is. If you do find a group, tell them what your experience has been so far and ask for their advice. I was very close to giving up and thinking I would never get any help from my ds' school when I called our local advocate's group, and what I found out was - it wasn't that my ds didn't qualify, it was just that we happened to be at a school that was notorious for doing everything they could to not offer services to students. The advocate was able to help give us the language and understanding of the law that we needed to successfully advocate for an IEP for our 2e ds, even though he is a high-IQ kid and he wasn't working below grade level at the time.

When you ask for the WISC-V results, be sure to ask for the subtest scores. These were really important in understanding that our ds really did have a challenge. When our school district tests, they just list the total/averaged scores for each category rather than individual subtests, and with 2e kids there can be huge variability in the some subtest scores that disappears when they are averaged in with the other scores. For the achievement tests (WJ-IV), you can find a description of each subtest online - read through each one so you understand what the specific task was, and then compare your dd's scores. You might notice a pattern - does she score lower on timed tests, on tests that require handwriting, on tests where she had to read vs listen to an oral statement, on tests with visual skills required etc. If there is a noticable pattern that may help in understanding what's going on.

In addition to reviewing the two sets of data (WISC and WJ), think through your dd's development history from the time she was little. When did she start talking, walking etc. What is school like for her - are there certain types of assignments or tasks that she struggles with?

Once you've done all of that, including talking to an advocate if you can find one in your area who is familiar with your school district, think through whether or not you want to try to pursue further evaluation from the school. There are pros and cons to each. The pros for school evaluation are that it's free; on the other hand, you will only learn if your dd qualifies for help through the school district. You won't get a diagnosis, and you won't learn anything re how to help your dd with her challenge if she doesn't qualify. The pros for a neuropsych are that testing beyond ability vs achievement is included when there is a suspicion of a challege based on the results of the ability/achievement tests, and that testing will be directed at determining a diagnosis. A neuropsych should give you a report which will include recommendations for remediation/accommodations as needed at school, and that report can be used to advocate for an IEP or 504. The downside to a neuropsych eval can be the time (they are sometimes booked up several months in advance) and the expense (although we were able to get our neuropsych paid in part by medical insurance).

How to find a neuropsych? I'd start by asking your pediatrician. Your pediatrician might be a good resource in general re what to do re the school situation - our ped had good advice for us about dealing with LDs in our local schools.

If you decided to try to work through the school before seeking out a neuropsych eval, make a written request for an IEP eligibility review (if your dd hasn't already been through one - which I don't think she has from what you've written). Give the school 10 business days to respond (let them know in writing that you expect a response in 10 days). They will then either have to set up a meeting within a certain amount of time or tell you "no" and give you a reason why they said "no". The meeting will consist of SPED staff person, teacher, parents, possibly other SPED staff people, possibly a school administrator. This is the meeting where the "team" agrees or disagrees that an evaluation for IEP eligibility should or shouldn't happen. This is where you'll need to be able to state your case for why you believe it should happen. Share the data you've gleaned from looking at the patterns in the ability subtests and achievement testing. Share concerns you have from what you've seen of classwork. If your dd is spending a much larger amount of time on her homework that you'd expect, share that. The whole team is supposed to agree on whether or not an eval is needed, and if you find yourself in the situation where the team says no but you think the answer should be "yes" and there's no way you're going to get a "yes" out of them, be sure to include your concerns in the section left for parent input, and then research what your next options are. If the school says yes, they will identify (during that meeting) the areas they will evaluate - be sure that they include every area you think needs to be included. This evaluation still isn't an official diagnosis, it's an evaluation to determine whether or not your dd needs individualized instruction at school. If she's found eligible, the school will make goals and a plan for how your dd will be instructed to meet those goals for the next 12 months.

For us, it was really helpful to have gone to the neuropsych first - because we not only had a diagnosis, we knew what our ds needed re accommodations and remediation. The school would not have shared anything with us outside of what they legally had to share. This isn't easy to explain (and I'm half-asleep today so I'm most likely not explaining anything clearly!) ... but I was a much more effective advocate when I knew what my ds needed than when I was depending on the folks across the table (school) to tell me what he needed. I don't say that to negate the expertise of his teachers or the special ed staff, but the school wasn't looking to find something - they were looking to disprove that he needed help. It was up to me as his parent to know what he needed, and also to know what the law was surrounding what he was eligible to receive at school. Had I not had the neuropsych results, I wouldn't have known that there were things the school could do for my ds because the school wasn't going to tell me about them. With the neuropscyh report, I knew to ask for them, and the school really couldn't deny them because they were all things that were very routinely offered to students with his LD in our school district. Hope that makes sense.

Gotta run - please feel free to ask if you have any questions.

Best wishes,

polarbear

ps - you mentioned she had difficulties with math facts. Is it with understanding them or writing them down? Can you ask her to do 12-7 and give you an oral answer and it's ok, or is that difficult.

I'm popping in to encourage you to trust yourself. If something doesn't seem right, it's probably not. Even if your get "she's okay, she's normal" response from the school, if it doesn't feel right, keep investigating until you have a definitive answer.

My son was labeled "normal" and "typical" by the elementary school and the school shamed me as a neurotic tiger mom. Neuropsychology came back with average IQ, 66th percentile. Turned out my son has ADHD. After ADHD diagnosis and treatment, his GAI (an alternate calculation of IQ) was 141, I think that is 99.7th percentile?

Learning difficulties can have dramatic results on testing!

I'm not at all surprised by math fact recall. My son has terrible math fact recall, counts on his fingers and couldn't pass a timed math fact test to save his life. He's also in Algebra 2 at 9 years old. Math fact recall is a different set of ability than Mathematica thinking! My niece couldn't learn the alphabet or math facts, she Was diagnosed with ADHD in 1st or 2nd grade and is starting to catch up to age mates now that she has treatment. I'm sure there are other reasons for difficulty with ordering the alphabet and difficulty with math fact recall, but I always think "ADHD?". I was in denial about ADHD for my son for a whole year because I didn't understand it is more complex than just hyperactivity - and my son is not at all hyperactive!

Best of luck to you as you start digging to uncover your daughter's struggles! (((Hugs)))

Thank you all for your thoughtful responses.
@aeh, I'm not sure that I can get the results. My school psychologist is now officially out of town until April 4, but she wrote me this:
"For your information, when testing for TAG identification, we administer only the 7 subtests needed to obtain a Full Scale score. That means that we do not have composite scores for several areas. "
The only results I currently have are the full scale results:
standard score - 123
percentile -94
95% conf. interval - 116-128
I will try to get the subtest scores from somebody else.

@portia, thank you for your feedback. That makes so much sense. I'm worried that I won't be able to find a nueropsych that specializes in both, but that sounds like the way to go. If I was wealthy, I would send her to a nueropsych and then send her to a private school that deals with these kind of learners if I had to. Unfortunately, we don't have that kind of money.
@ploarbear, thanks for your thorough post. This is very helpful. Knowing the step by steps will definitely help me as we walk through the process. I know what you say is true, but arguing my side is not a skill set that I have. It will be tough as I know the district is not going to helpful in the least. sigh.
As for her math, she understands what 12-7 means, although at times, it seems like she forgets! But she has to basically draw a picture of it. For addition, she can count on her fingers and do easier ones in her head like 5+2. I know that she has trouble to determine which operation to use in word problems. She is good at data interpretation. If there is a visual aide, she seems to do much better. With subtracting large numbers, she forgets how to borrow. She's been doing this kind of subtraction for at least a year now.
It sounds like my next step is to find a nueropsych.
@sanne Thanks you for your encouragement. It's nice to hear that your son is successful in math regardless of him not knowing his math facts.
I wouldn't be surprised if my daughter was diagnosed with ADHD. We always thought she had those symptoms when she was younger, but she didn't have trouble sleeping or watching full length movies, so we decided to muddle through the difficulties as we didn't feel good about medicating. I did take her to a pscyhologist a couple of times and she did not recommend meds anyway. But she didn't run any tests on her. Her diagnosis was very subjective so I was skeptical.