Gifted Issues Discussion homepage Forums Identification, Testing & Assessment Twin's Neuropsych Help and 2nd Opinion Reco?

Hello and thank you in advance for reading this! I've learned so much here (including the directive to be concise so I promise I’ve tried hard to edit). I would love thoughts about my 11yo twins' neuropsychs and the discrepancies therein. I am also interested in any neuro-affirming or 2e therapist/psychiatrist/evaluator recommendations in NJ or NYC.

My kids were evaluated so we could learn more about their interesting brains, to help us advocate for the help/enrichment we feel they need etc. My daughter exhibits many behaviors consistent with girls with ADHD (sensory issues, difficulty with transitions, interruptive, sensitive, hyperfocuses on creative projects etc, anxiety etc etc) and/or maybe PDD? (Also ADHD/giftedness runs in the family). She has always seemed (to us and other adults) to have gifts in the sense she makes these surprisingly sophisticated analogies, and in her writing and drawing. However often she doesn’t really “get” basic things. She does very well in school, behaves well, and scores in the top tier on standardized tests.

My son is a deep thinker and a clearly gifted kid who has many ADHD characteristics (very poor organizational skills/memory, procrastination, sensitivity, can’t sit still at home) but seems to hide them well at school and doesn’t disrupt. He is well above grade level in school (and bored!), but makes careless mistakes and really takes his time.

The neuropsychologist administered a battery of tests in a 4-hour session with one or two super quick breaks. While the psychologist did note some discrepancies, he didn’t find them concerning and said lots of kids have discrepancies and certain low scores were likely due to lack of motivation or anxiety. He didn’t think either had ADHD or other learning differences. Thank you so so much for any thoughts, referrals or insights!!!! Maybe I'm just overthinking everything. This had been a long road.

This is my DAUGHTER’S WISC-V (FSIQ 107)
-Does it seem feasible she could be 2e or just neurodivergent? Should I get a second opinion to try to understand this better? (He just recommended CBT and meds for anxiety)

PRIMARY INDEX SCORES ANCILLARY SCORES INDEX
(121) VCI - 92% (119) Verbal (Exp. Crystallized) - 90%
---15 Similarities - 95% —15 Similarities 95%
–-13 Vocab - 84% –-13 Vocab 84%
–-12 Information -75% –-12 Information 75%
–-13 Comprehension - 84% –-13 Comprehension 84%
(117) VSI- 87% (89) Expanded Fluid - 23%
–-13 Block Design 84% –-07 Matrix Reasoning 16%
–-13 Visual Puzzles - 84% –-06 Figure Weights 09%
(79) FRI- 08% –-09 Picture Concepts 37%
–-07 Matrix Reasoning - 16% –-12 Arithmetic 75%
–-06 Figure Weights -09% (94) Quantitative Reasoning - 34%
–-09 Picture Concepts -37% –-06 Figure Weights 09%
–-12 Arithmetic - 75% –-12 Arithmetic 75%
(115) WMI- 84% (116) Auditory Working Memory- 86%
–12 Digit Span 75% —12 Digit Span 75%
–13 Picture Span 84% –-14 Letter-Number Sequencing 91%
–14 Letter-Number Sequencing 91% (103) Nonverbal - 58%
(103) PSI - 58% –-13 Block Design 84%
–-11 Coding 63% –-13 Visual Puzzles 84%
–-10 Symbol Search 50% –-07 Matrix Reasoning16%
–-06 Cancellation 09% –-06 Figure Weights 09%
–-09 Picture Concepts 37%
–-11 Coding 63%
(105) General Ability -63%
–-15 Similarities 95%
–-13 Block Design 84%
–-07 Matrix Reasoning 16%
–-06 Figure Weights 09 %
(111) Cognitive Proficiency - 77%
–-12 Digit Span 75%
–-13 Picture Span 84%
–-11 Coding 63%
–-10 Symbol Search 50%

-Child and Adolescent Memory Profile (CHAMP) 105 Total Memory 63 % w/subtests ranging from 7-15
-Connor’s Continuious Performance Test =Scores in 40s. 3 Low & 6 average
-Reynolds (RIT) - Object Interference=49 (average), Color Interference=58 (above av)
—----------------------------------------------------------------------------------------------
This is my SON'S 2nd WISC-V (FSIQ 129)
(His WISC-V from 3 years ago had VCI=146, VSI=135, FRI=118, WMI=110, PSI=100)

-His discrepancies are not as big as they were 3 years ago, but combined with the Champ, RIT and CCPT, there seems to be a pattern.

PRIMARY INDEX SCORES ANCILLARY SCORES INDEX
(121) VCI -92% (127) Verbal (Exp. Crystallized) - 84%
---13 Similarities - 96% —13 Similarities 85%
–-15 Vocab - 95% –-15 Vocab 95%
–-15 Information -95% –-15 Information 95%
–-15 Comprehension - 95% –-13 Comprehension 84%
(126) VSI- 96% (89) Expanded Fluid - 23%
–-15 Block Design 95% –-07 Matrix Reasoning 16%
–-14 Visual Puzzles - 91% –-06 Figure Weights 09%
(118) FRI- 88% –-09 Picture Concepts 37%
–-11 Matrix Reasoning - 16% –-12 Arithmetic 75%
–-15 Figure Weights -95% (94) Quantitative Reasoning - 34%
–-11 Picture Concepts -63% –-06 Figure Weights 09%
–-19 Arithmetic - 99.9% –-12 Arithmetic 75%
(110) WMI- 75% (116) Auditory Working Memory- 86%
–18 Digit Span 99% —12 Digit Span 75%
–05 Picture Span 5% –-14 Letter-Number Sequencing 91%
–15 Letter-Number Sequencing 95% (103) Nonverbal - 58%
(105) PSI 63% –-13 Block Design 84%
–-11 Coding 63% –-13 Visual Puzzles 84%
–-11 Symbol Search 63% –-07 Matrix Reasoning16%
–-06 Cancellation 09% –-06 Figure Weights 09%
–-09 Picture Concepts 37%
–-11 Coding 63%
(105) General Ability -63%
–-15 Similarities 95%
–-13 Block Design 84%
–-07 Matrix Reasoning 16%
–-06 Figure Weights 09 %
(111) Cognitive Proficiency - 77%
–-12 Digit Span 75%
–-13 Picture Span 84%
–-11 Coding 63%
–-10 Symbol Search 50%

-Child and Adolescent Memory Profile (CHAMP) = low average
-Connor’s Continuious Performance Test =Scores in 40s. 3 Low & 6 average
-Reynolds (RIT) Object Interference =42 (below average), Color Interference =52 (average)

Welcome, PerryStreet!

Sorry about the delay in anyone responding.

I do have some questions about the scores you've posted, since some of them don't line up: The fluid reasoning and general ability subtests are reported differently in different places for both children's results. And it appears you may have copied the same child's scores into the other child's list by accident. Perhaps you could go back and doublecheck to make sure the scores listed are correct. General Ability should have five subtests listed (Block Design, Similarities, Matrix Reasoning, Vocabulary, Figure Weights).

Happy to comment once we have the right numbers!

Adding on from aeh,

Neuropsych testing, according to Barkley, doesn't have much use in diagnosing ADHD (https://www.researchgate.net/public...he_Diagnosis_of_ADHD_Stop_It_or_Prove_It).

They can, however, shine a picture on the kid's cognitive weaknesses and strengths.

Other source () from the same psychiatrist shows how neuropsych testing does not measure the same construct as ADHD.

A diagnosis of ADHD/ASD is based on the DSM-V-TR criteria, with some clinical judgment. The criteria may be confusing at times, though you may attempt to read it. If you have any questions about interpreting the criteria, you could ask us.

Note that for gifted people, their symptoms may present differently and in a more socially acceptable light. For example, 'Is often “on the go,” acting as if “driven by a motor”' (DSM-V-TR) for an average or below average kid may be as stereotyped. For a very gifted child, it may be "channeled" into productive activities, thus they may appear workaholics, very studious, etc.

Your son is clearly gifted. He might be compensating for his symptoms such that they appear significantly milder than they actually are. I wouldn't discount the possibility other symptoms may be hidden but he had learnt to compensate for it.

In your daughter's case it is less clear. Considering her gifts, I suggest digging deeper. Ask both of them for their self-reported symptoms. How is she with time management? How long can she study for? How much does she procrastinate? Try giving her significantly less structure, organisation - if she struggles a lot, perhaps you had been compensating for her symptoms.

I suggest trying to find a psychiatrist in this site: https://www.davidsongifted.org/gifted-blog/gifted-testers-and-therapists-list/

Good luck!