WISC-IV Discrepancies

[rosie42]

Hi

I apologise if this has been done already but struggling to find an answer. Dd has just had this assessment, and there is a gap between her WMI = 83 and her PSI = 136. I am reading that this a significant and unusual discrepancy but cannot find out why it is significant or unusual.

If anybody has any knowledge would appreciate hearing it. Thankyou.

[scattergun]

It's significant because it's unlikely for someone to show such a gap in scores by chance. It's unusual because you'd probably see a discrepancy that size in less than 1% of the population. The WMI is low average (and about 12-15% of children would get that score or lower, roughly) but the PSI is extremely high (99% would get a lower score). Did the psych tell you what the scores meant re the reason for the assessment?

[rosie42]

Sorry for the late reply, the psyche said it was extremely rare and didn't believe our dd had a learning disorder, but that she does think there is a problem with her recall. She thinks it would be a good idea for her to see a neurologist to rule out any organic matter.

[scattergun]

Having a WMI of 83 does not, on its own, mean there's a problem with recall. It would depend on her other test scores and the reason for the assessment, i.e. what's the problem you're seeing that might be reflected in the scores. The PSI being higher than all her other scores (VCI, PRI and WMI) would be a different problem from the WMI being lower than everything else.

[rosie42]

Ok, this is what I have been looking for, as I wondered if we should be worrying about the higher psi. Her VCI was 100 and PRI 112.

We had concerns about her memory, but kept thinking it was just her age. But school commented on it also, for example sometimes she just cannot find the word for something despite knowing it previously. She may say a fruit is a vegetable, a circle a triangle, not remember a good friends name. She has been struggling with spellings and spells as it sounds but if you are 1 on 1 with her and ask her if she is sure about a spelling she will rectify the mistake correctly.

She is quite sensitive to noise, and doesn't like alot of shouting or fuss around her, she likes calm and quiet.

So I have been trying to find out what the other possibilities maybe for the scoring. The psyche just focused in on the low wmi. Thanks for any advice.

[scattergun]

Your description of her difficulties suggests there is a problem with controlled retrieval of words, i.e. she might be finding the right category but not checking it's the right word in that category. She may be responding impulsively. This fast speed of response would potentially fit with the high PSI. This would be considered an attention problem (lack of monitoring) rather than a language or memory problem per se, although that's where its impact is seen. Her relatively low score for WMI, particularly if her reversal of digits is poor, would also support this hypothesis.

Clearly this is just a suggestion, but a more comprehensive assessment would be needed to determine exactly where the root of the problem lies and that would inform more precise intervention. Is that an option?

[rosie42]

You are making sense, I am lost. We have just seen a neuro as suggested, he said he thinks she is fine and that it may just be the way she is. But he has suggested an Audiologist now and blood tests.

I am really not happy for my 7 year old to have blood tests. So I am still no clearer as to the significance of all this. Are the wmi and psi meant to be in the same range?

We just want to make sure that she receives any support that will benefit her so testing is not a problem. The problem I have is that I don't understand all of this and living in this part of the world (Middle East) things work very differently to what they do at home. So I am not sure if I am just being passed from pillar to post and hearing the kerching each time, or if this really is significant and needs addressing.

If the problem is as you describe is there something we can do to help her, I can't rely on what I am being told here unfortunately. Thank you so much.

[rosie42]

I am sorry but have just realised there was also a WIATT and NEPSY test, these were all combined in one report and I had wrongly assumed they were all part of WISC.

Results as follows

WIATT Subtests
Word Reading 91, Reading Comprehension 111, Pseudoword Decoding 99, Numerical Ops 104, Math Reasoning 84, Spelling 78, Written Expression 88, Listening Comprehension 85

Then NEPSY-II Auditory Attention and Response. No scores it just says that she struggled to sustain attention on the simpler part of the test, whereas her vigilance improved as it became more challenging.

Executive functioning assessed also which states was comparable to chronological peers.

Cognitive flexibility and initiation assessed with Design Fluency and she scored above the expected level on both structured and unstructured arrays.

[scattergun]

Okay. First thing, try not to worry. Easier said than done but the profile would not suggest she needs lots of medical tests from the information given, unless there is a deterioration in performance. Do you know what the blood tests would be for?

With the WISC, most children have test scores within the average range (hence the term) but those who have scores outside the average range do not necessarily have them all at the same level. Having an uneven profile is also normal but the more uneven the profile, the less often it is seen.

At the age she is, the test used (NESPY) is not that good at picking up more subtle difficulties with working memory and executive functioning that you are possibly observing in her everyday life.

When children's vigilance improves with complexity it is because they recognise the need to attend more closely and so they make more effort. At lower levels of demand, their concentration can be relatively poorer. It still suggests a difficulty with regulation of attention.

Did the psych administer any memory tests from the NEPSY?

[rosie42]

other reference to Nepsy is relating to Language Ability using Repetition of Nonsense Words to assess ability to phonologically decode sound patterns. And Phonological Processing both were marginally average.

List Memory was marginally average and the Narrative was below the expected level. Visual rote memory skills assessed with Memory for Designs were above the expected level. These are all of the references to NEPSY, I am not sure if I am meant to have scores or not, but I don't just the comments.

The blood tests are ESR, B12, CBC/Diff and T4 and TSH, I think these are just overkill, and if Dubai wasn't such a ticket for writing your own check in relation to medical insurance I am sure they would not be included.

[scattergun]

Your psych has clearly done a lot of tests. Have you got an appointment to discuss the implications and will they be advising the school re how to support your daughter?

She seems, from these results, to have good visual and nonverbal reasoning skills. Areas of weakness are all language related. Not her understanding of language concepts but her auditory memory, possibly speed of auditory processing and systematic retrieval of verbal information from memory. There may also be an attention weakness. These are usually problems that are best supported environmentally, e.g. reducing distractions, providing visual information to support language processing, asking forced-choice rather than open-ended questions. Your daughter may also need help to develop her literacy skills but this will need to be provided by someone who understands the various different presentations of literacy difficulties. She clearly does not have general difficulties with phonological processing. I would be pushing the psychologist to provide structured support and advice for the teachers.

If I was to suggest any further doctor input, it would be for a neurodevelopmental assessment, preferably multi-professional with an OT and SALT, to look at her language and sensory issues in more detail and to determine how much her attention is an issue.

[rosie42]

The psyche has given the report and suggested as you say by reducing distractions, highlighting info, but we were disappointed by the guidance for what next.... She just wrote that dd would likely benefit from learning support at the school. But didn't suggest what kind of support, it was all very open to interpretation. We asked her is she thought dd had dyslexia, dysgraphia, dyscalcua, ADHD, CAPD and she said no. She just said to see a neuro to rule out any organic matter that may be the cause of the scattered resut. So having done all this testing and spending we are still no wiser what we need to do in order to support dd. All we know is she is weak in spelling which we already knew, that she doesn't recall very easily which again we already knew. We were hopjng to discover the whys and hows. Maybe the audiologist will uncover something.