Martie, can you help me understand this?

Discussion in 'Special Ed 101' started by mistmouse, Jan 29, 2007.

  1. mistmouse

    mistmouse New Member

    Martie,
    I know you said you don't know much about the RIAS that was adminstered to my daughter. I did use the link Sheila gave me and found out what the subtests are and then based on what information I got from that link, I asked for the T scores and such.

    I need to know if there is something I need to be looking for that they won't tell me about based on the T scores and such. The RIAS reports intellectual indexes rather than IQ scores. My daughter's VIX is 104 and her NIX is 129. The VIX (verbal) is comprised of two subtests which show a T score of 53 on 'Guess What' and 51 on 'Verbal Reasoning'; the NIX (nonverbal) is comprised of two subtests which show a T score of 65 on 'Odd Item Out' and 65 on 'What's Missing'. This gives her a Composite Intellectual Index of 117. Then there is the Composite Memory Index (CMX) which is also comprised of two subtests, verbal memory and nonverbal memory. On the VRM (verbal) she has a T score of 26 and on the NVM she has a T score of 60, with a CMX of 88.

    I just wondered if you could tell me if there is something that jumps out because of the discrepancy in the verbal and nonverbal being so high? We are talking about a child who has been in the gifted program (qualified with an IQ on the WISC in K of 136 and scored off the bell curve in creativity), reads at above high school level and comprehends at that level as well. She also talked in paragraphs by the time she started kindergarten.

    It isn't as if I am looking for something if there is nothing, but I do not trust them to inform me if this does indicate a problem. About the only thing they do say besides indicating how infrequently some of these discrepancies occur in the general population, is to say this indicates she is a visual/spatial learner. However a lot of the recommendations they give for a visual/spatial learner, my daughter has already had problems with. Such as they recommend the use of an overhead for teaching, but this is a big problem for difficult child and always has been. She loses her place both on the material on the overhead and on her paper as she looks back and forth. Perhaps that is due to the visual/motor difficulties they claim she doesn't have?

    If you have any ideas, please let me know. We have an IEP meeting on Friday.

    mistmouse
     
  2. Martie

    Martie Moderator

    MM,

    I am not sure if you know this stuff--but someone won't, so I will write it.

    This test is TRYING to be hard to understand. The composite indices have a mean of 100 and a standard deviation of 15 or 16. The subtests have a mean of 50 and a standard deviation of 10. Therefore, everything that you report looks arithmetically Kosher to me (as best I can tell without a manual for the test.)

    The VIX is 4 points above the mean. The NIX is almost 2 standard deviations above the mean. This is LIKELY to be a statistically significant split. Are such splits important? They can be--or not and there are several ways to get them--some indicating problems and others being somewhat artifactual.

    The subtests are mixed. The verbals are not unusual because they are very slightly above the mean of 50, which, of course, yields a VIX very close to the mean also.

    Likewise, the nonverbal subtests are well above the mean (they would have to be to yield a NIX of 129) with both of them 1.5 standard deviations above the mean. Because it is statistically unlikely to be this way, the composite is even higher (almost 2 s.d. above the mean of 100.)

    The composite memory is the most interesting because it is a non-meaningful combination of one score that is 2.5 s.d. below the mean, and one that is one s.d. above the mean, yielding a composite that is almost a s.d. below the mean. If someone tells you an 88 with within normal limits--it is, but how your difficult child got there is not. There is a significant problem (2.5 s.d. below the mean is below the 2nd percentile on most norming samples) on one half of the composite and performance at the 68th percentile on the other. THIS difference would be stat sig and also very important in my opinion. Your daughter has a deficit in verbal memory that is quite pronounced. I think this is a problem given the high scores in other areas. Such discrepancies are called INTRAindividual differences, and can make the child feel "strange" about motivation because he/she can do well in some things but struggles with others.

    Examples from my kids' lives--one very bad--one interpreted badly but without meaning which shows that one cannot generalize about splits---it depends upon how it came about.

    When easy child was a toddler, she had a significant expressive language delay and was served privately 2X per week from age 18 months. I had a very good handle on what was going on because she had been evaluated by the best (Northwestern U. Sp/Language Clinic.) When she turned 3, the school district evaluated her. She scored a VIQ of 75 and a PIQ of 138. The ditz who evaluated said that she averaged out within normal limits (with a 63 point split!!!!) because the FSIQ was around 106. This is not OK--we moved out of this school district when they stood behind this nonsense. There was nothing average about her--she was VERY strong in nonverbal reasoning and having serious problems with verbally expressing what (it subsequently was shown) she knew--but couldn't get across to the examiner. To ignore this type of split is very incompetent of the examiner and would have very negative effects on the child.

    Ex-difficult child was evaluated to rule out Learning Disability (LD) (and ADHD) in second grade. He scored well above 145 on PIQ because he is blazingly fast and got every time bonus available AND mental math is also on the PIQ. He scored a VIQ of 120 giving him at least a 25 point split which by age 8 is stat sig. The school district used this "discrepancy" to "prove" he had an Learning Disability (LD) he didn't have because first, a VIQ of 120 suggests above average verbal skill--AND he was at or above grade level in reading. I told the school psychologist that if he were retested, and I told him it was VERY IMPORTANT TO SLOW DOWN, to make sure he made NO ERRORS, those time bonuses would disappear, and then he would not have a stat sig split and his bogus Learning Disability (LD) would disappear.

    The school psychologist--who was competent but under pressure to find ex-difficult child Learning Disability (LD), looked at me and said, "I take your point, that won't be necessary." Statistically significant splits that are produced by one score being extraordinarily high should not be a basis for concern when compared to an "adequate" score.

    Your daughter MIGHT have that type of benign split based on the VIX and the NIX only--but that subtest at 25 with a mean of 50 and a s.d. of 10 is a problem. Sure, it's only one test--and not very good one at that from what I can understand, but you have other concerns in this area. I think her verbal memory should be evaluated thoroughly to try to figure what isn't "working" for her so a remediation strategy can be tried. Trust your gut--this is not inconsequential in my opinion.

    Martie
     
  3. mistmouse

    mistmouse New Member

    Thanks Martie,
    I do wish they would have just done the WISC-IV, especially in light of my reasons for the re-evaluation, and since that would have given me a comparison with how she tested initially. I can't find the initial evaluation since I have notebooks from the various years, as well as things that were disorganized when I provided everything to the attorney when we went to due process the first time. I do remember on the WISC although my daughter did end up with a FSIQ of 136, her nonverbal IQ was 144. I also remember that her subtests were anywhere from a 9 to a 19, but I was told this wasn't significant by the school district, and it was early into my own research regarding things. Later I was told it just indicated her ADHD.

    What I am trying to find out is if this can be causing some of her anxieties, and if so how and what do we do about it? Right now in our area she is still in elementary school being in sixth grade, but she goes to junior high next year.

    What will I need to ask for in regards to having her verbal memory evaluated thoroughly to try to figure out what is working for her or not? Do I just tell them that I would like further testing as I am concerned about the big difference in verbal and nonverbal memory? The IEP meeting is to discuss the evaluations done, both the re-evaluation the school did, as well as the Occupational Therapist (OT) evaluation requested for the umpteenth time. I am not confident that will yield the results desired either, because rather than focusing on whether my daughter is behind age equivalent or grade equivalent on visual/motor, it seems the Occupational Therapist (OT) is more focused on recommendations regarding modifications and accommodations as he says that at her age there is little that Occupational Therapist (OT) can do. I of course want the numbers since I have been saying since second grade that she has visual/motor deficits.

    I guess I just want to be sure that none of this is a cause to some of the behaviors my daughter has, or is the cause of her anxieties, which we know are predominantly school related.

    Thank you for your detailed information. I will keep plugging along trying to figure out what is going on and trying to help my daughter to be as successful as possible, but it sure as heck would be nice if the school district were helping instead of hindering.

    mistmouse
     
  4. Martie

    Martie Moderator

    MM,

    I have to go to work.

    I'll get back to you later (tonight)

    Martie
     
  5. mistmouse

    mistmouse New Member

    Thanks for all your time Martie. I appreciate it and will be looking for further information when you have time.

    mistmouse
     
  6. Martie

    Martie Moderator

    MM,

    This is just my opinion BUT I do think that widely discrepant abilities cause anxiety in children and adolescents. I referred to this in the example of my daughter who could, at 18 months, solve non-verbal puzzles at a 4 to 5 year old level but still could not talk (much) at 3. This is a set-up for feeling "strange" which I called 'motivation' in the earlier post but also could be true for for anxiety, as in 'why am I like this?" Further when children are good at one thing, people assume they will be good at others and they are BLAMED for not achieving evenly, and called lazy or unmotivated.

    Case in point: my ex-difficult child only NOW can "own" his lack of motivation for most of what is taught in elementary and middle school--and he COULD HAVE done it--but the whole "Is he Learning Disability (LD) or is he just lazy or is he just strange???" all increased his anxiety. Imagine how much worse this would have been for him if he really couldn't do these things.

    I think that your daughter's diagnosis's also set her up for feeling her discrepancies to a greater degree because she is so bright. I have a lot of experience with mood disorders, anxiety and lack or performance--and the whole failure to 'get it' on the part of school personnel leaves a mark on kids with mood problems that might roll off more externalizing kids.

    What should you ask for? Well, first you need to convince someone that the discrepancy is a problem. Notice in the example of my kids that in the case that was severe and the problem real, we just moved out of the school district--for other reasons, too, but their having it so wrong about easy child was a very big reason. Did I win that war? No I left the field of battle. With ex-difficult child, I was easily able to convince the school psychologist that the stat sig spread was artifactual and even offered to make it "go away" to prove my point. I KNEW and he KNEW that ex-difficult child was not Learning Disability (LD) but teachers still talked (about his mother's denial for one thing) and did damage to his self-esteem.

    So if your school district thinks they can "blow off" the differences in memory performance, they will. by the way, a spread between 9 and 19 on the WISC series is a spread of 3 standard deviations and is not in my opinion a product of ADHD.

    There are tests that target memory specifically and I have not been doing enough direct service evaluation for the last 10 years to be certain which might be best. I can check it out with colleagues, but truth be told, most of them are into RTI and not very interested in the types of diagnosis that identifies specific problems which is then used to target remediation. I think that a OSFA intervention based on RTI is wrong. My gut tells me that, and I put it into action with my kids--I did not get generic help for either. I found out what the problem was, and had it addressed. Under RTI, it would have been assumed that easy child had problems she didn't have and would have been remediated for output problems instead of underlying problems. The proof is when she finally started talking, a whole lot came out and she began reading spontaneously at 5 which is not typical for a child who is going to have LDs. If I had allowed ex-difficult child to be treated as an Learning Disability (LD) kid just because he wasn't performing, his self-esteem would be long gone before he ever got to age 12. He has a mood disorder (predominantly depressed) and when he is OK--everything works. When he is not OK, nothing works--how does an intervention for Learning Disability (LD) help any of this?

    I think there are fairly strong parallels to your daughter's situation.

    If I were going to ask for an evaluation--it would be to investigate what I am certain is a meaningful split in memory abilities.

    One such test is the TOMAL (Test of Memory and Learning). Unfortunately one of the authors is Reyonolds. It assesses verbal memory, delayed recall, learning, free recall, attention/concentration, nonverbal memory, sequential memory, associate recall, and yields a composite memory score. The administration time is 45 minutes. It is normed on a national representative sample.

    The other thing I found is the WRAML2 (Wide Range Assessment of Memory and Learning 2nd ed.) It evaluates immediate and delayed recall and differentiates between verbal, visual, and global memory. It is often used in rehab situations following Traumatic Brain Injury (TBI) to plan interventions. It has 2 verbal, 2 visual, and 2 attention/concentration subtests yielding a General Memory Index, a symbolic working memory index and a verbal working memory index. These last two might be very helpful in sorting out what is going on with your daughter. The scoring includes a discrepancy analysis. I have no information on administration time but the test is normed on an unspecified "national sample."

    I can not vouch for the utility of these two tests. When I used to evaluate lots of kids, I had strong opinions on many evalaution instruments--now I am more into the theoretical end of things--standing firm in the belief that it really is important to find out what is going on, before deciding what to do. This is not a currently popular view--but I think "try anything and everything" approach is sloppy and hard on the child's sense of self-efficacy.

    I hope this gives you some ideas of how to manage your school district's denial of what I think is quite possibly a contributor to your daughter's anxiety, especially since you report it is limited pretty much to school settings.

    Martie
     
  7. mistmouse

    mistmouse New Member

    Thanks Martie, That is the kind of information I was needing. I am most likely going to have a problem convincing them the discrepancy means something. As noted in the report, it just wants to lean toward saying my daughter is a visual/spatial learner and make a few recommendations. Like you said, I believe this can be contributing to my daughter's anxiety, whether it is from the differences she may feel in being able to do most things and not others, or whether it is due to the general attitude on the part of the school district that if difficult child isn't doing something she is just being lazy or is "willfully disobediant".

    I have another question for you, if you check in on this thread again. Today I got the Occupational Therapist (OT) evaluation report, which of course was requested on my part yet again due to the continued problems with handwriting and the big issue they made out of it. She hadn't been tested since third grade, but just before third grade started I had gotten an outside Occupational Therapist (OT) evaluation and on the TVMS-R he reported a standard score of 80, percentile rank of 9, and a motor age of 5.1 (she was a little less than 4 months away from being 9); the school district rejected my report and said they would retest her, and they did about a month after my outside Occupational Therapist (OT) evaluation. The results of the Occupational Therapist (OT) evaluation done by the school district doesn't give me anything except Age Equivalancy, and they say that is 8 years 7 months (she was now just a little less than 3 months from turning 9). Now the school district has done another Occupational Therapist (OT) evaluation, but they did send her to somebody outside the school district. However, he seems to think the reason for the evaluation is to get meaningful modifications and accommodations, as he said "at this age there isn't much in the way of Occupational Therapist (OT) that is going to remediate anything, so we look at keyboarding or other accommodations." Fine, we want that too, but I did want the comparative value to see where my daughter is over 3 years later when the school district denied she had any deficits a month after I presented a report that said she did. This evaluator didn't give any age equivalancy or motor age, so I don't know how to determine where she is now to where she was three years ago. He reports a Standard Score of 88, and a Scaled Score of 8, but doesn't tell me how that translates to either the motor age reported on the outside evaluation I had done, or the school district evaluation done a month later which reports an AE of 8.7. Since the school district didn't give me a Standard Score or a Scaled Score then I have nothing to compare this to. What does stand out is he says, "difficult child demonstrates minimal to negligible overall improvement in the area of visual motor skills when compared to her past scores on this assessment tool." OK, is he talking about the one I had done in August of 2003 or the one the school district did in September of 2003, and the same test was done so there is the problem with repeating a test so soon and how that figures into how she scored on it. Either way, I do know it seems as if the evaluator is saying my daughther has made little progress, so at the least that would put her at an AE of 8.7 where she was when the school district tested her, and she is 12.1 years old. I believe that if she has not made much progress over three years, then three years ago the test I had done that showed a motor age of 5.1 was probably correct, and in the little over three years she has improved to the point of being AE 8.7 now, which would be three years growth over three years time, but still she is 12.1 and any improvement she made was on her own as they supplied no Occupational Therapist (OT) services. I am dismayed that this evaluator didn't take it to the logical step so that it could be used as a comparative tool rather than just to make suggestions for how to keep difficult child from doing so much handwriting. Anyway, I am rambling again. If you happen to check in again and see this, if you have any suggestions regarding the Occupational Therapist (OT) evaluation, it would be greatly appreciated.

    mistmouse
     
  8. Martie

    Martie Moderator

    MM,

    You can roughly figure out the school district score from their evaluation: if she was only six months behind at that time, the SS would not have fallen much below 90 (which is within normal limits) Age equivalents are a mess because they have no relative meaning which is why SS should be used. What does it mean if a 12 month old child is 6 months delayed (an IQ of 50 comes to mind--with the hope that it won't turn out that way.) A lag of six months at age 8 is a concern but unlikely to trigger Special Education services (absent a performance problem which your daughter had) and at age 18--a 6 month lag is no big deal at all. It might yield a SS of 97 or 98 (because so many more months have been lived.) One can represent this mathematically: at 6 months-- 6/12; at 8 years 6/96; at 18 years--6/216.

    I suspect that the current Occupational Therapist (OT) is being compared to the 8 year old test and "no absolute gain" should yield a much lower standard score. However, what I am confused about is whether your Occupational Therapist (OT) and the school district Occupational Therapist (OT) used the same instrument; if so, one or the other was an invalid administration. If they were different instruments, then who knows?

    At this point in time, you can ask for direct remediation OR you can go with accommodation. Keyboarding is important but not all kids with motor delays and handwriting problems are good at keyboard either.

    I really think the memory issue is more important although not being able to do something as common and frequent as hand writing could also contribute to anxiety.

    I do not have any personal experience with fine motor problems--it is a major strength for both my kids-- Professionally, I screened with the VMI a lot and referred complicated cases to the OTs.

    I'm sorry I don't know more about this but GET THE PERCENTILE RANK ON THE VERBAL MEMORY from the school district. Then let them explain it away--it's going to be very low--On a scale with a mean of 50 and a s.d. of 10, a 25 is 2.5 s.d. below the mean. That's LOW--and the nonverbal memory subtest was at the 64%ile.


    Good luck on this--it's a hard row to hoe--bright kid with a mood disorder, been there done that.

    Martie
     
  9. mistmouse

    mistmouse New Member

    Martie,
    Yes, the same test was used all three times; in August of 2003, in September of 2003 by the school district, and then in December of 2006 by an Occupational Therapist (OT) outside the school district. The test given was the Test of Visual Motor Skills-Revised in all three cases. I did have an opportunity to talk to the Occupational Therapist (OT) tonight as he called to make sure I had gotten the report. I was explaining to him that I needed some comparative measure to know where my daughter is now. He basically said the same thing you did about the age equivalent stuff, but I explained to him that in September of 2003 the school district didn't provide me with standard scores or percentiles or anything when they did their testing, they just said age equivalent of 8.7 years and she was 8 years and 9 months old at the time. The outside report was done when she was 8 years 6 months old and showed a motor age of 5.1, but he did give the standard score and it was 80. So, this Occupational Therapist (OT) said when he got home he would look it up so that he could give me that information for comparative value. He sent me an email saying that my daughters age equivalency is the same as it was in September of 2003. For that reason he added this paragraph to the report:
    "Meghan was administered this specific test twice in 2003; once on August 8, and again on September 5. The results of these two administrations were significantly different, with a 3 year 6 month discrepancy in overall motor age between the two. This discrepancy could be due in part to a learned response in a test-retest situation since the instrument was administered so close together (less than 1 month apart). Thus, it is difficult to determine Meghan’s true progress in the area of visual motor skills by comparison with previous scores, as she made has made 3 years 6 months improvement when compared to one, and no improvement when compared to the other. The information to consider at this time is that current assessment shows that although Meghan falls in the low average range of overall visual motor skills, she does experience difficulties in the areas listed above, which compromises her ability to successfully complete handwriting tasks."

    My thinking is regardless of whether she made 3 years 6 months progress from where she was on the Occupational Therapist (OT) evaluation I had done, or no progress from the one the school district did, if she is still at an age equivalency or motor age of 8.7 years, then she definitely has visual/motor deficits since she is 12 years old, and they have been denying all along that she has any visual motor difficulties at all.

    However, I do believe the memory is a bigger issue and I will be trying to get them to look at that on Friday. I did finally get a RIAS Extended Score Summary Table from the diagnostician. It doesn't give percentiles for verbal and nonverbal, but rather just gives a percentile for the composite memory index of 21%. Her raw scores for the verbal memory 6 and for nonverbal 87. The percentiles for the VIX is 61, NIX is 97, CIX is 87, and then like I said for CMX it is 21. On the summary table it gives a stanine for the above too with it being 6, 9, 7,and 3 respectively.

    I do thank you for all your help. I know just enough, having only gotten a bachelors in psychology, and my own research to know that these kinds of discrepancies can and usually are significant. I will let you know how the IEP meeting goes on Friday.

    mistmouse
     
  10. Martie

    Martie Moderator

    MM,

    How did the meeting go?

    Martie
     
  11. mistmouse

    mistmouse New Member

    Martie,
    Thanks for asking...it was postponed until Monday due to the weather being such that their attorney couldn't make it here. Of course my attorney was going to look into that since they had communication that they were both going to attend by telephone since it is a long trip for both.

    Anyway, I will let you know on Monday how things went. I did talk to my daughter's therapist, who is also a part of the IEP team and the behavior consultant. She says that she normally uses the WRAML2 instead of the TVMS-R, but that she doesn't need more testing to figure out what is going on with my daughter now that I gave her the subtest scores. She had some great ideas of what to tell the school district about how this effects my daughter, not only for academics, but also for the directives or redirections they are giving. She also said that it will be important to point out to them that while the testing indicates that difficult child is a visual-spatial learner, that the way she would best be able to learn isn't going to be possible for her since she also has visual/motor delays. So, we will see how things go, and unless they try to deny anything as far as a problem, then I won't ask for further testing right now. At least not from the school district. I will probably be trying to get a neurological exam set up for my daughter.

    So, I get to wait through the weekend for a meeting that probably could have taken place today.

    mistmouse
     
  12. Martie

    Martie Moderator

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