school psychiatric report...

[ksm]

I don't have time to type everything... but I was wondering if anyone is familiar with these...

WISC-IV test scores

Verbal comprehension 114 82% High average
Perceptual Reasoning 117 87% High average
Working Memorey 102 55% Average
Processing Speed 83 13% Low average
Full scale 108 70% Average


On another part of the testing for behavior...

At risk for

Externalizing Problems
Hyperactivity At Risk
Aggression "
Conduct problem "

Internalizing Problems
Anxiety Clinically significant
Depression "
Somatixing "

Behvioral Symptoms
withdrawal Clinically significant
attention problmes "

adaptive skills
adaptability at risk
Social skills "
leadership "
actities of daily living at risk
fuctional communication at risk


OK - that is the main things.... thanks! KSM



Thanks for your ideas

 

[buddy]

The testing shows a clinically significant difference between ability and processing.

There needs to be in depth processing testing to see if there is a problem and what is the cause.... Could mean there is some kind of glitch in the brain for interpreting sounds, visual input, language, or a combination.

Imagine if what is coming at you, in terms of information, got goofed up enough that you had to compensate, deal with misunderstandings, suffer through people thinking you are not trying hard enough, are just not doing what you are told/not following directions on purpose.... would you not seek ways around it, become fatigued, maybe get headaches or stomach aches from the stress, start to act up because everyone is upset with you all the time anyway, or any number of other issues???

Not saying this IS why all of the behaviors happen (not even sure of the exact behaviors) but it could be a huge contributor.

 

[InsaneCdn]

The WISC results also show a very significant gap between various sub-tests. We were told that this is unusual (not wrong or invalid, just unusual), and while the sub-tests are valid, the overall score may not be accurate.

The whole "at risk" phrase... drives me crazy. We were told that, too - in the first round of testing. But nobody could tell us what it really meant or what to do about it. It was a catch-all phrase used to CYA for the tester... if something showed up later as a major problem, the tester would just say that they DID flag it...

 

[TeDo]

At risk of having issues in the areas of: Externalizing Problems, Hyperactivity, Aggression, Conduct problems, Internalizing Problems, Depression, Somatization

Anxiety level is Clinically Significant meaning it "indicates" there appears to be severe anxiety issues

Behavioral Symptoms displayed include attention problems
Withdrawal level is Clinically Significant "indicates" there could be some depression

Adaptability (to people, situations, problems), activities of daily living (normal necessary life activities), functional communication (ability to make needs known and carry on conversations) are at risk of being "issues" so there is some concern.

Does that help? To me it says ADHD, Anxiety, and Depression are what they are seeing as the main psychological issues. The Clinically Significant stuff should be verified & treated by a psychiatrist, if not already. Areas that are At Risk are the things that should be accommodated and actively taught (through goals & special services) through an IEP.

 

[buddy]

I agree, but would definitely first check to see if there is a serious processing issue.... since he is so bright, he could be fighting with all he can to push through a physical/neurological issue that is manifesting as these psychological and behavioral issues. Probably not the whole story but the psychiatric is not going to give it much of a thought. I truly believe they underestimate these things that can have such a HUGE impact.

 

[ksm]

Does that help? To me it says ADHD, Anxiety, and Depression are what they are seeing as the main psychological issues. The Clinically Significant stuff should be verified & treated by a psychiatrist, if not already. Areas that are At Risk are the things that should be accommodated and actively taught (through goals & special services) through an IEP.

That is just it - we have the meeting next week - and they are already telling me that she doesn't qualify for an IEP based on testing. I don't get it. She is is the 87th percentile on some things and 13th percentile on processing speed. Seems very significant to me. I will be having an appointment with my therapist (whom I mainly see to discuss difficult child) and hoping he will give me pointers to get thru the meeting. Then I will forward all the info to the nueropsych that wanted to do more testing and see if she can get insurance to OK it. Insurance has already "allowed us 6 more visits until July) as they don't see a need for it. I have a severely depressed and anxious 13 year old who may be bipolar...but they don't think therapy appts are indicated. WTH?? KSM

 

[buddy]

yeah, they are going to say the language processing is still within normal limits... it is the difference between ability and processing that should be able to get their attention.

The clinically significant levels in the adaptive scales are so important and how they could ignore them and deny an EBD IEP I just dont understand. I am glad you have your psychiatric to run it by... Straight out ask if he/she would be willing to make a statement if there was a need in an appeal with the school.

 

[soapbox]

Working memory is a challenge, but not so far out of range as to be unusual. There are interventions, and accommodations.

Processing speed. Hmmm...
Nothing in any of the testing or results provides any clue as to WHY this is so low compared to everything else.

But... this wasn't "team testing".
So... there's other tests not done that might provide clues.

Occupational Therapist (OT) evaluation won't address anything to do with processing speed - the testing that was done wasn't motor-skills or sensory dependent. It would still be worth getting the evaluation done - additional info, may need additional accommodations etc.

The big missing piece, to me, is auditory processing.
Its not "just a hearing screen"... that is useful, but doesn't address the "brain" involvement.
Speech Language Pathologist (SLP) testing, including screening for the lessor-known APDs like auditory figure ground, would be important now.
If he is having trouble picking out what is being said (could be a variety of factors...), then his focus will be on trying to fill that gap... and he won't have much brain power left to actually process what was said... so, if he catches the words at all, they may literally be lost almost as fast as they come in. This is mentally exhausting, and the results of that exhaustion can be extreme behavior problems.

Speech Language Pathologist (SLP) testing will just determine whether or not advanced specialty audiologist needs to be involved.

IF APDs are part of the picture, then accommodations and interventions are crucial to his ability to move forward.

 

[buddy]

Speech Language Pathologist (SLP) testing will examine language processing and there are specialty visual people who help to sort through visual processing too...that can really affect reading and math.

 

[soapbox]

yeah, they are going to say the language processing is still within normal limits... it is the difference between ability and processing that should be able to get their attention.

The clinically significant levels in the adaptive scales are so important and how they could ignore them and deny an EBD IEP I just dont understand. I am glad you have your psychiatric to run it by... Straight out ask if he/she would be willing to make a statement if there was a need in an appeal with the school.

Where's a brick wall to bang my head against for you?
THIS is exactly the problem I'm trying to highlight...
APDs can be language processing problems - in particular, spoken language.
However,...

APDs can also be auditory processing problems, without any of the language processing problems.

And most don't test for them.
APDs can look exactly like ADHD. Not paying attention, not following instructions, etc.
So, especially if the kid has an ADHD label to start with - they STOP RIGHT THERE.

And... its wrong.

How does his performance compare between:
1) one-on-one in a quiet environment, and
2) classroom?
If the problem is things like auditory figure ground, the student works well in case 1) and terrible in case 2)... and they assume its the "distractions", when in fact the problem is the noise pollution in a typical classroom.

You're going to have to really push for this one to be tested... but if this is one of his problems, solving it will provide a HUGE stepping stone to better performance and better behaviour.

 

[buddy]

yes .... AND a language processing problem can be just that, in the area of the brain that understands and the areas that formulate language there can be problems whether or not that input comes through auditory means (including reading or sign language).

This is why with those scores it would be good to have it all checked to make sure.

Clearly emotional and behavioral issues could also affect processing.... but in those cases you would expect to see more areas affected, not as much a singled out area of deficit.

In this case so much of it is probably intermixed by this age... needing to attack things on several fronts. Even though my son has obvious learning issues, processing issues, sensory issues, motor issues.... that probably drive many of the emotional and behavioral problems.... does not mean that even if I could magically fix all of the developmental problems he would be ok emotionally and behaviorally. Much of his self image and even brain function in terms of emotions have been affected over years of problems. He still needs attention for all of it.