Questions about neuropsychologist evaluation results...

Discussion in 'General Parenting' started by Cindijh, Sep 6, 2008.

  1. Cindijh

    Cindijh New Member

    B had her first neuropsychologist evaluation done almost three weeks ago. Finally, we will get the results on Monday. She was not tested for learning disabilities because we do not suspect any other than ADD...and insurance would not cover them. The test consisted of IQ testing, personality testing and whatever testing they do for ADD.

    There was some friction with ex and neurodoc about the length of time this took etc. She called me concerned that it might affect the appointment. I told her I thought he would behave during the appointment. She has something to tell us. She said she wants Beth to "be able to hear what she is saying because a lot of this will be up to decide if she wants to take it and run with it" Her words exactly.

    So my questions are these
    1. What should I expect her to cover as far as information?
    2. Are there any particular questions I should ask/things I should watch out for etc?
    3. Any cautions, words of wisdom, advice?
    4. We have always been told Beth is very, very bright but "does not work up to her potential". Are there any particular questions/issues concerning her IQ test score that I should be aware of?
    I am new at this. B has always been oppositional in a sneaky way...but it is more full blown now. Exponentially worse the past 6 months. Drug use, running away, etc. She has ceased to run away. CPS and the judge ordered weekly drug tests. She is going to a special school for truant kids with behavior problems. For the most part her behavior is not confrontational in school, but more was due to cutting classes etc.

    And as a side note, I found a naked picture of her on her myspace. She is with her dad this weekend....and they are all late sleepers....but we will definitely be chatting about the picture later. I guess the Tshirt with the huge graffiti like letters that spell out YOUR GOD IS DEAD just wasn't getting her enough attention. :hammer:

  2. klmno

    klmno Active Member

    Others here have more knowledge and experience with these than I do, but I'll share my minimal experience- based on my difficult child having one neuropsychologist testing. The psychiatric should cover most of what you have asked about during the meeting. Specific questions are dependent upon the child, any concerns you have, etc, and you can jot those down and take a list of questions in with you to ask.

    The biggest thing that I wish I had known then- my difficult child had been exhibiting a lot of bad behavior and odd behavior before the testing and the neuropsychologist was aware of this. She "touched" on it in her written report and I never thought anything about her very brief written references to certain incidences at the time. However, these test results and written report will probably end up being seen by sd and a lot of others over the next few years. When others read the report, they only see the brief references, with no clarification or explanation of context. People tend to assume the worst, so it has caused a problem because it ends up making difficult child look a lot worse. (Example- my son had almost set himself on fire- no one else was around and I happened to catch him in time because I saw him from the window of our house. The neuropsychologist only put in her report that difficult child had set his tire swing on fire. There was no mention that he set leaves in the swing on fire and the continuously pushed the burning portion into his chest. So anyone reading this report sees a bad kid- not one who potentially could have killed himself. What's worse- a year later he set a brush fire by dropping matches around his feet. No one sees a self-destructive child- they convicted him of felony arson.) So, make sure anything that might be clear to you is somehow clear enough in the report that anyone without other knowledge can understand the real picture based only on what is written in there. (sorry- that was a bit wordy!) And, if ANYTHING is not correct, address it with the psychiatric ASAP.

    The report was long so I didn't have time to read it word for word until after bringing it home. Something was misunderstood about the history that I had provided. It made it in the report- although it wasn't true. I later found out that a psychiatric can change the wording in a report if they choose to and are notified by parent within a certain period of time after the report is written. If the psychiatric chooses not to change anything in the report, the parent can submit something in writing that is supposed to become a permanent attachment to the report. If there is anything at all that you know is not correct in the report, I would strongly advise addressing it ASAP in writing.

    Good luck! The testing is very useful and beneficial so I hope I haven't scared you-
  3. smallworld

    smallworld Moderator

    Here's an abbreviated look at what WISC-IV IQ test scores mean:

    Four indices make up a total of 10 subtests:
    1) Verbal Comprehension Index (VCI) - assesses different aspects of verbal/linguistic intelligence
    Similarites subtest
    Vocabulary subtest
    Comprehension subtest

    2) Perceptual Reasoning Index (PRI) - assesses visual perceptual reasoning, conceptualization and orgnization, as well as an understanding of spatial relations and the ability to perform tasks that require some degree of visualization
    Block Design subtest
    Picture Concepts subtest
    Matrix Reasoning subtest

    3) Working Memory Index (WMI) - assesses the ability to actively hold and manipulate auditorially presented infromation in "working memory" (an "attentionally based" memory store used to temporarily hold in mindthe fasts essential for completing multi-step tasks)
    Digit Span subtest
    Letter-Number Sequencing subtest

    4) Processing Speed Index (PSI) - assesses the general efficiency of mental processing on simple paper-and-pencil tasts that place heavy demands on visual discrimination and symbol decoding
    Coding subtest
    Symbol Search subtest

    A full-scale IQ score is computed based on the above four indices scores, but if there is too much discrepancy among the index scores, the full-scale IQ score is not a meaningful measure of intelligence. Furthermore, WISC-IV profiles with high VCI and PRI scores and lower WMI and PSI scores are commonly seen in students struggling with emotional difficulties as well as those struggling with attentional and executive function disorders. However, an IQ test is not in and of itself diagnostic in any way.

    An IQ test is helpful for giving a general sense of a child's potential, his strengths and weaknesses. But it is more helpful when you can compare IQ test scores (potential) to measures of achievement (actual performance). My personal opinion is that you should have ruled in or out learning disabilities as well. It's unfair to a child or teen to say, "You're very bright, but not working up to your potential," if you don't know WHY she's not working up to her potential. As a possible scenario, she could have undiagnosed LDs that were not addressed, which would then cause her to have poor self-esteem, which would then cause her to act up . . . You get the picture.

    You should also be aware that some children without ADHD test as if they have significant attentional and executive function deficiencies. My own three children fit this profile. Each of them has at one time or another received a diagnosis of ADHD - predominantly inattentive. But we and their doctors believe they don't actually suffer from ADHD. Their mood issues make them appear that way, but if we treated them with traditional ADHD medications (stimulants), it is likely their mood issues would worsen.

    neuropsychologist testing results are a lot to absorb all at once. I hope your neuropsychologist is able to provide results tht make sense in your daughter's case and provide a basis for making decisions that will help you plan your daughter's future treatment.

    Please feel free to post the results once you get them, and we'll try to help you make sense of what's going on. Good luck.
  4. Cindijh

    Cindijh New Member

    We ruled out the learning disabilities portion because the insurance would not cover it at this point, and the dr. thought it was okay because of B's history. Even ADD never occurred to us until just this year because she was doing well in certian classes and not in others. Plus she scores way up there in the PSAT type tests they take. In middle school, she scored in the top 5% in the state of Pennsylvania. There are serious issues with impulse control too...which I've read is a sign of ADD. She does not have the "H" part at all....but does have poor impulse control.

    What will the personality part of the test tell me?

  5. smallworld

    smallworld Moderator

    The personality part of the testing will give you an idea of her psychological functioning. My own daughter's personality testing recently revealed excessive worrying in spite of treatment with two anti-anxiety medications. Clearly, we're reviewing and modifying her treatment at this time. Do you know which personality tests were administered?

    The disorder is now called ADHD whether there is hyperactivity involved or not. Usually there is a qualifier after the diagnosis of ADHD, such as "predominantly inattentive type," "predominantly hyperactive-impulsive type" or "combined type." Like inattention or hyperactivity, lack of impulse control can be a symptom of other disorders besides ADHD.
  6. Cindijh

    Cindijh New Member

    Forgive me for picking your brain...and I know you cannot give me an exhaustive list, but can you give me a few examples of the other disorders?

  7. smallworld

    smallworld Moderator

    Lack of impulse control can appear in Obsessive Compulsive Disorder (OCD), bipolar disorder, Autistic Spectrum Disorder and addiction related to substance abuse. My list is in no way exhaustive.
  8. Superpsy

    Superpsy New Member

    This can be done by your local school district for free if you request it and difficult child is exhibiting some concerns in school (request should be presented well...). If the school district doesn't do the evaluation as requested they have to provide you with prior written notice to let you know why they refused to evaluate, what data they used to inform this decision and other important information.

    How'd the results session go?