WISC-IV results - what do these IQ results indicate?

[whichcamera]

I have been advised by professionals that the following results on an IQ test indicate that my son is unlikely to have Aspergers and that he does not need further testing for this at the moment. As expected he loved doing the tests and wants to go back for more.

Verbal comprehension index - in the very superior range with comprehension the best of the 3 sections (99th percentile).

Perceptual reasoning index - superior

Working memory index - overall average but the digit span section below average (would this explain his inablity to follow my simple instructions wth everyday tasks?)

Processing speed index - average

Does anyone have any comments on these fluctuating results and what they may or may not indicate?

Also if your child has a similar profile how does it show itself in behaviours and school performance?

Many thanks

My ds was:

Verbal comprehension - 95th percentile - superior
Perceptual reasoning - average
Working memory - high average
Processing speed - low average

He scored highly on two out of the three Perceptual reasoning subtests, but much lower on the third, which brought his score down. We have since discovered he has a visual control problem which would explain this discrepancy. With the visual issue corrected/removed the EP expects he would be high average or superior for PRI.

With working memory, his digital span was apparently particularly high. This is what the EP said about the working memory section of the WISC:

The two subtests administered are a measure of working memory abilities. Tasks that require working memory require the ability to temporarily retain information in memory, perform some operation or manipulation with it and produce a result. Working memory involves attention, concentration, mental control and reasoning. Research suggests that working memory is an essential component of other higher order cognitive processes, as well as being closely related to achievement and learning. X's scores indicate that he performed in the high average range.

If you take into account my ds's undiagnosed visual problem, their profiles are quite similar, although my ds has a slower processing speed than yours.

My ds was dx with Aspergers, a month after he did the WISC, at a mutli-disciplinary assessment that included consideration of his WISC results a as part of the process. The EP responsible for ds's WISC was present and involved with the dx.

I'm not sure if I'm exactly right on this, but a WISC test cannot test for non-verbal communication skills, which is essential in dx AS. As far as I am aware, AS should not be discounted based purely on WISC results.

A dx of AS requires evidence of traits from all three areas of the triad of impairments. I was going to link you to the NAS information about the triad of impairments and how it relates to AS, but it seems to be down at the moment.

Who carried out the test for your ds?

An IQ test has nothing to do with whether or not your child has Aspergers! Which professional told you this? An EP? It's absolutely shocking.

Problems with working memory can cause huge problems with learning, especially learning to read. But 'below average' doesn't sound like 'problems with working memory'

I'm afraid you're going to have to try and get a proper dx of Aspergers. Ask your GP to refer you to a child development paed.....

But there is no relationship between your IQ and whether or not you have the triad of impairments that get labelled as Aspergers.....

Indigo said it much better than I did.

The WISC can only identify specific areas of strength and weakness in relation to learning - it has nothing to do with whether or not a child has Autism and is not designed for that purpose, anyone who tells you otherswise is a) wrong and b) highly unprofessional.

I only related my ds's scores to show you that the WISC results were irrelevant to his diagnosis.

Don't let them grind you down which... my Dd1 scored very high on an iq test when she was 6.5, the result was thrown back at me by every professional and family member I ever spoke to about her behaviour.

I eventually gave up seeking a dx because a family therapist told me it was my parenting style which was causing her challenging behaviour.

I am to this day convinced she has an ASD albeit high functioning.

She has such a spikey profile, terrible theory of mind and auditory processing amongst other things but got 10 gcse's without even breaking into a sweat!!

Your son's comprehension and reasoning skills are high, but his processing and memory are average or slightly below. This is a typical spikey profile found in children with Asperger's - it doesn't rule out AS in any way (but AS is complex to dx and will probably need a multi-disciplinary team). It means that his underlying abilities are good but his performance skills are poorer, which could cause frustration as he will find it difficult to keep up with sequences of instructions, as you've noticed.

Try to break down instructions so that he only receives one at a time. Also, give him time to process any information - allow five seconds for the information to sink in before saying anything else or expecting a response. Written reminders will help.

The fact that his comprehension is high means that he will probably develop coping strategies of his own accord, but he could be vulnerable to having his difficulties ignored as he'll come across as bright.

lol indigo

dd2 was (is?) in the very superior/ superior range for everything except processing, which was below average. she came out at 142 overall.

she doesn't have aspergers, she has cerebral palsy, we knew that before she did the wisc iv.

but it doesn't mean that a child with similar results wouldn't have aspergers.

are there really people using the wisc iv in isolation to dx?

Thank you all for your replies. This report was produced by the multi disiplinary NHS team we are under. I presume they are quoting the WISC results to support their belief to justify not conducting further tests. This belief is founded on the school (NQT) not noting a problem and him being amazing in 1 to 1 tests with an adult. No surprise there as he is an absolute delight in such adult situations.

I knew a diagnosis was unlikely to be conclusive at this time as he is still young, has learnt so many covering up behaviours in public and if he has it would only be mild in some areas... but having been told the ADOS was being done I just got a total shock when I got the report and it had not as I had mentally prepared for weeks for the result of this test.

This is the first time in the whole 2 year battle for help that I have not slept at all. I keep reflecting on what can the report mean by the complexity of my relationship with him. What is being suggested? I just dont understand as it has always been apparent that he is very different/eccentric but as many of the characteristics are no doubt inherited from me and my family I have always felt that made my relationship stronger. I just feel sick now and really dont know what to do.

We dont have the option of nothing like Ineedalife because my son has toileting issues and is being called stinky at school and he wants friends.

Hi, moosemama,

How was your ds's visual issue diagnosed? It's just that all aspects of my ds's memory, and his verbal reasoning, were exceptionally high (in top 0.5%) but his perceptual reasoning was massively lower than this, which is odd, since he never confused left from right or reversed letters, writes beautifully and learnt to form his letters correctly at a very early age, read from a very young age (so no trouble combining letters to make words), has no trouble with symbols or numbers (his mental arithmetic is abnormally good, he recognises number sequences and connections between numbers very easily)... his perceptual difficulties seem to relate entirely to dealing with anything in 3D - whether that is a 2D representation of 3D or real life 3D (eg he had to be taught how to manipulate his clothes in order to dress himself; he doesn't really understand perspective in pictures). He was very late moving - didn't crawl until he was 17 months old, as a result of hypotonia and hypermobility, which could explain some of the difficulties with 3D perception (ie lack of experience moving around in the real 3D world!!!), but since the area where he seems to lack understanding is so incredibly specific, I can't help thinking there is something a bit odd going on, there...

Rabbit - it's perfectly possible he has no 3d vision. My DS didn't.

Easiest way to get this checked is at a behaviour optometrist...

Which- for now just focus on the toiletting issue. Every time he has an accident at school go I to school and ask them what they are doing to help. Make a formal appt with the senco to discuss the issue. Then when I keeps happening make a formal appt to see the HT.

Be the biggest PITA imaginable. They have a duty of care to your DS and they are not looking after him. Just keep on and on at them. What are they doing to look after him.

Follow up every meeting with an email stating what they promised you.

Don't let them attack your parenting. These accidents are happening at school. Just keep repeating that.

And the same with other proffs. Just keep asking what are they going to do to help.

If you are a big enough PITA at school they will have to do something....

Thanks, Indigo - can this be cured?!

I've got the details of a behavioural optometrist near here from the BABO site you linked on another thread...

Rabbit - it can certainly be improved. DSs was helped by the sound learning centre. But I think vision therapy done through the behaviou optometrist should also help it.

DD did vision therapy and it massively improved her vision but I don't think 3d was one of her problems (can't remember)

but I remember DS saying (after doing LWS at the SLC) "when I play warhammer I can now tell if the figure is behind or in front if the gate"!

What does LWS stand for?

Light wave simulation I think. The sound learning centre offer it when you do auditory integration therapy....

And I've said on many many threads how much I recommend that.

whichcamera, I am so sorry they are messing you around like this. Is there any possibility you could get a private Ed Psych assessment? If not, could you write to them, including a report of all the traits you see and relate them to the triad of impairments.

This article might be useful as it states that children with HFA typically perform highly in VCI and PRI and lower in WMI and PSI. The only difference is that it in the article it states that, typically children with HFA perform below normal on the latter two, whereas both your ds and mine performed within the average range - that shouldn't matter - its the wide span or difference between their VCI and WMI/PSI scores that is significant, not where they fall in the centiles. Taking this into consideration, both our ds's fit the profile for AS based on their WISC scores, so the multi-disciplinary team are wrong. This is borne out by the fact that my ds was indeed dx with AS (by an NHS multi-disciplinary team who carried out both the WISC and the ADOS tests).

As for the toiletting issue, as Indigo said, keep on at the school, put everything in writing and ask for written responses within a specified timeframe (have learned that one the hard way myself this week). They need to come up with a pastoral care plan that will support his needs around this.

Apologies for the quick hijack whichcamera:

Rabbit, his visual issues were observed by the Ed Psych during the WISC test - he obviously couldn't track from left to right for the perceptual reasoning test he struggled with.

The OT also picked up that he has extremely poor depth perception - which makes sense of his inability to catch a ball bounced off a wall or throw a beanbag anywhere near a target on the floor. She also picked up that he isn't able to see a ball coming towards him, so uses his body to block it, rather than trying to actually catch it.

A standard optician noticed problems during her test, particularly extremely poor binocular vision and tracking.

Finally, he had some visual interference that made it impossible for him to read a few weeks ago and was seen in the specialist Eye A&E, who pretty much backed all of the above up and also revealed that he has sensory issues surrounding his sight. Since discovering the interference was a sensory type problem, amazingly he has been able to retrain himself to tune it out to a large extent. Never ceases to amaze me that boy.

Despite all this, he is a prolific reader, who when tested last year, was reading four years above his age - although they felt he was probably reading higher than that, but didn't have the tests to try him on.

I have spoken to ds2's paediatric consultant optician and she said they can test a lot of the above at the paediatric eye clinic, so he's been referred there in the first instance. She said if they can't help, they will be able to recommend where to take him for the right sort of visual training, but we will have to pay. I think we'll probably still end up paying for a full BABO assessment and training programme, but its worth trying the NHS route first. NHS support for this kind of thing is almost none-existent in the UK, but its worth investigating as going private is extremely expensive.

whichcamera

Didn't explain that very well.

Ds's EP showed me the graph of ds's WISC results and pointed out the big gap between his VCI and PRI scores - up at the top of the graph (also bearing in mind his predicted high PRI once his visual problems are resolved) and his WMI and PSI scores much lower down the graph.

She explained that is isn't the actual scores, but the size of the gulf between them that is significant.

So effectively if your child scores high-average/superior/very-superior for VCI and PRI and low average for WMI and PSI, there is still a highly significant gulf between the two sets of results, even though he actually scored within the 'average' centiles for WMI and PSI.

There are lots of articles online which discuss the importance of this distinction. A child can still be considered gifted and talented, yet have low working memory and processing scores. (Often the case in HFA/AS.) They have the intelligence level required for superior attainment - they just need to be given longer to reach their conclusions and in some cases a slightly difference approach to learning.

There is no way that the WISC should be used to exclude the possibility of ASD. Its a tool which was designed and is used to identify possible learning disorders and difficulties - of which ASD is neither - its a developmental delay. Its perfectly possible to have ASD, but no learning difficulties.

Not sure I've made that any clearer. I think I'm confusing myself now. [clearly not as intelligent as my ds1 emoticon]

My other post may have made it sound like we didn't need to get help for Dd1, that was not the case, her social difficullties made her life dificult at secondary school.

She was mega popular with the teachers but had a hard time with her peers.

She still struggles with making friends and makes herself unpopular with her poor understanding of social etiquette.

Despite all her issues she coped academically at school and stayed under the sn radar all the way through school.

This is why we are fighting soo hard to get Dd3's issues recognies, we have been down this road before!!

I hope you get the support for your Ds that he needs, but you will have to fight school all the way because if he loves adults and tests he could easily slip through the net.

Just to say - this sort of profile (with high verbal and perceptual skills and average working memory and precessing) are actually fairly typical in classically gifted children.

Thanks to everyone for their help.

moosemama ? thank you very much for the link to the article, that certainly disputes what we have been told! Yes we could get a private assessment and I have been trying to look into it. As far as providing examples I had given pages of examples of behaviours from birth as I had fantastic records plus sensory and social communication questionnaires with pages of supporting evidence for each point. The only other supporting information I can think of would be our videos or feedback from friends and family but as the questionnaires etc have never been discussed I think this is unlikely to help at this stage. Yes I understand that the 10 point gap between his top and bottom score is very significant and I think we will find this quite helpful information ie in our use of instructions to our son and our expectations re working memory etc.

oakmaiden ? please can you clarify do you mean that this suggests it is not ASD just classically gifted?

Ineedalife ? my brother was almost exactly the same as my son but coped by rarely going to school beyond age 7 and I dont want my son to experience the same either much as I am sure that he could also home educate himself with the same success hence my 2 year battle for help so far.

Does anyone have any recommendations for finding someone experienced to conduct a private assessment for ASD?

Many thanks.

Whichcamera - I don't think you can definitively diagnose or rule out ASD based on WISC results, but he clearly IS gifted whether he has ASD or not. It is apparently fairly typical for gifted children to still score averagely in WMI and PSI.

I don't know your son, so I couldn't comment on whether he has ASD as well - although the profile is not atypical for that either. Research suggests that children with High Functioning Autism have above average VCI and PRI and below average WMI and PSI, so the profile is similar. My only surprise would be for a child with Aspergers to have scored so highly on the verbal comprehension subtest, compared to other subtests - this is answering questions based on their understanding of general principals and social situations - something which generally isn't a strong point for children with Aspergers! It could be that this is what is making the "professionals" think the problem might not be Aspergers.

Daphne Keen is excellent for ASD and ADHD, she is a highly respected paediatrician. I've also heard good things about the London Children's Practice - which will probably be a bit more expensive as they'll do a multi-disciplinary assessment.

Oakmaiden ? thanks for this, yes you are right this is exactly the professionals reasoning and it is obviously interesting for me to hear you support this.

I dont understand exactly what the tests consist of but he was far lower on vocabulary which really surprised me although it still averaged out at 98th percentile. Amazing if he understands social situations as his behaviour attacking well behaved girls at school or according to school not being embarrassed at being wet or soiled or crawling down the high street barking like a dog would have made me think he doesnt have any idea of what is appropriate for a 6 year old!

Does anyone else have a child who scored highest in comprehension of all 10 sections and would they still display inappropriate behaviours?

Also advice still welcomed for finding a private assessment

Many thanks

Oakmaiden/whichcamera

These are my ds's VCI results:

Similarities 14
Vocabulary 16
Comprehension 12

I was told he is strong on verbal comprehension, but has almost non-existent non-verbal communication skills. I think there was some initial debate about whether he might have NVLD rather than ASD, but after carrying out the ADOS they said they were completely satisfied that it definitely was AS. Apparently the fact that we've taught him lots of metaphors and idioms would have ramped up his score a bit.

During his assessment, the Clinical Psych tried to see if he could understand metaphor by asking if his pocket money burns a hole in his pocket - he just looked up and said - that's a metaphor for wanting to spend it straight away isn't it.

However, in the section of the ADOS where he had to interpret social situations from pictures, he basically got as much wrong as it was possible to get wrong, he just couldn't read the situations/body language/facial expressions at all.

I think his diagnosis was assisted by the fact that he'd had 10 sessions with one of their Ed Psychs for school related anxiety in the preceding months and he had been observed by two specialist ASD inclusion teachers who also work closely with the EP and assessment team, so the service had already gathered a lot of evidence towards his assessment by the time his appointment came up.

My ds really struggles to read social situations. This has made him extremely unpopular with his peers at times. He is also extremely inflexible and very black and white in his thinking, in addition, he's never done any imaginative play and was totally unable to do so during the ADOS.

I've always thought his higher score on the verbal comprehension subtest was down to the fact that he is a very advance reader, as well as us working hard with him on metaphor, idiom and sarcasm. He is a bit of a natural at language anyway eg he's always got full marks on spelling tests without having to learn the words or practise.

Not sure if that helps at all?

Moosemama - yes, you are right, children with Aspergers can learn to understand this sort of thing, and presumably that would boost their score.

Also whichcamera - it is possible for children with Aspergers to have an intellectual understanding of social norms and situations but to still be unable to apply them in real life. This may be the case with your son.

I don't know how the "system" works in your area, but when my son was being diagnosed he riginally had a IQ test done with a community paed, who said all was well. As all definitely WASN'T well I contacted one of the local support groups and found the name of the local NHS "expert" and insisted my GP refer my son there, where he was diagnosed. It might be worth going down a similar route - finding someone who really knows Aspergers well (which the Ed Psych doesn't necessarily - and in any case is not qualified to diagnose) and seeing what they think. You know your son best - if you think there is a problem, then there probably is.

Incidentally, my son has an enormous scatter on his latest wisc assessment, ranging from 17 and 18s for most of the VCI and PRI subtests (except comprehension, which he got 7 in), down to 6's in WMI and PSI. Nobody professional has even looked at it and tried to use it to diagnose his developmental difficulties, merely as a tool to understand why he finds learning so very difficult.