Uneven profile of abilities - Spiky profile - Autism

[ronaldmacdonald]

Hello All, My Son is currently in the last stages of his developmental check.
He was referred over to the developmental team to test for Autism.
Unfortunately my Sons school have given their views to the developmental team and I believe have made it seem that there is definitely no way he could be autistic as they'd never seen the behaviour he has recently been displaying....However the EP that the school called in (I believe to prove he was just a naughty kid) performed tests which seemed to point to autism or some sort of social and communications disorder....Visual cues and stuff like that were advised to be put in place....
My reason for posting is I desperately would like to compare another EP report (only the percentile page, not name or personal stuff) So I can compare my Sons abilities test just to work out whether his profile is just a spiky or very spiky. So I know myself what this "Somewhat uneven profile of abilities means".
I have searched the internet high and low and cannot find a thing on the tests performed under the BAS II system which is the one which was used for his test!! Can anybody help ... x (Also I will be happy to share my Sons percentile findings if anybody wants to compare)

I don't think that comparing another report will show you the information you are looking for to be honest. As no two children with autism are the same. Their 'spikes' are often different.

What tests did the EP do?

How old is your child?

Welcome to MNSN.

They potentially dx autism just based on a BAS II?

Wow.

Fwiw, ds1 has a v spiky profile (50 centiles difference between his highest and lowest scores and nothing in between ) and does not have a dx of asd.

He didn't do BAS II though.

He did WISC IV, WIAT III, Beery VMI, NEPSY II, CPT II v. 5, BASC-2, and the child interview schedule from the DSM- IV, so I don't think you can do an exact correlation.

I am v impressed that they have put interventions in place though. Tbh that means a lot more than any test result. Does it matter how he compares to other children? Tbh no two kids are ever going to be alike, and it's more important that his own needs are met. Not how he matches up to any other child?

There is another thread running in sn that is discussing the same topic, with some facts about statistical significance iirc. That might give you some ideas.

I don't know what all this spiky profile indicating autism on a cognitive assessment is. I've been an autism specialist for 10 years and done 100s of cog assessments and there is no one pattern of abilities that autistic children have. The only thing I can guess at is that if children score uniformly very low, that can explain social immaturity, and quite a few autistic children do worse in the 'comprehension' task in the wisc than the other verbal tasks.

To the best of my knowledge, there is no way to rule autism in or out on the strength of a cognitive assessment alone.

To ilikemysleep. I can understand that the cognitive assessment on it's own is not enough to indicate Autism but it does seem that a lot of the Higher functioning Autistic individuals score quite low in the verbal reasoning in comparison to non-verbal reasoning, which is what the BAS II tests can show. And from what I hear the uneven profile of abilities is possibly going to form part of the triad of impairments soon, as it seems to be that relevant to the Autistic traits. I've put one of the many link references to it that can be found on the TINternet :-) Lucky my Son has inherited the splinter skills section as well so not all doom and gloom :-).

www.autismawarenesscentre.com/maureens-blog/205-the-third-part-of-the-triad-the-uneven-cognitive-profile

My Son wasn't referred to CAMHS based on E.Ps BAS II reports, the BAS II assessment was organised by the school quite a few months after my Son had been referred to CAMHS. And he has already had an interview with the developmental team as have I but just waiting for them to get back to me with their findings. And am still waiting for the school to put the full support in place for my Son, which they should be doing whether he gets diagnosis of Autism or not.The EP has not given her advice based on him being diagnosed with anything, just given her advice. Gotta stay on the schools back......

And thank you for giving me the percentage differences on your Son MADWOMANINTHEATTIC.... The differences between my sons lowest and highest was 79 .... but as you rightly said the test on it's own is not a cause for Autism concern,just highlights strengths and weaknesses. Personally I think that Autism in the higher functioning folks can be managed as a much more clearer way of thinking rather than an illness, but the Autistic individual does need help in this world of neuro-typical unclear way of thinking. If the majority of the world had the higher functioning Autistic way of thinking things would run just fine I'm sure....Then the neuro-typical that smiles at things that are not funny and lies and uses incorrect grammar etc...and does all the other things that are not understood by the straight forward thinking High function Autistic would be in BIG trouble. :-) ....

Okay ronald. I've read your posts and I think I can see where you're at.

Correct me if I'm wrong but your at the:

'WTF stage'. Where it has just been brought to your attention that your child has difficulties and will need support and you're in a hurry to figure out what you can do to help and feel you are racing a clock to do so, whilst at the same time trying to predict what the future will be and look for a way to make everything all right.

The good news is that you can achieve this. But where you are now and the journey towards this is very hard emotionally.

MN can help loads. It helped me. Soon you'll be able to build up a picture of your child, and the available help (warning: most of it is parent implemented or parent guided).

Oh right, but the sort of thing that link is discussing won't be obvious from a BAS II? I'm not sure I agree with Maureen's use of 'cognitive' tbh. Or where the self help skills fit into the BAS picture. (But, as I said, Ds didn't do BAS, which probably explains it. How does the self care stuff fit in? It doesn't feature in the tests I've seen?)

Madwomanintheattic...To be honest didn't read through all of that link,was just one of many that i'v come across, so slung it on, must read through it properly later. There's so much stuff on the net about Autism, and so much of it's with different views, experiences,....have had to take a back step from google cause lot of the time causes me more harm than good :)

Madwomanintheattic...And wasn't in the test room with my Son while he did BAS II test as he's seven so they did the tests with him alone. Tests took about an hour, and did ask him what kind of stuff went on but he was more interested in getting outta dodge city :-)

ronald Mcdonald

That 'third part of the triad' link is someone's personal conceptualisation of autism (an uneven cognitive profile is NOT part of the triad at present) and I don't disagree that many HF autistic people have very high measurable 'intelligence' and yet can struggle with everyday living skills, and from the quick read I have had that is what this guy is talking about. However that is not what an IQ test like the WISC or the BAS measures. It doesn't measure adaptive living skills or ability to tie shoelaces, and it has only a brief cursory go at measuring executive functioning skills which is another area where HF autistic people tend to struggle (it makes up part of what they call 'working memory' on the WISC).

I don't think an uneven cognitive profile is going into the triad. Certainly not the kind of profile a WISC or BAS measures. In fact, they are turning the triad into a dyad next year and it will be 'social imagination' and 'social communication and interaction'. They are putting sensory difficulties into the list of features.

However, obviously any HF autistic person will in daily life have a spikey profile, probably lower with self help skills and obviously social interaction etc than intellectual reasoning skills. Otherwise they would just be all around high functioning in daily life and wouldn't have a problem, so there wouldn't be a diagnostic process.

I think this might be what is meant by an uneven profile of development etc rather than a particular cognitive profile obtained on a WISC or BAS. I don't really agree that many HF people with autism have higher non verbal than verbal reasoning scores on the cognitive assessments. People tend to say autistic people are visual processors and many are but people can have a NVLD profile and have an aspergers diagnosis or be uniformly high scoring on verbal and non verbal measures. I certainly don't find any consistent profile on the HF autistic people I assess.

BTW I wasn't intending to comment on any process you have been through with your DS, just confused at this sudden spate of talk about spikey profiles as indicators of autism.

If it only took an hour to complete the test, and it was just a basic cognitive test, I don't think it will be of much use as a diagnostic tool, tbh (although with a range covering 79 centiles even in such a short test, she would have been hard pushed to say 'he's absolutely fine, no issues at all. )

That said, the EP saw him for an hour, and has recommended some support, and further assessment, which is great. Good luck with camhs.

My aspie DS scores pretty well on cognitive assessments, but on a speech and language test he recently had he attained maximum spread with vocabulary at 99th centile and word retrieval at 1st centile. I was quite proud, you can't be any spikier than that :)

TBH percentiles are easy to understand but not can be a bit misleading. So Tough I hope you don't mind me commenting...12th percentile sounds bad but actually it's only just falling below the bit of the bell curve where you start to get great clusters of children (15th to 85th percentile) and where answering one or two questions differently might cause a percentile jump from, say, 25th to 40th percentile because so many children's attainments are clumped in that area. So 12th percentile whilst it is quite low is what an EP would term 'low to below average' as if she'd answered one more question it might have tipped into the average range, low end, and on a different day she might have answered one more question right. Cognitive assessments are only a snapshot of performance on one day after all. Not to say that she doesn't have a particular reading difficulty, it sounds like she does in comparison with that NVR score, though the skills needed for good decoding of text are phonological in the main (assuming her visual decoding would be intact wih that NVR score) so more often linked with auditory skills rather than the NVR skills of pattern, spatial and logical reasoning. What's her auditory analysis like? That is what I would want exploring next

I know very little about the whole Autism world to be totally honest, all new to me. I didn't even realise there was such a thing as High functioning Autism until my sons problems surfaced. I'v just been living in my bubble raising my children, all of whom have Autistic traits...to me these were just their quirks or bad habits .... and fortunately they all have strengths in certain skills that they'll be able to pick up as careers if they choose.....All but one have major difficulties in self help skills though I must say and it doesn't matter how much I try to instill good hygiene and organisational skills it doesn't seem to work ..........

And to Ilikemysleep I cannot believe that Sensory problems are not part of the diagnosis at present because 9 times out of 10 it's sensory's that set my son off!!...makes sense to put this in the triad soon....and going back to the uneven profile of abilities (wish i'd never put that on here now :..- In my request for comparison it is because the EP has written on the report that there is an uneven profile of abilities and I had heard that in CHILDREN the displaying of this COULD quite often point to social and communication difficulties, especially if like my son the verbal reasoning is at 10% and his non verbal reasoning is a 89% (with others scattered in between). As I said i'm new to the world of Autism and mumsnet ....(go easy on me........). Just gotta go back through the posts to work out the mumsnet jargon.....:-)

Oh, it's not a bad thing to be asking questions - where there are obvious differences in cognitive ability, they need to be evaluated (in an rl context). A lot of the gifted experts, for example, suggest that any deviations ought to be viewed as a potential learning difficulty, etc.

It has definitely highlighted the need for more assessment, and for support in school towards the areas of concern, which was the point. I'm not sure how much use comparison would be - dd2 has cerebral palsy, and I know a brain MRI can tell you virtually nothing about ability/ disability. In the same way, her cognitive profile suggests she is a genius, but doesn't give a reader any other clues... Including that she has brain damage, lol. Cognitive stuff is fascinating.

And to toughasoldboots, thank you for yr figures. I will go through my sons report to look at all the figures. I was very surprised with my sons reading and spelling as it was 94 and 95% which did surprise me as his verbal abilities was so low.....was just wondering what the bell curve was as well? Really wish I'd known about higher functioning autism when my eldest was younger as she really could have done with the support and suffered in school with no proper support, just treated as a delinquent child and not only by the school, i'm the first to admit :-/... Gotta get it right this time!!

Ronald mcdonald

Sorry think my tone might be making it sound like I'm cheesed off or irritated or something, I'm not at all - I have a bunch of kids all of whom are neurodevelopmentally challenged or challenging to one degree or another [grin[] so I tend to get the odd 2 mins on the computer and end u writing for brevity. I'm just a bit nonplussed because a couple of different posters have been on in the last day or two asking specificaly about spikey profiles and apparently been told by EPs that a spikey profile is the only profile indicative of autism, and that worries me a bit - but not your fault if someone has said that :) Thing is, it doesn't rule it in, and it doesn't rule it out.

In your child's case, if there is a massive gap between verbal and non-verbal reasoning as you describe I would be wanting a speech therapy assessment and investigating Specific Language Impairment (SLI), esp if all the verbals are low and all the non-verbals are high....

I completely understand your questions, it's a good thing to question :)

Lots of us in the field can't believe sensory wasn't included in the triad either....

Odd. We've been told numerous times over the past couple years that DS2 had a "spikey profile" but nobody has ever definitively linked it to ASD. He does have ASD (as well as ADHD, and a number of other things) but I was always under the impression that the "spikey profile" meant that his development was very uneven - much more delayed in certain areas, while ahead in others (which he is). Not that they specifically meant ASD.

Not a clue now. Nothing like a bit of confusion, eh?

Christmas treegles, your interpretation matches mine....uneven development, but not necessarily specifically linked to asd. Thank heavens another ep out there thinks the same as me, I was starting to think I had imagined all that training about no autism cognitive profile and was losing the plot :-)

Toughasoldboots...sorry your youngsters having such a difficult time on the social side....life's difficult enough for kids that do fully understand the world, let alone our ones with their difficulties....That side of life's a nightmare for my son aswell. He's only social life at the moment is school :-/ ....but now i'm aware of his sensory issues I'm trying to organise his socialising with that in mind. Least your youngsters got all the love and support needed from home, and the sociaising I suppose is one of those tough nuts we gotta try and crack xx

Sorry to butt in on the post but was looking through the net for info, my daughter has just had an assessment bas iii and bas ii it says on her report the ed psychologist has said based on the report that my daughter has no significant learning difficulty but is low ability, her scores through the test vary from the 3rd percentile right up to the 66th with her overall gca score falling at the 16th percentile, I was under the impression that her score should more or less be around the same, doesn't a jump of 63 percentiles difference show there could be learning problems?