Interpretation of WiscIII performance scores

Whenever somebody says “that isn’t consistent with the diagnosis” because the verbal - performance spread is too small, I begin to suspect that he’s working from a formula, not trying to understand something as complicated as a human.

THe “picture completion” test asks you to find the missing part of a picture — things like a door without a handle. Kids who have trouble with this one are often kids who have lots of trouble losing things — they don’t see what’s missing in their backpacks, either ;) I wonder if it would help to have ‘em slow down and look at what’s there and consciously try to remember it… to actively choose an arrangement of the Stuff In The Backpack — and for that matter, to consciously arrange Stuff in general — to look at your desk and say “okay, what are the important things here (clock, computer, keyboard…) and make a mental picture and/or a list.

I also think that this kind of “part to whole” thinking is not related to verbal part-to-whole thinking, if only because I’m really good at the latter and disgustingly inadequate at the former. I can analyze an idea … but don’t make me figure out what’s missing from teh grocery list or the plans for that surprise party or the huge project I once mailed off to the grad school teacher with the “self-evaluation” part left out (the easiest part ;( )…

Hi Beth,

I don’t know if you have this information but it certainly helped me simplify things. A “parent-ese” explanation of what these subtests measure:

Picture completion= Alterness to detail, visual discrimination
Coding= Visual-motor quickness, concentration, persistence
Picture arrangement= Planning, logical thinking, social knowledge
Block design= Spatial analysis, abstract visual problem-solving
Object assembly= Visual analysis and construction of objects

The number scale is 1 thru 19 with a mean of 10 and a standard deviation of 3. So a subtest score of 7 is one SD below the mean (-1SD) which converts to 16th percentile.

Hope this is helpful if you didn’t have this info already.

I have heard this before and know many ADDer’s are top down thinkers, little things like parts that make up the whole and sequential steps with details elude them.

Also- keep in mind that unless something traumatic has happened to your son this does not necessarily signify a decline in performance. What it does mean is that these areas have not developed at the same pace as other parts of his profile. And he is still young Beth- lability in scores is the norm for this age range. All those developmental surges…

Robin

We too took two sets of IQ and academic testing to an outside psychologist(whom we know and trust) for another opinion; she said that FS IQ is the most reliable score over time, and that individual subtest scores should not dictate a diagnosis. As the child gets older, to get a higher performance score they need to go faster, to get the bonus points for speed. Look at www.nasponline.org/publications/spr262.html If you are concerned about ADHD, the rating scales developed by Russell Barkley for home and school may be helpful.

Oh, I know this. These two scores were very low before—they are just lower now. I realize this means he is developing slower than other kids in these areas—I just am not sure what he is developing slower at!!! The school psychologist tried telling us that the low picture completion score meant that he had poor long term memory. This never made sense to me–my son has short term memory weaknesses but once he learns something, he remembers it. I was hoping that this psych would shed more light on him but I didn’t get much help there either. You guys on this board are better than him..

Beth

So what does it mean to be poor at part to whole thinking…. I can understand what this means verbally (do you want to get the conceptual picture first or do you need all the sequential steps) but not in a performance test.

Beth

I never said the guy was very good!!!

Oh, this is scary stuff you are suggesting. My son never seems to know what he doesn’t have or as in his backpack!! He also regularly leaves things he needs places. Now I have been wondering whether this is ADD–there are other signs of inattentiveness at school that are difficult to attribute to his CAPD, which clearly also part of the picture. Maybe, as Pattim, is suggesting, the type of thinking and ADD are related. It is so hard to sort out.

Do you think games that something is missing (I have one for my other son that you take away one of the Curious George pictures) might help him? I tried it once and he hated it—which means, of course, that he is terrible at it. I could modify it to make it easier.

I know we all have weaknesses but if this is related to the state of his backpack—well it is a problem!!

Beth

I am very curious, if anyone can help me, how CAPD can effect “similarities” score, but not “information” and “vocabulary.” I should think a scaled score of “8” in similarities would be indicative of a deficit in categorical thinking, a higher level thinking skill.

I am hardly an expert but I have been told by several audiologists that similarities is the most integrative of the verbal tasks. Thus, it is typical for a child like mine, who has an integration deficit, to have more trouble with this test than information or vocabulary. In fact, two years ago my son scored an 8 on similarities and a 13 on information and a 12 on vocabulary. The scores are more even now–(similarities higher and the others lower) for whatever that is worth.

CAPD is not one disability but rather a cluster of disabilities–and thus how it presents will differ from child to child.

Beth

I don’t know the particulars of the WISC myself. Perhaps your son did not understand the directions, I am not sure…but there does seem to be a pattern that I have seen over the years as I have read your posts….problems with CAPD and possibly a co-morbidity with deficits in executive functioning. A person who has trouble with parts to whole is one who has a hard time putting things in an organized sequential fashion, remembering all the finite details and putting it in gear. They will have the “IDEA” of what needs to be done but they have a hard time knowing where to begin and how to tell you what steps need to be taken and how to do it. They sometimes will have problems with logic and reasoning.

They may be the child who responds with an ambiguous answer that is in the ballpark but it is kind of foggy, it doesn’t have the supportive details to correctly answer the question fully but they can’t tell you what is missing. They need to be taught how to read, ponder, and then formulate their response in a sequential manner.

An analogy to possibly explain this could be of a child with deficits executive functioning looking at their messy room, backpack or desk that needs to be cleaned and organized. They know it needs to be done but everything is all over the place, they are overwhelmed and don’t know where to begin. Someone with good logic and reasoning skills would just dive in and start sorting things by type, possibly having a filing system of throwing away, putting away or donating the items to goodwill. The person with defiicient skills in this area will also have trouble sticking through for the duration of the project. They may have a great start but they become distracted and don’t finish.

It is hard to say without observing your son in the classroom, seeing how he processes information and if he is a passive or active listener, attentive or inattentive.

Pattim,

This does sound a lot like my son. I have had to teach him to clean his room. It didn’t seem to be a problem of distractability—but more that he was overwhelmed and didn’t know where to begin. For a long time I had to stand there and say “now do this.” (For example, I’d tell him to first put the dirty clothes in one pile and the clean ones in another pile.) He is to the point now that he seems to know what to do and can organize the mess. But my other two kids seemed to just know how to do it –when they wanted to that is!

He often can get an answer to a question—a math problem for example but is clueless as to explain the logic. He doesn’t seem to know what he did or where to start if he doesn’t know how to do it.

In the classroom, I think he is a very passive listener from the descriptions of his teachers. The slt has agreed to teach him some active listening skills. He also seems to zone out at least some of the time. They also report that he is a very hard worker so it is hard to put all the pieces together, even being as close as I am to the situation.

We are starting IM next week. His pretest was about 200 ms off–which is a big improvement from the over 350 he was before we did Neuronet but clearly there is lots of room for improvement here since 60 ms off is considered “normal” for a kid his age who has not been through IM training. His timing is poor enough that he is outside the “normal” range that are expected to respond adequately in the standard 15 sessions. I am hoping that IM will help with the attention. I do agree there is at least some degree of problem with executive functioning. He fits the organization subtype of the Bellis/Ferre model of CAPD—word retrieval difficulties, organization, had absent contralateral acoustic reflexes (which therapy brought back), fine, and gross motor planning difficulties. As I understand it, this subtype often coexists with ADD.

Do you have any suggestions as to teaching part to whole thinking? He is going to do LIPS and V & V this summer with a slt. I was then going to follow up in the fall with Language Wise.

I do appreciate your comments. My son is such a puzzle and sometimes it is hard to figure out what is behind his difficulties and thus what might help.

Beth

Well Beth, I surely do appreciate your responses and you frequently offer good information. I, however, still question whether this can be explained as a processing deficit or as a specific cognitive deficit. I think there may be a difference, but maybe not. And, maybe we’ll never know for certain.

My oldest son who is dx’d CAPD had a higher score on the similarities (10) test then he did vocab (7) and information (8). My youngest son who falls on the autism spectrum had this same pattern similarities (9), vocab (7) and information (6). Both boys scored much better on the performance scales with scores of 9-13. The weakest area on performance for my son with PDD was Picture arangement (9) but for his brother it was Picture completion (9). The strange thing is that they each got a 13 where the other scored the 9. The rest of their scores were very similar with scores of 10-12. I find it interesting how much alike they are yet still so much different if you know what I mean. I don’t think there really is anyone formula for interpurting all these scores.

Now my son with CAPD scores higher on verbal than performance—which I don’t think is typical!!! I think it probably has to do with what type of CAPD you have and what else is going on. I do think some of my son’s lower performance scores is genetic—you have never seen my husband try to assemble something from directions!! I am only somewhat better.

Beth

You are right, of course, that a low similarities score indicates a cognitive deficit. Perhaps I didn’t explain myself very well. But my understanding is that deficits in processing information at the level of integration can show up in a cognitive deficit as well as in auditory processing tests. Of course, an integration processing deficit is not the only cause of a low similarities score.

It is interesting to me that his similarities score went from 8 to 10 in two years (that seems to me to be significant) without any specific intervention addressing abstract thinking (We are, however, doing V & V this summer followed by Language Wise). We have focused instead on resolving his sensory-motor integration issues. As these have been gradually resolved, I have seen improved cognitive functioning. For my son, at least, there is a relationship.

Beth

Try a google search on stability of WISC II subtest scores, and their reliability over time. Most experienced evaluators will tell you that the most stable scores is the FS IQ, followed by the V and P scores; Do Not interpret subtests in isolation; there are formulas and specific ways of reporting these scores.

My son’s full scale is stable—average. The verbal has consistently been higher than the performance. There is a large range of scores though from 5 to 13.

Are saying that this range doesn’t mean anything about strengths and weaknesses? Or have explanatory value as to why he has the troubles he has?

Beth

Beth, I have copies of two really good, really long posts on IQ that I think you’d find interesting. Unfortunately, they were both posted by Shirin and Karyn(on the parenting LD child board) on July 7, 2000. The archives do not go back that far. At one point Victoria or someone talked about having a way to archive the most generally useful posts somewhere as reference. These really belong in this category. What I like about these are that they are immensely practical—definitely not a politically correct, bureacratic-specialist analysis of IQ. They run over five pages single spaced. I wonder if anyone has a way to make these generally available.

Anitya,

I know you think I am all wet—and perhaps I am a perfect example here of how dangerous a little bit of knowledge is–but thought you might be interested in Teri Bellis’ book When The Brain Can’t Hear: Unraveling the Mystery of Auditory Processing Disorder. It is in layman’s language and in it she talks the primary findings associated with different types of CAPD—including cognitive findings. She says “specific weaknesses will be found in those subtests that require both hemispheres of the brain to work together” when discussing an integration deficit and “relative weaknesses in analytic (whole to part) skills and sequential processing” when discussing an auditory decoding deficit. Now she also says that some auditory disorders are merely the auditory piece (a symptom) of other disorders.

Beth

Marie,

That does sound interesting!! Do you have a copy on disk? If so, maybe you could cut and paste it here. Or maybe someone else does.

Beth

Beth from FL wrote:
>
> Marie,
>
> That does sound interesting!! Do you have a copy on disk?
> If so, maybe you could cut and paste it here. Or maybe
> someone else does.
>
>
> Beth

Beth, I just printed it out from the website, so I only have it in print form. Shirin wrote both posts (Karyn’s message was a repost)—she used to post here often and was a veritable gold mine of information. I haven’t seen any posts from her recently, nor from her sister Shari, also incredibly knowledgeable.

Marie,

Yes, I remember their posts.

Could you email me?

Beth

I would make those games easier and work/play on that skill. You will probably be amazed at how easy you do have to make it :-) It’s like that muscle for memory just doesn’t exist. Just like any other kind of learning, tying it to stronger areas can be really helpful — and it helps to talk through how to do that and figure out strategies. So if his verbal memory is better, knowing that there are five things to look for in the backpack or in the game of remembering is a good strategy; the other really important one is “Clumping” things together. More than once, I have had a student come to me for tutoring having spent hours trying to learn 12 parts of the pathway of the circulatory system, in order… and in half an hour, we’ve made 3 groups of four things and we review and visualize and practice and it’s in there. It takes time to develop any habit, of course.

I was reading in _The Bonesetter’s Daughter_ that the protagonist’s mother, or was it the protagonist, kept her mental “to do” list “on her fingers” and would count through them at free moments throughout the day… so she would do arbitrary thigns to keep the total at either 5 or 10. I’ve managed to remember the keys-phone-glasses-water-helmet for bike rides much more regularly since then. Having an arbitrary list for the same kind of task works well — I don’t always bring the phone, or the glasses… but I have “checked” my list to see if I need them. And of course I contemplated just how many “normal” people use strategies that kids with labels get all sensitive about because they’re associating strategies with being proof being damaged goods, instead of associating them with success.

If his LiPS teacher is a good one it will do him a world of good because doing LiPS right means Socratic teaching — *pulling* the answers from *his* head and making him conscious of the active learning. I’m really hoping ;) :)

Me too!!! She is a slt who got trained in LIPS and V & V as part of a new local pilot program. This is where my son belonged last year but the pilot is new this year. He isn’t bad enough now for it–plus it is at a different school. The friend of mine, an ed psych for the school system, told me she was awesome. He is going to have private therapy 3 x a week this summer.

I also am glad to see that my district is maybe figuring some things out—even if it won’t directly benefit my son.

Beth

The checking idea is a good one. He is always not bringing his agenda book home or his homework folder as well assorted books. I tend to put them back at home—which I know is not a good idea but one gets worn down afterawhile. Maybe we could just work on his folder and agenda book to start with. I do need to teach him strategies here as well as work on some underlying skills.

I think your point on strategies is well taken. This week I forgot to turn in a report to the grants office and to pick up piano books from a friends house. Both times I was thinking about meetings I had just had. I have a colleague who has some mild memory problems (she said she always had to work twice as hard as everyone else to memorize stuff for school ) who asked me why I didn’t simply write a note and leave it on my seat of my car. Never occurred to me because I have a great memory and am not used to it failing –and it doesn’t except when I get overstressed, which seems to happen more and more. So I think I need to learn some strategies and teach them to my son!!!

Thanks for your insights.

Beth

Beth, I am having delivery failure to your email address.

Well, the system could be down or I could not know how to type. Try replying to this message.

Beth

Things have been hectic as we are being “orthopedically challenged” in our home right now..:-).. I have to have knee surgery and my son is having a lot of problems with a chest deformity and adolescent onset scoliosis. So if you don’t hear from me, e-mail me and I will get back to you when I can.

Lips and VV won’t teach him organizational skills in regards to the “Big Picture”. Yes, it will teach him the “rules of phonics” and VV will teach him how to describe things he sees and organize some of is ideas as he gets more into the HOTS, higher order thinking skills.

In addition to this program I wonder if it would be of benefit to do something like Anita Archer’s skills for school success and have the SLP work on his logic and reasoning skills in addition to using idioms and analogies.

After you try all the non medical treatments and he appears to still be struggling then I would suggest trying the medication route. From my own expereince, meds have been a Godsend.

Pattim,

Can you give me a website or any information on Antya Archer’s skills for school success? I agree that what we are doing won’t help his organizational skills.

I haven’t ruled out medication–it is a hard decision, as you know. I just want to try the nonmedication route first. I do think of your comments on this board when I try to sort all of this out.

I hope the orthopedically challenged are doing better!!

Is your semester about over?

Beth

Curriculum Associates (800) 225-0248
e-mail [email protected]
WEb: www.curriculumassociates.com

In an earlier thread you commented that poor parts to whole thinking is characteristic of kids with ADD. Does medication have any impact on their ability in your experience? I know medication can improve attention but and what children are able to process as a result.

Beth