The Frustration Profile: Strong Verbal Skills with Slow Processing Speed

Glen* is a third grader who was brought to testing to determine the best teaching style for him.  Testing revealed that Glen’s overall intelligence and academic skills were in the Average range. However, great variability exists within the tests. Glen demonstrated excellent Verbal Comprehension skills, while his Processing Speed Index and Perceptual Organization Indexes fell significantly below his other indexes. Glen’s cognitive and academic skills are inhibited by his weak organizational skills and slow processing speed.

This is what I call the frustration profile. The child has a good vocabulary and is able to answer questions verbally, but due to difficulties with fine motor skill  (drawing/writing) it is very hard for him to write down his ideas.  Glen’s speed of processing is significantly lower than his verbal comprehension abilities, which cause him to need extended time in order to demonstrate his true abilities on any written assignment. Generally writing skills are the greatest academic weakness in a child with this profile.

Glen’s weak Perceptual Organizational skills make short structured writing tasks much easier for him than open-ended assignments without structure. Building language organization skills (the ability to mental manipulate ideas) will help him in projects that require him to structure the material independently.  Posing questions, researching answers, organizing information, and expressing ideas clearly are higher order thinking skills that depend on the ability to use language to analyze, compare, judge, and connect ideas.

In addition to limiting him in open-ended, abstract work, Glen’s organizational difficulty also restricts his good working memory for concrete material.  Because he does not easily organize ideas into related–thus memorable–chunks, the quantity of information Glen can store actively in mind while working on other steps in a complex task is limited.   As a result, his good memory skills quickly become overwhelmed, and multi-step problems become taxing for him.  In other words, while his basic memory function is fine, his difficulty categorizing verbal and visual information places undue stress upon it. Teaching Glen how to make information meaningful to him will facilitate his learning.

Another element in Glen’s challenges is his relatively less developed executive functions of plan and initiate, —the ability to start, plan, assess and adjust his actions and thinking.  As a result, problems with many steps or ones that require mid-process assessment and adjustments shake the self-confidence Glen has in more structured demands.   As he advances in school, more assignments will expect exactly this ability to structure and express material on his own.

RECOMMENDATIONS

Processing Speed

  • Allow longer response time for Glen to:
    • respond orally to questions in class
    • complete seatwork assignments in class
    • make decisions when offered a choice of activities
  • Allow extra time for tests, usually time and a half.
  • Shorten assignments so they can be accomplished within the time allotted.
  • Provide copies of notes rather than requiring Glen to copy from the board in a limited time.
  • Build Glen’s efficiency in completing work through building automaticity.
  • Train Glen in time management techniques to become aware of the time that tasks take.
  • Emphasize accuracy rather than speed in evaluating Glen in all subject areas.
  • Replace timed tests with alternative assessment procedures.
  • Provide a scribe or voice-to-text software to record Glen’s answers on tests to accommodate for slow writing fluency.
  • Use test formats with reduced written output formats (e.g. multiple choice, True / False, fill in the blank) to accommodate for slow writing fluency.

Writing Skills

  • Teach brainstorming, clustering and mind mapping skills.
  • Teach editing skills.
  • Allow the use of a computer.

Fine-Motor skills

  • Use Retrain the Brain to build fine motor skills.
  • Use Handwriting without Tears to enhance letter formation.

Visual-Perceptual Strategies

  • Use of graphic organizers to depict information visually and increase his retention of ideas.
  • Exercises to sharpen his ability to attend to visual detail and to express similarities and differences between images.
  • Use the Snap Cubes and Visualizing/Verbalizing Programs to facilitate his ability to conceptualize and process visual information.
    • This program focuses on strengthening a student’s ability to mentally manipulate objects, improving visual- spatial skills, and whole-part relations.
    • Use logic puzzles to teach sequential thinking skills, cause and effect, and how to identify and provide missing information.

Executive Function/Memory Skills

  • Build strategies to help him analyze, prioritize, and execute specific steps in a given assignment.
  • Break down tasks and follow the order checking work along the way.
  • Rehearse new information to help encode it.
  • Use his verbal strengths to talk himself through tasks.
  • Teach Glen strategies to help him recall information, such as PAR.
    • 1. P= Picture it.
    • 2. A= Associate it
    • 3. R= Review it.
    • Teach Glen to recognize common words for ordering a sequence of instructions, such as “first,” “next,” and “finally.”
    • Teach Glen how to effectively follow written directions by underlining key words, numbering steps, and crossing off tasks when he has completed them.
  • Teach Glen to use graphic organizers such as checklists and timelines for breaking down assignments, as well as classify and categorize information.

* Note: The student profile above is a composite of students with similar learning styles.

About Melissa Mullin, Ph.D.

I am the director of the K & M Center in Santa Monica, CA. Our goal is to help children reach their academic potential. We specialize in creating individualize learning programs so each of our students can do better in school and life.
This entry was posted in Executive Functioning, Learning, Processing Speed, Visual Processing and tagged , , , , , , , . Bookmark the permalink.

161 Responses to The Frustration Profile: Strong Verbal Skills with Slow Processing Speed

  1. Jing Ying says:

    Dear Melissa,

    Thank you for your very insightful posts – I’ve learnt much from it :)
    I was wondering, what happens if the converse is true? i.e., if the verbal comprehension abilities is significantly lower than his speed of processing? would this profile also cause some kind of frustration, and why might that be so?

    Looking forward to hearing from you. :)

    • Melissa Mullin, Ph.D. says:

      That is a great question. There are many profiles where signficant differences in learning skills pose learning challenges. The highly verbal child who has trouble writing down his thoughts becomes frustrated because she knows what she wants to write, but the difficulty of writing the ideas down is hard. The reverse profile, quick processing speed with low verbal skills, would be challenging for different reasons. This type of student can quickly write but doesn’t have the vocabulary or expressive language skills to articulate his thoughts. There are many variables to consider with this profile. Is there is difference between receptive ( what he understands) language and expressive (what he can say) language? Is there a global language deficit or a specific deficit? Is the fast processing speed making it hard for the child to slow down to think before talking or writing. Is this child a “rusher” who need to slow down over all?
      I hope this answers your question.

    • Chartric says:

      Unbelievable how well-written and infomtravie this was.

  2. Jing Ying says:

    Thank you, Melissa. Yes, you did answer my questions, and set me to thinking too. :)
    Sorry, I didn’t introduce myself before. I’m an EPiT in Singapore, and happened to chance upon your site. Found your sharings very insightful and thought-provoking. Thank you, once again :)

  3. jennifer carter says:

    I have a question. I have 3 sons 2 of which have slow processing skills. My youngest was tested yesterday for dyslexia. I am a teacher and I want to know, if I get certified to teach children with dyslexia will this help also with processing skills, organization and writing. I have spent countless hours and read every book that I can to figure out how to help them. They have been tested, and we have seen 3 specialist and they have been wonderful to us but I have no concrete answer. I need a plan or system to follow. If I have an experts opionion on whether a program (Wilson Reading or Susan Barton or S.P.I.R.E) would help children, not necessarily tested as dyslexic but have other delays in reading. I would get certified to help my boys and other students with reading delays. My school, at the moment, does not have these programs. My boys already qualify for special servies but they need more. I would like your input, if it would be benefical to use a dyslexia program or would there be little gain and more frustration.

    Thank you so much
    Jennifer Carter

    • Melissa Mullin, Ph.D. says:

      It is difficult to answer your question without more information about your boys. Slow processing speed alone does not cause a reading issue. However, if the slow processing speed is caused by eye tracking issues that slow down the ability to take in visual information swiftly, then reading fluency will likely be impacted. So, Question One: is this a visual input issue? If so, I recommend vision therapy first to get the eyes better at taking in visual information. Next, you mention organization and writing skills. This leads me to consider fine motor skills ( writing) and executive functioning skills. Is the motor part of writing difficult for them? if so, I like the Retrain the Brain program (RetraintheBrain.com). Are your boys able to break tasks down and do one step at time? I have posted blogs on executive functioning, so hopefully you can find more information to help you. I am also available as a consultant if you would like to have me review the testing you have had done and give specific suggestions to you. The reading programs you are considering are all good programs. The trick is to find the program that build the skills that your boys need to develop. Most reading programs focus on building auditory processing and phonemic skills. It sounds like your boys may need to build rapid naming skills. The only program I know of that focuses on Rapid Naming is the RAVE-O program. The PACE program is also good at building visual skills. I hope this helps!

  4. Hello! I am a School Psychological Examiner and I have three sons of my own. My oldest son just turned 6 and I administered the WISC-IV on him because of difficulties that he is having in Kindergarten and the need to develop strategies at home to help him. His Processing Speed Index is significantly higher than his other index scores and I’m having a hard time understanding how it is so much higher. His FSIQ and GAI are only 6 points apart and I know that they have to be at least 8 points apart to be considered statistically significant at the .05 level. If you could give me any insight, I would greatly appreciate it. Here are his scores:

    Composite Scores Summary

    Verbal Comprehension (VCI) 73 4 68-81 Borderline
    Perceptual Reasoning (PRI) 82 12 76-91 Low Average
    Working Memory (WMI) 86 18 79-95 Low Average
    Processing Speed (PSI) 109 73 99-117 Average
    Full Scale (FSIQ) 81 10 77-87 Low Average
    GAI 75

    Any insight or suggestions would be greatly appreciated. Thank you so much!!

    • Melissa Mullin, Ph.D. says:

      It is always hard to know what is going on with children and their learning. Looking at the scores you have shared, the most important thing to me is the low Verbal Comprehension score. I don’t have the subtest score so I don’t know if one low score pulled the Index score down, or if all the scores were low. Language is important for so much of learning. If this were my child I would go for a Speech and Language Evaluation and investigate what is going on there. If he has weak auditory processing skills it will affect his reading, listening comprehension and language development. Your son’s Processing Speed is average, so that is good. I would not worry about significant differences as much as building the skills that are low. I hope this helps.

      • Thank you so much for your reply! He is currently on an IEP for Speech and Language with 30 minutes daily of academics. However, he is on grade level with academics but he has a hard time processing verbal commands. His Verbal Comprehension subtest scaled scores are as follows:

        Similarities: 6
        Vocabulary: 8
        Comprehension: 2

        Thanks so much!

  5. C. Callaghan says:

    I recently became full time step mom for a 13 year old boy. He has problems at school and I’m trying to figure out how to help him in the best way. It is unclear if he is diagnosed with, or just show symptoms of ADD, OCD and PDD.

    His WISC-IV score is:

    VCI: 91 27 85-98 Average
    PRI: 90 25 83-98 Average
    WMI: 91 27 84-99 Average
    PSI: 56 0.2 52-70 Extremely low (subtest: CD: 1 0.1 – SS 3 1)
    FSIQ: 78 7 74-84 Borderline

    He has deficits in reading comprehension, numerical operations, math reasoning, spelling and written expression. He is currently in an integrated class, and I’m looking for a program we can use at home to help him cope with his problems. Any suggestion on where to start?

    • Melissa Mullin, Ph.D. says:

      The first thing I would do is set up a meeting with the school and review the testing and diagnoses. I would think that with his difficulties he would have an IEP or some type of individualized learning plan. Given his low Processing Speed Index he should qualify for extra time on tests. The questions you needed answered are: 1) Does he have ADHD, OCD and/or PDD? 2) Depending on the diagnoses, is there a medical intervention available?; 3) What is causing his low processing speed; is it attention, perfectionism, visual scanning, visual discrimination, and/or weak fine motor skills. Once you know the specific areas of weakness you can work with the school and/or a learning specialist to help design a program to build his skills.

      • Anita Deme says:

        Hello Dr. Mullin, I was so happy to chance upon this discussion after getting my son’s triennial review results back. He is a 14 year old boy originally diagnosed in preschool with ADHD but now is classified as other health impaired. He is a bright and sweet boy. He has an IEP and has accommodations for time and a half for testing. His teachers complain that he is not writing notes and that he seems to drift off during lectures, they need him to practice time management and autonomy. They say that sometimes he is angry and resentful and other times he seems happy, and that he strives for perfection and never tell lies not even little “white” ones. Homework is a struggle and if I do not stay on top of it he leaves out assignments. He sometimes works for hours on homework well into the late evening and night. When I confront him about the teachers e-mailing me of work missing, he is so remorseful about failing to do it.
        He says he is overwhelmed and stressed and does a lot of escapeism into video games or just into his own world. It seems like he needs the world to stop spinning so fast.
        We are having a year end IEP meeting deciding what course of action to take with him for High School next year and I do not seem to understand the testing scores too well. There seem to be a big gap in %iles in different aspects of the testing.
        His testing results were:
        WISC-IV FSIQ=119, VCI=132, PRI=110, WMI=107, PSI= 103
        SS %ILE
        VCI:
        SIMILARITIES 16 98
        VOCAB 18 99.6
        COMP 12 75
        PRI:
        BLOCK DESIGN 10 50
        PICTURE CONCEPTS 13 84
        MATRIX REASONING 12 75
        WMI:
        DIGIT SPAN 12 75
        LETTER/# SEQUENCE 11 63
        PSI:
        CODING 12 75
        SYMBOL SEARCH 9 37

        Any information would be most valuable to our decision making process. His grades do not reflect his abilities. He has come a long way but we cannot seem to put our finger on what is his true disability is and how to truely help him.

      • You son has a very strong verbal ability with average scores in the other indexes. I think that his executive functioning skills may be the issue. Most children with ADHD have issues with executive functioning. You can have him take the quiz on my website to see how he rates. You can take it and answer the questions as you view him and he can take it for himself. Compare the two scores, do you agree? I have also just completed an Executive Functioning Workbook. I hope this helps.

  6. Anna Marie Pederson says:

    This article describes my 9th-grader well. She has been to many doctors and participated in many interventions. Her neurological disorder manifests itself like a severe dyslexia. I noticed that you mentioned vision therapy in one of the posts. It is one of the few therapies we haven’t tried because I could not find clinical documentation for its effectiveness. The most definitive response given regarding its impact on their children by two or three parents I interviewed was, “I think it helped.” Do you have personal experience with this therapy? On what basis might I reconsider it?

    FYI: My daughter learned to read, her miracle at age 11, through F.A.S.T. Reading System, created by Steve Tattum.

    • Melissa Mullin, Ph.D. says:

      I have seen vision therapy make a big difference in a number of students. What I have found is that vision therapy is most helpful for students who have tracking issues. When the eye muscles have trouble scanning a line, or moving smoothly from one word to the next, eye exercises can help.

      In my experience visual memory, visual spatial and visual attention issues do not always benefit from vision therapy. I only recommend vision therapy to students who have tracking issues. I have also found that students who have attention issues that are not addressed have a low success rate with vision therapy.

      So, vision therapy has a high success rate, from what I have seen over 16 years, with the students whose profiles include low processing speed and/or low reading speed due to difficulty with eye tracking.

  7. Amy Williams says:

    This article describes my second grade son completely. He has been diagnosed with ADHD combined type but he is an avid reader and can read for hours at a time at a level well beyond his current grade level. His WISC-IV scores are Verbal Comprehension 136 but his Processing speed is 83. We have been struggling with convincing his teachers that he is not actively choosing not to do the work. We have not yet formalized modifications at school but it may soon come to this. I would be interested in any resources regarding IEP/504 plans for students like my son and “Glen”. How do I find the right professional help that can help me with the slow processing speed and his lack of writing?

    Thank you.

    • Melissa Mullin, Ph.D. says:

      An IEP (Individualized Educational Plan) with a 504 is a good idea to consider. When the WISC-IV Verbal Comprehension Index score is more than 15 points higher than the Processing Speed Index score there should be no problem getting a 504, which allows extra time on tests. The difference between the Index scores indicates that the child is able to communicate ideas verbally, but that his visual-motor processing skills are slow. Therefore, this child needs extra time on visual-motor tasks to allow him to get his ideas down on paper. I would also ask for modifications on homework and in-class writing assignments, so that the student only has to do enough to show he has grasped the concepts. Allowing the student to dictate extra practice materials is another option.

      Finding the best professional help to build processing speed and writing skills is trickier. The types of professional services you can use are:

      1. Occupational therapy to work on building the fine motor skills for writing.
      • The amount of effort it takes students to write makes the whole writing process laborious. The frustrating part for the students is that they have the ideas but it’s too much work to communicate them.
      • I recommend the Retrain the Brain program along with Handwriting Without Tears.
      • An occupational therapist has additional tools that can be used to build the hand muscles needed for fluent writing.

      2. Vision Therapy, if visual tracking is an issue.

      3. Educational specialists or tutors can help with organizing language and writing skills. The writing skills that a student with this profile needs to learn, includes pre-writing skills to help him organize his ideas before he writes.
      • Mind maps or advanced organizers such as graphical organizers are great tools.
      o In other words, we want to take the grand ideas that the student has and get them onto paper.
      o This process alone will alleviate a lot of stress on the student.
      • Once the ideas are on paper, they can be numbered in the order the student wants to present them in his final paper.
      • You can use the format from my 5 paragraph essay worksheets and modify them for writing one paragraph. Once one paragraph has been mastered, you can start on two paragraphs. The goal is to get the ideas out so that the student can look at and work with his thoughts without becoming overwhelmed.

      It is important to remember that when you are building new pathways in the brain, daily practice is necessary. This means to really build the fine motor skills and/or eye muscles you need to do the exercises daily. It will only take 5 to10 minutes of daily exercises for most students to develop increased productivity within six months.

      I also think educating teachers is important so they can understand what your child is experiencing. Share any articles you like that explain the issue your child is having, along with the testing results, so the teacher realizes this is not an issue of lack of effort, but a real learning challenge. Your communication with the teacher will also allow her to become part of your team. Letting teachers know that you understand that your child is struggling and that you are actively working to get help for him, will allow the teacher to know she has your support and that you don’t expect her to do all the work alone. Building a successful educational team that works and communicates together is the best intervention.

      You can find a bit more about this on my blog article:Finding The RIght Help to Build Processing Speed.

  8. amanda says:

    Hi Melissa,
    Thank you so much for writing this article. It describes my eldest son, who was diagnosed mild-moderately dyslexic last Summer. He is 8 years old – was 7 years and 8 mths when the WISC tests were done. His scores are as follows:

    Verbal Comprehension (VCI) 98th centile
    Perceptual Reasoning (PRI) 83rd centile
    Working Memory (WMI) 75th centile
    Processing Speed (PSI) 7th centile
    Full Scale (FSIQ) 118

    What I don’t understand is the good memory score – he has huge problems learning by rote – he can spell words if they are phonetic, and can retain a difficult spelling for about 30 minutes, then it disappears somewhere. He is really struggling with tables.

    His word attack skills are poor but his reading comprehension is good (reading age of 10 1/2)

    He is not doing well at school, and believes himself to be “dumbest in the class” – largely the result of a year of daily spelling and maths addition/subtraction tests (26 spellings including 8 irish spellings a week) that he struggled with. Also for the 3 preceding years he struggled at school.
    This school year is going better as the school have his diagnosis, and have adapted for him. He now does 8 spellings a week – tested only on a Friday separately – but the worksheets to go with the spellings are very simple – they don’t challenge or engage him at all. He is happy but bored – and happy to drift.

    Parents evening is in 2 weeks – please can you tell me where I can find out more about mind-mapping? When I google it, I get a lot of software programmes that I can buy/subscribe to but I wouldn’t know which ones to pick.

    Many thanks
    Amanda

    • Melissa Mullin, Ph.D. says:

      The reason his Working Memory Index (WMI) is higher than his memory for spelling words is related to the difference in the tasks. The WISC WMI is an auditory memory task. There are 2 subtests in this index. On the Digit Span subtest I say a group of numbers and you repeat them back in the same order, then I say the numbers and you say them in the reverse order of what I said. Often children who are labeled dyslexic will do well on the number forward portion of this test and have trouble on the digit backwards section. The forward portion is rote memory: say what I said. The backward portion requires working memory: remember the numbers, and then reorganize them. The WMI is the sum of the two portions. So, it is worth checking to see if there was difference between his forward and backward portions of the Digit Span subtest. Spelling requires strong working memory, as well as strong auditory processing and visual memory (not tested on the WISC).

      You state that your son has good comprehension but weak phonics. There is a great computer program called LEXIA that can help build phonic skills. Other issues many students with reading weaknesses have are weak rapid naming and sequencing skills. There are number of assessments to measure these skills. Finally with the Processing Speed Index (PSI) you get the measure of visual discrimination and visual-motor integration. It helps to determine if there are visual discrimination issues that are affecting the visual-motor weakness. That is why I always consider a visual assessment with a doctor that believes in vision therapy when there is a very low PSI.

      You clearly have a bright child, I assume that you have read my other articles on processing speed issues, so you know all my advise on that. You wanted suggestions for mind mapping. Here is a great article with a video on how to make a mind map: <a href="http://www.mindtools.com/pages/article/newISS_01.htm

      Here is a site that provides a number of sample maps you can copy and use:graphic organizers

      I hope this helps you and your son.

  9. Ben says:

    Hello, my 12 yo daughter is having difficulty academically in the small private school we just enrolled her in. It doesn’t seem to be getting better and my wife and I are seriously considering homeschooling for her .
    PRI is 18th percentile
    WMI 86th percentile
    PSI 13th percentile
    I am trying to understand the implications of this score. The private school is so small it cannot make much in the way of accommodations. Abeka is used. Her grades in the core classes are basically failing.
    Any insights would be helpful. Thanks

    • I am sorry to hear that your daughter is struggling. The Verbal Comprehension Index score is not included in your message, but I am going to assume that it was high since your comment is based on my Frustration Profile article.

      Here is what I see in the profile you present for your daughter: She is strong verbally and had excellent working memory skills. Her ability to work with visual material is weak. The PRI in the 18th percentile indicates that visual problem solving is hard for her, and her low PSI shows how difficult it is for her to quickly process pencil and paper timed tasks.

      To support this profile I suggest:

      Improve Executive Functioning Skills, Working Memory and Study Techniques
      • Teach the use self-talk to organize her learning and performance strategies and to focus her attention on tasks
      • Build strategies to help analyze, prioritize, and execute specific steps in a given assignment
      o Break down tasks and follow the order checking work along the way
      o Encourage your daughter to visualize what she is going to do before she begins the task
      o Teach your daughter strategies that cater to her understanding of the big picture:
      • Outlining
      • The SQ3R approach is recommended as an approach to studying information from text books
      • Give her a concept of the finished product when working on projects
      • When working with academic material, review the components and the whole picture
      • Build memory skills by building association to preexisting knowledge
      • Teach your daughter strategies to help her recall information, such as PAR:
      o P= Picture it.
      o A= Associate it.
      o R= Review it.
      • Memory strategies such as:
      o “Chunking” information into more manageable units
      o Rehearse new information to help encode it

      Build your daughter’s visual-perceptual strategies and perceptual organization to support her problem solving skills:
      • Exercises to increase your daughter’s understanding of part-to-whole relationships is recommended
      • The Snap cube Program will help your daughter build her visual thinking skills.
      • Teach her how to use graphic organizers to depict information visually and increase her retention of ideas.
      • Teach Active Reading Strategies to build verbal memory and reading comprehension skills:
      o KWL Charts
      o Predicting, paraphrasing, story/plot maps, character maps
      • Teach note-taking techniques that will present and summarize heard information visually.
      • Exercises to sharpen her ability to attend to visual detail and to express similarities and differences between images are recommended.

      • Use of a computer for school assignments and exams is recommended.
      • It is recommended that your daughter be allowed to tape all lectures due to her need for extra processing time and her difficulty with visual motor speed.
      • Use of Dragon Dictation software may be helpful for your daughter in getting her ideas out.
      • Access to class notes is recommended.
      Processing Speed
      1. Allow longer response time for your daughter to
      a. complete seatwork assignments in class
      b. make decisions when offered a choice of activities
      2. Allow extra time for tests, usually time and a half
      3. Reduce the amount of work required.
      4. Shorten the assignment so it can be accomplished within the time allotted
      5. Train your daughter in time management techniques to become aware of the time that tasks take.
      6. Emphasize accuracy rather than speed in evaluating your daughter in all subject areas
      7. Replace timed tests with alternative assessment procedures

      Fine-Motor skills
      1. Use Retrain the Brain to build fine motor skills
      2. Use Handwriting without Tears to enhance letter formation.
      3. Become a touch typist

      • Ben says:

        Thank you for your response Dr. Mullin. My daughter may end up repeating the 6th grade at the private school as her math wasn’t passing and launguage was barely. Initially she didn’t pass language but after a month of tutoring privately during the Summer she retested and passed it. My wife and I were hoping she could pass all of the core classes and move on to the 7th grade. I think she could go back to the public school system and be placed into the 7th grade (the public school has a lot of resources, whereas, this private school has 1 teacher per 2 grade levels in the same room). I’m nervous about holding her back. She would like to go on to the 7th grade but sounds willing to repeat the 6th as there will be a new teacher (which is a good thing (the old one accused her of not trying, etc)). Hopefully, she will “get a better hold” of the 6th grade material repeating it. If it was me, I would have a difficult time concentrating on material that I had already been taught. Insight on “holding back” kids who are having a difficult time taking written tests and proving that they know material would be appreciated. I wonder if I should contact the public middle school to see what my options are. I guess the answer to that is obvious, I should.

      • Here is a great article listing the pros and cons of holding a student back. http://www.greatschools.org/special-education/health/659-repeating-a-grade.gs?page=all I hope this helps.

  10. Colleen says:

    My 8 year old daughter has scores just like what is described for Glen. What is Glen’s diagnosis? Is slow processing speed a learning disability in itself or is there a common diagnosis for this?
    VCI 92 percentile
    PRI 87 percentile
    WMI 68 percentile
    PSI 21 percentile
    We have had her tested for dyslexia – they said she didn’t have it because her phonemic awareness was average. However her rapid naming scores were low. Based on that and her writing samples, they thought she had dysgraphia, but we don’t have an official diagnosis. Her grades in school are quite good, but the teacher is frustrated with her because she takes forever to finish work. She writes very slowly and her written grammar and spelling are poor. She’s been working with a tutor, so now she is finally starting to recognize misspelled words and grammar mistakes in her writing with a little prompting from me. Writing an essay or a story is a long laborious process. Her teacher seems convinced her problem is attention and has told us to get her medication. That makes me very uncomfortable since her teacher isn’t a doctor. We think her attention is okay and that writing is the issue. She can read for hours. She recently did very well on a school project where she had design a poster to advertise her invention, but she did this project on the computer and organized her ideas by talking to me about them. She seems to organize her ideas pretty well if she can do it verbally, but struggles if she has to write it down. She is very good at math. She understood algebra after a 5 minute explanation at the dinner table (she asked me what “X” was in a problem she saw.) She seems to understand the work quickly, so based on her understanding level, she could be doing accelerated work, but her output level won’t let that happen. We have just had additional testing done by a psychologist, but don’t have results yet. What can we do to help her?
    Thanks.
    Colleen

    • Once you get the report back from the psychologist you will know more about what is going on. If there is an attention issue, it can affect processing speed. However, there are many students who have processing speed without having an attention issue. Similarly, dyslexia can affect processing speed if there is a visual component.

      Here are some suggestions from my article Finding the Right Intervention to Increase Processing Speed:

      1. Build fine motor skills for writing.
      • The amount of effort it takes students to write makes the whole writing process laborious. The frustrating part for the students is that they have the ideas but it’s too much work to communicate them.
      • I recommend the Retrain the Brain program along with Handwriting Without Tears.
      • An occupational therapist has additional tools that can be used to build the hand muscles needed for fluent writing.

      2. Vision Therapy, if visual tracking is an issue.
      3. Educational specialists or tutors can help with organizing language and writing skills. The writing skills that a student with this profile needs to learn, includes pre-writing skills to help him organize his ideas before he writes.
      • Mind maps or advanced organizers such as graphical organizers are great tools.
      • In other words, we want to take the grand ideas that the student has and get them onto paper.
      • This process alone will alleviate a lot of stress on the student.
      • Once the ideas are on paper, they can be numbered in the order the student wants to present them in his final paper.

      You state that Rapid Naming skills are low, that can create an issue with reading fluency and may be adding further evidence that there is a visual processing issue affecting the processing speed.

      The main factors that affect processing speed are:
      • Visual processing skills
      • Fine motor skill
      • Cognitive processing speed
      • Attention
      If your child has a weakness in more than one of these factors, it will make her processing speed slower. When planning an intervention you want to address each area of difficulty individually.

      I hope this helps.

  11. Renee says:

    My son, Michael is 8 yr old and diagnosed at 3 years old with PDD/NOS. He has had private ot for years and she believes Michael has auditory processing , visual processing , low tone and he shows symptoms of dyspraxia. Michael is currently in an inclusion class with pull out to resource room for 3 subjects. His special ed teacher has said Michael still cant finish work in resource room, needs prompt to start writing tasks and believes he would do better in self contained next year. Michael exhibits anxiety due to his acedemics and we are thinking of sending him to a private school who uses orton-gillingham method and multi sensory approach to teaching. He recently had assessments done and they are as follows: vci 89 composite score (sum of scaled scores 24) PRI 88 (sum of scaled scores 24) WMI 80 (sum of scaled scores 13) PSI 85 (sum of scaled scores 15) FSIQ 82 (sum of scaled scores 76). All scores put him low average range. verbal comprehension subtest score summary for similarities raw score 13, scaled score 9, vocabulary raw score 18, scaled score 6, comprehension raw score 16, scaled score 9. Perceptual Reasoning subset scores; Block design raw score 18, scaled score 8, picture concept raw score 15 scaled score 10, matrix design raw score 10, scaled score 6. working memory subset: digit span raw score 10, scaled score 6, letter number sequencing raw score 10, scaled score 7. processing speed subset : coding (CD) raw score 22, scaled score 6, symbol search (ss) raw score 15, scaled score 9. Please help us with what would benefit Michael. He tries so hard and gets so frustrated.
    Thank you,
    Renee

    • Hi Renee,
      Looking at the scores you provided, I would suggest focusing on building Michael’s working memory skills. Working memory is a key aspect of executive functioning. When a child has a learning issue he has to work harder and use more of his working memory capacity to process information than a typical learner. This means there is less working memory capacity left for the actual task. A typical learner has many of the basic learning skills mastered and these skills move to automaticity, which means it happens without them having to expend much focus or effort to retrieve the information. Information that has become automatic is efficient and uses very little working memory capacity. The struggling student is struggling because basic learning processes are often still effortful and require both focus and energy to achieve. Therefore this child is taxing his working memory capacity and decreasing his executive functioning abilities. Initiating tasks is an executive functioning skill, so building working memory skills will help Michael be better able to start tasks on his own.

      Building working memory will help Michael learn better, but finding the right educational setting will help even more. Finding a school that will give instruction at his level, with the amount of repetition he needs to master the material is a good idea. The Ortion-Gillingham system is very good. I would recommend you look closer at Michael’s learning profile and find out if he matches the profile for dyspraxia. If so, then there are more specific interventions you can investigate for him. If not, then continuing OT, along with building his visual and auditory skills, as well as his working memory and executive functioning skill will be the way to go.

      Development Dyspraxia Definition
      Developmental dyspraxia used when the disorder occurs in children. In adults, apraxia or dyspraxia is usually called “acquired” as it results from brain injury. It is usually congenital in children (ie they are born with the disorder). Disorders that are observed as a child is growing (or developing) are referred to as “developmental”.

      Children with developmental dyspraxia find it hard to learn to talk and the normal course of language development doesn’t occur as expected. The normal milestones for speech development are not reached at the expected time. They will have difficulty making any or all of the specific speech sounds, and the sounds that they are able to produce may be distorted. They find it harder than other children in learning new words and joining up words into phrases or sentences. They may or may not also have difficulty using all the oral muscles to do actions such as chewing, blowing and sucking.

      Verbal Dyspraxia or Verbal Apraxia Definition
      Verbal dyspraxia is sometimes used instead of the terms oral dyspraxia or oral apraxia. In children it can also refer to Childhood Apraxia of Speech (CAS). Verbal dyspraxia often occurs in adults who have had a CVA (stroke), brain lesion, head injury or neurological disease.

      Verbal dyspraxia results in minor or significant difficulty in talking. It is hard to make speech sounds and to join them into words and then into sentences, or to imitate words and sounds. People with verbal dyspraxia usually understand more than they can say.

      Oral Dyspraxia Definition
      Oral dyspraxia involves difficulty using the muscles of the face and especially around and inside the mouth. People with oral dyspraxia find it hard to imitate other people’s facial expressions and to do actions that involve the mouth, including chewing, manipulating the tongue, sucking and blowing.

      Motor Dyspraxia Definition
      Motor dyspraxia involves the brain not being able to plan and execute bodily actions. For every action to occur, the brain needs to make a ‘motor program’ (plan) and carry it out (execute) using all the right muscles in just the right way. The brain either does not understand all the information it needs to plan the movement or there is a disruption to carrying it out. It is sometimes called a motor learning disability or Development Co-ordination Disorder (DCD).

      Children with motor dyspraxia can seem to be clumsy, and often have difficulty sensing where their body is in space and so will have difficulty with actions such as jumping, skipping and climbing. They usually also have difficulty with find motor skills such as picking up small objects, colouring in and handwriting.

  12. KC says:

    Thank you so much for your thoughtful responses. My 7 year old son is really struggling in school with writiing, pacing and staying on-task. He displays some signs of disgraphia and is extremely anxious about school and friends. He’s at a private school and we are scaffoling in OT and other pieces bu we’re thinking of sending him to a different school which focuses on processing and other issues and used the orton-gillingham method and multi sensory approach to teaching.
    He trys so hard and is so frustrated with school and friends telling him he’s slow. He’s a sweet boy who is now angry to the point of tantrums and rage.
    Thank you,
    KC
    His full results are:
    Verbal: 134
    Perceptual Reasoning: 123
    Working memory: 132
    Processing Speed: 100

    • He does indeed fit my classic Frustration Profile. His processing speed is between 23 and 34 points below his other index scores. That is a big difference. You have a very smart child who is thinking verbally and spatially at a swift and advanced level, but when he wants to get his thoughts out in writing he has to slow down to average. The slowing down, along with the effort to form the letters is annoying and frustrating him.

      I don’t have a full profile on your son, but one thing to consider is the effect of the different speeds he is functioning on. When he is working in his head there is no delay between what he is thinking and his ability to communicate it, but when he has to write there is a big disconnect between what he is thinking and his ability to communicate it. This would explain his difficulty with writing and pacing. Regarding staying on task, well if you are annoyed and frustrated that you can’t communicate at the rate you are thinking, you just might want to do something else.

      Solutions: work on fine motor skills, over and over and over and then some more. He might hate it, so create a rewards chart, use motivation, and educate him about his learning style. He should be working on his fine motor skills 15 minutes everyday. You are building pathways in the brain and they need to be stimulated daily (OK, 5 days a week) to open up and become automatic. Everything is easy for him in his head and writing/drawing/fine motor skills are hard. The effort is worth it! Your son is smart enough that schoolwork should not be a problem for him.

      You can also investigate and make sure that his vision is strong. Make sure that his visual-motor integration skills are good. Rule out everything you can so you can focus on the main area of difficulty.

      Your son is going to have this discrepancy regardless what school he goes to. Changing schools will not solve the underlying issue, but if social issues are a concern, follow your heart.

  13. Kristen says:

    My 5th grade son was recently tested and his scores on the WISC-IV are:
    VCI=124, POI=13, WMI=104, PSI=83
    Achievement scores showed low average scores in Math Fluency and Writing Fluency, but high average in Math Calculation, Picture Vocabulary, and Oral Comprehension.

    Is it correct to assume that his “processing difficulties” are visual-motor in nature? (rather than auditory processing?) What professional would you recommend him working with to help with the processing speed and working memory? Would an OT be the correct person?

    • Kristen says:

      I mistyped…..POI is 131!!!

    • Your son is clearly very bright. His scores indicate that he has strong verbal skills and is a good problem solver. The large discrepancy between his two high scores (VCI, POI) and his low scores (WMI, PSI) does indicate that he is better able to tell you his ideas than write them down.

      The processing speed is usually hindered by visual-motor weaknesses. It is important to determine if it mostly due to motor skills, visual processing skills or the integration between the two. If it is due to a fine-motor or visual-motor deficit then OT is the way to go. If it is due to a visual processing deficit then vision therapy is an option.

      The issue of his relatively low working memory is worth considering. Working memory is important for executive functioning skills. There is a computer program called CogMed that builds working memory. Attention issues can affect working memory and processing speed, so it would be wise to rule that out. Sometimes very bright children can rely on their exceptional memories and avoid developing their working memory until later when they begin to be challenged. I would suggest that you read about executive functioning skills and working memory and see what matches your son.

      • Kristen says:

        Thank you so much for the information! How do I determine whether the processing deficit is due to motor skills, visual processing skills or the integration between the two? Who would assess that? Also, my son started on attention medication this week and the teachers have noticed a HUGE difference. Would it be worthwhile to have him retested on the working memory and/or processing speed while on the medication?

      • I’m happy to hear your son is doing better. The issue of re-evaluation is important. You and the teachers have seen a big improvement, so AHDH may have been the biggest challenge for your son. Now that he is able to focus and attend better, a re-assessment for processing speed and working memory will help determine his current level of functioning. It is recommended that you wait until the medication is stabilized before reassessing. Check with your doctor and when the doctor feels the medication is effective and stabilized it is definitely worth re-evaluating. Once you have the new scores you can make a new plan.

        To determine whether the processing deficit is due to motor skills, visual processing skills or the integration between the two, you need to talk to the person who evaluated your son. There are so many individual aspects to consider. One test alone cannot be used to make diagnoses. The person who did the testing should be able to look at the test results and break apart some of these issues to give more information.

  14. Erika Owen says:

    Hello! Thank you so much for your comments. I enjoyed reading and trying to figure out a little more about my 7 year olds test results.
    Her verbal comprehension 79
    Perceptual Reasoning 100
    Working Memory 102
    Processing Speed 112
    Full Scale IQ 95
    Her Subtest Score for Verbal Comprehension
    Similarities 8 Vocabulary 7 Comprhension 4
    Subtest for Perceptual Reasoning
    Block Design 7 Picture Concepts 11 Matrix Reasoning 12
    I would GREATLY APPRECIATE any assistance. Thank you so much!

    • Looking at the scores you provided the greatest area of difficulty is the Comprehension score. The Comprehension test on the WISC IV measures social comprehension. It requires answering open ended questions about the world around you. Based on these scores I would recommend a Speech and Language evaluation. Language skills are very important for both taking in new information and sharing the information you have.

      • Erika Owen says:

        Thank you! Contrary to what the psychologist that performed the cognitive tests concluded I am learning the test results point to language processing issues so we do plan to take her to for the speech and language evaluation. Thanks for your input. It is reassuring we might have finally found the right problem to correct.

  15. Catherine says:

    Dear Melissa
    I am struggling to interpret these index scores on the WISC
    VCI 85 (mostly due to a very poor vocabulary – scale score 4)
    PRI 94
    WMI 113
    PSI 83
    GAI 89
    This child is a second language speaker and finds verbal expression very difficult. I am puzzled as to why her processing speed is so slow – especially since her WMI is by far her highest score. I have assessed her handwriting speed which is normal. She does not have any fine motor difficulties. She reads fluently and accurately, but her reading comprehension is very poor as she does not understand the meaning of many words in the text. Her spelling is age appropriate. She also has no difficulties with concentration.

    Any input or suggestions would be sincerely appreciated.
    Regards

    Catherine

    • I really like Virginia Berninger’s work in this area. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2717633/

      Dysgraphia

      Some children have diagnosable motor problems and also related handwriting problems, but the larger number have dysgraphia (Greek word meaning impaired letter form production by hand), that is, handwriting problems despite motor function that falls within the normal range; see Berninger (2004) for further information on this distinction. The hallmark features of dysgraphia, a biologically based learning disability, are impaired orthographic coding and/or graphomotor planning for sequential finger movements, which together function as the orthographic loop (Berninger, Raskind et al., 2008).

      She has written 2 books: Teaching Students with Dyslexia and Dysgraphia and Helping Students with Dyslexia and Dysgraphia Make Connections.

      I hope this helps.

  16. Rashida says:

    My 14 year old has 136 verbal comp. But processing speed only in the 2nd percentile. Working memory tests low, but performance is non consistently poor. IE, has no problem with telephone numbers or addresses. Suffice to say this has effected his motivation and produced extreme frustration for him and his family. We’ve done PACE, he attends an incredibly expensive private high school with experienced support staff. Is COGMED truly effective? He takes ADHD drugs, but I really believe it’s the inability to keep ideas in his head. All this contributes to tremendous anxiety. Help…..

    • Rashida says:

      Oops I left the wrong email address.

      • Cogmed helps build working memory skills, and I have seen its effectiveness, so for increasing his working memory Cogmed is a good choice. Your son’s 2% processing speed score suggests that he finds visual motor tasks very challenging. Writing, copying from the board and taking a written test are all visual motor tasks. I suggest that your son get an eye examination from a developmental eye doctor and have an occupational therapy assessment. Addressing the processing speed and/or making classroom/homework accommodations is going to be important for your son’s academic success.

  17. Christine says:

    I am interested in hiring you to do an over the phone consultation to better help me understand how to help my son. How can I contact you for this purpose? Thank you.

  18. Chris says:

    Hi Melissa,

    I am not sure if you can comment on my situation or not as I am an adult. I took the WAIS-IV. My scores are:
    Verbal Fluency 147
    Working Memory 145
    Perceptual Reasoning 115
    Processing Speed 94

    I am currently in a Ph.D. program. I *really* struggle with sitting down to work on tasks and staying focused and on task. A friend gave me some adderall and that did seem to help. What is the likelihood that I have ADHD? Is there some other issue I need to look into?

    I have no problem paying attention in class. My struggle is with working on assignments.

    Thanks.

    • Looking at your scores it is clear you are very bright. You have read my post so know the basic advice I gave. Another post explains what you might be experiencing:
      http://bitsofwisdomforall.com/2011/10/29/finding-the-right-help-to-build-processing-speed/. The interventions are geared towards children. In your case, I would recommend that you become a touch typist and that you use a speech to text software program like Dragon along with a graphic organizer program like Inspiration. You can use Inspiration to graphically organize your thoughts into chunks so you get your great ideas out quickly, then you can export to Word to write your papers. The only way to know about whether ADHD is an issue for you is to be evaluated. My guess is that you are verbally strong and you think much faster than you can write, so the disconnect is causing problems. If you could type as fast as you think, then the disconnect would be much smaller.

  19. Juls says:

    Melissa- first let me say you are doing a great service to parents like me who are raising FRUSTRATED kids! I had my three kids tested (each had a different tester) and no one commented on the problem of index discrepancies. Even internet searches turned up little guidance, this article and your comments are so valuable! Your practical advice is right on track.

    But I wanted to discuss older kids. Here’s the profile for my three children:
    Index Boy (10th grade) Boy age (8th grade) Girl (4th grade)
    VCI 144 114 112
    PRI 123 117 125
    WMI 120 126 110
    PSI 91 85 133
    Index rang 53pts 41pts 23pts

    * All three kids have school issues (bored, hate it, frustration!).
    * All used Handwriting Without Tears.
    * Oldest was tested did not need vision therapy. Middle did both vision therapy and OT.
    * All were homeschooled for a few years and are now in private school.
    * Both boys used ADHD meds for the first time this past year (9 months), but side effects have out weighed the minimal benefit. We will not continue.
    * All three are doing Nuerofeedback now
    * Both boys are good writers when using a computer and have this accommodation at school.
    *BTW oldest had subtest scores of 19 on both Vocab and Arithmetic

    My oldest struggles the most in school. He is a very fast reader and reads everything assigned (plus more), he discusses a ton, usually writes his papers and hates all homework (doesn’t do it). He gets As and Fs (often averaging to Cs). Higher math is a very big struggle- he is excellent with concepts and he calculates well in his head, but now that problems are longer and must be written out he gives up unless problem load is very reduced or someone will write what he says down for him. Algebra I could be done in his head but Algebra II he needed accommodations. He will take precalc this year and if he gets accommodations he will do great if he doesn’t the teacher will think he is lazy (“he’s so smart but doesn’t do the work”). His PSAT was in the 96% for math when compared with kids a year older than him, so he clearly understands the math. This poor kid is also suffering from depression. All that to ask, where does this lead? We may be able to get the accommodations through high school but what about college? This kid is smart and capable but unbelievably frustrated (and depressed). What majors or careers will work for him? That 53 point index difference is a killer! Do you have any other advice for older kids or kids in college?

    Also, as a side note- any comments on my middle son or daughter would be appreciated. My daughter is quite different as you can imagine.

    Thank you so very much!
    Juls

    • You certainly do have smart kids. I understand the issues you are dealing with. I recommend you read a few more of my posts. I have found that many of our gifted students are struggling in school because they have trouble with flexible thinking/set shifting. They have grown up with such quick brains that they have been able to quickly do their work mentally, so they haven’t had the practice with set shifting that other kids have. Then, when the work gets harder and they are required to slow down and work through and write down their thought process it is difficult for them (http://bitsofwisdomforall.com/2011/09/16/how-to-build-flexible-thinking-skills/). Next, since your kids have to learn to slow down to go through the mental processes they need to build metacognitive skills (http://bitsofwisdomforall.com/2012/02/05/metacognition-helps-build-self-regulation-and-executive-functioning-skills/) and finally they need to be motivated and organized (http://bitsofwisdomforall.com/2011/09/23/help-with-organizational-skills/).

      Now, the issue in math is real for kids with visual-motor issues. I have heard about new software where you can drag and drop numbers so kids do math on the computer, this is not a calculator. I understand this is the software they use to make the math textbooks, so it is basically a grid page that the child can do all the math on. I have not seen it yet, but you should search for it. I am sure there will more tools like this soon. I hope that schools will be open to allowing kids to use these tools for homework and tests.

      Looking at your daughter profile I am guessing that she might be speeding through things. Her profile usually requires the mantra, “STOP!, Think, Plan, then Do.

      There are more accommodation for older kids/adults. I like Dragon speech to text software and Inspiration for graphically organizing information. The burst of new apps and software will offer many solutions to help your kids. You have done a great job with them. Keep reminding them of how smart they are and that the hardest thing is getting through school. All three of your children have wonderful potentials, I don’t see why they can’t have any job they want. Remember that we pick our careers based on what we are interested in and motivation is the key to success. In school children are absorbing a wide range of information that is not always of interest to them and therefore it is difficult for them to organize and make meaningful attachments for the information which will help them recall the information later. But once we specialize in something we become experts in that field, our new knowledge is organized because it is related to what we already know.

      I hope this helps.

  20. Lolitak8 says:

    Dear Dr. Mullin,
    Thank you for sharing your expertise and insight with all of us. After reading about Glen (whom realize is a composite of various children you’ve worked with), I was struck by how much his cognitive/academic profile resembles one that might be seen in a child with a Nonverbal Learning Disability. While I realize that there are many social/behavioral factors associated with this diagnosis that were not mentioned in Glen’s case, I’m wondering if this was what you had in mind when describing this case. If not, what might look different in a child with NVLD?
    Thank you for your time!
    (From a graduate student interested in assessment)

    • Your question is a good one. Diagnosing NLD is difficult. Here is a great article that can help you learn more about NLD. I have only included part of the article; I highly suggest you read the whole article to learn about the traits to look at for NLD. There is a difference between dysgraphia and LND and it is important to know what the differences are. Many dysgraphic students have neuropsychologial deficits which lead to academic issues which are the same as a child with NLD, but they do not have the social/emotional issues.

      The Syndrome of Nonverbal Learning Disabilities:
      Clinical Description and Applied Aspects by Michael A. Roman
      http://www.nldontheweb.org/nldadvancedreading/nldclinicaldescription.html

      Edited article

      Introduction

      The syndrome of nonverbal learning disabilities (NVLD) includes a number of specific, potentially debilitating symptoms. Rourke (1995a) has grouped these into three major areas:
      1. neuropsychological deficits, include difficulties with
      • tactile and visual perception,
      • psychomotor coordination,
      • tactile and visual attention,
      • nonverbal memory,
      • reasoning,
      • executive functions, and
      • specific aspects of speech and language
      2. academic deficits,
      • in math calculations,
      • mathematical reasoning,
      • reading comprehension,
      • specific aspects of written language, and
      • handwriting are primary academic concerns
      3. social-emotional/adaptational deficits.
      • problems with social perception and social interaction.
      • Children with this disorder are also seen as having substantially increased risk for internalized forms of psychopathology, primarily anxiety and depression.

      While the NVLD syndrome has only recently been described in detail (Rourke, 1987, 1989), a number of important articles and two major books have been dedicated to descriptions of the disorder (Rourke, 1989, 1995a). Despite this fact, the syndrome is unfamiliar to many psychologists, diagnosticians, and educators. There is no formal provision under federal special education law recognizing the existence of nonverbal learning disability as a handicapping condition. In most cases, children with this disorder are best classified as Other Health Impaired. Because they may also have specific motor skills deficits, problems with math, social interactional difficulties, and/or emotional disturbances, some of these children may also be appropriately classified as orthopedically handicapped, learning disabled, or emotionally disturbed. This may be particularly appropriate for cases of neurologically acquired NVLD rather than the more common developmental cases of the disorder.

      • Rashida says:

        I appreciate your detailed explanation of the relationship between extreme discrepancy and NVLD. My son is NVLD and very much fits the profile, which has been fairly well established. What’s missing from the literature is what to do with the profile! He was “kicked out” of a special education school for being too functional, but he cannot function in public school full of much more sophisticated teenagers. We are sending him to a Catholic prep school with an accommodative support program. The question will be: will he function independently?

      • Upon reviewing my reply I realized I didn’t provide suggestions on how to deal with a child with NLD. Setting up a strong support system for your son and helping him build coping skills will help him move toward independence. Using the scaffolding system, you give support while a skill is being developed and then slowly take it away as the student is able to perform on his own. Here is an edited article that outlines many suggestions. The website LDonline is a great resource, http://www.ldonline.org/indepth/nonverbal.

        Developing an Educational Plan for the Student with NLD
        By: Sue Thompson, M.A., C.E. (1998)
        Read the full article at: http://www.ldonline.org/article/6119/

        Has difficulty coping with changes in routine and transitions
        • Providing a predictable and safe environment with a consistent daily routine;
        • Minimizing transitions and giving several verbal cues to the student before transitions;
        • Furnishing the child’s parents with a schedule of activities so they can “rehearse” (preview and prepare) for the following day with their child and make sure he has the necessary supplies required for the day’s activities;
        • Posting a simple written schedule on the blackboard at the beginning of each day in primary grades;
        • Explaining the daily agenda to the older child so he can begin to internalize the structure of his school day;
        • Writing out a high school student’s daily schedule on a card (with any changes in routine highlighted) that can be carried from class to class, so it is always readily available.

        Has difficulty generalizing previously learned information
        • Never expecting the student to automatically generalize instructions or concepts;
        • Using language as the bridge to tie new situations to old learning;
        • Reviewing past information before presenting new concepts;
        • Verbally pointing out similarities, differences and connections;
        • Verbally indicating generalizations which can be drawn in various situations;
        • Methodically discussing the cause-and-effect relationships of events and situations with the student.

        Has difficulty following multi-step instructions
        • Writing out and/or tape recording multi-step instructions;
        • Numbering and presenting instructions in the most efficient sequence;
        • Breaking all tasks down into manageable segments and presenting them a few at a time;
        • Making sure the student understands your instructions- don’t assume that repeating them back to you means that he will remember and can follow through;
        • Pairing the student with NLD with a nondisabled “buddy” who can remind him of “the next step;”
        • \Teaching the student mnemonic devices for short term memory enhancement;
        • Checking with the student at frequent intervals to be sure he is not “lost” or confused.

        Makes very literal translations
        • Explaining what you mean by the things you say which may be misinterpreted;
        • Simplifying and breaking-down abstract concepts;
        • Starting with concrete concepts and images and slowly moving to abstract concepts and images, at a pace set by the student;
        • Understanding that metaphors, emotional nuances, multiple levels of meanings, and relationship issues as presented in novels will not be understood unless explained;
        • Teaching the student to say “I’m not sure what you mean” or “That doesn’t make sense to me” to give her a specific vocabulary to help her decipher your intent.

        Asks too many questions
        • Answering the student’s questions whenever it is possible and practical (other students in the class may actually have the same questions, but be lacking in the verbal abilities to ask them);
        • Starting the other students on the assignment and then individually answering the rest of this student’s questions;
        • Designating a specific time during the day when you can continue a discussion which needs to end at the moment;
        • Telling the student you only have time to answer three questions right now (a specific number is important – - don’t say “a few”), but that you will be glad to answer three more of his questions during the recess break;
        • Specifically teaching the student when it is appropriate to ask for help (i.e. if he will be unable to continue his assignment unless something he doesn’t understand is explained to him) and the appropriate methods of doing so;
        • Explicitly teaching the rules of polite social conduct, so that the child does not constantly interrupt class activities with his questions.

        Is easily overwhelmed
        • Diffusing potentially weighty situations as early on as possible;
        • Minimizing environmental stimuli (especially visual and tactile);
        • Having a consistent strategy to employ when the child can no longer cope due to overstimulation, frustration or confusion;
        • Allowing the child to abstain from participating in activities when she demonstrates any signs of overload;
        • Eliminating all nightly homework assignments;
        • Implementing a modified schedule or other creative programming strategy.

        May experience heightened sensory experiences
        • Preparing the environment for the child (eliminating known sensory stressors);
        • Reducing distractions and situations contributing to sensory overload;
        • Focusing on one sensory modality at a time (avoiding multi-sensory approaches to instruction);
        • Allowing modifications as needed to deal with sensitivity issues (protecting the child from sounds that hurt his ears or avoiding the use of fluorescent lights in the classroom);
        • Talking in a low whisper to a child with extreme auditory sensitivity;
        • Ensuring that this child is placed in a classroom location with the least amount of distraction (usually up at the front of the room, away from visual and auditory sources of “clutter”).

        May develop secondary issues with stress and anxiety

        • Previewing and preparing for all novel situations and transitions in advance;
        • Providing a consistent and predictable daily routine;
        • Gradually exposing this child to new activities, teachers, classes, schools, etc.;
        • Ensuring that this child is safe from physical and emotional abuse; · Avoiding sudden and unexpected surprises;
        • Thoroughly preparing the child in advance for field trips, modified schedules, or other changes, regardless of how minimal;
        • Talking the child through stressful situations or (non-punitively) removing her from the stressful situation;
        • Providing personal space in the resource room or other designated area for regrouping and relaxation.

        Imparts the “illusion of competency”
        • Providing a highly individualized educational program;
        • Applying age and grade-level expectations with flexibility;
        • Emphasizing the strong academic skills and gifts of the child with NLD by creating cooperative learning situations in which his proficient verbal, reading, oral spelling, vocabulary, and memory skills will be showcased to advantage (and his difficulties with writing can be de-emphasized);
        • Never assuming this child understands something just because he can parrot back what you have just said;
        • Never assuming this child understands what he has read, just because he is a “proficient” reader (has excellent word recognition);
        • Offering added verbal explanations when the child seems “lost” or registers obvious confusion.

  21. Nichola Bell says:

    Just stumbled across this and can’t believe how much this could be my son! He goes to OT as teachers have complained about his lack of attention and interest in class etc Out of the class environment he is an amazing (high energy!) child who just beats to his own drum but I have always worried about him fitting in the box . He did something called metronome which highlighted slow processing and now I feel I have at least found a way to explain him to teachers other than ADHD which never felt right to describe him that way. I”m delighted to have found your ‘frustration profile’ Do you have suggestions on good sports as my child struggles with martial arts, soccer, even swimming as he loves to swim but learning strokes he switches off! He’s highly active so needs something.
    Thanks in advance

    • Exercises that cross the midline of the body will help with the integration skills your son needs to build. Here is a great website that outline the process. http://www.ot-mom-learning-activities.com/crossing-the-midline.html. Another thing to consider is the Boy Scouts. While the Boy Scouts is not a sport it does offer group activities and exercises that build self-esteem and mastery in many fun areas.

      Other ideas include: Running, Hiking, Rock-wall climbing (sport climbing), Archery, Horseback riding, Rowing, Snow-shoeing, Cross-country skiing.

      I must say that the research on yoga, swimming and martial arts really highlights the benefits of these activities for integrating the mind-body connection. I do think they are the best to do. If you can find a good, patient coach that can help build the foundational skills needed to become strong in one of these activities it should be worth the effort.

      • Nichola Bell says:

        Thank you so very much for responding. He is a bit of an adrenaline junkie so short of letting him bungie Jump I was at a loss but rock climbing might be worth a try and of course skiing!
        Funnily enough he did mention polo !!! (typical! most expensive sport) so why we might not venture there just yet we will try horse riding as he doesn’t seem competitive but loves animals so that might just be it! The school is starting a running club also which is about achieving miles rather than winning or speed so I am going to try that as he can run forever.
        I’
        ll check out the link also ,

        Thanks

  22. jenroper says:

    I just stumbled upon this site in hopes to understand my daughters recent psychiatric evaluation. In a nutshell she is 6.5 entering 1st grade, goes to a bilingual (predominately French) school. She excels in French (her second language, and only spoken at school) but struggles in other areas this past year(math and reading). She has been criticized by teachers for not paying attention, talking too much, not completing her work, not listening. At home she has had extreme violent spells, tantrums, and threats of violence (getting way better). We started therapy about 6 months ago which led to a psych evaluation and IQ test. I dont totally understand all of the abbreviations and scores and didnt get it in that kind of breakdown that I have seen above but I will do my best to pass it along.
    FSIQ 113
    PR 81
    Verbal Comp 114
    visual perception 119
    processing speed 85
    From what it was explained to me she has an above average IQ but significantly below average processing speed. I am still trying to make sense of this and what it means. They said she has trouble processing written or spoken information but her verbal comp and perception seem high.
    I would love any insight or help with this.
    Thank you so much

    • Looking at your daughter’s scores I notice that her Perceptual Reasoning score is low. Many times students with strong verbal scores and low Perceptual Reasoning scores can be at risk for a Nonverbal Learning Disorder. I have just written a response to another comment outlining this. Read through the description of NLD and see if it matches your daughter. You can find more information about NLD at http://www.ldonline.org/indepth/nonverbal.

      Here are some of the area students with NVL struggle with:

      • Has difficulty coping with changes in routine and transitions

      • Has difficulty generalizing previously learned information
      • Has difficulty following multi-step instructions
      • Makes very literal translations
      • Asks too many questions,
      • Is easily overwhelmed
      • May experience heightened sensory experiences
      • 
May develop secondary issues with stress and anxiety
      • Imparts the “illusion of competency”

      It may be that the combination of the perceptual reasoning weakness and the slow processing speed is making it difficult for your daughter to understand new instructions. While she is able to use the information she does process, she is not able to process all the information she is given in the time allotted, causing her to become frustrated. Here is a great article to read if you think NLD might be an issue for your daughter: http://www.ldonline.org/article/6119/.

  23. racahel hegh says:

    Hi,
    I have been researching low processing speeds after my son who is 11 was recently tested on the Wechsler Intelligence Scale for Children IV. This is one of the first sites that I have come across where I have been able to garner some clear information,so thankyou. I was hoping for some further insight as we are really struggling to get his school on board with some support or any type of explanation.
    His intelligence scale score came in at 98 out of 100 which was in the vastly superior category but his processing speed score came in at 21 out of 100. He is really bright and funny and kind so he is very well adjusted socially and emotionally but in the classroom his work is sitting below the average of the rest of the class. He has presented consistently in the top percentage brackets for Naplan testing but the gap between what he is doing and what he is capable of doing is significant and I think he might be limited by his processing speed which is so low that I think could even be a learning disability? I was hoping for some insight, any of your thoughts would be appreciated. Is a low processing speed something that you adjust to in life or can that speed be helped through occupational exercises and the like and what should his school be doing to help support him do you think? Have you any suggestions on how we can help him at home?
    thankyou
    Rachael

    • Processing Speed can be improved, but it is not easy. Occupational therapy can help. Brain research has shown that consistent, intensive intervention opens up pathways in the brain. Basically what you need to do is get those pathways open and flowing. I suggest daily work with Re-train the Brain and Handwriting Without Tears. 15 minutes a day/ 5 days a week. Practice, practice, practice!! Make a reward chart to increase motivation. This is hard work for your son, but it is worth it. Also, start teaching him typing skills. Additionally, he should also qualify for extra time on tests due to a disability in fluency.

  24. Jim Space says:

    Dr. Mullin:
    Thank you for this informative website. It is so generous of you to do this and help all us families trying to figure out the best way to educate our children.

    I have a 7 year old son diagnosed with ADHD and Double deficit Dyslexia.
    Here is his info:
    Full scale IQ= 108 (70%ile)
    Verbal Comprehension= 124 (95%ile)
    Perc Reason: 100 (50%ile)
    Working Memory: 99 (47%ile)
    Processing Speed: 97 (42%ile)

    On further tests of processing speed, it showed that he scored:
    16th percentile when it had high working memory and fine motor demands,
    84th percentile when it had minimal working memory and fine motor demands
    75th percentile when it had minimal fine motor demands but greater working memory demands

    He scored in superior ranges on measures of verbal comprehension and has a great vocabulary (he talks like he is wise beyind his years), but very low on processing speed.

    On The GORT:
    Rate: 16%ile
    Accuracy: 9%ile
    Fluency: 9%ile
    Comprehension: 5%ile
    Oral reading quotient: 4%ile

    Testing showed significant retrieval deficits and rapid naming issues.

    DIBELS Oral reading fluency: 14 words per minute (at risk)
    Standardized Reading Inventory: Word Recognition (Fluency)= 2%ile
    and Passage Comprehension 5%ile

    What would you recommend?
    He is now in second grade and is on an IEP, but we want to target his specific type of dyslexia.
    What strategies/programs are there for retrieval issues as well as rapid naming?
    His school does Wilson, but he has had exposure to RAVE-O, which he liked.

    Thanks for your input.

    Jim

    • RAVE-O and Wilson are great programs. It appears that working memory and fine motor skills are average on their own but when they are combined with high demands each skill is hindered. Additionally, you have the reading issue. I would recommend that you focus on remediating the reading issue and then revisit the working memory and fine motor skills once your son is reading well. The RAVE-O program and Wilson combined would be wonderful for him. The two programs are slightly different and the RAVE-O program is designed to be done with a phonics based program like Wilson. Given his high verbal score I would like to see your son reading in the high average or above range.

  25. elizabeth says:

    I just found this thread! I think it also applies to my son who was recently evaluated by his school district. His scores on the WISC IV were:
    VCI- 126
    PRI-96
    WMI-129
    PSI-83
    FSIQ- 111

    He has a diagnosis of Asperger Disorder, ADHD and motor coordination disorder. He is great kid- a hard worker who always tries to do his best in school. I believe that his fine motor issues are slowing him down. He has been in OT and speech therapy since kindergarten. He comes home from school frustrated. I used to think that this was caused by sensory overload, but now I think that he may feel “misunderstood” by his teachers. What types of accommodations should I be looking for when we start to develop his IEP? Thank you so much!

    • Your son needs accommodations in classroom. Check with the school about how they can help him. You don’t say how old he is and that can change the type of accommodations available. Common accommodations are: extra time on tests, a note-taker, use of the computer for note taking and essay tests, use of a calculator for math, enlarged work space on tests, the ability to write on test forms rather than a separate answer sheet, and a reduced work load for assignments that are heavy on writing.

  26. Kate says:

    So happy to find you! In many respects, this describes my son who has just begun 4th grade. We always felt he was so bright, but have known he’s had difficulties for some time now (for which has long received OT and, earlier, some play therapy). He has an IEP, which includes OT, counseling and extended test time. We recently had him evaluated and were surprised (in part) and overwhelmed by the results, which show far fewer strengths than we have always felt he had. In short, his basic IQ scores were:
    VCI SS=108, 70th percentile
    PRI SS=84, 14th percentile
    WMI SS=107, 68th percentile
    PSI SS=59, <1st percentile

    He was dx with ADHD and Perceptual Motor Disorder (the latter of which I can find nothing about on line!), both of which make sense to us. We are just shocked by how low so many of his scores were and heartbroken to know how hard things must be for him. When he was 3-6 he was considered a math whiz! He was an early reader. My mind is just whirling about what happened and especially one comment from the evaluator when I asked about this: he said "the attention problem does erode overall skill development over time". Similarly he said the perceptual motor (visual-spatial, I think) are pretty much fixed at this point (he's 9.5). I just don't know quite what to do and how to pull together and prioritize all the services he needs. I wish you were located in NYC! Thanks SO MUCH for any advice. Kate

    • We are continuing to learn about the human brain, and what we are learning is that it never stops developing. The processing speed deficit is a real issue for your son and that is where I would focus first. Have you had his eyes tested by someone who measures tracking issues? If eye tracking is an issue, vision therapy could make a big difference. I have seen medication for ADHD make a significant improvement in processing speed. If you try medication, it might be worth having the Processing Speed Index re-evaluated.

      Attention deficit does not usually erode skills, rather it hinders the development of new skills therefore lowering the skills base of the child. Since we expect children to be continually absorbing new information, if they do not develop as expected their scores will go down. Once the attention is addressed then the skills can be developed. Medication does not build the skills, it allows the brain to more easily focus and process information making learning easier. So the skills that were not obtained due to lack of attention must be re-taught.

  27. Dana says:

    First, let me say you are very kind to respond to each an every post. I found your site while trying to understand my 7 yo son’s results. He was diagnosed ADHD combined today. I wonder if you could help me understand the descrepancies in his scores. I’m trying to understand how to help him. I wrote down the recommendations from above where verbal and processing speed scores are spread, but am curious about working memory. His scores are:
    Verbal 124
    Perceptual 100 (8 s except 14 on picture concepts)
    Working Memory 88
    Processing Speed 78 (3 on coding and 9 symbols he didn’t finish and made careless errors)
    FSIQ 100

    The psychologist recommends Cogmed and seeking meds from the pediatrician. We used HWT before and liked it. I will look into Retrain the Brain.
    I will look up the link to your phone consult information as well. My daughter has reading issues and dyslexia runs in her daddy’s family.
    Thank you,
    D

    • The Working Memory Index is often low in children with ADHD. I do recommend Cogmed to help build working memory skills. One way to look at this that the child with ADHD has to work harder to keep information in mind, so rather than being able to both hold and process the information, the child is working hard just to hold the information and often “loses” it before he can process it. This makes learning difficult.

      My favorite theory of working memory is by Baddeley and Hitch (1974). They created a multicomponent model of working memory. This theory describes two “slave systems” for short-term storage of information, and a “central executive” which integrates and coordinates the slave systems. The slave systems include the phonological loop and the visuo-spatial sketchpad.
      http://upload.wikimedia.org/wikipedia/en/0/01/Baddeley_and_Hitch%27s_Working_Memory_Model.png

      The phonological loop stores phonological information (that is, the sound of language). The visuo-spatial sketchpad, stores visual and spatial information. The important part of this is the current theories are indicating that working memory can be strengthened with mental training. That is why a program like Cogmed can be effective for people with working memory weakness. However, these same students need to learn metacognitive strategies to help them learn how to learn. Here is a link to an article I wrote about metacognitive strategies. http://bitsofwisdomforall.com/2012/02/05/metacognition-helps-build-self-regulation-and-executive-functioning-skills/

      • Dana says:

        Thank you for getting back with me. I saw on your website that you also use other programs as well. There is one that is used in children with brain injuries. The name escapes me right now. I believe it is less expensive than Cogmed. All three of my children are struggling in different areas right now, so I can’t spend the money on Cogmed. Will that program do essentially the same thing? I believe in neuroplasticity. If we can intervene now, then I believe he will improve and not need meds. He isn’t hyper, but is impulsive. If dyslexics can change their brains through intervention, then why can’t a similar approach work for ADHD?

      • I believe you are referring to Retrain the Brain. We use this program to remediate fine motor skills issues. The author of the program does think it rewires the brain and will help children with ADHD. I am careful not to make promises that are too big. I have seen the changes that Cogmed makes, and Cogmed has research backing up it’s claims. Retrain the Brain is a great program but I would not make any promises about its ability to get kids off ADHD meds. If you try it for attention, please let me know what you think of it.

        The issue with ADHD is that it is hard for these children to attend and work to their potential. Some children miss information in class and that adds to their learning issues. I like the idea that working memory can be strengthened or developed. Any increase in working memory will benefit your child. The challenge is to do intensive (daily) mental exercises that push the working memory capacity. Building executive functioning skills will also help. You can take the free quiz on my website http://www.kandmcenter.com to find your child’s executive functioning strengths and weaknesses.

      • Tim & Dana Gill says:

        Thank you for that information.

  28. Jenn says:

    We just received our 4th Grader / 9 year old son’s first PSI results. He attends private school, and has always struggled in school, but has been fortunate to have teachers make accomodations for him.

    He is a very talkative and social child, but not disruptive in school and is overall well-behaved. His BASC-2 TRC-2 test pretty much confirms this.

    Here are his PSI scores:
    VCI =116, 86th percentile
    PRI = 92, 30th percentile
    WMI =68, 2nd percentile
    PSI = 78, 7th percentile
    Full Scale = 89, 23rd percentile.

    His Beery VMI score was 55, which we find very troubling.

    He definitely fits The Frustration Profile, and some of the accomodations the teachers have made follow the recommendations you outlined.

    We are going to meet with to discuss with our pediatrician to hopefully get a referral to a specialists. The school team needs to decide if they are going to do a a Multi-Factored Evaluation (MFE) or not. What else should be the next steps?

    • I would suggest some more investigation into the area of Working Memory. Has attention been looked at as a factor? There seem to be a correlation between Working Memory/ Attention and Processing Speed. This is not always true, but with the low Working Memory and low Processing Speed I would look into that. Barkley explains the relationship of ADHD and executive functioning. Working memory is one of the major executive functioning components. http://russellbarkley.org/content/ADHD_EF_and_SR.pdf

      • Jenn says:

        Thank you so much for your response. We are taking him to his pediatrician to begin the discussion of these results with him, as well as his teachers who are now going to perform a Multi-Factored Evaluation.

        I never felt that his attention was lacking. He is able to focus on tasks, but we have to break instructions down one at a time because multiple steps and instructions cause him to often breakdown, get confused and sometimes “check out.” He repeats himself a lot, and we often have to repeat what we’ve said to him because he honestly said he never heard us tell him something. He also struggles with self-initiation, but is generally well-behaved and does follow instructions. Is this an EF issue?

      • It is good you are going to find out more about your son’s learning profile. Some of the things you describe sound like they would fall into the category of executive functioning skills, others may be due to issues with auditory processing or attention. Hopefully, further evaluation will shine a light on the areas your son needs to strengthen.

  29. Mark says:

    Thank you for this very informative site! Our youngest son (10) did a WISC-IV test last year through the school psychologist as he was getting conflicting reports from his teacher, our own observations of his abilities and his high NAPLAN test results. His WISC-IV test results where:
    Verbal Comprehension: 142 (99.7)
    Perceptual Reasoning: 108 (70)
    Working Memory: 91 (27)
    Processing Speed: 65 (1)
    He is a pretty relaxed and friendly little guy but has recently “lost” his long time friend (since prep) and is not coping with making new friends at all well. He now regularly says that he is having crap days at school and hates his life and doesn’t think it’s worth living. He says he hates being seen as a loner (a recent problem) but also finds most people at school boring and stupid. He listens patiently to us and makes the “right” comments when we try to help develop some strategies with him to make new friends. But a few minutes later he dogmatically reverts back to making extremely negative statements like “Yes, that sounds like it might work… for someone who doesn’t want to die!” and “I just hate people!” This is frustrating, disturbing and confusing as he can clearly see options and find solutions. We are quite worried about his state of mind at the moment.His teacher tells us she REALLY enjoys having him in her class as he always “gets” it, is able to quickly offer interesting, unique and valid alternative perspectives although his class mates often “don’t seem to get” him. He is slow to complete written tasks and is generally very slow at getting organised. He plays soccer but is very slow to react to the ball or general play and takes tackles on him as a personal attack and wont be swayed from that view.
    He has so often surprised us when we assumed he didn’t understand/hear a concept only to find out later he not only understands it completely but has done so for some time and can go back to specific conversations months or even years earlier where he first understood something and explain all the links he has made since then.

    We are not really sure how we can help him with his processing speed or his state of mind.
    He has got the social skills to be poplar but appears to choose not to use them…
    He is has very high verbal comprehension but very low processing speed…
    He appears happy and relaxed and then suddenly make statements that make us think he is deeply depressed…
    So many opposites!

    • The most important consideration is your son’s state of mind. I am not qualified to give any information about his mental health, but I do want you to make sure he is safe and secure. I would recommend talking to his doctor or a councilor at school to make sure this a passing phase and not anything more serious. Being lonely and feeling left out is not fun for a child and difficult for a parent to watch. There are many parenting books, like The Blessing of a Skinned Knee by Wendy Mogel, Ph.D., to help guide parents through the difficult task of helping our children grow up to be happy adults. Social groups and new activities are a great way to make new friends. What does he like to do? Sign up for an art class or martial arts class to get him out and around new kids his age. Find out if there is another child in the class who is feeling left out and arrange a play date.

      The second issue is the significant differences found in your son’s test results. Your son’s verbal comprehension is significantly higher than all his other scores. He is most likely thinking all the time. The issue may be that he is not as strong at organizing the ideas he has. While his Working Memory and Perceptual Organization are in the average range they are not as strong as his verbal skills. I would recommend building these areas. A program like Cogmed can help build working memory and games like Q-bitz can help build perceptual organization.

      Lastly is the issue of his processing speed. Given the great difference in his scores your son needs extra time on tests and assignments and a reduced homework load for written material. You have read my article so you know the recommendation I suggest. I would highly recommend you start with a vision exam with a doctor who believes in vision therapy and have your son’s eye tracking skills assessed.

      I hope this helps.

  30. Rejeania says:

    Our son is 7 years old and in 2nd grade. He was diagnosed with ADHD at the end of Kindergarten. His main areas of concern are attentiveness and hyperactivity. It was believed that his difficulty with his grades in K and 1st grade was stemming from his inability to sit still and concentrate coupled with trying to find the right fit with medication. He is currently on Ritalin twice a day and has responded fairly well with the dosage, although he did have some days that he would be inattentive and disruptive but this was not a daily problem. Once the behavior was under control, he continued to have problems across all subjects. He is able to comprehend and answer questions verbally, but he is unable to express thoughts on paper. This problem exists in ALL subjects (Math, Science, Social Studies and Language Arts). When he took a verbal comprehension test he scored at approx. 50 percentile but when he took the written comprehension test he scored less than 2 percentile. When given an assignment it takes him 10-20 minutes to begin. He is not playing during this time he is quiet and thinking. He then begins but the assignments take him at least twice as long as the other children in his class. The school and Sylvan both expressed that they believed this was a focusing issue. He is smart and grasp the concepts they are teaching, but he does not seem to be able to express them with pen and paper. We consulted our pediatrician and he increased my son’s Ritalin three weeks ago. Since then we have had no behavior problems at school. He is now sitting in class and no longer disrupts the people around him. However, after meeting today with his teacher he is still having issues with the school work. Again I was told he has problems beginning assignments and then he has trouble finishing them in the allotted time. He can copy sentences and stories, but he struggles with putting his own thoughts on paper. He also seems to miss part of words/sentences. For example on his spelling test, the word was “fast” he wrote “fa” and stopped the word “against” was spelled “again”. He seems to miss the last part of what people say to him. Does this sound like an extension of the ADHD or does this sound like it could be something more?

    • One of the common issues with ADHD is that students miss information when it is being taught. While the medication has helped your son’s behavior, it does not teach him any skills he might have missed before be began medication. The two areas I would look at are working memory and fine motor skills. ADHD affects working memory and this hinders a child’s ability to work with multiple bits of information at one time. Basically due to ADHD your child has not built the foundation for focusing and working on a task, he needs guidance and practice to learn this skills. Learning metacognitive strategies like: STOP, THINK, PLAN, DO can guide your son as he starts a task. When it come to writing something down he needs help to outline it, organize it and then write it.

      For fine motor skills Retrain The Brain and Handwriting Without Tears are good programs. Taking a drawing class is another way to build fine motor skills.

      • Rejeania says:

        First – Thank you so much for your response. It is wonderful how you answer each post. As a parent of a child who struggles, it is nice to have someone who will not only listen to your concerns but will give some guidance. I have had a lot of people telling me what is wrong with my son but no one has had any ideas on how I can better help him. I have been working with him at home on his writing skills for the last 6 weeks. We started out writing letters, then moved on to words and then sentences. Now that he has shown he can write out the words and knows a sentence structure, I plan on working with him on outlining his thoughts. He has 2 stories due at school which the teacher has sent home for me to help him with. I will start with those and help him outline his thoughts.
        I will also definitely look into these programs. Thank you again for your insight!

  31. Lila Hanft says:

    Thank you for this column and for your thoughtful answers to people’s replies.
    My question is about how to find someone who can do this kind of evaluations for my 8th grader. He is extremely bright and highly verbal and can write at an average speed on a computer, but with a pencil in hand he is very slow. He’s at a small private school now and his teachers give him informal accommodations, but I’m concerned about what will happen when he goes to high school next year, and so I’d like to have a professional assessment and possibly a 504 in hand before high school — and of course, I’d love to have strategies and coaching for him.

    So what kind of professional should I look for to provide the kind of analysis you’ve done for your composite student? A neuropsychologist? A school psychologist? Is this something which would be revealed in the course of WISC-IV (which he’s never had) or are there additional tests we’d want to get? Thanks.

    • I would check with your school about who they recommend. You need a Psycho-educational evaluation that includes the WISC-IV along with tests that measure his fine motor skills. You can interview some psychologists in your area that do educational assessments. The questions you want to ask include:
      - Are you familiar with the requirements for a 504?
      - Do you have tests that will measure my son’s fine motor and visual-motor skills to see if he has Dysgraphia?
      - Do you think that a child with strong verbal skills and weak writing ability has a learning disability?

  32. Denise Blake says:

    In trying to find out the best way to help my 14 year old do better at school and revise for exams I came accross your responses, I would be grateful for any advise you could offer. My son’s recent assessent shows his profile as

    Verbal Comprehension Composite Score 99
    Perceptual Reasoning Composite Score 117
    Working Memory Composite Score 94
    Processing Speed Composite Score 136 ( coding 17, symbol search 16).
    word reading ss 114
    Reading comprehension s.s 118
    Spelling s.s 110
    Math Reasoning 101

    Could you suggest any particular techique for use to retain information in preparation for exams? Does his score indicate he would be better in a particular type of occcupation?

    • It is always an interesting exercise to try to figure out what type of jobs our children would be best in. In today’s age of constant change I think any choice we make at this point will probably be obsolete by the time for children are out in the working world. It is always fun to look at the skills that a child has and to think about where they could best be used. Looking at your child’s scores I see that he is good at solving visual spatial puzzles, good at whole/part relations and coming up with a novel solution. I also see that he has very quick fine motor skills and a fine eye for detail. His visual scores are higher than his auditory scores, so he may like a job that has visual components to it, like architecture, computer programming, design. Your son’s reading comprehension is good while his math reading reasoning is a bit lower. But what I know about people is that when there is a will there is a way. Your son’s scores are strong across the board so I think he will do well at what ever he has a passion to succeed in.

      Now, to address the issue about how to help him on exams. My first advice would be to make sure he slows down when he takes the test. His processing speed is faster than his ability to mentally solve the problems presented. He needs to make sure that he gives himself time to read the question, think about the answer and THEN write the answer down. Additionally, his perceptual reasoning skills are higher than his working memory skills. When studying he would do well to use flashcards. He should write information on the flashcards so that he is putting the parts of information on individual cards and the whole concept on another. He should be able to make mind maps of the concepts and details. He should look at his studies as a puzzle to be solved rather than information to be memorized.

  33. Debbie Yoklavich says:

    I have a daughter with a 504 plan for low working memory and cognitive disorder. She is very bright and I have been told to enroll her in the magnet program. Is this a good idea since she has issues with her working memory and takes more time to complete assignments. Her test scores from a Ped. Neuro Psych results are:INTELLECTUAL FUNCTIONS:
    WISC-IV Composite Scores Summary
    Scale Sum ss Composite %ile Range
    Verbal Comprehension (VCI) 40 119 90 High Average
    Perceptual Reasoning (PRI) 40 121 92 Superior
    Working Memory (WMI) 22 104 61 Average
    Processing Speed (PSI) 23 109 73 Average
    Full Scale (FSIQ) 125 119 90 High Average
    General Ability Index (GAI) 80 123 94 Superior
    Verbal Comprehension Subtest Scores Summary

    • In looking at the scores you gave it appears that your daughter may have issues with executive functioning, specifically set shifting. I did edit the scores you sent, but her performance on the DKEFs indicates that she has trouble letting go of one idea and shifting to a new idea. Set shifting is the ability to move from idea to idea. It is a key component of learning. Our students need to take in an idea, transfer it to long-term memory and then be able to retrieve it from long-term memory. They need to be able to make associations between what they already know and what they’re learning. Students that have trouble with set shifting are often rigid in their thinking.

      Based on the information you have given me your daughter’s overall intellect is intact. While her perceptual reasoning is very high and her verbal comprehension is strong her weak areas are in the average range. I would think a program like Cogmed would be good to help build her working memory skills. I would also recommend building her executive functioning skills specifically set shifting skills. You can investigate flexible thinking programs to find activities to help with set shifting skills.

      It is hard to say whether the magnet program you’re looking at would be the right school for her as there are so many variables to consider when choosing a school. Will they allow her extra time on her tests? Will they support the learning tools she needs? Your daughter is bright and with hard work and the right intervention she should be able to do well at any school she chooses.

  34. Jane says:

    Like others here, I was delighted to come across your site and find it very helpful. My son’s profile doesn’t quite fit with others so I’d appreciate your opinion. My son is 7 and experiences great difficulty concentrating in class, teachers say he needs one on one attention all the time (which isn’t available). We had him assessed and his reading level was 4 years 4 months (when he was 6 years 10 months) . His WISC test results were:
    • Verbal comprehension 101-114, 70th percentile
    • Perceptual Reasoning 114-129, 94th percentile
    • Working memory index 107-122, 86th percentile
    • Processing speed index 58-76, 1st percentile
    The report concludes that his scores are significantly weaker than his assessed ability and are likely to indicate dyslexia. (not conclusive)
    Unfortunately, there are only basic learning supports in Ireland (no 504 type program) – he is entitled to 3 hours a week “learning support”, reading in a small group of 4. Hence, we need to do any specialist programs outside of school ourselves. Having read your article, I will try the Retrain the Brain but would find it very hard to get him to do extra handwriting with handwriting without tears, his writing is very weak and he resists any writing work, his homework already takes too long so I can’t imagine adding more torture to it.
    His school have recommended that we move him to an English medium school saying that he has enough difficulty with English literacy and that learning Irish as well was too much for him.
    My question is, does a low processing speed index impact your ability to learn a 2nd language? Do I need to limit the number of languages he learns. I realise it impacts his handwriting, ability to copy from the board etc. but would it matter that he’s learning 2 languages as well (He can get an exemption from Irish long term if it is definetly an issue).
    I’d appreciate your feedback on this,
    Thanks,

    • Is there a relationship between processing speed and learning a second language? That is not something I have thought about before. Here are the ways of thinking about this. First, is his processing weakness due to low cognitive processing? How you would tell this is by how quickly he can think and answer question. Does your son need extra time to take in information think about it and give an answer back? Or, is the processing speed weakness due to visual motor weaknesses? You can tell because by his ability to write letters on the page. You talk about his handwriting which makes me think the greatest weakness is in the visual motor domain.

      What does it take to learn a second language? Generally strong auditory processing skills relate to learning a language.This is what’s going to determine how easy or hard learning a new language will be. The school is indicating that your son might have issues with the reading and writing due to dyslexia. It seems that they are basing this assessment on his processing speed issue which is dependent on his visual-motor skills. Dyslexia can be caused by weak visual perceptual skills, so if learning to read is difficult in one language it will probably also be difficult in a second language.

      If you are interested, my learning Center(http://www.kandmcenter.com) has designed a reading program that can be done at home for children who are struggling to learn to read. The program develops auditory, visual and vocabulary skills to help students learn to read better.

      If your son resists writing you might want to get drawing activities like trace arounds. These are products that give a form for the child to actually trace around. The child then can add details into the middle. Finding activities that will strengthen the muscles in his hand and fingers along with the dexterity needed for writing will help make forming letters on a page easier. I hope this answers your question.

  35. Mary says:

    My Ds was assessed in 2008 when he just turned  7 ( it happened on his birthday) by an EP and did the WISC. He scored low in most things but there was huge variation and the EP wasn’t sure if the results reflected his capabilities as he was quite inattentive and distracted.  Roll forward 4 years and he recently had another WISC where the scores were very different. The EP said she had never assessed someone who had such different scores on 2 separate occasions. Since the first assessment he has been put on medication for his attention difficulties and he has been diagnosed with Asperger’s.  The results of his assessment 2nd time round were along the lines of
     
    VCI – 100 – 50th centile
    PII – 100 – 50th centile
    WMI – not sure but it was a bit below average
    PSI – 2nd centile
     
    I had felt haunted by the first set of results for 4 years and the fact that they placed him in the moderately globally delayed category. I could never believe that the results were a true reflection of him and the second set make a lot more sense. He was reading and writing and doing maths at the time although he struggled in the busy classroom environment. Processing was mentioned back then as was the fact that he seemed very capable and bright in some ways but not others. The EP said that because there was a lot of variation between the VCI/PRI and WMI/PSI it did not make sense to calculate a Full scale IQ and she would never be putting that in a report but if she did it would be 85. Is it  correct to say that a FSIQ would not be a good way to calculate his intellectual capabilities? She didn’t mention the GAI although the previous EP did when I got the results Do you think the GAI would be suitable? She felt from his scores that his working memory score was impacted by his weak PSI. Does the fact that he scored average scores in VCI and PRI mean that he is not delayed across the board and its specific issues that have been responsible?
    He has attended OT for the last year and not surprisingly  the OT has assessed him as having auditory processing difficulties. She claims that cognitively he is fine but that the speed at which he accesses his intelligence is not as effective as it should be? I suppose I’m trying to work out if this is the case and is he of average intelligence with some specific difficulties?  I have always felt his processing and not just language processing, sensory and visual are impacted also is his biggest stumbling block but that he is quite clever behind it all.
     
    Thanks for reading if you got this far. I have really enjoyed reading your article and your responses to other parents. It’s good of you to respond to so many
     
     

    • Based on the information you provided it does look as if his intelligence is in the average range. You did not give me the working memory Index so I can’t comment on that, but the processing speed Index is very low. The psychologist that did the assessment was correct to say that the full scale IQ would not be an accurate indicator of his intelligence. The significant difference between index scores would invalidate a full scale IQ score. The scores you provided show that his ability to reason with words and figure out visual spatial puzzles is in the average range. You mention the working memory was below average in the processing speed is very low, this would indicate that deeper thinking under timed conditions would be very challenging. Clearly this is a child who can take in information from the environment around him and is able to solve puzzles and think visually. This is the profile of a student who would qualify for extra time on assignments and tests. I would also ask for a reduced homework load.

      To know fully what is going on with the student more assessment than just the WISC is necessary. I would trust what the OT is saying and investigate auditory processing issues. This is a child who has demonstrated that he has the capability to learn, the trick is going to be finding the best teaching methods for him. Knowing that processing speed is a significant hindrance to his ability to express his knowledge means that alternative assessments should be provided. Being able to dictate answers, use a tape recorder or have a reduced test are all accommodations that would be beneficial.

  36. J'lyn says:

    Thank you for your website and your willingness to help so many families. My now 14 year old son took the WISC forth edition last fall, at the age of 13, due to concerns regarding a possible learning disability.
    VC: 116
    PR: 92
    WM: 99
    PS: 85
    FS: 100

    Besides the WISC, he was also given the Peabody and Expressive Vocab test for language, the Test of Memory and Learning, The Cognitive Assessment System, The Conners, on which he received an average score. He also took the developmental Test of Visual Motor Integration, with a score of 92, 30th percentile and the Rey Complex Figure was scored at 16th percentile and Immediate recall score was 63rd percentile.

    This is the wording from the final assessment. “Current assessment reflects his well above average verbal comprehension, average perceptual reasoning and working memeory. Learning and memory skills appear within the average range. Nueropsychological processes are noted by low average abilities overall with relative weakness in planning and simultaneous processing. Academic achievement reflects this profile. His overall academic achievement at this time is approximately a year below his grade placement with the greatest delay noted in reading. His phonemic awareness is markedly weak relative to his grade placement and intellect. This presentation is consistent for a youth experiencing a rote language weakness leading to problems with phonemic awareness and mild learning disability.”

    The psychologist who administered the test recommended phonemic instruction, to improve reading rate, and recommended we consider a tutor to help him keep pace as well as help with developing basic academic abilities. We were also told it was “not likely” he would qualify for any special services at school, but after reading several articles from your website, I am wondering if he might benefit from 504.

    I would really appreciate your thoughts and advise on where we should go from here.

    • Based on the test results that you have given me and the comments made by the psychologist who administered the assessment, I would focus on three areas.
      1. Phonemic awareness
      2. Processing speed
      3. Executive functioning skills

      To address phonemic awareness there are a number of excellent programs you can use. The Lindamood-Bell program, Wilson program and Lexia program will all build his phonemic awareness and help his reading.

      Processing speed is more difficult to address. I have listed many suggestions in my articles on processing speed. The issue of the 504 will be dependent on the criteria of your school district and all of the scores in his testing that have to do with fine motor skills and speed of cognitive processing. You can take the assessment you had done to your school and have a consultation with them regarding accommodations that they can offer.

      The issues with executive functioning are important to success in school. Weaknesses in planning and spontaneous processing impact a student’s ability to take notes, manage time, and plan for tests and long-term assignments. Simultaneous processing is an aspect of working memory. The ability to hold and work with multiple bits of information at one time becomes more important as school content becomes more complex. Building executive functioning skills will allow all your son to take in and process information better.

      I hope this helps.

  37. Mary says:

    Thank you for your response. It was most helpful..can I ask you one other question if you don’t mind. The Ep felt that his working memory score was being impacted by his low ps score and that made sense to me as I would think that If you are slow to process information in the first place then its going to be difficult to keep that info in a short term ace and retrieve it efficiently. Hover a fiends Ds also with AS who also has a slow ps (8th centile) had an average wm but a weak vci. I.’m trying to understand the 2 profiles and the reason for e difference. In a way I can understand why someone with a poor ps woul also have a weak vci as I woul think verbal comprehension would be difficult wih impaired proc speed or maybe it’s that the actual comprehension of language is ok in my Ds just the speed that he processes it? Sorry for rambling on

  38. Katy says:

    Thanks for this article. My son is in third grade and is not on an IEP and does not have a diagnosis. He is a smart boy but a slow processor. He struggles in school in the sense that he is the slowest child. He has been concerned about this for over a year now and so was he teacher last year. They did some testing and came up with nothing. This year I have contacted the teacher and the OT at his school and they will not do anything as they don’t feel it is necessary. His writing is slow as is his reading. He frequently tells me how hard it is and that all of the kids tell him he is to slow. He said that when the teacher asks him questions she doesn’t give him enough time to process it and then asks another child. He said this always happens and only to him. He also said that the teacher has a timer on his desk to help him to speed up and be more aware of the time he is working. He doesn’t like that he is the only child with this. I don’t know what I should do to help him more. I do not like his teacher as she makes him feel like he stands out more then the other children. He said that he does group work and that the other children will leave him and say that he is to slow. They aren’t allowed to but they do. When I talk to his teacher she tells him what I say and makes him feel worse. I really don’t know how to best handle this situation. What kind of testing should I do to get him the help he needs? Should I go to an eye doctor first? Is there a special eye doctor you go to? He was tested frequently when he was young since he would pass and fail eye tests often. He has food intolerances and I think that they make his wyes upset when he does get a food that he is intolerant to.
    He is a shy child and is starting to suffer socially. He was always very active and happy but now he is becoming less active and moody. I need to help him just don’t know where to start.

    • I’m sorry to hear that your son is struggling in school. I would recommend that you have his eyes evaluated with a Developmental Ophthalmologist. What you are looking for is how well his eyes are working together, not just how well he sees. However, from your description of your child, it sounds like there is more than a vision issue going on. I would recommend that you get a full neuropsychological evaluation. This evaluation would include:
      • WISC IV intellectual assessment
      • Woodcock-Johnson academic tests: selected tests that will give academic achievement as well as academic fluency so that they can be compared.
      • Woodcock-Johnson cognitive tests: selected tests that have to do with processing speed.
      • A language assessment including both receptive and expressive language skills
      • The Beery Visual Motor Integration Test (VMI)
      • I’m sure whoever does the assessment will have other tests may want to include based on your specific needs.

      It seems like you might want to be documenting how much time you child is spending on homework. I would look at his handwriting and see if it’s age-appropriate and how long it takes him to form his letters. Each school and state has their own guidelines for how children get referred for special services. It is worthwhile investigating what the criteria for your school system is.

  39. Andrea says:

    Wow, this is the best article I have found to help me understand what is going on with my 10 year old daughter. She has been struggling with reading and math, and over the last year although she is at ‘grade level’ (5th), the school process has been getting more painful, and homework is pushing us all over the edge. I just had her tested and her scores are:
    VCI: 119
    PRI: 92
    WMI: 91
    PSI: 85
    Her Matrix Reasoning is 15, but picture concepts was a low 5. The psychologist said she would not qualify for any special help at school, but her teachers I think would offer some accommodations. She is being offered ‘reading help’ though I’m not sure what this means exactly. We are wanting to get an out of school tutor, and I have no idea what kind of person I should be looking for or what I should ask them to do to help her. I would really appreciate your feedback. Thank you so much.

    • Getting help outside of school will be helpful to your daughter. Working with a program like Retrain The Brain and other fine motor skills and visual processing programs will help her get her ideas out much easier. The discrepancy between her superior Matrix Reasoning and her low Picture Concepts is something you might want to delve into further.

      Here is a summary of the two subsets from the website Thinktonight.com http://www.thinktonight.com/WISC_IV_subtests_s/331.htm
      Picture Concepts
      Picture Concepts measures categorical, abstract reasoning. Students are asked to look at two (or three) rows of pictured objects and indicate (by pointing) the single picture from each row that shares a characteristic in common with the single picture(s) from the other row(s).

      Picture Concepts is an untimed core Perceptual Reasoning Subtest.

      Example:
      Pick one picture from each
      row that go together

      Suggestions:
      Building Thinking Skills
      Analogies
      MiniLUK

      Matrix Reasoning

      Matrix Reasoning measures visual processing and abstract, spatial perception and may be influenced by concentration, attention, and persistence.

      Matrix Reasoning is an untimed core Perceptual Reasoning subtest.

      Children are shown colored matrices or visual patterns with something missing. The child is asked to select the missing piece from a range of options.

      Suggestions:
      Building Thinking Skills
      Math Analogies
      Visual Discrimination
      Look! Listen! Hear!
      Number Patterns
      MiniLUK

      Matrix Reasoning subtest measures visual spatial problem-solving and visual spatial relations and logic. The Picture Concepts subtest is actually a concept based assessment. The student is creating categories that are based on knowledge about the pictures presented. I would suggest that you investigate more into your daughter’s language abilities and her ability to categorize words and ideas. You mention that she is going to get reading help but I don’t have her scores for her decoding versus comprehension. If you have not done a language assessment I would suggest that that be done and that the outside help you receive be based on those findings along with the results you have.

  40. Rosalie Ohlsson says:

    Melissa, My 13 year old son has these scores on WISC-IV, VCI=99, PRI=86, WMI=97, PSI=83 and FSIQ=89. Can you tell me if I should have him tested for a learning disability, Non-verbal Learning Disability. The profile describes alot of behaviors he has but it is not to the T. He has ADHD, Dysthymia, Anxiety. The school gave him a psychoeducational evaluation and doesn’t think he has any learning disorder. His psychiatrist feels there might be a possibility of a Learning disability NOS. Please let me know what you think.

    Thanks for your help!

    • Here is a response I wrote to answer the question: What is a Non-Verbal Learning Disability?

      Diagnosing NLD is difficult. Here is a great article that can help you learn more about NLD. I have only included part of the article; I highly suggest you read the whole article to learn about the traits to look at for NLD. There is a difference between dysgraphia and NLD and it is important to know what the differences are. Many dysgraphic students have neuropsychologial deficits that lead to academic issues which are the same as a child with NLD, but they do not have the social/emotional issues.

      The Syndrome of Nonverbal Learning Disabilities:
Clinical Description and Applied Aspects by Michael A. Roman 
http://www.nldontheweb.org/nldadvancedreading/nldclinicaldescription.html
      Edited article
      Introduction
      The syndrome of nonverbal learning disabilities (NVLD) includes a number of specific, potentially debilitating symptoms. Rourke (1995a) has grouped these into three major areas:
1. neuropsychological deficits, include difficulties with
• tactile and visual perception,
• psychomotor coordination,
• tactile and visual attention,
• nonverbal memory,
• reasoning,
• executive functions, and
• specific aspects of speech and language
2. academic deficits,
• in math calculations,
• mathematical reasoning,
• reading comprehension,
• specific aspects of written language, and
• handwriting are primary academic concerns
3. social-emotional/adaptational deficits.
• problems with social perception and social interaction.
• Children with this disorder are also seen as having substantially increased risk for internalized forms of psychopathology, primarily anxiety and depression.
      While the NVLD syndrome has only recently been described in detail (Rourke, 1987, 1989), a number of important articles and two major books have been dedicated to descriptions of the disorder (Rourke, 1989, 1995a). Despite this fact, the syndrome is unfamiliar to many psychologists, diagnosticians, and educators. There is no formal provision under federal special education law recognizing the existence of nonverbal learning disability as a handicapping condition. In most cases, children with this disorder are best classified as Other Health Impaired. Because they may also have specific motor skills deficits, problems with math, social interactional difficulties, and/or emotional disturbances, some of these children may also be appropriately classified as orthopedically handicapped, learning disabled, or emotionally disturbed. This may be particularly appropriate for cases of neurologically acquired NVLD rather than the more common developmental cases of the disorder.

  41. Rachel says:

    You’ve been so kind to be so responsive to the comments here. Perhaps you could give me some input on how I can best help my 11 year old, fifth grade son. His most recent WISC came up with the following scores:

    VCI: 138
    PRI: 134
    WMI: 128
    PSI: 78

    He gets the dx of ADHD even though he really doesn’t meet the dsm criteria (he only has functional issues in school, there were no signs prior to age 7, he has no behavioral issues). But because he has a history of tics, the doctor was reluctant to try stimulants. So he was put on Inuniv which seems to help him a little bit (and made the tics stop). Since the Inuniv had stopped the tics, the doctor decided, after seeing the new WISC, that perhaps adding a stimulant would help. So he tried ritalin. My son reported that it didn’t help at all. It just made him jittery. So we stopped the ritalin.

    To complicate everything, we’ve recently moved, and he switched from a very intense private school (where he struggled under the work-load and was a pretty solid B student), to a large public school. I thought he would be happy to down-shift and have a much lighter work-load, but instead he’s really, really bored. So we’re looking at private schools again.

    In your opinion, what’s the best way to educate a kid like this? What kind of school environment works best? What should I be looking for? How do I help him stay excited about learning and challenged by school without burning him out?

    And do you have any thoughts about the medication issue?

    Lastly, do you happen to know of any specialists in the Boston area who could be helpful with these issues?

    Thank you so much!

    • You clearly have a gifted child, who has a processing speed deficit. His brain is working much faster then his hand can output his ideas. I highly recommend that he become a touch typist and he learned to use a speech to text software like Dragon. As far as what type of school would be good for him he needs a school that will challenge him intellectually and accommodate his output issues. In Los Angeles there is Bridges Academy which is designed for twice exceptional students. This means that they are exceptionally bright but also struggle with the learning difficulty. In your son’s case his learning difficulty is his processing speed. I have attached some information about Bridges Academy and it might be worth a phone call to them to see if they know any schools in your area that might match your son needs.

      Bridges Academy
      Bridges Academy has a unique and critical mission: to educate twice-exceptional (2e) students. 2e students demonstrate incredible gifted potential in one or more academic or creative areas (one exception), but also have learning differences and/or disabilities that complicate their overall academic success (another exception). You probably know or are a parent of a twice-exceptional student, even if the term itself is unfamiliar: 2e students are often identified as outside-the-box, “quirky” thinkers who can have encyclopedic knowledge in their fields of interest, but when it comes to participating in a conventional classroom setting, they become bored by the material and frustrated by the expectations placed on their output. This can lead them to withdraw or act out, further disenfranchising them from their own education.
      At Bridges Academy, it is commonly said that “If students don’t learn the way you teach, teach the way they learn.” Teaching 2e students the way they learn is an exciting, challenging, and incredibly rewarding imperative, one that involves differentiating material, keeping class sizes at a ratio of 1:8, and focusing on each student’s individual talent development.
      Bridges Academy is comprised of two main divisions: The Phoenix Program, and the 7th-12th grade post-secondary preparatory program. The Phoenix Program is specifically designed for 2e students ages 9-11, with a possible extension through age 12. The post-secondary prep program for students in grades 7-12 continues and deepens the development of the social, academic, intellectual, and creative potential necessary for post-secondary work in universities, internships, tech- or arts-oriented colleges, or early entry into a career in the student’s talent area.

  42. Heather says:

    My almost 7 year old son’s testing showed
    VCI 98
    PRI 106
    WMI 126
    PSI 106
    FS IQ 109

    It seems he has trouble verbally expressing his thoughts but has no trouble writing them down. He will be 7 next week and can write multiple page stories with very good handwriting and spelling. He is doing well in 1st grade and we were surprised when his scores were all over the board. We had him testing because we are trying to switch him to a new private school to be with his brother. Any insight or recommendations?

    • The scores you have shared are in the average range, with the exception of a superior working memory. Having a strong working memory is excellent. Your son is still very young so I would not be worried about his scores. The main thing to focus is developing his ability to express him self verbally if that is an area of concern. Is he shy? He may like to think about what he says before speaking. That strong working memory score indicates that he is able to hold and work with a lot of information at once, it may make it hard for him to organize all his ideas quickly. Writing gives him a chance to slow down and put his ideas in order. The strong working memory ability, along with a good work ethic makes for a great student.

  43. Natan says:

    Dear Melissa,
    My son is 9 years old, in third grade. He has always had difficulty when ‘to many words’ are used to give instructions or explain something. He picked up reading very easily and does very well in math and grammer. He is extremely motivated but in the classes that are heavily verbal, it is heartbreaking to see how it just doesn’t come together in his mind. As hard as he tries, there almost seems like a fog preventing him from grasping the meening of the collection of words.

    When he was younger, he always answered direct questions about verbal material he had learned with ‘I don’t know’ and the only way he shared things was indirectly. Now, he often gives the first answer that comes to mind, even though he really knows the correct answer.

    His teacher just mentioned possible ADD/ADHD issues and I am exposed to these concepts for the first time. We have not done any formal testing yet. Your excellent article came up in the very first search I am doing to get an idea of the possibilities. Since every site and article contains many new concepts for me, I would really appreciate if you could help me focus on the most important for my sons situation at this stage.

    • I do suggest that you have your son evaluated. ADHD is one possibility, but an auditory processing weakness could also be an issue for him. When you talk about the overload of verbal information, it made me question his ability to take in and process sounds. I would suggest that you have a Speech and Language evaluation and make sure that your son is able to process verbal information at the rate it is presented. If his auditory processing and receptive language skills are fine, then I would investigate other processing issues.

  44. Kim L says:

    Hello
    My 8 year old son is in his first year in a full time gifted program. My son’s teacher brought it to my attention that he is struggling to keep up with the other students. She feels it has something to do with his processing of info. She also gave an Example where he seems to learn and understand something new one day but cannot recall it the next day. Also his handwriting is not as expected. She thought by this point in the year his handwriting would be improved, but has not much. This is her first year as a gifted teacher so she has been discussing with other teachers to piece together an explanation, but yet unsuccessful. She said it could be he has some sort of problem (not her words!) or maybe he just hasn’t matured enough in certain areas. Her advice is to wait and see what happens. I feel compelled to do something now instead of just waiting to see what happens!

    In my opinion he has trouble staying focused and completing tasks in a timely manner.

    Can you offer any suggestions based on his scores?
    His composite WISC-IV scores, administered when he was 7 yrs 2 months:
    VCI 134
    PRI 147
    WMI 116
    PSI 103. (Coding scaled score 8 which shows 25th % !!! and symbol search scaled score 13 which shows 84th %)
    If you can help me, I would be so appreciative!
    Kim L

    • Your son appears to have a fine motor processing deficit. His processing speed is significantly below his other WISC scores. His visual perception (Symbol Search) is strong. You mention that his attention is weak, is this mostly on pencil and paper tasks? I would visit an Occupational Therapist and see if you can help build his fine motor skills. It is true that the PSI is average, but that is not his potential and much of the work at school is written, so he will be at a disadvantage if writing is hard for him. I would follow the recommendation in my article.

  45. sally says:

    My son(13) recently scored the following on the WISC-IV.
    VCI-112
    PRI-102
    WMI-94
    PSI-85
    FSIQ-101
    In the past, I always considered him as lazy but the tester sees more than that. He also believes my son may have an anxiety disorder. In the past, he has always excelled in math(especially quick at doing things in his head) but has struggled recently when it has come to fractions/percents. He has always required extra time involving anything written. He tested at below average level in reading and spelling on the Kaufman Assessment. He has frequent bouts with diarrhea which seems to be brought on by anxiety. His pediatrician has checked him out for any physical ailments. He is scheduled to take the TOVA and TOMAL test in a few weeks. I have been given a recommendation for BrainBuilder. He is homeschooled and I was hoping you could give me some insight(particularly curriculum). Thank you.

  46. Lisa says:

    Hello. You should really get some sort of medal for responding to each individual post. Thank you so very much!

    My daughter had IQ testing done over the summer when she was approx. 8.5. Her scores are as follows:

    VCI 124 (but w/subtests of similarities 16, vocab 17, comprehension 9)
    PRI 112 (block design 15, picture concept 14, matrix reasoning 7)
    WMI 126 (digit span 16, letter sequencing 13)
    PSI 80 (coding 4, symbol search 9)

    She has historically had fine motor issues, but a recent OT re-evaluation shows fine motor as a strength and identifies manual dexterity as an issue. She has elevated attention issues, but not to a diagnosable level. She has sensory processing issues, but nothing diagnosable on CAPD testing. She has social issues and is in a social skills group, but scores a perfect score on a Theory of Mind test, albeit extremely slowly. She also exhibits perfectionism, frustration with herself, anxiety.

    We are currently trying to determine what education model would work best for her and what accommodations and therapies we should consider given her particular strengths and weaknesses.

    Again, thank you so much for any light you are able to shed on our situation.

    • Your daughter’s scores do indicate variability that could be due to attention and focus issues. While her attention issues may not qualify her for a diagnosis, some of the behavioral interventions may help her, specifically interventions that have to do with structure and organization. The difference between her strong Block Design and Similarities and average Comprehension may be due to the open-ended nature of the Comprehension test.

      I also wonder if visual attention is an issue for her. Her low Matrix reasoning and Coding scores could be due to a challenge focusing on the details in the designs.

      From what you have given me I would suggest investigating programs that build visual attention and executive functioning skills. The PACE program could be good for her visual attention. Workbooks that build reasoning skills and pattern identification (critical thinking) could also be beneficial.

  47. Jackie says:

    My son was tested for a learning disabilityin the fall of 2011. He was 13 at the time. His scores are are as follows:
    Peabody: 119
    Expressive Vocab: 110
    Welcher Intelligence Scale IV:Verbal Comprehension: 116,Perceptual Reasoning: 92, Working Memory: 99, Processing Speed: 85
    Test of Memory and Learning: Verbal memory: 92, Non-verbal memory: 109, Composite memory: 101, Delayed recall: 98
    Cognative Assesment System: Planning: 88, Simultaneous: 91, Attention: 94, Successive: 100, full Scale: 91
    Attention and motorskills were both in the average range.
    Develpomantal Test of Visual Motor Integration: 92, 30th percentile
    Rey Complex Figure: 16th percentile and immediate recall 63 percentile.
    I alos have Woodcock scores if they would help.

    He is now 14 and I would love your opinion on how I can help him as he enters his last year of Jr. High and gets ready for High School. I am also wondering if testing accomidations might benefit him. I’m very worried regarding testing such as ACT and SAT. I don’t want to limit his chances. My husband is also concerned if we do get testing accomidations it could “label” him for life.

    • It looks like your son’s scores are mostly in the average range, with a strength in verbal skills. The issue is does he take a long time to write things down? Doe she have low fluency scores on the reading fluency, writing fluency and math fluency subtests of the Woodcock-Johnson? If so, then extended time on tests would be helpful for him.

  48. Susan says:

    Hi!
    My daughter is a straight A third grader who receives pull-out support in a gifted program once a week. However, she struggles with remembering her assignments and also with completing classroom work on time. She has recently been diagnosed with ADHD inattentive.

    Her WISC scores were:
    VCI 130
    PRI 108
    WMI 94
    PSI 112
    FS IQ 116

    The Beery Visual Motor Integration Test was also performed. On this test, she scored in the 5th percentile. When visual and motor were broken down, she scored in the 55th percentile for visual, and 1st percentile for motor.

    I would like to pursue a section 504 with the school. I believe that she has mainly been successful in school this year because her teacher has provided informal accommodations such as extra time to complete work. However, I would like to formalize this accommodation to avoid any issues next year should she get a teacher who is not so understanding.

    I have read that sometimes when grades do not indicate a problem, it can be difficult to receive a 504 plan. Do you think the above scores warrant one? I read above that more than a 20 point split between VCI and PSI warranted one, but I am curious if the same applies to a greater than 20 point split between VCI and WMI. Also, do you have any suggestions of other accommodations that might help based on the above scores? I have read about both retrain the brain and Cogmed and plan to look into both of these for supplemental use at home.

    Thanks so much!
    Susan

    • I’m glad that you are going to look up the Re-train the Brain and the Cogmed program; I think that both of them will be helpful for your daughter. The tricky thing about a 504 is that the school may want to see a functional disability. A functional disability would require a difference between her ability and her achievement in school. Your daughter’s full scale IQ is in the high average range, while her verbal abilities are in the superior range. Even though your daughter has a significant difference between her Verbal Comprehension Index and her Processing Speed Index, the school may require more than that for a 504. I would request an evaluation by an occupational therapist. The 1% you have on the motor component of the Beery Visual Motor Integration Test indicates that her motor skills may be significantly hindering her ability to write. Dysgraphia may be her greatest weakness. Building her fine motor skills and getting her extra time will hopefully allow her to perform better in school with less effort.

  49. SHEERIN says:

    hi Melissa
    my scores ON WAIS IV are as follows and me age is 27

    VCI 91 Percentile rank 27
    PRI 105 63
    WMI 89 23
    PSI 97 42
    FSIQ 95 37

  50. SHEERIN says:

    sorry i just saw that i didn’t ask the question my qustion is that how can i improve my overall scores because i am a unii student and i really struggling to memorise things even names and dates. i have problem with my spelling and reading too. i have too read each line atleast 3-4 times to grab the meaning. in my social life i have problem to remember names and dates, prices,
    addresses. i don’t know what is going on with me. i started uni after a long break from study because of my children and family. please help me i am looking forward your oppinion.
    thanks
    sheerin

    • I would recommend the Cogmed Working Memory Program for you. Building your working memory will help your retention of information, which will allow you to learn more easily. Finding a tutor, or someone who can help you with your reading and writing skills will also be beneficial. Many universities have Student Services Centers where you can find support to help you with your learning challenges. I congratulate you on going back to school and I wish you much success.

  51. George says:

    My son is 8 yrs old and about to complete 2nd grade. He has struggled with his academics for some time now and I finally requested he be tested. We just had our ard meeting and his scores are as follows:
    FCI. 98
    Sequential/gsm was 83(below average)
    Simultaneous/gv was 126(above average)

    Auditory process 125
    Process speed 75
    Sound blending 124
    Visual matching 71
    Auditory retention 108
    Decision speed 83

    They found he had difficulty with sequential processing/gsm/short term memory. As well as difficulty with processing speed/gs.

    The principal is recommending we hold him back and feels he will struggle in third grade especially because they begin state testing next year. I am really concerned and want to help my son!!! I don’t feel he is ready for third and I certainly do not want my happy little boys self esteem to be bashed because of his academics. I am having him tutored this summer and I am working with him as well. I am considering home school or holding him back in second grade. He did qualify for special Ed services. Please help! I am so stressed over this and want to make the best decision for my love. I want to help him progress and learn.

    Thank you

    • Your son has strong auditory processing skills with weak visual processing skills. I would recommend having him evaluated to make sure that his eyes are tracking across a page efficiently. It is unclear from the scores you gave me whether his processing speed weakness is due to slow visual intake or weak fine motor skills, or both. I would recommend finding out and trying to build any areas of weakness.

      The question of whether to retain your child is difficult to answer. Studies have shown that holding a child back is only beneficial if the reason for retention is based on maturity. If your child is not performing well in school due to a learning disability, then it is remediation, not retention that needs to be focused on. So the factors that need to be taken into consideration is if he has a developmental delay, or a birthday that makes him young for his grade.

      The best help you can give your child is to do what you can do to increase his processing speed. You have read my article, so hopefully the suggestions I gave will be helpful to you.

  52. online Yahoo says:

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  53. JulesK says:

    I just got my scores back as an adult. Unfortunately they don’t all seem to be broken down. From the doc’s comments:

    “Processing speed index Score was 73, falling in the Borderline range. These scores for Symbol Search and Coding are also consistent with a learning disability profile. If we compare here FSIQ of 130 to the score of 73 for PSI, this is SEVERE visual motor processing speed impairment and exceeds what we would expect to see with an emotionally based problem here”. Thoughts anyone?

  54. George says:

    Thank you for your response. His processing speed weakness is due to slow visual intake. He is not performing well in school because of his LD. They set accommodations but we only have 3 wks left in school because it was a long process to get him tested. I requested testing in October and we just got testing and results this month. The principal stated that because he is only reading 25 word per minute she wants to retain him. According to her by the end of Second grade students should be reading 90 wpm. Are there any online programs or supplemental help that you would recommended? The STAARR Test (Texas state mandated test) is timed and consists of a lot of reading and writing. I am very concerned because he will be required to test next year in third grade. The timing is what scares me for my son because I know he needs a lot more time than given. I am considering homeschooling and doing extensive research so that I am able to understand and help my son with his learning disability.

  55. Meghan says:

    Hi, Melissa,

    I am 27 and was recently administered the wais-iv. I have a history of struggling with organization and planning as well as paying attention (in class or to detail!) and task completion.

    My scores were a little unusual. The psych did not explain much, just said I have ‘a very powerful mind’. I don’t know and he didn’t explain what the real life application or meaning of the score disparity is or could be. Are they possibly significant/do you have any thoughts? Could they be related to visual issues at all? My scores were:

    VCI: 138
    PRI: 100
    WMI: 117
    PSI: 114.

    My.subtests on PRI were block design 10, matrix reasoning 12, visual puzzles 8.

    • Melissa Mullin, Ph.D. says:

      You do have a powerful mind. Your scores are strong and do not seem to suggest a visual issue. You have excellent verbal skills along with strong working memory and visual-motor processing speed. The greatest discrepancy is your average Perceptual Organization Index. This could explain some of your difficulty with task completion. The Perceptual Organization Index contains tasks that measure spatial problem solving and whole part relations. Often people who are weak in this area can have a difficult time with time management, organizing and sequencing material and understanding all the steps to complete a task. These skills all fall under the category of executive functioning skills.

      On my website (http://www.kandmcenter.com) we have an executive functioning quiz. You can take it and find out your areas of strength and weakness. Once you identify the areas you can strengthen there are many sites that have advise on executive functioning. I have also created an Executive Functioning Workbook, which may be helpful to you.

  56. Nicki says:

    Hi Melissa,

    I’m seriously impressed by your generous responses to people. Your site is exceptional and I plan to check out many of the suggestions you have provided.

    My 12 year old son was tested when he was 8.09 years due to a teacher wondering why he was insensitive to his peers and having lower awareness of others

    VCi79% sim 91 vocab 91 comp 37
    Pri 92% block design 99 picture 75matrix63
    Wm 68% digit 91 letter number sequ 37
    Ps 34% coding 50 symbol search 25

    Word reading 95 pseudo 99
    Num op 68
    Spelling 92
    Listening comp 99

    He seemed to cope really well at school apart from managing his temper so we did some social skills training.

    We had vision therapy testing and the result was no obvious tracking problems aside from a pronounced head tilt to the right when he started the tracking while sitting which disappeared when he did the tests standing.

    Now he i in middle school he is in a top class and feelingbthe pressure. he appears to be struggling with writing and maths though science is very good.

    Three questions. Does he need re-testing? Should he be given an IEP based on processing speed issue? What other therapies do you think he woul benefit from?

    Many thanks. Nicki

    • Melissa Mullin, Ph.D. says:

      I would recommend retesting. It is important to see the areas in which he has grown and the areas that remain weak. I am interested in the vision assessment and the head tilt. Especially as most schools make children sit while they read and write, so he needs to be able to function at his best sitting. I would revisit the vision issue as step one.

      Looking at your son’s scores, he is very strong verbally for memorized information but not as strong with open-ended questions about the social situations. I hope that the social skills program you did addressed this area. I often find a correlation between social awareness, reading comprehension and flexible thinking. Is your son a concrete thinker or a flexible thinker? I see he is strong with visual problem solving (PRI), which would suggest on visual, non-verbal and non-social problems, he is able to think flexibly. Is he able to transfer that skill to social (i.e. verbal) situations and problems?

      The new testing will determine if he needs an IEP for extra time based on his processing speed. My questions for the updated exam include:
      • If a difference remains between the Coding and Symbol Search subtest is it due to visual tracking or visual attention?
      • If a difference remains between Verbal subtests, is it due to the open-ended nature of the Comprehension questions or a lack of social awareness?
      • If a difference remains between the Digit Span and the Letter Number Sequencing is it due to attention, set shifting or working memory skills?

      Based on the results of the scores you gave me, I would recommend social skills training, flexible thinking training, vision therapy, and building executive functioning skills. For writing I recommending learning to use Inspiration to help organize his ideas before he writes and for math use graph paper, review basic facts and make sure he understand concepts that are presented in difference formats. The high Perceptual Organization score indicates that math concepts should be easy for him to understand, but the lower visual-motor skills may be making writing the problems down and working them out error free a challenge. Make sure he understands that so he can slow down and check for errors.

  57. Katie Greenebaum says:

    I am so happy to have found this site and apologize if this has been addressed before. I have the quintessential frustrated child (98th percentile verbal IQ, low average visual spatial, 7th percentile processing speed, huge ADHD and fine motor problems). Only he’s not a child anymore– he’s 17 and has just returned to the fancy private school where I teach and where he left, ignominious and frustrated, after 8th grade. After spending the first two years of high school self medicating and just trying to get by at our public school(by the way, we didn’t fail to assess and intervene when he was young–ran the gamut from OT, to sensory integration therapy, to visual therapy, to every ADD drug on the market, sadly), he has a had a burst of motivation that is incredibly heartening to see. We placed him in classes carefully– he’s repeating Spanish 2 and algebra 2– and he’s trying really hard (for him).
    The reason for this post is to ask guidance about foreign language learning and kids with this profile. After his first Spanish test yesterday, he was incredibly disheartened. He stayed after school and took 45 minutes longer than anyone else and made comments that I recognized from when he dropped French in 8th grade– “I don’t understand how we are expected to understand her when she speaks Spanish! I don’t speak Spanish! She goes so fast. I can’t write while she speaks” etc. he’s always struck us as someone who would soak up a language if he lived abroad– he has a great ear, does wonderful accents, is very social– but learning or understanding things systematically or abstractly is killer for him (he’s fine at mental math, for example, but still has now idea how to do the written process of long division). Our school is very accommodating and all of his teachers (my friends– at least for now!) want him to succeed. We could probably arrange to have foreign language waived, but I wanted to ask you if that is typical for these sorts of kids. With him, it’s always hard to tell if he just has no concept of how to study and hasn’t put the time in to learn the grammar and vocab. Attention issues and resultant anxiety and insecurity also play a huge role. By the way, his one year older sister just left for Yale yesterday. She has cast a long, intimidating shadow.
    Any advice about foreign language and these kids would be so appreciated. I don’t want him to give up if he can do it. Self esteem could be delivered a further blow either way, I fear.
    Thanks so much. Katie

    • Melissa Mullin, Ph.D. says:

      The frustration profile is mostly an output issue. Meaning that these children have more cognitive ideas flowing in their minds then they can express. The issue of learning a second language is an input issue first and then an output issue; learning a new vocabulary and a new way of speaking. The children that have difficulty with learning a second language often time have auditory processing weaknesses or rapid naming weaknesses. In your son’s case it sounds like the ADHD may be hindering his ability to attend to the fine auditory differences needed to learn a new language. Learning a new language also requires good executive functioning skills.

      Your question is difficult to answer because as you say you feel his self-esteem is going to be affected if he drops language or continues to take the class and struggle. So your decision needs to be made from a larger viewpoint. How much effort is the language class requiring? Will dropping the class allow him to do better in his other classes? I would discuss with him his stress level and have him rate his classes from 1 to 5 in order to determine how he perceives the workload in each class. The best solution is the one where he can feel powerful and successful.

  58. Sharon says:

    Your article has been incredibly helpful in gaining insight into what my son is struggling with. His scores are as follows:
    VCI: 121
    PRI: 104
    WMI: 113
    PSI: 70

    His coding subscore was 3, and symbol search 6. He was tested at age 7. Originally, it was suggested that he had ADHD, but I am no longer sure this is what is actually going on. I think he is incredibly frustrated and anxious, which causes him to have trouble paying attention. In his 4th grade curriculum, it it standard practice to teach several methods for solving any type of math problem. Many of these methods involve multiple steps and are cumbersome. He is literally “unlearning” math and becoming totally confused about concepts he previously understood.
    Do you have any suggestions for working with the school and teacher on this type of instruction? I understand that this is the “common core” way of teaching, and is supposed to be better for most kids. Also, are there any further tests we should do to find out if this is a visual processing, fine motor processing, or another issue? Thank you so much in advance!
    Sharon

    • Melissa Mullin, Ph.D. says:

      Looking at your son’s scores it is my guess that there are motor skills issues as well as visual processing issues. I would suggest that you do further evaluation with a developmental ophthalmologist and investigate both vision therapy and occupational therapy to help him. Additionally, building his visual spatial skills and his executive functioning skills will help even out his profile. While his Perceptual Reasoning Index is in the average range it is significantly below his Verbal Comprehension Index. The Perceptual Reasoning Index often has to do with being able to break things into their parts; this would affect his math skills, as he has to break down the problem into the steps needed to create the solution.

      As far as working with the school or the teacher, I would recommend a conversation with them to make sure they understand the impact his slow processing speed is having on his ability to complete any written work within school. I would also see what accommodations could be provided to help reduce his workload given his significantly slow processing speed.

      • Sharon says:

        Thank you so much for your help! The information you provide is really wonderful. At your recommendation, my son was seen by a developmental ophthalmologist and we learned that he has severe convergence insufficiency. In fact, he probably sees double at close range a majority of the time (but didn’t realize this wasn’t normal). He gets frustrated and / or anxious very easily with school work, dislikes writing and has a short attention span with close work, which could all be associated with convergence insufficiency. This may have also contributed to his relatively low PRI and very low PSI scores. We will be starting vision therapy ASAP, but I wanted to mention it here because I was told that convergence insufficiency is often misdiagnosed as ADHD or other learning problems, and is often missed at standard eye exams. I don’t expect vision therapy to be a cure all, but if it allows him to focus without seeing double, it will have to help! Thanks again!

      • Melissa Mullin, Ph.D. says:

        Thank you so much for sharing your experience. You are correct, a standard eye exam only measures what children can see, to assess for convergence issues you need to go to a specialist. Vision therapy can make a huge difference in a short time span for the children that need it. Good luck!

  59. Heather says:

    We had our daughter tested b/c we were having unexpected anxiety issues. Those are well under control after just a few changes but we are still seeing some oddities in school performance and learning some things/homework frustration/ etc. So we suspect an underlying issue as well. She has had extensive ear infections over life and has severe eye problem (unequal vision). We notice many odd things with reading like preferring my reading glasses, lying her head on her desk when practicing handwriting, etc. The biggest thing we noticed is that she is very far behind her glass in math drills that test speed and accuracy, but on her general school testing is she designated “above grade level in math. We also believe her WISC IV testing did not accurately reflect her over all IQ. Anyway, was wondering if you could look at these facts, opinions, and the WISC scores and note if you see anything that you would suggest we check out to make sure she is not being overlooked. Her tester said she had no indication of ADHD/ADD.

    Verbal 114 (ranges inf 14 – similarities 12)
    Perceptual reasoning 106 (Matrix reasoning 14 – picture concepts 9)
    Working memory 113 (Digit span 13 – other two 12)
    Processing Speed 97 (symbol search 12 – coding 97)

    Thank you for your generousity above. If you think a note above matches, just point me there.

    • Melissa Mullin, Ph.D. says:

      Your daughter’s WISC scores do not indicate any areas of difficulty. However, the odd things that you are observing regarding her vision and her history of having severe eye problems indicate that she continues to struggle with her visual processing. I would recommend an extensive visual evaluation to make sure that both eyes are working together and to make sure she does not need reading glasses. If she is struggling to visually intake information it will slow her down on time tasks.

      • Heather says:

        Thank you kindly. I did mis-type the coding results as 97, it was 7 (borderline). Not sure if that makes a huge difference. We have an upcoming eye appointment and will check your suggestions. Thanks again.

  60. Natalie Stephens says:

    Hi Melissa,
    I too am impressed with your generous responses to those who write to you. I am especially grateful to read your replies as I am in Australia and a little far away to pop over for a private consultation!
    My 12 year old daughter has recently been assessed using the WISC-IV. She had been referred to the psychologist for assessment by the paediatrician due to inattention, and social and emotional difficulties noticed at school. Her results were as follows;
    VCI – 136
    PRI – 104
    WMI – 104
    PSI – 88
    As you can see there is a very large difference between her verbal comprehension and her processing speed (48).
    She has always been an avid and very good reader and as shown by her scores, it able to understand in depth concepts within texts she reads. Similarly, she has always struggled with puzzles, or any kind of visual maze and has previously had OT for handwriting issues.
    Over the past 18 to 24 months she has had some behavioural issues lashing out at children she perceives as being mean to her.
    Do you believe these behavioural or anxiety related issues could stem from being a ‘frustrated learner’, and what programs would you recommend we pursue to assist her at school? Are there any further tests or assessments you would recommend for her?
    Further, thank you so much for making me feel like someone understands my daughter and for making me feel there are useful things I am able to do to help her once again be a happy student and reach her full potential. I will remain forever grateful to my search engine for bringing up your website when I simply searched her scores for the WISC-IV.
    Nat in Australia xx

    • Melissa Mullin, Ph.D. says:

      I do believe that behavioral or anxiety issues can stem from being a frustrated learner. Imagine having all this information in your head and you can’t share with the world in a timely manner. In your daughter’s case her verbal skills are significantly higher than all her other skills. In addition to building her processing speed I would also focus on helping her organize her verbal skills. You can find more suggestions in my article on Finding The Right Help To Build Processing Speed.

  61. Diane says:

    Hi – we had our 7 year old son tested because he zones out in school and refuses to do any work despite the fact that he is very bright. He has fine motor issues and sight issues (the latter of which were not discovered until after his cognitive testing).

    I don’t have any of the index values yet but essentially, he scores in the 96th percentile for verbal reasoning and 89th for non-verbal reasoning. Yet he has “low average” working memory and low processing scores. To me this is a total contradiction: in order to have high verbal reasoning (making connections to solve problems) I would think that you would need to be able to keep the information in your head long enough to make the necessary connections and use them to “reason”. So how could he have low working memory and high verbal and non-verbal reasoning?

    Also, I used to play card matching games with him (haven’t for a while) and he always did very well, beating me sometimes even when he was 3 (and I have very good working memory). Would that not be impossible if he had low working memory? Can it change (get worse) over time? Also, he is very good at playing adventure games where you have to remember where you have been (so you don’t go there again) and what you have done in order to move on. Wouldn’t that be impossible too if he had low working memory? His math is good, not great, but good. Wouldn’t that be a contradiction to low working memory too?

    I am feeling desperate here and feel like my son has just been handed a death sentence with all the articles out there about “working memory” being the “new IQ”. Does he have any hope at all of a future if he does indeed have low working memory issues?

    The psychologist ruled out ADD/ADHD at this point anyway.

    Thank you in advance for your reply.

    • Melissa Mullin, Ph.D. says:

      Your question about working memory is a good one. One very important fact about the WISC IV Working Memory Index is that all of the items are measuring verbal working memory. The items are presented verbally and the child has to work with the verbal information and give back a verbal response. There are no pictures or use of pencil and paper. The tasks you use as examples of your child’s working memory all had visual cues. It sounds like he has excellent visual working memory skills.

      Your son’s scores indicate that he is good thinker both verbally and visually. He may have difficulty quickly taking in and working with verbal information that lacks meaning (random orders of numbers and letters), but do better with verbal information in context (a story). It might be a good idea to investigate his auditory processing skills and see if there is something going on there. Bright children with auditory processing issues can look like a child with AD/HD as they disengage when information is presented too quickly without visual cues. They get overwhelmed and find other things to think about.

      The lower processing speed score is most likely due to the weak fine motor skills and visual issues. I would recommend an evaluation with a developmental eye doctor.

      Your son most definitely has a chance for an excellent future. He is very bright and you are researching the best ways to help him.

  62. Stacy says:

    Not Frustrated but Huge gap- Concern?
    Hi- Thank you for the great article. It caught my attention because my son (10yrs) has a very large difference between verbal scores and processing speed: VCI-138, Processing Speed -78. Apparently less than 1% of the population demonstrate that level of variability…
    (WM- 91, Perpt. Reasoning- 100)

    My specific question is that although this variance exists between composite scores, he achieves good grades: A’s and B’s and he scores goal to advanced in standardized state tests. He’s socially adjusted and happy. We don’t have struggles with homework and he’s an enthusiastic learner. He is however VERY unorganized and at times scattered. We are working on executive functioning skills with him, using checklists etc. I keep reading about 504 plans and extra time/accommodations– I don’t feel like we need to do this based on his school performance and attitude. My biggest concern is getting him prepared for multitasking in middle school (2 years away). Do you have thoughts or suggestions on what we should be focusing on with him? Thank you!

    • Melissa Mullin, Ph.D. says:

      I am glad your son is doing so well. The most important reason to have a 504 will be to enable you to access help if he needs it in the future. I have a number of students who have just entered middle school and are dealing with the huge transition that middle school entails. You are wise to be concerned and proactive in teaching your son executive functioning skills now. You can check out my Executive Functioning Workbook that teaches the skills students’ need for middle school. This includes:
      Self-assessment in each school subject
      Scheduling time for homework, study, and other activities
      Setting academic and personal goals
      Breaking down long-term projects into daily tasks
      Equipping a study space at home
      Active reading and study skills
      Organizing a backpack
      Taking useful notes on lectures and texts
      Using a planner to track daily, weekly, and long-term assignments
      Test preparation and test-taking strategies
      Accurately estimating how long homework will take
      Tracking progress and setting new goals

      Helping your son learn to master all of these activities as independently as possible prior to starting middle school will enable him to function better once he has to navigate on his own.

  63. Katie says:

    My 7-year-old son has been diagnosed with DAMP – Deficits in Attention, Motor Control, and Perception (basically a combination of ADHD and Developmental Coordination Disorder). He has received speech, OT, and PT services for the past 2 years. He has shown significant improvement but was recently assessed to get a fuller picture of his strengths and weaknesses. His test results are as follows:

    WISC-IV:
    VCI: 114
    PRI: 133
    WMI: 113
    PSI: 88 (Symbol search – 11; Coding – 5)

    WIAT: (overall did well. Fluency was weaker overall, except for oral word fluency)
    Total Reading Composite – 124
    Basic Reading Composite -120
    Reading Comprehension and Fluency Composite- 122
    Reading Comprehension – 125
    Word Reading – 110
    Pseudoword Decoding – 126
    Oral Reading Fluency – 112
    Mathematics Composite -126
    Math Problem Solving- 117
    Numerical Operations -130
    Math Fluency- 99
    Addition – 94
    Subtraction – 101
    Written Expression- 118
    Sentence Composition – 135 (she said he did very well with this task, but was very slow and made many mistakes while copying the sentences to create the new combined sentences. He did notice and correct all of his mistakes before finishing)
    Alphabet Writing Fluency – 96
    Spelling – 112
    Oral Language Composite -110
    Listening Comprehension -102
    Receptive Vocabulary – 92
    Oral Comprehension – 112
    Oral Expression – 115
    Expressive Vocabulary – 106
    Oral Word Fluency – 127
    Sentence Repetition – 104

    Beery VMI:

    Berry VMI 104
    Visual Perception 109
    Motor Coordination 95

    My questions pertain to his low PSI score. It’s obviously much lower than his other scores, but also, there is a big difference between the subtests comprising that score. I don’t know if his processing speed is actually an issue or is it more related to fine motor and motor coordination issues. His fluency scores on the WIAT were lower as well, but even there was scatter too – the math and writing fluency (which both require writing) were lower than the oral reading fluency and much lower than the oral word fluency.

    Also, his OT through school has recently suggested we end services for him. She is not quite sure what more she can do for him. He is performing well on all tasks she asks of him (writing letters, words, and sentences; visual memory tasks; proper pencil grip; beginning cursive skills; and copying patterns to a grid) and only struggles with catching a tennis ball or weighted ball (same with his PT who works on this as well – he “shields” his face and looks away when thrown a ball). I feel that his issues are with fine motor skills so it doesn’t make sense to me to end OT services, but I also don’t know what she could be working on with him to help him with his areas of weakness. She was happy to hear that his speech therapist was doing interactive metronome with him, but did not have any ideas of what more she could do with him, if anything. Many accommodations were suggested as a result of his testing for ways to cope/manage the slower writing skills, but I didn’t know if there was a way to improve graphomotor speed or other things the OT could be doing to help my son. Thank you!

    • Melissa Mullin, Ph.D. says:

      From the information you have provided it does look like fine motor skills are the biggest area of difficulty. Have you investigated Re-train the Brain? I like this program to build the hand brain connection. Given his reaction to the catching the ball I would continue to work on that area. The Learning Breakthrough has great program you can do at home or with the OT.

  64. Beth kane says:

    hello my son is 14 and was just tested in school for giftedness and aspergers because of social problems. he is very intelligent and was bored in school. he has often had problems with teachers since first grade because he doesn’t complete his work. he has always done well on his tests and state tests but doesn’t not complete classwork or homework and feels he isn’t learning much in school. i had hoped as school got harder he would be more interested but he has become more stressed and frustrated.
    he did not have aspergers according to the testing done by the school. and also isn’t elligle for gifted class based upon tests. his scores on wisc-iv were

    verbal comp 128
    perceptual reasoning 108
    working memory 123
    processing speed 88

    he was offered an iep for being emotionally disturbed based mostly on his teachers assessments. i strongly disagree with this label given by teachers who have only known him a short time. he is a smart kind boy who has not gotten in serious trouble beyond misunderstandings with his teachers about doing his work. he is socially awkward at school and has been bullied at school. i know he has been dealing with frustration and stress at school for so many years and always feels misunderstood. by his teachers. i do agree he is having problems and would like help for him but i don’t agree with the label emotionally disturbed and am trying for an independent evaluation. any thoughts would be greatly appreciated. thank you

    • Melissa Mullin, Ph.D. says:

      I think having an independent evaluation is a good idea. Your son is bright and he is struggling due to his slow processing speed. His verbal and working memory skills are high which shows he is a good verbal thinker. His Perceptual Reasoning Index is significantly below the VC and WM, which may indicate some difficulty with breaking down tasks and problem solving. This profile can be indicative of a non-verbal learning disability. Here is a link to NVLD a site about nonverbal learning disabilities.

  65. Valerie says:

    Dear Melissa,
    Firstly, thank you for writing the his wonderful article. It so clearly articulates our frustration at the moment. We had our son tested on the WISC IV a week after he turned 6. He has always been verbally competent, great sense of humour and mature. The reason for the test was to understand why he was though of as an ‘average performer’ in school and feedback was not necessarily equal to our opinion of him. His test results are as follows:
    VCI (132):
    Similarities 16, vocabulary 14, comprehension 16
    PRI (143):
    Block design 18, matrix reasoning 18, picture concepts15
    WMI (135):
    Digit span 15, letter number sequencing 17
    Processing speed (103):
    Coding 9, symbol search 12

    WIAT
    Word reading 130
    Maths reasoning 112
    Spelling 116

    We struggle, rather he struggles, and does not Iike writing. He has problems completing tasks/assessments on time in school, and his classmates all say his handwriting is weird – he can form letters and numbers but it’s not as ‘nice as his peers. He has trouble adjusting uppercase and lowercase letters, eg. The height of his lowercase letters will almost fill the entire vertical height of a line. He also floats lowercase letters with a ‘tail’ as he does not like the touching the letter in the line below. He also multitasks (is aware of everything else going on around him) and pays the least attention to his own task! Finally, my most vivid memory was when he was 4 years old – he had been refusing to practice writing and he finally told me, “mummy, my handwriting does not look as nice as what is on print”!
    I also struggle with his WIAT scores as for example his higher order math is equal, or faster, than his basic math (verbal, mental questioning).

    We have been turned down by schools with ‘gifted programs’ because his handwriting is not good enough, can’t spell, and the are concerned with the time it takes him to respond to a question (when the screened him). We are so frustrated! It seems that testing has opened up a can of worms for us!
    Sincerely appreciate any help/suggestions you can render us. Thank you.

    • Melissa Mullin, Ph.D. says:

      Your son sounds like he has fine motor issues and is perhaps a visual thinker. He may match the article I just wrote on visual learners. For his writing I suggest Re-train the Brain and Handwriting Without Tears. They are excellent programs to help develop writing skills. Regarding his thinking style, I would work on building his flexible thinking skills as he so smart and he may be frustrated that he can think faster than he can produce anything in writing or even translate his ideas to words.

  66. Laurie Neary says:

    Dr. Mullin,

    My son is currently in the first grade. We noticed difficulties around 4 years old with fine motor and other concerns. He is receiving OT, and speech in school. Currently he is in an inclusion class however he still cannot read to grade level and has great difficulty putting thoughts into words. Since he is only six obtaining additional evaluations has been a struggle no one wants to do it for another year or two. His frustration is growing as is mine. He does have a very low processing speed as determined through testing when he was 4. Do you have any recommendations for a path forward? I feel he is already giving up and checking out.

    • Melissa Mullin, Ph.D. says:

      I just wrote an article on the Visual Learner. It sounds like your son may be a visual learner, along with some fine motor issues and language development delay. I would suggest you also investigate my Flexible Thinking Workbook as it might help become a better problem solver which will help with his frustration.

      • Laurie Neary says:

        Melissa,

        Can you clarify or explain what a language development delay is exactly? I ask because my son actually spoke early and his vocabulary is above his age however his does have word finding difficulties. He tested with a large material weakness in processing speed. I feel he may be dyslexic however I am told that it is not recognized until he is much older. How can that be? How do you help someone if they don’t recognize it.

        Thank you.

        Laurie

      • Melissa Mullin, Ph.D. says:

        A developmental language delay means the child is not developing language at the level expected for her age. There are many causes of word finding difficult. Here is a link where you can find more about word findin. Students Who May Have Word Finding Difficulties. From wordfinding.com

        This article discusses six different groups of students who may have word finding difficulties:
        Students who have specific learning disabilities (LD)
        Students who have reading difficulties
        Students who have specific language difficulties (SLI)
        Students who have fluency difficulties
        Students who have known brain pathology
        Students who have attention difficulties and/or are hyperactive (ADHD)

  67. Andrea says:

    My 6 year old Daughter is in 1st Gr. French Immersion in Canada. Her teacher has expressed concern over her ability to keep up in the program, complains of her lack of participation in class activities/discussions, poor attention/focus and says she is easily distracted and requires 1 on 1 attention to start and complete tasks. She has suggested working with an OT to help with handwriting, letter reversal etc. We received her WISC-IV results today and they are as follows:

    VCI – 55th Percentile / 102 Score (subscores of 50 %tile /50 %tile /63 %tile)
    PRI – 27th Percentile / 91 Score ( 9%tile / 16%tile / 84%tile)
    WMI – 27th Percentile / 91 Score (37%tile / 25%tile)
    PSI – 2nd Percentile / 70 score (2% tile/ 1%tile)

    We have taken her for a vision tests and are about to have a further assessment to see if Vision Therapy will be of help to her. I had originally approached the Psychologist because of an interest in the Cogmed program (for working memory) to help with the attention/focus issues but she has discouraged the idea of persuing this type of training as she says working memory is in the average range.

    I’m shocked at how low her scores are in general. At this point we are trying to decide if we should pull her from the FI immersion program and send her to an English only school or have her continue for the rest of the year with the help of a tutor as the school is offering no support. Can you let me know which you think would be best for her at this point. And what support and class room strategies can we have her teacher employ to help her in the classroom? Her Psychologist recognises there is an attention issue but is reluctant to suggest medication before trying other methods to help. She is waiting for the OT report and Optometrist report before she makes these suggestions. She also want to complete an academic assessment to rule out a learning disability.

    Thank you in advance. Your website is a wonderful resource!

    • Melissa Mullin, Ph.D. says:

      I am glad you looking more closely into how your daughter is processing information. It sounds like it is too early to make a decision on what to do regarding the school placement as you are still gathering information. The only score that is really low is the processing speed. OT and/or Vision Therapy can be good interventions. If attentional issues are significant they can be impacting the processing speed. Even though her working memory is in the average range, if she struggles with attention Cogmed will be helpful in strengthening her ability to focus. You will be better able to make a decision on what to do once you have all the reports back. It sounds like your daughter is in good hands!

  68. Anindita Sen says:

    Dear Melissa,
    My 7.5 year old son recently took the WISC 4. His scores are as follows:His total score is 134 (verbal-152,perceptual reasoning-129, working memory-138 BUT processing speed score is 78). We are concerned about his low PS score compared to the other scales-the ed. psychologist said we should just ask him to write faster. He functions pretty well for a 7 yr old boy, is in the G & T program at his school, gets good grades and conduct grades. He is not exceptional but decent in sports as well.

    I would love to hear your feedback and what we can do to help him.
    Thanks,
    Ann

    • Melissa Mullin, Ph.D. says:

      I would not ignore the slow processing speed. I would follow the suggestions in the article (Re-train the Brain and have a vision assessment). Also I recommend you read my most recent article on visual-spatial learners. I am finding that many gifted students are visual thinkers and that can affect their writing skills.

  69. Miranda says:

    Hi,

    I seemingly have a frustrated child. I would like to echo the sentiments on here that this page is a godsend as it is difficult to find a one stop page for children who have processing disorders but not outright dyslexia- I literally just found it. More education is needed for teachers to truly understand how processing disorders presents itself in classroom settings but also more awareness on the emotional/frustrated side of the processing disorder (for parents as well). I am trying to teach Gus (soon to be 9) not to get so frustrated over certain tasks (for instance tying shoe laces, small arguments with his brother etc). It is probably my fault as I ask to tell me what he is finding difficult and he can’t communicate why he can’t do it – as he doesn’t understand himself. How do I start to address this psychological side as I feel he needs to become the master of his processing glitch as many people simply won’t truly understand- myself included? Is there literature out there aimed at children with these glitches?

    FYI – his WISC-IV scores are VCI – 126 (96 centile), PRI – 123 (94 centile), WMI – 107 (68 centile) and PSI- 83 (13 centile).

    I will be doing CogMed with him soon and I have started to do mind mapping with him (tony Burzan) and he touch types at home. Unfortunately, he goes to a London private school where they have to work hard and fast – meaning his ability to complete written work is poor. The same story where homework is nothing short of torture, particularly as by the end of the day his brain is exhausted. I am often his scribe. School wears him out and it can be a stressful experience. I welcome the holidays as much as he does! He also has poor organisational skills.

    I feel he may need to see an OT which he currently doesn’t and maybe a speech and language therapist. I am awaiting further advice on this.

    Just to say thanks, as this has been by far the most appropriate site I have found and I feel less anxious now I can see I am slowly beginning to get Gus the help he needs.

    Regards,

    Miranda

  70. CCA says:

    Hi. My son is in 5th grade and has been struggling in the area of reading and writing since 3rd grade. His most recent WISC IV tests :
    VC-112 (subtests: similarites-15, vocab-11, comprehension-11)
    PR-121 (subtests: block design-14, picture concepts-14, matrix reasoning-12)
    WM-91 (subtests: digit span-7, letter-number seq- 10)
    PS-109 (subtests: coding-11, symbol search-12)
    GAI-120

    Comprehensive Test of Phonolgical Processing-2 (CTOPP-2)
    Core Subtests Scaled Scores:
    Elision-11
    Blending words-11
    Phoneme Isolation-13
    Memory for Digits-5
    Nonword repetition-6
    Rapid Digit Naming-7
    Rapid Letter Naming-9

    Composite Scores (average is 85-115)
    Phonological Awareness-112
    Phonological Memory-73
    Rapid Symbolic Naming-88

    Test of Written Language (TOWL-4)
    Subtests (8-12 average)
    Vocab-7
    Spelling-6
    Puctuation-8
    Logical Sentences-7
    Sentence Combining-8
    Contextual Conventions-5
    Story Composition-10

    Composite Scores
    Contrived Writing-85 -below average
    Spontaneous Writing-87-below average
    Overall Writing-84- below average

    At one time he was thought to have ADHD but in his recent testing they have ruled that out. He has dyslexia and is getting tutored in an Orton Gillingham program at a dyslexic school. He has had 50 sessions of neurofeedback to help with his innattentiveness. His biggest issue in school is his abiltiy to get his thoughts down on paper with proper spelling, punctuation and detailed information. He also does poorly on tests. He is having an IEP meeting in a week. Any thougths on the best accomadations or other thougths as to how to help him become a better writer would be appreciated. Thanks!

    • Melissa Mullin, Ph.D. says:

      Many dyslexic students are visual thinkers.You can read my post titled Do visual learners have more difficulty with language organization than verbal learners?

      Educational specialists, tutors or a speech and language therapist can help with organizing language and writing skills. The writing skills that a student with this profile needs to learn, include pre-writing skills to help him organize his ideas before he writes.

      Mind maps or advanced organizers such as graphical organizers are great tools. It is too much for your son to think of his ideas AND think about the sequence of spelling. I often tell parents, let them write and underline the words they think might be spelled wrong and then when they are done they can go back and check their spelling. I would also ask for technology accommodations ( use of the computer with spell check) and extra time on tests to allow him to proof read.

  71. Teresa says:

    Hello, I am writing with hope that you can at least point me in the right direction. My 9th-grade son has been on a downward spiral in school since 7th grade. He did great in elementary and was placed in a gifted program. Here are his scores from the WISC-IV:

    Verbal Comprehension 152
    Perceptual reasoning 108
    Working Memory 102
    Processing Speed 97
    Full Scale 123
    GAI 136

    When he was tested, they told me there were meaningful differences between comprehension and wm/processing. At the time, he was doing great in school so we did not pursue this. He is a phenomenal reader at a 12+ grade level by 4th grade. By 7th grade, he went from mostly As with a B here and there, to Cs and Ds. A year ago, he visited a psychologist and was diagnosed with ADHD with low (sub-clinical) anxiety. The psychologist did not believe he had a learning disability. While I agree he demonstrates most ADHD characteristics, I do not want to label him. is now in 9th and cannot seem to do well or maintain doing well. His grades are at an all-time low. He is extremely bright, knowledgable, and articulate but basically cannot manage school. It is crucial he be in intellectually-stimulating classes but he has a difficult time keeping up with the pace. He is becoming apathetic and it is heart-breaking to watch his attitude and self-esteem drop. I cannot imagine what it must be like to be so intelligent but unable to do well in school. I also want to point out that he is very strong-willed and refuses help or guidance from me or my husband. He has been thIs way since Elementary so this is not a new development. He is a rule-questioning, unconventional thinker and possesses excellent social skills (which from what I’ve read isn’t always the case with ADHD). I am highly concerned about stimulant medications. He was placed on Concerta XR for the last 8 weeks and if anything I think his grades have declined . I realize not all medications work for all people. I want to help him find a way to succeed without prescription medication and I am not 100% sold on the long-term safety of the medications. I could go on and on and I know your time is valuable. I realize you cannot make a complete evaluation based just on these scores, but can you please advise on what your instinct tells you? My next step is to go to the school to request extra test-time accommodations to see if it would help. Understandably, my son is almost 15 and doesn’t want me to do this and doesn’t want to be differentiated.

    Thank you for any advice you can offer.

    • Melissa Mullin, Ph.D. says:

      I am sorry your son is struggling in school. Looking at his scores I see that his Verbal Comprehension score is very high and his other index scores are average. What this leads me to believe is that he is a quick thinker in the verbal domain. When it comes visual spatial, working memory and visual motor/processing he does not think as fast as he does verbally. When there are big differences in skills students like to use their strengths and avoid their weaknesses. Even though his weaknesses are in the average range, they are not as easy for him as verbal tasks. This means he has to slow down his thoughts to get them out on paper. It is like he has to translate into another language ( written language) to communicate in school as most assignments and tests are written not verbal. This translation is laborious and tedious for him and his impatience causes him to avoid the tasks, therefore causing to do poorly in school.

      I suggest that you get accommodations for him in school to use a computer to take notes and tests. He should become a touch typist so that he can type as fast as he can talk. When he can get his ideas out quickly and efficiently my guess is he will do much better in school.

      Here are few other posts that may be helpful to you.

      http://bitsofwisdomforall.com/2014/04/04/building-executive-functioning-skills-may-be-the-best-intervention-for-increasing-processing-speed/

      http://bitsofwisdomforall.com/2013/01/07/mastering-executive-functioning-skills-requires-grit-and-resilience/

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