Math, Visual Spatial Problems or ADHD

[deebee]

My 11 year old dau just had a new psych evaluation done. Most significant issues are math, and reading comprehension. I've spoke with the neuropsych about the results over the phone, but am still waiting for the official report.

I felt she had something along the lines of NLD, given her verbal strengths compared to lower math and inferential reading comprehension and I felt she had visual spatial problems. The evaluator felt her problem is primarily inattention (ADHD), and also recommended follow up for deficient Motor skills.

I don't know if I completely concur with this. She does make many frequent math errors, but given the opportunity to redo math assignments, she misses the exact same questions again, which to me seems unlikely if she solely had ADHD issues. Wouldn't the questions she miss be random, and there would be greater variability??

I have sent a written request to the school for an IEP evaluation, and have requested an OT evaluation as well. In speaking with the school psych she stated dau would not likely qualify for an IEP for SLD and stated "maybe a 504". My understanding is that 504 is only for accommodation. It would seem if my daughter is missing the same problems over and over, that this is something that would need 1:1 assistance to address, not a reduction in problems or other accommodations.

So how do I prove to school she needs more than accommodations?

Some background information:
Testing from last year

WISC-IV
Verbal Comprehension: composite 93
Similarities 6
Vocabulary 12
Comprehension 8
(Information) 13
(Word Reasoning) 14

Perceptual Reasoning: Composite Score 84
Block Design 8
Picture Concepts 8
Matrix Reasoning 6
(Picture Compeletion) 9

Working Memory Composite Score 86
Digit Span 6
Letter Number Sequencing 9
(Arithmetic) 7

Processing Speed 106
Coding 10
Symbol Search 12
(Cancellation) 16
_________________________

Woodcock Johnson III
Broad Reading 114
Broad Math 97
Broad Written Language 111

Math Calc Skills 95
Written Expression 108
Academic Skills 106
Academic Fluency 120
Academic Apps 95

Woodcock Johnson Achievement Tests, Form B
Letter Work Identification 106
Reading Fluency 128
Calculation 96
Math Fluency 93
Spelling 112
Writing Fluency 116
Passage Comprehension 92
Applied Problems 98
Writing Samples 95

_____________________________
NEPSY
Design Copying 13
Arrows 8
Comprehension of instruction 8

_______________________________
CTOPP

Elision ss 10, 50%
Blending Words, SS 9, 37%
Memory for Digits, SS 4, 2%
Rapid Digit Naming, SS 15, 95%
Nonword Repetition, SS 8, 25%
Rapid Letter Naming, ss 15, 95%

Phonological Awareness, 97 Composite, SS 42%
Phonological Memory, 76 Composite, SS 5%
Rapid Naming, 130 Composite, 98%

_______________________________

Kaufman Test of Education Achievement, II

Math Concepts and Applications 93
Math Computation 90

_______________________________

Recent math problems missed, and type of problem

This is a list of questions missed on recent assignments and quizes

Quiz 9A, Score 10/20 (50%)

#2, Measurement involving ruler
#3, Multiple Digit Subtraction with regrouping
#4, Correct answer, but she put answer in the box for problem 3
#10, Multiple Digit Subtraction with regrouping
#11, Multiplication with decimal, correct numbers, decimal in wrong place
#12, Multiplication, incorrect answer
#14, Correct answer, but numbers difficult to read
#15, Correct answer, but numbers difficult to read
#19, Multiple Digit Addition with carryover
#20, Correct numerical answer, but question asked how many dimes, instead answered stating nickels

Lesson 50, 17/29 (58%)
#8, Convert Fraction 7/8 to %, guessed at fraction, stating 10%
#9, Long Division, Started problem correctly, but didn’t complete last subtraction or find remainder
#10, Story Problem, Find total and then average. She missed average
#12, Multiply 2 2digit numbers, (34.28 * 60). only multiplied the 6 *34, skipping the .28
#13, Multiply 2 2digit numbers, only multiplied the ones column
#22, 2 step problem, only did step 1. Distributive property. (10 *43 + 2*43), only did 10*43
#23, Time problem involving months
#24, Round off number to nearest 100
#25 Story problem involving traveling and distance, no clue how she came up with answer
#27, story problem, find average
#28, Wrote the number 320,000 as 300,20,000
#29 Find largest 3 digit number divisible by 6, found largest 3 digit number but was not divisible by 6

Lesson 58, score 17/29 (58%)
#1, Skipped Problem
#2, Copied wrong number down (24 instead of 21) so resulted in incorrect answer
#3, Convert 3/5 to %, didn’t know how to do, just guessed, didn’t complete 2nd part of question
Using a % to determine answer
#5, Place value, asked to find number with 500,000 but answer with 500
#8, Long division, with 2 digit divisor, Started correctly, but didn’t complete last subtraction or find remainder
#9, Long division, with 2 digit divisor, error in multiplication
#13, Long Multiplication (679 * 989), only multiplied ones column
#20, Fraction problem, wrote down wrong denominator
#21, Division problem, missing zero in answer, told to show answer with fraction, but only did remainder
#22, Fraction 6 ¾ asked to identify denominator, instead identified whole number 6
#28, Use a fraction ¾ of 100 to determine solution. Guessed at answer with 20.
#39, Convert number word to actual number, answer missing last 0

Lesson 60, score 16/29 (55%)
#1, Story Problem, asked to find # total students, she solved for total number of girls
#7, Convert 7 lb 12 oz to total # ounces, determined ounces in 6 lbs,
#11. Fraction, Subtract fraction from whole number
#14, 3 Digit multiplication. multiplied all numbers but had 2 errors in adding/multiplying
#17, 2 step problem. First find fraction, then convert Fraction to percentage. did not do 2nd step.
#19. Long Division with 2 digit divisor, started correctly, but didn’t complete last subtraction or find remainder
#20, Multiply 2 2digit numbers, missing a zero. Answer 120 instead of 1200
#21, Long Division with 2 digit divisor, started correctly, but didn’t complete last subtraction or find remainder
#24, Look at number line, count number of tick marks and determine fraction. Answer should have been 3/10, had 3/11.
#25, Time subtraction, incorrect borrowing with minutes,
#27, Interpret information in Frequency Table, was just guessing answers,
#28, Interpret information in Frequency Table, was just guessing answers,
#29, Interpret information in Frequency Table, was just guessing answers,

Had redo Lesson 60
She missed all the problems listed above, except #7, which she got right
#1, after being asked how many girls there were, was able to figure out answer
#14,17, 19, 20, 21, 24, thought she knew what she was doing, but had made errors
#11, 25, 27, 28, 29 didn’t know how to do, and needed to be shown how to solve the problems

Lesson 61, Score 17/30 (57%)
5, Multiply 2 digit number by 2 digit number, missing 0 at end
6. Equivalent fractions
10. Subtract fraction from whole number
12. Add 4 fractions same denominator
20. Long division, subtraction error
21. Long division, subtraction error
22. Multiplication 3 digit by 2 digit, missing 0 at end
26. Subtraction error
27. Asked to identify angle, but only gave part of letters, should have been PWR, stated WR
29. Interpret information in a line plot graph
30. Interpret information in a line plot graph
31. Interpret information in a line plot graph

Lesson 62, score 16/30 (53%)
4. Told to shade 1/3 of circle, she shaded 2/3. Did not find fraction not shaded or % not shaded.
5. Estimate the product. Of 39 and 41, should be 1600, her answer 100.
6. Subtract fraction from whole number.
11. Convert Whole number to equivalent fraction and whole number
13. Add 4 5 digit numbers
14. Subtract a 5 digit number from a 5 digit number
17. Multiply 2 3 digit numbers, only multiplied the ones column
19. Long division by a 2 digit number. wrote problem down incorrectly. She also had errors in how she solved this problem, when she subtract 96-60 she came up with 67.
23. Using a ruler showing mm, determine perimeter. Should have been 15*4=60, she had 10*4=40
25. Time addition. incorrectly wrote one of the times., plus she doesn’t know how to borrow minutes from the hour
26. Probability. Wrong denominator
27. Probability. Wrong denominator
28 Identify Angle. only identified the end points, not the middle point
29. Estimate the perimeter. found ½ of the perimeter,

Lesson 63, score 18/30 (60%), lost, turned in late
9. Subtract fraction from a whole number, she did not know how to do, Had 7 - 1/3 = 6/7
10. Subtract fraction from a whole number,
11. Subtract fraction from a whole number
14. 5 Digit number subtraction
15. Multiply 3 digit number by 2 digit number. When starting hundreds row, instead of multiplying, added the first two numbers.
17. Division with remainder. She had correct #, but book requested remainder as fraction, she had as remainder.
18. Long division with 2 digit divisor, started correctly, but didn’t complete last subtraction or find remainder
19. Long division with 2 digit divisor, started correctly, but didn’t complete last subtraction or find remainder
23. Solve fraction problem, then find percent. Correct fraction, but didn’t find %
24. Put 3 fractions in order from least to greatest. She organized by denominator
26. Chart involving Frequency and Tally’s. She incorrectly counted so chart numbers were wrong.
27. Using protractor, find angle degrees

Lesson 63, Redo
2. Subtract fraction from whole number
Missed again 9, 10, 11, 14, 15, 18, 19, …. Didn’t finish the rest of assignment
Correct this time: 17,



Lesson 64, score
12. Time subtraction problem. Doesn’t understand how to borrow minutes from hours
13. Solving for the unknown, added numbers instead of subtracting
14. Solve problem for the unknown, involving a negative unknown
17. Long division, division error
21. Subtract fraction from a whole number, she doesn’t know how to do
23. Subtract fraction from a whole number, she doesn’t know how to do
26. Perimeter of equilateral triangle using the measurement on a ruler
27. Probability
28 Interpret information in Frequency Table, doesn‘t understand what different areas indicate
29. Interpret information in Frequency Table
30. Interpret information in Frequency Table.

Lesson 65, 18/30, (57%)
2. Story problem used irrelevant information
3. Asked for perimeter of rectangle, instead gave the area
4. Convert 1/4th of a yard to a percent.
5. Time subtraction, 8:30 - 7:45.
10. Order 4 fractions from smallest to largest
11. Factors. Asked to identify HOW MANY factors 10 has. She stated: 1,2
12. Long Division
18. Long Division. Her remainder was greater than the number being divided by.
19. Long Division with 2 digit divisor, started correctly, but didn’t complete last subtraction or find remainder
20. Long Division, multiplication error
22. Subtract a Whole number with fraction from a whole number. 5 - 3 3/8 = 2 3/8


Lesson 65, Redo, 15/30 = 50%, which is less than her original score

Missed again, 2, 3, 4, 5, 10, 11, 19, 20, 22
Problems missed previously that she got right 12, 18
Others missed
7, Miscounted picture diagram to make a fraction, put answer to 2nd part of question on the answer line for the next question
8, Wrote the answer to question 7 on this line and didn’t answer question 8
16, 5 digit number subtraction
17, Multiplication, 3 digit number by 2 digit number
21, Add mixed number fractions, 3 3/8 + 5 5/8 = 2
26, How many eggs in 2 ½ dozen… = 24

[lcdc1]

Wow, that is a lot of information and I know there are a couple people on here that understand that type of info better than I do.

The only advice I can give you is hang in there and if you suspect and issue, persue it now. I went through testing with my 14 year old last year and they tried to say ineligble and then 504. But, thanks to some input here from a couple members, I figured out enough to ask for the Woodcock Johnson subtest scores to be broken out for me and looked at those and the math stuff really stuck out in the subtest. I then requested in writing that they look at the area of math more thouroghly and they gave my kid the KeyMath Revised test and it was very revealing and showed a math LD and she was found eligible under IDEA and has been on an IEP for the last year! She is having some issues again in her current grade and I am very lucky to be able to have the school working together as a team in adding more accomodations to her IEP at the annual review recently. There is suspect innattention possibly related to ADD and I have an appt with a physc that I will pay for this friday, I could ask the school to do the additional testing, but I feel like I need to just get it done at this point with a physc outside the school to look at if it is ADD or anxiety or another LD type thing. Mine is getting ready for High School next year and we are determined to get things in place prior to that so she can be a successful learner.

After you get someone to help you look at the scores, I could give you advice on letter writing to document concerns to submit to the school for eligibility if you determine there is something of concern there. You probably already know there is much more to all this then test scores alone and there are differences in the way people interpret this stuff too.

My kid showed some struggles back in 5th grade, but at the time I was too off in my own issues to realize I should have pursued it when she was 11. It is better to determine if there is an issue as early as possible I think. Good luck.

[lillian]

I'm looking forward to hearing what the neuropsych tells you about this testing, and why the neuropsych believes ADHD is the major issue. For a child with ADHD, her fluency measures and her processing speed on symbol search are really good. With ADHD being the reason for her difficulties, I would expect lower scores on these. Where I see a problem related to ADHD is with memory, both short-term and long-term, and I wonder if this was how the neuropsych came to his/her conclusion? Maybe, it was observations the neuropsych made, while testing your daughter? Interesting.

Do you have a psuedoword decoding score? I see letter/word identification, but I don't see pseudoword decoding. Your daughter has a phonological memory issue, and I am curious what her pseudoword decoding score would be, in light of this issue. It's odd that her spelling, rapid naming, and reading fluency scores are so high, with this type of phonological memory issue. ADHD most certainly CAN interfere with language processing and memory, and, perhaps, because her language weaknesses are not phonetic weaknesses across the board, the neuropsych is attributing these language processing and language memory issues to ADHD? Again, interesting.

I love to read testing and analyze it, but I'm going to be honest and tell you that I'm a bit perplexed by this testing. I completely agree with Lcdc, however, when she says that additional math testing might shed light on the math issues you are seeing. I'd like for your daughter to receive more thorough math testing. I don't think this testing has gotten to the root of your daughter's issues. She's weaker in math than she is in the other academic areas, her Perceptual Reasoning Index is lower than her Verbal Comprehension Index on the WISC-IV, and she has memory deficits, which can give her a great deal of difficulty in math, whether those memory issues are being caused by ADHD or not. Obviously, her classroom work is clearly showing problems, as well. It might take her being tested by someone who really understands math LD's to find out what is going on, but something is definitely going on.

As far as motor and visual/perceptual issues being tested, I think they always should be tested. A good visual/motor integration test can tell you a lot. It sounds as if the neuropsych is concerned with motor issues, and, again, I'm wondering why. It's unusual for a child with motor issues to do as well in the Processing Speed Index on the WISC-IV, as your daughter did; however, motor issues most certainly can bring down PRI scores, particularly on Block Design.

LOL! I don't know if anything I told you helped. Your daughter's scores are complex, in my opinion.

[deebee]

lcdc1
I've already been done this road with my oldest child. Of course, I was naive and believed the school that he was smart, but just not applying himself.

I'm seeing the exact same learning problems in his sister, and so hopefully I can get the school on board. I keep hearing the same thing, "She's too smart to have a learning disorder".

lillian
I'm am very intrigued too to see what the report says and to see the testing results.

The motor concerns I guess were from the three motor related tests:
GRIP STRENGTH
GROOVED PEGBOARD TEST
FINGER TAPPING TEST

However, there wasn't any visual motor/ perception tests done so I'm following up with the school or an outside agency for that.

[lcdc1]

Well that is cool that you know about it already, maybe you can give me some advice! I too heard some stuff in 6th and 7th grade about how good her grades were and that she was on the honor roll and all that. I heard what a great kid she is and all, I said well she should be a great kid, I have taught her respect and that it is important to do well in school, I told the school at the time we were starting all this in 7th grade that I felt they did not want to do testing and that it was a form of discrimination to keep blowing off the testing for kids that were disciplinary problems. The school then listened and took a look at her scores on state testing and stuff and then we went the route I already outlined.

I guess it is up to the parents to lay out things that they see that are outside of testing. It is just frustrating to see the kid have to stand by while they do the testing and stuff.

[jmb3]

deebee,

Wow, that's a lot of data. Sorry, I can't really interpret it. I do see quite a bit of scatter scores. That means in the same area, where the score differs by more than 2 points -/+.

the math was detailed. It looks to me as if your child is missing basic skills. Almost like they are loosing there place in calculations.
Have you tried graph paper for writing numbers in to align columns . Or even turning a sheet of paper on it's side so that your child can align the numbers?

Sorry, I am not much help with all this detail. Perhaps, some else is.

[deebee]

Received report today from the IEE. Disappointed in that report fails to list all the scores for each of the tests, and only refers to percentages,
but this is what I received.

Tests Administered:
WISC-IV
WRAML
NEPSY
WRAT
Children’s Categories Test
Child Trail Making Test
Speech Sounds Perception Test
Seashore Rhythm Test
Grip Strength Test
Index Finger Tapping Test
SIBR
Child Depression Inventory

WISC-IV
VCI 27% Average
PRI 6 % Borderline
Working Mem 34% Average
PSI 50% Average
IQ 82 19% Low Average

VCI Range from 25% to 37%,
Vocabulary 37%

Block Design 25%
Picture Concepts, 9%
Matrix Reasoning, 6%

Symbol Search, SS 7

Academic proficiency, WRAT
Reading, 6.4 grade level
Math 6.5 grade level
Spelling, 8.3 grade level

Children’s category test, within normal limits

NEPSY
No significant functional difficulties
Variability between verbal/ nonverbal with nonverbal being lower, performance is “not deficit when compared to her level of overall intellectual ability”

Trail-Making Test A, mildly impaired
Trail-Making Test B, Seriously impaired

Wide Range Assessment of Memory and Learning
Auditory Verbal, 64%
Visual Memory, 21%
Attention/ Concentration Index, 1%, substantially impaired

Grip Strength, within normal limits

Grooved Pegboard
Right hand, mildly impaired
Left hand, seriously impaired
“Decrease in motor speed that is bilateral for upper extremities”

Current brief neuropsychological evaluation reveals compromised functioning in some areas of cognitive ability.

1. Impairment of attentional ability for both auditory and visual stimuli. Visual processing is more seriously impaired. As the complexity of the material is increased to require either alternation or division of attention, performance substantially drops. This is not specifically reflective of a decrease in speed of cognitive processing, this is a specific complex attentional deficit for visual stimuli.

2. Evidence of decrease in memory performance with visual stimuli. This pattern shows deficits in encoding with retention of the information that is ultimately consolidated into memory. This is probably secondary to visual attention deficit.

3. Evidence of upper extremity motor deficits. Motor speed is impaired bilaterally.

4. Child Depression Inventory, clinical elevation on scales measuring anhedonia. Mild to moderate feelings of depression.

Recommendations

Would benefit from assistance in school, although academic proficiency is within normal limits. Would benefit from efforts to assist in mitigating the effects of her deficits in complex visual attention.

Would benefit from OT evaluation to address some strategies for correcting the deficits in upper extremity motor speed and coordination.

[rakuflames]

Mar 2, 2008 1:12:37 GMT -5 deebee said:

Received report today from the IEE. Disappointed in that report fails to list all the scores for each of the tests, and only refers to percentages,
but this is what I received.

Tests Administered:
WISC-IV
WRAML
NEPSY
WRAT
Children’s Categories Test
Child Trail Making Test
Speech Sounds Perception Test
Seashore Rhythm Test
Grip Strength Test
Index Finger Tapping Test
SIBR
Child Depression Inventory

WISC-IV
VCI 27% Average
PRI 6 % Borderline
Working Mem 34% Average
PSI 50% Average
IQ 82 19% Low Average

VCI Range from 25% to 37%,
Vocabulary 37%

Block Design 25%
Picture Concepts, 9%
Matrix Reasoning, 6%

Symbol Search, SS 7

Academic proficiency, WRAT
Reading, 6.4 grade level
Math 6.5 grade level
Spelling, 8.3 grade level

Children’s category test, within normal limits

NEPSY
No significant functional difficulties
Variability between verbal/ nonverbal with nonverbal being lower, performance is “not deficit when compared to her level of overall intellectual ability”

Trail-Making Test A, mildly impaired
Trail-Making Test B, Seriously impaired

Wide Range Assessment of Memory and Learning
Auditory Verbal, 64%
Visual Memory, 21%
Attention/ Concentration Index, 1%, substantially impaired

Grip Strength, within normal limits

Grooved Pegboard
Right hand, mildly impaired
Left hand, seriously impaired
“Decrease in motor speed that is bilateral for upper extremities”

Current brief neuropsychological evaluation reveals compromised functioning in some areas of cognitive ability.

1. Impairment of attentional ability for both auditory and visual stimuli. Visual processing is more seriously impaired. As the complexity of the material is increased to require either alternation or division of attention, performance substantially drops. This is not specifically reflective of a decrease in speed of cognitive processing, this is a specific complex attentional deficit for visual stimuli.

2. Evidence of decrease in memory performance with visual stimuli. This pattern shows deficits in encoding with retention of the information that is ultimately consolidated into memory. This is probably secondary to visual attention deficit.

3. Evidence of upper extremity motor deficits. Motor speed is impaired bilaterally.

4. Child Depression Inventory, clinical elevation on scales measuring anhedonia. Mild to moderate feelings of depression.

Recommendations

Would benefit from assistance in school, although academic proficiency is within normal limits. Would benefit from efforts to assist in mitigating the effects of her deficits in complex visual attention.

Would benefit from OT evaluation to address some strategies for correcting the deficits in upper extremity motor speed and coordination.

Deebee, can you get the standard scores on the WISC? It looks as if MAYBE there is a significant difference between the two major subsets (Verbal concepts and Perceptual reasoning).

IF there is, then they should compare her academic achievement to the higher of the two scores, not the full score.

If the difference isn't really significant -- and we have to have standard scores, not percentiles, to see that clearly -- then unfortunately her IQ does make her achievement pretty much in line with expectations *for her.* This doesn't mean she will have no weaknesses. We all have relative strengths, and we all have relative weaknesses. But if the IQ of 82 turns out to be a reasonable measure, this means that other standard scores would have to be in a range of 5 or less to be considered significant, and one or two that didn't form a pattern would not be justification for services.

I'm NOT trying to end your search for help for your child. If you understand these things you have a better chance of finding an effective way to find help for your child.

The other problem you have is that on the test, her achievement was fine for a child that age. This is why they use standardized tests for children that age. What teachers put on classroom tests is arbitrary. The items may or may not be worded well. The child might be more distracted in a large group and not perform as well. Putting answers in nickels instead of dimes could easily be caused by distraction. So could a lot of the other errors you described.

Hope that helps.

Susan

[lcdc1]

When my child was tested using the WJ revised something or other, they gave me the scores all averaged for the sub categories. Then after some research and talking to lillian, I asked them to show me the sub categories that had like a 5 or 6 areas in each one, I had to see them broken down becasue in my daughters case an average was not a good tool to look at, her high verbal was distorting what was really happening with the math area. One I saw the sub categories, I then had the numbers and background to ask that they give her the Keymath revised test which really showed the true picture of what was up with her. So, I would just suggest that you ask for all the sub tests in each category to be broken out.

After I recieved the report from all the testing, I then called the school physc and set up a meeting with him a week prior to the eligibility meeting to ask him to explain how he interpreted the data and what it all meant - that was very helpful, he was a patient and good guy. Lillian had told me at that time that I could request that meeting with the physc that administered the test.

[charliegirl]

If you go here www.wrightslaw.com/advoc/articles/tests_measurements.html#12
and scroll about half way down you will see an area called subtest scatter. That explains how a child with an ld can look perfectly average on the composite scores but have a serious disability.