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Neuropsych testing

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    Neuropsych testing

    We finally got our neuropsych testing done and the results in hand. The tester was a cool guy who wore a Harley jacket and told us he owns seven dogs. My kid liked him right him. They did Reynolds Intellectual Assessment Scales-Second Edition, Grooved Pegboard Test, Benton Visual Form Discrimination Test, Child and Adolescent Memory Profile, Behavior Rating Inventory of Executive Function-Parent Form. Jethro is almost 11 now, using Simply Classical 4. (We're about halfway done. This spring has not gone too well, school-wise)

    He scored 120 on the Verbal Index Standard Score and 78 on the Nonverbal Index Standard Score on the Reynolds.

    Pegged Groove Board Test: Mildly impaired with right hand and moderately impaired on left hand with notable motor overflow in that hand.

    Benton Visual Form Discrimination Test his score was 24, which puts him in the moderately impaired range.

    On the Memory Profile of 121 (above average), Visual Memory Index of 86 (mild delay), Immediate Memory Index and Delayed Memory Index were both 103.

    He showed good impulse control scores, significant difficulties with regulating emotional reactions, mental flexibility, task initiation, and monitoring/self correction while engaged in cognitive or other activities. He has poor working memory.

    Diagnoses of frontal lobe and executive function deficit, generalized psychomotor slowing, and Neurocognitive Disorder, unspecified. That's in addition to ASD level I/II, and severe Anxiety Disorder, NOS.

    There were a lot of suggestions. A lot of things that I suspected, a few surprises. I strongly suspected the gap between his verbal and nonverbal, but I didn't think it would be so significant. A lot of the recommendations are already met by being in a homeschool setting or by the Simply Classical curriculum. The simple, no nonsense visuals in the books and the large for age print were both recommended. His susceptibility to stress and stressful environments was not a shock at all, for instance. The problem is that his threshold for 'stressful' environment is almost anything at all when it comes to tasks, and gets worse when confronted or challenged. The amount of tears that have gone on here the last few months...

    A big recommendation was to get him typing, and to strongly consider a voice to text output. I can see the wisdom in this. He has so many huge, creative ideas, and can't get any of them onto paper, which has him at a high level of frustration. There is such a disparity between his thoughts and his abilities in that area.

    We definitely have seen the problems with slow processing and output speed, inconsistency with performance, and perseveration, but it is nice to have them confirmed. A really hard part to keep in my mind is this bit, "These problems are processing related and not secondary to low ability, inattentiveness, carelessness, or lack of motivation." That one is so hard to hold onto in the face of knowing he is smart and seeing his functional level be so low (made even worse by the times when it is high, because then I want to point to that and say, "See? I know you can do it."

    A lot of these terms are new to me, because I've not had a kid get this testing done before (just when you think you've got all this down, right?). He's had an EEG recently, where they ruled out seizures, but the neurologist got a better handle on his migraines now, and so far this medication isn't making him gain weight.

    And on the plus side, we know for sure that he has a good verbal memory and verbal IQ score, so it wasn't without confirming strengths.

    I know I've sort of disappeared the last few months, but I had talked about getting this testing done often here, so I wanted to share. I hope you all are doing well.

    Miah - married to Warcabbage, 3 boys, BS in social work, AS in Electrical Engineering Technology

    Evulcarrot - 18, freshman in college, Medical Technology , mild autism
    Battlebroccoli - 17, lives with grandma, attends a special high school program part time
    Doomsprout - 10, highly verbal moderate autism, anxiety, motor delays, sensory processing issues - SC 4 with R&S 4

    Hi Miah,

    What a lot for you to take in! It sounds like it was a really positive and validating experience for you - to see where your sons strengths lie but also how much he is battling against each day.

    I remember that you have a lot on your plate already, blessings for you and your family as you go forward with this new/confirmed information.

    Sarah xo

    Aussies from Sydney, Australia
    Miriam 10yo
    Jonathan 8yo
    Elissa 5yo
    Thomas 2yo
    Caleb 2 months


      Good to hear from you, Miah. Thanks for sharing this.

      Yes, this confirms the high verbal memory and strong verbal intelligence. Hence the ability to memorize and deliver his lines in theater! Those scores are wonderfully high.

      At the same time, when you receive a report with glaring difficulties in other areas, clinical words such as "impaired," "deficit," and "poor" can be tough to see on paper.

      The key to unlocking such a report is realizing that this is the whole child, lows and highs, and neither can be denied.

      When we look only at our child's highest ability and say, "See, you can do this!", we neglect the realities of everything else encompassed within that child. Similarly, if we look only at the distasteful words such as "impaired," we forget how delightful and successful our child can be with adequate support.

      Moving forward, yes, those accommodations now become important. Through technology, give him the tools to write more efficiently. Just be cautious to do these things:

      1) Keep technological aids in their proper place as your tools to help him, and his tools to help himself, rather than allowing them to become a new or distracting obsession for your son.
      2) Continue teaching him one-on-one in ways that have been the most successful (short lessons, slowed pacing, plenty of encouragement).
      3) Resist the temptation to turn him over completely to the technology.

      Most of all, this testing may be a "wake-up call" to realizing that despite his strengths, he will need significant accommodations to succeed.

      If it is any consolation, we face that here with my son. At 24, he is verbal, bright, and loves history. We were recently contacted to have him start a new position at one of the notable historic homes in our town. Just this week he started this new position. He was thrilled. To outsiders who see our son at his best, it seems he should be able to work there full time. However, all of the things that plague your son also plague ours: difficulties with processing, mood regulation, sensory difficulties, visual-motor skills, and managing stress.

      We have learned the hard way with two previous jobs that working long, full days, even three or four days a week, becomes exceedingly stressful for him. Our son excels, but he excels only in small bites.

      I spoke to his new employer ahead of time. I explained that he would love to work there but needs short work shifts. She knows our son and admires his passionate knowledge of regional history, so she was willing to accommodate. He now works two days a week, Tuesdays and Fridays, for four-hour shifts. This is the same as our daughter works. To many people this sounds ridiculously light, but with the mental illness and autism combined, this is what he seems to need right now.

      We have always allowed our daughter to work such a light schedule but pushed our son because his intelligence is higher. This has now backfired twice for him. We do not intend to make the same mistake again. Like you, we need to look at the whole person when helping him create a schedule and accomplish tasks. We need to build in relaxation, time outdoors, family time, time for conversations to help him sort through things, and time to regroup before he heads back to work. I have learned that his strengths are a wonderfully surprising blip of blessing, not the sole standard by which he can be expected to perform hour by hour or day by day.

      I hope something here is helpful. With my son's new position beginning just this week, your son's report resonated as a loud-and-clear reminder.

      For you, it seems that even though the testing confirmed much of what you knew, seeing everything on paper can now serve as a turning point for determining your own expectations moving forward.