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Multiple Diagnoses and Further IQ Assessments

By Inderbir Kaur Sandhu, Ph.D

Q: My 9 year old grandson, who has an EHCP, was assessed on WISC IV. Composite scores:

Verbal Comprehension 128
Perceptual Reasoning 100
Working Memory 91
Processing Speed 94

My grandson has no sight or hearing problems. He suffers from severe hyper- mobility with associated anxiety state, and from dyspraxia. He had already been recognised as a very bright child by the school and others, before the WISC test, but was judged to be under-achieving, notwithstanding the fact that his school performance was within average, though at the low end. We have been told that he is a classic DME child.

His parents advocated further assessment, to identify the nature and extent of any learning difficulties, using WIAT in view of its compatibility and links to WISC. After first declining to arrange any further assessments, the school are now proposing to conduct two - one on WRIT (Wide Ranging Intelligence Test), the other on WRAT (Wide Range Achievement Test).

We are concerned and puzzled as to why the "natural" follow up assessment using WIAT is being eschewed in favour of tests which are not linked to WISC and which we believe would have make interpretation and comparison of results more difficult and less effective.

We also believe the WRIT and WRAT are less comprehensive. and that too is a matter of concern, and are contemplating arranging a WIAT assessment privately, though it is not in that option we seek advice.

What we should appreciate would be any guidance you are able to provide generally but, particularly, on the issue of whether or not there is need for further assessment, and the choice of tool if the answer is "Yes". Thank You!

A: Your letter sounds like a very challenging journey for both your grandson and the entire family. I am not an expert in most of the diagnoses mentioned but I would attempt to share my thoughts. From the WISC-IV scores alone, it is quite obvious that he is a brought child despite the concerns he has, which is probably making it harder for him to sail on. The huge discrepancies in scores also indicate learning challenges.

What he would need is a comprehension assessment and evaluation with a group of experts as the issues he has are multiple folds. Usually, for children with autism, it is common to have an Education, Health and Care Plan (EHCP). (These are official documents that records the child's special needs and notes what extra accommodation schools need to make, extra support/therapy the child is entitled to, and the kind of school that can meet their needs.) It is good that he already has an EHCP for his special needs which should be quite helpful. With all the diagnoses, he would therefore be considered a "Dual or Multiple Exceptional" (DME) child and would require a lot of learning support from the school.

On why the WIAT is not being used is quite puzzling - you would need to find out from the school. I can only think of reasons associated to the costs. I am not familiar with the WRIT and WRAT so unable to comment on it. You are right to be concerned here. What I believe that before he gets into higher grades, a complete evaluation on his condition needs to be done. As you have done a number of assessments, perhaps you now need to know the intervention plan. This would have to include therapy to help him with his psychological and developmental concerns.

As for which further evaluation would be suitable, would depend on a complete analysis by a team of clinicians in the different areas he has concerns in. Individual intervention may not work well as a comprehensive intervention is necessary. Do speak to the school authorities and psychologists to find out your options. My apologies for not being able to help much; as my expertise is mainly in the field of giftedness.

An interesting blog, if you haven't read it already:

All the best.

Further reply from reader: Hi, Dr. Sandhu. Thank you very much for your helpful advice. Quick update - we appear to be on the brink of the school/LEA agreeing to conduct the WIAT assessment for my grandson. The blog you attached was very interesting. We too had a long drawn-out battle to get an EHCP for our grandson and even getting an assessment, after the EHCP was granted, was very far from straightforward.

We got there after one failed SEN application and the whole process took 2+ years. We managed to do it with legal representation or invoking the appeal procedure but is a very wearing process - requiring dogged determination and much stamina!

Thanks once again for your help. Much appreciated.


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