Disclaimer: Dr. Bryant's answers to these frequently asked questions are not intended to replace actual assessment by an appropriately qualified professional, as every individual is different, and the determination of needed interventions for any child, student, or adult is a complex and multi-faceted process requiring individual evaluation.
My child's test scores from school keep jumping around... what's this about?
There are several reasons why this might be happening. First, most of the tests used to formally assess skills for the purposes of state-wide or district-wide assessment are administered to groups of children, who work independently at computer screens or at desks using pencil-and-paper test forms. For any of a number of reasons (e.g., immaturity, anxiety, physical discomfort, sleepiness, difficulties with attention and focus, learning problems, low motivation, etc.), children may have difficulty with persistently giving their best effort on tasks of this type, at least not without direct adult support (which, for good reasons, is generally not allowed during standardized assessments).
Furthermore, many of these group assessments are computer adaptive these days, which can add another level of potential inconsistency. More specifically, computer adaptive tests determine a child's level of ability based on responses to early test items. For example, if a child is successful with an item, he/she may receive a slightly more difficult item next. Conversely, if a child misses a first item, the next might be a bit less difficult. This process continues across several items, with the level of difficulty of the items adjusting based on the child's level of success with prior items. While this creates a more efficient and targeted assessment process that is less likely to be frustrating, it also has some built-in difficulties. For one, what if a child taking such a test is nervous, and guesses too quickly on the first few items? Or what if a child habitually tends to work too quickly to maintain accuracy (which is common in children with ADHD, for example)? In such cases, children might get tracked into items that are actually too easy for them. There are two potential problems with that. One is that the highest score a child can earn is directly related to the difficulty of the items completed. In other words, getting easier items automatically means a lower score. Also, getting tracked into easier items on a computer adaptive test also means the child will likely finish the test more quickly. For children with anxiety, learning difficulties, low self-confidence, and physical challenges, testing can be a very unpleasant process, and "getting it over with" can be very tempting...
Finally, on any standardized test, items are randomly chosen from a bank of items, meaning that children may randomly be assigned items that happen to be easier or more difficult for them during different testing sessions, and this too can affect scores -- particularly when testing occurs frequently. With children being tested two or three times per year on these assessments, it is thus not terribly unusual for scores to vary... and the reasons are many.
Looking at patterns of scores over time may provide a better measure of progress than looking at individual scores in comparison with the last set of scores earned. Are the child's scores generally going up? If so, a mild drop in scores here or there is not a problem. Only when there is no pattern of growth over time is there cause for concern. Talk with the School Psychologist at your child's school, if you have concerns about the pattern of your child's scores.
How soon should testing happen? My child's Kindergarten teacher is concerned...
First, it is very important to take teachers' concerns seriously: Teachers are the professionals who are most likely to know what is typical for a child's age and what is not, when it comes to academic skills. However, this stated, testing may not always be the best FIRST choice, especially for a child so young. The testing process can be demanding, and young children who have limited experience with school are often not developmentally ready for several hours of sitting still and working on tasks that require focused concentration, some of which will likely be difficult. Even with a skilled and experienced evaluator, colorful, child-friendly materials, and frequent breaks, testing can be hard work! Children who are still only 4 or 5 years of age are much more likely than older children to simply disengage and stop trying when frustrated -- not because they are misbehaving, but simply because they are still young. Unfortunately, this can result in test results that are hard to interpret: Did the poor score come from a real difficulty, or was the child just too tired or distracted to do her best on that test? While this can be a problem with testing individuals of any age, of course, this type of difficulty is all too common with young children.
There are definitely times when testing a child early is a very good idea, and it CAN be done. For example, a child with a known medical condition, such as a head injury or seizure disorder, may truly benefit from early and comprehensive testing, to be sure he is receiving proper support in the school setting, and that his unique profile of strengths and challenges is thoroughly understood by his parents and teachers. However, if the concern is strictly academic (e.g., trouble learning letter names and sounds, poor handwriting, difficulty learning basic math operations, etc.), tutoring may be a better place to start. For example, if the child's teacher is concerned about reading or pre-reading skills, the International Dyslexia Association website does provide a list of qualified local providers of tutoring services who can work with children to provide intensive work on those skill areas, and that might be a good place to start. Many school districts can also suggest local tutoring resources, as can teachers and local parent organizations. For a child who midway through 1st grade or beyond, and still struggling, testing (whether privately or through the school district) may be very, very helpful.
What is the difference between testing at school and private testing by a psychologist?
The law requires all public schools in the US to offer evaluation services for children and adolescents suspected of having learning disabilities or other barriers to educational success. Typically, after a referral is initiated by the child's teacher or parent, an IEP (Individualized Education Program) team (consisting of teachers, parents, a school psychologist and/or counselor, special education teachers, etc.) is convened, and a determination is made as to whether the referral indicates a need for full evaluation. If an evaluation is approved by the IEP team, the teacher and parents complete behavioral inventories, and the child or adolescent is then observed in the classroom and tested, often during the school day, or possibly at the local Education Service District office. Testing will typically measure academic achievement in areas of concern, while the inventories completed by parents and teachers describe behavior and screen for emotional difficulties. In some cases, cognitive tests, such as an IQ test or cognitive test battery will be administered as well, almost always by the school psychologist. After the testing is complete, the IEP team will reconvene, to determine whether the child/adolescent qualifies for special education services and/or classroom accommodations under a 504 Plan (i.e., an accommodation plan under Section 504 of a law that preceded the current special education laws, that provides accommodations, but NOT individualized instruction). Of note is that school testing is not intended to diagnose, but to determine eligibility for services and facilitate learning in the classroom. It is quite possible for a child or adolescent to have a diagnosable condition, such as ADHD or a learning disability, and still not qualify for services at school.
By contrast, testing by a psychologist is typically initiated by the child's or adolescent's parents, often at the suggestion of school personnel, a health care provider, a tutor, or a therapist/counselor. A psychologist will review records (school, and if relevant, medical), talk at length with the child's parents and other appropriate persons, seek additional information from teachers and parents via standardized symptom inventories, and with adolescents, interview the student as well. The testing is more comprehensive: It will almost always include a thorough assessment of emotional behavioral functioning, cognitive testing, and academic screening, and may also include adaptive assessment, neuropsychological skills assessment (attention, executive functioning, memory, etc.), language skills assessment, and/or in-depth academic skills assessment. This type of evaluation may have many purposes, but is commonly intended to both diagnose any mental health, behavioral, cognitive, or learning difficulties that may be present, and to facilitate appropriate interventions (i.e., through services and/or accommodations at school, medical care, mental health treatment, etc.). Evaluation by a psychologist is typically thorough and multifaceted, leaving "no stone unturned," and it typically encompassing all the academic, cognitive, and behavioral elements of a school-based assessment, and often includes a variety of other components besides.
What is the difference between an IEP and a 504 Plan?
A child or adolescent qualifies for an IEP, or Individualized Education Program, when a significant learning, physical, health, or mental health challenge interferes with learning in the regular classroom to such an extent that specially designed instruction is required for success in the public school setting. Students receiving services under an IEP will have been thoroughly assessed at school, often by a team of professionals including a School Psychologist, various Special Education staff members, professionals in education-relevant fields such as Speech/Language Pathology or Occupational Therapy, and classroom teachers, and on the basis of the results of that assessment, will have been found by the IEP team (typically made up of the student's parents, teachers, the School Psychologist, and other appropriate professionals) to be in significant need of services. The IEP will define a set of educational goals, and will typically designate how much and what types of special instruction and/or other services the student will receive. Often IEPs will also include lists of accommodations, which apply in both the regular classroom and in special education classes. Students who are afforded IEPs are (by law) reassessed every 3 years, and that student's IEP team will also reconvene each school year, to check progress and update the plan, as needed.
By contrast, a 504 Plan is typically offered to students who have some type of challenge, but are not found by the IEP team to need specially designed instruction. Students on 504 Plans spend 100% of their time in regular classes, but are provided with "adjustments" in that setting, to support their success and/or wellbeing. Many accommodations are possible, but appropriate accommodations are always chosen with respect to that particular child or adolescent's identified areas of challenge. For example, a child with severe food allergies might have a 504 Plan that calls for special precautions in the school setting, to prevent contamination. A high school student with reading difficulty may have a 504 Plan calling for audio versions of assigned readings and textbooks. A student of any age with ADHD might have a 504 Plan asking teachers to place the student in the least distracting space within the classroom, or to provide repetition of spoken directions when needed. A student with an anxiety disorder might have a 504 Plan that provides for provides for extra breaks from classroom activities, to support emotional control.
Of note is that students who receive services under an IEP are not necessarily less capable than those who receive accommodations under Section 504, but their difficulties have been deemed more likely to affect their success, and thus require more individualized and focused intervention. Students who receive services under IEPs can and often do "graduate" to a 504 Plan. Of note is that MOST students who are found to no longer need IEP services SHOULD still have access to accommodations! It is often necessary for parents to request a shift to a 504 Plan, if not specifically offered by school personnel during the IEP meeting during which it is determined that the student no longer needs IEP services.
My son/daughter has always received accommodations in public school under an IEP or 504 Plan, and is going to college soon. Will his/her accommodation plan transfer, if he/she attends a community college or state university?
That would be highly unlikely, so please do not assume that to be so, regardless of what you may have been told!!! Colleges and universities are not bound by the same Special Education laws as public schools, and thus do not afford or recognize either IEPs or 504 Plans. However, under the Americans with Disabilities Act (ADA), colleges and universities ARE required to afford reasonable accommodations to deserving students, and many times, students who have received IEP services or accommodations under Section 504 can also qualify for accommodations under ADA. However, the assessments used to justify an IEP or 504 Plan during high school are often too outdated or too limited in scope to be used as documentation of a need for accommodations at the college/university level. Typically, an adult level re-evaluation, completed when the student is at least 16 years of age, is required. To be sure the student's accommodations are in place for the first semester of college studies, any re-evaluation process should be scheduled and completed WELL BEFORE the student is to leave for college. One of the best times for such an evaluation is during the summer between the student's 11th and 12th grade years.
My son/daughter goes to private school, but is having learning problems. What do I do?
The answer to this question will vary from school to school. First, private schools are not bound by the same laws as public schools, with respect to requirements for specialized instruction or accommodations. In fact, private schools can choose not to admit students who have special learning needs - which is often in the student's best interest, if the school does not have the resources or specially qualified professionals needed to meet the student's educational needs. If school personnel are significantly reluctant to offer a student support with learning challenges, it may actually be wise to seek a different school that is a better "match" for that student's learning needs. This stated, more and more private schools ARE hiring Learning Specialists who support classroom teachers by providing one-on-one instruction to students who are struggling in the regular classroom. Private schools occasionally also have personnel who can provide assessments, but unlike the public schools, they are not required to do so. More often, private school professionals will recommend to parents that their child or adolescent be assessed privately, to facilitate support in the school environment. Many private schools will provide accommodations for students, once those have been recommended, based on assessment. However, again, they are not required to do so. It is recommended, however, that parents request some sort of documentation of any accommodations a student is afforded in a private school setting (comparable to a 504 Plan from a public school), in case the student continues to need accommodations at the college level, as many colleges are reluctant to afford accommodations to students who have not received such support during high school.
My son can play video games for hours... so how can he have ADHD?
My student spends hours on their phone, texting, posting to social media, and watching videos, and too often, homework is put off to the last minute, or isn't done at all. Isn't the PHONE the real problem here?
The distinction between true attention deficits and inadequate effort/motivation is a difficult one. All of us find it easier to stay focused and avoid distraction when we are engaged in activities we find interesting, stimulating, and fun, but for children, students, and adults with ADHD or other types of attention deficits, the amount of extra effort it takes to stay focused on a task or set of material that is not engaging and interesting may be huge. For this reason, some children who have attention deficits (and sometimes adolescents and adults as well) will tend to resist tasks they perceive to be difficult -- even if they truly can do the tasks.
Children and adolescents (and yes, adults!) are surrounded these days with MANY interesting, engaging, and highly stimulating activity options... videos, electronic games, and social media, to name just a few. Video games, for example, are often designed to be highly engaging, making concentration easy, even for students who have trouble with attention at other times. Thus, the same child who can play Minecraft for hours (and who may be so caught up in his game that he does not hear a parent calling him to dinner!) may struggle to stay focused while trying to finish his math homework. Socializing can also be interesting and compelling, and thus easy to attend to... thus social media and texting can much more easily hold the attention of an adolescent who struggles to complete the paper that is due tomorrow. Blaming the source of alternative engagement (in this case, most typically, the student's phone), while very understandable from a "proximity to the problem" standpoint, often misses the real underlying issue.
In short, while a positive attitude toward learning and school work is clearly very important, please don't assume your son's or daughter's attention issues with school work are all about attitude: They may truly be having more difficulty concentrating when performing less stimulating, less intrinsically motivating tasks, and a tendency to fall back into activities that are engaging may reflect a very real underlying difficulty with attention and focus. A proper evaluation can help make the distinction.
How can I tell if I have ADHD?
Self-diagnosis is not a wise idea! While it is easy to find lists of symptoms, self-tests, and discussion by experts and non-experts alike, online and elsewhere, diagnosing ADHD is not as simple as it may seem. For one thing, many of its symptoms also occur in other disorders. For example, poor concentration can happen as a result of ADHD, but can also be due to depression, certain medications, substance use, anxiety, head injuries, various medical conditions, and loss of sleep, to name just a few other possible causes. Next, most "tests" that are available online or in popular publications are not reliable indicators of whether a person has or does not have ADHD. Good tests are always standardized and carefully prepared, to ensure reliability and validity, and must be administered by a professional qualified to properly interpret the results. Finally, discussions posted on social media, in blogs, or on topical websites can be very interesting, but depending on the source, the information presented may or may not be accurate, and may or may not be applicable to any particular individual. The bottom line is: Always see an appropriately qualified health or mental health professional, for questions about the diagnosis of ADHD or other learning-related challenges.
ADD or ADHD? What's the difference?
The terminology can be confusing... Basically, the official diagnostic guide used in the USA (the DSM-5) calls both the inattentive only and hyperactive/impulsive patterns of behavior and functioning "ADHD," or Attention-Deficit/Hyperactivity Disorder. So yes, you can be diagnosed with ADHD and not be hyperactive or impulsive. However, the situation is really more complicated than even the terminology makes it seem, as the official diagnosis of ADHD does not require proof that a child or adult actually HAS deficits in any of the various attention skills that can be measured with neuropsychological tests. Instead, the diagnosis relies on observable behavior in real-life situations, such as in school or on the job. The trouble is, the behaviors that are used to diagnose ADHD can occur for other reasons. For example, a child can have trouble sitting still and staying focused while in school because of ADHD, but could also be feeling anxious because the work is too hard due to an unsuspected learning disability, be depressed due to difficult family issues, or be suffering from an unsuspected medical difficulty that is impairing concentration. It's very important to consider all possible causes, and not just assume that it's ADHD that's causing the problem. Additionally, performances on actual tests of attention can help a child or adult toward effective compensation for any problems that are evident, whether or not ADHD is present, because performance on such tests facilitates understanding of the problems and selection of appropriate interventions.
My child writes letters backwards... could he have Dyslexia??
A common misunderstanding about Dyslexia is that it has to do with reading and writing backwards... truly, that kind of directional confusion is actually quite rare. Most children and adults with dyslexia actually have an issue with auditory perception that makes it difficult for them to hear the individual sounds within words as individual sounds. Others have difficulty with mentally connecting printed symbols and words with the spoken words they already know. As teachers of young children know, writing the occasional letter or number backwards is very common in normally developing young children... it's usually only reflecting a real problem when it continues past grade 3 -- and by that time, it is very likely that other learning issues will have become evident as well.
Is there such a thing as "Visual Dyslexia"?
That's a tough question, actually! As my response to the prior question indicates, dyslexia is usually the result of a problem with auditory perception. However, dyslexic children do sometimes read words out of order or backwards, lose their place while reading, or frequently misread common words, leading to very reasonable questions about vision. And sometimes, reading problems DO result from vision problems -- and while this is not actually "dyslexia" in the strict sense of the term, children with these types of vision difficulties can have many of the same difficulties with word identification, reading fluency, etc. that plague children, students, and adults with dyslexia. My view is that ANYONE HAVING TROUBLE WITH READING SHOULD RECEIVE A FULL PROFESSIONAL VISION EVALUATION FROM AN OPTOMETRIST OR OPHTHALMOLOGIST, and should certainly tell the evaluating professional about the reading difficulties. Only this type of thorough vision exam can rule out an underlying vision problem that is making it hard for the child to learn to read. And by the way, the screenings that happen during regular physicals at the pediatrician's office are NOT full vision exams, as they typically evaluate only distance vision, not the near visual skills used during reading and other close work!!! Also, it is quite possible for a child, student, or even an adult to not realize he/she is having issues with vision, so don't let that prevent a full vision exam!
Do I (or does my child) need a vision evaluation, to rule out vision-related challenges with learning?
Vision is actually a varied set of skills that rely on both physical characteristics of the eyes and complex interactions between the brain and the various muscles used to focus and direct the eyes, in service of various visual tasks. There are many types of vision screenings and evaluations, and they vary quite a bit in terms of which vision skills are assessed, and how comprehensively. Basic vision screenings, for example, tend to focus primarily on distance vision, or the ability to see clearly several feet away. One common example would be the "read the letters off the chart on the wall" type of vision screening that is a component of many checkups offered by pediatricians and other primary care providers. Another would be the quick vision screening potential drivers must complete at the DMV, in order to qualify for a license. These types of screenings serve a useful function, in that they can identify a common vision problem, called "myopia" or "nearsightedness," but these are not comprehensive vision tests. In particular, these types of vision screenings will rarely catch the types of vision issues that most often interfere with reading.
Even vision exams performed in the office of a qualified "eye doctor" may vary in their breadth and depth. In fact, not all eye doctors are the same. Specifically, Ophthalmologists, or eye doctors with an "MD" degree, are specifically qualified to treat eye diseases and eye injuries, and also perform eye surgery. These eye doctors complete the same comprehensive medical training as others MDs, qualifying them to diagnose and treat a wide variety of medical conditions that can affect vision and/or eye health, and can also prescribe medications. Somewhere along the way, often during their specialized internship or residency training, Ophthalmologists also learn to test vision (though in some professionals' offices, technicians working under the physician's supervision actually do this testing). A special type of MD eye doctor, Neuro-Ophthalmologists, are specifically focused on caring for persons with brain conditions and injuries affecting their visual functioning. By contrast, Optometrists, who have an "OD" degree, are eye doctors who specialize specifically in vision testing and vision correction. Most notably, Optometrists focus intensely, throughout their training, on how to facilitate optimal visual functioning for each individual, based on that person's daily activities and specific vision needs. For example, a college student who spends many hours a day reading from a book or computer screen uses her vision very differently than might a truck driver or baseball player, either of whom must often track moving objects at various distances with exceptional accuracy.
Not all eye doctors test the same aspects of vision. While any qualified vision care professional can accurately diagnose and treat the most common vision issues (i.e., nearsightedness, farsightedness, and astigmatism), only specifically qualified Optometrists and Neuro-Ophthalmologists generally do in-depth assessments of such issues such as binocular functioning (i.e., how well the two eyes work together in providing consistent and easily meshed visual information to the brain), accommodative functioning (i.e., efficiency in achieving and maintaining focused near vision), and saccadic eye movement control (i.e., the ability to rapidly and accurately move the eyes to a new point of focus). Of note is that although these types of vision issues are less common than the more typical problems of nearsightedness, etc., they do occur in a significant number of individuals, and when they do, reading accuracy, fluency, and comfort are often affected. Optometrists treat these conditions using vision therapy, or a course of guided eye exercises (think: "physical therapy for the eyes"), which can often successfully improve visual functioning, sometimes removing a need for corrective lenses.
Children, students, or adults with persisting or newly acquired difficulties with reading can often benefit from a full professional vision evaluation with an Optometrist qualified to evaluate for and prescribe vision therapy. While most reading difficulties are not due to vision issues, in cases where there ARE vision issues that go unnoticed and untreated, other types of interventions for reading difficulty (including tutoring for Developmental Dyslexia) will be far less effective. A full vision evaluation is thus a wise precaution, well worth the time and cost, in supporting those who find reading and other visual tasks challenging.
We went to the eye doctor, my student got glasses, and now, doesn't wear them... so how could vision possibly be the problem?
Vision difficulties can be subtle, and except in rare cases, those difficulties also emerge very, very gradually. Many times, persons with vision difficulty are unaware that their vision has deteriorated or has always been less than optimal. Vision correction is also sometimes subtle, and it can take some time for the full benefit to become apparent. Please note that vision problems will not always manifest as "blurring", eye pain, or headache: In fact, one of the most common manifestations of untreated vision difficulty while reading is poor concentration.
Therefore, if a qualified vision care professional has prescribed corrective lenses or vision therapy, PLEASE follow that professional's advice!!! If you or your student has questions or finds wearing glasses/contacts difficult for some reason, please contact the prescriber, without delay. Ignoring vision as a potential difficulty is unwise.
What is "Dyscalculia"?
Dyscalculia basically means "difficulty with arithmetic", in the same way that Dyslexia means "difficulty reading words." Dyscalculia can take several forms. Some affected persons have trouble learning math concepts and procedures: Arithmetic doesn't make sense, the steps of how to solve problems are easily forgotten, and working with numbers always seems like hard work. Others with dyscalculia have difficulty learning basic math facts (e.g., 4 + 5 = ?, 8 x 3 = ?) by rote, even when their memories for everything else seem just fine. Still others have trouble with spatial aspects of math, so geometry concepts, graphing, and even lining up columns of numbers are unusually challenging. To complicate things further, it is quite possible for one person to have more than one of these types of difficulty.
What is "Dysgraphia"?
Dysgraphia means "difficulty writing letters," but a much more useful definition comes from the work of University of Washington Professor Emeritus Virginia Berninger, PhD, who described Dysgraphia as a "disorder of language by hand". Individuals with dysgraphia have a very hard time learning to write letters correctly and fluently, despite apparently normally developing fine motor dexterity for other tasks. Occupational Therapy can often be helpful, for children who are struggling to learn handwriting skills. Spelling is usually very challenging as well. Even individuals with strong spoken language skills can struggle with putting thoughts on paper, when dysgraphia affects their writing process. Technology, such as voice recognition software and word processors, can be very helpful, and appropriate accommodations can ensure that the difficulty does not interfere with test performance or undermine motivation for written expression.
How can I get accommodations for an important test?
Under the American's with Disabilities Act (ADA), individuals with documented disabilities (including learning disabilities, ADHD, medical conditions affecting cognitive performance, certain emotional disorders, as well as physical disabilities) are entitled to appropriate accommodations on standardized tests, such as the ACT, SAT, GRE, MCAT, LSAT, and others. First, appropriate documentation of the disability that is recent, thorough, and prepared by a qualified professional is key. Next, each testing organization has specific procedures (typically found on their websites) for registration for an accommodated test. Registration for a test with accommodations must often be requested earlier than standard test registration. Also, to maintain fairness for all, testing organizations typically review all accommodation requests and accompanying documentation, and may or may not grant requested accommodations, according to the parameters they have established. Therefore, a diagnosis by a qualified health or mental health professional does not automatically qualify an individual for accommodations on a particular test, though having such a diagnosis is an important part of the qualification process.
Some thoughts about "IQ": It's not a magic number!
There are not many numbers based on test results that have been more over-interpreted or mis-applied than the so-called "Full-scale IQ" score provided by such tests as the Wechsler Intelligence Scale for Children, the Wechsler Adult Intelligence Scale, the Stanford-Binet Intelligence Scales, and other similar instruments. The original purpose of the earliest versions of these tests was to help identify children at risk for academic difficulty, so that intervention could be provided in a timely manner.
Unfortunately, many "myths" have emerged over time, myths that are inaccurate and often, potentially damaging. First, IQ is NOT a permanent characteristic of an individual, like eye color... in fact, IQ can and often does change over time, in response to educational opportunity, skill practice, sensory issues, maturation, environmental factors, emotional status, health, and many, many other factors. Next, IQ may or may not accurately reflect a person's potential for learning. How a child or adult may score on a given day at a particular time may vary notably with such factors as quality/quantity of sleep, health status, and the presence or absence of problems with attention and concentration. IQ can seriously underestimate ability in persons who have learning disabilities, ADHD, Autism Spectrum Disorders, a history of concussion injuries, or a host of other difficulties. Also, people of all ages can also have good or even excellent IQ scores, yet have significant challenges with social skills, emotional stability, or adaptive functioning, any of which can seriously limit functioning: So IQ may or may not predict an individual's potential for future success, even within the domain of higher education. Finally, IQ tests are limited in their scope, and there are many important forms of "giftedness" they do not measure. Specifically, IQ tests focus on those abilities most relevant to traditional education, such as verbal skills, logical reasoning, and to a lesser extent, visuospatial awareness. While those are certainly all useful and relevant skills, the fact remains that an individual can be truly "gifted" as a dancer, an artist, an athlete, or a musician, can have fabulous social skills, a remarkable capacity for empathy, or be inherently in touch with nature and able to effortlessly relate to animals, but none of these highly prized talents and gifts will be evident in an IQ score. Just saying... Don't put too much stock in one very limited number!!
What do all these test scores mean??
If you or your child has received testing at school or by a qualified professional in the community, you may see many types of numbers in the written report, and this can be quite confusing. Essentially, standardized tests use one or more different scoring systems, and some are more useful and easy to understand than others. Also, knowing which scoring system is being used can make all the difference to what any particular number in a test report actually means.
One type of test score many people have some familiarity with, but which nonetheless often causes confusion, is percentile scores. Because the numbers range from 1-99, many people misinterpret percentile scores, thinking they mean "percent correct": NOT SO! For example, 50% correct would not be a very good performance on a regular classroom test, but a score at the 50th percentile (%-ile) on a standardized test would actually mean a normal, average performance -- in other words, a score that is perfectly okay!
Then there is a set of scores known as standard scores. IQ is a standard score: 90-110 is typically considered "average", while scores below 90 are problematic and scores above 110 are strong. The further a score lies from the mean of 100, the more rare and unusual it is: For example, many, many people earn scores around 100 on IQ tests, but very few earn scores as high as 130 or as low as 70. However, IQ scores are often quite misleading, as they are calculated from a variety of subtests that often measure very different skills and abilities. For many, particularly those children and adolescents who are having trouble in school, performance on those subtests may be uneven, with normal abilities or even strengths in some areas and weaknesses in others. An IQ score HIDES both strengths and challenges, and can therefore be very misleading! My recommendation? Pay little or no attention to the IQ score! Look at the subtest scores instead! That's where the useful information lies.
The subtests of IQ and other test batteries often use a type of score called scaled scores. These scores range from 1-19, and an average or normal score would be 8-12 (with scores lower than 8 suggesting difficulty and scores higher than 12 suggesting areas of strength). As with standard scores, the further a score is from the mean of 10, the more unusual that score is.
A fourth type of scores often seen on school-related tests are grade equivalency scores. These are perhaps the least helpful and most often misunderstood scores around. Grade equivalency scores range from K (for Kindergarten) to as high as 16 (meaning "college senior"), and are an attempt to estimate where in the grade-level structure of a typical school a child's test performance would best fit. So for example, if a child halfway through grade 4 earns a grade equivalency score of 4-5 (4th grade, 5th month), that would indicate very average performance for his/her grade level. However, trouble comes when these scores get over-interpreted. Suppose that same 4th grade child earned a grade equivalency score of 6-8 (6th grade, 8th month) on a math test... does this mean she should be in a 6th grade classroom for math instruction??? Probably not... though this would be an experienced teacher's call. Although a 4th grader who scored that high is probably doing well in math, there may be a number of concepts and procedures she has not studied that most 6th grade children have, and she would likely struggle mightily in a 6th grade math class. What the score actually means is that she performed like a typical 6th grader on the 4th grade test material.
Yet another type of score is the T-score. These scores range from 20-90, with a mean of 50. Scores ranging from 45-55 are considered "normal", while scores below 40 or above 60 suggest unusual performance -- whether a high score suggests a problem or a strength may vary with the test instrument, however: Please ask the professional who administered the test for help with interpretation. You won't see T-scores very often on school-based tests, like achievement tests, but they are often used for personality and behavioral assessments.
There are also other types of scores that are used on standardized tests, and as the paragraphs above suggest, knowing how to understand the information they provide requires special knowledge and training. The bottom line here is "ASK": If a number makes no sense, ask the person who did the test to describe what it means, or consult a psychologist for interpretation.
My child's test scores from school keep jumping around... what's this about?
There are several reasons why this might be happening. First, most of the tests used to formally assess skills for the purposes of state-wide or district-wide assessment are administered to groups of children, who work independently at computer screens or at desks using pencil-and-paper test forms. For any of a number of reasons (e.g., immaturity, anxiety, physical discomfort, sleepiness, difficulties with attention and focus, learning problems, low motivation, etc.), children may have difficulty with persistently giving their best effort on tasks of this type, at least not without direct adult support (which, for good reasons, is generally not allowed during standardized assessments).
Furthermore, many of these group assessments are computer adaptive these days, which can add another level of potential inconsistency. More specifically, computer adaptive tests determine a child's level of ability based on responses to early test items. For example, if a child is successful with an item, he/she may receive a slightly more difficult item next. Conversely, if a child misses a first item, the next might be a bit less difficult. This process continues across several items, with the level of difficulty of the items adjusting based on the child's level of success with prior items. While this creates a more efficient and targeted assessment process that is less likely to be frustrating, it also has some built-in difficulties. For one, what if a child taking such a test is nervous, and guesses too quickly on the first few items? Or what if a child habitually tends to work too quickly to maintain accuracy (which is common in children with ADHD, for example)? In such cases, children might get tracked into items that are actually too easy for them. There are two potential problems with that. One is that the highest score a child can earn is directly related to the difficulty of the items completed. In other words, getting easier items automatically means a lower score. Also, getting tracked into easier items on a computer adaptive test also means the child will likely finish the test more quickly. For children with anxiety, learning difficulties, low self-confidence, and physical challenges, testing can be a very unpleasant process, and "getting it over with" can be very tempting...
Finally, on any standardized test, items are randomly chosen from a bank of items, meaning that children may randomly be assigned items that happen to be easier or more difficult for them during different testing sessions, and this too can affect scores -- particularly when testing occurs frequently. With children being tested two or three times per year on these assessments, it is thus not terribly unusual for scores to vary... and the reasons are many.
Looking at patterns of scores over time may provide a better measure of progress than looking at individual scores in comparison with the last set of scores earned. Are the child's scores generally going up? If so, a mild drop in scores here or there is not a problem. Only when there is no pattern of growth over time is there cause for concern. Talk with the School Psychologist at your child's school, if you have concerns about the pattern of your child's scores.
How soon should testing happen? My child's Kindergarten teacher is concerned...
First, it is very important to take teachers' concerns seriously: Teachers are the professionals who are most likely to know what is typical for a child's age and what is not, when it comes to academic skills. However, this stated, testing may not always be the best FIRST choice, especially for a child so young. The testing process can be demanding, and young children who have limited experience with school are often not developmentally ready for several hours of sitting still and working on tasks that require focused concentration, some of which will likely be difficult. Even with a skilled and experienced evaluator, colorful, child-friendly materials, and frequent breaks, testing can be hard work! Children who are still only 4 or 5 years of age are much more likely than older children to simply disengage and stop trying when frustrated -- not because they are misbehaving, but simply because they are still young. Unfortunately, this can result in test results that are hard to interpret: Did the poor score come from a real difficulty, or was the child just too tired or distracted to do her best on that test? While this can be a problem with testing individuals of any age, of course, this type of difficulty is all too common with young children.
There are definitely times when testing a child early is a very good idea, and it CAN be done. For example, a child with a known medical condition, such as a head injury or seizure disorder, may truly benefit from early and comprehensive testing, to be sure he is receiving proper support in the school setting, and that his unique profile of strengths and challenges is thoroughly understood by his parents and teachers. However, if the concern is strictly academic (e.g., trouble learning letter names and sounds, poor handwriting, difficulty learning basic math operations, etc.), tutoring may be a better place to start. For example, if the child's teacher is concerned about reading or pre-reading skills, the International Dyslexia Association website does provide a list of qualified local providers of tutoring services who can work with children to provide intensive work on those skill areas, and that might be a good place to start. Many school districts can also suggest local tutoring resources, as can teachers and local parent organizations. For a child who midway through 1st grade or beyond, and still struggling, testing (whether privately or through the school district) may be very, very helpful.
What is the difference between testing at school and private testing by a psychologist?
The law requires all public schools in the US to offer evaluation services for children and adolescents suspected of having learning disabilities or other barriers to educational success. Typically, after a referral is initiated by the child's teacher or parent, an IEP (Individualized Education Program) team (consisting of teachers, parents, a school psychologist and/or counselor, special education teachers, etc.) is convened, and a determination is made as to whether the referral indicates a need for full evaluation. If an evaluation is approved by the IEP team, the teacher and parents complete behavioral inventories, and the child or adolescent is then observed in the classroom and tested, often during the school day, or possibly at the local Education Service District office. Testing will typically measure academic achievement in areas of concern, while the inventories completed by parents and teachers describe behavior and screen for emotional difficulties. In some cases, cognitive tests, such as an IQ test or cognitive test battery will be administered as well, almost always by the school psychologist. After the testing is complete, the IEP team will reconvene, to determine whether the child/adolescent qualifies for special education services and/or classroom accommodations under a 504 Plan (i.e., an accommodation plan under Section 504 of a law that preceded the current special education laws, that provides accommodations, but NOT individualized instruction). Of note is that school testing is not intended to diagnose, but to determine eligibility for services and facilitate learning in the classroom. It is quite possible for a child or adolescent to have a diagnosable condition, such as ADHD or a learning disability, and still not qualify for services at school.
By contrast, testing by a psychologist is typically initiated by the child's or adolescent's parents, often at the suggestion of school personnel, a health care provider, a tutor, or a therapist/counselor. A psychologist will review records (school, and if relevant, medical), talk at length with the child's parents and other appropriate persons, seek additional information from teachers and parents via standardized symptom inventories, and with adolescents, interview the student as well. The testing is more comprehensive: It will almost always include a thorough assessment of emotional behavioral functioning, cognitive testing, and academic screening, and may also include adaptive assessment, neuropsychological skills assessment (attention, executive functioning, memory, etc.), language skills assessment, and/or in-depth academic skills assessment. This type of evaluation may have many purposes, but is commonly intended to both diagnose any mental health, behavioral, cognitive, or learning difficulties that may be present, and to facilitate appropriate interventions (i.e., through services and/or accommodations at school, medical care, mental health treatment, etc.). Evaluation by a psychologist is typically thorough and multifaceted, leaving "no stone unturned," and it typically encompassing all the academic, cognitive, and behavioral elements of a school-based assessment, and often includes a variety of other components besides.
What is the difference between an IEP and a 504 Plan?
A child or adolescent qualifies for an IEP, or Individualized Education Program, when a significant learning, physical, health, or mental health challenge interferes with learning in the regular classroom to such an extent that specially designed instruction is required for success in the public school setting. Students receiving services under an IEP will have been thoroughly assessed at school, often by a team of professionals including a School Psychologist, various Special Education staff members, professionals in education-relevant fields such as Speech/Language Pathology or Occupational Therapy, and classroom teachers, and on the basis of the results of that assessment, will have been found by the IEP team (typically made up of the student's parents, teachers, the School Psychologist, and other appropriate professionals) to be in significant need of services. The IEP will define a set of educational goals, and will typically designate how much and what types of special instruction and/or other services the student will receive. Often IEPs will also include lists of accommodations, which apply in both the regular classroom and in special education classes. Students who are afforded IEPs are (by law) reassessed every 3 years, and that student's IEP team will also reconvene each school year, to check progress and update the plan, as needed.
By contrast, a 504 Plan is typically offered to students who have some type of challenge, but are not found by the IEP team to need specially designed instruction. Students on 504 Plans spend 100% of their time in regular classes, but are provided with "adjustments" in that setting, to support their success and/or wellbeing. Many accommodations are possible, but appropriate accommodations are always chosen with respect to that particular child or adolescent's identified areas of challenge. For example, a child with severe food allergies might have a 504 Plan that calls for special precautions in the school setting, to prevent contamination. A high school student with reading difficulty may have a 504 Plan calling for audio versions of assigned readings and textbooks. A student of any age with ADHD might have a 504 Plan asking teachers to place the student in the least distracting space within the classroom, or to provide repetition of spoken directions when needed. A student with an anxiety disorder might have a 504 Plan that provides for provides for extra breaks from classroom activities, to support emotional control.
Of note is that students who receive services under an IEP are not necessarily less capable than those who receive accommodations under Section 504, but their difficulties have been deemed more likely to affect their success, and thus require more individualized and focused intervention. Students who receive services under IEPs can and often do "graduate" to a 504 Plan. Of note is that MOST students who are found to no longer need IEP services SHOULD still have access to accommodations! It is often necessary for parents to request a shift to a 504 Plan, if not specifically offered by school personnel during the IEP meeting during which it is determined that the student no longer needs IEP services.
My son/daughter has always received accommodations in public school under an IEP or 504 Plan, and is going to college soon. Will his/her accommodation plan transfer, if he/she attends a community college or state university?
That would be highly unlikely, so please do not assume that to be so, regardless of what you may have been told!!! Colleges and universities are not bound by the same Special Education laws as public schools, and thus do not afford or recognize either IEPs or 504 Plans. However, under the Americans with Disabilities Act (ADA), colleges and universities ARE required to afford reasonable accommodations to deserving students, and many times, students who have received IEP services or accommodations under Section 504 can also qualify for accommodations under ADA. However, the assessments used to justify an IEP or 504 Plan during high school are often too outdated or too limited in scope to be used as documentation of a need for accommodations at the college/university level. Typically, an adult level re-evaluation, completed when the student is at least 16 years of age, is required. To be sure the student's accommodations are in place for the first semester of college studies, any re-evaluation process should be scheduled and completed WELL BEFORE the student is to leave for college. One of the best times for such an evaluation is during the summer between the student's 11th and 12th grade years.
My son/daughter goes to private school, but is having learning problems. What do I do?
The answer to this question will vary from school to school. First, private schools are not bound by the same laws as public schools, with respect to requirements for specialized instruction or accommodations. In fact, private schools can choose not to admit students who have special learning needs - which is often in the student's best interest, if the school does not have the resources or specially qualified professionals needed to meet the student's educational needs. If school personnel are significantly reluctant to offer a student support with learning challenges, it may actually be wise to seek a different school that is a better "match" for that student's learning needs. This stated, more and more private schools ARE hiring Learning Specialists who support classroom teachers by providing one-on-one instruction to students who are struggling in the regular classroom. Private schools occasionally also have personnel who can provide assessments, but unlike the public schools, they are not required to do so. More often, private school professionals will recommend to parents that their child or adolescent be assessed privately, to facilitate support in the school environment. Many private schools will provide accommodations for students, once those have been recommended, based on assessment. However, again, they are not required to do so. It is recommended, however, that parents request some sort of documentation of any accommodations a student is afforded in a private school setting (comparable to a 504 Plan from a public school), in case the student continues to need accommodations at the college level, as many colleges are reluctant to afford accommodations to students who have not received such support during high school.
My son can play video games for hours... so how can he have ADHD?
My student spends hours on their phone, texting, posting to social media, and watching videos, and too often, homework is put off to the last minute, or isn't done at all. Isn't the PHONE the real problem here?
The distinction between true attention deficits and inadequate effort/motivation is a difficult one. All of us find it easier to stay focused and avoid distraction when we are engaged in activities we find interesting, stimulating, and fun, but for children, students, and adults with ADHD or other types of attention deficits, the amount of extra effort it takes to stay focused on a task or set of material that is not engaging and interesting may be huge. For this reason, some children who have attention deficits (and sometimes adolescents and adults as well) will tend to resist tasks they perceive to be difficult -- even if they truly can do the tasks.
Children and adolescents (and yes, adults!) are surrounded these days with MANY interesting, engaging, and highly stimulating activity options... videos, electronic games, and social media, to name just a few. Video games, for example, are often designed to be highly engaging, making concentration easy, even for students who have trouble with attention at other times. Thus, the same child who can play Minecraft for hours (and who may be so caught up in his game that he does not hear a parent calling him to dinner!) may struggle to stay focused while trying to finish his math homework. Socializing can also be interesting and compelling, and thus easy to attend to... thus social media and texting can much more easily hold the attention of an adolescent who struggles to complete the paper that is due tomorrow. Blaming the source of alternative engagement (in this case, most typically, the student's phone), while very understandable from a "proximity to the problem" standpoint, often misses the real underlying issue.
In short, while a positive attitude toward learning and school work is clearly very important, please don't assume your son's or daughter's attention issues with school work are all about attitude: They may truly be having more difficulty concentrating when performing less stimulating, less intrinsically motivating tasks, and a tendency to fall back into activities that are engaging may reflect a very real underlying difficulty with attention and focus. A proper evaluation can help make the distinction.
How can I tell if I have ADHD?
Self-diagnosis is not a wise idea! While it is easy to find lists of symptoms, self-tests, and discussion by experts and non-experts alike, online and elsewhere, diagnosing ADHD is not as simple as it may seem. For one thing, many of its symptoms also occur in other disorders. For example, poor concentration can happen as a result of ADHD, but can also be due to depression, certain medications, substance use, anxiety, head injuries, various medical conditions, and loss of sleep, to name just a few other possible causes. Next, most "tests" that are available online or in popular publications are not reliable indicators of whether a person has or does not have ADHD. Good tests are always standardized and carefully prepared, to ensure reliability and validity, and must be administered by a professional qualified to properly interpret the results. Finally, discussions posted on social media, in blogs, or on topical websites can be very interesting, but depending on the source, the information presented may or may not be accurate, and may or may not be applicable to any particular individual. The bottom line is: Always see an appropriately qualified health or mental health professional, for questions about the diagnosis of ADHD or other learning-related challenges.
ADD or ADHD? What's the difference?
The terminology can be confusing... Basically, the official diagnostic guide used in the USA (the DSM-5) calls both the inattentive only and hyperactive/impulsive patterns of behavior and functioning "ADHD," or Attention-Deficit/Hyperactivity Disorder. So yes, you can be diagnosed with ADHD and not be hyperactive or impulsive. However, the situation is really more complicated than even the terminology makes it seem, as the official diagnosis of ADHD does not require proof that a child or adult actually HAS deficits in any of the various attention skills that can be measured with neuropsychological tests. Instead, the diagnosis relies on observable behavior in real-life situations, such as in school or on the job. The trouble is, the behaviors that are used to diagnose ADHD can occur for other reasons. For example, a child can have trouble sitting still and staying focused while in school because of ADHD, but could also be feeling anxious because the work is too hard due to an unsuspected learning disability, be depressed due to difficult family issues, or be suffering from an unsuspected medical difficulty that is impairing concentration. It's very important to consider all possible causes, and not just assume that it's ADHD that's causing the problem. Additionally, performances on actual tests of attention can help a child or adult toward effective compensation for any problems that are evident, whether or not ADHD is present, because performance on such tests facilitates understanding of the problems and selection of appropriate interventions.
My child writes letters backwards... could he have Dyslexia??
A common misunderstanding about Dyslexia is that it has to do with reading and writing backwards... truly, that kind of directional confusion is actually quite rare. Most children and adults with dyslexia actually have an issue with auditory perception that makes it difficult for them to hear the individual sounds within words as individual sounds. Others have difficulty with mentally connecting printed symbols and words with the spoken words they already know. As teachers of young children know, writing the occasional letter or number backwards is very common in normally developing young children... it's usually only reflecting a real problem when it continues past grade 3 -- and by that time, it is very likely that other learning issues will have become evident as well.
Is there such a thing as "Visual Dyslexia"?
That's a tough question, actually! As my response to the prior question indicates, dyslexia is usually the result of a problem with auditory perception. However, dyslexic children do sometimes read words out of order or backwards, lose their place while reading, or frequently misread common words, leading to very reasonable questions about vision. And sometimes, reading problems DO result from vision problems -- and while this is not actually "dyslexia" in the strict sense of the term, children with these types of vision difficulties can have many of the same difficulties with word identification, reading fluency, etc. that plague children, students, and adults with dyslexia. My view is that ANYONE HAVING TROUBLE WITH READING SHOULD RECEIVE A FULL PROFESSIONAL VISION EVALUATION FROM AN OPTOMETRIST OR OPHTHALMOLOGIST, and should certainly tell the evaluating professional about the reading difficulties. Only this type of thorough vision exam can rule out an underlying vision problem that is making it hard for the child to learn to read. And by the way, the screenings that happen during regular physicals at the pediatrician's office are NOT full vision exams, as they typically evaluate only distance vision, not the near visual skills used during reading and other close work!!! Also, it is quite possible for a child, student, or even an adult to not realize he/she is having issues with vision, so don't let that prevent a full vision exam!
Do I (or does my child) need a vision evaluation, to rule out vision-related challenges with learning?
Vision is actually a varied set of skills that rely on both physical characteristics of the eyes and complex interactions between the brain and the various muscles used to focus and direct the eyes, in service of various visual tasks. There are many types of vision screenings and evaluations, and they vary quite a bit in terms of which vision skills are assessed, and how comprehensively. Basic vision screenings, for example, tend to focus primarily on distance vision, or the ability to see clearly several feet away. One common example would be the "read the letters off the chart on the wall" type of vision screening that is a component of many checkups offered by pediatricians and other primary care providers. Another would be the quick vision screening potential drivers must complete at the DMV, in order to qualify for a license. These types of screenings serve a useful function, in that they can identify a common vision problem, called "myopia" or "nearsightedness," but these are not comprehensive vision tests. In particular, these types of vision screenings will rarely catch the types of vision issues that most often interfere with reading.
Even vision exams performed in the office of a qualified "eye doctor" may vary in their breadth and depth. In fact, not all eye doctors are the same. Specifically, Ophthalmologists, or eye doctors with an "MD" degree, are specifically qualified to treat eye diseases and eye injuries, and also perform eye surgery. These eye doctors complete the same comprehensive medical training as others MDs, qualifying them to diagnose and treat a wide variety of medical conditions that can affect vision and/or eye health, and can also prescribe medications. Somewhere along the way, often during their specialized internship or residency training, Ophthalmologists also learn to test vision (though in some professionals' offices, technicians working under the physician's supervision actually do this testing). A special type of MD eye doctor, Neuro-Ophthalmologists, are specifically focused on caring for persons with brain conditions and injuries affecting their visual functioning. By contrast, Optometrists, who have an "OD" degree, are eye doctors who specialize specifically in vision testing and vision correction. Most notably, Optometrists focus intensely, throughout their training, on how to facilitate optimal visual functioning for each individual, based on that person's daily activities and specific vision needs. For example, a college student who spends many hours a day reading from a book or computer screen uses her vision very differently than might a truck driver or baseball player, either of whom must often track moving objects at various distances with exceptional accuracy.
Not all eye doctors test the same aspects of vision. While any qualified vision care professional can accurately diagnose and treat the most common vision issues (i.e., nearsightedness, farsightedness, and astigmatism), only specifically qualified Optometrists and Neuro-Ophthalmologists generally do in-depth assessments of such issues such as binocular functioning (i.e., how well the two eyes work together in providing consistent and easily meshed visual information to the brain), accommodative functioning (i.e., efficiency in achieving and maintaining focused near vision), and saccadic eye movement control (i.e., the ability to rapidly and accurately move the eyes to a new point of focus). Of note is that although these types of vision issues are less common than the more typical problems of nearsightedness, etc., they do occur in a significant number of individuals, and when they do, reading accuracy, fluency, and comfort are often affected. Optometrists treat these conditions using vision therapy, or a course of guided eye exercises (think: "physical therapy for the eyes"), which can often successfully improve visual functioning, sometimes removing a need for corrective lenses.
Children, students, or adults with persisting or newly acquired difficulties with reading can often benefit from a full professional vision evaluation with an Optometrist qualified to evaluate for and prescribe vision therapy. While most reading difficulties are not due to vision issues, in cases where there ARE vision issues that go unnoticed and untreated, other types of interventions for reading difficulty (including tutoring for Developmental Dyslexia) will be far less effective. A full vision evaluation is thus a wise precaution, well worth the time and cost, in supporting those who find reading and other visual tasks challenging.
We went to the eye doctor, my student got glasses, and now, doesn't wear them... so how could vision possibly be the problem?
Vision difficulties can be subtle, and except in rare cases, those difficulties also emerge very, very gradually. Many times, persons with vision difficulty are unaware that their vision has deteriorated or has always been less than optimal. Vision correction is also sometimes subtle, and it can take some time for the full benefit to become apparent. Please note that vision problems will not always manifest as "blurring", eye pain, or headache: In fact, one of the most common manifestations of untreated vision difficulty while reading is poor concentration.
Therefore, if a qualified vision care professional has prescribed corrective lenses or vision therapy, PLEASE follow that professional's advice!!! If you or your student has questions or finds wearing glasses/contacts difficult for some reason, please contact the prescriber, without delay. Ignoring vision as a potential difficulty is unwise.
What is "Dyscalculia"?
Dyscalculia basically means "difficulty with arithmetic", in the same way that Dyslexia means "difficulty reading words." Dyscalculia can take several forms. Some affected persons have trouble learning math concepts and procedures: Arithmetic doesn't make sense, the steps of how to solve problems are easily forgotten, and working with numbers always seems like hard work. Others with dyscalculia have difficulty learning basic math facts (e.g., 4 + 5 = ?, 8 x 3 = ?) by rote, even when their memories for everything else seem just fine. Still others have trouble with spatial aspects of math, so geometry concepts, graphing, and even lining up columns of numbers are unusually challenging. To complicate things further, it is quite possible for one person to have more than one of these types of difficulty.
What is "Dysgraphia"?
Dysgraphia means "difficulty writing letters," but a much more useful definition comes from the work of University of Washington Professor Emeritus Virginia Berninger, PhD, who described Dysgraphia as a "disorder of language by hand". Individuals with dysgraphia have a very hard time learning to write letters correctly and fluently, despite apparently normally developing fine motor dexterity for other tasks. Occupational Therapy can often be helpful, for children who are struggling to learn handwriting skills. Spelling is usually very challenging as well. Even individuals with strong spoken language skills can struggle with putting thoughts on paper, when dysgraphia affects their writing process. Technology, such as voice recognition software and word processors, can be very helpful, and appropriate accommodations can ensure that the difficulty does not interfere with test performance or undermine motivation for written expression.
How can I get accommodations for an important test?
Under the American's with Disabilities Act (ADA), individuals with documented disabilities (including learning disabilities, ADHD, medical conditions affecting cognitive performance, certain emotional disorders, as well as physical disabilities) are entitled to appropriate accommodations on standardized tests, such as the ACT, SAT, GRE, MCAT, LSAT, and others. First, appropriate documentation of the disability that is recent, thorough, and prepared by a qualified professional is key. Next, each testing organization has specific procedures (typically found on their websites) for registration for an accommodated test. Registration for a test with accommodations must often be requested earlier than standard test registration. Also, to maintain fairness for all, testing organizations typically review all accommodation requests and accompanying documentation, and may or may not grant requested accommodations, according to the parameters they have established. Therefore, a diagnosis by a qualified health or mental health professional does not automatically qualify an individual for accommodations on a particular test, though having such a diagnosis is an important part of the qualification process.
Some thoughts about "IQ": It's not a magic number!
There are not many numbers based on test results that have been more over-interpreted or mis-applied than the so-called "Full-scale IQ" score provided by such tests as the Wechsler Intelligence Scale for Children, the Wechsler Adult Intelligence Scale, the Stanford-Binet Intelligence Scales, and other similar instruments. The original purpose of the earliest versions of these tests was to help identify children at risk for academic difficulty, so that intervention could be provided in a timely manner.
Unfortunately, many "myths" have emerged over time, myths that are inaccurate and often, potentially damaging. First, IQ is NOT a permanent characteristic of an individual, like eye color... in fact, IQ can and often does change over time, in response to educational opportunity, skill practice, sensory issues, maturation, environmental factors, emotional status, health, and many, many other factors. Next, IQ may or may not accurately reflect a person's potential for learning. How a child or adult may score on a given day at a particular time may vary notably with such factors as quality/quantity of sleep, health status, and the presence or absence of problems with attention and concentration. IQ can seriously underestimate ability in persons who have learning disabilities, ADHD, Autism Spectrum Disorders, a history of concussion injuries, or a host of other difficulties. Also, people of all ages can also have good or even excellent IQ scores, yet have significant challenges with social skills, emotional stability, or adaptive functioning, any of which can seriously limit functioning: So IQ may or may not predict an individual's potential for future success, even within the domain of higher education. Finally, IQ tests are limited in their scope, and there are many important forms of "giftedness" they do not measure. Specifically, IQ tests focus on those abilities most relevant to traditional education, such as verbal skills, logical reasoning, and to a lesser extent, visuospatial awareness. While those are certainly all useful and relevant skills, the fact remains that an individual can be truly "gifted" as a dancer, an artist, an athlete, or a musician, can have fabulous social skills, a remarkable capacity for empathy, or be inherently in touch with nature and able to effortlessly relate to animals, but none of these highly prized talents and gifts will be evident in an IQ score. Just saying... Don't put too much stock in one very limited number!!
What do all these test scores mean??
If you or your child has received testing at school or by a qualified professional in the community, you may see many types of numbers in the written report, and this can be quite confusing. Essentially, standardized tests use one or more different scoring systems, and some are more useful and easy to understand than others. Also, knowing which scoring system is being used can make all the difference to what any particular number in a test report actually means.
One type of test score many people have some familiarity with, but which nonetheless often causes confusion, is percentile scores. Because the numbers range from 1-99, many people misinterpret percentile scores, thinking they mean "percent correct": NOT SO! For example, 50% correct would not be a very good performance on a regular classroom test, but a score at the 50th percentile (%-ile) on a standardized test would actually mean a normal, average performance -- in other words, a score that is perfectly okay!
Then there is a set of scores known as standard scores. IQ is a standard score: 90-110 is typically considered "average", while scores below 90 are problematic and scores above 110 are strong. The further a score lies from the mean of 100, the more rare and unusual it is: For example, many, many people earn scores around 100 on IQ tests, but very few earn scores as high as 130 or as low as 70. However, IQ scores are often quite misleading, as they are calculated from a variety of subtests that often measure very different skills and abilities. For many, particularly those children and adolescents who are having trouble in school, performance on those subtests may be uneven, with normal abilities or even strengths in some areas and weaknesses in others. An IQ score HIDES both strengths and challenges, and can therefore be very misleading! My recommendation? Pay little or no attention to the IQ score! Look at the subtest scores instead! That's where the useful information lies.
The subtests of IQ and other test batteries often use a type of score called scaled scores. These scores range from 1-19, and an average or normal score would be 8-12 (with scores lower than 8 suggesting difficulty and scores higher than 12 suggesting areas of strength). As with standard scores, the further a score is from the mean of 10, the more unusual that score is.
A fourth type of scores often seen on school-related tests are grade equivalency scores. These are perhaps the least helpful and most often misunderstood scores around. Grade equivalency scores range from K (for Kindergarten) to as high as 16 (meaning "college senior"), and are an attempt to estimate where in the grade-level structure of a typical school a child's test performance would best fit. So for example, if a child halfway through grade 4 earns a grade equivalency score of 4-5 (4th grade, 5th month), that would indicate very average performance for his/her grade level. However, trouble comes when these scores get over-interpreted. Suppose that same 4th grade child earned a grade equivalency score of 6-8 (6th grade, 8th month) on a math test... does this mean she should be in a 6th grade classroom for math instruction??? Probably not... though this would be an experienced teacher's call. Although a 4th grader who scored that high is probably doing well in math, there may be a number of concepts and procedures she has not studied that most 6th grade children have, and she would likely struggle mightily in a 6th grade math class. What the score actually means is that she performed like a typical 6th grader on the 4th grade test material.
Yet another type of score is the T-score. These scores range from 20-90, with a mean of 50. Scores ranging from 45-55 are considered "normal", while scores below 40 or above 60 suggest unusual performance -- whether a high score suggests a problem or a strength may vary with the test instrument, however: Please ask the professional who administered the test for help with interpretation. You won't see T-scores very often on school-based tests, like achievement tests, but they are often used for personality and behavioral assessments.
There are also other types of scores that are used on standardized tests, and as the paragraphs above suggest, knowing how to understand the information they provide requires special knowledge and training. The bottom line here is "ASK": If a number makes no sense, ask the person who did the test to describe what it means, or consult a psychologist for interpretation.