VIQ > PIQ is not always the case with NLD patients

The Wechsler Intelligence Scale for Children (WISC) is an intelligence test developed for children between the ages of 6 16. The creator of this test is David Wechsler and the test can be completed without reading or writing. Usually it takes from 48 to 65 minutes to complete this test and it’s important to note that the test is being updated regularly. The point of the WISC is to give a complete IQ score for the individual. The test uses 5 primary index scores in order to show the individual what his Verbal IQ (VIQ) and Performance IQ (PIQ) score is.

There are few different tests in the WISC all depending on the age of the child that is being tested. The WISC is divided into several subgroups, which cover a couple of subtests. The most important subgroups are the Verbal Comprehension index (VCI), Processing Speed index (PSI), Working Memory index (WMI) and Perceptual Reasoning index (PRI). The subtests in these indexes all have equal weight towards the Full Scale IQ. In other words, children need to do all of the subtests in order to find out both their VIQ and PIQ scores.

The WISC is not limited to being an intelligence test only as it has uses in the clinical field too. Practitioners use it to diagnose ADHD and other learning disabilities. However, this test has lots of subtests and in some of those tests children with learning disabilities usually show scores that are similar to other children, which show that WISC is not really an effective way to spot that the child has a certain disability.

This test is regularly used on children that possibly have NLD because it is able to show the fluctuation between their Verbal IQ and Performance IQ. To be more precise if the child’s VIQ is unusually higher than his PIQ the child is usually diagnosed with NLD. But sometimes the results are wrong, sometimes the VIQ and PIQ drop down to an equal level. Does that mean that the person suffering from NLD is somehow cured? Of course not, that would be absurd.

The exact same thing mentioned happened to our daughter when she was diagnosed with NLD. We did continuous WISC’s through the years and suddenly after 7 years her VIQ > PIQ dropped down to an equal level. Her diagnosis was done by a qualified neuropsychologist so things just weren’t adding up.

I tried to find the reason behind this so I started looking at some of the subtest scores. I was amazed to find out that arithmetic and comprehension each dropped by 5 points. On the other hand the other verbal scores were pretty much the same with earlier results. One more subtest which needs to be noted is a little drop in picture arrangement which falls on the side of the Performance IQ.

With age the WISC tests become much more difficult in order to check if the child has made improvements in some areas. Lower scores in comprehension, picture arrangement and arithmetic subtests are supposed to be normal since they are related to social skills and math, skills that a child diagnosed with NLD has a problem grasping.

However, this brings us to a dilemma. According to professionals the VIQ>PIQ is constant and even continues with time. The VIQ is also supposed to increase as the child gets older. But when the NLD child is put in a proper learning environment, it is able to function as a normal child. Even though it takes him more time the child can still learn how to study and socialize properly. With time his PIQ should grow higher and eventually equal his VIQ.

I had no answer to my dilemma until I was finally able to ask this question to Dr. Byron Rourke a most profound neuropsychologist who has dedicated his life researching NLD and even publishing some works on the subject. So I asked him the question that was troubling me and that is “Is the VIQ > PIQ everlasting or is it subjected to change”. The answer I got was most inspiring as I have been thinking the same thing. According to him the VIQ >PIQ profile is very common with NLD patients, however, it might not be always present because with time the VIQ is getting suppressed by the PIQ, to be more precise by the comprehension and arithmetic subtest scores.

So what is exactly the point of this article? NLD as a disorder is being more recognized and more information about it is starting to appear. Works are being published; lots of articles are being written and are starting to appear in educational trade journals and etc. Teachers are also being taught on how to handle an NLD child if they ever come in contact with one. Simple stuff like that, they should split his work into few parts so it is easier for the NLD child to learn them, often praising him on the work he has done. A little motivation goes a long way because NLD children are socially impaired. Parents are also getting educated on how to treat their NLD child. Trying to connect his school and home environment, talking with the child when he does something he is not supposed to instead of scolding him because that will just make him fear the parent and bring forth additional social trauma.

To summarize and to answer the question that was asked before, if experts tend to believe that VIQ > PIQ equals NLD then they shouldn’t be called experts at all. My daughter’s VIQ and PIQ scores equalized after some years, but that doesn’t mean that she is now cured from the NLD. The subtests of the WISC must never be ignored because if we just look at the average scores we would have lots of wrongly diagnosed children. In addition, it is important to add that WISC results serve their purpose, but they can’t replace a full neuropsychological evaluation and the diagnosis which is a result of that evaluation.

















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