The diagnosis of Nicole, part 2 (the results)
We met with the pediatric neuropsychologist (Dr. Julien Smith) to receive the results of her evaluation last Tuesday (4/22). Dr. Smith said that she would send the full report sometime in the next two weeks, so what I’m sharing here is from my memory and may not be complete. I literally did not even write anything down.
Nicole’s IQ score came in at 99 which is average. Her achievement score was also average. That means that she has no intellectual disability and that so far she has learned the academic things that a typical child her age has learned.
The areas that showed impairment are primarily in language, particularly comprehension and working memory. Dr. Smith said that Nicole is only comprehending part of what is being said. Nicole may only understand a word or two out of a sentence and then guess at the meaning of the entire sentence. In addition, Nicole has a hard time keeping all the information in her head as she’s working with it. For example, Nicole struggles with blending sounds to form words. She has good knowledge of the sounds associated with letters, but has difficulty keeping all the sounds of a word in her head long enough to make an actual word out of them. Nicole also has a comparatively smaller vocabulary and a really difficult time describing the meaning of words. Nicole is completely unable to retell a story . She even has a difficult time telling about things that happened to her or things that she has done. Dr. Smith shared an analogy to describe Nicole’s brain. She said Nicole’s brain is like a library of books, but instead of the books being organized neatly on a shelf, they’re scattered all over the floor. So she may have the information in her head, but have difficulty accessing it and using it. Although Dr. Smith felt that Nicole was medicated appropriately (Nicole takes medication for the inattentive type of ADHD), Nicole had trouble staying focused on a task for an appropriate amount of time. There were a few tasks where Nicole was asked to study a picture and then recreate the picture and Nicole did not take the time to carefully examine the picture. She’d look at it and then tap it to indicate that she was ready.
Dr. Smith also told us that Nicole falls on the Autism Spectrum. The new DSM5 diagnostic criteria has eliminated terms like Aspergers and PDD and combined them all into the classification of Autism Spectrum Disorder with a severity rating. Nicole would be considered a level 1 which means she has a mild form of Autism and falls into the “high functioning” part of the spectrum. Dr. Smith emphasised that while Nicole falls on the Autism spectrum, the language impairments are more significant and require more intervention than the Autism classification. I will write more on the topic of Nicole’s symptoms of Autism in a separate post.