Measuring intelligence at 3

[djtippietoes]

I just got back from my first IEP meeting for DS, about to turn 3. They had evaluated him a month or so ago and presented me with the findings and the plan. He already has an ASD diagnosis. He also potentially has some sort of yet-to-be diagnosed genetic syndrome.

I know he's behind developmentally, but it sort of shocked me that they scored him extremely low on intelligence. It was something like 3 deviations below the median. He has a major inability to attend to much at all, and they said that could be making it seem like he doesn't understand. Or he might actually not be able to understand.

I don't know where I'm going with this except that his intelligence has never been brought up as an issue before and I'm upset. Are these things correct for an almost 3, ASD kid? I know it shouldn't matter in the grand scheme of things, but it's hard to see.

[seadragon2013]

djtippietoes, our evaluation when DH was 3.5 gave us very similar results. His cognition scores were quite low, but it was also clear (and noted in the report) that his lack of ability to attend to and engage with the evaluator were getting in the way of finishing the tasks used to measure cognition. He is a pretty curious kid who seems to learn practical things quickly at home, so we were initially surprised and dismayed.

When the evaluators met with us to discuss the report, they warned us to take the cognition results with a grain of salt. Likely, we won't have a good idea of DS's cognitive abilities and potential for several years. Addressing his ability to engage and attend is the first order of business right now and will hopefully put him in a better position to learn in the future. I can already see him making huge strides with just three months of therapeutic preschool. I think we will have a much better idea of his cognitive abilities by the time he starts Kindie.

It's frustrating not to know, but for now I would avoid making any assumptions about your LO's future cognitive abilities based on the assessment. Instead, focus on addressing the issues that you suspect might be getting in the way of his ability to learn.

[brachysira]

Even for kids who do focus on the tests and are NT, iq test results tend to be unreliable until age 7 or so.

[djtippietoes]

Now that I went back and looked more closely, there are several things in there about how it might not be an accurate measurement because of his inability to attend. I feel like all I saw when they first presented it to me was the low intelligence.

[numbbears]

I remember something like that on DS's eval and they said what seadragon2013 and brachysira said. Sorry it took you by surprise. I always feel like I'm unprepared for reading evals.

[akafred]

DD is 7 and not ASD and her psychoeducational evaluator made it that we were looking at the floor only. She has ADHD and had a VERY hard time attending (she spent a fair portion of the test crawling under desks and hanging upside down) so the evaluator only pushed hard enough to establish that she was "near average" or "average" in all areas. In reality, she may be above average or even gifted in some areas, but it wasn't something a test is going to show at this time.

[mrsbuttinski]

Jan 9, 2017 17:01:39 GMT -5 djtippietoes said:

I just got back from my first IEP meeting for DS, about to turn 3. They had evaluated him a month or so ago and presented me with the findings and the plan. He already has an ASD diagnosis. He also potentially has some sort of yet-to-be diagnosed genetic syndrome.


Did they specifically use the term IQ or did they reference cognitive skills? Not the same thing. A simplistic way of looking at the difference is that IQ is "what you know" and cognition is "how you use what you know". A child whose cognitive skills are blunted but ASD, ADHD and/or specific LDs may seem less intelligent than their potential.


 It's pretty unusual for those doing evals to do an actual IQ test on a child that young as they are known to be less reliable under school age- specifically under age 4. WPPSI is normed to 2.6 years; did they use that? In some cases, a child whose ASD severely impacts their communication and language development will test higher if given a non-verbal IQ test rather than a language based version. 

If it was a WPPSI, did they give you subset scores? This tests, along with WISC for older kids/adults, is divided into domains that for a verbal IQ and a performance IQ which is averaged. These subset scores add a dimension to the average score. For most on spectrum, PIQ is significantly higher than VIQ, sometimes by a lot. Language based LDs can also blunt VIQ. If there is a large gap between the scores, the result is not considered valid. 


I know he's behind developmentally, but it sort of shocked me that they scored him extremely low on intelligence. It was something like 3 deviations below the median. He has a major inability to attend to much at all, and they said that could be making it seem like he doesn't understand. Or he might actually not be able to understand.


These things are always hard to read even if you think you know what the report is going to say. DS once scored in the 1/10th of 1% on social communication- I could not reconcile that with a child who was fully mainstreamed and active in scouts. I was devastated.


Assuming this really was a proper IQ test, average IQ is considered 100, though it has drifted up since it was last reset. 3 std deviations below that would be around 55-60 which is low enough to have a major impact on his education and adult independence. 


These things are something of a snapshot in time- reflective of your son's ability to demonstrate cognitive and intellectual reasoning on that particular day. A lot of things could have led to a poor result.


He could be severely language impaired and would be better tested using something like Ravens Matrices.

He could have an attentional or processing disorder that impacts his ability to sit such tests. In such a situation his IQ could be higher than captured, but the result could still be predicitive of his abilities to learn.

You could be seeing developmental immaturity. Kids on spectrum tend to have the social and emotional development of someone nearly 1/2 their chronological age. Your almost 3 may be wired more like an 18 month old and perform more at that level. DS's Aspergers gives him a delay in this area of about 1/4- 1/3 according to tests. I have found he has so far grown into the skills at his own rate. 

Another thing that can impact IQ testing is the concept of enrichment. Kids who have not had opportunities to be exposed to different people, other children, outings to new places will not test as well as kids who do. Given that some presentations of ASD come with severe sensory and behavioral issues, these kids may not have experienced as much as same aged peers. A child who is anxious or who "lives in his own world" will miss a lot of what is going on around them, too. 

Cobbling onto the above, kids with ASD seem to come in 2 versions. There are those who are into everything and those who have very little curiosity about their world. How rigorously you've had to baby-proof can give you some idea about what kind of kid your have. 

All that said, having ASD does increase the likelihood of intellectual impairment. Around the time DS was dxd, much was made of the distinction "high functioning" autism because it was thought 75% on spectrum had ID. More recent studies put the percentage at closer to 55% having an IQ <70.

www.ncbi.nlm.nih.gov/pubmed/21272389

I don't know where I'm going with this except that his intelligence has never been brought up as an issue before and I'm upset. Are these things correct for an almost 3, ASD kid?


I'm sorry you are upset. Like I said, it's pretty rare for a school district to do an actual IQ test on a preschooler- they take a lot of time relative to the reliability of the result. IME, educators and clinicians don't start talking IQ until 6+ so I am not surprised this is the first you've heard about the possibility of ID.

This may or may not be accurate. Time should bring some clarity. If he were 6 or 8, the result would be more reliable.


I know it shouldn't matter in the grand scheme of things, but it's hard to see.

I think it matters. IQ is one of the factors critical to outcome. See pages 11-20.


www.drcoplan.com/media/RethinkAutismWebinar.pdf

[djtippietoes]

mrsbuttinski, the term they used was intellectual functioning. They used the Mullen Scales of Early Learning. The results read "Performance on the MSEL suggest this his overall intellectual functioning is within the very low range for his age level. Due to his inconsistent joint attention, the results of the MSEL may be an underestimate of his current functioning."

He presents with a severe receptive language delay and a moderate expressive one. I personally think that's unusual, as I usually hear of children who have more trouble with expressive than receptive. However, it is quite similar to how I learn (or tried to learn) a foreign language. I could speak Spanish much much better than I could understand it.

I had to baby proof the hell out of my house. He has a lot of curiosity and will inevitably find the one thing in the room that I don't want him to touch. He does not particularly "live in his own world" per se, but he is quite anxious and upsets fairly easily (though not to meltdown level.)

[mrsbuttinski]

Jan 10, 2017 7:19:46 GMT -5 djtippietoes said:

mrsbuttinski , the term they used was intellectual functioning. They used the Mullen Scales of Early Learning. The results read "Performance on the MSEL suggest this his overall intellectual functioning is within the very low range for his age level. Due to his inconsistent joint attention, the results of the MSEL may be an underestimate of his current functioning."


So, not IQ. MSEL is a broader test of cognitive ability and motor development. It's quick (25 minutes) as opposed to some of the others which is more suited to the age. 

He presents with a severe receptive language delay and a moderate expressive one. I personally think that's unusual, as I usually hear of children who have more trouble with expressive than receptive. However, it is quite similar to how I learn (or tried to learn) a foreign language. I could speak Spanish much much better than I could understand it.

Expressive language delays are more common, but it could some of his speech is echolalia or scripted. 

I had to baby proof the hell out of my house. He has a lot of curiosity and will inevitably find the one thing in the room that I don't want him to touch. He does not particularly "live in his own world" per se, but he is quite anxious and upsets fairly easily (though not to meltdown level.)

[theycallmemommy]

Not sure how relevant this really is to your topic, but at right at age 4 my son was in the 4th percentile for receptive and the 12th for expressive. However he used only nouns from about 2-3 and mostly Echolalic or used repetitively taught phrases until 5.5 years.

He is 6.5 years and is talking in very long, spontaneous, more appropriate and descriptive wording now (like uses proper words for things and less generalizing)

One win recently is that he started talking in first person!!! His pronoun reversal confuses the hell out of people--he is super awkwardly social. He loves people. He still says "what my name is?" Instead of what is your name. People then try to guess as I try to decide if it's worth intervening in the convo.

I think that it is too early to know exactly what your son's deficits are in the long run. Mrsbuttinski brought up a lot of reasons why he may have not shown as well to the evaluators. I wish I had advice as to how to react, but I myself remember seeing that 4th percentile on the paper and losing so much hope that day. I have come around but there were days and are days that I focus too much on what he can't do.

There is one more thing I want to mention. My DS got his ASD dx right before he was 5. Process took almost a year start to finish and he'd already been in private speech and ot for two years.

I asked the guy that dx'd him when we would need to come back and he said three years! I was shocked. Next thing I asked is what he saw for my son's future and he said no one can tell you that (typical response I know) but he said that age 8 is more of an indication of later on than the age he was. He said he was confident that my son was high functioning even though his verbal skills were behind. One thing that complicates people's reaction to my son is that he wasn't potty trained until 5 but he was reading before age 3 and had number recognition (double digit) before age 2. The doctor was leaning more toward these things being splinter skills but insisted that he felt he was still cognitively average.

His new speech therapist thinks he should be seen yearly, but I am unsure of what else we could possibly find out. She gave me the side eye but honestly I am a teacher and asked all the special ed distrct administration and the autism teachers themselves who I should see and this was the guy.

Anyway, I just wanted to offer creepy Internet hugs and let you know others have had similar experiences.

[mrsbuttinski]

Jan 10, 2017 22:42:31 GMT -5 theycallmemommy said:

Not sure how relevant this really is to your topic, but at right at age 4 my son was in the 4th percentile for receptive and the 12th for expressive. However he used only nouns from about 2-3 and mostly Echolalic or used repetitively taught phrases until 5.5 years.

He is 6.5 years and is talking in very long, spontaneous, more appropriate and descriptive wording now (like uses proper words for things and less generalizing)


Funny how different kids on spectrum can be. My kid's speech had a really extensive and precise vocab from very early on. I recall him pointing to a bolt of fabric and saying "look at the funny monkey wearing a fez" a four. Most fours would have said hat; mine knew fez and used it appropriately. 

One win recently is that he started talking in first person!!! His pronoun reversal confuses the hell out of people--he is super awkwardly social. He loves people. He still says "what my name is?" Instead of what is your name. People then try to guess as I try to decide if it's worth intervening in the convo.


OMG. That's a trip down memory lane. Mine was about seven when his me/you reversal finally resolved. He also reversed ask/tell which really confused people- I remember him wanting his friend Zach to come over and saying to his mom "Tell my mama if Zack can come over." as if it was an order. DS also had a different take on warmer/cooler. If the bath was too hot, he ask me to make it "warmer" which is more logical and precise. To him it meant "more warm/less hot to me it meant "hotter". 

Is it MGW who described kids with Aspergers as curiously social and socially curious? 


I asked the guy that dx'd him when we would need to come back and he said three years! I was shocked. Next thing I asked is what he saw for my son's future and he said no one can tell you that (typical response I know) but he said that age 8 is more of an indication of later on than the age he was. He said he was confident that my son was high functioning even though his verbal skills were behind. One thing that complicates people's reaction to my son is that he wasn't potty trained until 5 but he was reading before age 3 and had number recognition (double digit) before age 2. The doctor was leaning more toward these things being splinter skills but insisted that he felt he was still cognitively average.


We had a slightly different experience. Because of DS's crazy early speech and some other parlor tricks, both his dev pedi and psychologist were surprised that his IQ isn't higher than it is. He was late to read because of dyslexia, but hit all his adaptive skills (like toileting, dressing, etc) milestones within the usual range. His VIQ is supressed by dyslexia and his PIQ by Aspergers. He's been tested before remediation and after, with medication and without, by someone who got him and a stranger over the years and the results are weirdly consistent.


A lot of the delays I see are related to social and emotional immaturity; maybe even immaturity in brain development. If I correct his age based on the Vineland (he's got about a 25% delay in socio-emotional age), he does most things "on time". Like math facts. We drilled and drilled for several years, and then one day they were just there. Same with driving, we took a stab at it two different summers and then on the third he just nailed it and passed on his first try.


DS's dev pedi saw him yearly at first and then every couple years. He did suggest that DS would have a pretty good outcome even early on. It has been pretty close to what the doctor predicted. 

His new speech therapist thinks he should be seen yearly, but I am unsure of what else we could possibly find out. She gave me the side eye but honestly I am a teacher and asked all the special ed distrct administration and the autism teachers themselves who I should see and this was the guy.

Anyway, I just wanted to offer creepy Internet hugs and let you know others have had similar experiences.

[djtippietoes]

If I'm being honest, the thing that worries me is that DS doesn't really have any areas that he excels in. So it's not like though he can't talk, he was doing X since he was a baby, whatever X may be. He wasn't. He has a global developmental delay in the true sense of the term. So it does make me question his intelligence, especially when it is presented to me as something that could be very low. That said, he's a very curious child, so there's that. He's interested in things, though his interest is usually fleeting.