We got Kitty’s neuropsych feedback on Friday. The official report will come in later in the week, but I wanted to share this information from my notes immediately so we can help Kitty.
Probably the most significant test results came from the WISC, which were confirmed throughout the testing. Kitty’s Perceptual Reasoning (non-verbal) and Reasoning (verbal) were average and almost average (PR- 90 and R- 87). I believe this is consistent with what we’ve seen from Kitty academically and in discussing things with her. Given time she is capable of “getting it.” The time is the key word there though. Kitty’s WORKING MEMORY was low borderline (WM- 71), but even that she could overcome. What causes the issues for Kitty is the PROCESSING SPEED (PS- 65), which is in the mentally retarded range, and appears to be where many of her issues are coming from.
WHAT THIS MEANS: Kitty will have great difficulty with immediate recall. When GIVEN TIME she can usually figure out a problem. Doing math “in her head” would be a LOT more challenging for Kitty than other children. Things like remembering phone numbers is difficult. She has great difficulty with organization and needs things BROKEN DOWN INTO LESS OVERWHELMING STEPS that are given to her in small CHUNKS. TIME CONSTRAINTS MAKE TASKS TOO CHALLENGING. She needs smaller amounts of work, because it takes her longer. Things like Modified TAKS and administering tests in a one on one situation (so she has more time and doesn’t have the pressure of seeing other’s finish before she does).
ATTENTION – Visual Kitty’s attention meds appear to be working well. Her errors in the visual area were mostly impulsive errors and seemed to be more processing issues than an attention issue.
ATTENTION- Auditory This was the area Kitty had significant trouble in. Under quiet, structured conditions she did well, BUT… when distractions and noise were added her processing issues becaume extreme.
WHAT THIS MEANS: Kitty needs a SMALL, QUIET, structured environment, with frequent, regular eye contact from the instructor, with lots of one on one “checking in” to help her stay focused, on task and “getting it.”
EXECUTIVE FUNCTIONING SKILLS: Kitty had ELEVATED DIFFICULTY. This is things like impulsivity, transitions, organization, planning, self-monitoring, changing plans and how to approach things (ex. she needs someone else to redirect her if it’s not working or to help her think of different approaches if her chosen method of execution isn’t working).
COGNITIVE FLEXIBILITY: Low Average. She has difficulty shifting gears and looking at things in a different way.
WHAT THIS MEANS: Kitty needs lots of assistance with getting organized and planning, making transitions, redirecting her as needed and helping her improve her self-monitoring.
MEMORY: Kitty LEARNS BEST: AUDITORY
Hearing: Short Term: 97(average) Long-term: 102 (average)
Visual: Short Term: 76 (below average) Long-term: 75 (below average)
WHAT THIS MEANS: Reading books and reviewing notes is tough for her. She’s not going to learn well this way. She needs AUDIO RECORDINGS of lectures and books.
LANGUAGE: The Neuropsychologist believes that Kitty’s lower scores on this were more due to her processing issues because the test was timed than language issues.
WHAT THIS MEANS: Kitty need work broken down into chunks, small tasks given to her slowly, instead of overwhelming lists.
EMOTIONS: Kitty self-reported almost no problems in anything but somatic issues and slight depression. Mom reported her as having great difficulty in many other areas.
When Kitty was tested with more open ended tests (like telling stories about pictures, finishing sentences), her results were full of LOSS (leaving, dying, abandonment), contributing to feelings of sadness and anxiety. Even neutral prompts became about family/ attachment issues.
School/ Social – Kitty feels safe and secure at school. One reason she appears to be afraid of the Special School is because she is afraid it she will not be safe. During the feedback discussion with the neuropsychologist and Mom, Kitty understood that because of her issues with processing and noise that the Special School might be helpful in achieving her goal of getting through school without going back to the hospital and going to college. While all agreed that a school with a therapeutic component would be the most beneficial, until that becomes an option, she was willing to try the Special School to see if she could feel safe there. All agreed that adding a school counselor to Kitty’s therapeutic team was not in her best interest at this time.
WHAT THIS MEANS: Kitty is having a very hard time handling and coping with the feelings that she does express in this test. She appears to be have issues with recognition/ awareness of her emotions. School needs to have a THERAPEUTIC COMPONENT. She needs to have a QUIET, place to go when she is upset. Classrooms need to be small and quiet.