As a Developmental and Behavioral Pediatrician, I saw many patients with learning disabilities. The school psychologist and the neuropsychological testing that they did was vital in making the initial diagnosis. It was just as important in following the progress that the child made over the years.
The school rules required retesting every three years. Some of the tests we expected to remain consistent. For example, basic intelligence (tested by IQ testing) tended to be constant. We could expect pretty much the same results every time the testing was done.
If a child was tested at age 7 years, then the expectation was that he/she would perform at a 7 year level. If the performance was 100 percent of expected, then the score would be 100. Average range of intelligence runs between 90 percent of expected and 110 percent of expected. Thus, IQ scores of 90 to 110 are considered average. That average range takes in about 64 percent of the total population.
Those with scores of 70 to 90 are considered below average but normal. Those with scores of 110-130 are considered above average but normal. Together they make up an additional 32 percent of the population.
Those with scores above 130 fall into the gifted range. They represent the top 2 percent of the population. Those with scores of 70 or below (70 percent of expected) fall into what is termed intellectually disabled. They too make up 2 percent of the population.
If a 7 year old is tested three years later at 10 years of age, there are certain expectations. Since basic intelligence does not change with time, they would be expected to have the same score. Those who performed at 100 percent of what was expected for a seven-year-old should perform at 100 percent of what is expected for a ten-year-old three years later.
That test gives us the individual’s capacity for learning. The other tests then look at various areas of learning. These include reading. They include math. They include writing skills. The expectation is that their scores in all of these areas will match their cognitive ability score.
If they have an overall ability score of 100 percent of expectations, their performance in learning skills should also be at about 100 percent of expectations.
When there is a mismatch, it means that there is a learning disorder in the area that is below their overall ability.
The school psychologists have the capability of testing major subjects. If there is a discrepancy in a major area, they can then do further testing of the skills that make up that major area. That allows us to hone in on the area of disability.
Once that is discovered, a learning plan can be put in place. Then three years later testing is redone. If the learning plan is working well, the discrepancy should be less than it originally was.
Thus neuropsychiatric testing is a necessity to fine tune both the diagnosis and the treatment in children with learning problems.