Case Study 1
By Dr Melanie Adkins, Educational Psychologist
Brief Summary: The WISC®-VUK was used to measure the academic achievements and wider experience of David, a 12-year old child, who had sustained a brain injury in the past, following concerns by school staff that his skills had worsened.
David is a boy of 12 years and 6 months. He attends a mainstream secondary school for boys. David was referred to the Educational Psychology Service to explore the nature of some processing and physical difficulties observed by school staff.
David had a brain injury in the past and school staff were concerned that David’s skills had worsened recently. Staff were particularly concerned about David’s memory skills, fine and gross motor skills, and slow processing.
David is no longer under the specialist care team so school staff feel a responsibility to keep up to date with the nature of David’s difficulties and the impact of these on David’s academic achievements and wider experience of school.
When negotiating my role and ensuring the clarity of the function of my work, I suggested that any assessment work completed could also function as a baseline measure against which future progress could be measured.
I decided that my involvement would involve observations in several different curriculum areas, consultation with David and staff who had noticed the changes in David’s skills, and standardised assessment. I wanted to include consultations with parents to consider David’s behaviour and any changes noticed at home but I decided that the best time for this would be once the school-based work had been completed. We could then compare what had been noted and assessed at school to observations about home.
When considering an appropriate standardised assessment, the WISC-VUK felt entirely appropriate. The WISC-VUK with its new five models of interpretation offered me the possibility of exploring my hypothesis about changes to certain aspects of cognitive functioning without requiring David to complete subtests unnecessarily. Due to the nature of David’s difficulties it is essential not to put him through excessive testing sessions. This is one of the ethical considerations when working as an Educational Psychologist with students who have difficulties such as David’s.
Based on current Cognitive Neuroscientific and Neurodevelopmental conclusions about brain functioning, the new WISC-VUK assessment emphasises structural models of intelligence. The new structure acknowledges the separation and different functions of Fluid Reasoning and Visual Spatial Skills, as well as Processing Speed. The updated assessment presents these components as distinguishable aspects involved in problem solving. Assessment of individual discrete components is essential to be able to draw conclusions about David’s difficulties and to make recommendations as to appropriate ways to support him with these aspects. The WISC-VUK has also been developed to be used to test hypotheses about neuropsychological processing deficits. This makes the standardisation procedures appropriate for my assessment.
In addition to observations and consultations, I completed the subtests within the Visual Spatial, Fluid Reasoning and Processing Speed Scales. The five-factor model of interpretation allowed me to pinpoint the nature of David’s difficulties in the area of processing speed rather than the other areas assessed. David gained composite standard scores of 100 (95% Confidence Level (CL) 82-108 and 93-107 respectively, 50th percentile) for Visual Spatial skills and Fluid Reasoning.
I compared observations of David in his lessons with his ability to analyse and synthesise information, quantitative reasoning and induction, visual information processing and abstract reasoning skills measured in the subtests. Analysis of the scores within individual subtests provides further detailed information on David’s strengths and areas for development within these discrete areas.
The standardised assessment of David’s processing speed indicates that he has a difficulty within this area (composite score of 69, 95% Confidence Level 64-82, 2nd percentile). Once again, analysis of the individual subtests provides detailed information on the specific areas of strength and difficulty. David’s score for processing speed meets the criteria for reasonable adjustments to be made in normal working practice in the classroom and for formal assessments. The evidence from this standardised assessment can be used to support this application.
Although I do not have access to any standardised assessment that have been completed with David previously, this evidence is in-line with observations of David’s processing speed in the school environment. This assessment can be used to make future comparisons regarding David’s progress in the areas of processing speed, visual spatial and non-verbal fluid reasoning.
Case Study 2
By Dr Melanie Adkins, Educational Psychologist
Brief Summary: Anhar is a Year 4 child with refugee status and a diagnosis of Fragile X Syndrome. Dr Adkins felt that the non-verbal components of the WISC®-VUK would be appropriate in order to consider Anhar's needs and level of understanding without the unnecessary strain of the verbal scales.
Anhar is a Year 4 student who arrived at a mainstream primary school with refugee status. He is one of eight siblings, the majority of which are in one Primary School.
I was originally asked to complete an assessment of Anhar's special educational needs to make an urgent request for an assessment for an EHCP. Anhar has a diagnosis of Fragile X Syndrome and is accessing his education full-time via a small provision within the school with high staff-pupil ratio. The environment is specialist in terms of a mainstream school and caters for children with a variety of needs between Reception and Year 6.
Anhar does not have a high degree of English and completed a home language assessment at my request. When I negotiated the work, I was clear to outline the needs of the pupil and school, and the ethical considerations I abide by when completing work in schools. I discussed the importance of the home language assessment and the role of observation across different sessions to be completed. I planned this prior to any standardised work being completed with Anhar.
As a consequence of the inclusion of 13 special groups in the standardisation of the new WISC-VUK, I felt confident that I could use the non-verbal components in order to consider Anhar's needs and level of understanding without the unnecessary strain of the verbal scales.
The home language assessment provided insight into Anhar's speech, language and communication needs. The standardisation includes assessment of a group of young people with English as an Additional Language (EAL). Anhar is developing his knowledge and experience of English since joining school last year.
The completion of the Visual Spatial, Fluid Reasoning and Processing Speed scales provided detailed information that could be compared to the observations and conclusions made following consultations with Anhar and those who know him best at this time.
The development of the new WISC-VUK has enhanced clinical utility. Practical considerations around the language used in instructions and answers has been modified according to the needs of younger groups of children than those for whom the assessment is designed. This process of evaluation is important in helping me to feel confident that the level of language required to access the non-verbal subtests is appropriate for Anhar and will not cause him any undue stress.
I also found that the modified discontinuation rules also support any conclusions around appropriateness for Anhar. The pace of the standardised assessment was fast and maintained Anhar's attention for the duration of the tasks completed.
At the end of the assessment session, I felt confident that I had gained an appropriate picture of Anhar's strengths and areas for development following the completion of the whole process. Completion of the standardised assessment also provides a baseline against which Anhar's future progress and attainment can be measured and evaluated.
Case Study 3
An Application of the WISC-VUK
By Richard Pierson, Associate Fellow of the BPS and Chartered Psychologist.
Brief Summary: Charlie is a 10-year old boy who had been having problems at home and school with frequent temper tantrums. He was regarded as unperforming at school. Richard Pierson used the WISC-VUK and the WRMT to provide a realistic view of his abilities so that his parents and teachers could modify their expectations.
Charlie (not his real name) is a 10-year-old boy who had been a problem at home for a while, with frequent temper tantrums and refusals to co-operate with his parents. Things weren't much better at school and his parents had been called in to see the head on several occasions. Whilst expressing himself well and joining in with adult conversations, Charlie was regarded as under-performing at school: his standard of work across the curriculum was seriously below his teacher's expectations. He did not appear to be putting much effort into his work and was not completing set tasks. He had become increasingly disruptive, pushing the boundaries to the point at which his teacher was starting to feel threatened. Everyone wanted the best for Charlie, apart from Charlie, who appeared unwilling to keep to his side of the deal.
Charlie lives with his mum and a 20-year-old sister, Anna. Mum works in insurance and has been separated from Charlie’s dad, a lawyer, for over eight years. Charlie spends alternate weekends with Dad and his new partner. He said he gets on well with Dad, who treats him well on their weekend visits, but gets cross with mum, with whom he spends most of his time. He told me he didn't want to be like this but he, ‘Just gets cross.’
I decided to use a range of assessments over a couple of sessions, including parts of the Woodcock Reading Mastery Test (WRMT) and the newly published Wechsler Intelligence Scale for Children – Fifth UK Edition (WISC-VUK).
Despite ominous warnings from teachers before the sessions, Charlie was actually very co-operative throughout. He tried his best on all the tasks and gave considered, thoughtful replies to all my questions. He spoke freely about life in and outside school and regarded the WISC-VUK session particularly as a positive experience. I'd like to think this was down to my magnetic personality, but he really engaged with the test materials and seemed to enjoy switching between the various tasks within the new WISC-VUK. He reported that the tasks were, ‘Not like school work,’ which I guess contributed to his enthusiasm for the process.
We used the subtests in the suggested order, starting with Block Design and working through to Symbol Search. As issues had been raised concerning numeracy I also planned to include Letter Number Sequencing and Arithmetic. In the event I also had to do Cancellation as a substitute for Coding as Charlie was interrupted during the latter – one of the pitfalls of testing in a school setting I'm afraid!
Charlie obviously enjoyed the Block Design and Cancellation subtests. Whilst he obviously found some subtests difficult (not necessarily those in which he didn't excel), he appeared to engage with them and was not dispirited.
The WISC-VUK Record Form is easy to use, and with the substitutions I was able to complete the Full Scale and Primary Index Scales. The Composite Score profile gave a good graphic depiction of the results.
For Charlie the findings were interesting: his Verbal Comprehension score was broadly average, whereas his Visual Spatial, Fluid Reasoning, Working Memory and Processing Speed scores were all low average. My hypothesis was that because Charlie spent most of his time with adults he came across as strong verbally. This raised unrealistic expectations both in school and at home as to his general ability. As Charlie was unable to achieve these, his teachers thought he wasn't trying and his parents were disappointed. A destructive cycle of behaviour was started, which can hopefully be ameliorated with revised expectations.
So what became of Charlie further down the line? One of the problems with working as a freelance is that you don't always get the opportunity to find out how things have progressed, unless there's a problem. In this case I was fortunate as I met the parents when visiting the school some five months later on another matter and was able to enquire about Charlie. It would be great to report that there had been an overnight transformation, but we're dealing with reality here.
Charlie's teacher had modified her expectations of Charlie and was allowing extra time to complete work in class, as well as making instructions very plain and clear. There had been some improvement in Charlie's behaviour in school and he appeared happier about this. Things at home were also on a better footing, though progress was less marked and Charlie was still undergoing anger management counselling.
Richard Pierson is a freelance psychologist based in Yorkshire. He primarily works in schools and is an Associate Fellow of the BPS and Chartered Psychologist.