I teach SH students at a middle school. One of my students has cerebral palsy and globally functioning academically between K and 2nd grade. APE is about 6 years and delayed in speech (13 year old student). However his WISC indicated average to low average intelligence. He has not made academic progress for several years and continues to function at 2nd grade now for the last 4-5 years. He is certified OI and Speech and Language. It doesn’t add up. What to do?

Sharon Eilts
Special Education Teacher
Columbia Middle School
Sunnyvale School District

Answer:

Dear Sharon,

We see this type of “puzzle” frequently in students we evaluate at the Diagnostic Center. This sort of child almost always needs a multidisciplinary team to sit down and put their heads together. It would be a good idea to talk with his IEP team including his parents. Having an overall picture of this child is functioning levels is particularly important now at age 13 when he presumably will be entering high school and when transitional planning for high school and adult life will soon be needed.

Additional information might be sought from his family and, if he is a client, the Regional Center. It is important to know how he functions at home, whether his interests and friendships are age appropriate. Does he participate in extra-curricular activities? Are these activities modified for him? When was his cognitive testing done? Test results can change as a child matures. It is important that they be relatively recent.

Assessors put together a “profile”, sort of like a jigsaw puzzle, of where a child is functioning by standardized tests and how family and educators see him as functioning in different environments.

The tests used to assess him must be appropriate for his particular orthopedic handicaps, i.e. one should not use cognitive tests that employ motor tasks that he cannot do because of his cerebral palsy. You and your team should make sure that he has adequate vision and hearing and overall health. It is important to ask his parents if he has a history of other neurological difficulties such as seizures or hydrocephalus (increased size of the fluid filled openings in the center of the brain) that could affect his cognitive skills over time.

We find that a careful assessment of a student’s overall strengths and weaknesses including social maturity, speech and language, cognitive processing and retrieval usually leads to a more complete view of why this student is not making academic or speech progress despite measured “average to low average” cognitive abilities.

Often psychologists are able to put the final piece together with their knowledge of what the various assessment tools are really looking at. A child may be low average in three or four skill areas but the combination can lead to overall functioning being much more impaired.

I hope that this is helpful. Let me know, if you would, the outcome of your investigations.

Kay S. Browne MD
Behavioral Pediatrician