My Psychological and Developmental History
Page 1 of 1 [ 3 posts ]
10 Jul 2005, 1:14 am
I have been looking over some papers for things I have been diagnosed with over the years, and it is interesting. The first diagnosis is dated October 22, 1991, by the Special School District of St. Louis County; the diagnosis was simply "learning disabled."
Special School District wrote:
The following is a description of the information used as the basis for the proposed action: difficulty with sight vocabulary, phonic skills in reading; difficulty with applied math; behavioral concerns; fine-motor concerns
Other actions proposed were: time-out for misbehaving; praise; involvement in groups; modifications to provide oral responses; one-on-one instruction
Reasons they were rejected: continued concerns
Other actions proposed were: time-out for misbehaving; praise; involvement in groups; modifications to provide oral responses; one-on-one instruction
Reasons they were rejected: continued concerns
It is true I had trouble learning how to tie my shoes, using scissors (usually right-handed scissors when I was left handed!), and learning how to ride a bike; it is also true that I had trouble learning how to read and had some difficulty with mathematics for years. The Special School District assessment was mainly to get me into after-school reading instruction, in-school extra phonics lessons, and summer school after first grade (which was completely worthless). I remember having an insight learning how to figure out if two words rhymed by seeing if they ended with the same letters!
When I was in third grade in the spring of 1994, a clinical psychologist made some diagnoses of his own: overanxious disorder of the child (ICD-9-CM 313.00), undifferentiated attention-deficit disorder (314.00), and neurologically-based specific learning disability impacting on written language (ICD-9-CM 315.90).
Psychologist wrote:
On national achievement testing in September of 1993 his reading skills fell at the 92nd percentile, his language skills at the 70th percentile, and his math at the 57th percentile. He responds well to teachers. He is reported to be uncoordinated for both fine and gross motor activities. He has problems with tardiness due to a ritual he goes through before he is ready to leave the house. He is not a behavioral problem in the classroom or playground. He tends to stand back and observe others. He often has difficulty following through on instructions, is disorganized, forgetful, and loses things necessary for tasks. He often fidgets and squirms, and will blurt out answers. However, he does his homework quickly and efficiently.
[Néant Humain] does not make friends easily and tends to be a follower. He can be excitable, easily upset and tends to have intense emtional reactions. He has difficulty fitting in. He is sensitive and made fun of by his peers. He is easily frustrated, has a history of temper tantrums, and can be destructive. Complaints of headaches and leg pains were reported. Overall, his mother estimates he acts like a six year old.
[...]
[He] was described as a good, cuddly infant. He began to walk at nine months, but his language was somewhat delayed. There was a history of speech difficulties, but no difficulties with unusual language patterns or walking on his toes. He tends to talk too quickly and doesn't make eye contact easily. The listener always needs to probe further to clarify his message. [...] He attended preschool with some problems with aggressiveness. [His mother] described [him] as being independent, aggressive, destructive, curious, shy, distrustful, defiant, uncoordinated and easily frustrated as a preschooler.
[...]
Review of Prior Evaluation: [He] was evaluated by the Special School District of St. Louis County in October of 1991, due to academic and behavioral concerns. On the Weschler Intelligence Scale for Children - Revised he scored in the average to high average range. Visual-perceptual-motor and attentional deficits were noted. Academically, he was found to be learning disabled.
Behavioral Observation: [He] is a handsome (umm), 9-year-6-month old, white male who wore glasses. He was attractively (double umm) attired, well groomed, and appeared his stated age. He separated from his mother with ease and accompanied the evaluator. His initial compliance to the testing was good and he took his seat without problems. His in seat behavior was marked by frequent restlessness and fidgetiness. His task focus and attention span were adequate for his age in the one-to-one evaluation setting. He attempted all tasks that were presented, but his tolerance for frustration was low, limiting his ability to persevere. His response style was usually reflective. He would frequently repeat questions and directions to himself and talk himself through the tasks. [...]
[His] fine and gross motor skills appeared to be within normal limits. These unusual symptoms of visual-perceptual-motor integration dysfunction were noted: spatial relationship confusion, drawing clockwise circles, and difficulties with angulation. A left-handed preference was noted to have developed with a very awkward pencil grasp. [He] made frequent spontaneous comments during the evaluation. [...] His speech was easily intelligible despite persistent articulation problems. These unusual language structures were noted: mild word finding difficulties and a tendency to be tangential.
[...]
Interpretation of Test Results: Current test results are remarkable due to the degree of variability that emerged. Overall, [he] is functioning in the bright average range of intelligence (Full Scale IQ = 111). However, a significant 22 point discrepancy emerged between his Verbal skills (121), which fell in the superior range, and his Performance skills (99), which fell in the average range of intelligence. Factoring out those subtests most influenced by attentional factors increased this discrepancy. Factoring out Arithmatic increased his verbal comprehension index to 123, while factoring out Coding decreased his perceptual-organization index to 97. His remaining indexed, freedom from distractibility (93) and processing speed (104), both fell in the average range. Thus, [he] presents as a bright youngster with a highly uneven cognitive profile.
Further examination of [his] verbal comprehension factor reveals significant scatter with scaled scores ranging from 11 to 17. [He] was superb at recalling general information about the world around him, which fell at a fourteen-year-ten-month level. He also excelled at providing sound solutions to common sense situations. He is very aware of social norms and expectations. [His] receptive and expressive language skills are also mature. His performance on the PPVT-R, which requires the child to point to a picture that best depicts a stimulus word, fell in the superior range. Interestingly, [he] was least effective in perceiving and relating meaningful relationships between objects. His thinking appeared highly concrete and literal.
Only mild scatter emerged within the perceptual-organization index with scaled scores ranging from 7 to 11. [He] was able to utilize visual cues to anticipate consequences of events effectively, build abstract block designs to match a stimulus picture and identify missing elements in a picture at age level. Overall, [he] appeared to prefer a sequential processing style that allowed him to use a trial and error approach. He was not very creative or insightful, but he continued to work on tasks until he came across a correct solution. [...] Mild visual-perceptual-motor integration processing deficits were also noted [...] His projective drawings were simple and concrete.
[...]
[His] performance on the DAB revealed his writing skills, overall, fall in the low average range, significantly below his intellectual capabilities. His capitalization, punctuation and spelling skills fell near the mean, while his written vocabulary skills were significantly weaker. His essay, generated from three topical pictures, was highly concrete and literal.
[...]
Interpersonally, [he] was attentive, cooperative, and enjoyable to work with in the one-to-one evaluation setting. However, his uneven cognitive profile has had a significant impact on his psychosocial adjustment. According to his parent's response to the PIC, a lengthy, objective questionnaire assessing a child's overall adjustment and coping skills, there are significant concerns about [his] adjustment. Elevations on the PSY, D, ANX, and SSK scales would be reflective of a youngster who is highly uncomfortable in most social situations. Children with such profiles do not fit in. They come across as being shy, passive and afraid. There is anticipation of failure and rejection that prevents them from initiating new interactions. He also displays very limited self-control. Unless the environment provides high levels of structure, he has great difficulty being self-disciplined. He tends to disregard rules and societal expectations. Children with this profile tend to be argumentative, have temper tantrums, and have a very low tolerance for frustration.
[The parents'] response to the CPRS also generated significant elevations on the conduct problem, anxiety, and hyperactivity index scales. He is described as being shy, worries more than others, problems making and keeping friends, cries easily, quarrelsome, immature, easily frustrated, excitable, impulsive, controlling, destructive, denies making mistakes and blames others. Interestingly, his teacher's response to the CTRS revealed a flat profile, again reflecting the significant impact that structure has in [his] life.
Projective measures also reflect that [he] has a high need for structure and consistency. Change is very difficult and threatening. He is most comfortable when there are clear patterns, rules and procedures. [His] self-esteem is not positive. He tends to feel insecure, anxious and self-conscious. He does not view himself as a competent, worthwhile individual. He is prone to perseverate on anxiety-producing thoughts. Separation and individuation issues are problematic.
[..]
Summary and Recommendations:
[..]
Psychologically, the impact of his uneven cognitive profile is far more significant. His tendency to over-focus on minute aspects of his experiences make it very difficult for him to perceive the big picture. He does not integrate and synthesize his experiences in an effective manner. He is not intuitive, insightful, or have good common sense. This processing style makes the social arena highly anxiety provoking, leading him to withdraw and avoid interactions.
[Néant Humain] does not make friends easily and tends to be a follower. He can be excitable, easily upset and tends to have intense emtional reactions. He has difficulty fitting in. He is sensitive and made fun of by his peers. He is easily frustrated, has a history of temper tantrums, and can be destructive. Complaints of headaches and leg pains were reported. Overall, his mother estimates he acts like a six year old.
[...]
[He] was described as a good, cuddly infant. He began to walk at nine months, but his language was somewhat delayed. There was a history of speech difficulties, but no difficulties with unusual language patterns or walking on his toes. He tends to talk too quickly and doesn't make eye contact easily. The listener always needs to probe further to clarify his message. [...] He attended preschool with some problems with aggressiveness. [His mother] described [him] as being independent, aggressive, destructive, curious, shy, distrustful, defiant, uncoordinated and easily frustrated as a preschooler.
[...]
Review of Prior Evaluation: [He] was evaluated by the Special School District of St. Louis County in October of 1991, due to academic and behavioral concerns. On the Weschler Intelligence Scale for Children - Revised he scored in the average to high average range. Visual-perceptual-motor and attentional deficits were noted. Academically, he was found to be learning disabled.
Behavioral Observation: [He] is a handsome (umm), 9-year-6-month old, white male who wore glasses. He was attractively (double umm) attired, well groomed, and appeared his stated age. He separated from his mother with ease and accompanied the evaluator. His initial compliance to the testing was good and he took his seat without problems. His in seat behavior was marked by frequent restlessness and fidgetiness. His task focus and attention span were adequate for his age in the one-to-one evaluation setting. He attempted all tasks that were presented, but his tolerance for frustration was low, limiting his ability to persevere. His response style was usually reflective. He would frequently repeat questions and directions to himself and talk himself through the tasks. [...]
[His] fine and gross motor skills appeared to be within normal limits. These unusual symptoms of visual-perceptual-motor integration dysfunction were noted: spatial relationship confusion, drawing clockwise circles, and difficulties with angulation. A left-handed preference was noted to have developed with a very awkward pencil grasp. [He] made frequent spontaneous comments during the evaluation. [...] His speech was easily intelligible despite persistent articulation problems. These unusual language structures were noted: mild word finding difficulties and a tendency to be tangential.
[...]
Interpretation of Test Results: Current test results are remarkable due to the degree of variability that emerged. Overall, [he] is functioning in the bright average range of intelligence (Full Scale IQ = 111). However, a significant 22 point discrepancy emerged between his Verbal skills (121), which fell in the superior range, and his Performance skills (99), which fell in the average range of intelligence. Factoring out those subtests most influenced by attentional factors increased this discrepancy. Factoring out Arithmatic increased his verbal comprehension index to 123, while factoring out Coding decreased his perceptual-organization index to 97. His remaining indexed, freedom from distractibility (93) and processing speed (104), both fell in the average range. Thus, [he] presents as a bright youngster with a highly uneven cognitive profile.
Further examination of [his] verbal comprehension factor reveals significant scatter with scaled scores ranging from 11 to 17. [He] was superb at recalling general information about the world around him, which fell at a fourteen-year-ten-month level. He also excelled at providing sound solutions to common sense situations. He is very aware of social norms and expectations. [His] receptive and expressive language skills are also mature. His performance on the PPVT-R, which requires the child to point to a picture that best depicts a stimulus word, fell in the superior range. Interestingly, [he] was least effective in perceiving and relating meaningful relationships between objects. His thinking appeared highly concrete and literal.
Only mild scatter emerged within the perceptual-organization index with scaled scores ranging from 7 to 11. [He] was able to utilize visual cues to anticipate consequences of events effectively, build abstract block designs to match a stimulus picture and identify missing elements in a picture at age level. Overall, [he] appeared to prefer a sequential processing style that allowed him to use a trial and error approach. He was not very creative or insightful, but he continued to work on tasks until he came across a correct solution. [...] Mild visual-perceptual-motor integration processing deficits were also noted [...] His projective drawings were simple and concrete.
[...]
[His] performance on the DAB revealed his writing skills, overall, fall in the low average range, significantly below his intellectual capabilities. His capitalization, punctuation and spelling skills fell near the mean, while his written vocabulary skills were significantly weaker. His essay, generated from three topical pictures, was highly concrete and literal.
[...]
Interpersonally, [he] was attentive, cooperative, and enjoyable to work with in the one-to-one evaluation setting. However, his uneven cognitive profile has had a significant impact on his psychosocial adjustment. According to his parent's response to the PIC, a lengthy, objective questionnaire assessing a child's overall adjustment and coping skills, there are significant concerns about [his] adjustment. Elevations on the PSY, D, ANX, and SSK scales would be reflective of a youngster who is highly uncomfortable in most social situations. Children with such profiles do not fit in. They come across as being shy, passive and afraid. There is anticipation of failure and rejection that prevents them from initiating new interactions. He also displays very limited self-control. Unless the environment provides high levels of structure, he has great difficulty being self-disciplined. He tends to disregard rules and societal expectations. Children with this profile tend to be argumentative, have temper tantrums, and have a very low tolerance for frustration.
[The parents'] response to the CPRS also generated significant elevations on the conduct problem, anxiety, and hyperactivity index scales. He is described as being shy, worries more than others, problems making and keeping friends, cries easily, quarrelsome, immature, easily frustrated, excitable, impulsive, controlling, destructive, denies making mistakes and blames others. Interestingly, his teacher's response to the CTRS revealed a flat profile, again reflecting the significant impact that structure has in [his] life.
Projective measures also reflect that [he] has a high need for structure and consistency. Change is very difficult and threatening. He is most comfortable when there are clear patterns, rules and procedures. [His] self-esteem is not positive. He tends to feel insecure, anxious and self-conscious. He does not view himself as a competent, worthwhile individual. He is prone to perseverate on anxiety-producing thoughts. Separation and individuation issues are problematic.
[..]
Summary and Recommendations:
[..]
Psychologically, the impact of his uneven cognitive profile is far more significant. His tendency to over-focus on minute aspects of his experiences make it very difficult for him to perceive the big picture. He does not integrate and synthesize his experiences in an effective manner. He is not intuitive, insightful, or have good common sense. This processing style makes the social arena highly anxiety provoking, leading him to withdraw and avoid interactions.
10 Jul 2005, 2:04 am
This one is dated December 17, 2002, and is my diagnosis of Asperger's syndrome (technically, autism). I was 17 years old then.
Diagnostician wrote:
[His] performance on the Weschler Adult Intelligence Scale-III falls in the fast learner range of abilities (FSIQ = 116). There is a significant and meaningful split between verbal (VIQ = 134) and nonverbal (PIQ = 94) abilities. [His] abilility to use verbal reasoning skills falls in the superior range of abilities. His perceptual-organization abilities fall in the average range of abilities. [He] has relative difficulty noticing visual details and using those to solve problems. To even highlight this dichotomy further, the two subtests that measure social reasoning skills are highly discrepant. [His] ability to use his verbal reasoning skills to arrive at acceptable solutions in hypothetical situations falls in the superior range. When he has to use visual details to glean meaning in social situations, his performance falls in the slow learning range of abilities. [...]
Informal projective drawings suggest emotional concerns. [He] apparently wants to give the impression that he is socially able when in fact he seems to experience anxiety when interacting with others. He seems to feel inadequate and insecure when interacting with others. He appears to be overly sensitive to social criticism and may overreact to perceived criticism. [He] also seems to have a tendency to misperceive others [sic] intentions. His behavior may become expansive under stress.
[His mother and stepfather] completed the Asperger's Disorder Checklist. Scores of 48 or higher suggest a significant presence of behaviors associated with Asperger's Syndrome. [His mother and stepfather] endorsed items that yielded scores of 87 and 76 respectively. [Their] ratings reflect that [he] is socially isolated. He avoids social contact with others, has no close friends and shows no interest in making friends. He is also seen as having impaired interaction with others. He seems to be clumsy in social situations, has difficulty sensing the feelings of others and has one-sided responses to peers. His nonverbal communication is also seen as being impaired. He demonstrates limited facial expression and does not look at others when communicating. His speech is also viewed as being odd. He talks about the one subject over and over, lacks cohesion in his conversations and has an abnormal inflection (monotone) when he speaks.
The School Psychologist completed the Childhood Autism Rating Scale after gathering information and working with [him]. Scores above 30 signify the presence of autistic behaviors. [He] received a score of 36.5. [...]
[...]
There were no concerns about [his] semantic, syntax, and morphology skills; therefore the focus of this evaluation was of [his] pragmatics, or social language skills. These skills were assessed with one formal test, taped conversations, and various observations. [His] pragmatic skills are below expectancy and contain many features frequently observed in individuals who have Asperger's Syndrome.
[..]
[His] eye contact was unusual and limited in all contexts. He looked down or past the person who was speaking to him. At times, he used peripheral vision. His facial expressions varied very little. [He] maintained a serious demeanor with fleeting, slight smiles. He did not laugh or react when others did. [He] did not initiate conversation with peers or teachers. His responses to their initiations with him were brief and sometimes presented in an abrupt manner. [...]
[...]
Results of this multidisciplinary evaluation are consistent with the Missouri Department of Elementary and Secondary Education (DESE) criteria for identifying [Néant Humain] as a student with Autism.
[...]
An in-depth social history was conducted with [his] mother and his stepfather. [His mother] related that [he] walked early. However, he did not crawl. Talking started early and appeared to be on target.
[...]
[He] demonstrates sensitivities to sensory stimuli at an early age. He did not like to be held as a toddler. He demonstrated sensitivity to sounds and lights. The softest noises emitted by fluorescent lights in the basement of [sic] a television being watched at a whisper would cause [him] to overreact and try to shut down the source of his irritation.
[...]
[He] speaks in a monotone except when he becomes mad. On these occasions, he speaks in a high pitch of voice.
[...]
Informal projective drawings suggest emotional concerns. [He] apparently wants to give the impression that he is socially able when in fact he seems to experience anxiety when interacting with others. He seems to feel inadequate and insecure when interacting with others. He appears to be overly sensitive to social criticism and may overreact to perceived criticism. [He] also seems to have a tendency to misperceive others [sic] intentions. His behavior may become expansive under stress.
[His mother and stepfather] completed the Asperger's Disorder Checklist. Scores of 48 or higher suggest a significant presence of behaviors associated with Asperger's Syndrome. [His mother and stepfather] endorsed items that yielded scores of 87 and 76 respectively. [Their] ratings reflect that [he] is socially isolated. He avoids social contact with others, has no close friends and shows no interest in making friends. He is also seen as having impaired interaction with others. He seems to be clumsy in social situations, has difficulty sensing the feelings of others and has one-sided responses to peers. His nonverbal communication is also seen as being impaired. He demonstrates limited facial expression and does not look at others when communicating. His speech is also viewed as being odd. He talks about the one subject over and over, lacks cohesion in his conversations and has an abnormal inflection (monotone) when he speaks.
The School Psychologist completed the Childhood Autism Rating Scale after gathering information and working with [him]. Scores above 30 signify the presence of autistic behaviors. [He] received a score of 36.5. [...]
[...]
There were no concerns about [his] semantic, syntax, and morphology skills; therefore the focus of this evaluation was of [his] pragmatics, or social language skills. These skills were assessed with one formal test, taped conversations, and various observations. [His] pragmatic skills are below expectancy and contain many features frequently observed in individuals who have Asperger's Syndrome.
[..]
[His] eye contact was unusual and limited in all contexts. He looked down or past the person who was speaking to him. At times, he used peripheral vision. His facial expressions varied very little. [He] maintained a serious demeanor with fleeting, slight smiles. He did not laugh or react when others did. [He] did not initiate conversation with peers or teachers. His responses to their initiations with him were brief and sometimes presented in an abrupt manner. [...]
[...]
Results of this multidisciplinary evaluation are consistent with the Missouri Department of Elementary and Secondary Education (DESE) criteria for identifying [Néant Humain] as a student with Autism.
[...]
An in-depth social history was conducted with [his] mother and his stepfather. [His mother] related that [he] walked early. However, he did not crawl. Talking started early and appeared to be on target.
[...]
[He] demonstrates sensitivities to sensory stimuli at an early age. He did not like to be held as a toddler. He demonstrated sensitivity to sounds and lights. The softest noises emitted by fluorescent lights in the basement of [sic] a television being watched at a whisper would cause [him] to overreact and try to shut down the source of his irritation.
[...]
[He] speaks in a monotone except when he becomes mad. On these occasions, he speaks in a high pitch of voice.
[...]
10 Jul 2005, 3:41 am
Really interesting to read. The evaluation at 9 yrs old is particularly thorough, that person was worth the money. Funny about the comments on appearance and attractiveness, but I guess appearance could be part of the problem (presentation) or indicate problems at home....it's such a thorough report!
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