My Neuropsychological Results..

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After waiting 10 months I finally got the official paperwork back in. I'm having trouble understanding some of it however, in particular the part about "weakness in her right cortical hemisphere" since I've never heard of this before. Would this be a type of learning disability, or brain impairment (dysfunction, damage, there are so many words to use for brain type stuff....)I can't even find what "weakness" means. And for that matter, what does "impaired visual memory and impaired organizational abilities" mean? Do they go by other more commonly used names to describe it?

There were 15 pages of % and numbers, but this is the conclusion.
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DragonflyDreams Full Scale IQ of 112 placed her in the High Average range and the 79th percentile for overall intellectual processing. Verbal IQ score of 111, and Performance IQ score of 111. She demonstrated relatively even cognitive abilities across modalities.

The Neuropsychological testing findings indicated DragonflyDreams has mildly impaired visual memory and mildly impaired organizational abilities, in the context of otherwise within normal limits cognitive functioning. She demonstrated strong rote learning skills. The findings are suggestive of mild weakness in her right cortical hemisphere.

Behavioral ratings were significant for anxiety but not depression.

Diagnostically, DragonflyDreams history, previous and current symptoms, and observation of DragonflyDreams, indicate that she does meet the diagnostic criteria for Asperger's Disorder. Additionally, she has significant anxiety which is believed to be secondary to her primary diagnosis of Asperger's Disorder.

DragonflyDreams will benefit from learning more about Asperger's Disorder and developing social skills and coping strategies to reduce her anxiety levels. Her therapist should become familiar with issues faced by adults with Asperger's Disorder, if she is not already aware of issues concerning this population. DragonflyDreams maybe benefit from having some medication to help cope with particularly anxiety provoking situations. She may also benefit from reading about sensory integration disorder and consulting with an Occupational Therapist to identify strategies she can use to cope with her sensory sensitivities. There are many books for adults with Asperger's and she may find it helpful to find some which are directed toward her own goals.

DSM-IV
Axis I:
Asperger's Disorder
Anxiety Disorder NOS
Axis II: Deferred
Axis III: Sensory Integration Problems (rule out Sensory Integration Disorder)
Axis V: 65

those reports are in depth and difficult to sort out. the weakness in right cortical hemisphere refers to right-brain functions, which is where our troubles lie. so basically, it means you have a disorder, which the report goes on to specify is asperger's. weakness just means the tasks the right side of your brain handles aren't as easy as they are for people on the middle of the curve.

overall your results look really good and that will make it easier to learn ways around the actual impairments of visual memory and organizational abilities, which are mild (they're still there, they're just not crippling). the specifics of visual memory I'm not familiar with. my daughter tested high in it, which means if she sees something and doesn't get distracted, she's likely to remember it in great detail pretty much forever. your brain doesn't file things like that away as easily, you'll need auditory and kinetic support for memory, so basically you can just make sure you don't rely on looking at a map or having someone show you something and then try to remember later. things like that.

organizational... I'm not sure what that is, but I think it has to do with a test I took. being able to tell what steps go before and after something.

I've always known I wasn't a visual learner. Even though my auditory memory was in the normal range, I can't learn things that way either. I really have to touch things and do them myself in order to remember how. I get lost very easily, and still can't find my way around town. (I've lived here over 8 years now) Facial recognition on the test was below normal as well. (no surprise there)

So does this right cortical hemisphere weakness belong exclusive to Asperger's? I was under the impression that the majority of aspies were strongest visually. (and since I knew I was not, I was always confused by this.)

Don't tell me that means I got the worst of Aspergers and none of the perks.

I work as a visual artist, but I have the same visual memory weakness as you. I learn best by hands-on doing - the only way I can remember how to find my way back to someplace I've been is if I drive the route myself - you can take me there as a passenger a thousand times and I'll have only a vague sense of where the place is.

Same with drawing something - if it's right in front of me, no problem. If you let me see it for a few minutes, then take it away, I could give you a rough sketch, but any fine details would be missing. On the other hand, the more times I redraw the same object or type of object, the better I get at being able to fabricate that image entirely from imagination. Ironically for someone so weak in people skills, it's people I draw best. Especially female people.

Impaired organizational abilities probably refers to executive dysfunction. This means having difficulty in areas such as these: planning complex tasks, sequencing complex tasks, keeping track of many things at once, not becoming distracted, and inhibiting certain responses to stay on task.

i thought that aspergers and other pdds were supposed to be axis ii

i thought that aspergers and other pdds were supposed to be axis ii

It's sometimes classes as Axis III, as due to various sensory issues and motor co-ordination issues it could be considered a general medical disorder (correct me if I'm wrong)

No, they're Axis I, since they're still listed under "childhood disorders".

I agree they should be moved to Axis II, along with other long term, more or less stable things like Mental Retardation and the various "X Personality Disorder"s. Autistic people obviously do learn as they age; but so do people with MR, and so do (usually) people with personality disorders; the important thing about axis II is that these things are "running in the background" of any Axis I diagnosis, and tend to be the primary issue only if there isn't an Axis I present; but the Axis II has to be taken into account when working with the Axis I because it modifies a person's way of thinking and interacting with the world.

See why I think autism ought to be on II? But in the 1990s we just didn't know enough about autism to say that for sure yet.

Dragonfly, did you get your IQ sub-test results? I found mine to be a lot more useful than the overall IQ. For example, I have a startling weakness in the area of making stories out of pictures--not just social comprehension, but ambiguous information that can mean more than one thing. I also have a larger digit span backwards than forwards, which is interesting because that's the reverse of most people's, meaning that my memory (at least short-term) is probably better if I work with the information while I'm receiving it, rather than trying to passively memorize it. Knowing little things like that can really make your life easier Also: You're the first I've seen who didn't have a noticeable Performance/Verbal or subtest gap! That makes you unusual (but not too unusual) for an autistic person.

Lets see here... I'll type the whole thing out.
Please feel free to pick it apart! Help me to understand what all these mean. =)


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She was administered the Wechsler Adult Intelligence Scale III in order to evaluate for cognitive strengths and weaknesses.

On this administration of the WAIS III she achieved a Verbal IQ of 111, placing her in the High Average range and the 77th percentile for overall language based intellectual ability.

Verbal Comprehension Index score of 112, placed her in the 79th percentile and High Average range for language based cognitive functions involving reasoning, comprehension and conceptualization. Her expressive vocabulary placed her in the 75th percentile. Her abstract verbal reasoning placed her in the 95th percentile. Her fund of information placed her in the 50th percentile. Her ability to explain social norms and customs placed her in the 75th percentile.

Her Working Memory Index score of 104 placed her in the 61st percentile and the Average range for the ability to actively maintain information in conscious awareness, perform an operation or manipulation of it and produce a result. Her mental arithmetic placed her in the 16th percentile. Her digit span placed her in the 95th percentile. Her ability to sequence letters and numbers in mind placed her in the 50th percentile.

Her Performance IQ of 111 placed her in the 77th percentile and the High Average range for overall intellectual ability based primarily on visual spatial processing.

Her Perceptual Organization Index score of 103 placed her in the 58th percentile and the Average range for perceptual reasoning, fluid reasoning, and organization. Her visual alertness placed her in the 63rd percentile. Her fluid reasoning as measured by her ability to analyze increasingly complex visual patterns in mind placed her in the 50th percentile. Her ability to sequence pictures to make stories placed her in the 63rd percentile.

Processing Speed Index score of 125 placed her in the 95th percentile and the Superior range for the ability to efficiently process information. On a test of efficient coding she performed in the 98th percentile. On a test of efficient visual scanning she performed into the 63rd percentile. Processing speed as been found to serve as the foundation for many cognitive activities, including mental energy, and efficient use of working memory for higher level fluid reasoning tasks.

Then some more Neuropsychological test results-----

Using the Halstead Reitan Neuropsychological Battery and additional tests. Rating scale is "perfectly normal= lack of brain dysfunction" "Within normal limits=falls within average range of brain integrity "mildly impaired and moderatly impaired" = indicate different levels of brain dysfunction.

Her motor functions were assessed. She is right hand dominant. Her fire motor speed was in the within normal limits range, bilaterally. On a test of visual fine motor integration she performed in the 45th percentile with a standard score of 98. Her visual scanning placed her in the perfectly normal range.

She was administered the Rey Complex Figure Test and Recognition Trial in order to evaluate her organizational abilities. Her copy of the figure placed her in the 2nd to 5th percentile range. She worked with the gestalt of the figure but had difficulty accurately integrating the parts. Her incidental immediate recall of the figure placed her in the 8th percentile. Her delayed recall of the figure placed her in the 5th percentile. Cueing her was not helpful, and she performed in the 8th percentile when asked to discriminate between features of the figure and other geometric designs.

Her memory functions were evaluated. On a test of sustained attention requiring the discrimination of phonemes she performed in the within normal limits range. On a faster paced and less structured test of auditory attention requiring the discrimination of rhythms she performed in the perfectly normal range.

She was administered the Wechsler Memory Scale III in order to evaluate a variety of her memory functions.

Her Immediate Auditory Memory Index score of 108 placed her in the 70th percentile and the Average range. Her memory for two stories placed her in the Average range. Her memory for word pairs learned over several trials placed her in the Very Superior range. Her Delayed Verbal Memory Index score of 105 placed her in the 63rd percentile and the Average range. Her delayed recall of the stories placed her in the High Average range and her delayed recall of the word pairs placed her in the High Average range. Her recognition auditory memory placed her in the Superior range with a standard score of 120.

Her Immediate Visual Memory Index score of 88 placed her in the 21st percentile and the Low Average range. Her memory for faced placed her in the Low Average range. Her memory for complex visual scenes placed her in the Average range. Her Delayed Visual Memory Index score of 84 placed her in the Low Average range and the 14th percentile. Her delayed memory for the faces placed her in the High Average range. Her delayed memory for the complex scenes placed her in the Average range.

Her Working Memory Index score of 108 placed her in the 70th percentile and the Average range.

Her spatial memory was stronger than her verbal memory.

Her executive functions were evaluated. Executive functions include mental flexibility, deductive reasoning, and the ability to gude ones actions to a preset goal. On a test of mental flexibility requiring rapid switching between 2 competing sets of data (numbers and letters) she preformed in the within normal limits range. On a test of deductive reasoning in which she was required to deduce the principles underlying different problem sets and apply them to various examples she performed in the perfectly normal range.

Overall the neuropsychological testing indicated that she has mildly impaired visual memory and mildy impaired organizational abilities in the context of otherwise within normal limits cognitive functionig. She demonstrated strong rote learning skills. The findings are suggestive of mild weakness in her right cortical hemisphere.

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I think thats all there is. LOL
Aside from the back history and behavoral findings which I found interesting. I'll post them later simply because before my testing I wished I had known how some of the testing went. I like to know in advance about things but didn't have much info to tell me that.

I'll try to help you figure some of this out, but will stick to interpreting the results within the context of your AS diagnosis. There is no specific cognitive profile for AS because test results for the AS population are not consistent enough, but some trends have been found; areas of relative strength and weakness, for example.

The scores are good so far because they show no deficits or the uneven VIQ-PIQ scores often associated with AS.
VIQ > PIQ is commonly seen, but a large fraction of those with AS (including yourself) have no significant difference between verbal and performance IQ.

Attwood mentions that about 50% of AS children have relatively advanced verbal reasoning skills. I don't recall reading anything about adults though.




Many with AS have relative weaknesses in these areas; everything here seems more or less consistent apart from one of the areas. Working memory is fine and is a domain of executive functioning; being weak in this area also tends to be associated with social skills deficits.




Many with AS have a relative weakness in sequencing pictures, which you don't seem to show. I just looked up perceptual organization and found one study indicating adolescents with AS do not differ from controls. I'm not sure about the others.




Like above, you show none of the deficits in these areas that are sometimes associated with AS, apart from the one relative weakness in visual fine motor integration, which still seems within normal limits. The superior scores are interesting; I might investigate that further in case there are relevant examples in AS.




I looked this one up and it's for measuring visuospatial ability and visuospatial memory; it "captures five domains of neuropsychological functioning: visuospatial recall memory, visuospatial recognition memory, response bias, processing speed, and visuospatial constructional ability."

Some of these domains seem to be a relative weakness for you. I'm not sure why your assessors only specify it as measuring organizational abilities.




I think the former can be a weakness in ASD, which can contribute to language processing difficulties. I'm not sure about the latter.




Autistic children (again, not sure about adults) have been found to have weaknesses in verbal memory. These can be relative strengths in AS and NVLD.




Visual memory and memory for faces can be relative weaknesses in AS.


Some studies suggest that the apparent memory impairments associated with autism are really information processing or executive functioning impairments. The more complex the memory task, the more problems show up.




These are often impaired in AS, making it difficult to organize, stay on task, plan etc.




The relative weaknesses you have can be associated with AS, as can your strength in rote learning. Your other cognitive abilities are fine in general. The right hemisphere weakness appears consistent with AS, the neurocognitive profile of which often shares similarities with NVLD and right hemisphere developmental disabilities. These are associated with relative verbal strengths, relative visual-spatial weaknesses, as well as social and other deficits. The vague term weakness in this context is probably used (and also a better word to use than something like abnormality) because they have not performed any brain scans or an EEG to reach more specific conclusions or to support what your profile suggests.

So really, I don't have the verbal advantage that a good portion of people with AS have. LOL





I'm wondering how the very low math score adds in here. Another commonly said thing is that people with AS are better at math and things of that type. But I know I don't have any strengths in that area.






Oddly enough, I remember this test and though the score suggests I didn't have a difficult time with it... I DID have an extreme difficulty in sequencing the pictures. I'm guessing that because ultimately I got them correct (or close to correct) the fact that I did have difficulty doesn't show up.






Is it possible to have so many things inconsistent with what people normally associate with AS? I'm not sure what fine motor integration is, I need to look that up.






More things to look up. Is it possible that I wasn't tested for those things? Or does the test automatically encompass all of those? At some point in the report it said that my spatial memory was stronger than my verbal memory. Is visual-spatial the same thing? And if it is, how can it be a weakness... but yet be stronger than my verbal memory? (and it already says visual isn't my strong point.) Does that mean that my verbal memory isn't that great either? Ugh so many different components make up memory!











The memory word pair tests I remember. The way I remembered the word pairs was to construct an image in my head that used both words. If the word was "van" and "hairbrush".. I pictured a van with a big hairbrush graphic on the side of it. So when the word "van" was used, I automatically pictured a van with a hairbrush and knew the second word. That test I know I got 100% correct, though I'm not sure what that means really.







Some studies suggest that the apparent memory impairments associated with autism are really information processing or executive functioning impairments. The more complex the memory task, the more problems show up.






And I did ok on these. I'm not the typical profile for AS I guess.






So do you think my "weakness" on my right hemisphere are directly related to AS and just how I'm wired? Or that there might be something else underlying that would cause the weaknesses in addition to AS?

It seems I have a lot of "abilities" that are not consistent with AS, and a lot of weaknesses that are not consistent with AS. Though I guess we're all individuals, so its possible to march to the beat of a different drummer even within the context of an AS diagnosis. It does seem though that I'm missing some of the really good parts about being AS. Maybe I should write in that thread about envy after all.

I don't think it works like that. If you had the same VIQ as now but your PIQ was significantly lower, you would have a relative verbal advantage. Not significantly differing VIQ and PIQ is good to have.




Yes. There is no specific AS profile. They cannot diagnose anyone based upon these tests. You do show the typical right hemisphere "weakness" and a few other features associated with AS.




It would be odd if they didn't test all the things in the Rey. Is there a way you could find out and also why they call it organizational abilities? This seems to be where all the confusion lies.

The statement about your spatial memory being stronger than your verbal memory is confusing because they do not indicate which tests gave this result. I think spatial memory is just one component of visual-spatial ability. Your verbal and auditory memory are fine, and your recognition auditory memory is in the superior range.




Do you think this result reflects your daily experiences in this area?




The suggestion of an underlying weakness in the right hemisphere is based upon you obtaining some results that are consistent with this. The results found in many with AS can also be associated with conditions such as NVLD. Many conditions overlap, and these tests cannot be diagnostic concerning AS, but can show a few results often found in those with AS. Behavioural traits and development are diagnostic, however, and yours indicate AS.



Not showing many of the weaknesses consistent with AS is good; having relatively weak maths abilities is consistent with AS (e.g., see Attwood) and only a few show gifts in this area.

As for AS-related cognitive abilities, there are a number of other tests they did not administer that could reveal more of these.

Ah ok, that makes sense!




I might be able to call her and find out. Their office wasn't too great at returning phone calls, or giving back reports in a timely manner, but its worth a try. I wish they would give a good detailed description of the tests and what they do for all of the tests, and not just a few of them.

The spatial memory being stronger part is very confusing to me. I wish the internet gave me more places to look this information up. Most pages bring me to Med publications that you need subscriptions too.




I looked up some more about executive functioning and I'd have to say, I think I do have problems with this. For instance, I cannot remember a phone number long enough to dial it. I can't keep track of time well, or seek more information when I need it. I am horrible at perceiving and estimating time and distance.

I am ok with planning activities, but I think thats in part due to the fact that my anxiety is so high. I HAVE to plan out everything, and it has to be perfect... because if it isn't.. everything could fall through. I over plan, and over anticipate, and always make sure all the bases are covered. I'm NOT a spontaneous person at all. Spontaneity makes me shudder. I really have to be prepared, especially if what I have to do involves people. So I think thats what drives me to make sure that activities I do are organized and put together.

I don't write reports well. I can't organize my thoughts and get them on paper very well. I have a lot of trouble starting things like that and generating my own ideas. Once I get going, the details come to me easily. But starting is horrible. I was never one to make an outline of book reports in school. I don't even know how to make an outline work for me. It always caused more anxiety and issues trying to make the outline than it did the report. LOL

But it seems so many things overlap... are these part of executive functioning? Or part of organizing? Because when I look up executive functioning, a lot of what I read about is organization....



Ok. So its possible that its a NVLD as well as AS. (though isn't there some thinking that it might be the same thing?)



I need to check that book out of the library again. I read it a few years ago. Its time for a refresher.

Are the other tests neuropsych tests or intelligence tests?

They really should explain these things better. It might also be worth getting them to re-check your results to make sure they entered them all correctly into the report. They could be describing the Rey test as testing organizational abilities because it might be tapping into the visual-spatial domain of these, i.e., visual-spatial organizational abilities. Difficulties in this area are found in AS and NVLD.

If you find any particularly relevant articles in your searches, let me know and I can access them and PM you a summary or some excerpts from them.




Many of these are parts of executive functioning (which involves the organization and execution of behaviour), but not all. Executive functioning in real-life terms means being able to organize, execute tasks efficiently, not get stuck in unproductive routines, and learn from experience. It's a confusing construct and has overlap because it consists of several domains, which include mental flexibilty (i.e., shifting sets), selecting relevant information from non-relevant, keeping your goal in mind at the same time as the individual steps (which requires OK working memory), inhibiting irrelevant responses, planning, sustaining attention, and learning rules from experiences.




A number of neurological conditions can give rise to an NVLD phenotype/profile. However, some aspects may manifest differently between them, such as social deficits. AS is associated with nearly all the characteristics of NVLD, and most with AS are thought to have a neuropsych. profile consistent with it. There is typically a VIQ>PIQ gap in NVLD.




Both. For example, another type of IQ test is the Raven Progressive Matrices. There are many neuropsych tests; some books provide comprehensive lists of available tests.
The research literature reveals autistics have strengths in a range of reasoning and comprehension tasks. Many studies show autistics to have superiority in certain perceptual abilties, such as those involving music and those involving the visual modality. Autistic superiority is found in several sensory modalities.

In this book

Executive Function in Education
it says the Rey Complex Figure Test is used to determine visual spatial organization and visual memory, and provide a useful analysis of the persons executive functioning process.

Yet in the report it says my executive functioning was at least in the "within normal limits" range. Yet I performed very poorly on the Rey. Is executive function the same as "organizational abilities"?

It seems many tests can be used differently. I guess using one test doesn't mean it was used to determine everything the test is capable of determining?