(cost $1800) (procedure code 96101 or 96118)
(developmental dyslexia ) and attention deficit disorder ( ADD or ADHD ). It involves an assessment of overall cognitive functioning, tests of attention, questionnaires, rating scales and reading tests. A formal diagnosis is necessary if you are seeking insurance reimbursement or are trying to obtain special accommodations under the American with Disabilities Act in school, for standardized testing or for employment purposes. This evaluation results in an integrated written report. Problems with IQ Testing:
It is expected that the reading score for instance, will be significantly below the IQ score if dyslexia is present. Other factors are also considered, but he center piece to diagnosis is this discrepancy in scores. However, there are serious problems with this approach that are frequently not considered in a diagnostic evaluation. First, the concept of intelligence being a single ability ("g") accurately represented by a single score such as IQ has been seriously challenged by research. The overall functioning that is represented by IQ is actually the result of at least four, (and possibly more) separate cognitive abilities. The are most commonly identified as verbal reasoning, nonverbal reasoning, working memory and processing speed. When these are all functioning at the same level, then a single score such as the IQ can be regarded as validly representing a person's intelligence. However, It is not uncommon for people with learning disabilities to have very uneven functioning in these four areas, perhaps ranging from very low to very high. Consequently, a child or adult's reasoning and learning abilities may be much higher than what is reflected in the IQ score. Unfortunately, it is the lower IQ score that is often used in calculating the discrepancy between ability and achievement such as reading resulting in a discrepancy that is deemed within normal limits. Consequently, the learning disability that is actually present is not detected. Failing to detect a problem that is actually present is called a false negative. There are additional consequences in not properly interpreting intelligence tests. Working memory and processing speed are considered aspects of attention and are closely associated with some type of attention deficit disorder. Impairments in these areas strongly suggests that an evaluation for ADHD or ADD is in order. Relying on the traditional IQ score may mask actual impairments and result in failure to detect a problem, when in fact a problem is present. Again a false negative. This can also result in serious under measurement of actual ability or potential. Unfortunately many psychologists are only trained to use the traditional IQ score and ignore indications that a traditional IQ score is invalid.
directed to the task of reading comprehension. Automaticity is necessary for practical reading typical non-dyslexic readers. However, the extra steps and mental effort the dyslexic reader must use to perform basic decoding continues to reflect the ongoing interference that their dyslexia has with practical reading. Most reading tests that are used to evaluate for dyslexia are untimed and do not require Automaticity of decoding and will often fail to detect the presence of dyslexia in a person who has had substantial remediation. People with dyslexia who have had substantial amount of remedial reading instruction can often perform well on these untimed tests. Consequently, it is important to administer reading tests that require Automaticity of decoding for the evaluation to have a reasonable chance of detecting dyslexia. Unfortunately, such tests are often not included in an evaluation, which may result in a false negative diagnostic conclusion.
particularly difficult to diagnose because hyperactivity or impulsiveness are not the primary symptoms. People with ADD are not disruptive and are often well behaved in classrooms. Their symptoms involve internal, silent problems of mental processing of information that results in poor academic performance. Because their symptoms are not readily noticed by observers, their condition often goes undetected despite the suspicion that something is just not right. Because of the controversy regarding the core symptoms and the difficulty detecting symptoms evaluations often result in false negatives when in fact there is a problem. Evaluations require a care review of all tests, history, grade reports, teacher reports and parent reports. |
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| NEURO-PSYCHOLOGY SERVICES Robert D. Smith, Ph.D. Dyslexia, ADHD, Learning Disabilities, Psychotherapy Testing & Treatment For Children and Adults Serving Mid-Michigan 35 years experience |
