*7.3.2 Child H—profile of standard scores on the WISC IV (UK) (March 2019) here*

As in the IQ administered 3 years before, Child H's performance in all areas of the test was in the normal range. There was still evidence of some scatter in level of performance across different areas of the test, but within the different areas of the test there was far more homogeneous performance.

The verbal comprehension profile now indicated that Child H had well developed verbal reasoning ability, and average vocabulary, comprehension, general knowledge and verbal classification abilities relative to age level. The perceptual reasoning side of the test indicated well-developed perceptual and spatial abilities relative to age level. Child H's previous weakness in non-verbal reasoning was no longer evident, while the


*Note that in the above table, a standard score is a scaled score relative to a normal curve, where the average score would be a score of 10. Scores higher than 12 indicate above average performance relative to age level, indicating potential areas of cognitive strength. Scores lower than 8 indicate below average performance relative to age level, indicating potential areas of cognitive weakness. This type of profile interpretation needs to be conducted cautiously and substantiated against other information, as any scaled score is subject to measurement error.*

**Table 6.**

*Child H – profile of standard scores on the WISC IV (UK) (march 2019).*

scores in the working memory side indicated good short-term auditory memory as well as good sequential memory for letters and numbers.

Relative to Child H's standard scores in other areas of the test, there were still difficulties in processing speed. There was a particular weakness in coding, but the standard score indicated improvement relative to Child H's performance on this subtest in the IQ administered 3 years previously.

Overall there was thus evidence of some scatter in the test scores, but a far less scattered profile compared to 3 years previously. This will be evident from the graph presented below, which groups the standard scores on the IQ by cognitive area (**Figure 8**).

#### *7.3.3 Child H—profile of standard scores on WISC IV (UK) (march 2019) grouped by cognitive area here*

The indications from the profile were that Child H now had well-developed cognitive processing abilities in both verbal and non-verbal areas as well as well-developed auditory and auditory sequential memory skills. There were still weaknesses affecting processing speed. Coding was still a particular area of difficulty indicating continuing needs for intervention in developing sequential working memory for words. The indications were also that Child H's strengths in all other areas of the test could now be used as the basis for interventions to improve his functioning in writing and spelling.

This was done by using the high areas in the IQ as indicators of strengths in Child H's cognitive style at this point in time, and the low areas as indicators of weakness. These cognitive processing indicators were then supplemented with clinical evidence of the working memory strategies which Child H was using in remembering individual words and words in sequence (Note 18). The conclusion was that the tests of basic reading, writing and spelling skills conducted longitudinally over the past 3 years provided evidence of continuing difficulties with reading fluency, as well as with writing and spelling fluency. The age scores also fell well below what would be expected in terms of age level as well as Child H's overall level of cognitive performance, indicating that diagnosis of a reading disorder under DSM-IV code 315.00 was still applicable (Note 19), as well as a disorder of written expression in terms of the diagnostic criteria for DSM-IV code 315.2 (Note 20).

*Multivariate Treatment of Dyslexia, Dysgraphia and Dyscalculia DOI: http://dx.doi.org/10.5772/intechopen.110287*

The evidence also indicated a long-term difficulty in these areas, suggesting an ongoing learning problem likely to affect performance in school. Coding was still a particular weakness. Low scores on coding are often associated with difficulties in reading [120, 121], and for this reason Child H's continuing weakness in this area of the test indicated the need for continuing interventions to develop his coding and recoding abilities [122–126]. This required continuing focus on developing his visual memory for words, as indicated in the following section.

#### *7.3.4 Child H's profile on the Durrell*

As evidence from longitudinal testing of Child H's skills in one word reading, sequenced reading, one word spelling and sequential spelling was already available (refer **Table 5** above), the Durrell Analysis of Reading Difficulty was administered as part of his response to intervention assessment. The Durrell has a number of subtests of rate of reading as well as subtests tapping the ability to use phonic skills and visual memory, on which Child H scored as follows.

*Results of reading, writing and spelling tests conducted on 2019-2109-27*: Durrell Oral Reading (rate) 8 yrs. 8 mths Durrell Oral Reading (comprehension) 9 yrs. 6 mths Durrell Silent Reading (rate) 8 yrs. 8 mths Durrell Silent Reading (comprehension) 9 yrs. 9 mths Durrell Listening Comprehension 10 yrs. 2 mths Durrell Flash Words 11 yrs. 5 mths Durrell Word Analysis 11 yrs. 8 mths Durrell Test of Spelling 8 yrs. 0 mths Durrell Test of Handwriting 11 yrs. 0 mths Durrell Test of Visual Memory 9 yrs. 8 mths Durrell Test of Phonic Analysis 12 yrs. 3 mths

The scatter on the various subtests will be evident from the profile of test scores presented below, which shows the discrepancy between Child H's age (line in red) and his age scores on the different subtests administered (**Figure 9**):

**Figure 9.** *Child H – profile Durrell age scores (September 2019).*

#### *7.3.5 Child H—profile of 2019 Durrell age scores (September 2019) here*

Child H's continuing difficulty with rate of work in school-related activities was indicated both by his parents and his self-reports. The Durrell profile indicated that this was linked to difficulties with rate of reading and comprehension of contextual paragraphs. When compared to the scores from previously administered tests of reading, writing and spelling, the Durrell profile indicated improvement in the reading of individual words as well as in rapid recognition of letters and words, while the working memory subtests indicated progress in phonic spelling but continuing difficulties with visual memory for words. This would still need to be treated side by side with the reading and spelling sides of Child H's programme.

#### *7.3.6 Child H's profile on the phonic inventories*

As Child H was at this stage in Grade 6 at school, all three levels of the Phonic Inventories were administered (Note 21). The profile Child H's profile indicated high error scores on:


On the basis of previous research with the instrument which had indicated that errors on both ending consonant blends and medial vowel errors are indicators of learning disability both in primary school age children [99, 100] as well as high school children [101]. Child H's profile of errors on the instrument was used as corroborating evidence of the presence of a learning disability [90, 127, 128], while also providing evidence of specific areas of learning need. In addition, the profile was analysed to identify specific phonic errors and error types which could be targeted for instruction [129–131].

Compared to the previous profile of phonic errors made when Child H was in Grade 3 at school, his Grade 6 profile of errors on the phonic inventories provided evidence that substantial progress had been made in terms of his underlying phonological and phonic difficulties, as well as evidence that further work was necessary. This needed to target the specific errors made by Child H on ending consonant blends, continuing work on the use of letters used in combination to represent long vowel sounds, and work on base words combined with prefixes, suffixes and other morphological endings.
