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The FSIQ of 78

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The FSIQ of 78

A school counselor reviews a private psychologist's report on a 10-year-old in fourth grade who has had three years of schooling in the United States, speaks Spanish at home, and still receives English learner services. The child was tested in English. The WISC-V results are FSIQ 78 (95% CI 73-83), Verbal Comprehension 92, Visual Spatial 88, Fluid Reasoning 86, Working Memory 74, and Processing Speed 70. The report concludes, "FSIQ 78, borderline range, consistent with intellectual disability; rule out." Adaptive behavior was assessed only with the teacher form of a rating scale, composite 84; no parent form was collected and no interpreter was used in the parent interview. The eligibility meeting is in six days. The mother asks the counselor, through the school's interpreter, "Does my child have intellectual disability?"

1. Is the FSIQ of 78 interpretable as evidence of intellectual disability? Explain your reasoning.

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No, not on this record. Several problems compound:

  1. Index scatter. The four indexes range from 70 to 92 - a 22-point spread. When index scores diverge substantially, the FSIQ is not a meaningful unitary summary and should not be interpreted as "general ability." The evaluator's own data show relative strength in verbal comprehension and relative weakness in working memory and processing speed.
  2. The weakest areas are the most confounded ones. Working memory and processing speed tasks are heavily loaded on language proficiency, speeded responding, and familiarity with test conventions; they are the indexes most affected by second-language status and by attentiveness during a long testing session.
  3. The confidence interval. A 95% CI of 73-83 spans the borderline and low-average ranges; a single point estimate should never carry a classification.
  4. Adaptive functioning. A composite of 84 is within normal limits, and it rests on one teacher informant in a second-language context. Intellectual disability requires deficits in both intellectual and adaptive functioning, documented across multiple sources and informants, with onset in the developmental period. The adaptive criterion is not met here.
  5. Language of testing. Testing in English without a documented language-proficiency evaluation leaves the scores uninterpretable as measures of ability.

2. What should the counselor do between now and the eligibility meeting?

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She should not let a six-day calendar force a decision the data do not support. Steps:

  • Put her concerns in writing to the team before the meeting: index scatter, language of administration, single-informant adaptive data, and the CI. A written dissent with reasoning protects the child and the counselor.
  • Request the missing data: a parent-completed adaptive measure administered with a trained interpreter; adaptive information from home and community (caregiving, self-care, safety, communication); an observation in more than one setting; the English language proficiency assessment results; and a speech-language evaluation if language impairment is suspected.
  • Ask whether a nonverbal measure or testing in the child's dominant language is warranted, and whether the original evaluator can address the language issue in writing.
  • Follow procedural safeguards: notify the parent of the right to request additional evaluation and to postpone; check state timelines and whether the meeting can be reconvened rather than held.
  • Distinguish eligibility categories. The team may be looking at specific learning disability, speech-language impairment, or a language-acquisition issue rather than intellectual disability, and the assessment data should serve that question, not a predetermined label.
  • Document everything, including her recommendation to delay.

3. How should the counselor answer the mother's question in plain language?

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The answer has to be honest, non-committal about a label that is not yet supported, and useful - delivered through the trained interpreter, not through the child.

Something like: "The scores in this report do not tell us yet whether your child has an intellectual disability. Some of the scores are lower than others, and the parts that look lowest are the parts most affected by testing in English and by attention and speed - not necessarily by how well your child can learn. The report also says the adaptive rating was normal and only one teacher filled it out. So the team needs more information, including your view of what your child can do at home, before anyone decides anything."

Then: explain the right to request additional assessment and to have the meeting rescheduled; ask what she has observed at home and in Spanish; confirm she will have an interpreter at the meeting; avoid reassurances ("your child is fine") and avoid confirming the label; do not let the child interpret. Document the conversation, the interpreter used, and the questions the mother raised, since those become data for the team.