Illustrative Case Reports

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The following three case reports illustrate the methods and procedures for WAIS-III interpretation described in the nine interpretive steps. These techniques are also exemplified in the case reports at the end of Chapters 8, 9, and 13.


Referral and Background Information

Nicole (Nikki) volunteered for testing and evaluation available through the psychoeducational assessment class as she has been concerned about her poor performance on tests in a collegelevel statistics course, inconsistent performance in her college coursework, test anxiety, and a possible learning disability. She is interested in finding out if she has the ability to complete a degree from the University of Alabama. Nikki has been aware of a problem since grade school (she repeated the 7th grade). Her particular problems are with numbers and details. She has noticed that she reverses numbers (as well as some letters, but to a lesser extent).

She knows number concepts but makes mistakes with her checkbook, for example, despite good concentration. She took only one math course in high school; she took college algebra at the University of Alabama and failed it. She indicates that she is frustrated because she knows something is wrong, but she does not know what it is. She wants to know what the problem is and how to deal with it.

Nikki reports that she was diagnosed 8 years ago as having Grave's disease (hyperthyroidism with one or more of the following: goiter, exophthalmos, pretibial myxedema). The disease is not controlled at the present time, although she has had isotope therapy, which resulted in the reverse condition (hypothyroidism). Side effects of the disease and/or treatment, according to Nikki, include memory problems and emotional side effects such as nervousness and irritability.

Nikki is married and has two daughters (aged 2 and 11). Her husband is about to finish his Ph.D. program in physical education. She returned to school after more than 10 years and is now a junior in home economics at the University of Alabama, majoring in food and nutrition. One of her stated reasons for returning to school was to be a good mother to her older child, who is "gifted." Nikki is currently taking Introductory Statistics, Economics, and two classes in nutrition. While doing well in nutrition courses, she is having great difficulty with statistics and economics. Nikki works part-time at a local child development center. Although she is undertaking a great deal, she does not report a great deal of support from either her husband or parents.

Nikki says that she wants to be a county health counselor and work with pregnant teenagers regarding their prenatal care. She likes to read and play the piano.

Appearance and Behavioral Characteristics

Nikki, a 34-year-old Caucasian female, wears glasses and is of medium height and weight. She was cooperative and a willing worker throughout the testing session, although she was shy at the beginning.

It was evident throughout the session that Nikki was highly motivated. On a task requiring her to define a word she gave a string of responses until she felt comfortable with her answer. On a task of immediate recall of digits she closed her eyes and tried to concentrate on the task.

One of Nikki's outstanding characteristics was her excellent verbal ability (rich vocabulary and expressions). On a task requiring her to define words she frequently gave a few synonyms (e.g., terminate is 'to end,' 'complete,' and 'finish') or long elaborations. Nikki successfully used trial-and-error strategy to solve verbal questions. Asked to explain the meaning of the saying, "One swallow doesn't make a summer," on a task testing her commonsense understanding of social situations, she was puzzled at first, asking, "One swallow?" She did not seem to be familiar with the saying. She began to describe the migration of swallows. While giving trial responses, she was able to find the proper answer. It should be noted that, when she faced a hard question, she often laughed, saying, "Oh, boy," before trying. Laughing seemed to be her strategy for coping with anxiety.

Nikki exhibited her poor facility with numbers and her fear of them. On a test of general information, her responses to two questions requiring numerical answers (e.g., the population of the United States) were not even "in the ballpark." She also had extreme difficulty in repeating digits in their reverse order. When solving oral arithmetic problems, she was so nervous that she could not correct her responses even when she was aware that she was giving wrong answers. After the task she gave a sigh of relief.

Nikki showed her poor short-term memory, having to check with the key very often on a task requiring her to copy symbols that are paired with numbers. Though she tried to be careful, she made several mistakes, for example, copying the symbol for the number 3 in the box for the number 4.

Test Results and Interpretation

On the WAIS-III, Nikki earned a Verbal IQ of 106, a Performance IQ of 99, and Full Scale IQ of 103, scores that place her in the Average classification of intelligence and rank her at about the 50th-66th percentile for people her age (scores from all tests are listed in Table 12.7). Although her Verbal and Performance appear similar on the surface, Nikki's highly consistent scores on the three IQs mask the high degree of variability that characterized her subtest profile. Because of that variability, neither the Full Scale IQ nor the Verbal IQ provide a meaningful representation of her overall abilities. The Verbal scale is comprised of two indexes: Verbal Comprehension and Working Memory. In Nikki's case, these two indexes were significantly different from one another, rendering the Verbal IQ useless as a meaningful representation of her overall verbal skills. Examination of these indexes separately is much more informative. Nikki earned a Verbal Comprehension Index of 118 (88th percentile; 113-122 with 90% confidence) and a Working Memory Index of 82 (12th percentile; 77-89 with 90% confidence). The discrepancy between the indexes that comprise her Verbal scale indicate that Nikki's verbal conceptualization, knowledge, and expression are much stronger than her number ability and sequential processing. In addition, Nikki's Verbal Comprehension Index (118) was also significantly higher than her Perceptual Organization Index of 103 (58th percentile; 85-100 with 90% confidence). The discrepancy between these two indexes indicates that Nikki's ability to answer oral questions measuring factual knowledge, word meanings, and verbal expression is much stronger than her ability to integrate visual stimuli, reason nonverbally, and apply visual-motor skills to solve problems.

The variability in Nikki's WAIS-III profile was also evident in her pattern of relative subtest strengths and weaknesses. Similar to her overall High Average abilities depicted by her Verbal

Table 12.7


Wechsler Adult Intelligence Scale—Third Edition (WAIS-III)

Scale IQ 90% Confidence Interval Percentile Rank

Verbal Scale

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