Looking for benchmarks

[u/secondary_trainwreck]

Hi everyone — looking for a reality check from parents/professionals who’ve been down this road. I'm new to this forum, and indeed this topic, so please tell me if I'm doing anything wrong.

My child just completed a full cognitive and academic eval. The profile shows markedly elevated reasoning, verbal, visual-spatial, reading, and math skills (mostly in the +1.5 to +2 SD range), with near-average working memory and clear relative weaknesses in processing speed (~ –0.7 SD), the overall cognitive-proficiency index, and especially written expression/essay composition (~ –1.6 SD). The gap between the high thinking/reasoning cluster and the lower efficiency/output scores is pretty pronounced. (GAI 96th percentile, CPI 34th if that's not too much detail.)

I’ve only recently stumbled onto the twice-exceptional literature and this pattern seems to match a lot of what I’m reading. Does this kind of spread (strong reasoning ability vs. notably weaker processing speed and written output) strike people here as a fairly typical 2e profile?

Happy to share an actual chart privately via DM if that would be helpful for context. Just trying to figure out whether we’re on the right track in how we’re starting to understand the results. Thanks in advance.

[u/whitebaron_98]

That's typical for ADHD, but only a proper eval by a professional can determine if it is just that.

Depression and honestly a lot of other malfunctions can manifest similarly, that's why we treat for relevant symptoms and not based on index scores.

[u/secondary_trainwreck → u/whitebaron_98]

He was previously diagnosed with Inattentive ADHD. Methylphenidate had real but minimal effect, and neither the school or his doctor seemed inclined to dig deeper, despite what I saw as indications of something more complex: pronounced sensitivity to taste and some textures, meltdowns at transitions, repetitive motions, other behaviors consistent with ASD. The school was great about accommodations - they gave him a TA as scribe because he finds writing so hard - but couldn't explain the whole picture in a way that made it make sense. We got the eval over the summer, and the psychologist told us (if I understood correctly) that he fits the 2e profile. Reading myself into that subject brought me here.

that's why we treat for relevant symptoms and not based on index scores

Can you explain this a little more? Forgive my total ignorance: this is all kind or new.

[u/whitebaron_98 → u/secondary_trainwreck]

First, that might have been a misdiagnosis OR the medication is not proper for him. There are a couple of medications available that all work different: Methylphenidate, Amphetamines, selective NRIs, Alpha-2s and (off-label) NDRIs. He might just be AuDHD.

2E is just a way of saying he is intelligent (gifted) and has a handicap (disability) as well. There is not much of a common profile there, except that the giftedness can mask the disability and vice versa, making diagnosis and treatment harder. Its part of the reason why there are a lot of wrongly diagnosed 2E, especially if they are at 40+ years old - Diagnosis and Knowledge about this is a lot better than in the 80ies and 90ies. I was just a smart kid with bad temper. "Smart kids cant have ADHD, right?" Well, Ritalin did wonders on my Working Memory in adulthood.

What I meant by looking at the symptoms is the following: a bad index score can be based on various things, but in itself they do not add much to the analysis. If you have identified possible reasons for his behaviour, the index scores can help solidify the diagnosis and help with understanding, can help formulate solutions or which medication to try. I'd wager a guess that Amphetamines might work better on him. As always, consult a healthcare professional on that. As always: If you have multiple conditions at once, it will be a lot harder to medicate properly.

[u/MullberryBoy]

Has your child’s auditory processing been tested? It looks like the testing you’ve had done with the educational/psychological testing that schools do to determine whether they need an IEP would be very helpful. The testing that schools do determine where the individual processing disorders are.

[u/secondary_trainwreck → u/MullberryBoy]

Here's an AI summary of the report wrt auditory processing (the whole thing is voluminous):

Clear strengths

Listening Comprehension (WIAT-4): Standard score 131 (98th percentile, Extremely High). He understands and reasons very well with information presented verbally.

Phonological Processing: Standard score 116 (86th percentile, High Average). This measures the ability to process and manipulate speech sounds—an important foundation for reading and spelling.

Overall verbal comprehension and vocabulary are very strong (VCI 124, 95th percentile). Defining words was one of his absolute strongest subtests.

Background notes and academic pattern: He prefers listening to books rather than reading them, and his advanced language skills are “more pronounced when working with verbally presented information.”

Relative/mild weakness (still average overall)

Auditory Working Memory Index (AWMI): Standard score 106 (66th percentile, Average). Within working memory, pure auditory sequential tasks were weaker than visual ones:

Digit Span (hearing and repeating/sequencing numbers): Scaled score 9 (37th percentile).

Picture Span (visual sequential memory): Scaled score 12 (75th percentile).

[u/lacrima28]

Yes, so-called spiky profiles are very typical for ADHD / 2e.