Psychology in the Schools, Vol. 35(4), 1998 1998 John Wiley & Sons, Inc.

CCC 0033-3085/98/040309-08

WISC-III PROFILES FOR CHILDREN WITH AND WITHOUT LEARNING DISABILITIES susan dickerson mayes, susan l. calhoun, and errin w. crowell
The Pennsylvania State University College of Medicine The degree of WISC-III intersubtest scatter was normal and similar for 66 children with LD and 51 children without LD, but the pattern of scores differed. In the 8- to 16-year-old sample, children with LD scored lower on the Freedom from Distractibility Index relative to FSIQ than children without LD. This difference was found in both the ADHD and nonADHD subgroups, suggesting that children with LD may have an attention decit even if they do not meet the diagnostic criteria for ADHD. The CAD prole was evident in the mean scores for both the LD/ADHD and LD/ nonADHD subgroups, but it was not found among the lowest subtest scores for any of the nonLD subgroups. Though WISC-III prole types were apparent in LD group data, only a minority of individual children with LD actually had these proles. In the 6- and 7-year-old group, children with and without LD were indistinguishable on the WISC-III, which may reect the difculty of ruling out LD at this young age. 1998 John Wiley & Sons, Inc.

Reviews of research using the WISC-R show that groups of children with a learning disability (LD) scored low on the original Freedom from Distractibility Index (FDI) or factor (Arithmetic, Coding, and Digit Span subtests) relative to other factors (Kaufman, 1994; Wielkiewicz, 1990) and on the ACID pattern (Arithmetic, Coding, Information, and Digit Span) in comparison to other subtests (Joschko & Rourke, 1985; Sattler, 1988). However, Joschko and Rourke (1985) caution that the WISC-R ACID prole is common in LD group mean scores but is not found for the majority of individual children with LD. Similarly, Sattler (1988) states that there is no unique WISC-R prole characteristic of all children with LD and that prole analysis should not be used in the diagnosis of LD. To date, few studies are available that investigate the WISC-III performance of children with LD, and results are somewhat equivocal. Slate (1995) reported that FDI (Arithmetic and Digit Span) was not the lowest factor for 202 children with LD, whereas data collected during development and validation of the WISC-III (Pritera & Dersh, 1993; Wechsler, 1991, p. 213) showed that FDI was the lowest factor for a sample of 99 children with LD. Similarly, FDI followed closely by the Processing Speed Index (PSI) were both signicantly lower than the remaining two factors in a group of 26 children with a reading disability (Newby, Recht, Caldwell, & Schaefer, 1993). Data reported in the WISC-III manual (Wechsler, 1991) reveal another apparent discrepancy. According to the WISC-III manual and Pritera and Dersh (1993), the lowest subtests for children with LD were Arithmetic, Coding, Digit Span, and Symbol Search, which comprise FDI and PSI. However, the table in the WISC-III manual (Wechsler, 1991, p. 213) indicates that the mean score on the ACID prole (Arithmetic, Coding, Information, and Digit Span, which were not the four lowest subtests) is even lower than the mean scores on FDI and PSI (composed of the lowest subtests). According to the more detailed report of these data by Pritera and Dersh (1993, p. 48), the mean Information score was actually higher than the mean of all 13 subtests for the 99 children with LD. Kaufman states in his literature review and analysis, My suggestion to clinicians and researchers who have found value in the ACID prole is to abandon it for the WISC-III and to focus instead on the . . . FD and PS Indexes; in other words, they should replace the ACID prole with the SCAD [Symbol Search, Coding, Arithmetic, and Digit Span] prole (1994, pp. 218219). In addition to few and equivocal studies, existing WISC-III and LD research is limited by methodological problems. Some studies are not based on the administration of all subtests comprising the four WISC-III factors. For example, in the study by Slate (1995), Symbol Search was not adRequests for reprints should be sent to Susan Dickerson Mayes, Department of Psychiatry, Milton S. Hershey Medical Center, P.O. Box 850, Hershey, PA 17033.

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ministered and Digit Span was given to only some students. Specic and objective criteria for determining the presence or absence of LD are sometimes not provided, and children are simply described as having been classied or diagnosed with a learning disability (Pritera & Dersh, 1993; Wechsler, 1991). Data are also not analyzed as a function of comorbid diagnoses. For example, some of the children in the LD subgroup described in the WISC-III manual also had attention decit hyperactivity disorder (ADHD). Current research (Mayes, Calhoun, & Crowell, 1997) shows that children with ADHD score lowest on the Digit Span, Arithmetic, Coding, and Symbol Search subtests (SCAD prole). Considering the high incidence of ADHD in children with LD, LD prole analyses may easily be confounded by the presence of ADHD. The present study was undertaken to contribute to the sparse knowledge regarding the WISCIII performance of children with and without LD and to rectify some of the methodological problems limiting previous research. All children in the study underwent thorough clinical evaluations, criteria for determining LD were objectively dened using the WISC-III and Wechsler Individual Achievement Test (WIAT), all WISC-III factor subtests were administered, children with LD were compared with referred children without LD, the inuence of types of LD and comorbid diagnoses was analyzed, and several methods of prole analysis were conducted. Method Criteria for Inclusion The sample was drawn from 6- to 16-year-old children referred to diagnostic clinics at a department of psychiatry and a rehabilitation center at a university-afliated hospital. The majority of children were referred because of learning, attention, and/or behavior problems. All children evaluated in the clinics were included in the study if they (a) were administered the WISC-III and were not missing any subtest scores on the four factors; (b) were administered the WIAT Basic Reading, Reading Comprehension, Numerical Operations, Spelling, and Written Expression subtests (the latter if 8 years or older); (c) did not have a frank neurological impairment (e.g., spina bida, cerebral palsy, or closed head injury), psychosis, bipolar disorder, autism/pervasive developmental disorder, or signicant hearing or visual impairment; (d) were not on medication to treat ADHD symptoms at the time of the evaluation; and (e) had a WISC-III Full Scale IQ (FSIQ) of 80 or above. The latter criterion was included because a learning disability is dened in the authors state as a severe discrepancy between intelligence and academic achievement in children who have an IQ of 80 or higher (Pennsylvania Department of Education, 1994). Procedure and Instruments All children in the study were evaluated by a school psychologist and by a child psychiatrist or developmental pediatrician. The evaluations included clinical observations of the child; child and parent interviews; analyses of parent, teacher, and child rating scale and questionnaire data; and psychological testing. The psychological battery included the WISC-III, WIAT, a computerized continuous performance test (Gordon, 1982), and other psychological tests as indicated (e.g., self-report scales or specic ability tests). A child was designated as having LD if one or more of the WIAT subtest scores was signicantly lower (p .05) than predicted based on the WISC-III FSIQ, using the regression-based procedure specied in the WIAT manual (The Psychological Corporation, 1992). This denition was used because an IQ-achievement discrepancy is the most frequently used criterion for identifying a learning disability (Sattler, 1988, p. 607), and the regression equation reduces potential bias in identifying LD in children with high and low IQs (Shaywitz & Shaywitz, 1993; The Psychological Corporation, 1992).

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The sample comprised 66 children with LD and 51 children without LD. For all ages, the types and frequencies of LDs (as dened by the WIAT subtests) were Basic Reading (n 20), Reading Comprehension (n 28), Numerical Operations (n 28), and Spelling (n 32). For children 8 years of age and older, 39 had LD in Written Expression. In the 6- and 7-year-old subgroup of children with LD, eight had one type of LD, eight had two types, four had three types, and one had four types, which was the maximum possible for this age group. Frequencies for the 8- to 16-year-olds were 16 for one type of LD, 13 for two types, three for three types, nine for four types, and four for ve types, which was the maximum possible for the older group. The majority of children had one or more major DSM-IV diagnosis in addition to the presence or absence of LD. The most common was ADHD, including combined, predominantly inattentive, or predominantly hyperactive-impulsive types (n 69). Other behavior or mood disorders included oppositional deant (n 15), conduct (n 1), depressive (n 14), anxiety (n 11), and post-traumatic stress (n 4) disorders. The children with LD had a mean age of 10.0 years (SD 2.9), and the children without LD had a mean age of 9.9 years (SD 3.0), t 0.06, p .952. The mean IQ for children with LD was 104.6 (SD 11.2) and for children without LD, 105.2 (SD 13.2), t 0.24, p .810. Eight of the children with LD were female, and 17 without LD were female. All children were White, with the exception of four children in the nonLD group (two Hispanic, one African-American, and one AsianAmerican). On a 5-point parent educational attainment scale (education less than high school, high school graduate, some college, college graduate, beyond college), the mean educational level for all parent groups was some college (mothers of children with LD M 2.9, SD 1.3; mothers of children without LD M 3.0, SD 1.1; fathers of children with LD M 3.0, SD 1.5; fathers of children without LD M 3.1, SD 1.3). Mothers and fathers of children with versus without LD did not differ signicantly from each other when dichotomized according to education (up to and including high school versus beyond high school) and employment (professional or managerial position versus other), with all 2 probability levels at .733 or higher. Variables Children with and without LD were compared on four dimensions: (a) FSIQ-Index difference score calculated by subtracting each of the four Index scores (Verbal Comprehension, Perceptual Organization, Freedom from Distractibility, and Processing Speed) from FSIQ, (b) overall mean individual subtest difference score calculated by subtracting each of the 12 subtest scaled scores from the mean of the 12 subtest scores, (c) rank ordering of subtest scores from lowest to highest, and (d) degree of intersubtest scatter (standard deviation for the 12 subtest scores and range of scores). Standard deviations and ranges were used because these statistics describe the variability, distribution, and scope of scores and because these statistics are used to describe intersubtest scatter in the WISC-III manual (Wechsler, 1991, p. 266). Therefore, our results can be directly compared with those obtained in the WISC-III normative sample. Data Analyses Analyses were conducted separately for the 38 children who were 6 and 7 years of age and the 79 children who were 8 to 16 years of age for several reasons. Because 6- and 7-year-olds are at the beginning of their academic careers, a gap between IQ and achievement may be developing but may not yet be apparent or statistically signicant. Therefore, some children in this age group may have LD that is not yet detectable. More important, written expression cannot be assessed on the WIAT until age 8. Problems with writing are common in the general population (Hooper et al., 1986), and, in our sample of 8- to 16-year-olds, LD in written expression was a mean of 2.4 times more preva-

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lent than any other LD type. Therefore, some of our 6- and 7-year-olds will erroneously be in the nonLD group and will later prove to have LD in written expression. Because it is not possible to rule out LD in 6- and 7-year-olds, data were analyzed separately for 6- and 7-year-olds and 8- to 16year-olds to address this possible age confound and to determine if results do differ between the two age groups. To investigate the possible inuence of comorbid diagnoses, data were analyzed separately for children who had no comorbid diagnosis and for children who had a diagnosis of ADHD (with or without other behavior or mood disorders). Children were included in these subgroup analyses only if there was complete diagnostic agreement between the school psychologist and the child psychiatrist or pediatrician, so that children with equivocal diagnoses were excluded. Some analyses were also repeated comparing children without LD and children with each specic type of LD as dened by the WIAT subtests (i.e., LD in Basic Reading, Reading Comprehension, Numerical Operations, Spelling, and Written Expression). Difference in WISC-III scores between children with and without LD were analyzed using independent t-tests for groups not differing signicantly in age. For one comparison (6- and 7-yearolds with vs. without LD) signicant age differences were found, t 2.76, p .012. Therefore, general factorial analysis of variance with age as a covariate was used to make comparisons between these two groups. Differences in the frequency of WISC-III prole types between children with and without LD were investigated using Fishers exact probability estimate. For all statistical analyses, two-tailed statistics and a signicance level of .01 were used instead of the less conservative .05 level to adjust for multiple comparisons and reduce the likelihood of chance signicant ndings. Results Group Proles for 8- to 16-Year-Olds Total group. All comparisons between FSIQ-Index scores for the 45 children with LD versus the 34 children without LD were nonsignicant, with the exception of FDI, t 4.00, p .0001. FDI for children with LD was 10.7 points lower than FSIQ, whereas the mean difference was negligible (0.5) for children without LD. Sizable mean differences were found between FSIQ and FDI for all types of LDs, ranging from 7.9 points (Basic Reading) to 12.9 points (Reading Comprehension). For the two subtests comprising FDI, there were signicant differences between overall mean-individual subtest scores for children with versus without LD (Arithmetic t 4.19, p .0001 and Digit Span t 3.12, p .003). All other subtest difference score comparisons between children with and without LD were nonsignicant. The ve subtests with the lowest scores for the LD group (in rank order beginning with the lowest) were Digit Span, Arithmetic, Coding, Symbol Search, and Block Design. For the nonLD group, the lowest subtests were Coding; Object Assembly, Symbol Search, and Picture Arrangement (three-way tie); and Block Design. ADHD subgroup. In the ADHD subgroup, the difference between FSIQ and FDI was greater for the 28 children with LD (FSIQ-FDI 13.3) than for the 13 children without LD (FSIQ-FDI 2.6), t 2.60, p .013. For all types of LDs, the difference between FSIQ and FDI was greater for the LD than nonLD groups. No other FSIQ-Index score comparisons were signicant. The only overall meanindividual subtest score that differed signicantly between the LD and nonLD groups was for Arithmetic, t 2.77, p .009. The ve lowest subtests for children with LD in rank order were Digit Span, Arithmetic, Coding, Symbol Search, and Object Assembly. For children without LD, the lowest subtests were Object Assembly, Coding, and Symbol Search, followed by a three-way tie on Digit Span, Block Design, and Picture Arrangement. Subgroup with no comorbid diagnosis. Five children had LD with no comorbid diagnosis, and six children had no LD or any other diagnosis. Comparisons of FSIQ-Index scores were non-

WISC-III and LD
Table 1 WISC-III Mean Scores, Percentage of Children with Prole Types, and Subtest Standard Deviations and Ranges for 8- to 16-Year-Olds
Total sample LD (n 45) FSIQ VCI POI FDI PSI Picture Completion Information Coding Similarities Picture Arrangement Arithmetic Block Design Vocabulary Object Assembly Comprehension Symbol Search Digit Span AD CAD SCAD ACID Subtest SD Subtest range 105.7 108.4 106.1 95.0 99.7 12.0 11.2 9.5 11.7 11.0 9.1 10.2 10.7 10.4 12.1 10.0 8.8 37.8% 17.8% 11.1% 8.9% 2.6 8.5 No LD (n 34) 104.9 109.3 101.1 105.5 98.7 10.7 11.4 9.4 12.1 9.7 10.9 10.2 11.2 9.7 11.7 9.7 10.8 8.8% 5.9% 8.8% 2.9% 2.5 8.4 Subgroup with ADHD LD (n 28) 108.7 112.2 108.0 95.4 99.9 12.2 12.1 9.8 12.4 11.3 9.5 10.8 11.3 10.6 12.7 10.0 8.6 35.7% 10.7% 10.7% 3.6% 2.8 9.1 No LD (n 13) 105.9 112.2 100.2 103.3 99.7 10.2 12.6 9.5 12.3 10.0 10.8 10.0 11.5 9.3 12.1 9.9 10.0 15.4% 15.4% 15.4% 0.0% 2.9 9.3 Subgroup With No Comorbid Disorder LD (n 5) 97.8 99.2 101.4 89.8 101.0 11.8 8.2 8.6 11.2 10.8 7.8 8.0 9.2 9.8 10.6 11.4 8.2 40.0% 40.0% 20.0% 40.0% 2.4 7.4

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No LD (n 6) 97.0 97.5 94.5 107.3 100.2 10.0 8.7 10.7 9.7 8.3 10.3 8.7 9.3 9.0 10.3 9.0 12.3 0.0% 0.0% 0.0% 0.0% 2.0 7.3

signicant between the children with and without LD, with the exception of the difference score for FDI, t 3.66, p .005. Children with LD scored below IQ on FDI (FSIQ-FDI 8.0), whereas children without LD scored higher on FDI than IQ (FSIQ-FDI 10.3). The only overall mean individual subtest score that differed signicantly between the children with and without LD was for Digit Span, t 4.12, p .003. The subtests with the lowest scores in the LD group were Arithmetic, Block Design, Digit Span and Information (tie), and Coding. In contrast, Picture Arrangement, Block Design and Information (tie), and Object Assembly and Symbol Search (tie) were lowest in the nonLD group. Individual Proles for 8- to 16-Year-Olds For all 8- to 16-year-olds, the AD prole (i.e., 2 of the 3 lowest subtests including ties Arithmetic and Digit Span) was more common in the 45 children with LD (37.8%) than in the 34 children without LD (8.8%), Fisher 8.86, p .003. A similar pattern was found in the ADHD subgroup. The other proles (three of the four lowest CAD, four of the ve lowest SCAD, and four of the ve lowest ACID) were infrequent with nonsignicant differences (Fisher 2.36, ps .125) between children with and without LD in the total sample and the ADHD subgroup. Results for children without comorbid diagnoses were inconclusive because of the small numbers (see Table 1).

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Mean SDs calculated for each child on the 12 WISC-III subtest scores were similar for the 45 children with LD (M 2.6) and for the 34 children without LD (M 2.5), t 0.51, p .614. Ranges for the two groups were also comparable, with a mean difference of 8.5 points between the highest and lowest subtest scores for the LD group and 8.4 points for the nonLD group, t 0.31, p .760. Results were similar for the ADHD subgroup and for children without comorbid diagnoses, ts 1.10, ps .300. Results for 6- and 7-Year-Olds For the total sample of 6- and 7-year-olds, the four FSIQ-Index difference scores were not signicantly different for the 21 children in the LD group versus the 17 children in the nonLD group (Fs 1.85, ps .365). Similarly, nonsignicant differences were found in the overall meanindividual subtest scores between the two groups, Fs 4.74, ps .073. Information, Arithmetic, Digit Span, and Coding were among the ve lowest subtests for both the LD and nonLD groups. WISCIII subtest SDs for the 21 children with LD (M 2.6) were not signicantly different than those for the 17 children in the nonLD group (M 2.4), F 0.46, p 1.00, nor were signicant differences found in the range of subtest scores (LD range 8.4, nonLD range 7.9, F 0.13, p 1.00). Discussion Degree of intersubtest scatter was similar for all study subgroups, irrespective of diagnosis or age. Subtest standard deviations for all subgroups ranged from 2.0 to 2.9, and differences between the highest and lowest subscale scores ranged from 7.2 to 9.3 points. These ndings are similar to the norm. In the WISC-III standardization sample, the mean difference between the highest and lowest subscale scores was 8.1 with a standard deviation of 2.2 (Weschler, 1991, p. 266). Though degree of scatter was normal and comparable for all subgroups, prole differences were found in the 8- to 16-year-olds. The difference between FDI and FSIQ was signicantly greater for children with LD than for children without LD, and sizable differences between FSIQ and FDI were found for all types of LD (Basic Reading, Reading Comprehension, Numerical Operations, Spelling, and Written Expression). In the ADHD subgroup, children with LD also scored signicantly lower on FDI relative to FSIQ than children without LD. In the subgroup of children without ADHD or any other comorbid diagnosis, children with LD scored below FSIQ on FDI, whereas FDI was higher than FSIQ in children without LD. This did not simply reect poorer performance on the Arithmetic subtest because, of all the subtest comparisons, only the discrepancy between Digit Span and the overall subtest mean differed signicantly between the LD and nonLD groups. This suggests that children with LD who do not meet the diagnostic criteria for ADHD may still have attention problems, given current research (Mayes et al., 1997) that supports interpretation of FDI as a measure of attention. Continuous performance test data (Richards, Samuels, Turnure, & Ysseldyke, 1990; Robins, 1992; Tarnowski, Prinz, & Nay, 1986) also suggest that children with LD have an attention decit. If this is indeed the case, research is needed to determine if children with LD can benet from specic treatment of their attention decit (e.g., medication), as do children with ADHD (Mayes, Crites, Bixler, Humphrey, & Mattison, 1994). Though ndings for FDI (or the AD prole) were the strongest, the CAD prole was also found among the ve lowest mean subtest scores for all LD subgroups of 8- to 16-year-olds. In the subgroup of children with ADHD and LD, CAD and SCAD were among the ve lowest subtests, and in the subgroup with LD and no ADHD, CAD and ACID were among the lowest ve. Although the overlap between the ACID and SCAD proles is considerable, it is possible that groups of children

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with pure LD (i.e., without ADHD or any other comorbid disorder) may be more likely to have the ACID prole, whereas the SCAD prole may be more evident in children with both ADHD and LD. The AD, CAD, SCAD, and ACID proles were not found in any of the nonLD groups among 8- to 16-year-olds. The presence of the CAD prole in children with LD suggests that, in addition to a weakness in attention, these children may also be prone to difculties in other areas measured by the Coding subtest (e.g., graphomotor skill, performance speed, or memory). Even though proles emerged for LD group data for 8- to 16-year-olds, the frequency of proles for individual children with LD was relatively low. The only prole with statistically signicant frequency differences between children with and without LD was AD. For children with LD, 38% had Arithmetic and Digit Span as two of their three lowest subtest scores, whereas this was the case for only 9% of children without LD. The fact that only a minority of children with LD exhibited any of the proles is consistent with previous WISC-R research (Joschko & Rourke, 1985; Sattler, 1988). Given this nding, prole analysis may not be helpful diagnostically (and, in fact, it is irrelevant to the diagnosis of LD), but it is potentially useful in understanding cognitive differences in children with LD. For 6- and 7-year-olds, WISC-III proles were basically indistinguishable between children with and without LD. Interestingly, the AD, CAD, and ACID proles were present in group mean scores both for children with an identied LD and for children with no LD or for whom LD was not yet apparent. Nonsignicant differences were found between children with and without LD on the FSIQ-Index and the overall meanindividual subtest difference scores. The lack of differences may be an artifact of the difculty diagnosing LD at this young age. The WIAT Written Expression subtest cannot be administered below age 8, so it is not known if any of these young children will have a learning disability in written expression. Further, a discrepancy between IQ and academic achievement may be developing but may not be statistically signicant until the mid-elementary grades. Therefore, some 6- and 7-year-olds in the nonLD group who did not currently meet the criterion for LD may meet the criterion in the future. Because of age-related differences in our ndings, it will be important for future research to consider age in the analysis of WISC-III data. References
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