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Neuro Psych Test
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Neuro Psych Test

I had my appointment with my PC today at the VA and picked up the progress notes from my Neuro Psych Testing that was done 1 month ago. I found it a very interesting read and contained some thoughts that may help others here. It will be in the final section that may be of interest to others in handling some of the problems we tend to face.

But first a word from our sponsor The Wildlife Report.....

I was surprised and delighted to see two deer on my trip along the Trace on my way to the VA. Surprised because this was around noon with scorching heat.  The heat index today at home hit 110 degrees.

The first deer was a fairly large doe that I only got a spit second look at as it head down and out of sight into a hollow. This was about 1/2 the way up the 50 mile drive along the trace. The second deer I saw I had a good long look at about 1/2 mile before leaving the Trace to enter Nashville. The deer was a young fawn. If you have ever seen a deer in the wild as the run away they usually have their tails and heads  held up high and they take bound leaps. But this fawn had it tail and head down and was running more like to see a dog run. And it was really moving at a good clip. At the time I was going 40 mph and guessing from that this fawn must have been doing 35 mph at least because it took along way for me to get past it as it ran along the tree line about 25 feet from the road. I have never seen a deer do that before and I have seen many of them over the years.

And now back to our regular scheduled topic....

The doctor was very through ( not sure if that is the word I meant ) and really listened to everything I said to him. Almost wonder if he had a tape recording going because of this. LOL.

There were a total of 17 tests he did ( some of them were going on at the same time I guess to determine if I could handle distractions  ).

He estimated my Premorbid IQ at 104.

He did use abbreviations for some things so I don't really know what it means,

First he listed things that I tested as average with qualifiers as needed.

Verbal speed / category organization retrieval ( animals )
Object naming / word retrieval
Visual search / motor speed ( low average )
Visual search / motor speed working memory / divided attention
Visual scanning / visual fields ( letter cancellation )
Auditory attention working memory
Fine motor speed left hand
Fine motor speed and dexterity left hand
Visuospatial organization / planning ( but slow )
Visuospatial construction ( high average but slow )
Executive functioning mild deficits - slowed

Next came the mild deficits

Verbal speed / phonemics Organization retrieval
Complex visual attention / psycho-motor processing speed.

Next came the moderate deficits:

Fine motor speed and dexterity right hand

Then severe deficits

fine motor speed right hand

I've skipped over most of the diagnostic impression section as it just tells in English about the test results above.  

To Be Continued:
Dennis
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Avatar_m_tn
But I found the last paragraph very interesting in this section.

The most consistent finding on testing is the overall mental slowing which is common in MS ( yes he put down I have a DX of MS) as well as those with CAD / vascular related conditions. Over time as both conditions progress, he will likely experience greater cognitive decline. His report of OCD/anxiety symptoms, PTSD, Pain, and mild depression will tend to FURTHER EXACERBATE cognitive deficits/ inefficiency as they may be highly distracting and further decrease mental efficiency  particularly when in distracting environments or when needing to perform tasks quickly. Intervention to help better manage worsening anxiety and mood symptoms may be helpful in reducing overall distress.

General recomendations:

memory and new learning:

Associate new information with something that is already familiar to him.
Create a visual image of the new information when possible
Actively rehearsh new information outload or to himself frequently
Provide cues/hints ( notes/ lists)
Monitor behavior to ensure that direct attention/eye contact is focused on teh to be remembered information or speaker
Placing frequently needed items ( keys wallet) in a central ( specific) location so they are retreived easily.

Attention / distractability

Decrease distractions in the environment whenever possible. ( go to quiet room, remove materials from view that are not relevant to the current task ).
Break up complex multi-step tasks into smaller components so that there is decreased need to constantly monitor multiple components of a task.
Allow extra time to complete tasks that are complex and require sustained attention in order to reduce the feeling of being overwhelmed.
Take frequent breaks when working task in order to reduce fatigue and frustration.

Dennis




  
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Avatar_m_tn
One more thing that stuck out.

He indicated that my speech is slow and slurred mildly. I had know idea that this was going on with me.

Dennis
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572651_tn?1333939396
Dennis, overall it sounds like a day well spent.  Especially with spotting the deer.  People who live in other parts of the country have deer the size of perhaps Great Danes.  They can'tr begin to understand how large our midwest deer can be.

now back to your topic - did this doc refer you to one of their sites for practicing your redcommmended techniques?

best, Lulu
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Avatar_m_tn
He sends those recommendations to the Neuro that referred me to him. It is then up to my Neuro to decide if he will send me elsewhere to implement them.  I see the Neuro in a couple of weeks.

Dennis
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Avatar_f_tn
Dennis, I don't remember, but are you on an anti-depressant?

He says your psychiatric or psychological symptoms are likely to further exacerbate your cognitive decline, so it's important to do something about those symptoms. Luckily they are very treatably.

And regarding your wildlife report, we have whiite-tailed deer around here, and they're pretty darned big.

ess
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Avatar_m_tn
No I'm not any anti-depressant. My depression is of the seasonal type for the most part. More of a concern to this doctor is my OCD and PTSD symptoms. These are not being treated by the VA. The last time I talked to a shrink at the VA he said I lived too far away to get treatment for that stuff. Hopefully this report will make a difference in that assessment.

Dennis
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Avatar_f_tn
Well, OCD and PTSD are both anxiety disorders, but they're often treated with the SSRI antidepressants. It can't hurt to ask about this.

ess
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987762_tn?1331031553
hmmmm if you 'dont' look deeper into the individual subsets, the collective data would of averaged out to be meaningless, you have highs and lows in cognitive skills but overall your functioning within 'normal' IQ range. To some testers 'average' aint a problem, but yours was looking at the big picture, your picture and seeing your low subsets are consistent with the cognitive problems you are experiencing.

What I see is 'organised rutine' and 'extra time' is going to be something that helps, your brain is still functioning albeit slower, knowing your informational data base is still accessible but its your retreval of that info that needs a helping hand, so you've still got it. When my executive function plays up, i think of it like my computer needs rebooting, i pause, take a mental deep breath and try again. Its become second nature and isn't as noticable, I have more control or at least think I do lol.

Acquiring new info/skills isn't getting into your data bank as it should, you need more repetition with segmented components to make it easier to retain. Rutine and visual clue aid memory retreval but certain things inhib rather than help, frustration, anxiety, distraction (audio, visual, internal), prior expectations etc all work against you, just knowing this does actually help you to deal with it.

I could go on and on but i wont bore you to death, lol so at the end of the day, this is your proof that your not as dumb and stupid as you've been telling your self, i've a feeling you've been beating your self up abit, sorry if i've got that wrong (hug) Just know your an average intelligent person who's brain isn't functioning as it once was. That new functioning will take some getting use too, there are many many things you can try, something will work for you, you just have to find it!

Hugs............JJ  
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Avatar_m_tn
I have never thought that I was dump or stupid, quite the opposite. If I didn't believe this I would not be able to laugh at myself and the really stupid things I do most days.  The thing this doctor confirmed to me was that my brain is functioning in the manner that I suspected it was. Since developing MS my mind has gone through periods where it was functioning like it use to do and at other times a lot worse than it is now.

The only things that surprised me was that my speech was slowed and slurred and the extend of my right hand dexterity was diminished. While I did know that my dexterity was being impaired as I have had some trouble picking up small objected I had know idea it was severe. I also had know idea of the speech problems.

I actually knew at an early age that I was "smarter than the average bear" as I was reading Plato, Homer, and Shakespeare as well as doing algebra,and trigonometry, when I was 8 years old. When I was about 25 I took an IQ test with a score of 138 which ws high enough to joined Mensa which is an organization of very smart people.

The only area I had trouble with in school was those English courses. And then is was only because of the "book reports" you had to do. It wasn't that I had trouble with English but at that time I could not express my feelings. So my book reports always consisted of just one line." I liked the book".  Which of course was not acceptable to the teacher. On the bright side since developing MS I have been able to express my feelings. It is like the emotional part of my brain has become dominate due to damage to the logical part so that I can know access my feelings.

Dennis


Dennis
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987762_tn?1331031553
I thought afterwards 'dumb and stupid' might not be the right words to use, I am really sorry if that was offensive to you!

In my family we 'use' to joke that i'm the 'dumb' one in the family, the others are in the exceptionally/profoundly (160+) gifted IQ group and i am (was!) in the highly (145+) gifted IQ group. I knew I was loosing my long established cognitive and communication skills long before it was evident to my family, when i lost all nouns and struggled to speak coherantly, we knew the cause could only be neurological.

Gifted, IQ's, brain development, testing subsets, cognitive developments, verbal communication, psychological aspects of gifted etc etc etc has been my world since my son started reading at 10 months. What we scientifically know about the 'gifted' brain is that the neuro pathways develope differently to a 'normal' brain, basically a 'gifted' brain lights up with more activity. If your IQ was previously 138 then you have a gifted brain!

I will stop because i could easily talk your head off, i just love everything about brain development and i could on and on about this topic lol its a passion that can bore you to sleep.

Cheers...........JJ

  
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Avatar_f_tn
To tell the truth, I am really afraid to go thru an IQ test at this point, and luckily there's no reason for me to do so. I doubt if Mensa would have me these days, not that I want to join, or ever have wanted to. But I know I'm not as sharp a cookie as I used to be.

However, since the standard IQ test shows the ratio betw. mental age and chronological age, it is pretty much meaningless past adolescence. Our abilities may be finite but our age keeps increasing, so the IQ score should go down. Also, of course, the test is very limited in measuring overall intelligence. This has been a big sticking point with all IQ tests. A dog might be measured by how well it can do the things it wants to do or is trained to do, none of which has the slightest thing to do with verbal, logical or mathematical skills. A child living in a crime and poverty-stricken area might have lots of street smarts to survive. And so on.

Also, it's so personal. Very few people are gifted across the board. Dennis, you used to have great trouble doing English reports, while I just lapped them up, but put me in an engineering course and I'd be bewildered. I worked for many years with computer geeks, systems, networking and communications guys who just intrinsically absorbed everything without any effort, but ask them to read and discuss even a Sherlock Holmes story and they seemed downright dumb, for lack of a kinder word that gets my meaning across. I felt happy that I could do the computer stuff, even if I had to learn it slowly and carefully, so I thought I was ahead of the game :-) But I'm sure not gifted in computers.

So anyway, Dennis, your abilities may have slowed due to MS, but they probably have changed as well, and there are no tests for the kinds of things you understand inherently at this point in your life. Guess that goes for all of us.

ess



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Avatar_m_tn
The dumb and stupid didn't offend me at all. Heck that is what I say to myself when I mess up. LOL And I have done some really dumb things when my brain has not been working that great.

I have always been fascinated with the workings of the brain and took philosophy and psychology type courses for my electives in college in order to learn all I could.

Personally I think your son is very lucky to be living in todays world, When I was growing up most gifted kids where bored to death in school like I was. At the start of each year I would go through all of my text books within 2 weeks and then spend the rest of the year just trying to stay awake in class because I already knew everything the teacher was telling us.

Dennis

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Avatar_m_tn
You misunderstood what I was saying about English classes. I never had any trouble discussing books on an impersonal level. My English teachers in high school ( which is when my troubles with English started ) where the touchy feelly types and wanted us to tell them what we felt about stories. I used a logical approach to the reports but could not express how I felt about what was going on in the books. In fact I don't think even one guy in the classes got over a "D" in them while the girls all got "A" and "B".  Guys just weren't suppose to talk about how they felt back then.  
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LOL Dennis, my son at a young age described school as "being a slave master environment in the classroom and an unfair unfriendly environment in the playground" and it sort of went down hill from there. Nothings really changed much at school, DS encountered a school system that felt it was in his best interest to not teach him. The bubble really burst when we were told "it was unexceptable for him to produce work that the teacher didn't understand" hmmm even his choice of books to read were confiscated because they were 'inapropriate' lol one was a book on the big bang theory.

So he's home schooled, not something I ever wanted to do, still dont if truth be told but the alternative is not 'appropriate' lol

Cheers.........JJ  
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