DDS Eligibility Decision by H.O. Mackiernan 2010-36

Date:

01/01/10

Author:

Sara Mackiernan

Outcome: ineligible

Keyword: mental health

Hearing Officer: Sara Mackiernan

Counsel present for Appellant: Yes, redacted

Counsel present for DDS: James Bergeron

Appellant present: no

Hearing Officer decision: 2010

Commissioner letter: 2010

Year	Test	Age	Score							Diagnosis regarding MR in report (or info on disability affecting result of testing)
			Verb.		Perf.		Full
1992	Stanford Binet	4					90			Only score was a Full Scale IQ of 90 with a mental age of 4. Demonstrated delays in motor skill development and significant speech difficulties.
1996	WISC-III	7	66		60		60			Could only maintain concentration for a brief period of time, speech difficult to understand and made many articulation errors. Evaluator recommended that medical or neurological consultation be sought to evaluate his attention problems.
2001	Neurological Evaluation									At time of evaluation Appellant was in a substantially separate sixth grade class with increasing behavioral difficulties and had become violent on several occasions. No meaningful interaction with other students, and impulsive. Academic test scores similar to 1996 results: articulation difficulties, attention and concentration consistent with ADHD. Evaluator also thought behavior (difficulty behaving in socially appropriate manner) consistent with autistic spectrum disorder.
2003	WISC-III		64		64		54			Highest score on a subtest (similarities) was 7. His other scores were between 1 and 4. On WISC-III subtests his verbal skills were consistently better than visual-perceptual skills. On a test for attention and self-regulation, his best performance was at six year old level. On computerized test of attention, his performance was consistent with diagnosis of ADHD. Disruptive behavior met criteria for Oppositional Defiant Disorder. Scores placed him in mentally retarded range.
2008	WAIS-III			63		58		58	Not able to sustain attention to tasks without prompting and extensive support.

FUNCTIONAL ABILITY

Year	TESTS	Age	Score	Diagnosis regarding MR in report, if any (or info on disability affecting result of testing)
1997	Neuropsychological Evaluation	8		No numerical scores given, but he scored in the intellectually deficient range in the tests. Early developmental milestones were met, although still ongoing difficulty with speech and fine and gross motor skills. Trial of Ritalin began in 1996. When evaluator when to school to observe him, re-administered several WISC-III subtests to see if he performed better with Ritalin. Evaluator noted that it appeared Ritalin may be benefitting him in terms of attention capabilities but does not increase intellectual capabilities.
2003	Neurological Evaluation			Observation at school, review of past testing: Disruptive Behavior Disorder Rating Scale primary concern was episodes of loss of behavioral control and symptoms associated with Oppositional Defiant Disorder.
2005	Discharge Summary Psychiatric Hospitalization			Discharge Diagnosis: Psychotic Disorder NOS, R/O Schizophrenaform, Moderate Mental Retardation and GERD. This is the first time that he was diagnosed as being psychotic.
2006	Discharge Summary				Admitted for dangerousness/suicidality. Diagnosed as schizophrenic disorganized type.

Issue is whether Appellant is mentally retarded as defined in 115 CMR 2.01 (a person with significantly sub-average intellectual functioning existing concurrently and related to significant limitations in adaptive functioning).

Appellant is 21 years old and his parents maintain guardianship over him. When first tested at age four, Appellant was described as cooperative and responded well to positive reinforcement, with an Full Scale IQ score of 90. Subsequently Appellant’s IQ score dropped 30 points between the ages of four and seven years old. Dr. Johnson, Psychologist for DDS interpreted the drop in IQ scores as a result of mental illness and behavioral problems (possibly early onset childhood schizophrenia) interfering with the Appellant’s ability to demonstrate his true cognitive abilities.

Hearing Officer decided that Appellant is not a person with mental retardation. Although Appellant has tested as such since age seven, these scores were adversely affected by his emotional and mental health issues. Testing indicates as mental health and behavioral issues worsened, Appellant’s intellectual abilities declined as well. Appellant is therefore not eligible for support from DDS.

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2010 - 36 Mackiernan.pdf (736.43 KB)	736.43 KB