DDS Eligibility Decision by H.O. Silver 2010-1

DDS Eligibility Decision by H.O. Elizabeth Silver 2010

Outcome: Ineligible

Keyword: range of IQ scores, drop in IQ scores

Hearing Officer: Elizabeth Silver

Counsel present for Appellant: N/A

Counsel present for DDS: John C. Geenty, Jr.

Appellant present: Yes

Hearing Officer decision: 2010

Commissioner Howe letter: 2010

 

 

IQ

 

Year	Test	Age	Score			Diagnosis regarding MR in report (or info on disability affecting result of testing)
			Vb.	Perf.	Full
1994	WPPSI-R	5	81	86	81	Appellant had significant learning disabilities related to language, verbal memory, attention, and organization of information. Also diagnosed with ADHD
1997		9	64	80	70
	WISC-III		80	90	83	Appellant’s verbal scores ranged from a 3 on Digit Span to a 9 in Similarities. Performance scored scattered from a 7 on Object Assembly and Picture Arrangement to an 11 on Coding. Scores fell within the low to average range of intellectual functioning, though the scatter of scores were less meaningful indicators of true potential.
2002	WISC-III	13	84	89	85	Place in foster care since 1997. Appellant has global academic delays, low to extremely below average intellectual abilities, language difficulties, and significant issues with attention, executive functioning and short-term memory. Appellant had PTSD and anxiety issues and was on the following medications: Adderall, Zyprexia, Clonidine, and Trazodone.
2002	SB-4	13			75	Verbal 88; Abstract/Visual 78; Short Term Memory 66. Significant variances in sub-scores, and intellectual scores in the low to extremely below average age range. Appellant was fidgety, easily distracted, and had difficulty.
2005	WISC-IV	16	74	69	63	Index scores: Verbal Comprehension 84, Perceptual Organization 72, Working Memory 63, Processing Speed 76. Intellectual domain scores in the below average range. Appellant’s Schizophrenia diagnosis questioned, as testing did not reveal psychotic processes, and Appellant’s ADHD diagnosis questioned. After comparing WAIS-III scores with previous scores, doctor concluded Appellant’s scores were higher than mentally retarded category and Appellant’s cognitive deficits stemmed from developmental factors.
2009	WAIS-IV	20			67	Verbal Comprehension: 72, Perceptual Reasoning: 75, Working Memory: 66, Processing Speed: 76. Appellant not distracted during testing

 

 

 

FUNCTIONAL ABILITY

 

Year	TESTS	Age	Score	Diagnosis regarding MR in report, if any (or info on disability affecting result of testing)
	VABS			Communication 58, Daily Living 62, Socialization 72.
2002	CPT-II	13		Test abandoned
2009	ABAS-II	20	64	Conceptual: 70, Social: 66, Practical: 63. Overall score extremely low. Noted that Appellant was hospitalized in 2001 and 2002 for medication adjustments.
2009	ABAS-II	20	64	Conceptual: 72, Social: 72, Practical: 70. Overall score extremely low.

 

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 a 21 yr old male.  He had numerous evaluations, from age 5 until age 20  in the form of the Wechsler Pre-School and Primary Scale of Intelligence – Revised (WPPSI-R), obtaining a Full Score of 81 to the Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV), obtaining a Full Score of 67.

 

Appellant was also diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), at age 5, and Post Traumatic Stress Disorder (PTSD), at age 13, and had been taking Adderall, Zyprexia, Clonidine, and Trazodone. At the time of the report, Appellant was taking Wellbutrin and Abilify. Appellant was also diagnosed with Mood Disorder NOS, Psychotic Disorder, NOS, and R/O Dissociative Identity Disorder. However, the ADHD and Schizophrenia diagnoses were later brought into doubt at age 16.

 

Arguing for Appellant, Appellant’s foster mother of 10 years noted that Appellant’s Schizophrenia had been stable for three years, but his cognitive abilities had declined, and others could take advantage of Appellant’s trust. Appellant has trouble comprehending time and money, and while he does have friends, he prefers to stay inside his room. Dr. Corneau, working with the Appellant for 10 years, confirmed the trust issue and noted that Appellant needed intense supervision, as Appellant’s abilities are lower than perceived.

 

Arguing for DDS, Dr. Crenshaw, stated that Appellant was ineligible for DDS services, as his IQ test scores, while in the borderline low average range, did not meet DDS criteria. Dr. Crenshaw based this conclusion by on noting the discrepancy between Appellant’s full score IQ and sub-score IQs.  Dr. Crenshaw noted that IQ variances in test administration may sufficiently affect IQ test scores and also that Appellant’s attention span sub-scores consistently brought down Appellant’s full score IQ. While Dr. Crenshaw could not pinpoint the cause of this attention problem, he did conclude that something impaired Appellant’s attention span and ability to process information. Therefore Appellant was not eligible for DDS services.  

 

The hearing officer denied Appellant’s DDS claim, as Appellant did not show a mental retardation claim from the preponderance of the evidence, though the hearing officer noted that Appellant would need DMH services for his greatly diminished capacities. The hearing officer did find that Appellant’s IQ scores in his earlier developmental years (0-13) did range from 70 to 85, which are above DDS’s criteria for mental retardation, and Appellant’s IQ scores after 16 dropped to the 63 to 69 range, which are within DDS’s criteria for mental retardation. The hearing officer noted the question of why Appellant’s scored had dropped was the crux of the issue at hand. The hearing officer took note of Dr. Crenshaw’s findings, and the hearing officer further noted that Appellant’s eight verbal scores ranged from 64 to 88 and that Appellants eight performance scores ranged from 90 to 67. Later evaluations by doctors determined that Appellant’s functioning levels appeared too high to be considered mentally retarded.  The hearing officer took note of Dr. Crenshaw’s findings and also that Appellant was fidgety and easily distracted during testing, resulting in the abandonment of the Conner’s Continuous Performance Test-II (CPT-II). The hearing officer noted that the Appellant’s other psychological issues could contribute to his lower IQ scores, and Appellant’s acceptance of DMH services would be in line with such issues.