The Additional Burden of Auditory Processing Skill “Deficits” for a Young Person with Multiple Exceptionalities: A Case Study of a Twice-Exceptional Student

Figures & data

Table 1. An overview of Ivan’s twice-exceptionality

Diagnosis	Age of diagnosis
Behavioral optometry - Eye teaming and accommodation/focusing issues	7 years, 3 months
Low muscle tone Joint hypermobility Dysgraphia	7 years, 11 months 7 years, 11 months 7 years, 11 months
Auditory processing skill deficits	8 years, 2 months
Phonological skill deficits	8 years, 3 months
Twice-exceptional	9 years, 3 months
Generalized anxiety disorder	9 years, 3 months
Dyslexia	9 years, 11 months
ASD ADHD Confirmation of generalized anxiety disorder	11 years, 1 month 11 years, 1 month 11 years, 1 month

Table 2. Ivan’s timeline of assessments and results

Age (Grade)	Practitioner	Assessment/s	Diagnosis/Results
7 years, 3 months (Grade 2)	Behavioral Optometrist	Behavioral optometry to assess impact of vision on learning	Convergence eye teaming – occasional loss of attention on sustained tasks Accommodation/Focusing: Insufficient for task demand Oculomotor skills: Smooth with concentration Visual acuity (sight): High Recommendation: Spectacles for all indoor activities
7 years, 11 months (Grade 2)	Occupational Therapist (non-school based)	Occupational therapy (OT) assessment	Low muscle tone and joint hypermobility, dysgraphia – ongoing OT therapy (finished at 11 years, 9 months, Grade 6)
8 years, 2 months (Grade 3)	Neurosensory Auditory Specialist Clinic	Auditory processing assessment (audiology report)	See Tables 3 and 4
8 years, 3 months (Grade 3)	Speech Language Pathologist (non-school based)	SPAT-R (Sutherland Phonological Awareness Test – Revised)	Overall score 3rd %ile: Onset identification 3rd %ile; Non-word spelling 3rd %ile; Non-word reading 3rd %ile; all others Developed/Average
		Clinical Evaluation of Language Fundamentals, Fourth edition (CELF-4)	Core Language SS 100 PR 50th %ile, Average range Receptive Language SS 116 PR 86th %ile, Above Average range Expressive Language SS 99 PR 47th %ile, Average range Language Structure SS 103 PR 58th %ile, Average range Ongoing speech language therapy up until 11 years, 9 months (Grade 6)
9 years, 3 months (Grade 4)	Psychologist	WISC-IV	See Tables 5 and 6
		WRAML2	See Table 7
		WIAT-II	See Table 8
9 years, 11 months (Grade 5)	Dyslexia diagnostic clinic	Bangor Dyslexia Test-II	Developmental dyslexia
10 years, 2 months (Grade 5)	Elementary school support teacher – literacy and numeracy	Neal Analysis of Reading Ability – Revised (Form 2)	Reading age: 10 years (44th %ile – Average) Comprehension age: 11.8 years (71st %ile, Above Average)
		South Australian Spelling Test	Raw score 27, spelling age 7.8 years (critical low score < 28), confusion of letter order (e.g., “frie” for fire), overreliance on sounding out strategies to spell words
		Sutherland Phonological Awareness Test (SPAT-R) (Form A)	SPAT-R total score: 56th %ile; Non-word Spelling In-Depth Analysis: 22nd %ile, SPAT-R total Form A: Just above median percentile for Grade 4
11 years, 1 month (Grade 6)	Developmental Paediatrician	Unknown	Autism Spectrum Disorder (ASD)
		Unknown	ADHD
		Unknown	Generalized anxiety disorder (confirmation)

Table 3. Teacher assessed SIFTER results for Ivan

Content area	Total score (Out of 15)	Passing score range (Marginal score range)	Fail score range
Academics	6^	10–15 (8–9)	3–7
Attention	7*	9–15 (7–8)	3–6
Communication	12	11–15 (8–10)	3–7
Class participation	13	9–15 (7–8)	3–6
School behavior	9*	10–15 (8–9)	3–7
Teacher qualitative comments	Ivan receives learning support for literacy, mainly for writing and spelling. Ivan enjoys talking to his friends, which often serves as a distraction to him.

Note. ^Fail; *Marginal.

Table 4. Ivan’s SCAN-C test results

Test for auditory processing disorder	Raw score	Standard score (Normal range 7–13)	Percentile rank
Filtered Words	31	9	37
Auditory Figure Ground	34	11	63
Competing Words	36	9	37
Competing Sentences	14	10	50

Table 5. Ivan’s WISC-IV results

Scale	Index score	Percentile rank	95% Confidence range	Description
Verbal Comprehension	140	99.6	128–144	Very Superior
Perceptual Reasoning	108	66	97–113	Average
Working Memory	86	21	81–98	Below Average
Processing Speed	94	34	85–105	Average
FSIQ	113	81	106–109	Above Average

Table 6. Ivan’s subtest scores on the WISC-IV

Subtest	Scaled score (Av. =10)	Subtest	Scaled score (Av.=10)
Similarities	17	Block Design	10
Vocabulary	16	Picture Concepts	12
Comprehension	18	Matrix Reasoning	12
(Information)	(14)	Coding	10
(Word Reasoning)	(16)	Symbol Search	8
Digit Span	7
Letter-Number Seq.	7

Table 7. Ivan’s WRAML2 results

Index	Score	Level
Verbal Memory Index	117	Above Average
Visual Memory Index	103	Average
Attentional/Sequential Memory Index	82	Below Average
General Memory Index	101	Average

Table 8. Ivan’s WIAT-II results

Area assessed	Score	Level
Word Reading Score	99	Average
Reading Comprehension Score	118	Above Average
Spelling Score	88	Below Average
Pseudoword Decoding Score	90	Lower End of Average
Written Expression Score	93	Lower End of Average
Maths Reasoning Score	90	Lower End of Average

Table 9. Overview of Ivan’s academic report (Grade 4, aged 9 years)

Curriculum area	Achievement (Descriptions)
English	C (Satisfactory)
Mathematics	C (Satisfactory)
Science	B (Very Good)
Social Sciences	B (Very Good)
The Arts	B (Very Good)
Information and Communication Technologies	C (Satisfactory)
Standardized English test (undertaken by Grade 4 students)	D (Needs Attention)