Characteristics of children referred for evaluation of school difficulties who have adequate academic achievement scores.

Forty children (7 to 11 years old) referred for evaluation of learning problems, who had scores within the normal range on standardized measures of academic achievement, were compared to 81 similarly referred children who had scored low (< 90) on at least one measure of academic achievement. We tested the hypothesis that children with normal achievement scores who are referred for evaluation of learning problems show neuropsychological profiles comparable to those of children with low achievement. Referral problems, school history, IQ, academic achievement, and neuropsychological function were evaluated. Referred children with normal achievement scores came from more advantaged backgrounds and had less intensive academic interventions, higher IQs, and better decoding skills. Nonetheless, the two groups showed similar neuropsychological profiles. Vulnerability to complexity and decreased automaticity were prominent. Normal-range achievement test scores among children referred for evaluation should not be regarded as indicating absence of neurodevelopmental vulnerability.