PsychologicalReports, 2000,87,759-765.

O Psychological Reports 2000

WISC-I11 SUBTEST PATTERNS OF ADHD AND NORMAL SAMPLES '

JANIE B. SNOW AND GARY L. SAPP

Jeflerson Corrrlty Schools U~riversifyof Alabama a1 Birnzingham

Sz,~lrnary.-WISC-IT1 subtest patterns of children with Attention Deficit Hyper-

activity Disorder were compared with nvo other groups of children described in the
U'ISC-III manual, a sample with Attention Deficit Hyperactivity Disorder and h e
\-YIISC:-111 standardization sample. Subtest patterns of primary interest were the
S C m Index based on Symbol Search, Coding, Arithmetic, Digit Span, Bannaryne
scores for Spatial, Verbal Conceptualization, Sequencing Ability, and the ACID Pro-
f i e including Arirhmetic, Coding, Information, and Digit Span. Comparisons of
WISC-111 scaled scores and subtest patterns for the samples with Attention Deficit
Hyperactivity Disorder supported the congruence benveen them. Further, the cumula-
uve percentages of children in the three samples who obtained differences benveen
the SCAD Index and the Perceptual Organization Index were computed. Analysis in-
dicated char 17 of the 35 subjects in the current sample obtained difference~of 9
points 01 grc.iter. The results were substantially different from the WISC-I11 stan-
dardizauon sample but congruent with the WISC-Ill sample of children with Atten-
tion Deficit Hyperactivity Disorder. These outcomes support the diagnostic utility of
WISC-111 subtest profile patterns for children with Attention Deficit Hyperactivity
Disorder.

Relatively few studies have examined the subtest patterns of exceptional

children on the Wechsler Intelhgence Scale for Children, Third Edition (Pri-
fitera & Dersh, 1993; Schwean, Saklofske, Yackdc, & Quinn, 1993). Earlier
studies frequently used subtest p r o f h g of the WISC-111 as a critical tool
(Smith, Coleman, Dokech, & Davis, 1977; Goldstein, 1987; Lufi, Cohen, &
Parish-Plass, 1990). However, Kavale and Forness (1984) in their seminal
meta-analysis of 94 studies of WISC-R subtest profiles of learning disabled
students did not identdy WISC-R subtest patterns or any recategorization
procedure which differentiated between children with learning disabhties
and those without learning disabhties. They reaffirmed the necessity of con-
ceptualizing Wechsler scales as measures of general intelhgence and asserted
that using them for conducting profile analysis is questionable.
More recently, a number of writers incluclmg McDermott, Fantuzzo,
Glutting, Watkins, and Baggaley (1992) and McDermott, Fantuzzo, and
Glutting (1990) offered strident criticisms of profile analysis. They suggested
that there are few data to support the practice and that it is a violation of
basic principles underlying valid test interpretation. The person most central
to the controversy may be Alan Kaufrnan, the most eloquent proponent of

'Send requescs for reprints to Gary L. Sapp, Ed.D., 1530 3rd Avenue South, EB 201, The
University of Alabama at Birmingham, Birmingham, AL 35294-1250.
7 60 J. B. SNOW & G. L. S U P

profile analysis. Kaufman (1994) suggested that the antiprofile stance of Mc-
Dermott, et a/. (1992) focuses more on the normative evaluation of chil-
dren's obtained scores and less on the individual intelbgence interpretation
of them (p. 25). Kaufman's continued emphasis on the significance of his
clinical method is crucial. H e contended that conducting profile analysis
without embedding it in his system "eviscerates" the process (p. 5 ) .
The study by Prifitera and Dersh (1993), while criticized for its use of
profile analysis (Flanagan, Andrews, & Genshaft, 1997), was extensively ana-
lyzed and deemed significant by Kaufman (1994). In the study the authors
described three groups of children tested as part of the validation process of
the WISC-111. The groups were children with learning disabhties, children
diagnosed with Attention Deficit Hyperactivity Disorder, and those included
in the standardization sample. Prifitera and Dersh found evidence "for spe-
cific patterns of cognitive deficits" (p. 51) in the two clmical groups. The
subtest groupings they identified in the literature as having diagnostic uthty
for these children were (a) the ACID Profile (Arithmetic, Coding, Informa-
tion, Digit Span) and (b) the SCAD Index (Symbol Search, Coding, Arith-
metic, and Digit Span) which place strong demands on a child's ability to
encode information.
The configuration of subtests proposed by Bannatyne (1971) has long
been considered useful in examining inrrasubject variabhty. This was a
grouping of Spatial (Picture Completion, Block Design, and Object Assem-
bly), Verbal Conceptualization (Similarities, Vocabulary, and Comprehen-
sion), Sequencing Abihty (Arithmetic, Digit Span, and Coding), and Ac-
quired Knowledge (Information, Arithmetic, and Vocabulary). Bannatyne's
reorganization was an outgrowth of his attempt to diagnose children with
reading disabdities assumed to be genetic in origin (Kaufman, 1994).
This study was conducted on the assumption that identification of
WISC-I11 subtest patterns may facilitate the diagnosis of Attention Deficit
Hyperactivity Disorder and may assist practitioners in the development of ap-
propriate remedial methods. Following Prifitera and Dersh (1993) and
Schwean, et a/. (1993), WISC-I11 subtest scores of 35 children with Atten-
tion Deficit Hyperactivity Disorder were compared to those of two samples
of children described in the WISC-I11 manual: children with Attention Defi-
cit Hyperactivity Disorder and the WISC-I11 standardization sample (Wech-
sler, 1991). The primary purpose was to compare the magnitude and fre-
quency of selected subtest patterns among the respective samples. It was hy-
pothesized that children with Attention Deficit Hyperactivity Disorder would
present distinctive subtest patterns different from those of normal children.
Specifically, it was hypothesized that the ~ r o f i l epatterns of the ACID Pro-
file, SCAD Index, and Bannatyne scores would be more identifiable in the
scores of children with Attention Deficit Hyperactivity Disorder.
 WISC-I11 SUBTEST PATTERNS: ADHD AND NORMAL SAMPLES 761

METHOD
Subjects were 35 children, 30 boys and 5 girls, ranging in age from 6
yr., 9 mo. to 16 yr., 9 mo. (M= 10.9, SD=2.8). Thirty-two of the children
were Euro-American and three were African American, all of whom at-
tended a large public school system in the southeast. AU subjects had been
assessed and lagnosed initially with Attention Deficit Hyperactivity Disor-
der; however, continuing learning and behavioral difficulties required an ex-
panded psychoeducational assessment. The WISC-I1 was administered by J.
B. Snow, a Certified School Psychologist, as part of the comprehensive as-
sessment procedure. The scale was administered in its entirety, except for
Mazes.
RESULTS
The four WISC-I11 index scores, Verbal Comprehension, Perceptual
Organization, Freedom from Distractibhty, and Processing Speed, were
computed using procedures recommended in the WISC-111 manual (Wechs-
ler, 1991). Following Kaufman (1994), the ACID Profile was computed by
summing the scaled scores for Arithmetic, Coding, Information, and Digit
Span and converting them to standard scores ( M = 100, SD= 15). Scaled
scores for the Freedom from Distractibility Index and the Processing Speed
Index were summed and compared (Kaufman, 1994) to obtain the corre-
spondmg SCAD Index (Symbol Search, Coding, Arithmetic, Digit Span).
Bannatyne's scores (1971) were computed by summing subtest scores for
each grouping of Spatial (Block Design, Object Assembly, Picture Comple-
tion), Verbal Conceptualization (Similarities, Vocabulary, Comprehension),
Sequential Ab&ty (Arithmetic, Digit Span, Coding), and Acquired Knowl-
edge (Information, Arithmetic, Vocabulary), and calculating the mean for
each group.
Table 1 presents the means for the IQ, index, ~rofile,and Bamatyne
scores. Ten of the 13 means of the WISC-111 standardization sample were
higher than the respective means of the two samples with Attention D e f ~ c ~ t
Hyperactivity Disorder. The exceptions were three means of the WISCl-I11
sample with Attention Deficit Hyperactivity Disorder: the Performance IQ
scale, the Perceptual Organization Index, and Bannatyne's Spatial Ability
score
The variables of primary interest were the scores of the two groups with
Attention Deficit Hyperactivity Disorder. To examine whether the two
groups were independent, the standard deviations were assumed to be 15,
and t tests for uncorrelated data were computed on the Verbal, Perfor-
mance, and F d Scale IQs. The standard deviations were assumed to be 15
points since they were unavailable. No significant differences were obtained
as mean differences ranged from one point on the Verbal IQ to 4.8 points
on the Performance I Q ( t = 1.53).
762 J. B. SNOW & G. L. SAPP

TABLE 1
O F WISC-111 IQ, INDEX,PROFILE,
MEANS SCORES
A N D BANNAI-~NE

Measure Attention Deficit WISC-111

Hyperactivity Disorder Standardization
Current Sample WISC-111 Sample Sample"
(12=35) (fz = 65) (n=2,158)
Verbal IQ 99.0
Performance IQ 96.5
Full Scale IQ 97.8
Verbal Comprehension Index 100.4
Perceptual Organization Index 98.2
Freedom from Distractibility Index 92.7
Processing Speed Index 95.1
ACID Profile 92.9
SCAD Index 91.1
Bannatyne: Spatial Ability 10.3
Verbal, Conceptual Ability 9.4
Sequencing Ability 8.5
Acquired Kno\vledgc 9.0
*Re roduced from [he \Y'echsler Intelligence Scale for Children, Third Edition Data and
~ a b 01992
k by The Psychological Corporation, a Harcourt Assessment Co., Reproduced by
permission. AU rights reserved. (cf. Table 2)

With regard to the ACID Profile (Arithmetic, Coding, Information,

Digit Span) the two samples with Attention Deficit Hyperactivity Disorder
showed substantial congruence as the mean difference was 2.3 points. How-
ever, the mean of the ACID Profile on the WISC-111 standardization sample
was higher (10.9 and 8.9 points, respectively) than those in the two samples
with Attention Deficit Hyperactivity Disorder.
Similarly, the SCAD Indces (Symbol Search, Coding, Arithmetic, Digit
Span) of the two samples with Attention Deficit Hyperactivity Disorder were
congruent, differing by one-tenth of a point. Further, the SCAD Index on
the WISC-I11 standardization sample was about 9 points higher than those
for the two samples with Attention Deficit Hyperactivity Disorder (8.9 and 9
points, respectively).
The Bannatyne scores also indicated congruence between the two groups
with Attention Deficit Hyperactivity Disorder as a comparison of the means
indicated that the largest difference was 1.2 points on Spatial Abhty. Signifi-
cantly, both groups presented with the predicted ~ a n n ~ r pattern
~ n e of high-
est scores on Spatial Ability, intermediate scores on Verbal Conceptualiza-
tion, and lowest on Sequencing Abhty. This finding is also consistent with
Rugel's study (1974), one of the first to apply Bannatyne's approach to ana-
lyzing WISC profiles of disabled readers.
Table 2 presents the cumulative percentages of the three samples ob-
taining discrepancies between scores on the Perceptual Organization Lndex
 WISC-111 SUBTEST PATTERNS: ADHD AND NORMAL SAMPLES 763

(Picture Completion, Picture Arrangement, Block Design, and Object As-

sembly) and the SCAD Index (Symbol Search, Coding, Arithmetic, and Dig-
it Span). While the smaller size of the current sample requires caution in in-
terpretation, the current sample and the WISC-I11 sample of children with
Attention Deficit Hyperactivity Disorder have 25.7% and 21.5%, respective-
ly, of children who obtained a difference of 17 points or more. In contrast,
in the standardization sample just 2.6% of children obtained this ddference.
Further, 17 of the 35 children in the current sample obtained a difference of
9 points or greater, and six children obtained differences of 23 points or
more.

TABLE 2
CUMUVITWTPERCENTAGES
O F THE CURRENT SAMPLE,WISC-I11 SAMPLE WITHATTENTION
DEFICIT
HYPERACTMTYDISORDER, A N D WSC-I11 STANDARDIUTION SAMPLEOBTAINING
DIFFERENCU
BETWEEN WSC-III INDEX SCORES AND T H E SCAD INDEX

Difference WISC-III
Current Sample Attenuon Deficit Standardizauon*
Hvoeractivitv Disorder
23 < 17.2
19 19.2
18 19.2 16.9 2.1
17 25.7 21.5 2.6
15 28.6 26.2 4.3
14 34.3 30.8 5.8
12 40.0 38.5 9.2
10 45.7 52.3 13.6
9 48.6 56.9 16.0
"Re roduced Erom the Wechsler Intehgence Scale For Children, Third Edition Data and
01992 by The Psychological Corporation, a Harcourt Assessment Co., Reproduced by
~ a b E
permission. All rights reserved. (cf. Table 6 )

DISCUSSION
This study supports prior research (Prifitera & Dersh, 1993; Schwean,
et al., 1993) suggesting that children with Attention Deficit Hyperactivity
Disorder are more likely than other children to present unique WISC-I11
subtest patterns. These patterns may possess diagnostic and treatment uthty
but must be considered along with other relevant data.
A number of indicators purported to have diagnostic uthty were com-
pared. Scores on these indicators were consistent between the two samples
with Attention Deficit Hyperactivity Disorder but were dscrepant from the
WISC-111 standardization sample. Scores on the ACID Profile and the
SCAD Lndex showed unique patterns for both the current sample and the
WISC-I11 sample with Attention Deficit Hyperactivity Disorder. Further,
the predicted Bannatpe score pattern of highest scores on Spatial subtests,
intermediate scores on Verbal Conceptualization subtests, and lowest scores
7 64 J. B. SNOW & G. L. SAPP

on Sequential subtests was obtained. These outcomes provide information

that many chicians may find to be valuable in diagnosis and planning intes-
vention.
Given the current controversy surrounding the use of subtest profile
analysis, many researchers w d remain unconvinced by evidence supporting
the notion that profile analysis has diagnostic or treatment uthty. The con-
troversy is framed as an issue of construct validity but may relate more
&rectly to the role of the clinician in assessment. ~ l l t t i n ~~ c, ~ e r m o tand
t,
Konold (1997) and Glutting, McDermott, Prifitera, and McGrath (1994),
while being vocal critics of profile analysis, have proposed a method of pro-
file analysis that employs a multivariate approach based on a normative sub-
test taxonomy. One of the reasons they offer for developing this method is
that, since the practice is widespread, practitioners should use the best meth-
ods currently available.
This study used an incidental sample with a small number of subjects
and the outcomes must be interpreted with caution. These subjects were in
considerable academic jeopardy either performing well below their predicted
levels academically or manifesting a significant behavior problem. Their lives
were severely influenced by their disability. Other groups of children may
not experience the same academic or behavioral dkficulties. When these chil-
dren are assessed, their presentation of dvergent subtest profiles might be
more subtle. The outcomes of this study suggest that careful analysis of the
relationship among WISC-I11 scales, indices, and profiles should not be sum-
marily dsmissed, particularly when Attention Deficit Hyperactivity Disorder
or a specific learning dsabhty is suspected.
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Accepfed October 10, 2000.