WISC–IV Profiles in Children With Traumatic Brain Injury: Similarities to and Differences From the WISC–III Daniel N. Allen, Nicholas S. Thaler, and Brad Donohue University of Nevada, Las Vegas Joan Mayfield Our Children’s House at Baylor The Wechsler Intelligence Scale for Children—Fourth Edition (WISC–IV; D. Wechsler, 2003a) is often utilized to assess children with traumatic brain injury (TBI), although little information is available regarding its psychometric properties in these children. The current study examined WISC–IV perfor- mance in a sample of 61 children with TBI. As compared to the standardization sample, results indicated that the TBI group exhibited relative deficits on all subtest and index scores, with the greatest deficits on the Processing Speed Index (PSI) and Coding subtest scores. However, the Perceptual Reasoning Index score was not uniquely sensitive to brain injury, and the Cognitive Processing Index score was less sensitive to TBI than the PSI score. Also, the PSI did not uniquely predict learning and memory abilities, as had been reported in previous studies of the Wechsler Intelligence Scale for Children—Third Edition (WISC–III; D. Wechsler, 1991). The present findings indicate substantive differences between the WISC–III and WISC–IV profiles of children with TBI. Keywords: WISC–IV, traumatic brain injury, Processing Speed Index, Cognitive Performance Index, General Abilities Index The Wechsler Intelligence Scales for Children (WISC; Wech- sler, 1974, 1991, 2003a) have often been used in the neuropsy- chological assessment of children and adolescents with acquired and neurodevelopmental brain dysfunction, with some of the WISC subtests used to establish premorbid levels of ability (Schoenberg, Lange, Saklofske, Suarez, & Brickell, 2008) and others used to assess severity of impairment across a number of abilities (Weiss, Saklofske, Prifitera, & Holdnack, 2006). Some subtest and index scores from the WISC are sensitive to neurode- velopmental disorders, such as autism (Asarnow, Tanguay, Bott, & Freeman, 1987; G. Goldstein et al., 2008) and attention-deficit disorders (Solanto et al., 2007), as well as to cerebral insult caused by a variety of conditions, including neonatal brain injury (Schafer et al., 2009), hydrocephalus (Dalen, Bruarøy, Wentzel-Larsen, & Laegreid, 2008; Fletcher, Francis, Thompson, & Brookshire, 1992), stroke (Everts et al., 2008), and traumatic brain injury (TBI; Calhoun & Mayes, 2005; Donders, 1997; Donders & Janke, 2008; Donders & Warschausky, 1997; Kinsella, Prior, Sawyer, & Murtagh, 1995; Mayes & Calhoun, 2004; Prigatano, Gray, & Gale, 2008; Tremont, Mittenberg, & Miller, 1999). With regard to TBI, in addition to its role in educational and vocational planning, the WISC has been utilized extensively in TBI research to characterize those neurocognitive deficits that most commonly accompany TBI, as well as to identify abilities that exhibit relative sparing. Profiles unique to TBI have been identified and include a pattern of impaired performance IQ rela- tive to verbal IQ for the WISC, Wechsler Intelligence Scale for Children—Revised (Wechsler, 1974), and Wechsler Intelligence Scale for Children—Third Edition (WISC–III; Wechsler, 1991), as well as impaired performance on the Digit Symbol/Coding subtest (Calhoun & Mayes, 2005; F. C. Goldstein & Levin, 1987; Mayes & Calhoun, 2004; Tremont et al., 1999). In the most recent revision of the WISC, the Wechsler Intelli- gence Scale for Children—Fourth Edition (WISC–IV; Wechsler, 2003a), Performance and Verbal IQ scores were replaced with four index scores that were derived based on factor analytic work. The move away from a verbal–performance dichotomy of intellectual abilities has strong support even from earlier versions of the WISC, where factor analytic studies of the subtest scores demon- strated a three- and sometimes four-factor latent structure (rather than two-factor) consisting of Verbal Comprehension, Perceptual Organization, and Freedom From Distractibility factors (composed of Digit Span and Arithmetic subtests), as well as a fourth factor sometimes reported with loadings from Digit Symbol/Coding and Picture Arrangement (Blaha & Wallbrown, 1984). For the WISC– IV, the Verbal Comprehension and Perceptual Organization fac- tors were essentially retained, but the addition of a number of subtests also allowed the identification of Working Memory and Processing Speed factors. Inclusion of the Letter–Number Se- quencing subtest forms the Working Memory Index (WMI) in combination with the Digit Span subtest, while the Symbol Search subtest is paired with the Digit Symbol subtest to form the Pro- cessing Speed Index (PSI). Thus, even for this newer version of the WISC, the factors identified in earlier versions continue to provide a meaningful organization of the subtests. However, revisions made to the WISC–III when developing the WISC–IV may alter previously identified patterns of subtest and Daniel N. Allen, Nicholas S. Thaler, and Brad Donohue, Department of Psychology, University of Nevada, Las Vegas; Joan Mayfield, Our Chil- dren’s House at Baylor, Dallas, Texas. Correspondence concerning this article should be addressed to Daniel N. Allen, Neuropsychology Research Program, Department of Psychology, University of Nevada, Las Vegas, 4505 Maryland Parkway, Las Vegas, NV 89154-5030. E-mail: daniel.allen@unlv.edu Psychological Assessment © 2010 American Psychological Association 2010, Vol. 22, No. 1, 57– 64 1040-3590/10/$12.00 DOI: 10.1037/a0016056 57