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Saturday, January 12, 2019

Smart and Slow: What is a Processing Speed Deficit? How Can Evaluation Help?

From NESCA

By Jessica Geragosian, Psy.D.
Pediatric Neuropsychologist

January 7, 2018


Emilia is in the 7th grade. Teachers have always found her to be an intelligent and academically motivated child; however, she has historically been quite slow in completing classwork and tests. Homework, particularly now in middle school, has been a highly laborious process, taking her far longer than her peers.

Emilia’s parents were also concerned when receiving her SSAT results, as the scores did not seem to reflect the capabilities of their smart kid. But what is most concerning to Emilia’s parents is that Emilia has recently been coming home saying she is “dumb” and hates school.

Processing speed is the rate at which an individual can process information and produce an output. Although it is measured as part of many standard intelligence tests, it has nothing to do with how “smart” an individual is.


Processing speed challenges can be visual, oral, and graphomotor in nature. They do not have to be related to a learning disability or ADHD, though they can be.

Also, processing speed can be easily impacted by many things. For example, while an individual may not have a primary processing speed deficit, depression and anxiety can temporarily cause deficits in processing speed.

It is not uncommon for children to have strengths and weaknesses in their cognitive profile. Weaknesses in processing speed, however, can be particularly frustrating, especially when children are very bright. This is because these children may have many ideas, but cannot produce them efficiently or effectively.


Children with processing speed deficits tend to experience a high level of frustration, as they are not able to demonstrate their knowledge and keep up with their peers in the classroom. Sometimes, processing speed deficits do not become apparent until middle or high school when work demands ramp up, or the student begins taking standardized exams with strict time limits.

For students like Emilia, who experience increased academic challenges as they progress in school, neuropsychological evaluation can be extremely useful and effective. In this case, the purpose of neuropsychological testing aims to better understand the nature of the processing speed challenges, the impact on the child, and how to utilize strengths to overcome challenges.


Students with processing speed deficits are often entitled to academic accommodations and can be quite successful with such supports in place. Testing can also be important for ruling in, or out, emerging mental health issues.

For Emilia, the following recommendations were particularly important to address in her educational planning:

  • extra time on tests (including standardized exams such as the SSAT);
  • the use of a computer to minimize graphomotor output demand (and access to voice-to-text software); help with notetaking in the classroom (copy of teacher’s notes);
  • learning tools to circumvent processing speed challenges (i.e. use of a Livescribe pen which records audio as she is taking her own notes);
  • putting value on quality rather than quantity of school work (e.g., when given a homework assignment in math, Emilia was required to complete every other item).

However, the most effective approach, and one of the most important outcomes made possible by neuropsychological evaluation, was explicitly teaching Emilia about her unique strengths and challenges. Children (especially middle schoolers) tend to be black and white—if they finish their test last, then they must be “dumb.”

When Emilia was able to see that this was a challenge that could be overcome, especially in the context of her very impressive intellectual abilities, she was able to re-engage in school without frustration. Moreover, parents and teachers were able to better understand and address her academic challenges in a thoughtful and effective way.


Dr. Jessica Geragosian is a psychologist licensed in Massachusetts and New Hampshire. She has a wide range of clinical experience – in hospital, school and clinic settings – working with children and adolescents presenting with a wide range of cognitive, learning, social, and psychological challenges.

She earned her doctoral degree from William James University, before completing postgraduate training in pediatric neuropsychology at the Massachusetts General Hospital for Children at North Shore Medical Center.

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