Objective: Little information exists concerning the differences between FSIQ scores in normative and inpatient psychiatric samples amongst children leading to concerns about test interpretation. This retrospective study examines the relationship between Full Scale IQ scores on the WASI-II between the normative sample, an outpatient control sample, and an inpatient sample in an attempt to identify clinically relevant differences in test outcome. Method: Retrospective chart reviews were conducted on 187 inpatient children aged 6–13, who were assessed with the WASI-II between the years 2010 and 2014. Comparisons were made on the basis of FSIQ scores of the WASI-II using Welch's t test. Specifically, control group mean scores were compared to both inpatient and control sample mean scores on the WASI-II FSIQ. Results: When compared to normative samples FSIQ results did not indicate a significant difference between outpatient controls FSIQ score (p = .1872). However, when the normative sample mean and standard deviation was compared to an inpatient sample FSIQ, results indicated a significant difference at a level of (p =< .0001). Conclusion: Significant differences in FSIQ scores indicate an incongruity between normative samples and inpatient sample performance. The need to consider the impact of clinical status on intellectual outcomes in children is critically important particularly as relates to inpatient populations. Results indicate the need to consider additional factors and standards of “normal” assessment outcomes in inpatient child intellectual assessment.