Full Psychological Report.Sample

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Sample- Psychological Report

Full Psychological Report.Sample

  1. 1. SAMPLEConfidential Psychological Report Names have been changed For Professional Use Only Prepared By: Debra Bassett EdS Student in School Psychology University of Northern Colorado June 28, 2011
  2. 2. CONFIDENTIAL PSYCHOLOGICAL REPORT For Professional Use OnlyNAME: Jane Smith BIRTHDATE xxxADDRESS: Xxx : AGE: 9 years, 7 months Xxx GRADE: Third grade (completed)PHONE: Xxx SCHOOL: xxxExaminer Debra Bassett, School Psychology Ed.S. StudentREFERRAL QUESTION:Jane was referred as practice for the examiner. Jane’s mother is concerned about Jane’s readingfluency and comprehension. Jane appears to experience difficulties in word decoding andcompleting vocabulary and comprehension tasks when they require her to read and respond toquestions (versus orally presented tasks). Jane’s mother believes the nature of the problem isminor and Jane’s dislike of reading may have contributed.ASSESSMENT PROCEDURES Interviews with : Cindy S., Jane’s mother: 6/16/2011: Cindy briefly talked about the family environment, stating that her and John are happily married and have a good relationship with both Jane and Grant (Jane’s half brother). John has good employment which calls him to travel often, but Cindy describes a happy home situation even when one member is away. Cindy and John are in good health and very active in their children’s lives and in their church. Cindy describes Jane has having good health with no major problems, illness, or accidents during her childhood. She describes Jane as very upbeat, eager to please, funny, and a very positive little girl. She talked about Jane’s close group of friends and how they have nice neighbors (even friends across the street for Jane to play with). Cindy doesn’t believe that Jane exhibits emotional tension, fear, or a lack of confidence. Instead, she said Jane seems very comfortable in many situations, has an overall positive attitude and can express her feelings well. Cindy did mention that Jane has experienced bullying at her school. They have met with the bully and her family to discuss the problem, but things haven’t really improved. Cindy doesn’t notice any unusual behavior patterns in Jane. She describes Jane’s development as average academically and above average emotionally. Since beginning school, Jane has attended the same Christian private school. Cindy says that Jane always excelled at her subjects as seen through grades and teacher comments until she reached this year (third grade). Now, Jane has had difficulty with reading and she participates in a special reading group at school. She says that the teacher encourages Jane to “tackle” words (i.e. sounding them out loud), but that Jane struggles and is hesitant to try. It’s been frustrating for Cindy when Jane now brings home vocabulary worksheets with a D or F because she can ask Jane those same vocabulary words and Jane knows the answer. Cindy has also watched TV news stories with Jane and Jane can comprehend the information
  3. 3. when asked about it a couple days later. However, Jane struggles with reading comprehension tasks in class. Because of the skills she sees at home, Cindy’s unsure why Jane is having trouble at school. When Cindy asks Jane about her D or F assignments, Jane just says “that was silly of me.” Cindy doesn’t believe Jane stresses about it (almost to a fault). Cindy tries to encourage Jane to read more, saying that she doesn’t really like to read but at times, can’t put a book down when the subject is interesting. Cindy plans to get a tutor this summer for Jane and said it would be helpful to know what the tutor can work on. She’s also curious about what the assessments reveal because she knows Jane doesn’t really want to be in the special reading group anymore.Jane on 6/16/2011: Jane enjoys school and just finished the third grade at ABC Christian School. Jane does wellin science but math and social studies are difficult for her. Jane said multiplication facts aredifficult for her because she can’t memorize them. Jane was generally positive about school,saying that she liked seeing friends and running home to tell her mom about her day. Jane has 4-5good, close friends who are her same age. She describes one girl as her “best friend” and says she’s“amazing.” Jane participates in a church youth group and enjoys playing soccer. She likesreading mystery books, drawing her family, and going on vacations. She truly enjoys anythinghaving to do with Justin Beiber and wishes to meet him someday. She discusses feeling angry when friends or other kids gossip about her. She doesn’t feelangry at her parents but describes very rare occasions in which her brother can make her angry.She could recognize her behaviors that make others mad or times she felt guilt or jealousy. Shelikes her personality, described as funny and fun, but doesn’t like that she can get angry after along day or when she’s tired. Jane said she gets sad when she’s tired and identifies her attitudeas one thing she’d like to change about herself. Specifically, she’d like to be able to change heranger to happiness. She repeatedly described a student who has bullied her since kindergartenand reports feeling angry, sad, and a desire to get even when this individual has embarrassed heror encouraged her to make others feel bad. She describes bullying as the worst thing that hashappened to her. She has positive early memories of family events (i.e., Easter, weddings) andhopes someday to be a hair dresser or teacher. She admits that death of a loved one is on hermind a lot. She says that she hasn’t experienced death much but is aware someone (i.e. grandmaand grandpa) will die at some point. Jane discussed herself and her feelings openly, taking time to really think about the question.General themes included a close attachment and love for her family and friends, as well asnegative feelings surrounding the bully at school. She had trouble remembering negativememories with her family (i.e. times of anger), but could easily recall detailed memories of whenshe was bullied. Review of records: Jane’s attendance records indicated consistent, good attendance. She hasno unexplained absences or discipline problems. Previous report cards indicate a 3.25 GPA (ona scale of 4.0). At this time, there were no CSAP records available.
  4. 4. Classroom observations: Jane was observed during her reading group. She was very social,talking with the other students around her and waving across the room. She appearedcomfortable overall in the group, but at times, distracted. She would look up at the clock andplay with her nails on a couple occasions. She only raised her hand 50% of the time whenquestions were asked, but her answers were accurate. When she read aloud, she appeared tostruggle on decoding words. She would attempt to sound them out quietly (whispering) until theteacher would ask her to speak up or would provide the word to her. These occasions seemed toembarrass her (i.e. face turned red, kept head down). Her teacher indicated that her behaviorduring observation was typical. Tests administered: Wechsler Intelligence Scale for Children – Fourth Addition (WISC - IV) Basic Achievement Skills Inventory (BASI-Survey) Behavior Assessment System for Children, Second Edition (BASC-2); Parent Rating Scale (PRS-C) Behavior Assessment System for Children, Second Edition (BASC-2); Child Self Report Scale (CSR): administered but not scored at this time Vineland Adaptive Behavior Scales, Second Edition (Vineland II) Parent/Caregiver Rating Form Draw A Person: Screening Procedure for Emotional Disturbances (DAP: SPED) House-Tree-Person (HTP) Kinetic Family Drawing (KFD) Child Depression Inventory Roberts-2 Feedback session: None to date. (No formal feedback provided since this assessment wasconducted for training purposes).BACKGROUND AND BEHAVIORAL OBSERVATIONS:Family History Jane is the second child of John and the first child of Cindy S. Cindy and John are currentlymarried and have a very close relationship with Jane. Cindy is a stay-at-home mother and Johnworks in sales and finance, requiring frequent travel. Jane has an older step-brother who isfourteen years old. He primarily resides with his biological mother but also spends considerabletime at Jane’s residence. Jane and her brother share a close relationship, described by Cindy as“communicative, affectionate and expressive.” Parental disciplinary procedures include firmtalking and removing privileges (on rare occasions). Jane’s family resides in the suburbs, withsports and church activities available. There is no history of significant mental illness orcognitive deficits in Jane’s family.Medical History Jane had normal prenatal, natal and postnatal medical history. Her recent physicalexamination took place on October 10, 2010 and her general health was good. Her overallmedical history is good, with no surgeries or noteworthy illnesses. Her developmentalmilestones were normal.
  5. 5. Prior Educational History Jane has attended Preschool through third grade (current year) at ABC Christian school. Shehas not repeated or skipped any grades. Cindy describes this school as adequate, but havinglimited resources. During the school year, Jane was part of a special reading program (ReadingNaturally) for help with comprehension and fluency. Jane admitted not enjoying the specialreading group she attends, saying that she reads better than the other students and wants to rejoinfriends in the normal reading program.TEST RESULTS:COGNITIVE:All test scores are reported at the 95% confidence intervals (CI) unless otherwise indicated. It islikely that Jane’s true score will fall somewhere between the stated lower to upper classificationranges.Wechsler Intelligence Scale for Children- Fourth Edition (WISC-IV) WISC-IV Score SummaryVerbal Comprehension Scaled Score Perceptual Reasoning Scaled Score (mean=10; SD=3) (mean=10; SD=3) (mean=10; SD=3)Similarities 11 Block Design 6 (W)Vocabulary 9 Picture Concepts 7Comprehension 8 Matrix Reasoning 11Information 10 Picture Completion 10Word Reasoning 8Working Memory Scaled Score Processing Speed Scaled Score(mean=10; SD=3) (mean=10; SD=3) (mean=10; SD=3) (mean=10; SD=3)Digit Span 7 Coding 14 (S)Letter-Number Sequencing 11 Symbol Search 10Arithmetic 9 Cancellation 11Scaled Score IQ Index Classification Percentile Confidence (mean=100; SD=15) IntervalVerbal 96 Average 39 89-103ComprehensionPerceptual Reasoning 88 Low Average 21 81-97Working Memory 94 Average 34 87-102Processing Speed 112 (S) High Average 79 102-120Full Scale * * * **Note: A statistically significant difference was observed between Jane’s working memory, processing speed,verbal comprehension, and perceptual reasoning scores. This discrepancy renders the calculation and interpretationof her full scale IQ score (FSIQ) meaningless.*Note: (S) indicates an area of strength for Jane and (W) indicates an area in need of growth.
  6. 6. ACHIEVEMENT TESTS:Basic Achievement Skills Inventory (BASI-Survey) For Totals: MEAN = 100 STANDARD DEVIATION = 15SUBTEST Standard Score Classification Percentile Confidence Equivalence Interval Grade/AgeMath Computation 7 Low AverageMath Application 7 Low AverageMath Total 83 Low Average 13 76-93 <3.0/ -8.0Vocabulary 3 Well Below AverageLanguage Mechanics 8 AverageReading 7 Low AverageComprehensionReading Total 78 Below 7 72-87 <3.0/ -8.0 AverageSOCIAL/EMOTIONAL TESTS:Draw-A-Person: Screening Procedure for Emotional Disturbance (DAP:SPED) MEAN = 50; STANDARD DEVIATION = 10SUBTEST T-Score Percentile Confidence Further Interval evaluation is: Total DAP:SPED 33 4 23-43 Not indicatedChildren’s Depression Inventory- Self ReportSUBTEST T-Score Percentile Classification Mean=50; Standard Deviation=10A. Negative Mood 45 35 AverageB. Interpersonal Problems 45 35 AverageC. Ineffectiveness 41 17 Slightly below averageD. Anhedonia 42 25 Slightly below averageE. Negative Self-Esteem 40 14 Slightly below averageTotal CDI Score 40 11 Slightly below averageBehavior Assessment System for Children-Second Edition (BASC-2): Parent Rating Scale T-Score Mean 50; Standard Deviation=10 COMPOSITE/ SUBTEST T- Percentile 90% Confidence Classification Score IntervalExternalizing Problems 46 38 42-50 AverageComposite Hyperactivity 47 48 41-53 Average Aggression 40 9 34-46 Low Conduct Problems 51 64 45-57 Average
  7. 7. (BASC-2 PRS continues) COMPOSITE/ SUBTEST T- Percentile 90% Confidence Classification Score IntervalInternalizing Problems 41 19 36-46 AverageComposite Anxiety 49 47 43-55 Average Depression 41 16 35-47 Average Somatization 39 11 31-47 Low COMPOSITE/ SUBTEST T- Percentile 90% Confidence Classification Score IntervalAdaptive Skills Composite 64 93 60-68 High Adaptability 64 93 57-71 High Social Skills 65 93 59-71 High Leadership 59 81 52-66 Average Activities of Daily Living 60 83 52-68 High Functional Communication 62 90 56-68 High INDEX T-Score Percentile 90% Confidence IntervalBehavioral Symptoms Index 40 12 36-44Vineland-II DOMAIN/ v- Domain 95% %ile Adaptive Age Stanine SUBDOMAIN Scale Standard Confidence Rank Level Equivalent score Score IntervalCommunication 113 105-121 81 Adequate 7 Receptive 18 16-20 Moderately 18:0 High Expressive 16 14-18 Adequate 10:6 Written 17 15-19 Adequate 10:8Daily Living 114 105-123 82 Adequate 7Skills Personal 19(S) 16-22 Moderately 14:0 High Domestic 17 15-19 Adequate 11:3 Community 16 14-18 Adequate 10:6Socialization 115 106-124 84 Moderately 7 High Interpersonal 16 14-18 Adequate 11:6 relationships Play & Leisure 17 14-20 Adequate 11:3 Time Coping Skills 19(S) 17-21 Moderately 15:0 High*Note: (S) indicates an area of strength for Jane
  8. 8. (Vineland-II continues) COMPOSITE Standard Confidence %ile Adaptive Level Stanine Score IntervalAdaptive Behavior Composite 113 108-118 81 Adequate 7 INDEX v-scale Score 95% Confidence Interval LevelMaladaptive Behavior Index 13 11-15 Average Internalizing 13 11-15 Average Externalizing 14 12-16 AverageRoberts-2 DEVELOPMENTAL/ T-Score DEVELOPMENTAL/ T-Score ADAPTIVE SCALES Mean=50;Standard ADAPTIVE SCALES Mean=50;Standard Deviation=10 Deviation=10Theme Overview Scale Problem Identification Scales Popular Pull 52 Recognition 61 (S) Complete Meaning 43 Description 39 (W)Available Resources Clarification 56 Support Self-Feeling 54 Resolution Scales Support-Self-Advocacy 51 Simple Closure or Easy 50 Outcome Support Other-Feeling 56 Easy & Realistically 32 (W) Positive Outcome Support Other- Help 45 Constructive Resolution 44 Reliance on Others 47 Limit Setting 46*Note: (S) indicates an area of strength for Jane and (W) indicates an area in need of growth. CLINICAL SCALES T-Score Mean=50;Standard Deviation=10Emotion Scales Anxiety 43 Aggression 53 Depression 50 Rejection 70 (PCS)Outcome Scales Unresolved Outcome 71 (PCS) Non-adaptive Outcome 49 Maladaptive Outcome 47 Unrealistic Outcome 48Unusual or Atypical Responses Unusual- Refusal, No Score, Antisocial 76 (PCS) Aytpical Categories 41*Note: (PCS) indicates an area of potential clinical significance. This means Jane’s answers were not averagecompared to the general population and these areas may indicate something significant for Jane and require furtherattention and/or inquiry.
  9. 9. INTERPRETATION:COGNITIVE:Jane’s cognitive abilities were measured with the WISC-IV. The following paragraphs willdiscuss her performance in various cognitive areas and an interpretation of her scores.Verbal Abilities: Jane’s verbal comprehension and expression ability fell in the average range and rankedin the 39th percentile (WISC-IV VC=96; 39th percentile). This suggests that her performanceexceeded that of 39 percent of children her own age in the general population. It is likely (95%confidence) that her verbal abilities fall into a range from low average (89) to average (103).Verbal comprehension refers to her ability to listen to a question, draw upon learned information,reason through an answer, and express thoughts verbally. Jane’s performance varied amongverbal tasks. Jane’s highest score was on a task requiring her to demonstrate knowledge abouthow two items or concepts are similar. She also did well on tasks in which she woulddemonstrate general information knowledge. Her lower score was on a task that also involvedgeneral principles or situations, but specifically required her to utilize comprehension skills.Jane also had more difficulty with a task where she identified an item/concept based on cluesgiven by the examiner. Another task required Jane to demonstrating vocabulary knowledgewhen questions were verbally presented by the examiner. She scored average on this task. Inconnection to the classroom, these scores may imply that Jane’s reading comprehension isn’tlimited by general information knowledge. Comprehending verbally presented information isalso not largely limited by vocabulary knowledge. In other words, when she is told a storyverbally, she has appropriate vocabulary knowledge to answer certain comprehension questions.She doesn’t struggle with receiving the verbal information or retaining factual information in herlong-term memory. At times, though, she may have some trouble when asked to draw meaningor inferences from verbal discussion, readings, or lectures. Jane’s verbal skills are expressed through receptive, expressive and writtencommunication. Jane’s abilities in types of communication are discussed below in thesocial/emotional interpretation section.Nonverbal Ability: Jane’s perceptual reasoning fell in the low average range and ranked in the 21st percentile(WISC-IV PR=88; 21st percentile). It is likely (95% confidence) that her perceptual reasoningabilities fall into a range from low average (81) to average (97). Perceptual reasoning measuresher ability to reason using visual cues in the environment; to examine, think about, and solvenovel tasks without using words. Relative to her own overall performance on these tasks, Janescored the highest on tasks requiring her to complete missing sections of a picture matrix andname the essential part missing from a picture within the time limit. One of Jane’s lower scoreswas on a task that looked at her ability to select one picture among 2-3 picture rows in order tocompile a group with similar characteristics. Jane also experienced difficulty in a task requiringher to replicate a geometric pattern using blocks. This area is considered a weakness for Janeand her performance on this task is seen in 10-15% of children her age in the general population.Jane’s scores imply that Jane is able to take in visual information from her environment, thinkabout the information, and complete school tasks. However, she may need to work harder when
  10. 10. working with novel tasks and solving problems using mainly visual cues, versus verbalinformation. Within the classroom, for example, Jane would benefit from hearingcomprehension questions explained verbally in addition to a visual representation, such as a storygraph or mobile.Working Memory: Similarly to Jane’s verbal skills, her working memory falls in the average range and ranksin the 34th percentile (WISC-IV WM=94; 34th percentile). This suggests that Jane’s performanceexceeded 34 percent of children her own age in the general population. It is likely (95%confidence) that Jane’s working memory abilities fall into a range of low average (87) to average(102). Jane’s working memory ability involves the ability to attend to verbally presentedinformation, hold information in her immediate awareness, and then be able to use thatinformation within a short period of time. Relative to her performance on working memorytasks, Jane scored the highest on tasks requiring her to listen to the examinee read a sequence ofletters and numbers and then recall the information. Jane’s lower scores involved tasks askingher to repeat number verbatim, as state or in reverse order. The final task required her tomentally compute math problems in a time limit and her performance fell in the average range.From her performance, it appears that Jane doesn’t have a weakness between long-term memoryand short term memory capabilities. With one of the items, she had trouble holding theinformation long enough to apply the correct action to the information, but her other scores arenormal. Difficulties in working memory could affect comprehension as well as decoding orreading fluency. However, this performance doesn’t raise a flag that she is struggling in workingmemory. It may be helpful to note that if Jane experiences anxiety or stress during a school task,her working memory could be affected and she may find it difficult to hold onto the informationand apply it as needed. However, if anxiety is an issue, Jane can learn ways to reduce heranxiety during various situations.Processing Speed: Jane’s processing speed falls in the high average range, ranked in the 71st percentile, andis considered a personal strength (WISC-IV PS=112; 79th percentile). This suggests that Jane’sperformance exceeded 79th percent of children her own age in the general population. It is likely(95%) that her Processing Speed abilities fall into a range from average (102) to superior (120).Processing speed involves Jane’s ability to scan, discriminate and process visual information tocomplete a task. Jane’s highest score was on a task requiring her to copy a symbol that pairedwith a shape or number according to a reference key. This area is considered a strength and herperformance is seen in only 5-10% of children her age in the general population. Her lowerscore was on a task requiring her to scan a group of symbols for a target symbol and indicate ifthe symbol was present or absent. The final processing speed asked Jane to scan pictures andmark target items within a time limit. Her performance suggests that Jane doesn’t experiencetrouble with concentration, attention or short-term memory according to this sample of behavior.She doesn’t appear to struggle with visual-motor coordination or discrimination. With regard toreading and other academic tasks, her performance implies that she is able to concentrate on theletters and words and discriminate different letters from one another.
  11. 11. ACADEMIC ACHIEVEMENTJane’s academic achievement in reading and math were measured with the BASI-Survey and herperformance is summarize and interpreted in the following paragraphs.Reading In the overall area of reading, Jane’s achievement scores are below average and rank inthe 7 percentile (BASI-2 Survey RT= 78; 7th percentile). This suggests that Jane’s performance thexceeded 7 percent of children her age in the general population. Based on this behavior sample,there is a discrepancy between her reading abilities and where she should be for other childrenher age and grade. Reading, in this case, included Jane’s performance in vocabulary, languagemechanics, and reading comprehension. Each of these skill areas were assessed by Jane readinga question and selecting an answer from a multiple choice format. There was a time limit oncompletion of the reading task. Jane’s lowest score was in vocabulary, which involvesidentifying word meanings within context and in isolation, recognizing synonyms and antonyms,and analyzing verbal analogies. On this task, her performance was well below average. Herperformance was low average in reading comprehension tasks, which required her to read apassage and answer questions about the main idea, event sequence, and setting. This skills areaincludes identifying cause and effect relationships, predicting outcomes and drawingconclusions. Jane scored in the average range on the final task involving language mechanics.Language mechanics measures her knowledge of grammar and syntax rules, such ascapitalization, punctuation, verb form and tense agreement. These scores imply that Jane is experiencing difficulty with vocabulary when she isrequired to read the words, versus hearing them verbally as with other tasks discussed above.Figuring out the words (decoding) may be placing additional demands on her working memoryas she works to sound out the letters, hold onto the sound, and connect the word sound with hercurrent vocabulary knowledge. This process can make it challenging for Jane to comprehend thetext since she is using her resources to figure out the word and then must simultaneouslyremember the story details. This achievement test supports the concern that Jane is experiencingdifficulties in comprehension. Since much of the work in school involves students readingassignments, drawing conclusions and working to gain meaning from the information provided,Jane’s difficulties in reading may affect her ability to understand information and completeassignments in various subject areas.Mathematics Similarly, Jane’s overall math abilities fell in the low average range. However, herperformance ranked slightly higher in the 13th percentile (BASI-Survey MT=83; 13th percentile).This suggests that her performance exceeded 13 percent of children her age in the generalpopulation. It is likely (95% confidence) that her math abilities fall into a range from belowaverage (76) to average (93). Math abilities involve Jane’s performance on math application andmath computation tasks. As with the reading tasks, the math tasks are presented in a test bookletwith answers available in a multiple choice format. There is a time limit to complete thequestions. Jane’s math application ability fell in the low average range. Math applicationinvolves using arithmetic operations to solve mathematical word problems. These problems mayinvolve interpreting data from graphs or use measurement principles (i.e., length, volume).Jane’s math computation ability fell in the low average range. Math computation requires her to
  12. 12. apply skills in addition, subtraction, multiplication and division to whole numbers, fractions anddecimals. She was also asked to simplify numerical expressions and equations. These scores imply that Jane is having difficulty in math computations and applying herknowledge of arithmetic operations to story problems. Jane mentioned in her interview that shestruggles with math class. She may have approached this task with some level of anxiety,recognizing that this is a subject that is often challenging for her. It’s important to note that onprevious tasks, discussed above in working memory, Jane performed arithmetic operations onquestions presented verbally. On this task, she scored in the average range. This suggests thatdifficulties in math are not due to her working memory. It also suggests that she understands theconcept of arithmetic language (i.e. what “less than” means). The previous task on arithmeticwas also timed, as was the math application task, but the previous task was delivered verballyversus in a test booklet. Since these tasks required that Jane read the question and select thecorrect written response, her difficulties in reading may have affected her ability to gathernecessary information to complete the math task.SOCIAL EMOTIONALJane’s social and emotional abilities were measured with the following: Behavior AssessmentSystem for Children (Second Edition), Parent Rating Scale (BASC-2; PRS-C), VinelandAdaptive Behavior Scales (Second Edition), Parent Rating Form (Vineland II); Draw A Person:Screening Procedure for Emotional Disturbance (DAP: SPED), House-Tree-Person (HTP),Kinetic Family Drawing (KFD), Child Depression Inventory (CDI), and the Roberts-2. Thefollowing paragraphs will discuss Jane’s abilities and the interpretation of the informationgathered by the various assessments.Externalizing Problems: Hyperactivity, Aggression, Conduct Problems Jane’s tendency toward externalizing problems fell in the average range and ranked in the th38 percentile (BASC-2 PRS, EP= 46; 38th percentile). This suggests that Jane’s responsesindicating externalizing problems exceeded that of 38 percent of children her own age in thegeneral population. The task to assess externalizing problems involved a parent questionnaire.From this task, it is likely (90% confidence) that Jane’s tendency to exhibit externalizingproblems falls into an average range. Externalizing problems includes disruptive behavior,including hyperactivity, aggression, and conduct problems. Jane’s tendency toward hyperactivity was average and ranked in the 48th percentile.Hyperactivity is the tendency to be overly active, to hurry through activities, and/or behavewithout thinking. It appears that hyperactivity isn’t a problem that would interfere with Jane’sschool work. Most of the time she will display good self-control, be able to take turnsappropriately, and not be overactive to the point of disruption. The measures of aggression were consistent and Jane fell in the average range. Jane’stendency to behave in an aggressive manner on one assessment was in the average range andranked in the 9th percentile. It is likely with 90% confidence that her aggressive tendencies fallin the low (34) to average (46) range. Aggression involves the degree to which Jane tends tobehave in a verbal or physically hostile manner that threatens individuals or property. On
  13. 13. another task, Jane was in the average range (Roberts-2 Agg: 53 T-score). The task looked atstates (feelings) and expressions (verbal and/or physical) of anger. Jane was required to tellstories based on a picture presented. It’s important to note that in stories including aggressiontypically involved an individual getting bullied, suggesting a fear of aggression. Furthermore,Jane was not able to resolve her aggressive stories in a positive manner, often leaving thesituation in the present tense (i.e. “the girl is getting bullied for her clothes”). This suggests shemay struggle with problem-solving in these situations or coping with her emotions from bullyingsituations. These scores imply that even if Jane displays some aggressive behaviors at times,such as arguing or name-calling, her behaviors are average compared to her peers and are nothighly disruptive to the class environment. Aggression by Jane does not appear to be a factor inany academic difficulties. However, she is currently influenced by the aggressive tendencies ofothers, which can affect schoolwork for some children by causing anxiety, stress or somedepression. It may benefit Jane to learn additional problem-solving methods when dealing withbullies and ways to identify, express and deal with her emotions. Similar to Jane’s performance on hyperactivity task, the issue of conduct problems alsodoes not appear to be a noteworthy problem for Jane. On one measure, Jane’s tendency forconduct problems fell in the average range and ranked in the 64th percentile. It is likely (90%confidence) that Jane’s tendency toward conduct problems falls into an average range. Conductproblems include antisocial and rule-breaking behaviors, such as destroying property. However,as with aggression discussed above, although conduct problems by Jane is not an issue, itappears that she is greatly affected by the antisocial behaviors of others. On one task whichrequired Jane to tell stories in response to pictures presented, her score of Antisocial responseswas considered potentially clinically significant (Roberts-2 UNUSUAL-Antisocial= 76 T-score).Her responses on these tasks were mainly connected with bullying. These scores imply that Janecan control her behaviors and behaviors she displays don’t interfere with her ability to completeschool tasks, maintain relationships or follow the rules of society. However, the conductproblems of others are on her mind. This may impact how she feels in different environmentsand relationships at school, as well as leading to emotions that can impact concentration and self-confidence.Internalizing Problems: Anxiety, Depression, Somatization, Rejection Various assessments were used to assess Jane’s tendency toward internalizing behaviors.Jane’s tendency to experience overall internalizing problems fell in the average range and rankedin the 19th percentile (BASC-2 PRS IP 41; 19th percentile) according a questionnaire completedby Cindy. From this assessment, it is likely (90% confidence) that Jane’s internalizing problemsfell in the low (36) to average (46) range. Internalizing problems are not disruptive, as withexternalizing, but may often go unnoticed. These problems include anxiety, depression andsomatization. With regard to anxiety, results were average but conveyed that Jane is experiencinganxiety from time to time. On one measure, based on Cindy’s responses to a questionnaire, Janefalls in the average range and ranks in the 47th percentile (BASC-2 PRS 49; 47th percentile). It islikely (90% confidence) that Jane’s tendency to experience anxiety falls in the average range.Anxiety involves feeling nervous, fearful, or worried about problems, either real or imaginary.
  14. 14. Jane also fell in the average range on a task requiring her to make up a story in respond to apresented picture (Roberts-2 Anxiety= 43 T-score). Anxiety was represented, but not a strongtheme on assessments that asked Jane to draw pictures of people, houses, and so on (HTP, KFD).The combination of these assessments suggests that while Jane may not continuously experiencehigh levels of anxiety, she may experience anxiety in certain situations or when problems are onher mind. If Jane experiences anxiety during her school work, it can affect her concentration andability to process information using her working memory. For example, when she is trying todecode a word, if anxiety makes it difficult for her to hold the letter sound in her workingmemory long enough to blend the sounds together, she will experience difficulty sounding outwords. In addition to occasional anxiety, it’s important to note that a few assessments indicated atheme that Jane experiences feelings of inadequacy at times and may feel insecure in herenvironment (HTP; KFD; Sentence Completion). There was some indication that Jane maydesire control over her environment and strive for self-control almost to a rigid degree. Oneassessment connected these feelings and needs to social interactions with peers, specifically withexperiences of being bullied (Sentence Completion). These measures indicated that relationshipswith peers and family hold special importance to Jane and difficulties with relationships caninvoke feelings of inadequacy, insecurity, and a strong need to control her surroundings. With regard to depression, Jane measured average to slightly below average. Depressioninvolves feelings of unhappiness or stress that may interfere with daily activities. On aquestionnaire completed by Jane, she scored slightly below average and ranked in the 11thpercentile on an overall measure of depression (CDI TS= 40). In this measure, depressionincludes a combination of negative mood, interpersonal problems, ineffectiveness, anhedonia(absence or inability to feel pleasure), and negative self-esteem. In the various areas ofdepression, Jane rated average to slightly below average in comparison to children of similar ageand gender. Jane’s profile is indicative of a normal pattern and when her elevated responseswere examined, there was no pattern. This result is supported by a questionnaire completed byCindy, in which Jane’s tendency for depression fell in the average range, ranking in the 16thpercentile (BASC-2 PRS Depression 41; 16th percentile). It is likely (90% confidence) thatJane’s depression tendency falls in the low (35) to average (47) range. Jane also rated averageon depression in the story telling task and Jane’s drawings did not display a theme of depression(Roberts-2 Depression= 50 T-score; HTP; KFD). In fact, a task requiring Jane to completesentences showed a tendency toward positive affect. These scores imply that Jane does notappear to have an elevated tendency toward depression and depression is not a factor that isinfluencing her school work at this time. Jane fell in the low range for somatization and ranked in the 11th percentile (BASC-2PRS Somatization 39; 11th percentile). This score is based on a parent rating scale and indicatesthat Jane’s tendency for somatization likely (90% confidence) falls in a range of low (31) toaverage (47). Somatization includes being oversensitive to and complaining about minorphysical problems or discomforts. These scores imply that relatively minor physical discomfortsdon’t interfere with Jane’s ability to complete tasks at school or complete daily activities.
  15. 15. One task looked at rejection as an internalizing problem for Jane, and her responsesshowed high, clinically significant levels of rejection (Roberts-2 Rejection= 70 T-score). Thetask for rejection required Jane to tell stories in response to pictures that were presented. Themajority of responses, again, involved either bullying behaviors or other peer rejection. Thisscore implies, again, that the negative behaviors of others (i.e. bullies, peers) have a significantimpact on Jane at times. Negative peer experiences at school impact how she perceives certainsituations and may elicit feelings of rejection.Overall Problem/Maladaptive Behavior or Emotional Disabilities Jane appears to have a low level of problem behavior according to the assessmentsperformed. One parent rating scale rates Jane’s overall level of problem behavior in the lowrange and ranks in the 12th percentile (BASC-2 PRS=40; 12th percentile). It is likely (90%confidence) that Jane’s level of problem behavior falls in the low (36) to average (44) range.Overall problem behavior combines Jane’s performance on measures of hyperactivity,aggression, depression, attention problems, atypicality (behaving in “odd” ways), and withdrawal(evading others). This assessment is supported by another in which Jane demonstrates averageinternalizing and externalizing maladaptive behaviors as compared to other children her age(Vineland-II MBI=13). Assessments involving Jane’s drawings did not indicate maladaptivebehavior tendencies, disturbances in functioning, or pathology (HTP; KFD; Roberts-2 Atypical=41 T-score). These scores imply that Jane displays a low level of problem or maladaptivebehaviors and that her behaviors do not affect her functioning in the school environment ornegatively impact her academic progress. This is consistent with the referral concern which hasno mention of disciplinary or behavioral problems. In addition, Jane does not indicate an emotional disability based on the conductedassessment. With regard to indications of emotional disability, Jane ranked in the 4th percent ascompared to other children of her age (DAP:SPED= T-score 33; 4th percentile). Furtherevaluation for emotional disabilities was not indicated. This test suggests that Jane’s emotionaldevelopment is normal and this is not a concern with regard to her school work or schoolexperience.Adaptive Skills As seen in various assessments, Jane’s adaptive skills fall in the average to high range.Based on one parent questionnaire, Jane’s overall adaptive skills fall in the high range and rankin the 93rd percentile (BASC-2 PRS ASC= 64; 93rd percentile). Adaptive skills includebehaviors important for functioning at home, school, with peers and in the community. Theyinclude adaptability (ability to readily adapt to environmental changes), social skills, leadership,activities of daily living, and functional communication. Functional communication refers toJane’s ability to express her ideas and communicate so that others can easily understand her. Oneach of these skills, it is likely (90% confidence) that Jane’s abilities fall in the average to highrange and rank in the 81st to93rd percentile. Another parent survey showed Jane’s adaptivebehavior falls in the adequate range, ranking her in the 81st percentile (Vineland-II ABC=113;81st percentile). According to this task, it is likely (95% confidence) that Jane has adequate tomoderately high adaptive skills in communication, daily living skills, and socialization. Jane’s
  16. 16. scored high in receptive communication (i.e., ability to listen, pay attention, and understand whatis conveyed), and has strengths in coping skills and personal daily living skills. Coping skillsinvolves how Jane shows responsibility and her sensitivity to others, which personal daily livingskills involves personal hygiene practices. Jane’s lower scores still fell in the adequate range andinvolved expressive communication, community living skills, and interpersonal relationships.Expressive communication involves how Jane uses words to gather or convey information.Community living skills refers to how Jane uses items such as money, the telephone orcomputer. In the near future, this could involve the use of job skills. Interpersonal relationshipsrefer to how Jane interacts with others. Another task confirmed that Jane’s adaptive skills fall in the average range, but alsoprovided additional information about certain areas that may be considered weaknesses or needadditional attention (Roberts-2). This task required Jane to tell stories about pictures that werepresented. Jane’s average scores indicate she is able to accurately perceive what is going on inher environment, follow directions, and utilize her knowledge to make sense of tasks (Roberts-2POP= 52 T-score; MEAN= 43 T-score). She is also had a good sense of support systemsavailable, including protective, positive external supports (i.e. family, friends) and internalresources (i.e., her own resourcefulness) (Roberts-2 A.R. Scales). Jane demonstrated a goodsense of support systems, indicated that she had confidence certain people would provide aidupon her request. It’s important to note from the content of her stories that individuals providingsupport were family figures. In addition, Jane conveyed appropriate understanding with limitsetting or consequences for behaviors. Jane demonstrated a strength in her ability to recognize afeeling or behavior in a situation, but showed a weakness in her ability to pick out and define thecause for an emotional response (Roberts-2 Recognition=61; Description=39). This insight isimportant with regard to Jane’s ability to select the best coping mechanism, support system, orproblem-solving method. Another aspect of this task involved Jane’s ability to describe apositive outcome to her stories. Her performance on these tasks indicated that at times, Jane isunsure how to resolve problem feelings or conflicts in a positive or successful manner and mayexperience significant difficulties (Roberts-2, Easy-Positive Outcomes=32). These scores combined imply that Jane displays good adaptive skills which allow her tofunction properly in various environments. These skills will allow Jane to communicate withpeers and her teacher appropriately, participate in the classroom activities, and use coping skillsto be responsible and sensitive to others. She has knowledge of support systems and confidencein these support systems and herself to tackle problems. Although Jane can use coping skills andsupport systems, at times she may lack the insight to distinguish which coping mechanisms orsupports are best for her situation. She may be unsure how to solve certain problems or feelingsin a positive way. Jane may have excellent support with family members and close friends, butthere may be environments in which it is more difficult to find a dependable support system (i.e.,classroom).SUMMARY Based on her performance on certain tasks, Jane has good general information andvocabulary knowledge. Jane can appropriately receive and attend to verbal information and isable to retain information in her long-term memory. When information is presented verbally,
  17. 17. she shows some difficulties in comprehension, but overall, still performs average compared toother children her age. Therefore, in general, she is able to comprehend lectures or verbalreadings, but may experience confusion time to time. With regard to information presentedvisually, Jane can attend to and think about the information in order to complete tasks. However,novel or problem-solving tasks utilizing mainly visual information may be tricky for her.Whether the information is presented verbally or visually, Jane does not have trouble withconcentration or attention to the information. With regard to reading, she can concentrate on theletters or words and discriminate among letters. Her attention and processing abilities aid thereading process by freeing up mental resources that can be used for comprehension. Jane’s memory abilities, short-term and long-term memory, are average as compared toother children. On one task, it was difficult for her to hold some information long enough toprocess the required task. This indicates that although her overall memory abilities are good,with certain tasks she could experience difficulties in holding the information in her workingmemory long enough to apply required actions to the information and then act accordingly.Decoding words, reading fluently and comprehending text all involve the working memory. Forexample, Jane needs to hold letters sounds long enough to combine them into a work and thenretrieve the word meaning from her vocabulary knowledge. At the same time, she needs toretain story facts in her working memory to later apply to comprehension questions. If she isanxious, her working memory will be less efficient and this could impact her reading abilities. Jane’s performance on reading tasks confirmed her parent’s concerns that she isstruggling with comprehension and fluency. Vocabulary tasks were particularly difficult for her,although she was able to perform vocabulary tasks when the information was presented verbally.The vocabulary knowledge is present, but Jane had difficulty in decoding the words to a pointthat she could access her vocabulary database. Her comprehension performance was low,although as with vocabulary, she performed better with verbally presented information. If Jane’smental resources are preoccupied with decoding, it may be difficult for her to attend to storydetails or retain the information in her working memory to answer comprehension questions.However, it’s important to note that Jane has an average understanding of language mechanics,which aids the reading process. Further evaluations are needed to determine what aspect or stageof the reading process is difficult for Jane. Jane is also experiencing difficulty in math computation and application. Jane was ableto perform verbally presented arithmetic tasks, suggesting that her working memory is able tohold the data and process it as needed. This also suggests she understands mathematicallanguage. However, Jane had difficulties applying her knowledge to tasks when she had to readthe question or information in story form. Laure shared that math is her most difficult subjectand that she struggles remembering multiplication tables. No problems were evidence from thetasks with regard to her long-term memory abilities. It may be hard for Jane, though, to accessinformation in her current knowledge when her mental resources are occupied with reading theproblem, comprehending what is being asked, and holding the information in her workingmemory if she’s anxious or nervous during the task. Jane demonstrates normal levels of hyperactivity, aggression, and conduct problems. Inaddition, she displays low levels of problem or maladaptive behaviors. This means that in the
  18. 18. classroom, she will often display good self-control and be able to take turns and follow the rules.In general, she does not display disruptive behavior or act aggressively, which helps Jane inmaintaining healthy adult and peer relationships. Interpersonal relationships are important forJane and she seems strongly affected by aggressive and antisocial tendencies of others. Bullying,gossip and other inappropriate social behaviors may be causing Jane anxiety or stress at times,which can affect concentration, self-confidence, and areas of cognitive functioning (such as herworking memory). Tasks revealed that although Jane is not continuously showing signs of anxiety, she doesexperience anxiety during certain situations or when problems are on her mind. For Jane,difficulties with relationships may invoke feelings of inadequacy, insecurity, rejection, and aneed to control her environment. A school task could be challenging if Jane is trying to focus oninformation while simultaneously dealing with negative emotions. Her negative emotions maysimply appear at a particular moment or task and not linger with her for other activities.However, Jane does not currently display depression or somatization tendencies, and shedisplays a normal level of emotional development which allows her to recognize feelings. Thisis important for Jane in finding ways to deal with negative emotions and situations. Jane displays good adaptive skills which allow her to function properly in variousenvironments, participate in activities and communicate effectively. Jane knows and trusts hercurrent support systems (particularly her family and close friends). She also possesses internalresources to tackle problem situations. At times, however, Jane may lack insight into the causesand proceeding factors leading to problem feelings or situations. This will make it more difficultfor Jane to distinguish which coping mechanisms or supports are best for her situation. She maybe unsure how to solve certain problems or feelings in a positive way.RECOMMENDATIONS: According to the reviewed evidence, Jane is experiencing difficulties with readingcomprehension, math computation, and math application. Further tests should be done toprovide a better understanding of which specific reading components or math processes needassistance. The Woodcock-Johnson III Test of Achievement is recommended to provide furtherinformation, including but not limited to, Jane’s phonological and orthographic (i.e., spellingmethod) coding ability, reading fluency, receptive and expressive story recall abilities, andfluency with math facts. DIBELS is also recommended to assess Jane’s current reading abilitiesand assess progress over time. These assessments should provide further insight toward which reading components towork on during the summer months with the tutor (per Cindy’s request) and during the nextschool year. Since Jane has trouble sounding out words, interventions that target decodingabilities may be helpful. Examples would include performing the Drilling Error Wordstechnique and using the decoding strategy procedure in the Reading First Program. Also, it would be helpful to increase memorization of sight words. These wordsgenerally include common words that Jane will see when reading. If she can memorize thesecommon words, it will free up her working memory to focus on sounding out other words and
  19. 19. help her with reading fluency and comprehension. One task would be the folding-in techniquewhich provides Jane with many opportunities to practice and respond to words (similar to theDrilling Error Words technique mentioned above). Information on performing these techniqueswill be provided to the mother for summer work. Previewing procedures may also benefit Janesince she will hear the passage read first (and follow along with the reader) and then have anopportunity to practice reading the passage out loud. The first reader of the passage can be hermother, a teacher, or a tape recording. Comprehension could be further assist by teaching Jane to take notes during a story,including how to pick out important story elements (setting, plot, characters). Jane has goodconcentration and attention. Learning to give special attention to story elements will aid hercomprehension and through note taking, she can focus on decoding the words as needed withoutfear of forgetting story facts. Finally, it is recommended that Jane be given many different opportunities to practicedecoding and comprehension as possible. This includes reading not only various book genres,but also magazine articles (i.e., Justin Beiber magazine), cookbooks, or business fliers in stores.Jane mentioned playing restaurant and clothes designer with her friends. Menus or clothingprice lists could be made that would give Jane in informal way to practice reading and evenmath. Reading emails from her father during business trips, if possible, could also give Jane achance to practice decoding and comprehension (especially if specific word lists wereincorporated). Regarding math, evaluation of her math homework or tests from school is recommendedto look for patterns in her math abilities. Specifically, does she perform the computations well ifthere are no words in the question, only numbers? Does she struggle with multiplication, but dowell on addition and subtraction problems? Since she was able to perform arithmetic problemswhen delivered verbally but struggled when they were presented in a workbook, furtherevaluation of her previous work and a conversation with Jane about what specific areas of mathare tricky would be beneficial before choosing an intervention. In addition, it would be helpfulto observe Jane solving a math problem to see if she struggles at certain points of thecomputation process. It may benefit Jane to use a schema-based learning in which she is taughtto break word problems down into the essential elements and depict the numerical relationshipsin a schema map. It is also recommended to provide Jane with tools to aid her memorizationsince she expressed this concern with multiplication tables. With regard to social/emotional support for Jane, further discussions with Jane arerecommended to see how she feels when she struggles with reading or other subjects and howoften she is confronted by bullying or other negative interpersonal situations. For example, ifshe is in a reading group that she doesn’t like, has a bully in the room, and then struggles withsounding out a word, the anxiety alone may be affecting her performance. However, if Janedoesn’t face such scenarios or feelings, the recommendations will differ. Currently, it isrecommended that Jane receives support in finding an adult in the school building that can serveas a support system for her when she is bullied or has negative emotions. This individual couldbe a counselor or trusted teacher, for example. It is not recommended that the individual beJane’s current teacher for the year. Since Jane has strong support systems at home and with
  20. 20. certain friends, this would help her to have another system in place at school that could help herdiscuss different coping skills or problem-solving methods that are applicable for thecircumstances quickly after the incident has occurred. Jane does well identifying her feelingsand those of others. It would be beneficial to talk to Jane about various coping skills and howeach may better apply given her feelings and circumstances. Also, helping Jane identifypreceding events to conflicts and how conflicts can be resolved in a positive way (without her orother students suffering) may help her gain more control over her environment. A peer group ledby a counselor or school psychologist allowing kids to talk about bullying situations may behelpful for Jane. The peers in such a group may also provide a further support system for Janewhen needed. Finally, Jane mentioned feeling angry and wanting to change her occasional angryattitude. It would be beneficial to have a person at school readily available to listen, help herwith expressive language, teach her anxiety relieving strategies, and help her work through angerwould be beneficial. Jane can also work on expressive language and anxiety-relief techniqueswith a counselor outside the school during the summer or as needed.Debra Bassett June 28, 2011________________________________________ Date: ________________Debra Bassett (Examiner); School Psychologist in Training

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