aseba

1. 0 22.NotSleepAlone
1 38.SleepProb
1 48.Nightmares
1 64.ResistsBed
0 74.SleepLess
0 84.TalkInSleep
0 94.WakesOften
3
53
62
Sleep Problems
Mother
Daniela Fernandez
Relationship:
Informant:
Burlington agency
Masha ivanova
Clinician:
Agency:
2016-08-08
Birth Date:
Date Filled:
F
1
Gender:
Age:
Anna Fernandez
Name:
ID: Testing Profiles - Anna maria 2018-05-03 Society: ASEBA Standard
Verified: Yes
1 21.DistChange
0 46.Twitching
0 51.ShowsPanic
0 79.RapidShifts
1 82.MoodChang
1 83.Sulks
1 92.UpsetByNew
1 97.Whining
1 99.Worries
0 10.Dependent
1 33.FeelingsHurt
0 37.UpsetBySep
1 43.LookUnhappy
0 47.Nervous
0 68.SelfConscious
0 87.Fearful
1 90.Sad
0 1.AchesPains
0 7.ThingsOut
0 12.Constipated
0 19.Diarrhea
1 24.NotEat
0 39.Headaches
0 45.Nausea
0 52.PainfulBM
0 78.Stomachaches
0 86.TooNeat
0 93.Vomiting
1 8.Can'tWait
1 15.Defiant
1 16.Demanding
0 18.DestroyOther
1 20.Disobedient
1 27.NoGuilt
1 29.Frustrated
1 35.Fights
1 40.HitsOthers
1 42.HurtAccident
1 44.AngryMoods
0 53.Attacks
1 58.Punishment
1 66.Screams
1 69.Selfish
1 81.Stubborn
1 85.Temper
1 88.Uncooperative
0 96.WantAttention
0 2.ActsYoung
1 4.AvoidsEye
1 23.NoAnswer
0 62.RefusesActive
0 67.UnrespAffect
0 70.LittleAffect
0 71.LittleInterest
0 98.Withdrawn
0 5.Concentrate
1 6.Can'tSitStill
0 56.Clumsy
1 59.ShiftsQuickly
0 95.Wanders
3
52
58
Anxious / Depressed
1
50
<=50
Somatic Complaints
16
59
81
Aggressive
Behavior
2
56
73
Withdrawn
2
51
54
Attention Problems
B = Borderline clinical range; C = Clinical range; Broken Lines = Borderline clinical range
50
60
70
80
90
100
Percentile
T Score
Raw Score (Sum)
CBCL/1.5-5 - Syndrome Scale Scores
65
52
50
56
53
51
59
6
65-B
93
Emotionally
Reactive
Clinical
Normal
T
Printed by: ASEBAasebatech2
Externalizing
Internalizing
www.ASEBA.org
Burlington, VT 05401-3456
1 South Prospect St.
ASEBA, University of Vermont
Copyright 2018 T.M. Achenbach Page 1/5

2. 0 5.Concentrate
0 45.Nausea
0 47.Nervous
0 78.Stomachaches
1 81.Stubborn
1 82.MoodChang
1 90.Sad
50
60
70
80
90
100
Percentile
T Score
Raw Score (Sum)
50
60
70
80
90
100
Percentile
T Score
Raw Score (Sum)
Mother
Daniela Fernandez
Relationship:
Informant:
Burlington agency
Masha ivanova
Clinician:
Agency:
2016-08-08
Birth Date:
Date Filled:
F
1
Gender:
Age:
Anna Fernandez
Name:
ID: Testing Profiles - Anna maria 2018-05-03 Society: ASEBA Standard
Verified: Yes
45
58
79
Total Problems
58
12
58
79
Internalizing
Problems
58
B = Borderline clinical range; C = Clinical range; Broken Lines = Borderline clinical range
Other Problems
1 3.AfraidOfNew
1 9.ChewNonFood
0 11.SeeksHelp
1 13.Cries
1 14.CruelAnimal
1 17.DestroyOwn
1 25.NotGetAlong
0 26.NoFun
0 28.OutofHome
1 30.Jealous
0 31.EatNonFood
1 32.Fears
0 34.GetsHurt
1 36.GetIntoThings
0 41.HoldsBreath
0 49.Overeating
0 50.Overtired
CBCL/1.5-5 - Internalizing, Externalizing, Total Problems, Stress Problems, and Other Problems
Clinical
Normal
T
Printed by: ASEBAasebatech2
18
57
76
Externalizing
Problems
57
Clinical
Normal
T
3
58
79
Stress Problems
58
1 54.PicksSkin
0 55.SexParts
0 57.EyeProb
0 60.SkinProb
1 61.Won'tEat
0 63.RocksHead
0 65.ResistToilet
0 72.LittleFear
1 73.Shy
0 75.SmearsBM
0 76.SpeechProb
0 77.Stares
0 80.StrangeBehav
0 89.Underactive
0 91.Loud
- 100.OtherProb
www.ASEBA.org
Burlington, VT 05401-3456
1 South Prospect St.
ASEBA, University of Vermont
Copyright 2018 T.M. Achenbach Page 2/5

3. Mother
Daniela Fernandez
Relationship:
Informant:
Burlington agency
Masha ivanova
Clinician:
Agency:
2016-08-08
Birth Date:
Date Filled:
F
1
Gender:
Age:
Anna Fernandez
Name:
ID: Testing Profiles - Anna maria 2018-05-03 Society: ASEBA Standard
Verified: Yes
50
60
70
80
90
100
Percentile
T Score
Raw Score (Sum)
1 13.Cries
1 24.NotEat
1 38.SleepProb
1 43.LookUnhappy
0 49.Overeating
0 50.Overtired
0 71.LittleInterest
0 74.SleepLess
0 89.Underactive
1 90.Sad
0 10.Dependent
0 22.NotSleepAlone
0 28.OutofHome
1 32.Fears
0 37.UpsetBySep
0 47.Nervous
1 48.Nightmares
0 51.ShowsPanic
0 87.Fearful
1 99.Worries
1 4.AvoidsEye
0 7.ThingsOut
1 21.DistChange
1 23.NoAnswer
1 25.NotGetAlong
0 63.RocksHead
0 67.UnrespAffect
0 70.LittleAffect
0 76.SpeechProb
0 80.StrangeBehav
1 92.UpsetByNew
0 98.Withdrawn
0 5.Concentrate
1 6.Can'tSitStill
1 8.Can'tWait
1 16.Demanding
1 36.GetIntoThings
1 59.ShiftsQuickly
1 15.Defiant
1 20.Disobedient
1 44.AngryMoods
1 81.Stubborn
1 85.Temper
1 88.Uncooperative
5
63
90
Depressive Problems
3
51
54
Anxiety Problems
5
61
87
Autism Spectrum
Problems
5
52
58
Attention Deficit /
Hyperactivity Problems
6
59
81
Oppositional Defiant
Problems
B = Borderline clinical
range; C = Clinical range;
Broken Lines = Borderline
clinical range
63
51
61
52
59
CBCL/1.5-5 - DSM-Oriented Scales
Clinical
Normal
T
Printed by:
ASEBAasebatech2
www.ASEBA.org
Burlington, VT 05401-3456
1 South Prospect St.
ASEBA, University of Vermont
Copyright 2018 T.M. Achenbach Page 3/5

4. 15
20
25
30
35
40
45
50
55
60
65
70
75
80
85
Percentile
Total Words
20
25
30
35
40
45
50
55
60
65
70
75
80
Percentile
Avg. Length
Mother
Daniela Fernandez
Relationship:
Informant:
Burlington agency
Masha ivanova
Clinician:
Agency:
2016-08-08
Birth Date:
Date Filled:
F
1
Gender:
Age:
Anna Fernandez
Name:
ID: Testing Profiles - Anna maria 2018-05-03 Society: ASEBA Standard
Verified: Yes
CBCL/1.5-5 - Language Development Survey for Ages 18-35 Months
Printed by: ASEBAasebatech2
Average Length Of Phrases Vocabulary Score
Scores <= 20th percentile suggest delayed phrase development Scores <= 15th percentile suggest delayed phrase development
Vocabulary Score: 114
Average Length Of Phrases: 2.8
No
I.Born Early
6
II.Birth Weight
6-8
III.Ear Infection
Yes
IV.Non-English spoken
No
V.Delayed Speech in family
No
VI.Worried about development
Yes - Please
VII.Says words spontaneously
Yes
VIII.Combines Words
Vocabulary Score displayed only for ages 18-23 months, 24-29
months, and 30-35 months.
Average Length of Phrases displayed only for ages
24-29 months and 30-35 months.
24-29 months 30-35 months 24-29 months
114
60
18-23 months
60
30-35 months
www.ASEBA.org
Burlington, VT 05401-3456
1 South Prospect St.
ASEBA, University of Vermont
Copyright 2018 T.M. Achenbach Page 4/5

5. CBCL 1.5-5 - Narrative Report And Critical Items
2018-05-03
Mother
Daniela Fernandez
Relationship:
Informant:
Burlington agency
Masha ivanova
Clinician:
Agency:
2016-08-08
Birth Date:
Date Filled:
F
1
Gender:
Age:
Anna Fernandez
Name:
ID: Testing
Printed by: ASEBAasebatech2
The Child Behavior Checklist for Ages 1 1/2-5 (CBCL 1.5-5) was completed by Daniela Fernandez, Anna's mother, to obtain her
perception of Anna's problems.
On the CBCL 1.5-5 problem scales, Anna's Internalizing Problems, Externalizing Problems, Total Problems and Stress Problems
scores were all in the normal range for girls aged 1. Her scores on the Anxious / Depressed, Somatic Complaints, Withdrawn,
Sleep Problems, Attention Problems and Aggressive Behavior syndromes were in the normal range. Her score on the Emotionally
Reactive syndrome was in the borderline clinical range (93rd to 97th percentile). These results indicate that Daniela Fernandez,
Anna's mother reported more problems than are typically reported for girls aged 1, particularly problems of Emotionally Reactive
nature.
On the CBCL/1.5-5 - DSM-Oriented Scales, Anna's scores on all rated scales were in the normal range.
On the CBCL/1.5-5 - Language Development Survey for Ages 18-35 Months, Anna's Vocabulary score for 18-23 months was at
the 60th percentile, which suggests normal vocabulary development for children aged 18-23 months.
Page 5/5
Copyright 2018 T.M. Achenbach ASEBA, University of Vermont 1 South Prospect St. Burlington, VT 05401-3456 www.ASEBA.org