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SAMPLE Confidential 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

Confidential Psychological Report

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Page 1: Confidential Psychological Report

SAMPLEConfidential Psychological Report

Names have been changed

For Professional Use Only

Prepared By:

Debra BassettEdS Student in School PsychologyUniversity of Northern Colorado

June 28, 2011

Page 2: Confidential Psychological Report

CONFIDENTIAL PSYCHOLOGICAL REPORTFor Professional Use Only

NAME: 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. Student

REFERRAL QUESTION:Jane was referred as practice for the examiner. Jane’s mother is concerned about Jane’s reading fluency and comprehension. Jane appears to experience difficulties in word decoding and completing vocabulary and comprehension tasks when they require her to read and respond to questions (versus orally presented tasks). Jane’s mother believes the nature of the problem is minor 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

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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 well in science but math and social studies are difficult for her. Jane said multiplication facts are difficult 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 4-5 good, 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 likes reading mystery books, drawing her family, and going on vacations. She truly enjoys anything having 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 feel angry 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. She likes her personality, described as funny and fun, but doesn’t like that she can get angry after a long day or when she’s tired. Jane said she gets sad when she’s tired and identifies her attitude as one thing she’d like to change about herself. Specifically, she’d like to be able to change her anger to happiness. She repeatedly described a student who has bullied her since kindergarten and reports feeling angry, sad, and a desire to get even when this individual has embarrassed her or encouraged her to make others feel bad. She describes bullying as the worst thing that has happened to her. She has positive early memories of family events (i.e., Easter, weddings) and hopes someday to be a hair dresser or teacher. She admits that death of a loved one is on her mind a lot. She says that she hasn’t experienced death much but is aware someone (i.e. grandma and 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 as negative feelings surrounding the bully at school. She had trouble remembering negative memories with her family (i.e. times of anger), but could easily recall detailed memories of when she was bullied.

Review of records: Jane’s attendance records indicated consistent, good attendance. She has no unexplained absences or discipline problems. Previous report cards indicate a 3.25 GPA (on a scale of 4.0). At this time, there were no CSAP records available.

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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 appeared comfortable overall in the group, but at times, distracted. She would look up at the clock and play with her nails on a couple occasions. She only raised her hand 50% of the time when questions were asked, but her answers were accurate. When she read aloud, she appeared to struggle on decoding words. She would attempt to sound them out quietly (whispering) until the teacher would ask her to speak up or would provide the word to her. These occasions seemed to embarrass her (i.e. face turned red, kept head down). Her teacher indicated that her behavior during 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 timeVineland Adaptive Behavior Scales, Second Edition (Vineland II)

Parent/Caregiver Rating FormDraw A Person: Screening Procedure for Emotional Disturbances (DAP: SPED)House-Tree-Person (HTP)Kinetic Family Drawing (KFD)Child Depression InventoryRoberts-2

Feedback session: None to date. (No formal feedback provided since this assessment was conducted for training purposes).

BACKGROUND AND BEHAVIORAL OBSERVATIONS:

Family HistoryJane is the second child of John and the first child of Cindy S. Cindy and John are currently

married and have a very close relationship with Jane. Cindy is a stay-at-home mother and John works in sales and finance, requiring frequent travel. Jane has an older step-brother who is fourteen years old. He primarily resides with his biological mother but also spends considerable time at Jane’s residence. Jane and her brother share a close relationship, described by Cindy as “communicative, affectionate and expressive.” Parental disciplinary procedures include firm talking and removing privileges (on rare occasions). Jane’s family resides in the suburbs, with sports and church activities available. There is no history of significant mental illness or cognitive deficits in Jane’s family.

Medical HistoryJane had normal prenatal, natal and postnatal medical history. Her recent physical

examination took place on October 10, 2010 and her general health was good. Her overall medical history is good, with no surgeries or noteworthy illnesses. Her developmental milestones were normal.

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Prior Educational History Jane has attended Preschool through third grade (current year) at ABC Christian school. She

has not repeated or skipped any grades. Cindy describes this school as adequate, but having limited resources. During the school year, Jane was part of a special reading program (Reading Naturally) for help with comprehension and fluency. Jane admitted not enjoying the special reading group she attends, saying that she reads better than the other students and wants to rejoin friends in the normal reading program.

TEST RESULTS: COGNITIVE:All test scores are reported at the 95% confidence intervals (CI) unless otherwise indicated. It is likely that Jane’s true score will fall somewhere between the stated lower to upper classification ranges.

Wechsler Intelligence Scale for Children- Fourth Edition (WISC-IV)WISC-IV Score Summary

Verbal Comprehension Scaled Score (mean=10; SD=3)

Perceptual Reasoning (mean=10; SD=3)

Scaled Score(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 (mean=10; SD=3)

Scaled Score(mean=10; SD=3)

Processing Speed (mean=10; SD=3)

Scaled Score(mean=10; SD=3)

Digit Span 7 Coding 14 (S)Letter-Number Sequencing 11 Symbol Search 10Arithmetic 9 Cancellation 11

Scaled Score IQ Index(mean=100; SD=15)

Classification Percentile Confidence Interval

Verbal Comprehension

96 Average 39 89-103

Perceptual 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 interpretation of 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.

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ACHIEVEMENT TESTS:

Basic Achievement Skills Inventory (BASI-Survey) For Totals: MEAN = 100

STANDARD DEVIATION = 15SUBTEST Standard Score Classification Percentile Confidence

IntervalEquivalenceGrade/Age

Math 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 Comprehension

7 Low Average

Reading Total 78 Below Average

7 72-87 <3.0/ -8.0

SOCIAL/EMOTIONAL TESTS:

Draw-A-Person: Screening Procedure for Emotional Disturbance (DAP:SPED)MEAN = 50; STANDARD DEVIATION = 10

SUBTEST T-Score Percentile Confidence Interval

Further evaluation is:

Total DAP:SPED 33 4 23-43 Not indicated

Children’s Depression Inventory- Self ReportSUBTEST T-Score

Mean=50;Standard Deviation=10

Percentile Classification

A. 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 average

Behavior Assessment System for Children-Second Edition (BASC-2): Parent Rating Scale

T-Score Mean 50; Standard Deviation=10COMPOSITE/ SUBTEST T-

ScorePercentile 90% Confidence

IntervalClassification

Externalizing Problems Composite

46 38 42-50 Average

Hyperactivity 47 48 41-53 AverageAggression 40 9 34-46 Low

Conduct Problems 51 64 45-57 Average

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(BASC-2 PRS continues)

COMPOSITE/ SUBTEST T-Score

Percentile 90% Confidence Interval

Classification

Internalizing Problems Composite

41 19 36-46 Average

Anxiety 49 47 43-55 AverageDepression 41 16 35-47 Average

Somatization 39 11 31-47 Low

COMPOSITE/ SUBTEST T-Score

Percentile 90% Confidence Interval

Classification

Adaptive Skills Composite 64 93 60-68 HighAdaptability 64 93 57-71 HighSocial Skills 65 93 59-71 High

Leadership 59 81 52-66 AverageActivities 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 36-44

Vineland-IIDOMAIN/

SUBDOMAINv-

Scale score

Domain Standard Score

95% Confidence Interval

%ileRank

Adaptive Level

Age Equivalent

Stanine

Communication 113 105-121 81 Adequate 7Receptive 18 16-20 Moderately

High18:0

Expressive 16 14-18 Adequate 10:6Written 17 15-19 Adequate 10:8

Daily Living Skills

114 105-123 82 Adequate 7

Personal 19(S) 16-22 Moderately High

14:0

Domestic 17 15-19 Adequate 11:3Community 16 14-18 Adequate 10:6

Socialization 115 106-124 84 Moderately High

7

Interpersonal relationships

16 14-18 Adequate 11:6

Play & Leisure Time

17 14-20 Adequate 11:3

Coping Skills 19(S) 17-21 Moderately High

15:0

*Note: (S) indicates an area of strength for Jane

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(Vineland-II continues)

COMPOSITE Standard Score

Confidence Interval

%ile Adaptive Level Stanine

Adaptive 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 AverageExternalizing 14 12-16 Average

Roberts-2DEVELOPMENTAL/ADAPTIVE SCALES

T-ScoreMean=50;Standard

Deviation=10

DEVELOPMENTAL/ADAPTIVE SCALES

T-ScoreMean=50;Standard

Deviation=10Theme Overview Scale Problem Identification

ScalesPopular Pull 52 Recognition 61 (S)

Complete Meaning 43 Description 39 (W)Available Resources Clarification 56

Support Self-Feeling 54 Resolution ScalesSupport-Self-Advocacy 51 Simple Closure or Easy

Outcome50

Support Other-Feeling 56 Easy & Realistically Positive Outcome

32 (W)

Support Other- Help 45 Constructive Resolution 44Reliance 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-ScoreMean=50;Standard Deviation=10

Emotion ScalesAnxiety 43

Aggression 53Depression 50

Rejection 70 (PCS)Outcome Scales

Unresolved Outcome 71 (PCS)Non-adaptive Outcome 49Maladaptive 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 average compared to the general population and these areas may indicate something significant for Jane and require further attention and/or inquiry.

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INTERPRETATION:COGNITIVE: Jane’s cognitive abilities were measured with the WISC-IV. The following paragraphs will discuss 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 ranked

in the 39th percentile (WISC-IV VC=96; 39th percentile). This suggests that her performance exceeded 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 among verbal tasks. Jane’s highest score was on a task requiring her to demonstrate knowledge about how two items or concepts are similar. She also did well on tasks in which she would demonstrate general information knowledge. Her lower score was on a task that also involved general 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 clues given by the examiner. Another task required Jane to demonstrating vocabulary knowledge when questions were verbally presented by the examiner. She scored average on this task. In connection to the classroom, these scores may imply that Jane’s reading comprehension isn’t limited by general information knowledge. Comprehending verbally presented information is also not largely limited by vocabulary knowledge. In other words, when she is told a story verbally, she has appropriate vocabulary knowledge to answer certain comprehension questions. She doesn’t struggle with receiving the verbal information or retaining factual information in her long-term memory. At times, though, she may have some trouble when asked to draw meaning or inferences from verbal discussion, readings, or lectures.

Jane’s verbal skills are expressed through receptive, expressive and written communication. Jane’s abilities in types of communication are discussed below in the social/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 reasoning abilities fall into a range from low average (81) to average (97). Perceptual reasoning measures her ability to reason using visual cues in the environment; to examine, think about, and solve novel tasks without using words. Relative to her own overall performance on these tasks, Jane scored the highest on tasks requiring her to complete missing sections of a picture matrix and name the essential part missing from a picture within the time limit. One of Jane’s lower scores was on a task that looked at her ability to select one picture among 2-3 picture rows in order to compile a group with similar characteristics. Jane also experienced difficulty in a task requiring her to replicate a geometric pattern using blocks. This area is considered a weakness for Jane and 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, think about the information, and complete school tasks. However, she may need to work harder when

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working with novel tasks and solving problems using mainly visual cues, versus verbal information. Within the classroom, for example, Jane would benefit from hearing comprehension questions explained verbally in addition to a visual representation, such as a story graph or mobile. Working Memory:

Similarly to Jane’s verbal skills, her working memory falls in the average range and ranks in the 34th percentile (WISC-IV WM=94; 34th percentile). This suggests that Jane’s performance exceeded 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 presented information, hold information in her immediate awareness, and then be able to use that information within a short period of time. Relative to her performance on working memory tasks, Jane scored the highest on tasks requiring her to listen to the examinee read a sequence of letters and numbers and then recall the information. Jane’s lower scores involved tasks asking her to repeat number verbatim, as state or in reverse order. The final task required her to mentally 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 memory and short term memory capabilities. With one of the items, she had trouble holding the information long enough to apply the correct action to the information, but her other scores are normal. Difficulties in working memory could affect comprehension as well as decoding or reading fluency. However, this performance doesn’t raise a flag that she is struggling in working memory. 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 information and apply it as needed. However, if anxiety is an issue, Jane can learn ways to reduce her anxiety during various situations.

Processing Speed: Jane’s processing speed falls in the high average range, ranked in the 71st percentile, and

is considered a personal strength (WISC-IV PS=112; 79th percentile). This suggests that Jane’s performance 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 to complete a task. Jane’s highest score was on a task requiring her to copy a symbol that paired with a shape or number according to a reference key. This area is considered a strength and her performance is seen in only 5-10% of children her age in the general population. Her lower score was on a task requiring her to scan a group of symbols for a target symbol and indicate if the symbol was present or absent. The final processing speed asked Jane to scan pictures and mark target items within a time limit. Her performance suggests that Jane doesn’t experience trouble 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 to reading and other academic tasks, her performance implies that she is able to concentrate on the letters and words and discriminate different letters from one another.

ACADEMIC ACHIEVEMENT

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Jane’s academic achievement in reading and math were measured with the BASI-Survey and her performance is summarize and interpreted in the following paragraphs.

ReadingIn the overall area of reading, Jane’s achievement scores are below average and rank in

the 7th percentile (BASI-2 Survey RT= 78; 7th percentile). This suggests that Jane’s performance exceeded 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 children her age and grade. Reading, in this case, included Jane’s performance in vocabulary, language mechanics, and reading comprehension. Each of these skill areas were assessed by Jane reading a question and selecting an answer from a multiple choice format. There was a time limit on completion of the reading task. Jane’s lowest score was in vocabulary, which involves identifying word meanings within context and in isolation, recognizing synonyms and antonyms, and analyzing verbal analogies. On this task, her performance was well below average. Her performance was low average in reading comprehension tasks, which required her to read a passage and answer questions about the main idea, event sequence, and setting. This skills area includes identifying cause and effect relationships, predicting outcomes and drawing conclusions. Jane scored in the average range on the final task involving language mechanics. Language mechanics measures her knowledge of grammar and syntax rules, such as capitalization, punctuation, verb form and tense agreement.

These scores imply that Jane is experiencing difficulty with vocabulary when she is required 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 memory as she works to sound out the letters, hold onto the sound, and connect the word sound with her current vocabulary knowledge. This process can make it challenging for Jane to comprehend the text since she is using her resources to figure out the word and then must simultaneously remember the story details. This achievement test supports the concern that Jane is experiencing difficulties in comprehension. Since much of the work in school involves students reading assignments, drawing conclusions and working to gain meaning from the information provided, Jane’s difficulties in reading may affect her ability to understand information and complete assignments in various subject areas.

MathematicsSimilarly, Jane’s overall math abilities fell in the low average range. However, her

performance 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 general population. It is likely (95% confidence) that her math abilities fall into a range from below average (76) to average (93). Math abilities involve Jane’s performance on math application and math computation tasks. As with the reading tasks, the math tasks are presented in a test booklet with answers available in a multiple choice format. There is a time limit to complete the questions. Jane’s math application ability fell in the low average range. Math application involves using arithmetic operations to solve mathematical word problems. These problems may involve 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

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apply skills in addition, subtraction, multiplication and division to whole numbers, fractions and decimals. She was also asked to simplify numerical expressions and equations.

These scores imply that Jane is having difficulty in math computations and applying her knowledge of arithmetic operations to story problems. Jane mentioned in her interview that she struggles 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 on previous tasks, discussed above in working memory, Jane performed arithmetic operations on questions presented verbally. On this task, she scored in the average range. This suggests that difficulties in math are not due to her working memory. It also suggests that she understands the concept of arithmetic language (i.e. what “less than” means). The previous task on arithmetic was also timed, as was the math application task, but the previous task was delivered verbally versus in a test booklet. Since these tasks required that Jane read the question and select the correct written response, her difficulties in reading may have affected her ability to gather necessary information to complete the math task.

SOCIAL EMOTIONALJane’s social and emotional abilities were measured with the following: Behavior Assessment System for Children (Second Edition), Parent Rating Scale (BASC-2; PRS-C), Vineland Adaptive 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. The following paragraphs will discuss Jane’s abilities and the interpretation of the information gathered 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 38th percentile (BASC-2 PRS, EP= 46; 38th percentile). This suggests that Jane’s responses indicating externalizing problems exceeded that of 38 percent of children her own age in the general 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 externalizing problems 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 behave without thinking. It appears that hyperactivity isn’t a problem that would interfere with Jane’s school work. Most of the time she will display good self-control, be able to take turns appropriately, and not be overactive to the point of disruption.

The measures of aggression were consistent and Jane fell in the average range. Jane’s tendency to behave in an aggressive manner on one assessment was in the average range and ranked in the 9th percentile. It is likely with 90% confidence that her aggressive tendencies fall in the low (34) to average (46) range. Aggression involves the degree to which Jane tends to behave in a verbal or physically hostile manner that threatens individuals or property. On another task,

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Jane was in the average range (Roberts-2 Agg: 53 T-score). The task looked at states (feelings) and expressions (verbal and/or physical) of anger. Jane was required to tell stories based on a picture presented. It’s important to note that in stories including aggression typically 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 the situation in the present tense (i.e. “the girl is getting bullied for her clothes”). This suggests she may struggle with problem-solving in these situations or coping with her emotions from bullying situations. 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 not highly disruptive to the class environment. Aggression by Jane does not appear to be a factor in any academic difficulties. However, she is currently influenced by the aggressive tendencies of others, which can affect schoolwork for some children by causing anxiety, stress or some depression. It may benefit Jane to learn additional problem-solving methods when dealing with bullies and ways to identify, express and deal with her emotions.

Similar to Jane’s performance on hyperactivity task, the issue of conduct problems also does not appear to be a noteworthy problem for Jane. On one measure, Jane’s tendency for conduct 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. Conduct problems 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, it appears that she is greatly affected by the antisocial behaviors of others. On one task which required Jane to tell stories in response to pictures presented, her score of Antisocial responses was 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 Jane can control her behaviors and behaviors she displays don’t interfere with her ability to complete school tasks, maintain relationships or follow the rules of society. However, the conduct problems of others are on her mind. This may impact how she feels in different environments and 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 ranked in the 19th percentile (BASC-2 PRS IP 41; 19th percentile) according a questionnaire completed by Cindy. From this assessment, it is likely (90% confidence) that Jane’s internalizing problems fell in the low (36) to average (46) range. Internalizing problems are not disruptive, as with externalizing, but may often go unnoticed. These problems include anxiety, depression and somatization.

With regard to anxiety, results were average but conveyed that Jane is experiencing anxiety from time to time. On one measure, based on Cindy’s responses to a questionnaire, Jane falls in the average range and ranks in the 47th percentile (BASC-2 PRS 49; 47th percentile). It is likely (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.

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Jane also fell in the average range on a task requiring her to make up a story in respond to a presented picture (Roberts-2 Anxiety= 43 T-score). Anxiety was represented, but not a strong theme 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 experience high levels of anxiety, she may experience anxiety in certain situations or when problems are on her mind. If Jane experiences anxiety during her school work, it can affect her concentration and ability to process information using her working memory. For example, when she is trying to decode a word, if anxiety makes it difficult for her to hold the letter sound in her working memory long enough to blend the sounds together, she will experience difficulty sounding out words.

In addition to occasional anxiety, it’s important to note that a few assessments indicated a theme that Jane experiences feelings of inadequacy at times and may feel insecure in her environment (HTP; KFD; Sentence Completion). There was some indication that Jane may desire control over her environment and strive for self-control almost to a rigid degree. One assessment connected these feelings and needs to social interactions with peers, specifically with experiences of being bullied (Sentence Completion). These measures indicated that relationships with peers and family hold special importance to Jane and difficulties with relationships can invoke feelings of inadequacy, insecurity, and a strong need to control her surroundings.

With regard to depression, Jane measured average to slightly below average. Depression involves feelings of unhappiness or stress that may interfere with daily activities. On a questionnaire completed by Jane, she scored slightly below average and ranked in the 11th percentile on an overall measure of depression (CDI TS= 40). In this measure, depression includes a combination of negative mood, interpersonal problems, ineffectiveness, anhedonia (absence or inability to feel pleasure), and negative self-esteem. In the various areas of depression, Jane rated average to slightly below average in comparison to children of similar age and gender. Jane’s profile is indicative of a normal pattern and when her elevated responses were examined, there was no pattern. This result is supported by a questionnaire completed by Cindy, in which Jane’s tendency for depression fell in the average range, ranking in the 16th percentile (BASC-2 PRS Depression 41; 16th percentile). It is likely (90% confidence) that Jane’s depression tendency falls in the low (35) to average (47) range. Jane also rated average on 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 complete sentences showed a tendency toward positive affect. These scores imply that Jane does not appear to have an elevated tendency toward depression and depression is not a factor that is influencing her school work at this time.

Jane fell in the low range for somatization and ranked in the 11th percentile (BASC-2 PRS Somatization 39; 11th percentile). This score is based on a parent rating scale and indicates that Jane’s tendency for somatization likely (90% confidence) falls in a range of low (31) to average (47). Somatization includes being oversensitive to and complaining about minor physical problems or discomforts. These scores imply that relatively minor physical discomforts don’t interfere with Jane’s ability to complete tasks at school or complete daily activities.

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One task looked at rejection as an internalizing problem for Jane, and her responses showed high, clinically significant levels of rejection (Roberts-2 Rejection= 70 T-score). The task for rejection required Jane to tell stories in response to pictures that were presented. The majority of responses, again, involved either bullying behaviors or other peer rejection. This score implies, again, that the negative behaviors of others (i.e. bullies, peers) have a significant impact on Jane at times. Negative peer experiences at school impact how she perceives certain situations 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 assessments performed. One parent rating scale rates Jane’s overall level of problem behavior in the low range 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 average internalizing and externalizing maladaptive behaviors as compared to other children her age (Vineland-II MBI=13). Assessments involving Jane’s drawings did not indicate maladaptive behavior 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 maladaptive behaviors and that her behaviors do not affect her functioning in the school environment or negatively impact her academic progress. This is consistent with the referral concern which has no mention of disciplinary or behavioral problems.

In addition, Jane does not indicate an emotional disability based on the conducted assessment. With regard to indications of emotional disability, Jane ranked in the 4th percent as compared to other children of her age (DAP:SPED= T-score 33; 4th percentile). Further evaluation for emotional disabilities was not indicated. This test suggests that Jane’s emotional development is normal and this is not a concern with regard to her school work or school experience.

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 rank in the 93rd percentile (BASC-2 PRS ASC= 64; 93rd percentile). Adaptive skills include behaviors important for functioning at home, school, with peers and in the community. They include adaptability (ability to readily adapt to environmental changes), social skills, leadership, activities of daily living, and functional communication. Functional communication refers to Jane’s ability to express her ideas and communicate so that others can easily understand her. On each of these skills, it is likely (90% confidence) that Jane’s abilities fall in the average to high range and rank in the 81st to93rd percentile. Another parent survey showed Jane’s adaptive behavior 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 to moderately high adaptive skills in communication, daily living skills, and socialization. Jane’s

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scored high in receptive communication (i.e., ability to listen, pay attention, and understand what is conveyed), and has strengths in coping skills and personal daily living skills. Coping skills involves how Jane shows responsibility and her sensitivity to others, which personal daily living skills involves personal hygiene practices. Jane’s lower scores still fell in the adequate range and involved 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 or computer. In the near future, this could involve the use of job skills. Interpersonal relationships refer to how Jane interacts with others.

Another task confirmed that Jane’s adaptive skills fall in the average range, but also provided additional information about certain areas that may be considered weaknesses or need additional attention (Roberts-2). This task required Jane to tell stories about pictures that were presented. Jane’s average scores indicate she is able to accurately perceive what is going on in her environment, follow directions, and utilize her knowledge to make sense of tasks (Roberts-2 POP= 52 T-score; MEAN= 43 T-score). She is also had a good sense of support systems available, including protective, positive external supports (i.e. family, friends) and internal resources (i.e., her own resourcefulness) (Roberts-2 A.R. Scales). Jane demonstrated a good sense of support systems, indicated that she had confidence certain people would provide aid upon her request. It’s important to note from the content of her stories that individuals providing support were family figures. In addition, Jane conveyed appropriate understanding with limit setting or consequences for behaviors. Jane demonstrated a strength in her ability to recognize a feeling or behavior in a situation, but showed a weakness in her ability to pick out and define the cause for an emotional response (Roberts-2 Recognition=61; Description=39). This insight is important with regard to Jane’s ability to select the best coping mechanism, support system, or problem-solving method. Another aspect of this task involved Jane’s ability to describe a positive outcome to her stories. Her performance on these tasks indicated that at times, Jane is unsure how to resolve problem feelings or conflicts in a positive or successful manner and may experience significant difficulties (Roberts-2, Easy-Positive Outcomes=32).

These scores combined imply that Jane displays good adaptive skills which allow her to function properly in various environments. These skills will allow Jane to communicate with peers and her teacher appropriately, participate in the classroom activities, and use coping skills to be responsible and sensitive to others. She has knowledge of support systems and confidence in these support systems and herself to tackle problems. Although Jane can use coping skills and support systems, at times she may lack the insight to distinguish which coping mechanisms or supports are best for her situation. She may be unsure how to solve certain problems or feelings in a positive way. Jane may have excellent support with family members and close friends, but there 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 and vocabulary knowledge. Jane can appropriately receive and attend to verbal information and is able to retain information in her long-term memory. When information is presented verbally,

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she shows some difficulties in comprehension, but overall, still performs average compared to other children her age. Therefore, in general, she is able to comprehend lectures or verbal readings, but may experience confusion time to time. With regard to information presented visually, 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 with concentration or attention to the information. With regard to reading, she can concentrate on the letters or words and discriminate among letters. Her attention and processing abilities aid the reading 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 to other children. On one task, it was difficult for her to hold some information long enough to process 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 working memory 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. For example, Jane needs to hold letters sounds long enough to combine them into a work and then retrieve the word meaning from her vocabulary knowledge. At the same time, she needs to retain story facts in her working memory to later apply to comprehension questions. If she is anxious, 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 is struggling 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 point that she could access her vocabulary database. Her comprehension performance was low, although as with vocabulary, she performed better with verbally presented information. If Jane’s mental resources are preoccupied with decoding, it may be difficult for her to attend to story details 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 stage of the reading process is difficult for Jane.

Jane is also experiencing difficulty in math computation and application. Jane was able to perform verbally presented arithmetic tasks, suggesting that her working memory is able to hold the data and process it as needed. This also suggests she understands mathematical language. However, Jane had difficulties applying her knowledge to tasks when she had to read the question or information in story form. Laure shared that math is her most difficult subject and that she struggles remembering multiplication tables. No problems were evidence from the tasks with regard to her long-term memory abilities. It may be hard for Jane, though, to access information in her current knowledge when her mental resources are occupied with reading the problem, comprehending what is being asked, and holding the information in her working memory if she’s anxious or nervous during the task.

Jane demonstrates normal levels of hyperactivity, aggression, and conduct problems. In addition, she displays low levels of problem or maladaptive behaviors. This means that in the

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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 in maintaining healthy adult and peer relationships. Interpersonal relationships are important for Jane 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 her working memory).

Tasks revealed that although Jane is not continuously showing signs of anxiety, she does experience anxiety during certain situations or when problems are on her mind. For Jane, difficulties with relationships may invoke feelings of inadequacy, insecurity, rejection, and a need to control her environment. A school task could be challenging if Jane is trying to focus on information while simultaneously dealing with negative emotions. Her negative emotions may simply 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 she displays a normal level of emotional development which allows her to recognize feelings. This is 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 various environments, participate in activities and communicate effectively. Jane knows and trusts her current support systems (particularly her family and close friends). She also possesses internal resources to tackle problem situations. At times, however, Jane may lack insight into the causes and proceeding factors leading to problem feelings or situations. This will make it more difficult for Jane to distinguish which coping mechanisms or supports are best for her situation. She may be unsure how to solve certain problems or feelings in a positive way.

RECOMMENDATIONS:

According to the reviewed evidence, Jane is experiencing difficulties with reading comprehension, math computation, and math application. Further tests should be done to provide a better understanding of which specific reading components or math processes need assistance. The Woodcock-Johnson III Test of Achievement is recommended to provide further information, including but not limited to, Jane’s phonological and orthographic (i.e., spelling method) coding ability, reading fluency, receptive and expressive story recall abilities, and fluency with math facts. DIBELS is also recommended to assess Jane’s current reading abilities and assess progress over time.

These assessments should provide further insight toward which reading components to work on during the summer months with the tutor (per Cindy’s request) and during the next school year. Since Jane has trouble sounding out words, interventions that target decoding abilities may be helpful. Examples would include performing the Drilling Error Words technique and using the decoding strategy procedure in the Reading First Program.

Also, it would be helpful to increase memorization of sight words. These words generally include common words that Jane will see when reading. If she can memorize these common words, it will free up her working memory to focus on sounding out other words and

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help her with reading fluency and comprehension. One task would be the folding-in technique which provides Jane with many opportunities to practice and respond to words (similar to the Drilling Error Words technique mentioned above). Information on performing these techniques will be provided to the mother for summer work. Previewing procedures may also benefit Jane since she will hear the passage read first (and follow along with the reader) and then have an opportunity to practice reading the passage out loud. The first reader of the passage can be her mother, 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 good concentration and attention. Learning to give special attention to story elements will aid her comprehension and through note taking, she can focus on decoding the words as needed without fear of forgetting story facts.

Finally, it is recommended that Jane be given many different opportunities to practice decoding 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 clothing price lists could be made that would give Jane in informal way to practice reading and even math. Reading emails from her father during business trips, if possible, could also give Jane a chance to practice decoding and comprehension (especially if specific word lists were incorporated).

Regarding math, evaluation of her math homework or tests from school is recommended to look for patterns in her math abilities. Specifically, does she perform the computations well if there are no words in the question, only numbers? Does she struggle with multiplication, but do well on addition and subtraction problems? Since she was able to perform arithmetic problems when delivered verbally but struggled when they were presented in a workbook, further evaluation of her previous work and a conversation with Jane about what specific areas of math are tricky would be beneficial before choosing an intervention. In addition, it would be helpful to observe Jane solving a math problem to see if she struggles at certain points of the computation process. It may benefit Jane to use a schema-based learning in which she is taught to break word problems down into the essential elements and depict the numerical relationships in a schema map. It is also recommended to provide Jane with tools to aid her memorization since she expressed this concern with multiplication tables.

With regard to social/emotional support for Jane, further discussions with Jane are recommended to see how she feels when she struggles with reading or other subjects and how often she is confronted by bullying or other negative interpersonal situations. For example, if she is in a reading group that she doesn’t like, has a bully in the room, and then struggles with sounding out a word, the anxiety alone may be affecting her performance. However, if Jane doesn’t face such scenarios or feelings, the recommendations will differ. Currently, it is recommended that Jane receives support in finding an adult in the school building that can serve as a support system for her when she is bullied or has negative emotions. This individual could be a counselor or trusted teacher, for example. It is not recommended that the individual be Jane’s current teacher for the year. Since Jane has strong support systems at home and with

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certain friends, this would help her to have another system in place at school that could help her discuss different coping skills or problem-solving methods that are applicable for the circumstances quickly after the incident has occurred. Jane does well identifying her feelings and those of others. It would be beneficial to talk to Jane about various coping skills and how each may better apply given her feelings and circumstances. Also, helping Jane identify preceding events to conflicts and how conflicts can be resolved in a positive way (without her or other students suffering) may help her gain more control over her environment. A peer group led by a counselor or school psychologist allowing kids to talk about bullying situations may be helpful for Jane. The peers in such a group may also provide a further support system for Jane when needed. Finally, Jane mentioned feeling angry and wanting to change her occasional angry attitude. It would be beneficial to have a person at school readily available to listen, help her with expressive language, teach her anxiety relieving strategies, and help her work through anger would be beneficial. Jane can also work on expressive language and anxiety-relief techniques with a counselor outside the school during the summer or as needed.

Debra Bassett June 28, 2011________________________________________ Date: ________________Debra Bassett (Examiner); School Psychologist in Training