PARENT INTERVIEW

Child: Kaelyn Allana Krause Date of Birth: Dec 3, 2002 Age: 9 Interviewer: Rhonda Williams

July 17, 2012 Parent/Guardian: Shelagh Krause School: Ecole Sundance Elementary School Grade: going into grade 5 Reason for Referral: very emotional, perfectionist, easily frustrated, poor team work in class, reading comprehension issues, inflexibility

CONFIDENTIALITY AND PURPOSE OF INTERVIEW Thank you for taking the time to meet with me today and for completing the background document that you received before our meeting. I have reviewed the information you provided, and I would like to hear more about your concerns about Kaelyn. Your perspective as a parent is very important for me in understanding Kaelyn. I want to let you know that the interview may touch on a lot of feelings, but were here for the purpose of helping your child. Usually your first response to a question can be the right observation, but if you want to go back and explore the answer further or change an answer we can do that. And if you dont know the answer to a question thats ok. If you need to take a break at any time, just let me know. This interview is part of my evaluation and will be summarized in my written report. I want you to know that I only include information that is relevant for understanding Kaelyn functioning and planning appropriate interventions. We can discuss what information will or will not be included at the end of the interview if you like. Please let me know if you have any questions at any time. Lets take a few minutes to review your consent for me to complete the psychoeducational assessment by going through this checklist. Its important for you to know and understand the purpose & nature of the assessment, the benefits & risks, mutual responsibilities, the alternatives to assessment & consequences of not consenting to the assessment, your ongoing right to refuse or rescind consent, the time limits, and the multiple uses of the assessment. Purpose & Nature of Assessment Investigation into strengths & weaknesses (areas for growth) Cognitive ability, academic achievement, language & behaviour Involves intelligence tests & other testing, rating scales, interviews, observations, history taking, & measuring responses to intervention Assessment occurs one-on-one within the UCAPES clinic today and again on Thursday from 9-12pm and 1-3pm

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July 17, 2012

Written report will be shared with you during a final review meeting to discuss our findings Parents have opportunity to ask questions & make suggestions about the report Goal is to gather specific & new information to better understand your child and improve their current functioning or learning. Various assessment tasks can potentially bring about different emotional responses that can range from having fun and interesting to challenging and frustrating. We will monitor closely and be attuned to Kaelyns emotional states. Benefits May help develop insights into needed changes or develop new strategies, accommodations & adaptations that may be necessary to improve your childs learning and overall functioning May help school personnel and your family gain a better understanding of your childs strengths and challenges May help school based team develop educational programs to improve success in school May lead to a child being diagnosed as having special educational needs. Diagnosis can make it easier to access some additional services that might benefit your child. Risks Not all assessments lead to the possible benefits we discussed May lead to diagnosis of learning or language disabilities, developmental disorders, and/or behavioural/emotional disorders that will require follow up treatment or interventions, which can be upsetting Assessment results may contribute to a re-evaluation of school or life plans for your child If diagnosis leads to your child being identified as a special needs student, it may limit their enrollment in some classrooms or programs To minimize unexpected problems its important that any concerns or questions that develop over the assessment period be mentioned as soon as possible. Mutual Responsibilities I will ensure that a written copy of the assessment is given to you in a timely manner Together we will collaborate to ensure your child is prepared for any changes in routine and is made to feel as comfortable as possible regarding the assessment Ongoing Right to Refuse or Rescind Consent You have the right to refuse consent at any time during the assessment Just contact myself or the main UCAPES line & ask that the assessment be stopped Because this is an ongoing process, I will inform you of any changes in the assessment process and get your consent before implementing any changes

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July 17, 2012

Limits of Confidentiality Information within the reports is considered private, confidential, & protected by law They may not be disclosed to any person or agency without your specific & written consent The only time confidentiality could be breeched would be when I am required by law to contact the appropriate agencies if there is a clear risk of harm such as suspected child abuse or if your child poses a danger to themselves or others, or if a court orders the disclosure of the records

Do you have any questions? Okay, now Id like to continue by hearing more about your concerns for Kaelyn.

CONCERNS What concerns you most about Kaelyn?

RESPONSES/COMMENTS

You mentioned you had concerns since the age of 2-3years. Can you describe these concerns a little more?

Tell me about the dramatic down-turn regarding Kaelyns academics.

Is there anything else you are concerned about?

How much do you feel this impacts Kaelyn daily functioning? How often does it occur?

Has Kaelyn been evaluated or received any help for [problem]? If so, query: type, progress, etc. (What are Kaelyns strengths?) What do you want to see happen for Kaelyn?

Strengths: intelligent, ability to stay very focused on tasks, mathematically inclined, very artistic, visually perceptive with patterns, very good memory, friendly, kindhearted Happy and confident, control her emotions

PARENT INTERVIEW
Now lets discuss how Kaelyn is doing in school. SCHOOL FUNCTIONING How is Kaelyn getting along in school? You mentioned that Kaelyns teacher may have a different opinion regarding staying focused on tasks at school. Tell me a little more about that. What does Kaelyn like best about school? What does Kaelyn like least about school? What are Kaelyns best subjects? What are Kaelyns worst subjects? How much of Kaelyns instruction is delivered in French? Does she perform better in one language than the other? LEARNING How well does Kaelyn learn things? Does Kaelyn seem to understand things that are said to him/her? Does Kaelyn stick with tasks that he/she is trying to learn? You brought up Kaelyns reading comprehension problems, does Kaelyn have any other learning problems? If yes, what kind of learning problems? Why do you think he/she is having learning problems? What has been done to address these problems? HOMEWORK How does Kaelyn feel about his/her schoolwork? His/her homework? How much homework does she/he have? Mathematically inclined RESPONSES/COMMENTS

July 17, 2012

You talked about coping skills that Kaelyn has and gave some examples (reading lips, language development)

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When & where does Kaelyn usually do homework? Does she/he have any trouble with homework? How long does homework typically take? Does she/he get help with homework? If yes, how does that work out? TEACHER RELATIONSHIPS How does your child get along with his/her teacher(s)? Is there anyone at school who is important to him/her? Are you generally satisfied with Kaelyns achievement in school? If no, tell me what youre not satisfied with Has Kaelyn ever received special help at school? If yes, tell me more about that: what kind of help? How often? Do you think this is enough? Has Kaelyn ever been retained or held back a grade? If yes, when? For what reason? How did they feel? How did you feel? Does Kaelyn have any behaviour or emotional problems at school? If yes, what kind? Where? When? For how long? How often? What usually happens at school? What has been done to address these problems? Do you have any other school concerns? What else would you like to have happen for Kaelyn at school?

July 17, 2012

Lets move on to talking about Kaelyns behaviour and emotions. BEHAVIOURAL/EMOTIONAL PROBLEMS ATTENTION/FOCUS Does Kaelyn have trouble paying attention? RESPONSES/COMMENTS

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Does Kaelyn have trouble staying with one activity? What kind of self-control does Kaelyn have? How well does Kaelyn follow directions? Tell me about Kaelyns activity level.

July 17, 2012

Is Kaelyn impulsive? If yes, tell me about this impulsiveness. EMOTIONAL REGULATION How does Kaelyn behave when faced with a difficult problem? When Kaelyn get frustrated, how does Kaelyn manage frustration? How often? How long does it last? How quickly can Kaelyn calm down when upset? What helps Kaelyn calm down? Are Kaelyns emotional responses unpredictable? Does your child seem unusually anxious or worried about things? If yes, tell me more about that. Has Kaelyn ever seemed very sad or depressed for a long period of time? If yes, tell me more about that. TRANSITIONS Does it take Kaelyn a long time to warm up to new situations or new people? You talked about Kaelyn struggling with transitions and changes to routines. Tell me more about that.

PARENT INTERVIEW
How does Kaelyn feel about himself/herself?

July 17, 2012

What do you think is most important to address now? Now Id like you to tell me about Kaelyns social relationships. SOCIAL FUNCTIONING How many close friends does Kaelyn have? How do you feel about her choice of friends? How does Kaelyn get along with his/her friends? What do they like to do together? Do other kids come to your house to play? Does Kaelyn go to other kids houses? Sleepovers? RESPONSES/COMMENTS

You talked about Kaelyn being friendly, fairly popular and having a fun personality. However, when she struggles emotionally it Does Kaelyn have any problems getting becomes alienating and she is now selfalong with other kids? If yes, tell me more conscious. Does this happen with her close about that. friends as well? Now Id like to talk about Kaelyns medical and developmental history. MEDICAL, DEVELOPMENTAL, & FAMILY HISTORY Does Kaelyn take any medications? If yes, please describe (what for, name, dose, purpose, effect, doctor) Thank you for the very detailed medical history. Please tell me more about Kaelyns current hearing abilities? Is there any specific details about what she finds harder to hear? Are you concerned about any aspect of Kaelyns health? RESPONSES/COMMENTS

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Have you noticed any problems in Kaelyns development? If yes, please describe. Have any members of your family had a problem similar to Kaelyns? Tell me about that. Has any relative of Kaelyn have any of the following problems? Chronic diseases (diabetes) Mental illnesses Neurological disease (seizures) Mental retardation Learning problems Behaviour problems Other problems?

July 17, 2012

Now I would like to talk about Kaelyns family relations and home situation. FAMILY RELATIONS & HOME SITUATION Tell me about your family. What are your familys strengths? Is there anything about your home or living situation that is a problem for you or the family (work situation, financial problems, etc.)? How does Kaelyn get along with members of the family in your home? (father, mother, siblings, grandparents, stepparents, etc.) You mentioned that you carry out most of the discipline and that you and your husband disagree on discipline. Tell me more about that. What are the rules & expectations about behaviour in your home? RESPONSES/COMMENTS

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What happens when Kaelyn does something good or special? What types of rewards is Kaelyn motivated to earn? Does Kaelyn have any special chores or jobs at home? Tell me about Kaelyns daily activities and routines. Did you experience any difficulties in school? Your husband? What is your highest level of education? Your husband?

July 17, 2012

Id like to hear a little about Kaelyns interests and hobbies. CHILD INTERESTS & HOBBIES What does Kaelyn do in his/her spare time? Is Kaelyn involved in any sports or extracurricular activities? Tell me about that. What activities does Kaelyn like the most? The least? RESPONSES/COMMENTS Gymnastics, ballet, swimming, biking, drawing and colouring, computer/ipod games, TV shows Most Least- homework, helping around the house, reading

I have just a few general questions left. CONCLUDING QUESTIONS Overall what do you see as Kaelyns strong points? And overall, what do you see as Kaelyns weak points? Is there any other information about Kaelyn you think I should know? What do you want from the assessment? RESPONSES/COMMENTS

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Do you have any questions at this point?

July 17, 2012

Thank you so much for being open and sharing so much information about Kaelyn and your family. This is a really important aspect of the assessment because you know Kaelyn the best and your input has been very insightful for me. SUMMARY I just want to briefly review what we discussed Current functioning Major problem areas Competencies & strengths Relevant circumstances

Do you have any concerns about reporting any of the information we discussed today? You may go home and rethink some of your answers, if you want to change anything or discuss anything further you can email or call me. From here we will go ahead with the assessment, and I will contact you for our meeting to discuss the results and recommendations for your child. Thank you for coming today and if you have any other questions please call me.