University of Calgary Applied Psychological & Educational Services (UCAPES)

Assessment, Intervention and Professional Development Kelly Dean Schwartz, Ph.D., Director
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2nd Floor, Education Block (Room 281) 2500 University Drive NW Calgary, AB T2N 1N4 Tel: (403) 220-2851 Fax: (403) 210-8712 Email: UCAPES@ucalgary.ca
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CLIENT NAME: BIRTHDATE: AGE: SCHOOL: GRADE: Key Clinician(s):

Sniffles March 22, 1998 12 years 3 months Ascension of Our Lord 6 France Goulard Trista Knoetzke (PhD, R.Psych.) July 12 & July15, 2010

DATES OF ASSESSMENT: DATE OF REPORT:

Statement of Confidentiality
All psychological assessments are confidential in nature as they contain private information, which may be used inappropriately by others. To protect the privacy and ensure confidentiality of the persons involved, please ensure that this report is only circulated to those who are considered essential to related judgments and decision-making. The intent of this report is to provide opinions and recommendations in the context of psychological intervention, educational and vocational decision-making, and any use of this report outside of that purpose should only be done with the informed consent of the parties and in consultation with the writer. REASON FOR REFERRAL: His mother, Mrs. Tissue, referred Sniffles for psychoeducational assessment due to academic concerns. Staff at Childrens Hospital referred Mrs. Tissue to the U-CAPES clinic. Mrs. Tissue reports that Sniffles struggles with Reading, Writing, Math, and has low standing in school. She wants to know what his strengths and weaknesses are, and how best to help him succeed in school.

FACULTY OF EDUCATION
25 0 0 U n i v e r s i ty Dr i ve N. W. , C al g ar y , Al be r t a, C a na d a T 2 N 1N 4 ww w . uc a l g a r y . c a

Joseph 2

BACKGROUND INFORMATION: The following information was obtained from an interview with Mrs. Revillo and Sniffles, as well as from the BASC-2 Structured Developmental History (SDH) completed by Mrs. Tissue. Family Information Sniffles, a twelve-year-old boy, lives with his mother, stepfather, and two-year-old brother in Calgary, Alberta. Mrs. Tissue and her husband separated when Sniffles was 3 years old. Sniffles biological father lives in South Korea and Mrs. Tissue reports that Sniffles sees his father every two years and that they have a good relationship. Sniffles and his stepfather, Kleenex, have a good relationship and the family enjoys spending time together playing games, going on walks, and vacationing. Family Psychological or Educational History Mrs. Tissue reported that she did not encounter any difficulties in school, attended College and is trained as a Personal Support Worker. Sniffles biological father has a University Education and teaches in South Korea. There is a history of Learning Disabilities on the fathers side of the family. Prenatal, Perinatal and Early Developmental History Mrs. Tissue reported no difficulties with her pregnancy with Sniffles who was born two weeks early. She was 28 years old when she had Sniffles. The delivery was difficult as Sniffles was in a breech position and required forceps to help with the delivery. With the exception of a lazy eye (strabismus), Sniffles was born healthy. Mrs. Tissue reported that Sniffles reached developmental milestones including crawling, walking, and feeding within expected periods. Mrs. Tissue reported that Sniffles had unclear speech for a time due to learning two languages at home (English and Spanish) and had some difficulty with fine-motor skills such as using pencils and crayons. Sniffles has regular medical, dental, hearing, and vision checkups. He required surgery at ten years of age to correct his lazy eye. Other than the difficulties reported Sniffles is in good health. Educational History Mrs. Tissue reported that Sniffles received ESL support from Kindergarten to Grade 6. He changed schools when the family moved from Ontario to Calgary and is currently attending Ascension of Our Lord School and transitions to Junior High in September. She reports that he struggles with Reading and Writing, has difficulty with Math and Social Studies, and performs adequately with Computers, Science, Art, and Physical Education. Mrs. Tissue discussed how Sniffles needs constant support in order to get his homework completed, and that either she or Kleenex sits with him until completion. While Sniffles has struggled academically since beginning school, some improvement occurred in the fifth grade when he really liked his teacher. He continued to struggle once again in sixth grade. Sniffles reports liking school but finds some aspects difficult as noted by his mother. He reports getting along with his teachers and has a fair number of friends. He likes playing sports with his friends and will possibly play organized sports, such as soccer, in the future. He enjoys playing video games and watching television. He dislikes reading and finds homework a challenge.

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Joseph 3 This is Sniffless first psychoeducational assessment. ASSESSMENT INSTRUMENTS: Parent/Child Interview Wechsler Intelligence Scale for Children Fourth edition (WISC-IV) Woodcock-Johnson III Tests of Cognitive Abilities (WJ III Cog) Wechsler Individual Achievement Test Second edition (WIAT-II) A Developmental Neuropsychological Assessment - Second Edition (NEPSY-II) Childrens Memory Scale (CMS) Expressive Vocabulary Test 2nd edition (EVT-2) Peabody Picture Vocabulary Test 4th edition (PPVT-4) Behavioural Assessment System for Children 2nd edition (BASC-2): parent, teacher, and self-report Conners 3: Parent, Teacher, and self-report Conners Continuous Performance Test II (CPT-II V.5) Beery-Buktenica Developmental Test of Visual-Motor Integration - Fifth Edition (Beery VMI) ASSESSMENT OBSERVATIONS: It was very easy for the clinicians to establish rapport with Sniffles During the initial interview, Sniffles readily answered questions when asked. When the clinicians were talking with Mrs. Tissue Sniffles appeared uninterested in the conversation and would often play with his clothing or open doors in the wall unit that was in the interview room. During assessment, he was not always eager to partake in work, although he performed the tasks required of him. He often yawned or asked questions pertaining to time or number of questions remaining, especially on tasks in the academic areas he has difficulty in. On several occasions Sniffles found it difficult to attend to the required task and looked off into space, put his head down on his arms, or wondered what the people behind the glass were doing. He returned from breaks ready to engage in further testing. Overall, it is believed that the results of this assessment accurately reflect J Sniffles academic and cognitive ability. ASSESSMENT RESULTS AND INTERPRETATIONS: Wechsler Intelligence Scale for Children Fourth edition (WISC-IV): The Wechsler Intelligence Scale for Children- Fourth Edition (WISC-IV) is a standardized intelligence test consisting of a series of ten core subtests and five optional subtests designed to measure the intellectual functioning of an individual as compared to others of the same age. A Full Scale Intelligence Quotient (FSIQ) is derived from the combined results of the core subtests. The WISC-IV also provides four factor-based scores, including Verbal Comprehension, Perceptual Reasoning, Working Memory and Processing Speed. Canadian norms were used to score this measure. Sniffles performance on the WISC-IV indicates that his cognitive abilities are in the Borderline range, with his Full Scale Intelligence Quotient (FSIQ) at the 4th percentile. This means that his overall performance across the WISC-IV was equal to, or better than, four percent of children his age. This score is considered by the test developers to be the most reliable and valid measure of overall cognitive ability.

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Joseph 4 Sniffles ability to understand and use language to communicate and engage in verbal reasoning was evaluated by the Verbal Comprehension Index. Sniffles obtained a composite score in the Low Average range at the 23rd percentile, indicating that his verbal reasoning abilities are developing below that of his same-age peers. One of the tasks included an assessment of his ability to engage in verbal reasoning and associative thinking (e.g. How are a dog and cat alike?) where he scored in the Low Average range at the 16th percentile. Another activity asked Joseph to use his prior knowledge to solve social-reasoning based questions (e.g., Where do you go to buy groceries?). Here he achieved a score in the Average range at the 37th percentile. A final activity had Joseph answer questions on a broad range of general knowledge topics (e.g., What is an elephant?). In this area Sniffles scored in the Low Average range at the 16th percentile. Based on his scores in this area, Sniffles verbal knowledge and comprehension of verbally presented information is not at the same level as a majority of his same age peers. Sniffles ability to engage in perceptual and fluid reasoning was evaluated by the Perceptual Reasoning Index, when he obtained a composite score in the Borderline range at the 7th percentile. Sniffles demonstrated Average abilities (50th percentile) on a task assessing his ability to engage in non-verbal analogical reasoning (e.g., grouping pictures with a common theme together). His performance on a task requiring him to engage in a non-verbal conceptual thinking task (e.g., completing patterns and sequences) was in the Borderline range (5th percentile), and his visual-spatial processing abilities (e.g., using blocks to construct specific designs) were in the Borderline range (5th percentile). These scores indicated that Sniffles perceptual reasoning abilities are significantly lower than a majority of his peers. Sniffles ability to retain and manipulate auditory information in short-term memory was evaluated by the Working Memory Index. Overall, he demonstrated an auditory working memory capacity in the Low Average range at the 9th percentile. Sniffles scored in the Low Average range on a task requiring him to repeat strings of numbers forwards and backwards (16th percentile), and on the task requiring him to repeat letters and numbers in sequential order, he scored Below Average at the 9th percentile. The third task involved solving orally presented arithmetic problems within a time limit. On this task Sniffles scored Below Average at the 9th percentile. All of these tasks also required concentration and sustained attention, cognitive flexibility, and numerical awareness. The Processing Speed Index evaluated Sniffles ability to quickly and efficiently complete simple visually mediated cognitive tasks. He obtained a composite score in the Extremely Low range at the 1st percentile, indicating that his speed of processing visual-perceptual information is particularly poor compared to that of his same-age peers. Sniffles performed within the Borderline range (5th percentile) on a task that required him to quickly learn and copy a set of codes and within the Extremely Low range on a task that required visual scanning, discrimination, and identification of common symbols. Woodcock-Johnson III Tests of Cognitive Abilities (WJ III COG) The Woodcock-Johnson III Tests of Cognitive Abilities (WJ III COG) are divided into two batteries: the Standard Battery (tests 1 through 10) and the Extended Battery (tests 11 through 20). This assessment instrument provides a comprehensive set of individually administered tests for measuring intellectual abilities. Depending on the purpose of the assessment, the examiner can administer the

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Joseph 5 Standard Battery alone or in conjunction with the Extended Battery. The clusters or grouping of tests are the primary source for interpretive information to help identify performance levels and individual strengths and weaknesses. Norms are provided for individuals ranging in age from 2 to over 90 years. In order to confirm the results found on the WISC-IV of Sniffles cognitive abilities, Sniffles completed the tests on the WJIII Cognitive. Sniffles performance indicates that his cognitive abilities are in the Borderline range, with a General Intellectual Ability (GIA) score of 75 (71-80) at the 5th percentile. This means that his overall performance across the WJ III Cognitive was equal to, or better than 5 percent of the children his age. The verbal ability composite score represents the depth and breadth of Sniffles knowledge of individual words and the relationship among words. It also represents his ability to reason with, and communicate this knowledge. Sniffles verbal ability is in the Borderline range, at the 8th percentile, meaning that Sniffles verbal abilities are at or above only 8 percent of his same age peers. Sniffles verbal comprehension was assessed by measuring various aspects of language development in English including lexical knowledge, vocabulary knowledge, and language reasoning. Sniffles scored in the Borderline range, at the 8th percentile, on tests of verbal comprehension. The thinking ability composite score represents a number of different thinking processes including long-term retrieval, visual spatial thinking, auditory processing, and fluid reasoning. Sniffles thinking ability is in the Borderline range, at the 6th percentile. This composite score is made up of four subtests discussed subsequently. Visual-Auditory Learning assesses Sniffles long-term retrieval abilities, and required Sniffles to learn, store, and retrieve a series of visual-auditory associations. In this task Sniffles was asked to learn and recall a series of pictographic representations of words that were combined into phrases in increasing complexity and length. Sniffles scored in the Borderline range, at the 7th percentile, on this subtest. Spatial Relations tests Sniffles visual-spatial thinking and required him to identify two or three pieces that form a complete target shape. More difficult items include drawings that are flipped, rotated, or those that are similar in appearance. Sniffles scored in the Low Average range, at the 24th percentile, on this test. Sound Blending is a test of auditory processing that measures Sniffles skill in synthesizing language sounds. In this task Sniffles was asked to blend a series of phonemes or syllables into a word, increasing in difficulty Sniffles scored in the Low Average range, at the 9th percentile, on this subtest. Concept Formation is a test of fluid reasoning and measure of flexibility in thinking, an aspect of executive thinking, that requires frequent shifting of ones mental set. Sniffles scored in the Low Average range, at the 11th percentile, on this subtest.

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Joseph 6 The cognitive efficiency composite score represents Sniffles capacity to process information automatically and provides information on two different automatic cognitive processes, processing speed and short-term memory. Sniffles cognitive efficiency is in the Low Average range at the 10th percentile. Visual Matching is one of two subtests that comprise the cognitive efficiency composite and is a test of processing speed and perceptual speed. This task measures an aspect of cognitive efficiency, or the speed at which Sniffles is able to make visual symbol discriminations. Sniffles scored in the Low Average range, at the 9th percentile, on this subtest. Numbers Reversed is a test of short-term memory, or working memory. This task required Sniffles to listen to a group of numbers and then repeat the numbers backwards in reverse order. Sniffles scored in the Low Average range, at the 11th percentile, on this subtest. The phonemic awareness composite score represents Sniffles ability to identify and spell words. Sniffles scored in the Borderline range at the 6th percentile on his ability to learn to read and spell words. Specifically, this score is comprised of the following subtests: Incomplete words is an auditory processing test. This task required Sniffles to identify words with missing phonemes (group of sounds). Sniffles scored in the Borderline range at the 8th percentile on tasks in this subtest. The working memory composite is a test that requires the manipulation of information mentally. Sniffles working memory abilities scored in the Low Average range at the 10th percentile. The following subtests contribute to this composite score: Auditory working memory is a test of short-term memory. This asked Sniffles to listen to a mixed set of numbers and words and reorder them into two sequences. Sniffles scored in the Low Average range at the 10th percentile on tasks in this subtest. Visual-Auditory Learning-Delayed tasks measured long-term retrieval. Tasks in this subtest required Sniffles to recall and relearn picture representations of words that were shown to him earlier that day. Joseph scored in the Low Average range at the 24th percentile on this subtest. Wechsler Individual Achievement Test Second Edition (WIAT-II), Canadian Norms: The Wechsler Individual Achievement Test - Second Edition (WIAT-II) is a standardized test of achievement and functioning. The WIAT is an individually administered measure that examines performance in the areas of Reading, Mathematics, Language and Writing. These areas are combined to provide an overall achievement score. Sniffles ability to perform academically was assessed using the Wechsler Individual Achievement Test, Second Edition (WIAT-II). Sniffles overall performance on tasks involving reading was in the extremely low range at the 1st percentile. Across all three subtests, Sniffles scored in the extremely low range on reading

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Joseph 7 comprehension at the 1 percentile, scored in the Borderline range on word reading ability at the 5th percentile, and scored in the extremely low range in Pseudoword decoding at the 2nd percentile, a task that required Sniffles to use phonetics to sound out non-words. Sniffles was able to read words that were familiar to him with ease. He was not as successful reading unfamiliar words that needed decoding. He did not use proper strategies to help him decode unfamiliar words. For example, he said duputy instead of deputy , sculpture instead of scholar , aplogio instead of apology . In reading comprehension, Sniffles read the passages at a fast rate but was not able to answer most of the questions without referring back to the text. Even when he was referring back to the text, he seemed to give up easily if the answer was not found right away. In Pseudoword decoding, Sniffles had a hard time decoding the words as they were unfamiliar to him and seemed to have guessed the majority of the words presented. For example, he said stuck instead of sluck , nab instead of nad , stay instead of snay .
st

Sniffles overall performance on tasks involving mathematics was in the Borderline range at the2nd percentile. He scored in the Borderline range at the 5th percentile on tasks that required him to solve written equations, and he scored in the Borderline range at the 3rd percentile on tasks examining word problem solving, including problems related to time, money, measurement, and interpreting graphs. In the numerical operations subtests, Sniffles did well with the additions and subtractions. He was also able to solve some of the multiplications but did not attempt solving operations using division. In his math-reasoning subtest, Sniffles seemed a little anxious. He was good at telling time and solving problems using money, but was not as successful at describing quantities, using patterns, and geometric/spatial reasoning to solve problems. Sniffles is at the middle of the grade 4 level in numerical operations and at the beginning of the grade 4 level in math reasoning. Sniffles overall performance on tasks involving written language was in the extremely low range at 0.4 percentile. Sniffles scored in the Borderline range at the 3rd percentile in both the spelling subtest and the written subtest. In the spelling subtest, Sniffles started out well but misspelled a couple of words due to their meaning (new instead of knew). He also omitted simple contraction usage (wrote coundled instead of couldnt). During his written expression subtest, Sniffles had a hard time linking 2 sentences together. He wrote both sentences down and separated them with a comma instead writing one well-written sentence. In his paragraph, there were less than 5 sentences and his sentence structures were very simple. Although, he did not veer from the topic and his sentences followed a logical order, the vocabulary words used were redundant and there were no examples or linking expressions in his writing. Sniffles overall performance on oral language tasks was in the Borderline range at the 3rd percentile. He scored in the low Average range at the 12th percentile on the listening comprehension subtest, where he was required to either choose a picture to match the word verbally provided or verbally provide a word that matched the picture. He scored in the Borderline range at the 5th percentile on the oral expression subtest, where he was required to repeat sentences orally presented to him, create stories based on visual story boards, or give directions based on pictorial cues. In the oral subtests, Sniffles was able to identify some of the receptive and expressive vocabulary but needed some encouragement. He seemed unsure of certain words but did ok overall. In the sentence comprehension section, Sniffles did very well and seemed more engaged in the task. Overall, he

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Joseph 8 seemed more comfortable and willing to participate in these subtests. Sniffles is at the end of grade 3 in listening comprehension and below grade 4 in oral expression. A Developmental Neuropsychological Assessment - Second Edition (selected subtests) (NEPSYII) The Developmental Neuropsychological (NEPSY-II) assessment is a measure of an individuals neuropsychological functioning. It incorporates six domains: Attention and Executive Functioning, Language, Social Perception, Visuospatial Processing, Memory and Learning, and Sensorimotor. Often, a clinician chooses to only administer the subtests most relevant to the individual clients needs. To examine further Sniffles attentional issues, selected subtests form the Attention and Executive Functioning and Language Domains on the NEPSY-II were administered. Attention and Executive Functioning Domain On a task involving sorting cards with pictures into groups based on common characteristics, Sniffles experienced difficulty correctly sorting cards, scoring at the Borderline Range at the 16th percentile. When completing tasks involving touching a particular color in response to hearing a target word presented within a list of words, Sniffles scored at the Below Expected or Well Below Expected Range on most of these tasks. While Sniffles displayed an understanding of the concepts related to these tasks, he failed to respond to many target words receiving a score for correct responses in the Well Below Expected Level at the 1st percentile. The design fluency subtest required Sniffles to create as many novel designs as possible within a specified time limit. He performed at the Below Expected Level at the 5th percentile. The Inhibition subtest involved completing tasks involving rapidly naming familiar symbols and providing alternate names for the symbols based on specific criteria. While Sniffles did not have trouble naming familiar objects, he performed in the Below Expected to Well Below Expected Level range when he had to inhibit saying the correct name and name the symbols based on alternative criteria. These subtests from the NEPSY-II support the notion that many tasks requiring Sniffles to pay attention and exert mental control are quite difficult for him. Language Domain On the Phonological Processing subtest Sniffles was required to determine what words would be with sounds removed (say smile without the /s/). He performed in the Borderline range at the 9th percentile on this task. This subtest required Sniffles to attend to the stimulus word, remove the required sound and produce the new word. Childrens Memory Scale (CMS) The Childrens Memory Scale (CMS) is a standardized test that evaluates the important processes involved in learning and memory and compares performance to that of others of the same age. A General Memory and Index score can be derived from the core subtests. Results are interpreted in accordance with United States norms.

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Joseph 9 Sniffles completed a number of memory-based tasks that assessed his ability to consolidate, store, and retrieve newly learned information presented either visually or verbally. These tasks involved both meaningful and non-meaningful information and his ability to recall the information was assessed both immediately after learning and after a short delay. Sniffles performance across these tasks varied depending on whether the tasks were verbal or visual, with a General Memory Index score in the Low Average range at the 18h percentile. Sniffles immediate memory for visually presented information fell in the Average range at the 58th percentile. He performed within the Average range on a non-meaningful (dot patterns) material task and within the Average range on a meaningful (faces) task. Sniffles was better able to remember the visually presented meaningful information after a delay, scoring in the Average range. This indicates Sniffles benefits from having more time to consolidate contextual information that is presented visually. Sniffles had relatively more difficulty remembering the non-meaningful material after a delay, scoring in the Low Average range at the 16th percentile. When the tasks involved verbally-presented information (stories and word pairs), Sniffles ability to recall the material in an immediate timeframe fell within the Low Average range at the 12th percentile and in the Borderline range when assessed after a delay (7th percentile). This may reflect Sniffles need for additional time to process verbally presented information. Within the verbal domain, Sniffles obtained higher scores on his ability to recall the meaningful (e.g., retelling stories) over the nonmeaningful information (e.g., reciting lists of words). An important distinction concerning memory is recall versus recognition memory. Recognition memory occurs when a cue is provided, such as in a multiple-choice exam where one answer is correct, whereas recall memory uses no such cue. The verbal delayed memory abilities discussed above are recall in nature. When Sniffles was provided with a cue to assist in remembering story information, his performance was in the Average range at the 25th percentile. Sniffles also completed two tasks that assessed his ability to sustain and direct attention, his speed of processing, and his working memory. He performed in the Extremely Low range at the 2nd percentile across these tasks. Specifically, Sniffles performed in the Borderline range on a task in which he had to repeat number sequences either as they were presented or in reverse order, and within the Extremely Low range on a task requiring him to repeat sequences (e.g., counting by twos, or reciting the days of the week). It is important to note that the second task was a timed subtest. While Sniffles was able to successfully complete the majority of the items, his score was affected by his slower processing time. Expressive Vocabulary Test, Second Edition (EVT-2): The Expressive Vocabulary Test, Second Edition (EVT-2) is designed to measure expressive vocabulary and word-retrieval abilities, or the ability to retrieve and pronounce the correct word in order to communicate verbally. Sniffles was administered the EVT-2 Form B, and was required to respond with a one-word answer when
presented with a question pertaining to either a picture or stimulus word. He obtained a score in the Low-

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Joseph 10
Average range at the 39 percentile, indicating that his expressive vocabulary functioning is equal to, or better than, 39 percent of his peers.
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Peabody Picture Vocabulary Test-4th Edition Form X administered (PPVT-IV) The Peabody Picture Vocabulary Test-4th Edition (PPVT-IV) is a test of listening comprehension for spoken English. It is designed to measure a students vocabulary acquisition that does not require a spoken response. Sniffles was administered the PPVT-4 Form B, and was required to respond by pointing to one picture
among four pictures when presented with a stimulus word pertaining to a picture on each page. He obtained a score in the Average range at the 61st percentile, indicating that his receptive vocabulary functioning is average compared to a majority of his peers.

Behavior Assessment System for Children (BASC-2) The Behavior Assessment System for Children (BASC-2) is an assessment tool that evaluates the behavior and self-perceptions of children ages 4 to 18 years. It measures numerous aspects of behavior and personality including positive (adaptive) as well as negative (clinical) dimensions. The BASC-2 provides information about a student from a variety of sources, allowing for a more complete understanding of the student. On the BASC-2, scores that fall in the Clinically Significant range suggest a high level of maladjustment. Scores in the At-Risk range identify eithim a significant problem that may not be severe enough to require formal treatment or the potential of developing a problem that needs careful monitoring. The Behavioral Assessment for Children, Second Edition (BASC-2) was completed independently by his classroom teachers, Mrs. Tisuue, and by Sniffles. Sniffles teachers completed the BASC-2 providing a measure of Sniffles problematic behaviours in the classroom and school setting. Sniffles teachers rated him in the Clinically Significant range for Hyperactivity, Attention Problems, Learning Problems, and Atypicality. He was rated in the At-Risk range for Conduct Problems. His teachers rated him very low in Functional Communication and Low in Study Skills. Sniffles mother completed the BASC-2 providing a measure of problematic behaviours in the home. His mother rated him in the At-Risk range for Hyperactivity, Conduct Problems, Anxiety, Atypicality, Attention Problems, and Social Skills. She rated him Low for Adaptability. Sniffles completed the BASC-II at first with the clinician reading the questions, but took over partway through as he became comfortable with the format. Sniffles rated himself normally within all but one domain on the test. He rated himself Low on Locus of Control suggesting he feels some lack of control for his life. He did respond to several critical items indicating that at times he has problems with hyperactivity and attention. Conners Third Edition (Conners -3) The Conners-3 uses observer ratings to help assess a childs behavior related to inattention, hyperactivity/impulsivity, learning problems, executive functioning, aggression, and peer relations. In addition, the scale provides a total score indicative of an attention or behavioral disorder. Scores

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Joseph 11 in the Very Elevated range indicate a possible significant problem and scores in the Elevated range indicate a possible concern. The Conners-Third Edition (Conners-3) was completed independently by Sniffles Teachers, his mother, and himself. Sniffles Teachers completed the Conners-3 providing a measure of his Hyperactivity, Inattentiveness, and Behaviour Issues in the school environment. They rated him in the Very Elevated range for Attention Deficit Hyperactivity Disorder Combined Type (ADHD Combined Type), for Oppositional Defiant Disorder (ODD), and Learning Problems and Executive Functioning. Sniffles mother completed the Conners-3 providing a measure of his Hyperactivity, Inattentiveness, and Behaviour Issues in the home environment. She rated him in the Very Elevated range for Learning Problems, in the Elevated range for Inattention and Hyperactivity, and in the High Average range for defiance and aggression. Sniffles completed the Conners-3 and rated himself in the average range on all scales except for Learning Problems where he rated himself in the High Average range. He indicated that his problems seriously affect his schoolwork or grades on occasion. Conners Continuous Performance Test II (CPT II V.5) The Conners Continuous Performance Test II (CPT) was designed for use in detecting difficulties with inattention, especially that of attention deficit hyperactivity disorder. This test requires the respondent to view alphabet letters appearing on the computer screen, with the requirement that the test-taker press the space bar for all letters except X. The letters and the Xs appear at varying rates and the task occurs for approximately fifteen minutes. The Confidence Index, as denoted immediately below, indicates the degree of fit with most clinical samples (e.g., ADHD) versus those without a clinical problem. Sustained Attention is the ability to stay on task during continuous or repetitive activity. In the classroom, there are many tasks that require Sniffles to pay attention to material that he might find challenging, boring and repetitive such as completing many pages of arithmetic calculations or listening to a teachers lecture. The CPT-II task was administered to Sniffles to assess for inattention. For this task, he looked at a computer screen that had letters pop up in varying intervals. He was required to press the space bar on the keyboard as quickly as possible after each letter except for the letter X. The Confidence Index indicates that there is a greater likelihood that Sniffles performance matches a clinical profile. Examining Sniffles performance further showed an indication of inattention and impulsiveness as demonstrated by his moderately slow Hit Reaction Time, which is the average speed of correct responses for the entire test, his pressing the space bar when not required to, and the variability of his responses. Beery-Buktenica Developmental Test of Visual-Motor Integration - Fifth Edition (Beery VMI) The Beery-Buktenica Developmental Test of Visual-Motor Integration - Fifth Edition (Beery VMI) is a standardized test that examines a childs ability to accurately integrate visual skills, visual perceptual skills and motor skills to produce visual models using paper and pencil.

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Joseph 12 In order to assess his visual-motor integration skills, Sniffles completed the Beery VMI. Overall, his score was in the Average range at the 50th percentile. He was able to draw simple line drawings, but had significant difficulty replicating complex shapes, often missing details in his drawing and failing to connect shapes together. On the visual perception subtest, Sniffles scored in the Borderline range at the 7th percentile. On this task, he was required to find matching shapes within an array. He was able to match shapes when there were printed in large print and when few distracters were present (e.g., selecting between 3 shapes), but had a much more difficult time matching shapes when the array was smaller in font size and had multiple selection options (e.g., selecting between 6 shapes). On the motor coordination subtest, Sniffles was required to trace numerous shapes, staying within the road of each item. On this subtest, Sniffles scored within the Extremely Low range at the 2nd percentile. Although he was able to complete each item, he had significant difficulty maintaining pencil control and often went outside the lines of the drawing. Taken together, these scores indicate that although Sniffles is able to replicate simple shapes with some detail, he has more difficulty in visually identifying similarities between items. Sniffles finds it even more difficult to trace accurately these shapes when provided with a guide. Sniffles will have difficulty in neatly printing or writing between the lines on his paper. It is important to note that this was the final test on the second day of testing and Sniffles commented that he could do better but he just wanted to be done. Thus, the scores on the Berry VMI should be interpreted with caution. FORMULATIONS/SUMMARY: Sniffles is a 12 year old who just finished grade 6. An educational assessment was done to help determine
his strengths and weaknesses in regards to his academic difficulties.

Overall, Sniffles presents as a friendly and cooperative young man who wants to do well. While he struggled in many areas of the assessment he demonstrated the ability to persevere throughout. On the WISC-IV and WJ-III COG, general measures of cognitive ability and academic potential, he obtained scores indicative of Borderline cognitive abilities as described by his Full Scale Intelligence Quotient and General Intellectual Ability (FSIQ=74; GAI=75). He is better able to work with verbal information (Low Average) than visual information (Borderline). His Working Memory was in the Low Average range on both the WISC-IV and CMS, which suggests that he will need support in remembering instructions and algorithms. His Processing Speed (Extremely Low) is significantly below that expected at his age suggesting he will need extra time to process information. Since learning often involves a combination of routine information processing (such as reading or scanning information) and complex information processing (such as reasoning), weaknesses in reasoning, memory, and information processing may make the task of comprehending novel information more time-consuming and difficult for Sniffles. Sniffles struggles in all academic areas although he has a relative strength in verbal ability, including strong expressive and receptive language abilities. His reading, writing, and mathematics were

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Joseph 13 assessed with the WIAT-II. Results of the achievement testing indicated Borderline to Low Average mastery of basic academic skills. The PPVT-IV indicates that Sniffles has Average receptive vocabulary. Similarly, the results of the EVT-2 indicate that Sniffles has Low-Average expressive vocabulary. Sniffles relative strength with verbal information combined with his relative strengths in receptive and expressive vocabulary should be of benefit when he is learning new material. Socially and behaviourally Sniffles teachers, and to a lesser extent his mother expressed concerns surrounding hyperactivity, inattention, and externalizing behaviours. The information provided by the teachers for the BASC-2 and Conner 3 suggests that Joseph struggles with self-control in the classroom environment. According to the parent BASC-2 and Conners 3 Sniffles has some selfcontrol issues but not to the extent of impairing his functioning in the home or community. It is felt that Sniffles attentional issues are commensurate with his intellectual functioning, especially when material is beyond the range of his current abilities. The primary finding from the assessment process is that Sniffles cognitive abilities are below those of a majority of his peers. It is apparent that Sniffles will struggle with grade level work and will therefore need some programming accommodations, modifications, and consideration of his learning style and relative verbal strength. Given the results of the current assessment and the behavioural patterns demonstrated, Sniffles does not fully meet criteria from the Diagnostic and Statistical Manual of Mental Disorders Fourth Addition Text Revised (DSM-IV-TR) for any diagnostic categories. Axis I Axis II Axis III Axis IV Axis V V71.09 No Diagnosis V71.09 No Diagnosis none Educational Problems GAF=55 (current)

RECOMMENDATIONS: Based on the current assessment, the following suggestions are offered for consideration: 1. It is recommended that the school prepare an IPP for Sniffles to reflect his current level of functioning, and that targets the development of his academic skills. 2. Classroom/Home Strategies: The following recommendations may allow Sniffles to succeed in the classroom and/or at home: Seating: o Being seated near the teacher, being surrounded by positive role models, and in areas free from distractions such as high traffic areas, doors, windows, and pencil sharpeners. Organization/Memory aids: o Using an agenda book or calendar to write down assignments. A notebook may also be helpful to keep a to-do list.

Empowering People Building Strengths

Joseph 14 o Having cues placed in a prominent place (e.g., school bag by the door, picture of lunch on the door) o Verbal reminders (e.g., from teachers, parents, or peers). Pre-Listening Strategies: o Having independent work and assignments provided and reviewed with him in advance to allow extra time to process the instructions and content. 00000000During Listening Strategies: o Reminders to maintain eye contact. o Questions aimed at assessing his listening and comprehension during class discussion and teacher instruction. o Instructions for multi-step tasks presented in a step-by-step fashion with adequate time between the presentation of each step to allow him to process the presented information. o Lessons presented in a clear and short manner through the use of pictures and highinterest materials. o Having classroom instruction provided in both verbal and non-verbal forms (multimodal instruction) and a visual stimulus for him to refer back to as necessary and process at his own pace. Post-Listening Strategies: o Being asked to paraphrase information in his own words after it has been delivered to ensure he has received the entire message. Assignments/Tests: o More time for exams and papers/assignments. Individuals with attention difficulties often have difficulty putting their thoughts on paper. o Having tasks broken down into subtasks and taking breaks after the completion of each subtask. o The opportunity to write his exams in a quiet location where he will not be distracted by other students or noise. Self-monitoring: o Becoming aware of his personal academic strengths and needs, being involved in discussions regarding establishing attainable goals, and monitoring his own progress Praise and Encouragement: o Encouragement within the classroom setting to support him in maintaining his determination and to increase his positive feelings toward school work and his own achievement. o Having something to look forward to doing as soon as a task is finished (e.g., free time on the computer, time to play a game with a friend). o An incentive system where he is awarded points for work completed within specific time parameters. Together Sniffles and his teachers may determine and agree on realistic goals, explicitly state the expectations for these goals and review the goals

Empowering People Building Strengths

Joseph 15 regularly. A communication system may be established to report daily success. This daily report may have a page divided into goals and a place to rate progress towards determined goals. Points may be awarded for completion of goals. These points may be traded in for permission to do a favored activity, such going biking or playing soccer. Communication: o Ensure regular communication between parents and teacher. This communication may be through a homework agenda. For example, Sniffles may write down his homework for the evening and the classroom teacher may include other updates for his parents. Regular parent-teacher meetings will also be important to ensure that Sniffles is supported in all aspects of academic functioning. 3. Written Expression: Sniffles demonstrates difficulty in expressing himself through writing and will need additional support in order to improve his writing and complete written work at grade level. Suggestions to help improve Sniffles writing may include: Writing mechanics o Direct and specific instruction in sentence composition (punctuation, capitalization, and grammar, etc.) as well as an editing sheet to remind him to review his work for correct capitalization, punctuation, etc. o Exploring software options may allow Sniffles to increase his written output as well as helping with the mechanics of writing such as spelling and grammar. The computer can be used as a tool that provides Joseph with programs that enhance his learning and awareness of editing his written work. o Prompts to help Sniffles proofread work (e.g., COPS checking for capitalization, organization, punctuation, and spelling) along with an editing checklist as visual strategies to help remind him of the mechanics of writing. Spelling o Immediate feedback when a spelling error is made to allow for immediate correction. o Generating a list of key words associated with the writing topic, using this list as a reminder during the writing process. These words could then be kept in a word bank and referred to later on for subsequent activities. Written composition: o Building an outline by talking through the topic. Have Sniffles study notes from the topic as well as describe what he knows about the topic and its significance to the listener (this can be audio-recorded for later playback). After the conversation, he can jot down an outline from memory to capture the structure and main ideas. o Keeping a personal dictionary containing frequently used and frequently misspelled words, as well as unfamiliar words.

Empowering People Building Strengths

Joseph 16 o Developing a mind map or a web. This may help him develop loosely structured pictures of his emerging thoughts that will enhance the flow of his ideas. o Support in getting started with the writing process, by first providing him with a broad topic on which to write. Within the broad topic assigned, have him brainstorm and list as many ideas for subtopics as possible. Next, have him cross out the subtopics that seem least interesting and then rank the remaining ones from most to least interesting. Have him select the top choice and make up a title that can evolve into the main idea statement for the paper. o To build on the previous suggestion, an additional strategy would be to have Sniffles write down everything he knows about the topic on individual sticky notes which he can organize into groups and rearrange to visualize the order of the writing piece. After Sniffles has completed a draft of the paper, either a parent or teacher can go through the editing process with him and help him to identify and correct mistakes. o Sniffles may benefit from participating in guided writing groups or small group writing activities if these are available at the school, as these types of groups provide guidance through the brainstorming and plot development stages of writing. 4. Mathematical abilities: In order to help Sniffles improve his math abilities, the following recommendations may be used: o Strategies: o Teach Sniffles to cross out all irrelevant information in a word problem or question. o Teach and encourage Sniffles to use self-monitoring strategies while completing his work (e.g., color code, underline or circle math symbols in each equation). Other suggestions: reading each question carefully, talking quietly to self while arriving at an answer, underlining relevant information in word problems, and double checking each answer. o Have Sniffles write down, verbalize and create a visual image of the steps needed to perform an operation. o Whenever possible, model mathematics concepts to be learned using a visual medium, such as an overhead or manipulatives to promote a concrete understanding of the concept. Further, provide instructions both visually and verbally. o Repeated teaching and practice of math facts, through the use of flash cards or educational software, to support him in developing automaticity in this area. Other: o Provide extra time for Joseph on timed math activities, as he requires an extended amount of time to process and respond to math problems o Allow the use of a calculator, or visual supports such as a computation table, to support him in completing numerical operations more fluently.

Empowering People Building Strengths

Joseph 17 5. Reading: In order to support Sniffles in reading, the following recommendations are made: Reading Fluency and Vocabulary: o Sniffles may benefit from practicing reading words beginning with easier words and progressing to more difficult words using a flashcard drill method. This includes presenting a new word on a flashcard and modeling the word for Sniffles. Next, Sniffles will read the word himself and put it into a sentence. After the few words targeted that day are finished (i.e., 3-5 words), the cards should be shuffled and read by Sniffles alone without modeling. Immediate feedback should be provided and unmastered words should be added to the list for the next day. o It may also be beneficial for Sniffles to have taped books for his reading level, allowing him to read along with the tape. o Reading on a daily basis and support in obtaining enjoyable reading materials that contain vocabulary at his reading level. Reading Comprehension: o Prior to reading: o Preview the book with Sniffles by reading everything except the regular printed text. This information includes reading titles, subtitles, captions, chapter review questions, graphics and pictures. o Activating prior knowledge (e.g., ask questions, make predictions). o Before Sniffles reads a chapter or a book, let him know that you will have a conference after he is finished to discuss with him his reaction to the material. o During reading: o Creating graphic organizers to help organize new learning in a visual format that can later be retrieved and manipulated. o Regularly summarizing, connecting what he has read with what he already knows and determining the most important ideas, events and the relationships between them. o Re-reading portions of the text he finds confusing. o Making a movie in his mind about the information being read. o After reading: o Draw a picture or write a reading response about new learning. o Talk to a peer, teacher or parent about information learned. 6. Follow up assessment: It will be necessary to provide continued follow-up assessment for Sniffles in order to ensure that his academic programming is appropriate for his cognitive abilities. As such, it is recommended that Sniffles be reassessed in 3-4 years in order to monitor his cognitive progress. 7. Extra-curricular involvement: Sniffles may benefit from continual involvement in extracurricular activities outside the school, such as a biking and soccer. Specifically, he may benefit from the opportunity to participate in less structured activities which he finds enjoyable and experiences success, possibly helping to increase his motivation to work hard in the classroom.

Empowering People Building Strengths

Joseph 18 It was a pleasure working with Sniffles I trust that the information contained in this report, as well as the recommendations provided above, will aid in providing him with the most appropriate educational opportunities. I wish him great success. If you have any questions regarding this report or if you require any assistance in implementing the programming suggestions, please do not hesitate to call me. ____________________________ M.Ed. student ________________________ Trista Knoetzke Ph.D., R.Psych

NOTE: Due to the developing and changing nature of an individuals skills and abilities, the
results and recommendations contained in this report are intended for current use. Care must be taken not to characterize an individual on the basis of statements in this report, and not to assume that such statements apply indefinitely. Any reference to these results and recommendations in the future should be made with caution.

Empowering People Building Strengths

Joseph 19 Appendix 1. Wechsler Intelligence Scale for Children, 4 Edition The Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) is an individually administered, comprehensive clinical instrument for assessing the intellectual abilities of children ages 6 years, 0 months through 16 years, 11 months. The WISC-IV provides composite scores that represent intellectual functioning in specified cognitive domains (i.e., Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Processing Speed Index (PSI)). Lastly, the WISC-IV provides a composite score that represents a childs general intellectual ability (i.e., Full Scale IQ (FSIQ)). Percentile scores, scaled scores, and confidence intervals are also provided to assist in interpretation. The IQ and Index scores have a mean of 100 and a standard deviation of 15. Each of the subtests has a mean of 10 and a standard deviation of 3. The subtests can be broken down as follows: Verbal Comprehension Index (VCI): is composed of subtests measuring verbal abilities utilizing reasoning, comprehension and conceptualization. Similarities, Vocabulary and Comprehension are the three core subtests that comprise the VCI, and Information and Word Reasoning are the two supplemental subtests of the VCI. Perceptual Reasoning Index (PRI): is composed of subtests measuring perceptual and fluid reasoning, spatial processing, and visual-motor integration. Block Design, Picture Concepts and Matrix Reasoning comprise the three core subtests of the PRI, and Picture Completion is the sole supplemental subtest of the PRI. Working Memory Index (WMI): is composed of subtests measuring attention, concentration and working memory. Digit Span and Letter-Number Sequencing comprise the two core subtests of the WMI and Arithmetic is the sole supplemental subtest of the WMI. Processing Speed Index (PSI): is composed of subtests measuring the speed of mental and graphomotor processing. Coding and Symbol Search are the two core subtests that comprise the PSI, and Cancellation is the sole supplementary subtest of the PSI. The results of the Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Processing Speed Index (PSI) are reported in the following table. The scores on the WISC-IV have a mean of 100 and a standard deviation of 15.
th

Empowering People Building Strengths

Joseph 20

Appendix 1.B. Wechsler Individual Achievement Test, 2nd Edition

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Joseph 21 The Wechsler Individual Achievement Test, Second Edition (WIAT-II) is a rich and reliable source of information about an individuals academic skills and problem-solving abilities that can be used to guide appropriate intervention. It is a comprehensive yet flexible measurement tool useful for achievement skills assessment, learning disability diagnosis, special education placement, curriculum planning, and clinical appraisal for preschool children through adults. The WIAT-II provides composite scores that represent academic ability in several domains (i.e., Reading, Mathematics, Written Communication, and Oral Communication). Percentile scores, scaled scores, and confidence intervals are also provided to assist in interpretation. The Composite and Scaled scores have a mean of 100 and a standard deviation of 15. The composites can be broken down as follows: Reading Composite: is composed of subtests measuring pre-reading, reading, and decoding skills. Word Reading, Reading Comprehension, and Pseudoword Decoding are the three subtests in this area. Mathematics Composite: is composed of subtests measuring the ability to evaluate and write numbers, to solve written calculation problems, identify geometric shapes, solve multi-step problems, and identify mathematical patterns. Numerical Operations and Math reasoning are the two subtests in this area. Written Language Composite: is composed of subtests evaluating spelling and written communication including sentence and paragraph construction. Spelling and Written Expression are the two subtests in this area. Oral Language Composite: is composed of subtests measuring the ability to listen for details, generate a word that matches a given picture and oral description, generate stories from visual cues, and generate directions from visual or verbal cues. Listening Comprehension and Oral Expression are the two subtests in this area.
WIAT-2 Subtest Scores Summary Subtests: Reading Word Reading Reading Comprehension Pseudoword Decoding Composite Mathematics Numerical Operations Math Reasoning Composite Writing Spelling Written Expression Composite Oral Listening Comprehension Standard Score 76 63 69 63 75 71 70 72 71 60 Percentile 5 1 2 1 5 3 2 3 3 0.4 Classification Borderline Extremely Low Extremely Low Extremely Low Borderline Borderline Borderline Borderline Borderline Extremely Low

84

12

Low Average

Empowering People Building Strengths

Joseph 22
Oral Expression Composite 76 72 5 3 Borderline Borderline

Empowering People Building Strengths