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PSYCHOMETRIC SUMMARY

WECHSLER ADULT INTELLIGENCE SCALE – THIRD EDITION (WAIS-III)Administered on: Administered by:

The WAIS-III is an individually administered, clinical instrument for assessing the intellectual ability of adults aged 16 years, 0 months to 74 years, 11 months.

The following subtest scores have a mean score of 10 with a standard deviation of 3. Scores between 7 and 13 are considered average.

Verbal SS Performance SSVocabulary Picture CompletionSimilarities Digit Symbol- CodingArithmetic Block DesignDigit Span Matrix ReasoningInformation Picture ArrangementComprehension Symbol SearchLetter-Number Sequencing Object Assembly

The following composite scores have a mean score of 100 and a standard deviation of 15. Scores between 85 and 115 are considered average.

StandardScore

PercentileRank

ConfidenceInterval

Verbal Intelligence QuotientPerformance Intelligence QuotientVerbal ComprehensionPerceptual OrganizationWorking MemoryProcessing SpeedFull Scale Intelligence Quotient

The Wechsler Adult Intelligence Scale, Third Edition (WAIS-III) was administered as a measure of intellectual ability. XXXX's overall estimate of intelligence, the Full Scale Intelligence Quotient (FSIQ), places him in the average range. Specifically, he obtained a FSIQ score of 87, which is comprised of a Verbal Intelligence Quotient of 77 and a Performance Intelligence Quotient of 102. Given the significant difference between his verbal and performance abilities, the FSIQ is not an accurate estimate of his overall abilities. Instead, his abilities should be examined in terms of his Verbal Comprehension (standard score = 84) and his Perceptual Organizational ability (standard score = 105). His index scores indicate a significant overall strength in the area of Perceptual Organizational ability and a weakness in Verbal Comprehension. Additionally, his individual subtest scores indicate significant strengths in Gestalt (part-to-whole) and abstract reasoning and a weakness in working memory.

WOODCOCK-JOHNSON TESTS OF COGNITIVE ABILITY: 3RD EDITION/ NORMATIVE UPDATE (WJ-III:COG/NU)Administered on: Administered by:

The WJ-III:COG/NU is a wide-range comprehensive set of individually administered tests measuring cognitive abilities. This test can derive scores that examine verbal and thinking ability as well as cognitive efficiency.


ClustersGrade

EquivalentPercentile

RankStandard

ScoreConfidence

BandsVerbal Ability Thinking Ability Cognitive Efficiency

SubtestsVerbal ComprehensionVisual-Auditory LearningSpatial RelationsSound BlendingConcept FormationVisual MatchingNumbers ReversedGeneral Intellectual Ability

DIFFERENTIAL ABILITY SCALES, SECOND EDITION (DAS-II) Date administered: Administered by: The DAS-II is an individually administered intelligence test for children and adolescents.

The following composite standard scores have a mean of 100 and a standard deviation of 15. Scores between 90 and 110 are considered average.

DomainsStandard

ScorePercentile

RankConfidence

IntervalVerbalNonverbalSpatialGCA

The following T-scores have a mean of 50 and a standard deviation of 10. Scores between 40 and 60 are in the average range.

Domains T-ScoresVerbal: Word Definitions:

Verbal Similarities:Nonverbal: Matrices:

Sequential & Quantitative Reasoning:Spatial: Recall of Designs:

Pattern Construction:

The Differential Abilities Scales (DAS-II) were administered as a measure of intellectual ability. XXXX's overall estimate of intelligence, the General Cognitive Ability (GCA), places him in the average range. Specifically, he obtained a GCA score of 92, which is comprised of a Verbal cluster score of 99 and a Nonverbal cluster score of 90. There is a 90% chance that his "true" General Cognitive Ability score falls in the 86 to 98 range.

His cluster scores indicate no significant strengths or weaknesses. This means that he does equally well when asked to perform tasks that require verbal skills such as defining and comparing words as he does tasks that require problem-solving skills such as discovering and using patterns to solve puzzles and copying from a picture. Each cluster score can be further broken down into subtest scores. When examined this way, XXXX’s scores indicate no other significant strengths or weaknesses.

DIFFERENTIAL ABILITY SCALES, SECOND EDITION: PRESCHOOL LEVEL (DAS-II)Date administered: Administered by: The DAS-II is an individually administered intelligence test consisting of 6 "core subtests." These core subtests are used in the calculation of the General Cognitive Ability (GCA) score, an estimate of overall intelligence.


DomainsStandard

Score90% Confidence

BandsGCAVerbalNonverbal


Domains T-ScoresVerbal:Verbal ComprehensionNaming VocabularyNonverbal:Picture SimilaritiesPattern ConstructionCopyingOther:

Early Number Concepts

The Differential Abilities Scales (DAS-II) were administered as a measure of intellectual ability. XXXX's overall estimate of intelligence, the General Cognitive Ability (GCA), places him in the average range. Specifically, he obtained a GCA score of 92, which is comprised of a Verbal cluster score of 99 and a Nonverbal cluster score of 90. There is a 90% chance that his "true" General Cognitive Ability score falls in the 86 to 98 range.

His cluster scores indicate no significant strengths or weaknesses. This means that he does equally well when asked to perform tasks that require verbal skills such as defining and comparing words as he does tasks that require problem-solving skills such as discovering and using patterns to solve puzzles and copying from a picture. Each cluster score can be further broken down into subtest scores. When examined this way, XXXX’s scores indicate no other significant strengths or weaknesses.

COMPREHENSIVE TEST OF NONVERBAL INTELLIGENCE, SECOND EDITION (CTONI-2)Administered by: Administered on:

The CTONI-2 is an individually administered intelligence test that is given with basic English or pantomime instructions. All items are nonverbal and require no speech. It is made up of six subtests that provide two composite scores and a Nonverbal IQ score.

The CTONI-2 subtests provide scores with a mean of 10 and a standard deviation of 3.Scores between 7 and 13 are considered average.

Subtests Scaled ScorePictorial AnalogiesGeometric AnalogiesPictorial CategoriesGeometric CategoriesPictorial SequencesGeometric Sequences

The CTONI quotients provide scores with a mean of 100 and a standard deviation of 15.Scores between 85 and 115 are considered average.

CompositeStandard

ScorePercentile

RankPictorial Intelligence Quotient (PNIQ)Geometric Intelligence Quotient (GNIQ)Full Scale Intelligence Quotient (NIQ)

The Comprehensive Test of Nonverbal Intelligence (CTONI-2) was given as another measure of intellectual ability. XXXX’s Nonverbal Intelligence Quotient (NIQ) fell in the delayed range (standard score = 77). This score is comprised of a below average Pictorial Nonverbal Intelligence Quotient (standard score = 81) and a delayed Geometric Nonverbal Intelligence Quotient (standard score = 76).

KAUFMAN ASSESSMENT BATTERY FOR CHILDREN, SECOND EDITION (KABC-II)Administered on:Administered by:

The KABC-II is a measure of intelligence and achievement made up of five scales (Sequential, Planning, Learning, Simultaneous, and Knowledge). Scores from all of these scales are combined to form a composite (FCI).

The following subtests yield a scaled score with a mean of 10 and a standard deviation of 3. Scores between 7 and 13 are considered average.

Subtests Scaled Score

AtlantisStory CompletionNumber RecallRoverVerbal KnowledgeRebusTrianglesBlock CountingWord OrderPattern RecognitionRiddlesThe following subtests yield a standard score with a mean of 100 and a standard deviation of 15.

Standard scores between 85 and 115 are considered average.Scale Indices Standard

ScoreConfidence

BandSequential/ GsmSimultaneous/ Gv Learning/ GlrPlanning/ GfKnowledge/ GcComposite (FCI)

XXXX was given the Kaufman Assessment Battery for Children, Second Edition (KABC-II) as a second measure of intellectual ability due to the discrepancy between his scores on the DAS and his scores on the K-BIT. His composite score on the KABC-II fell in the delayed range (FCI = 75), which was a similar score to that on the DAS-II. Given this, his overall ability appears to fall in the delayed range. Scale scores on the KABC-II indicate that XXXX exhibits a relative cognitive strength in the area of concept learning; however, he has difficulty applying these learned concepts to solve problems.

XXXX was given the Kaufman Assessment Battery for Children, Second Edition (KABC-II) as a measure of intellectual ability. All of the subtests were administered in English or

Nonverbally, except the Riddles subtest where he could answer in English or in Spanish. His composite scores (including all verbal subtests, even those that allowed for English-only items) fell in the delayed to below average range (standard score=79). His nonverbal composite score fell in the average range (standard score=86). Cluster scores indicate a significant strength in Simultaneous processing (e.g., tests requiring nonverbal reasoning and visual problem solving) and significant weakness in Sequential processing (e.g., tests requiring short-term memory tasks) and Learning tasks (e.g., tasks requiring long-term verbal memory).

KAUFMAN BRIEF INTELLIGENCE TEST, SECOND EDITION (KBIT-2)Administered on: Administered by:

The KBIT-2 is a screening measure of intelligence comprised of two subtests: Matrices and Vocabulary. Scores from these two subtests are combined to form the IQ Composite, which serves as the measure of intelligence on the KBIT-2.


Domains T-ScoreVerbalNonverbalIQ Composite

The Student Support Team administered an intellectual screening using the Kaufman Brief Intelligence Test, Second Edition (KBIT-2) on 1/14/2004. XXXX’s composite score cannot be interpreted given the significant difference between subtest scores. Subtest scores include a very delayed score on the Verbal subtests (standard score = 64) and an average score on the Nonverbal subtest (standard score = 91). -------The Student Support Team administered an intellectual screening using the Kaufman Brief Intelligence Test, Second Edition (KBIT-2) on 4/4/2004. XXXX’s composite score fell in the average range (standard score = 110). This composite score was derived from average scores on the Verbal subtests (standard score = 100) and the Nonverbal subtest (standard score = 119).

UNIVERSAL NONVERBAL INTELLIGENCE TEST (UNIT)Administered by: Administered on:

The UNIT is an individually administered intelligence test that is given with only pantomime instructions. All items are nonverbal and require no speech. It is made up of four subtests that provide four Quotient Scores and a Full Scale IQ score.

The UNIT subtests provide scores with a mean of 10 and a standard deviation of 3.Scores between 7 and 13 are considered average.

Subtests Scaled ScoreSymbolic Memory

Cube DesignSpatial MemoryAnalogic Reasoning

The UNIT quotients provide scores with a mean of 100 and a standard deviation of 15.Scores between 85 and 115 are considered average.

QuotientStandard

ScorePercentile

RankConfidence

IntervalClassification

Memory QuotientReasoning QuotientSymbolic QuotientNonsymbolic QuotientFull Scale IQ

The Universal Nonverbal Intelligence Test (UNIT) was administered as a measure of intellectual ability. XXXX’s estimate of intelligence, the Full Scale IQ (FSIQ), places him in the delayed range. Specifically, he obtained a FSIQ score of 79, which is comprised of a Memory Quotient score of 88, a Reasoning Quotient score of 74, a Symbolic Quotient score of 76, and a Nonsymbolic Quotient score of 85. There is a 90% chance that his "true" Full Scale IQ score falls in the 74 to 86 range. His quotient and scores indicate strength in short-term visual memory.

TEST DE VOCABULARIO DE IMAGINES PEABODY (TVIP)Date administered: Administered by:

The TVIP is a Spanish version of the PPVT-III. It serves two purposes: (1) as an achievement test of receptive (hearing) vocabulary attainment for standard Spanish; and (2) as a screening test of receptive language ability.

The TVIP provides standard scores with a Mean of 100 and Standard Deviation of 15. Scores between 85 and 115 are considered average.

Standard Score Percentile Rank Age Equivalent

XXXX was given the Test de Vocabulario de Imagines Peabody (TVIP) and the Peabody Picture Vocabulary Test- Third Edition (PPVT-III), additional screeners of receptive language (how well she can identify drawings depicting single, spoken words in both English and Spanish). Her scores indicated that she performs in the delayed range in receptive language in both languages.

PEABODY PICTURE VOCABULARY TEST- THIRD EDITION (PPVT-III)Date administered: Administered by:

The PPVT-III is designed for persons aged 2 1/2 through 90+ years. It serves two purposes: (1) as an achievement test of receptive (hearing) vocabulary attainment for standard English; and (2) as a screening test of receptive language ability.

The PPVT-III provides standard scores with a Mean of 100 and Standard Deviation of 15. Scores between 85 and 115 are considered average.


XXXX was given additional screeners of receptive language (how well he can identify drawings depicting single, spoken) and expressive language (how well he provides the verbal label or synonym for another word or a picture).

EXPRESSIVE VOCABULARY TEST (EVT)Date administered: Administered by:

The EVT is designed to measure expressive language ability

The EVT provides standard scores with a Mean of 100 and Standard Deviation of 15. Scores between 85-115 are considered average.


XXXX was given additional screeners of receptive language (how well he can identify drawings depicting single, spoken) and expressive language (how well he provides the verbal label or synonym for another word or a picture).

EXPRESSIVE ONE-WORD PICTURE VOCABULARY TEST: SPANISH-BILINGUAL EDITION (EOWPVT: SBE)Date administered: Administered by:

The EOWPVT: SBE is designed to examine expressive language ability across languages. The test consists of a series of pictures, and the test-taker is asked to identify the picture in either English or in Spanish. For this reason, the test yields a combined English/Spanish expressive language score and not a language proficiency score.

EOWPVT:SBE provides standard scores with a Mean of 100 and a Standard Deviation of 15. Scores between 85 and 115 are considered average.

Standard Score Confidence Interval Percentile Rank

In addition to the WJ-R, the Expressive and Receptive One-Word Picture Vocabulary Tests: Spanish-Bilingual Edition (EOWPVT-SBE and ROWPVT-SBE) were given. XXXX was allowed to answer each question on the test in whichever language (Spanish or English) he preferred. When given this option, he performed in the delayed range for receptive language (standard score = 71) and in the average range for expressive language (standard score = 91).

RECEPTIVE ONE-WORD PICTURE VOCABULARY TEST: SPANISH-BILINGUAL EDITION (ROWPVT: SBE)Date administered: Administered by:

The ROWPVT: SBE is designed to examine receptive language ability across languages. The test consists of a series of pictures, and the test-taker is asked to identify the picture in either English or in Spanish. For this reason, the test yields a combined English/Spanish receptive language score and not a language proficiency score.

ROWPVT:SBE provides standard scores with a Mean of 100 and a Standard Deviation of 15. Scores between 85 and 115 are considered average.


In addition to the WJ-R, the Expressive and Receptive One-Word Picture Vocabulary Tests: Spanish-Bilingual Edition (EOWPVT-SBE and ROWPVT-SBE) were given. XXXX was allowed to answer each question on the test in whichever language (Spanish or English) he preferred. When given this option, he performed in the delayed range for receptive language (standard score = 71) and in the average range for expressive language (standard score = 91).

EXPRESSIVE ONE-WORD PICTURE VOCABULARY TEST (EOWPVT)Date administered: Administered by:

The EOWPVT is designed to screen for expressive language vocabulary skills.The EOWPVT provides standard scores with a Mean of 100 and a Standard Deviation of 15.

Scores between 85 and 115 are considered average.Standard Score Confidence Interval Percentile Rank

XXXX was given additional screeners of receptive language (how well he can identify words spoken to him by pointing to a drawing on the word) and expressive language (how well he can state the word that identifies pictures shown to him).

RECEPTIVE ONE-WORD PICTURE VOCABULARY TEST (ROWPVT)Date administered: Administered by:

The ROWPVT is designed to screen for receptive language vocabulary skills.

The ROWPVT provides standard scores with a Mean of 100 and a Standard Deviation of 15. Scores between 85 and 115 are considered average.


XXXX was given the Receptive One-Word Picture Vocabulary Test (ROWPVT), an additional test of receptive language (how well he can identify words spoken to him by pointing to a drawing on the word).

WECHSLER PRESCHOOL AND PRIMARY SCALE OF INTELLIGENCE, THIRD EDITION (WPPSI-III)Administered by: Kathleen KrachAdministered on:

The WPPSI-III is an individually administered clinical instrument for assessing the intellectual ability of young children through age 7 years, 3 months.The following subtest scores have a mean score of 10 with a standard deviation of 3.

Scores between 7 and 13 are considered average.Verbal SS Performance SSInformation Block DesignVocabulary Matrix ReasoningWord Reasoning Picture ConceptsOther OtherWord Reasoning Coding

The following composite scores have a mean score of 100 with a standard deviation of 15. Scores between 85 and 115 are considered average.

CompositesComposite

ScorePercentile

RankConfidence

BandsVerbal ScorePerformance ScoreFULL SCALE SCORE

The Wechsler Preschool and Primary Scale of Intelligence, Third Edition (WPPSI-III) was administered as another measure of intellectual ability. XXXX’s overall estimate of intelligence, the Full Scale IQ score (standard score = 78) places him in the delayed range. This score is made up of a delayed score on Verbal ability (standard score = 74) and a low average score on Performance ability (standard score = 86).

WECHSLER ABBREVIATED SCALE OF INTELLIGENCE (WASI)Date administered: Administered by:

The WASI is an individually administered instrument measuring intellectual ability. The following subtest scores have a mean score of 50 with a standard deviation of 10.

Scores between 40 and 60 are considered average.Verbal SS Performance SSVocabulary Block DesignSimilarities Matrix Reasoning

Composite scores have a mean score of 100 with a standard deviation of 15. Scores between 85 and 115 are considered average.

Composites T-Score90% Confidence

BandsVerbal ScorePerformance ScoreFULL SCALE SCORE

The Wechsler Abbreviate Scale of Intelligence (WASI) was given as another measure of intellectual ability. His Full Scale IQ score placed him in the delayed range (standard score = 77). This score is made up of a verbal score (standard score = 83) in the below average range and a performance score (standard score = 76) in the delayed range.

WECHSLER INTELLIGENCE SCALE FOR CHILDREN – 4th EDITION (WISC-IV)Date administered: Administered by:

The WISC-IV is an individually administered clinical instrument for assessing the intellectual ability of children aged 6 years through 16 years, 11 months. The child's performance on 10 subtests is summarized in an overall intelligence score called the Full Scale standard score.

The following subtest scores have a mean score of 10 with a standard deviation of 3. Scores between 7 and 13 are considered average.

Verbal Comprehension SS

Perceptual Reasoning SS

Working Memory SS

Processing Speed SS

Similarities Block Design Digit Span CodingVocabulary Picture Concepts Letter-Num. Symbol SearchComprehension Matrix Reason.


StandardScore

PercentileRank

ConfidenceInterval

Verbal Comprehension (VCI)Perceptual Reasoning (PRI)Working Memory (WMI)Processing Speed (PSI)Full Scale (FSIQ)

The Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) was administered as a measure of intellectual ability after his glasses were repaired. Austin’s overall estimate of intelligence, the Full Scale IQ (FSIQ), places him in the delayed range. Specifically, he obtained a FSIQ score of 75, which is comprised of a Verbal Comprehension Index (VCI) score of 89, a Perceptual Reasoning Index (PRI) score of 75, a Working Memory Index (WMI) score of 86, and a Processing Speed Index (PSI) score of 73. Given that his index scores are statistically different from one another, the FSIQ may not be the best indicator of his actual overall ability. Of all of the indices, the VCI is considered to be the most reliable estimate of ability, thus this should be used to predict academic achievement. His VCI score fell in the average range.

REYNOLDS INTELLECTUAL ASSESSMENT SCALES (RIAS)Date administered: Administered by:

The RIAS is an individually administered measure of intellectual ability for ages from 3 to 94. The primary purpose of this measure is to provide an accurate and comprehensive full scale intelligence score.


DomainsStandard

ScorePercentile

Rank90% Confidence

BandsTotal Test BatteryTotal Verbal BatteryTotal Nonverbal Battery


Domains Scaled ScoresVerbal BatteryGuess WhatVerbal ReasoningNonverbal BatteryOdd-Item OutWhat’s MissingMemoryVerbal MemoryNonverbal Memory

The Reynolds Intellectual Assessment Scales (RIAS) was given as a test of general cognitive ability. XXXX’s Total Test Battery (TTB) score places her in the very delayed range (standard score = 69). This score is made up of a Total Verbal Battery (standard score = 78) and a Total Nonverbal Battery (standard score = 70). In addition, there are index scores that break down test performance into verbal (standard score = 69), nonverbal (standard score = 90), and memory

(standard score = 60) scores. These index scores indicate that she has a cognitive strength in the area of nonverbal reasoning. Subtest scores indicate a weakness in visual short-term memory.

REYNOLDS INTELLECTUAL ASSESSMENT SCALES (RIAS)Date administered: Administered by:

The RIAS is an individually administered measure of intellectual ability for ages from 3 to 94. The following T-scores have a mean of 50 and a standard deviation of 10.

Scores between 40 and 60 are in the average range.Domains

Verbal Battery SS Nonverbal Battery SS Memory Battery SSGuess What Odd-Item Out Verbal MemoryVerbal Reasoning What’s Missing Nonverbal Memory


DomainsStandard

ScorePercentile

Rank90% Confidence

BandsVerbal Intelligence Index (VIX)Nonverbal Intelligence Index (NIX)Composite Memory Index (Not Part of CIX)Composite Intelligence Index (CIX)

XXXX was given the Reynolds Intelligence Assessment Scale (RIAS) as a comprehensive intelligence measure. The RIAS was designed to provide a pure measure of intellectual ability instead of examining his ability levels across processing areas. XXXXs’s Composite Intelligence Index (CIX) score places him in the average range (standard score = 95). This score is made up of an average Verbal Intelligence Index (standard score = 91) score and an average Nonverbal Intelligence Index (standard score = 102) score. In addition, the RIAS gives a Composite Memory Index score, which fell in the average range (standard score = 90).

BEERY-BUKTENICA DEVELOPMENTAL TEST OF VISUAL-MOTOR INTEGRATION (VMI)Administration date: Administered by:

The VMI requires the child to copy figures such as a line, square, and circles. It measures how effectively the child can integrate what he or she sees with fine motor output.

The VMI yields a standard score with a mean of 100 and a standard deviation of 15. Scores between 85 and 115 are considered average.

Standard Score: Percentile:

In addition, XXXX was given the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI). This test required him to draw designs, starting with simple lines and building to complex shapes, and compared his drawings to other children his own age. His scores indicated no problems with visual-motor integration.

STREET SURVIVAL SKILLS QUESTIONNAIRE (SSSQ)

Administered by: Administered on:

The SSSQ is an individually administered measure of self-help and daily living skills.

The individual scales provide standard scores with a mean of 10 and a standard deviation of 3. Scores between 7 and 13 are considered average.

DomainStandard

ScoresBasic ConceptsFunctional SignsToolsDomesticsHealth and SafetyPublic ServicesTimeMonetaryMeasurementsTotal

The Quotient has a standard score with a mean of 100 and standard deviation of 15. Scores between 85 and 115 are considered average.

Survival Skills Quotient

XXXX was given the Street Survival Skills Questionnaire (SSSQ) as a direct measure of her daily living skills. Her overall score fell in the delayed range with a quotient score of 79. This score reflects only her daily living skills abilities and excludes any social skill and communication skill information.

VINELAND ADAPTIVE BEHAVIOR SCALES - INTERVIEW EDITION (VABS) Completed by: Completed on:

The VABS is a measure of adaptive behavior, or the ability to perform daily activities required for personal and social sufficiency.

The VABS provides standard scores with a mean of 100 and a standard deviation of 15. Scores between 85 and 115 are considered average.

DomainStandard

ScoresAdaptive

LevelConfidence

BandsCommunicationDaily Living SkillsSocialization SkillsAdaptive Behavior Composite

A second formal adaptive measure, the Vineland Adaptive Behavior Scales (VABS), was completed as part of an interview with XXXX’s foster mother on 12/9/2003. The responses on this measure place XXXX’s adaptive performance in the average range. Specifically, her VABS Composite score was 103. This is comprised of three subtests (Communication, Daily Living Skills, and Socialization) each of which produced a score in the average range.

VINELAND ADAPTIVE BEHAVIOR SCALES, SECOND EDITION – TEACHER RATING FORM (VINELAND-II)Completed by: Completed on:

The Vineland-II is a measure of adaptive behavior, or the ability to perform daily activities required for personal and social sufficiency. In this version of the scale, adaptive behavior is measured in three domains: Communication, Daily Living Skills, and Socialization. The combination of these domains forms the Adaptive Behavior Composite. The domain scores are used to determine an overall adaptive behavior composite and age equivalent.

The VABS provides standard scores with a mean of 100 and a standard deviation of 15. Scores between 85 and 115 are considered average.

DomainStandard

ScoresAdaptive

LevelConfidence


VINELAND ADAPTIVE BEHAVIOR SCALES, SECOND EDITION – SURVEY INTERVIEW FORM, SPANISH RECORD BOOKLET (VINELAND-II)Completed by: Completed on:


The VABS provides standard scores with a mean of 100 and a standard deviation of 15.

Scores between 85 and 115 are considered average.

DomainStandard

ScoresAdaptive

LevelConfidence



A formal adaptive measure, the Vineland Adaptive Behavior Scales (Vineland-II), was given to Ms. XXX to complete. The responses given on this measure placed XXXX’s adaptive performance in the very delayed range. Specifically, her Adaptive Behavior Composite score was 63, which is comprised of very delayed scores in Communication (standard score = 64), Daily Living Skills (standard score = 69), and Socialization skills (standard score = 63).

ADAPTIVE BEHAVIOR ASSESSMENT SYSTEM – SECOND EDITION (ABAS-II) Completed by: Completed on:

The ABAS-II is a measure of adaptive behavior, or the ability to perform daily activities required for personal and social sufficiency.

Skill areas provide scaled scores with a mean of 10 and a standard deviation of 3. Scores between 7 and 13 are considered average.

Skill AreasScaledScores

CommunicationCommunity UseFunctional AcademicsSchool LivingHealth and SafetyLeisureSelf-CareSelf-DirectionSocial

Composites provides standard scores with a mean of 100 and a standard deviation of 15. Scores between 85 and 115 are considered average.

Composite ScoresStandard

ScoresConfidence

BandsPercentile

Rank

ConceptualSocialPracticalGAC

A formal adaptive measure, the Adaptive Behavior Assessment System – Second Edition (ABAS-II) was given to XXXX’s teacher, Ms. XXXX, to complete. The responses given on this measure placed XXXX’s adaptive performance in the very delayed range. Specifically, his General Adaptive Composite (GAC) score was 55. Scores indicate personal strengths in the areas of leisure and self-help skills; personal weaknesses fall in the areas of functional academics and self-direction.

SCALES OF INDEPENDENT BEHAVIOR-REVISED (SIB-R)Completed on:Completed by:

The SIB-R is a measure of adaptive behavior, or the ability to perform daily activities required for personal and social sufficiency.

The SIB-R provides standard scores with a mean of 100 and a standard deviation of 15. Scores between 85 and 115 are considered average.

DomainsStandard

ScoresPercentile

RankMotor SkillsSocial Interaction and Communication SkillsPersonal Living SkillsCommunity Living SkillsBroad Independence

A formal adaptive measure, the Scales of Independent Behavior-Revised (SIB-R), was given to Ms. XXXX to complete. The responses given on this measure placed XXXX’s adaptive performance in the very delayed range. Specifically, his Broad Independence Composite score was 63, which is comprised of very delayed scores in Motor Skills (standard score = 64), Social Interaction and Communication Skills (standard score = 69), Personal Living Skills (standard score = 67), and Community Living Skills (standard score = 63).

ADAPTIVE BEHAVIOR INVENTORY (ABI)Completed by: Completed on:

The ABI is a measure of adaptive behavior, or the ability to perform daily activities required for personal and social sufficiency. Adaptive behavior is measured across five scales, whose scores are combined to form the Adaptive Behavior Composite Quotient.

The individual scales provide standard scores with a mean of 10 and a standard deviation of 3. Scores between 7 and 13 are considered average.

DomainStandard

ScoresPercentile

RankAdaptive

LevelSelf-Care SkillsCommunication SkillsSocial SkillsAcademic SkillsOccupational SkillsThe Composite Quotient has a standard score with a mean of 100 and a standard deviation of 15.

Scores between 85 and 115 are considered average.Adaptive Behavior Composite Quotient

A formal adaptive measure, the Adaptive Behavior Inventory (ABI), was given to one of XXXX’s teachers to complete. The responses given on this measure placed XXXX’s adaptive performance in the very delayed range. Specifically, her ABI Composite Quotient score was 47. This is comprised of five subtest scores (Self-Care Skills, Communication Skills, Social Skills, Academic Skills, and Occupational Skills) each of which produced scores in the very delayed range.

DIAGNOSTIC ACHIEVEMENT BATTERY- THIRD EDITION (DAB-3)Date administered: Administered by:

The DAB-3 is a comprehensive test of achievement. It has subtests in Listening, Speaking, Reading, Writing, and Mathematics.

DAB-3 subtest scores produce standard scores with a mean of 10 and a standard deviation of 3. Interpreted standard scores are derived from subtest scores.

Interpreted standard scores have a mean of 100 and a standard deviation of 15.Scores between 85 and 115 are considered average.

SubtestsStandard

ScoresInterpreted

Standard ScoresPercentile

RankStory CharacteristicsCharacteristicsSynonymsGrammatic CompletionAlphabet/Word KnowledgeReading ComprehensionCapitalizationPunctuationSpellingWriting: Contextual LanguageWriting: Story ConstructionMathematics Reasoning

Mathematics CalculationThe DAB-3 produces quotient scores with a mean of 100 and a standard deviation of 15.

Scores between 85 and 115 are considered average. Domains Quotients Percentiles

ListeningSpeakingReadingWritingMathSpoken LanguageWritten LanguageTotal Achievement

The school administered the Diagnostic Achievement Battery: Third Edition (DAB-3) on 3/13/2003. She scored in the low average to average range on all subtests except Reading Comprehension, Synonyms, and Phonemic Analysis. On these, she scored in the delayed range.

KAUFMAN SURVEY OF EARLY ACADEMIC AND LANGUAGE SKILLS (K-SEALS)Date administered: Administered by:

The K-SEALS is an individually administered, nationally normed measure of children’s language (expressive and receptive skills), pre-academic skills (knowledge of numbers, number concepts, letters, and words), and articulation.

The K-SEALS provides standard scores with a mean of 100 and a standard deviation of 15.Scores of 85 to 115 are considered average.

Domains Standard Score ConfidenceInterval

Expressive SkillsReceptive SkillsNumber SkillsLetter & Word SkillsEarly Academic & Language Skills Composite

The Kaufman Survey Of Early Academic and Language Skills (K-SEALS) was administered on 9/4/2003 by his school. The administrator noted that they believed his behavior impacted his scores. Specifically, they stated that the scores may be an underestimate of his actual skill levels. XXXX scored in the average range on Receptive Skills (understanding verbal information that is spoken to him) and Letter & Word Skills. He scored in the below average range on Expressive Skills (being able to express himself verbally whenever he wants to get an idea across to someone else). XXXX scored in the delayed range on Number Skills.

DEVELOPMENTAL INDICATORS FOR THE ASSESSMENT OF LEARNING, THIRD EDITION (DIAL-3)Completed by:Completed on:

The DIAL-3 is a developmental screener for children between the ages of 3 and 6 years old. It examines skills across the areas of motor, language, and concept skills. Age scores are based on how well a child should be able to perform at task at a given age.Domains English

Age Scores

SpanishAge

ScoresMotor

CatchingJump, Hop, and SkipBuilding (blocks)Thumbs & Fingers (twiddling and touching)Cutting (lines, curves, and figures)Copying (shapes)Writing Name

ConceptsBody Parts (pointing)Colors (identifying slowly)Rapid Color Naming (identifying quickly)CountingPositions (e.g., under, over, etc.)Concepts (e.g., smallest, wettest, etc.)Shapes

LanguagePersonal Data (name, age, etc.)Articulation (sounding out words)Objects and Actions (what is this and what does it do?)Letters and SoundsRhyming and “I Spy”Problem Solving (what do you do if…?)

Interpreted standard scores are derived from percentile ranks. Interpreted standard scores have a mean of 100 and a standard deviation of 15.

Scores between 85 and 115 are considered average.

DomainSpanish

Standard ScoreSpanish

PercentileEnglish

Standard ScoreEnglish

PercentileMotor 22Concepts <1Language <1DIAL-3 Total 1

The Developmental Indicators For The Assessment Of Learning, Third Edition (DIAL-3) was administered in English and in Spanish. Her scores in all three areas (motor, concepts, and language) all fell in the three-year-old or younger range. Her standard scores were not calculable because she received a raw score of zero on most subtests. However, her scores do fall in the very delayed range (all standard scores < 61).

BRACKEN BASIC CONCEPT SCALE: REVISED (BBCS-R)Administered on: Administered by: K. Krach

The BBCS-R was designed as an individually administered measure of achievement in young children ages 2 years, 6 months through 8 years old.

The BBCS-R subtests provide scores with a mean of 10 and a standard deviation of 3.Scores between 7 and 13 are considered average.

Subtests Scaled ScoreSchool ReadinessDirection/ PositionSelf-/Social AwarenessTexture/ MaterialQuantityTime/ Sequence

The BBCS-R composites provide scores with a mean of 100 and a standard deviation of 15.Scores between 85 and 115 are considered average.

CompositesStandard

ScorePercentile

RankConfidence

IntervalTotal TestSchool Readiness Composite

The school administered the Bracken Basic Concept Scale-Revised (BBCS-R) on 4/23/2004. XXXX scored in the average range overall. Individual subtest scores fell in the average range in all areas except Self-/Social Awareness. He scored in the below average range on this subtest. Self-/Social Awareness is a subtest asking children to identify emotions and/or emotional actions (e.g., point to the girl who is crying).

DEVELOPMENTAL PROFILE II (DP-II)Completed by: Completed on:

The DP-II compares developmental milestones in each area to the current abilities of a child to determine if there is a developmental delay.

Age scores are based on what age a child should be able to do some or all of a task.Domain Age ScorePhysical

Self-HelpSocialAcademicCommunication

BRIGANCE INVENTORY OF EARLY DEVELOPMENT: SECOND EDITION (IED-II)Completed by: Completed on:

The IED–II serves as a diagnostic instrument and a criterion-referenced classroom assessment for children between birth and seven years old.

Age scores are based on what age a child should be able to do some or all of a task.Area Age

ScoreArea Age

ScoreFine-Motor Skills Body Parts-ReceptiveBlock Tower Building Colors-MatchingSelf-Help Skills (Feeding/Eating) Colors-PointsSpeech and Language Devt. Colors-NamesVerbal Directions Social & Emotional Picture Vocabulary Work Skills & Behavior

The school administered the Brigance Inventory Of Early Development: Second Edition (IED-II) in September 2003. Her scores in all areas ranged from one year, six months through four years old. All of her scores were significantly lower than would be expected for a child her age.

Age scores are based on what age a child should be able to do some or all of a task.

DomainsAge

ScoresGross Motor Skills and Behaviors

StandingWalkingStairs and ClimbingRunningJumpingHoppingKickingBalance BeamCatchingRolling and Throwing

Fine Motor Skills and BehaviorsGeneral Eye/Finger/Hand Manipulative SkillsBlock Tower Building

PrehandwritingDraw a PersonFormsCutting with Scissors

Self-Help SkillsFeeding/EatingUndressingDressingUnfasteningFasteningToiletingBathingGrooming

Speech and Language SkillsGeneral Speech and Language DevelopmentLength of SentencesPersonal Data ResponseVerbal DirectionsPicture VocabularyRepeats NumbersSentence Memory

General Knowledge and ComprehensionResponse to and Experience with BooksBody Parts-ReceptiveBody Parts-ExpressiveColorsShapes ConceptsQuantitative ConceptsDirectional/Positional ConceptsClassifyingKnows What to Do in Different SituationsKnows Use of ObjectsKnows Function of Community HelpersKnow Where to Go for Services

Social and Emotional DevelopmentGeneral Social and Emotional DevelopmentPlay Skills and BehaviorsWork-Related Skills and Behaviors

ReadinessVisual Discrimination-Two SymbolsVisual Discrimination-Three SymbolsRecites AlphabetUppercase LettersLowercase Letters

Basic Reading SkillsAuditory DiscriminationMatches Initial Consonants with PicturesSubstitutes Initial Consonant SoundsSubstitutes Short-Vowel SoundsSubstitutes Long-Vowel Sounds

Basic MathNumber ConceptsRote CountingReads NumeralsNumeral ComprehensionOrdinal PositionNumerals in Sequence

YOUNG CHILDREN’S ACHIEVEMENT TEST (YCAT)Administered on: Administered by:

The YCAT was designed as an individually administered measure of early achievement for children ages 4-0 through 7-11.

The YCAT yields standard scores with a Mean of 100 and a Standard Deviation of 15. Standard Scores between 85 and 115 are considered average.

Domains Standard Scores PercentileGeneral InformationReadingMathematicsWritingSpoken LanguageEarly Achievement Composite

The Young Children’s Achievement Test (YCAT) was administered as an achievement measure. Austin scored in the very delayed range in Reading and Writing, the delayed range on Spoken Language, and in the average range on Mathematics and General Information. He could identify some of his letters and numbers. He could not add or subtract, but he could count to twenty.

WIDE RANGE ACHIEVEMENT TEST, REVISION 3 (WRAT-3)Administered on: Administered by:

The WRAT-3 is an individually administered measure of school achievement.It yields standard scores with a mean of 100 and a standard deviation of 15.

Standard scores between 90 and 110 are considered average.

Domains Standard Scores90% Confidence

BandsReadingSpellingArithmetic

The Wide Range Achievement Test, Revision 3 (WRAT-3) was administered on 5/1/2003. She scored in the below average to average range on Reading and Arithmetic. She scored in the very delayed range in Spelling.

WIDE RANGE ACHIEVEMENT TEST, FOURTH EDITION (WRAT-4)Administered on: Administered by:

The WRAT-4 is an individually administered measure of school achievement.It yields standard scores with a mean of 100 and a standard deviation of 15.


DomainsStandard

ScoresPercentile

Rank90% Confidence

BandsWord ReadingSentence ComprehensionSpellingMath ComputationReading Composite

The Wide Range Achievement Test, Fourth Edition (WRAT-4) was administered on [insert date here] to assess basic academic skills. [Client’s name] obtained a score in the [see score chart description] range on [insert subtest here]. In addition, a Reading Composite score was generated. The Reading Composite score was calculated by combining the Word Reading and Sentence Comprehension scores. [Client’s name] obtained a score in the [see score chart description] on this composite.

A response analysis of items on the WRAT-4 finds that [Client’s name] can read [describe types of words, letters, etc that he/she can read] but struggles with [describe types of errors]. [Client’s name] can [describe types of math problems that he/she can do] but struggles with [describe types of math errors].

KAUFMAN TEST OF EDUCATIONAL ACHIEVEMENT, SECOND EDITION (KTEA-II)Administered on: Administered by:

The KTEA-II is an individually administered measure of school achievement.The KTEA-II yields standard scores with a mean of 100 and a standard deviation of 15.


DomainsStandard

ScoresConfidence

BandsLetter & Word RecognitionReading ComprehensionReading CompositeMath Concepts & ApplicationsMath ComputationMath CompositeWritten ExpressionSpellingWritten Language CompositeListening ComprehensionOral ExpressionOral Language CompositeTotal Test Composite

The Kaufman Test Of Educational Achievement, Second Edition (KTEA-II) was administered across two testing sessions. During the first two-hour session, XXXX completed the Letter & Word Recognition, Math Concepts & Applications, and Math Computation subtests. He completed the other subtests during the next session over a 1.5 hour time period. Total testing time on the KTEA-II was roughly 3.5 hours.

XXXX’s scores on all of the subtests fell in the average range. His performance did not indicate any significant strengths or weaknesses. An analysis of his reading errors indicate that although he has good phonics skills, when XXXX does not know a word, he occasionally struggles with deciphering certain “g” and “l” consonants as well as certain short vowel sounds. In reading comprehension, he was easily able to extract the literal information from a passage, but he struggled when asked to infer information based on other information in the passage.

An analysis of his math errors indicate that although he has solid skills with basic processes (addition, subtraction, multiplication, and division) with whole numbers, he demonstrates some problems with decimals, and fractions as well as using algebra and geometry to solve problems.

An analysis of his writing finds that XXXX has good penmanship. His sentences are complete for the most part. His writing is understandable and mostly on topic. His greatest problems are with writing procedures such as spelling, capitalization, and especially punctuation.

ORAL AND WRITTEN LANGUAGE SCALES (OWLS)Administered on: Administered by:

The OWLS is an individually administered assessment of receptive and expressive language for children and young adults. The OWLS consists of three scales: Listening Comprehension, Oral Expression, and Written Expression.

The OWLS yields standard scores with a Mean of 100 and a Standard Deviation of 15. Standard Scores between 85 and 115 are considered average.

Domains Standard Scores Confidence BandsListening ComprehensionOral ExpressionOral Composite

The listening comprehension and oral expression sections of the Oral and Written Language Scales (OWLS) were administered. His scores on both of these sections fell in the below average range.

ORAL AND WRITTEN LANGUAGE SCALES (OWLS)Administered on: Administered by:

The OWLS is an individually administered assessment of written language for children and young adults.

The OWLS yields standard scores with a Mean of 100 and a Standard Deviation of 15. Standard Scores between 85 and 115 are considered average.

Standard Scores: Percentile Rank:

Written Expression Scale of the Oral and Written Language Scales (OWLS) was administered as well. He scored in the delayed range (standard score = 77) on the OWLS.

TEST OF AUDITORY-PERCEPTUAL SKILLS-REVISED (TAPS-R)Administered on: Administered by:

The TAPS-R is an individually administered assessment measuring how a child processes information that is heard.

The TAPS-R yields standard scores with a Mean of 100 and a Standard Deviation of 15. Standard Scores between 85 and 115 are considered average.

DomainsStandard

ScorePercentile

Rank Auditory Number Memory-ForwardAuditory Number Memory-BackwardAuditory Sentence MemoryAuditory Word MemoryAuditory Interpretation of DirectionsAuditory Word DiscriminationAuditory Processing (Thinking and Reasoning)Auditory Perceptual Quotient

The Test of Auditory-Perceptual Skills-Revised (TAPS-R) was given as a second measure of auditory and language skills. Subtest results indicate delayed word and number memory (except backward number memory), delayed ability to hear and process information given as directions, below average skills in solving problems given orally, and average ability to determine the similarity and differences in word sounds (e.g., wreath vs. reef).

KEYMATH: REVISEDDate administered: Administered by:

The KeyMath: Revised is an individually administered test of math achievement.

The KeyMath: Revised yields standard scores with a mean of 100 and a standard deviation of 15. Standard scores between 90 and 110 are considered average.

DomainsStandard

ScoresPercentile

RankBasic ConceptsOperationsApplicationsTotal Test

Due to her problems with math, a further measure of math ability was given. XXXX scored in the below average range (standard score = 83) on overall math ability on the KeyMath: Revised. This score is comprised of subtests measuring the areas of Basic Concepts (standard score = 83), Operations (standard score =85), and Applications (standard score = 80).

PEABODY INDIVIDUAL ACHIEVEMENT TEST- REVISED, NORMATIVE UPDATE (PIAT-R: NU) Date administered: Administered by: Kathleen Krach

The PIAT-R is an individually administered achievement test providing wide-range assessment in six content areas: General Information, Reading Recognition, Reading Comprehension, Mathematics, Spelling, and Written Expression.

The PIAT-R yields standard scores with a mean of 100 and a standard deviation of 15. Standard Scores between 85 and 115 are considered average.

DomainsStandard

ScoresConfidence

BandsGeneral InformationReading RecognitionReading ComprehensionTotal ReadingMathematicsSpellingWritten Language

Total Test

The Peabody Individual Achievement Test- Revised, NU (PIAT-R:NU) was administered as an achievement measure. The PIAT-R was administered, in part, because it required few motor skills to complete. Tiffany scored in the below average to average range in all areas except Mathematics. She scored in the delayed range in mathematics.

WECHSLER INDIVIDUAL ACHIEVEMENT TEST, SECOND EDITION (WIAT-II) Date administered: Administered by:

The WIAT-II is a comprehensive individually administered battery for assessing achievement.The WIAT-II yields standard scores with a mean of 100 and a standard deviation of 15.

Standard scores between 85 and 115 are considered average.Domains Standard Scores Confidence Bands

Word ReadingReading ComprehensionPseudoword DecodingReading CompositeNumerical OperationsMath ReasoningMath CompositeSpellingWritten ExpressionWriting Composite

XXXX was given the Wechsler Individual Achievement Test, Second Edition (WIAT-II). His scores fell in the delayed range in all areas, except Pseudoword Decoding. His score on Pseudoword Decoding (a test of phonetic ability) fell in the very delayed range. The listening comprehension and oral expression sections of the Oral and Written Language Scales (OWLS) were administered. His scores on both of these sections fell in the below average range.

TEST OF WRITTEN LANGUAGE, THIRD EDITION (TOWL-3)Administered on: Administered by:

The TOWL-3 was designed as a comprehensive measure of writing ability that can be used to determine strengths and weaknesses in writing. For the Spontaneous Writing Section, the child is asked to write a story that tells about the picture presented.

The following subtest scores have a mean of 10 with a standard deviation of 3. Scores between 7 and 13 are considered average.

Domains Subtest ScoresVocabulary

SpellingStyleLogical SentencesSentence CombiningContextual ConventionsContextual LanguageStory Construction

The following quotient has a mean of 100 with a standard deviation of 15. Quotients between 85 and 115 are considered average.

Quotient Quotient ScoreContrived Writing QuotientSpontaneous Writing QuotientOverall Writing

Due to his problems with writing, a further measure of writing ability was given. XXXX scored in the delayed range (standard score = 71) on overall writing ability on the Test of Written Language, Third Edition (TOWL-3). This score is comprised of subtests measuring the areas of Contrived Writing (standard score = 67) and Spontaneous Writing (standard score = 82).

WOODCOCK READING MASTERY TESTS- REVISED (WRMT-R)Administered by:Administered on:

The WRMT-R is an individually administered comprehensive battery of tests measuring several important aspects of reading ability.

The WRMT-R yields standard scores with a mean of 100 and a standard deviation of 15. Standard scores between 90 and 110 are considered average.

DomainsStandard

ScoresConfidence

BandsVisual-Auditory LearningLetter IdentificationWord IdentificationWord AttackWord ComprehensionPassage ComprehensionReadiness ClusterBasic Skills ClusterReading Comprehension ClusterTotal Reading Cluster

The Woodcock Reading Mastery Tests – Revised (WRMT-R) was given as a comprehensive test of reading ability. His Reading Comprehension cluster score fell in the delayed range (standard score = 79), and his Basic Skills cluster score fell in the very delayed range (standard score = 69).

BATERIA III WOODCOCK-MUNOZ PRUEBAS DE APROVECHAMIENTO (BATERIA III)Date administered: Administered by:

The Batería III is an individually administered achievement test given in Spanish.

The Batería III yields standard scores with a mean of 100 and a standard deviation of 15. Standard scores between 85 and 115 are considered average.

DomainsStandard

ScoreConfidence

IntervalIdentificación de letras y palabras (Letter-Word Identification)Passage Comprehension (Comprensión de Textos)Calculation (Cálculo)Applied Problems (Problemas Aplicados)Spelling (Ortografía)Writing Fluency (Fluidez en la Escritura)Writing Samples (Muestras de Redacción)Written Expression (Expresión Escrita)Broad Written Language (Amplio Lenguaje Escrito)Academic Skills (Des Académicas)Academic Applications (Aplicaciones Académicas)

The Batería III: Pruebas de Aprovechamiento was administered as a measure of Spanish achievement. XXXX scored in the very delayed range in Letter-Word Identification and Spelling, in the delayed range on Calculation, in the below average range on Writing Samples and Applied Problems, and in the average range on Passage Comprehension.

WOODCOCK-JOHNSON TESTS OF ACHIEVEMENT: THIRD EDITION/ NORMATIVE UPDATE (WJ-III:ACH/NU)Date administered: Administered by:

The WJ-III:ACH is an individually administered achievement test.

The WJ-III:ACH yields standard scores with a mean of 100 and a standard deviation of 15. Standard scores between 85 and 115 are considered average.

DomainsStandard

ScorePercentile

RankConfidence

IntervalLetter-Word IdentificationPassage Comprehension

CalculationApplied ProblemsSpellingWriting Samples

The Woodcock-Johnson Tests of Achievement, Third Edition (WJ-III: ACH/NU) was administered as an achievement measure. XXXX scored in the very delayed range in Letter-Word Identification and Spelling, in the delayed range on Calculation, in the below average range on Writing Samples and Applied Problems, and in the average range on Passage Comprehension.

BECK YOUTH INVENTORIES, SECOND EDITION (BYI-II)Date administered: Completed by:

The BYI-II consists of five different self-report scales to examine a child’s level of depression, anxiety, anger, disruptive behavior, and self-concept. Each of the scales contains 20 questions pertaining to the child’s experiences and levels of distress.

Scales on the BYI-II provide T scores with a mean of 50 and a standard deviation of 10.Scores between 40 and 60 fall in the average range.

Scores on the first four scales indicate problems with higher scores: Scores between 60-69 should be considered at risk; scores above 70 are clinically significant.

Scales T-Scores PercentilesBeck Depression Inventory for Youth (BDI-Y)Beck Anxiety Inventory for Youth (BAI-Y)Beck Anger Inventory for Youth (BANI-Y)Beck Disruptive Behavior Inventory for Youth (BDBI-Y)

Scores on the last scale indicates problems with lower scores: Scores between 40-45 should be considered at risk; scores below 40 are clinically significant.

Scale T-Scores PercentilesBeck Self-Concept Inventory for Youth (BSCI-Y)

The Beck Youth Inventories, Second Edition (BYI-II) was administered to Paul on 5/18/2009 as a self-report measure of how he is feeling at this time. His scores on this measure indicate that he is at risk for significant anxiety problems. In addition, his scores indicate clinically significant levels of depression and anger for a child his age.

BECK’S DEPRESSION INVENTORY (BDI)Date completed:Completed by:

The BDI is a questionnaire completed by adults designed to measure the severity of general symptoms of depression.

The BDI yields a raw score.

A total raw score of 0 to 9 indicates within normal range or asymptomatic. A total raw score of 10 to 18 indicates mild to moderate depression.

A total raw score of 19 to 29 indicates moderate to severe depression.A total raw score of 30 to 63 indicates extremely severe depression.

Total Raw Score

BECK’S ANXIETY INVENTORY (BAI)Date completed:Completed by:

The BAI is a questionnaire completed by adults designed to measure the severity of general anxiety problems.

The BAI yields a raw score. A total raw score of 0 to 9 indicates normal anxiety levels.

A total raw score of 10 to 18indicates mild to moderate anxiety levels.A total raw score of 19 to 29 indicates moderate to severe anxiety levels.

A total raw score of 30 to 63 indicates severe anxiety levels.Total Raw Score

PERSONALITY ASSESSMENT INVENTORY (PAI)Date administered: Completed by:

The Personality Assessment Inventory (PAI) is an inventory of adult personality that assesses psychopathological syndromes. Adults rate themselves across various behaviors, and the scores are combined to form clinical and validity scale and subscale results.

Scores on the PAI have a mean of 50 and standard deviation of 10.Average scores fall between 40 and 60

Some of the scores above 70 are significant and some scores below 30 are significant. For clarity, clinically significant scores are marked with an asterisk (*).

Clinical Scales and Subscales T scores Clinical Scales and Subscales T scoresSOMATIC COMPLAINTS (SOM) PARANOIA (PAR) Conversion (SOM-C) Hypervigilance (PAR-H)Somatization (SOM-S) Persecution (PAR-P)Health Concerns (SOM-H) Resentment (PAR-R)ANXIETY (ANX) SCHIZOPHRENIA (SCZ) Cognitive (ANX-C) Psychotic Experiences (SCZ)-PAffective (ANX-A) Social Detachment (SCZ-S)Physiological (ANX-P) Thought Disorder (SCZ-T)ANXIETY RELATED DIS. (ARD) BORDERLINE FEATURE (BOR) Obsessive-Compulsive (ARD-O) Affective Instability (BOR-A)Phobias (ARD-P) Identity Problems (BOR-I)Traumatic Stress (ARD-T) Negative Relationship (BOR-N)DEPRESSION (DEP) Self-harm (BOR-S)

Cognitive (DEP-C) ANTISOCIAL FEATURES (ANT)Affective (DEP-A) Antisocial Behaviors (ANT-A)Physiological (DEP-P) Egocentricity (ANT-E)MANIA (MAN) Stimulus –Seeking (ANT-S)Activity level (MAN-A) ALCOHOL PROBLEMS (ALC)Grandiosity (MAN-G) DRUG PROBLEMS (DRG)Irritability (MAN-I)

Treatment Scales and Subscales T scores Treatment Scales T scoresAGGRESSION (AGG) SUICIDAL IDEATION (SUI)Aggressive Attitude (AGG-A) STRESS (STR)Verbal Aggression (AGG-V) NON-SUPPORT (NON)Physical Aggression (AGG-P) TREATMENT REJECT (RXR)

Interpersonal Scales T scores Interpersonal Scales T scoresDOMINANCE (DOM) WARMTH (WRM)

Validity Scales T scores Validity Scales T scoresINCONSISTENCY (ICN) NEGATIVE IMPRESSION (NIM)INFREQUENCY (INF) POSITIVE IMPRESSION (PIM)

BEHAVIOR ASSESSMENT SYSTEM FOR CHILDREN, SECOND EDITION - PARENT RATING SCALES (BASC-2:PRS)Date administered: Completed by:

The BASC-2:PRS is a questionnaire that is filled out by parents in order to assess the behavior problems, emotional problems, and social competence of their children.

The BASC-2:PRS yields T-Scores with a mean of 50 and a standard deviation of 10. Scores of 65 to 70 indicate some difficulty, and scores above 70 indicate significant problems.

Domains T-ScoresHyperactivityAggressionConduct ProblemsExternalizing Problems CompositeAnxietyDepressionSomatizationInternalizing Problems CompositeAtypicalityWithdrawalAttention ProblemsBehavioral Symptoms Index

Scores below 30 on Personal Adjustment are considered significantly low.

AdaptabilitySocial SkillsLeadershipAdaptive Skills

The Behavior Assessment System for Children, Second Edition (BASC-2) is a questionnaire to rate adaptive skills as well as behavior and emotional problems in children. It was given to XXXX and his teacher, Mr. XXXX, to complete. Mr. XXXX indicated no significant social, emotional, or behavioral problems; however, his scores show that XXXX has significant Learning Problems and is at-risk for Attention Problems. XXXX rated himself as having significant problems with depression and self-esteem and being at-risk for problems with anxiety.

BEHAVIOR ASSESSMENT SYSTEM FOR CHILDREN: SECOND EDITION - SELF-REPORT OF PERSONALITY (BASC-2:SRP)Completed on:

The BASC-2:SRP is a self-report measure designed to evaluate the personality and self-perceptions of children.

The BASC-2:SRP yields T-Scores with a mean of 50 and a standard deviation of 10. Scores of 65 to 70 indicate some difficulty and scores above 70 indicate significant problems.

Domains T-ScoresAttitude to SchoolAttitude to TeachersSensation SeekingSchool Maladjustment CompositeAtypicalityLocus of ControlSomatizationSocial StressAnxietyDepressionSense of InadequacyClinical Maladjustment CompositeEmotional Symptoms Index

Scores below 30 on Personal Adjustment are considered significantly low.Relations with ParentsInterpersonal RelationsSelf-EsteemSelf-ReliancePersonal Adjustment Composite

The Behavior Assessment System for Children (BASC-2) is a questionnaire to rate adaptive skills as well as behavior and emotional problems in children. It was given to XXXX and his

teacher, Mr. XXXX, to complete. Mr. XXXX indicated no significant social, emotional, or behavioral problems; however, his scores show that XXXX has significant Learning Problems and is at-risk for Attention Problems. XXXX rated himself as having significant problems with depression and self-esteem and being at-risk for problems with anxiety.

BEHAVIOR ASSESSMENT SYSTEM FOR CHILDREN: SECOND EDITION - TEACHER RATING SCALE (BASC-2:TRS)Date administered: Completed by:

The BASC-2:TRS is a questionnaire completed by teachers to obtain ratings of adaptive skills and behavior and emotional problems of students.

The BASC-2:TRS yields T-Scores with a mean of 50 and a standard deviation of 10. Scores of 60 to 70 indicate some difficulty. Scores above 70 are considered significantly high.

Domains T-ScoresHyperactivityAggressionConduct ProblemsExternalizing Problems CompositeAnxietyDepressionSomatizationInternalizing Problems CompositeAttention ProblemsLearning ProblemsSchool Problems CompositeAtypicalityWithdrawalBehavioral Symptoms Index

Scores below 30 on the adaptive scales are considered significantly low.Domains T-Scores

Social SkillsLeadershipStudy SkillsAdaptive Skills Composite

The Behavior Assessment System for Children (BASC) is a questionnaire to rate adaptive skills as well as behavior and emotional problems in children. It was given to XXXX and his teacher, Mr. XXXX, to complete. Mr. XXXX indicated no significant social, emotional, or behavioral problems; however, his scores show that XXXX has significant Learning Problems and is at-risk for Attention Problems. XXXX rated himself as having significant problems with depression and self-esteem and being at-risk for problems with anxiety.

BEHAVIOR ASSESSMENT SYSTEM FOR CHILDREN, SECOND EDITION - TEACHER RATING SCALE (BASC-2: TRS)Date administered: Completed by:

The BASC-2: TRS is a questionnaire completed by teachers to obtain ratings of adaptive skills and behavior and emotional problems of students.

The BASC-2: TRS yields T-Scores with a mean of 50 and a standard deviation of 10. Scores of 60 to 70 indicate some difficulty. Scores above 70 are considered significantly high.

Domains T-ScoresHyperactivityAggressionConduct ProblemsAnxietyDepressionSomatizationAttention ProblemsLearning ProblemsAtypicalityWithdrawalExternalizing ProblemsInternalizing ProblemsSchool ProblemsBehavioral Symptoms Index


AdaptabilitySocial SkillsLeadershipStudy SkillsAdaptive Skills

The Behavior Assessment System for Children, Second Edition (BASC-2) is a questionnaire to rate adaptive skills as well as behavior and emotional problems in children. It was given to Luis’s teacher, Ms. Wise, to complete. Mr. Wise indicated no significant social, emotional, or behavioral problems.

BEHAVIOR ASSESSMENT SYSTEM FOR CHILDREN, SECOND EDITION - PARENT RATING SCALE (BASC-2: PRS)Date administered: Completed by:

The BASC-2: PRS is a questionnaire completed by the parent/guardian to obtain ratings of adaptive skills and behavior and emotional problems of students.

The BASC-2: PRS yields T-Scores with a mean of 50 and a standard deviation of 10. Scores of 60 to 70 indicate some difficulty. Scores above 70 are considered significantly high.

Domains T-ScoresHyperactivityAggressionConduct ProblemsAnxietyDepressionSomatizationAttention ProblemsLearning ProblemsAtypicalityWithdrawal

Externalizing ProblemsInternalizing ProblemsSchool ProblemsBehavioral Symptoms Index


AdaptabilitySocial SkillsLeadershipStudy SkillsAdaptive Skills

BEHAVIOR ASSESSMENT SYSTEM FOR CHILDREN, SECOND EDITION – SELF-REPORT OF PERSONALITY (BASC-2:SRP)Completed on:

The BASC-2:SRP is a self-report measure designed to evaluate the personality and self-perceptions of children.

The BASC-2:SRP yields T-Scores with a mean of 50 and a standard deviation of 10. Scores of 65 to 70 indicate some difficulty and scores above 70 indicate significant problems.

Domains T-ScoresAttitude to SchoolAttitude to TeachersSensation SeekingAtypicalityLocus of ControlSocial StressAnxietyDepressionSense of Inadequacy Somatization

Attention ProblemsHyperactivitySchool Problems CompositeInternalizing Problems CompositeInattention/Hyperactivity CompositeEmotional Symptoms Index

Scores below 30 on Personal Adjustment are considered significantly low.Relations with ParentsInterpersonal RelationsSelf-EsteemSelf-ReliancePersonal Adjustment Composite

CLINICAL ASSESSMENT BATTERY - TEACHER FORM (CAB-T)Date administered: Completed by:

The CAB-T is a questionnaire completed by teachers to obtain ratings of adaptive skills and behavior and emotional problems of students.

The CAB-T yields T-Scores with a mean of 50 and a standard deviation of 10. Scores of 60 to 70 indicate some difficulty. Scores above 70 are considered significantly high.

Total Index Score T-ScoreCAB Behavioral Index

Clinical Cluster T-ScoresAnxietyDepressionAngerAggressionBullyingConduct ProblemsAttention-Deficit/HyperactivityAutistic Spectrum BehaviorsLearning DisabilityMental Retardation

Clinical Scale T-ScoresInternalizing BehaviorsExternalizing Behaviors

Scores below 30 on the following scales indicate significant problems.Adaptive Cluster T-Scores

Executive FunctioningGifted and Talented

Adaptive Scale T-ScoresSocial SkillsCompetence

The Clinical Assessment Battery - Teacher Form (CAB-T) is a questionnaire to rate adaptive skills as well as behavior and emotional problems in children. It was given to XXXX’s mother and his teacher, Mr. XXXX, to complete. Mr. XXXX indicated no significant social, emotional, or behavioral problems; however, his scores show that XXXX has significant Learning Problems and is at-risk for Attention Problems. XXXX’s mother rated him as having significant problems with depression and self-esteem and being at-risk for problems with anxiety.

CLINICAL ASSESSMENT BATTERY – PARENT EXTENDED FORM (CAB-PX)Date administered: Completed by:

The CAB-PX is a questionnaire that is filled out by parents in order to assess the behavior problems, emotional problems, and social competence of their children.

The CAB-PX yields T-Scores with a mean of 50 and a standard deviation of 10. Scores of 60 to 70 indicate some difficulty. Scores above 70 are considered significantly high.

Total Index Score T-ScoreCAB Behavioral Index

Clinical Cluster T-ScoresAnxietyDepressionAngerAggressionBullyingConduct ProblemsAttention-Deficit/HyperactivityAutistic Spectrum BehaviorsLearning DisabilityMental Retardation

Clinical Scale T-ScoresInternalizing BehaviorsExternalizing BehaviorsCritical Behaviors

Scores below 30 on the following scales indicate significant problems.Adaptive Cluster T-Scores

Executive FunctioningGifted and Talented

Adaptive Scale T-ScoresSocial SkillsCompetenceAdaptive Behaviors

The Clinical Assessment Battery - Teacher Form (CAB-PX) is a questionnaire to rate adaptive skills as well as behavior and emotional problems in children. It was given to XXXX’s mother and his teacher, Mr. XXXX, to complete. Mr. XXXX indicated no significant social, emotional,

or behavioral problems; however, his scores show that XXXX has significant Learning Problems and is at-risk for Attention Problems. XXXX’s mother rated him as having significant problems with depression and self-esteem and being at-risk for problems with anxiety.

ACHENBACH CHILD BEHAVIOR CHECKLIST - PARENT REPORT FORM (CBCL-PRF)Date completed:Completed by:

The CBCL-PRF is a questionnaire that is completed by parents in order to report behavior and emotional problems of their children.

The CBCL-PRF yields T-Scores with a mean of 50 and a standard deviation of 10. Scores between 67 and 70 are considered borderline significant.

Scores above 70 are considered clinically significant.Domains T-Scores

WithdrawnSomatic ComplaintsAnxious/DepressedSocial ProblemsThought ProblemsAttention ProblemsDelinquent BehaviorAggressive BehaviorINTERNALIZING COMPOSITEEXTERNALIZING COMPOSITE

ACHENBACH CHILD BEHAVIOR CHECKLIST - TEACHER REPORT FORM (CBCL-TRF)Date completed:Completed by:

The CBCL-TRF is a questionnaire to be completed by teachers in order to report behavior and emotional problems.

The CBCL-TRF yields T-Scores with a mean of 50 and a standard deviation of 10. Scores between 67 and 70 are considered borderline significant.

Scores above 70 are considered clinically significant.Domains T-Scores

WithdrawnSomatic ComplaintsAnxious/DepressedSocial ProblemsThought ProblemsAttention ProblemsDelinquent BehaviorAggressive BehaviorINTERNALIZING COMPOSITE

EXTERNALIZING COMPOSITE

ACHENBACH CHILD BEHAVIOR CHECKLIST – TEACHER REPORT FORM (CBCL-TRF)Date completed: T1Completed by:

Date completed: T2Completed by:

The CBCL-TRF is a questionnaire to be completed by teachers in order to report behavior and emotional problems.

The CBCL-TRF yields T-Scores with a mean of 50 and a standard deviation of 10. Scores between 67 and 70 are considered borderline significant.

Scores above 70 are considered clinically significant.

DomainsT1

T-ScoresT2

T-ScoresWithdrawn/ DepressedSomatic ComplaintsAnxious/DepressedSocial ProblemsThought ProblemsAttention ProblemsRule-Breaking BehaviorAggressive BehaviorInternalizing CompositeExternalizing CompositeTotal ProblemsAffective ProblemsAnxiety ProblemsSomatic ProblemsAttention Deficit/ Hyperactivity ProblemsOppositional Defiant ProblemsConduct Problems

ACHENBACH CHILD BEHAVIOR CHECKLIST-YOUTH SELF-REPORT (CBCL-YSR)Date completed:

The CBCL-YSR is designed to obtain students' reports of their own competencies and problems. The CBCL-YSR yields T-Scores with a mean of 50 and a standard deviation of 10.

Scores between 67 and 70 are considered borderline significant. Scores above 70 are considered clinically significant.

Domains T-Scores

Anxious/DepressedWithdrawnSomatic ComplaintsSocial ProblemsThought ProblemsAttention ProblemsRule-Breaking BehaviorAggressive BehaviorINTERNALIZING COMPOSITEEXTERNALIZING COMPOSITETOTAL PROBLEMS

The Achenbach Child Behavior Checklist (CBCL) is a questionnaire to rate adaptive skills as well as behavior and emotional problems in children and adolescents. It was given to XXXX and his teacher, Mr. XXXX, to complete. Mr. XXXX indicated no significant social, emotional, or behavioral problems; however, his scores show that XXXX has significant Learning Problems and is at-risk for Attention Problems. XXXX rated himself as having significant problems with depression and self-esteem and being at-risk for problems with anxiety.

BROWN ADD SCALES – ADOLESCENT VERSION (BADDS) Date administered:

The BADDS is a self-report questionnaire designed to screen for problems in the areas of attention and hyperactivity.

T-Scores between 45 and 59 indicate a risk of problems.T-scores of 60 or higher indicate significant problems.

Clusters Score1 Organizing and activating for work2 Sustaining attention and concentration3 Sustaining energy and effort4 Managing affective interference5 Utilizing “working memory” and accessing recallTotal In addition, due to his report that he was previously diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), the Brown ADD Scales (BADDS) was given to examine XXXX’s perception of these types of problems. His ratings indicated that he sees himself as having significant problems with organization, paying attention, concentrating, difficulty with mood, problems with memory, and difficulty sustaining energy to complete his work.

KOVAC’S CHILDREN’S DEPRESSION INVENTORY (CDI) SHORT FORMCompleted on: Completed by:

The CDI is a ten-item survey completed by the child to examine questions related to depressed feelings.

The CDI yields a T-Score with a mean of 50 and a standard deviation of 10. Scores of 65 to 70 indicate some difficulty, and scores above 70 indicate significant problems.

Domains ScoresCDI: T-Score

Formal surveys of depression were read to XXXX so that he could answer them. His scores on these tests indicate that he does not seem to think of himself as depressed.

A formal survey of depression, the Kovac’s Children’s Depression Inventory (CDI) Short Form was read to XXXX so that she could answer them. Her scores on these tests indicate that she does not seem to think of herself as depressed.

CONNERS’ ADOLESCENT SELF-REPORT SCALE (CASS)Date administered:

The CASS is a widely used rating scale that can help identify behavioral problems.

The CASS yields T-Scores with a mean of 50 and a standard deviation of 10. Scores between 61 and 65 are considered above average.

Scores between 66 and 70 are considered much above average.Domains T-Score

Conduct ProblemCognitive Problems/ InattentionHyperactivityConners’ ADHD Index

Because his teachers noted concerns of inattention, XXXX was asked to complete a Conners’ Adolescent Self-Report Scale (CASS). This measure indicates that he sees himself as having no problems with inattention, hyperactivity, or impulsivity.

CONNERS’ TEACHER RATING SCALE-REVISED: SHORT FORM (CTRS-R:S)Date administered: Completed by:

The CTRS-R:S is a widely used rating scale that can help identify behavioral problems in children and adolescents using three factors.

The CTRS-R:S yields T-Scores with a mean of 50 and a standard deviation of 10. Scores between 61 and 65 are considered above average.


Conners’ ADHD IndexDSM-IV: InattentiveDSM-IV Hyperactive-Impulsive

DSM-IV: Total

Testing to explore problems with inattention, impulsivity, and hyperactivity was conducted using the Conners’ Teacher Rating Scale-Revised: Short Form (CTRS-R:S) and the Conners’ Parent Rating Scale-Revised: Short Form (CPRS-R:S). His mother’s scores on the CPRS-R:S indicate significant problems with oppositional and hyperactive behavior as well as inattention. Three of his teachers completed the CTRS-R:S. All of these teachers rated him as being at-risk or having significant problems with inattention, impulsivity, and hyperactivity.

CONNERS’ TEACHER RATING SCALE-REVISED: SHORT FORM (CTRS-R:S)Date administered: Completed by:

The CTRS-R:S is a widely used rating scale that can help identify behavioral problems in children and adolescents using three factors.

The CTRS-R:S yields T-Scores with a mean of 50 and a standard deviation of 10. Scores between 61 and 65 are considered above average.


OppositionalCognitive Problems/InattentionHyperactivityConners’ ADHD Index

CONNERS’ PARENT RATING SCALE-REVISED: SHORT FORM (CPRS-R:S)Date administered: Completed by:

The CPRS-R:S is a widely used rating scale that can help identify behavioral problems in children and adolescents using three factors.

The CPRS-R:S yields T-Scores with a mean of 50 and a standard deviation of 10. Scores between 61 and 65 are considered above average.


DSM-IV: InattentiveDSM-IV: Hyperactive-ImpulsiveDSM-IV: TotalConners’ ADHD Index

Testing to explore problems with inattention, impulsivity, and hyperactivity was conducted using the Conners’ Teacher-Rating Scale-Revised: Short Form (CTRS-R:S) and the Conners’ Parent-Rating Scale-Revised: Short Form (CPRS-R:S). His mother’s scores on the CPRS-R:S indicate significant problems with oppositional and hyperactive behavior as well as inattention. Three of his teachers completed the CTRS-R:S. All of these teachers rated him as being at-risk or having significant problems with inattention, impulsivity, and hyperactivity.

CONNERS’ TEACHER RATING SCALE-REVISED: LONG FORM (CTRS-R:L)Date administered: Completed by:

The CTRS-R:L is a widely used rating scale that can help identify emotional and behavioral problems in children and adolescents.

The CTRS-R:L yields T-Scores with a mean of 50 and a standard deviation of 10. Scores between 61 and 65 are considered above average.


OppositionalCognitive Problems/ InattentionHyperactivityAnxious/ShyPerfectionismSocial ProblemsConners’ ADHD IndexConners’ Global Index: Restless-ImpulsiveConners’ Global Index: Emotional LabilityConners’ Global Index: TotalDSM-IV: InattentiveDSM-IV: Hyperactive-ImpulsiveDSM-IV: Total

CONNERS 3 - TEACHER- SHORT (CONNERS 3)Date administered: Completed by:

The CONNERS 3 is a widely used rating scale that can help identify behavioral problems in children and adolescents using three factors.

The CONNERS 3 yields T-Scores with a mean of 50 and a standard deviation of 10. Scores between 61 and 65 are considered above average.


Inattention

Hyperactivity/ ImpulsivityLearning Problems/ Executive FunctioningAggressionPeer Relations

DIFFERENTIAL TEST OF CONDUCT AND EMOTIONAL PROBLEMS (DT/CEP)Date completed: Completed by:

The DT/CEP is a questionnaire that should be used along with other assessment information to determine if a child’s classroom behavioral problem is due to conduct problems or emotional problems. A child with emotional problems will usually show low scores on the conduct scale and high scores on the emotional scale. A high score on both does not indicate emotional problems, as a high conduct scale score will often increase the emotional scale.

A score of 9 or more on the Emotional scale indicates significant risk of emotional problems.A score of 6 to 8 on the Emotional scale indicates a mild risk of emotional problems.

Emotional Score Emotional ScoreA score of 14 or more on the Conduct scale indicates significant risk of conduct problems.

A score of 9 to 13 on the Conduct scale indicates a mild risk of conduct problems.Conduct Score Conduct Score

The Differential Test of Conduct and Emotional Problems (DT/CEP) was given to Ms. XXXX, the paraprofessional in the self-contained classroom, and Ms. XXXX, his special education teacher. Ms. XXXX’s scores indicate that Steven is mildly at-risk for emotional problems and significantly at-risk for behavioral problems. Ms. XXXX’s responses indicated that Steven is significantly at-risk for emotional and behavioral problems.

PIERS-HARRIS CHILDREN'S SELF-CONCEPT SCALE: 2 ND EDITION (PIERS-HARRIS-2) Completed on: Completed by:

The Piers-Harris-2 is a brief, self-report measure designed to aid in the assessment of self-concept in children. All cluster scales are scored in the direction of positive self-concept so that a high score on a particular cluster scale indicates a high level of assessed self-concept within that specific dimension.

The Piers-Harris-2 provides T-scores with a mean of 50 and a standard deviation of 10. A T-score between 35 and 39 is below average while a T-score below 35 is significantly low.

Domains T-ScoresBehaviorIntellectual and School StatusPhysical Appearance and AttributesAnxietyPopularity

Happiness and SatisfactionTotal Score

The Piers-Harris Children's Self-Concept Scale, Second Edition (Piers-Harris-2) was given. His scores on this measure indicate significant self-esteem problems, particularly, in the areas of popularity, freedom from anxiety, and school status.

PIERS-HARRIS CHILDREN'S SELF-CONCEPT SCALE: 2 ND EDITION (PIERS-HARRIS-2) Completed on:

The Piers-Harris-2 is a brief, self-report measure designed to aid in the assessment of self-concept in children.

The Piers-Harris-2 provides T-scores with a mean of 50 and a standard deviation of 10. All cluster scales are scored in the direction of positive self-concept so that a high score on a

particular cluster scale indicates a high level of assessed self-concept.Domains T-Scores Percentile

BEH: Above average range ≥ 56T; Average 40T-55T; Low ≤ 39TBehavioral Adjustment (BEH)

INT: Above average range ≥ 56T; Average 40T-55T; Low ≤ 39TIntellectual and School Status (INT)

PHY: Above average range ≥ 56T; Average 40T-55T; Low ≤ 39TPhysical Appearance and Attributes (FRE)

FRE: Above average range ≥ 56T; Average 40T-59T; Low ≤ 39TFreedom from Anxiety

POP: Above average range ≥ 56T; Average 40T-55T; Low ≤ 39TPopularity (POP)

HAP: Above average range ≥ 56T; Average 40T-55T; Low ≤ 39THappiness and Satisfaction (HAP)

TOT: High range ≥ 60T; Average 40T-59T; Low ≤ 39TTotal Score

Validity scales are used to evaluate the responses for inconsistencies or repetitions.Scores of ≥ 60T are indicators of an invalid score profile

Inconsistency Responding (INC)Random Responding (RES)

REVISED CHILDREN'S MANIFEST ANXIETY SCALE (RCMAS)Date completed:Completed by:

The RCMAS is a questionnaire completed by children, designed to assess the level and nature of anxiety or worry in children.

The RCMAS Subscales yield scaled scores with a mean of 10 and a standard deviation of 3.A scaled score between 7 and 13 is considered to be average.

Domains Scaled ScoresPhysiological AnxietyWorry/OversensitivitySocial Concerns/ConcentrationLie

The Total Score is a T-Score with a mean of 50 and a standard deviation of 10.A T-Score above 60 is a caution, while scores above 70 are clinically significant.

Composite T-ScoreTotal

A formal survey of anxiety, the Revised Children's Manifest Anxiety Scale (RCMAS) was read to XXXX so that he could answer the items. His scores on this test indicate that he does not seem to think of himself as anxious.

REVISED CHILDREN'S MANIFEST ANXIETY SCALE, SECOND EDITION (RCMAS-2)Date completed:

The RCMAS-2 is a questionnaire completed by children, designed to assess the level and nature of anxiety or worry in children.

The RCMAS-2 Subscales yield T-Scores with a mean of 50 and a standard deviation of 10.A T-Score above 60 is a caution, while scores above 70 are clinically significant.

Domains Scaled ScoresPhysiological AnxietyWorrySocial AnxietyDefensiveness

The Total Score is a T-Score with a mean of 50 and a standard deviation of 10.A T-Score above 60 is a caution, while scores above 70 are clinically significant.

Composite T-ScoreTotal*Inconsistent Responding Index score = 0

A formal survey of anxiety, the Revised Children's Manifest Anxiety Scale, Second Edition (RCMAS-2) was completed by XXXX. Her scores on this measure indicate that she does not seem to think of herself as anxious.

REYNOLDS CHILD DEPRESSION SCALE (RCDS)Date completed:Completed by:

The RCDS is a questionnaire completed by the child. It measures depressive symptoms relative to other children.

The RCDS yields a raw score, which is converted to a percentile. A Total Raw Score above 74 is considered clinically significant.

Domains Scores

Total Raw ScoreTotal %ile

A formal survey of depression, the Reynolds Child Depression Scale (RCDS) was read to XXXX so that he could answer them. His scores on this measure indicates that he does not seem to think of himself as depressed.

REYNOLDS ADOLESCENT DEPRESSION SCALE – SECOND EDITION (RADS-2)Completed on: Completed by:

The RADS is a questionnaire completed by the adolescent and measures a range of symptoms associated with depression.

The RADS-2 yields T-Scores with a mean of 50 and a standard deviation of 10. Scores between 61 and 66 indicate that the adolescent is at-risk for problems.

A score of 67 or above indicates significant problems.

DomainsT-ScoresScores

PercentileRank

Dysphoric MoodAnhedoina/Negative AffectNegative Self-EvaluationSomatic ComplaintsDepression Total

The Reynolds Adolescent Depression Scale, Second Edition (RADS-2) was given to investigate concerns of problems with depression. His scores indicate significant problems with depression, particularly, in the area of self-esteem.

16-PF, FIFTH EDITION (16-PF)Administered on:

The 16-PF is self-report rating scale designed to evaluate general personality factors.It yields stem scores with a mean of 5.5 and a standard deviation of 2.

Sten scores between 4 and 7 are considered average.Primary Factors Sten ScoresWarmthReasoningEmotional StabilityDominanceLivelinessRule ConsciousnessSocial Boldness

SensitivityVigilanceAbstractednessPrivatenessApprehensionOpenness to ChangeSelf-ReliancePerfectionismTensionGlobal Factors Sten ScoresExtraversionAnxietyTough-MindednessIndependenceSelf-Control

Validity scales examine patterns of responses from the rater for any unusual response patterns.These scores are either rated as “unusual” or “common.”

Validity ScalesImpression ManagementInfrequencyAcquiescence

The 16-PF, Fifth Edition (16-PF) was administered as a measure of personality for [Client’s name]. Validity scales on the 16-PF (Impression Management, Infrequency, and Acquiescence) were used to evaluate item response patterns for random responses or social desirability. Based on an evaluation of these validity scales, [describe if any validity scales were unusually high and what that means OR describe that none of the validity scales indicated any unusual response patterns]. An evaluation of the Broad Factor scores found that the following scales fall outside of the average range. Specifically, [describe any clinically significant Broad Factor scores]. This means that [Client’s name] provided responses indicating [describe specific personality data here]. An evaluation of the Primary Factor scores found that the following scales fall outside of the average range. Specifically, [describe any clinically significant Primary Factor scores]. This means that [Client’s name] provided responses indicating [describe specific personality data here]. Overall [Client’s name] appears to be a person who [give a general description of the holistic findings].

WOODCOCK-MUÑOZ LANGUAGE SURVEY: (WMLS)Administered by: Administered on:

The Woodcock-Muñoz Language Survey is an individually administered language proficiency test that is given in English and Spanish. It is comprised of a number of subtests, the results of which are combined into a language composite score.

The WMLS yields standard scores with a mean of 100 and a standard deviation of 15. Standard scores between 90 and 110 are considered average.

DomainsEnglish

Standard Score

SpanishStandard

ScorePicture VocabularyVerbal AnalogiesORAL LANGUAGE ABILITIESLetter-Word IdentificationDictationREADING-WRITING ABILITIESBROAD ENGLISH/SPANISH ABILITYCognitive Academic Language Proficiency (1 = low; 5 = fluent)

The Woodcock-Muñoz Language Survey was given in both English and Spanish to determine the language used in further testing. His broad English (standard score = 75) fell in the delayed range and his broad Spanish (standard score = 45) score fell in the very delayed range. Given this, XXXX should be considered as having very-limited to limited English and negligible Spanish. Given that he is not fluent in either language, all further testing was done in both languages (when available) or nonverbally.

BILINGUAL VERBAL ABILITIES TEST (B-VAT)Administered by: Administered on:

The B-VAT provides an estimate of verbal cognitive ability across both languages combined. The measure is originally administered in English and then any questions answered incorrectly are asked again later in the child’s native language. This provides as accurate an understanding of the child’s verbal ability as possible.

The B-VAT provides standard scores with a mean of 100 and a standard deviation of 15. Standard scores between 85 and 115 are considered average.

DomainsStandard

ScorePercentile

RankConfidence

IntervalPicture VocabularyOral VocabularyVerbal AnalogiesEnglish Language Proficiency BILINGUAL VERBAL ABILITY

The Bilingual Verbal Ability Test (B-VAT) was administered as a measure of verbal intelligence. This measure was given in both languages (Spanish and English), and he received full credit for either answer given. His Bilingual Verbal Ability Composite score places him in

the delayed range. Specifically, he obtained a composite score of 71. Overall, his score indicates that his verbal skills are somewhat below his nonverbal skills.

GILLIAM AUTISM RATING SCALE (GARS)Completed on:Completed by:

The GARS is designed to screen a child for autism. Parent and/or teacher are asked to decide if the child does certain activities. These activities are typical for most children to some extent, but as a combination or with increased frequency they are more often seen in children with autism.

The GARS subtests provide standard scores with a mean of 10 and a standard deviation of 3.Subtest scores between 7 and 13 are considered average.

Subtests Standard Score

Percentile Rank

ProbabilityOf Autism

Stereotyped BehaviorsCommunicationSocial InteractionDevelopmental

The quotient provides standard scores with a mean of 100 and a standard deviation of 15.Quotient scores between 85 and 115 are considered average.

Autism Quotient

GILLIAM AUTISM RATING SCALE (GARS)Completed on:Completed by:

The GARS is designed to screen a child for autism. Parent and/or teacher are asked to decide if the child does certain activities. These activities are typical for most children to some extent, but as a combination or with increased frequency they are more often seen in children with autism.

The GARS subtests provide standard scores with a mean of 10 and a standard deviation of 3.Subtest scores between 7 and 13 are considered average.


Percentile Rank

ProbabilityOf Autism

Stereotyped BehaviorsCommunicationSocial Interaction


Autism Quotient

The Gilliam Autism Rating Scale (GARS) compares information from XXXX’s teacher, Ms. XXXX, and his mother, Ms. XXXX, to information gathered from children with and without

autism. Based on this information, the normative data can help to determine the probability of XXXX having autism. XXXX’s scores indicate a very low or below average chance of him being a child with autism.

GILLIAM ASPERGER’S DISORDER SCALE (GADS)Completed on: Completed by:

The GADS is designed to screen a child for Asperger’s Disorder. A parent and/or a teacher are asked to decide if the child does certain activities. These activities are typical for most children to some extent, but as a combination or with increased frequency they are more often seen in children with Asperger’s. These items are combined into four general categories of behavior and an Asperger’s quotient is generated.

The GADS subtests provide standard scores with a mean of 10 and a standard deviation of 3.Subtest scores between 7 and 13 are considered average.


Percentile Rank

ProbabilityOf Asperger’s

Social InteractionsRestricted BehaviorCognitive PatternsPragmatic Skills


Asperger’s Disorder Quotient

The Gilliam Autism Rating Scale (GARS) was given to his teacher, Ms. XXXX, to complete. The results of this scale indicated no significant problems with Autism. The Gilliam Asperger’s Disorder Scale was administered, as well. Ms. XXXX’s answers (standard score=90) and his mother’s answers (standard score=115) produced a high/probable scale quotient, indicating significant behaviors associated with Asperger’s Disorder. These problems include difficulty in social interactions, restricted patterns of behavior, poor pragmatic skills, and unusual cognitive patterns.

PROJECTIVE TESTING:

Informal, projective type tests were given to XXXX to determine what he was thinking and feeling. His drawings were age-appropriate and positive but indicated some problems with self-esteem. His responses on the Sentence Completion Test and Roberts Apperception Test for Children (RATC) were indicative of a child with a positive home and school life and a view of the world as a fair and nonthreatening place. However, it should be noted again that these tests were given during a period of time that he was exhibiting few emotional or behavior problems and may not be an accurate representation of how he thinks or feels on a regular basis.

His answers on the Roberts Apperception Test for Children and the Madeleine Thomas Stories indicated that he had difficulty identifying the correct emotions to go with certain behaviors (e.g., “He’s feeling loved by his mother so he feels bad.”), and almost every person in almost every picture felt “bad” or “sad.” In addition, the characters in his stories responded to the activities going on around them in socially inappropriate ways (e.g., “he is looking at her in the shower, so he started laughing” and “they were fighting because they don’t know who is whose best friend, but they all feel pretty normal about that”). When asked what would happen next, he could not provide an answer for any story.

Projective testing was done using the Draw-A-Person Test. His drawing reflects a child who is socially well adjusted with no emotional problems.

Psychometric Summary Add-ons:

WOODCOCK-JOHNSON TESTS OF ACHIEVEMENT: THIRD EDITION/ NORMATIVE UPDATE (WJ-III:ACH/NU)Date administered:Administered by:

The WJ-III:ACH/NU is an individually administered achievement test. The WJ-III:ACH/NU yields standard scores with a mean of 100 and a standard deviation of 15.


DomainsStandard

ScorePercentile

RankConfidence

IntervalLetter-Word IdentificationReading FluencyPassage ComprehensionCalculationMath FluencyApplied ProblemsSpellingWriting FluencyWriting SamplesBroad ReadingBroad MathBroad Written LanguageMath Calculation SkillsWritten ExpressionAcademic SkillsAcademic FluencyAcademic ApplicationsTotal Achievement

BEHAVIOR RATING INVENTORY OF EXECUTIVE FUNCTION, TEACHER FORM (BRIEF)Date completed: Completed by:

The Behavior Rating Inventory of Executive Function (BRIEF) is a questionnaire designed to help evaluate general problem solving skills.

The BRIEF yields T-Scores with a mean of 50 and a standard deviation of 10. Scores of 65 to 70 indicate some difficulty and scores above 70 indicate significant problems.

Domains T-ScoresInhibitShiftEmotional ControlBehavioral Regulation Index (BRI)InitiateWorking MemoryPlanning/ OrganizationOrganization of MaterialsMonitor

Metacognition Index (MI)Global Executive Composite (GEC)

Validity scales examine patterns of responses from the rater for any overgeneralizations.Negativity AcceptableInconsistency Acceptable

The Behavior Rating Inventory of Executive Function (BRIEF) is a questionnaire designed to help evaluate XXXX’s general problem solving skills. This measure was given to one of XXXX’s Teachers, Ms. Elliot, to complete. Concerns are noted with her ability to inhibit impulsive responses, modulate her emotions, plan and organize problem solving approaches, and monitor her own behavior.

WOODCOCK-MUÑOZ LANGUAGE SURVEY, REVISED (WMLS-R)Administered by: Administered on: The Woodcock-Muñoz Language Survey, Revised (WMLS-R) is an individually administered language proficiency test that is given in English and Spanish. It is comprised of a number of subtests, the results of which are combined into a language composite score.

The WMLS yields standard scores with a mean of 100 and a standard deviation of 15. Standard scores between 90 and 110 are considered average.

Cognitive Academic Language Proficiency (1 = low; 5 = fluent)English Spanish

SubtestsStandard

ScoreConf.

Interval CALPStandard

ScoreConf.

Interval CALPPicture VocabularyVerbal AnalogiesLetter-Word IdentificationDictationPassage Comprehension

CompositesOral LanguageReading-WritingBroad English AbilityReadingWriting

BATERÍA III WOODCOCK-MUNOZ PRUEBAS DE APROVECHAMIENTO (BATERÍA III)Date administered: Administered by: S. Kathleen Krach, Ph.D.

This portion of the Batería III is an individually administered achievement test given in Spanish. The Batería III yields standard scores with a mean of 100 and a standard deviation of 15.


DomainsStandard

ScoreConfidence

IntervalLetter-Word Identification (Identificación de letras y palabras)Reading Fluency (Fluidez en la lectura)Passage Comprehension (Comprensión de Textos)Calculation (Cálculo)Math Fluency (Fluidez en Matemáticas)Applied Problems (Problemas Aplicados)Spelling (Ortografía)Writing Samples (Muestras de Redacción)Broad Mathematics (Amplio Matemáticas)Broad Reading (Amplio Lectura)Academic Skills (Des Académicas)Academic Applications (Aplicaciones Académicas)

BATERÍA III WOODCOCK-MUNOZ PRUEBAS DE HABILIDADES COGNITIVAS (BATERÍA III)Date administered: Administered by:

This portion of the Batería III is an individually administered test of cognitive abilities given in Spanish.

The Batería III yields standard scores with a mean of 100 and a standard deviation of 15. Standard scores between 85 and 115 are considered average.

DomainsStandard

ScoreConfidence

IntervalVerbal Comprehension (Comprensión Verbal)Visual-Auditory Learning (Aprendizaje Visual-Auditivo)Spatial Relations (Relaciones Espaciales)Sound Blending (Integración de Sonidos)Concept Formation (Formación de Conceptos)Visual Matching (Pareo Visual)Numbers Reversed (Inversión de Números)Verbal Ability (Habilidad Verbal)Thinking Ability (Habilidad Pensar)Cognitive Efficiency (Eficiencia Cognitiva)General Intellectual Ability (GIA)

The Batería III: Pruebas de Habilidades Cognitivas (Batería III) was administered as a Spanish measure of intellectual ability. Olga's overall estimate of intelligence, the General Intellectual Ability (GIA), places her in the low average range. Specifically, she obtained a GIA score of 85, which is comprised of a Verbal Ability cluster score of 74, a Thinking Ability cluster score of 92, and a Cognitive Efficiency cluster score of 96.

Her cluster scores indicate a significant weakness in her verbal ability. This means that she does worse on test items that require her to use language to identify pictures or objects and to use language to solve problems. Olga’s scores indicate no other significant strengths or weaknesses.

SCHOOL MOTIVATION AND LEARNING STRATEGIES INVENTORY (SMALSI)Date completed: Completed by:

The SMALSI is a self-report questionnaire designed to assess student’s learning, test taking, and organization styles as well as their motivation, anxiety, and confidence in their academic abilities.

The SMALSI yields t-scores with a mean of 50 and a standard deviation of 10. Standard scores between 40 and 60 are considered average.

For strength domains, scores below 40 are considered to be at risk.Student Strength

DomainsT-

ScorePercentile

Rank DescriptorsStudy StrategiesNote-Taking/ Listening SkillsReading/ Comprehension SkillsWriting/ Research Skills

Test-Taking StrategiesOrganizational TechniquesTime Management

The SMALSI yields t-scores with a mean of 50 and a standard deviation of 10. Standard scores between 40 and 60 are considered average.

For liability domains, scores above 60 are considered to be at risk.Student Liability

DomainsT-

ScorePercentile

Rank DescriptorsLow Academic MotivationTest AnxietyConcentration/ Attention Difficulties

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PSYCHOMETRIC SUMMARY - Troy University …trop.troy.edu/kkrach/forms/psychsum_example.doc · Web viewScales T-Scores Percentiles Beck Depression Inventory for Youth (BDI-Y) Beck Anxiety