University of Calgary Applied Psychological & Educational Services (U-CAPES)

Assessment, Intervention and Professional Development Director: Kelly Dean Schwartz, Ph.D., R.Psych.
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2nd Floor, Education Block (Room 281) 2500 University Drive NW Calgary, AB T2N 1N4
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Tel: (403) 220-2851 Fax: (403) 210-8712 Email: UCAPES@ucalgary.ca Joe Davies XXXX, XXXX Twelve Westside School Six

CLIENT NAME: BIRTHDATE: AGE: SCHOOL: GRADE:

DATES OF ASSESSMENT: July X & X, 2011 DATE OF REPORT: August X, 2011 ASSESSED BY: Tara Crumpler B.A. Joanna Johns B.Sc. B.Ed. Karen Zwicker B.Sc. Christine Bierman B.A.

Statement of Confidentiality
All psychological assessments are confidential in nature as they contain private information, which may be used inappropriately by others. To protect the privacy and ensure confidentiality of the persons involved, please ensure that this report is only circulated to those who are considered essential to related judgments and decision-making. The intent of this report is to provide opinions and recommendations in the context of psychological intervention, educational and vocational decision-making, and any use of this report outside of that purpose should only be done with the informed consent of the parties and in consultation with the writer. REASON FOR REFERRAL: Joe was referred for a psychoeducational assessment due to concerns his parents have regarding his ability to focus and his math skills.

FACULTY OF EDUCATION
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DAVIES, Joe 2 of 26 BACKGROUND INFORMATION: Background information was obtained from an interview with Joes mother Lorraine, his father John, and Joe himself. Additional information was gathered from questionnaires and the BASC-2 Structured Developmental History. Joe is a 12 year old boy who lives in Calgary, Alberta. His parents separated approximately one year ago, and he and his 14 year old brother live together in each parents home on alternating weeks. Joes father is a cabinet maker. His mother works in retail and was a full-time caregiver until the time of the separation. Family mental health history is relevant, as Joes mother is on medication for depression and his aunt and uncle are both on medication for anxiety (panic attacks). Joes mother suspects that his maternal grandmother had depression as she appeared sad much of the time and consumed alcohol in excess. Developmental and Medical History Mrs. Davies pregnancy with Joe was unremarkable with no complications. During the last month, Prozac was prescribed to his mother at 10mg per day. During delivery Joe showed signs of stress, as his heart rate dropped and he had a bowel movement in utero, but no complications were reported and he was healthy at birth. Joe met all developmental milestones at a typical age with the exception of speech, which developed early according to his mother. His teachers also report that Joe is very coordinated when participating in physical education class. Presently, Joe has eczema, a severe nut allergy and asthma. He is currently taking Singulair, Flovent and Ventalin to control his asthma. He has worn glasses for astigmatism and distance vision problems since he was six years old and has had yearly vision examinations. He is reported to have some difficulty falling asleep but sleeps in when he has the opportunity to. His appetite is healthy and he eats a variety of nutritious foods. Educational Information Joe has attended his current school since kindergarten. He was homeschooled during grade five as his family took a year-long sailing trip. While his parents noted that Joe has always experienced some difficulty focussing on the task at hand, his mother became particularly aware of it during the year he was homeschooled. Joe recently completed grade six at Westside School, where he had two main teachers. His homeroom teacher taught math, science, and social studies, while another taught language arts and art. He is reported to have had good relationships with both of his teachers and to have made a particularly good connection with his homeroom teacher. Joe received math support in the form of extra help and review during grade six. He was also tutored at home in math from September through April in grade six but this was discontinued as they were not seeing improvement and Joe was not enjoying the process. Joes teachers report that he is positive and willing to learn, and that he engages in class discussions, debates, stories, and group work. He is reported to have more difficulty with independent work, written work, being prepared for class, and applying math concepts independently. Joes teachers indicated that he often seems distracted, that it can be

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DAVIES, Joe 3 of 26 difficult to get his attention and that he requires prompts and reminders to complete tasks. Joe does not engage in impulsive or disruptive behaviour at school. Social/Emotional/Behavioural Information At home, Joe is reported to require support to follow through on instructions and complete tasks like chores or schoolwork. His father noted that when the task involved physical movement (e.g., helping clean up his fathers shop) he was more able to focus. He does not appear to engage in over active (i.e. running or climbing excessively) or impulsive behaviour at home. Joes parents report that he has several close friends that he spends time with. His mother noted, however, that Joe often requires prompting and support in order to organize his plans to get together with his friends. He enjoys playing soccer, hockey and video games. Joes parents note that he has always been a very shy and quiet child who has had difficulty attending to the task at hand. They indicated that he has consistently had difficulties sustaining attention since he began school. They note, however, that he has become significantly more withdrawn and inattentive since their marital separation. His father noted that Joe increasingly chooses to retreat into his room. His parents also indicated that Joe appeared to take the separation harder than his older brother. Joe has difficulty going back and forth between the two homes, likes structure, and generally has more difficulty than his brother with adapting to negative changes. His father noted that Joe frequently appears unhappy and has not laughed since last summer. Previous Assessments Joe has had no previous assessments. ASSESSMENT INSTRUMENTS: Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV) Wechsler Individual Achievement Test Third Edition (WIAT-III) Developmental Neuropsychological Assessment - Second Edition (NEPSY-II) Behavior Assessment System for Children (BASC-2) Conners Third Edition (Conners-3) Diagnostic Interview for Children and Adolescents Fourth Edition (DICA-IV) ASSESSMENT OBSERVATIONS: Joe was seen for formal assessment over the course of two days. He was quiet and reserved but very pleasant and extremely cooperative throughout the assessment. He appeared nervous at the beginning of the first day but was observed to relax quickly once the assessment began. It is believed that the results of the assessment are an accurate representation of his current abilities. ASSESSMENT RESULTS: Assessment results are often described in terms of percentiles. If a childs current ability is being described as being at the 35th percentile, this means that the child performed as well as, or better than 35% of their peers. Conversely, it means that the child performed more poorly than 65% of their peers.

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DAVIES, Joe 4 of 26 Wechsler Intelligence Scale for Children 4 Edition (WISC-IV): The Wechsler Intelligence Scale for Children- Fourth Edition (WISC-IV) is a standardized intelligence test consisting of a series of ten core subtests and five optional subtests designed to measure the intellectual functioning of an individual as compared to others of the same age. A Full Scale Intelligence Quotient (FSIQ) is derived from the combined results of the core subtests. The WISC-IV also provides four factor-based scores, including Verbal Comprehension, Perceptual Reasoning, Working Memory and Processing Speed. Canadian norms were used to score this measure. The WISC-IV was administered to gain an understanding of Joes current level of intellectual functioning. The WISC-IV measures four broad cognitive domains and assessed his ability to reason with verbal and nonverbal information, hold and manipulate information in his short term memory, and the speed at which he processes information. Joe obtained a Full Scale Intelligent Quotient (FSIQ) at the 21st percentile, indicating that his cognitive ability is in the Low Average range. This means that his overall performance across the WISC-IV was equal to, or better than, 21 percent of children his age. This score is considered to be a reliable and valid measure of Joes overall cognitive ability. Verbal Comprehension Joes ability to understand and use language to communicate and engage in verbal reasoning was evaluated by the Verbal Comprehension Index (VCI) on which he scored in the Average range (61st percentile). His performance was relatively consistent across tasks. Specifically, Joe scored in the Average range (50th percentile) in his ability to express the meaning of individual words, and in the Average range (37th percentile) when asked to describe how two common objects or concepts are alike (e.g., How are a car and a bus alike?). The last task within this domain required Joe to demonstrate his social reasoning abilities by solving everyday problems (e.g., Why is it important to tell the truth?). He scored in the High Average range (84th percentile) on this task suggesting that social reasoning is a relative strength for him. Taken together, these results indicate that Joes abilities to learn implicitly from his environment and engage in verbally-based problem solving are at the expected level relative to his same-age peers. Perceptual Reasoning Joes visual perceptual and reasoning abilities were evaluated by the Perceptual Reasoning Index (PRI) where he obtained a composite score in the Low Average range (10th percentile). Specifically, he was required to group pictures with a common theme together which assessed his non-verbal categorical reasoning ability, where he scored in the Average range (25th percentile). Another task within this domain required Joe to complete a series of visual patterns and sequences which assessed his non-verbal conceptual thinking ability. Again he scored in the Average range (25th percentile), suggesting he is able to reason with and conceptualize nonverbal information at the expected level for his age. On a task that assessed his visual-spatial processing and visual-motor coordination and required him to quickly recreate visually-presented patterns using blocks, he scored in the Borderline range (5th percentile). This score was significantly inconsistent with his performance on the other two tasks and he was therefore asked to complete another related task to ensure his abilities were properly captured. Specifically, Joe was required to examine pictures and identify important aspects that were missing, measuring his visual-spatial processing ability,
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DAVIES, Joe 5 of 26 resulting in another score in the Borderline range (5 percentile). This score provides additional information in regards to Joes ability, but was not included in the overall composite score. Overall, these scores suggest Joe has a relative weakness in the area of visual perception whereas his visual reasoning and conceptual thinking abilities are at the expected level for his age.
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Working Memory Joes ability to retain and manipulate auditory information in short-term memory was evaluated by the Working Memory Index (WMI). Overall, he demonstrated an auditory working memory capacity in the Average range (42nd percentile). This performance was consistent across tasks within this domain. Specifically, on a task that required him to repeat strings of numbers both forwards and backwards, he performed in the Average range (37th percentile). Similarly, he performed in the Average range (50th percentile) on a task that required him to repeat letters and numbers in sequential order with increasing difficulty and manipulation. These scores suggest Joes ability to hold and work with verbal information in his short term memory is at the expected level compared to his same aged peers. Processing Speed Joes ability to quickly and efficiently complete simple visual tasks was evaluated by the Processing Speed Index (PSI) where he obtained an overall composite score in the Low Average range (9th percentile). His performance was consistent across tasks within this domain. More specifically, the first task required Joe to quickly learn and use a set of number-symbol associations to complete a code, where he performed in the Low Average range (9th percentile), indicating his mental speed and fine motor abilities are slightly below expected level for his age. Similarly, the second task required him to quickly discriminate between and match detailed abstract symbols where he again scored in the Low Average range (16th percentile), indicating his efficiency in processing visual information is somewhat slower compared to others his age. Overall, Joes ability to fluently and automatically process visual information is slightly below the expected level compared to his same aged peers. Overall, Joes cognitive abilities fall in the Low Average range compared to other children his age. Specifically, Joes working memory and reasoning abilities are similar to his same aged peers, whereas his ability to efficiently process visual-spatial information is slightly below the expected level for his age. The Wechsler Individual Achievement Test - Third Edition (WIAT-III) The Wechsler Individual Achievement Test - Third Edition (WIAT-III) is a standardized test of achievement and functioning. The WIAT III is an individually administered measure that examines performance in the areas of Reading, Mathematics, Written Language and Oral Language. Scores in each of these domains are then combined to provide an overall achievement score. Joes ability to perform academically was assessed using the WIAT-III. Overall, Joe demonstrated academic abilities that were in the Average range with some variability across the subject areas, and therefore each domain will be addressed individually. Reading

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DAVIES, Joe 6 of 26 The Total Reading Composite evaluated Joes reading skills, oral reading fluency, and understanding of the written language. Joes overall reading performance was within the Average range (34th percentile). Joe scored in the Low Average range (23rd percentile) on the Reading Comprehension subtest, which measured his understanding of literal and inferential reading comprehension skills. These skills were measured by asking Joe to read specific passages and orally answer comprehension questions with the passage available for reference. He performed in the Average range (66th percentile) on the Word Reading subtest, which required him to read from a list of increasingly difficult words, and on the Pseudoword Decoding subtest (45th percentile), which evaluated Joes phonetic decoding skills by having him read a list of nonsense words. On the final task, Oral Reading Fluency, which assessed both reading rate and accuracy, Joe also scored in the Average range (34th percentile). Overall, Joes reading skills are within an age appropriate level. Mathematics The Mathematics Composite measured Joes ability to perform math calculations and to reason mathematically. Overall, Joe obtained a score within the Average range (32nd percentile). Specifically, he performed in the Average range (34th percentile) on the Math Problem Solving subtest, indicating adequate ability to solve word problems. On the Numerical Operations subtest Joe was also within the Average range (34th percentile), indicating his ability to perform mathematical computations are at an age appropriate level. On the Math Fluency subtest, which measured his speed and accuracy of solving basic addition, subtraction and multiplication problems, Joe performed in the Average range (47th percentile). Overall, Joes mathematics skills are within an age appropriate level. Written Expression The Written Expression Composite measures spelling and writing abilities. Joes performance on the Spelling subtest was within the Average range (30th percentile), indicating that his spelling skills are at an age appropriate level. On the Sentence Composition subtest which measured Joes sentence formulation skills (i.e., morphology, grammar, syntax, semantics, and mechanics) he performed within the Low Average range (12th percentile). This may be indicative that Joe had difficulties with combining sentences while retaining essential information, and to use target words correctly and within an appropriate context. Within the Essay Composition subtest, Joe was measured on his spontaneous written expression in response to a prompt. He performed within the Average range (58th percentile). Although Joes theme development and text organizational skills were strong, many of his sentences lacked appropriate punctuation and spelling, and had general grammatical issues such as incomplete and run-on sentences. Joe has the ability to organize his ideas as demonstrated in his essay writing, but currently lacks the ability to create consistent and cohesive sentence structures. Overall, Joes written language abilities, although strong in concept, will require support and structured guidance in terms of the mechanics of sentence structure and written expression. Oral Language The Oral Language Composite measures oral expression and listening comprehension. Joes performance in Oral Language was within the Average range (34th percentile). Specifically, he obtained an Average score in Listening Comprehension (27th percentile) which is comprised of Receptive Vocabulary and Oral Discourse Comprehension. On the Receptive Vocabulary task, Joe

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DAVIES, Joe 7 of 26 performed within the Average range (63 percentile) in demonstrating his abilities and knowledge in language development. On Oral Discourse Comprehension, Joe performed within the Low Average range (9th percentile). On the Oral Discourse Comprehension task, Joe listened to an audio recording of narrative information and then orally answered questions. Joes abilities in Oral Discourse Comprehension may indicate that he has challenges remembering and recalling auditory information, which may be related to an underlying attention difficulty. Joe performed within the Average range (50th percentile) in Oral Expression indicating that he has the skills to effectively express himself, demonstrating abilities such as word retrieval, flexibility of thought process, and short-term memory of basic oral stimuli. Overall, Joes abilities such as language development and listening skills are within the Average range.
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Overall Joe demonstrated abilities in the Average range in reading, mathematics, oral language, and writing. Joes academic skills are at an age appropriate level, but he demonstrated slight difficulties in reading comprehension, sentence composition, and oral discourse comprehension, indicating that he may require additional support in these areas. Childrens Memory Scale (CMS) The Childrens Memory Scale (CMS) is a standardized test that evaluates the important processes involved in learning and memory and compares performance to that of others of the same age. A General Memory and Index score can be derived from the core subtests. Results are interpreted in accordance with United States norms. Joe completed a number of memory-based tasks that assessed his ability to encode, store, and retrieve newly learned information that was presented either visually or verbally. These tasks involved the presentation of both meaningful (contextual) and non-meaningful (non-contextual) information and assessed his ability to recall information both immediately and after a short delay. In addition to these recall abilities, Joes ability to recognize and distinguish previously learned information was evaluated. Overall, Joe obtained a General Memory Index score in the Average range (73rd percentile). Joes memory for visually presented information within an immediate time frame was in the Average range (73rd percentile). More specifically, he performed in the High Average range (75th percentile) on non-meaningful tasks (recalling the location of dots on a grid) and in the Average range (63rd percentile), on meaningful tasks (remembering previously-viewed faces). Following a short delay, Joes ability to remember visually presented information remained in the Average range (66th percentile). Specifically, his ability to retain non-meaningful (63rd percentile) and meaningful (63rd percentile) visual information were both in the Average range. Overall, Joe has no difficulty remembering meaningful and non-meaningful visual information immediately and after a short delay. Joes ability to immediately recall verbally presented information fell within the Average range (58th percentile). Following a short delay his ability to recall verbally presented information remained in the Average range (58th percentile). Specifically, he performed in the High Average range when asked to immediately recall a list of non-meaningful word pairs (75th percentile). When he was asked to perform the same task after a short delay he again performed in the High

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DAVIES, Joe 8 of 26 Average range (84 percentile), indicating he is able to retain information even after a delay. Joe performed in the Average range when asked to retell verbally presented stories immediately (37th percentile) and following a short delay (25th percentile). Joe demonstrated that he is able to remember meaningful and non-meaningful verbally presented information immediately and after a short delay.
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In addition to the recall tasks described above, Joes recognition memory was also assessed. Recognition memory involves the ability to identify previously-learned information when a cue is provided, such as in a multiple choice exam. This is in contrast to recall memory, which involves independently retrieving this information when no such cue is provided. Joe demonstrated recognition memory ability in the Average range (42nd percentile). Specifically, his ability to recognize components of the stories that he previously heard was in the Average range (37th percentile). Similarly, when asked to recognize previously-learned word pairs, his performance was again in the Average range (50th percentile). These scores suggest that when provided a cue, Joe is consistent in his ability to remember meaningful and non-meaningful verbal information. Joe also completed two tasks that assessed his ability to sustain and direct attention, his speed of processing, and his working memory. Specifically, Joe performed in the Average range (37th percentile) on a task that required him to repeat number sequences either as they were presented or in reverse. He scored in the High Average range (84th percentile) on tasks requiring him to repeat sequences (e.g., counting by twos, or reciting the days of the week) indicating that he is slightly better able to retrieve and manipulate familiar information from long term rather than short-term storage. Overall, Joes memory is a relative strength for him. He is consistently able to remember information immediately and after a short delay regardless of its context (non-meaningful/ meaningful) or presentation (visual/verbal). A Developmental Neuropsychological Assessment - Second Edition (selected subtests) (NEPSY-II) The Developmental Neuropsychological (NEPSY-II) assessment is a measure of an individuals neuropsychological functioning. It incorporates six domains: Attention and Executive Functioning, Language, Social Perception, Visuospatial Processing, Memory and Learning, and Sensorimotor. Often, a clinician chooses to only administer the subtests most relevant to the individual clients needs. Attention and Executive Functioning: To address concerns brought forth by Joes parents regarding his inattention, selected subtests from the Attention and Executive Functioning domain of the NEPSY-II were administered. The first task within the Attention and Executive Functioning domain required Joe to organize a number of cards into two distinct categorical groups of four based on conceptual similarity, within a given time limit. Overall, Joe performed Below Expected Level (5th percentile) on this task. He was able to create a reasonable number of correct combinations of pictures (25th percentile) but also made more errors than expected compared to his same aged peers (<2nd percentile). These scores indicate that Joes task initiation and flexibility in thinking are at the expected level for his age,

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DAVIES, Joe 9 of 26 whereas his ability to self-monitor his behavior is below the expected level, as shown by his impulsivity in creating incorrect sorts and repeating previously created groups. Another task evaluated Joes ability to sustain attention (maintaining focus on a task over time), his selective attention (attending to relevant stimuli while ignoring irrelevant stimuli), and his ability to control and inhibit impulsive responding. The auditory attention component required Joe to listen to an audio recording and touch a specific colored circle every time the target word was heard throughout the presentation of a string of random words. Joe performed At Expected Level (75th percentile) in terms of his total correct responses. Similarly, he performed At Expected Level when errors were taken into consideration (75th percentile), indicating that Joe is able to inhibit impulsive responding and sustain his attention. The next component of this task was more complex in that Joe was required to respond using a new and more complex instruction set, hold multiple rules in working memory, and inhibit the responses from the previous component. Joe performed At Expected Level (37th percentile) in terms of his total correct responses, and when errors were taken into consideration (25th percentile). However, in examining Joes total inhibition errors, he scored in the Borderline range, indicating that he has greater difficulty inhibiting responses when cognitive demands increase (e.g., retaining and following complex instructions). Overall, Joes selective and sustained attention is at a level expected for his age; however, his ability to control and inhibit his responses was reduced as tasks become more difficult. Joe also completed a task which required him to generate unique designs by connecting up to five dots, presented in two arrays; structured and random. Joe scored At Expected Level (63rd percentile) on this task. Specifically, Joe scored At Expected Level on the structured array and Above Expected Level on the random array. Joe was able to plan and carefully complete the designs and demonstrated the cognitive flexibility to fluently come up with alternative solutions. Lastly, Joe performed a variety of tasks that assessed his ability to use inhibitory control, selfmonitoring, and cognitive flexibility. The initial component of this task required Joe to look at a series of symbols and rapidly provide the symbols proper name. He performed At Expected Level (25th percentile) on this task. However, he completed this task faster than expected for his age (Above Expected Level) and in doing so failed to correct his errors (Below Expected Level). The second component of this task was more complex and required him to provide the opposite name for the symbols, assessing his ability to inhibit the more automatic response in favour of a counterintuitive one. Joe performed At Expected Level (25th percentile) when completion time and errors were taken into consideration. Although he completed this task at a rate expected for his age, it should be noted that he performed in the Borderline range when his rate of uncorrected errors was examined, suggesting he did not utilize effective self-monitoring strategies when completing this task. A final variation of this task required Joe to provide alternate names for symbols based on more complex instructions where he performed At Expected Level (25th percentile) when completion time and errors were considered. Consistent with the other two variations of this task, Joe completed the task at a speed expected for his age (75th percentile), however he performed Below Expected Level for uncorrected errors, again indicating insufficient self-monitoring abilities. Overall, when taking speed and accuracy into consideration, Joe consistently performed At Expected Level (25th percentile). However, it should be noted that Joe consistently failed to correct

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DAVIES, Joe 10 of 26 his errors resulting in a total error score in the Borderline range (9 percentile) providing further evidence to his lack of self-monitoring skills.
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Visuospatial Processing: As Joe struggled significantly with specific tasks within the PRI component on the WISC-IV, tasks within the visual-spatial processing domain of the NEPSY-II were administered. The first task within this domain assessed Joes visuospatial skills and required him to judge the direction and orientation of lines by selecting two arrows out of an array that pointed directly to the target. He performed in the Borderline range (9th percentile) on this task. It did not appear that Joe was using a strategy to determine which arrows were pointing at the target, as he quickly scanned to find one arrow that was correctly oriented towards the target and appeared to guess on the second one. This indicates Joe may have some difficulty in visuospatial processing, particularly in determining the orientation of lines in two-dimensional space, although impulsive responding played a role as well. This performance is consistent with the previous findings from the WISC-IV. A subsequent task required Joe to reconstruct three-dimensional designs from a two-dimensional model or picture by using blocks. Joe scored in the Borderline range (16th percentile) suggesting his visuospatial and visuomotor abilities are below expected for his age. Again, this finding is consistent with the previous findings from the WISC-IV. The next task required Joe to mentally rotate geometric shapes and determine their correct matches. Joe scored At Expected Level (37th percentile) on this task indicating his spatial-perception and mental rotation ability are at the expected level for his age. Next, Joe was required to deconstruct a picture into its constituent parts and recognize part-whole relationships, assessing his visual perception of real objects and landscapes. Similar to his performance on the previous task, Joe scored At Expected Level (37th percentile) within this task, indicating his spatial-perception is at the expected level for his age. The final task assessed Joes knowledge of visual-spatial relations and directionality, and the ability to use this knowledge to transfer a route from a simple schematic map to a more complex one. This task required him to view a schematic map leading to a target house and then to find that house in the same location on a larger map with other houses and streets, where he performed At Expected Level. Overall within the visuospatial processing domain, it was noted that Joe has difficulty in judging the orientation of lines as well as reconstructing designs from pictures; however, he appears to perform at the expected level for his age in visual scanning and mental rotation. This difference may suggest Joe has greater difficulty in tasks that require more complex planning and strategy use as well as motor integration compared to those tasks that are less demanding and do not require motor coordination. Behavior Assessment System for Children (BASC-2)

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DAVIES, Joe 11 of 26 The BASC-2 is an assessment tool that evaluates the behavior and self-perceptions of children ages 4 to 18 years. It measures numerous aspects of behavior and personality including positive (adaptive) as well as negative (clinical) dimensions. The BASC-2 provides information about a child from a variety of sources, allowing for a more complete understanding of the child. On the BASC-2, scores that fall in the Clinically Significant range suggest a high level of maladjustment. Scores in the At-Risk range identify either a significant problem that may not be severe enough to require formal treatment or the potential of developing a problem that needs careful monitoring. Joe, his mother, and his homeroom teacher, Mrs. Nayak, completed BASC-2 rating scales individually. Self Report When Joe completed the BASC-2 Self-Report of Personality, he rated himself as being in the Average range for all externalizing problems (Hyperactivity, Aggression and Conduct Problems), internalizing problems (Anxiety, Depression and Somatization), behavioural symptoms (Atypicality, Withdrawal and Attention Problems) and adaptive kills (Adaptability, Social Skills, Leadership, Activities of Daily Living and functional Communication). All validity indexes were in the acceptable range, suggesting that Joe does not believe he has any difficulties with externally directed misbehavior, internal mood problems or problems with social or other daily living skills. Teacher Report Joes grade six homeroom teacher Mrs. Nayak completed the Teacher Rating Scale. Her ratings placed him in the Clinical range on the School Problems Composite scale at the 99th percentile. This composite score is composed of two subscales: Attention Problems and Learning Problems. Mrs. Nayaks ratings placed Joe in the Clinical range for Learning Problems (99th percentile) and in the At-Risk range for Attention Problems (95th percentile). Some of the items endorsed by Mrs. Nayak included that Joe is almost always easily distracted from class work, has a short attention span, has trouble keeping up in class, has poor handwriting or printing, gets failing school grades, and has problems with spelling, reading, and mathematics. Mrs. Nayaks ratings also placed Joe in the Clinical range for Atypicality at the 95th percentile. Items endorsed by Mrs. Nayak include that Joe almost always seems out of touch with reality, sometimes has strange ideas, and sometimes says things that make no sense. Mrs. Nayaks ratings placed Joe in the At-risk range on the Adaptive Skills composite scale (13th percentile), specifically in the areas of Leadership (17th percentile), Study Skills (20th percentile), and Functional Communication (4th percentile). A few examples of items endorsed by Mrs. Nayak include that Joe never makes decisions easily, never asks to make up missed assignments, never is organized, never tracks down information when needed, and never is able to describe his feelings accurately.

Parent Report Ms. Davies completed the BASC-2 Parent Rating Scales. Her ratings did not suggest concerns with either externalizing (hyperactivity, aggression or conduct problems) or internalizing behaviours (anxiety, depression or somatization). Ms. Davies ratings did, however, place him in the At-risk

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DAVIES, Joe 12 of 26 range on the Behavioral Symptoms Index at the 84 percentile, indicating that although Joe is not causing problems for others and is not exhibiting signs that his difficulties are troubling him, he is behaving in ways that are considered odd, tends to avoid social contact and tends to be easily distracted. In terms of specific behavioural symptoms, Ms. Davies ratings indicated that he is AtRisk for Atypicality (89th percentile), Withdrawal (92nd percentile), and Attention Problems (83rd percentile). A few examples of items endorsed by his mother include often seeming unaware of others, h often prefers to be alone, and never quickly joins group activities.
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Ms. Davies indicated that her most significant concerns were in the Adaptive Skills Composite in which her ratings placed Joe in the Clinical range at the 1st percentile. Specifically, her ratings placed him in the Clinical range for Social Skills (1st percentile), Leadership (1st percentile), and Functional Communication (1st percentile). A few examples of items endorsed include never complimenting others or encouraging them to do their best, never is good at getting people to work together, and almost always has trouble getting information when needed. In addition, her ratings placed him in the At-Risk range for Activities of Daily Living at the 6th percentile. Items on this scale include skills that are associated with performing basic, everyday tasks in an acceptable manner such as almost always needing help from others to get up on time, never setting realistic goals, never attending to issues of personal safety, and never picking out clothes that match the weather. Overall, Joes mothers ratings indicate that Joe is not exhibiting behaviours that are disruptive to others and that his difficulties are not causing him clinical levels of anxiety or depression. However, he exhibits unusual behaviours, withdraws from others, and exhibits problems attending to tasks both at home and in the classroom. In addition, Joe is having difficulty developing several adaptive life skills. Conners Third Edition (Conners-3) The Conners-3 uses observer ratings to help assess a childs behavior related to inattention, hyperactivity/impulsivity, learning problems, executive functioning, aggression, and peer relations. In addition, the scale provides a total score indicative of an attention or behavioral disorder. Scores in the Very Elevated range indicate a possible significant problem and scores in the Elevated range indicate a possible concern. Parent Report Ms. Davies completed the Conners-3 Parent Assessment Report. Her ratings placed Joe in the Very Elevated range for Inattention, Learning Problems, and Peer Relations, indicating many more concerns than are typically reported. Her ratings also placed him in the Elevated range for Executive Functioning concerns. When Joes behaviour is compared to the normative group, Ms. Davies ratings indicate that he exhibits 7 out of 9 symptoms of Attention Deficit Hyperactivity Disorder Inattentive type and very few of the symptoms of other forms of ADHD, Oppositional Defiant Disorder or Conduct Disorder. When asked about the level of impairment Joe is experiencing, Ms. Davies noted that his problems very often seriously affect his schoolwork or grades and his home life.

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DAVIES, Joe 13 of 26 Overall, Joe is experiencing significant issues sustaining attention at school and at home. He is also experiencing significant difficulty with learning and making social connections with his peers. His behaviour, however is not disruptive to others, aggressive or defiant. Teacher Report Joes grade six homeroom teacher, Mrs. Nayak completed the Conners 3 Teacher Assessment Report. Her ratings placed him in the Very Elevated range for Inattention, Learning Problems, and Executive Functioning as she indicated many more concerns than are typically reported. Her ratings also placed him in the Elevated range for Defiance/Aggression. None of the behaviour descriptions suggest, however, that Joe is exhibiting any outwardly aggressive behaviours. What may have triggered this rating are avoidance behaviours, like not completing tasks that have been requested of him. The Connors-3 Teacher form provides a comparison of Joes behaviours at school to the criteria set out for various behaviour-based disorders in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV-TR). When Joes behaviour is compared to the normative group, his teachers ratings indicate that he exhibits 9 out of 9 symptoms of Attention Deficit Hyperactivity Disorder Inattentive type and very few of the symptoms of other forms of ADHD, Oppositional Defiant Disorder or Conduct Disorder. When asked about the level of impairment Joe is experiencing, his homeroom teacher noted that his problems seriously affect his schoolwork or grades very often. Conners Continuous Performance Test II Version 5 (CPT-II Version 5) The CPT-II V.5 is an assessment tool that measures an individuals sustained and selective attention and impulsivity. The individual is presented with a repetitive, boring task and is required to maintain their focus over a period of time in order to respond to targets and inhibit their responses when they are required to. Joes performance on the CPT-II indicates that the results better match a non-clinical than clinical profile of individuals with Attention Deficit Hyperactivity Disorder. The chances are 54.21 out of 100 that no significant attention problem exists. Joe made fewer omission errors than his peers (not responding when he should have) and made the average number of commission errors (responding when he shouldnt have) and had a typical reaction time. This reflects Joes difficulties attending to detail. Overall, Joes pattern of responses does not match the typical pattern of an individual with attention problems. Diagnostic Interview for Children and Adolescents Fourth Edition (DICA-IV) The DICA-IV is a complete structured interview based on the DSM-IV. It is a valuable assessment tool to supplement a clinical examination by efficiently screening for a broad range of behavioral problems in order to determine which areas need attention. The DICA yields current or lifetime diagnoses, and the latest version of the DICA is compatible with both DSM-III-R and DSMIV diagnostic systems (and can yield some ICD-10 diagnoses). The DICA has separate versions for children, adolescents, and parents. A computerized-assisted version of the DICA is also available.

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DAVIES, Joe 14 of 26 Joes mother and father completed the DICA-IV separately to further investigate difficulties that have been indicated in regards to Joes mood and emotional well-being. Parent Mother Joes mother completed the DICA-IV to evaluate reported concerns related to AttentionDeficit/Hyperactivity Disorder (ADHD), depression, dysthymia, and anxiety. In regards to ADHD, Ms. Davies indicated that Joe does meet the diagnostic criteria for Attention-Deficit/Hyperactivity Disorder. Joe demonstrates six or more symptoms of inattention that are present to a degree that is maladaptive and inconsistent with his developmental level. For example, he daydreams a lot, has difficulties concentrating at school or at home, and is often forgetful in day-to-day activities. She also indicated that the symptoms of inattention were all happening at about the same time and have gone on for six months or longer, that some of these symptoms were present when Joe was seven years old or younger, and that these behaviours are having a definite impact at home and at school. Joes mother indicated that while Joe exhibits the characteristics of an individual with ADHD Predominantly Inattentive, he does not exhibit the characteristics of an individual with ADHD Hyperactive Impulsive. In regards to a present Major Depressive Episode, Ms. Davies indicated that Joe does meet the diagnostic criteria. Joe demonstrates five or more symptoms of depression that have been present during the same two week period. For example, Joe has felt crabby, irritable, or in a bad mood a lot more than usual, has felt that way for more than two or three days, and when he felt this way, he was that way most of the day. Ms. Davies also reported that Joes sleep has been disturbed. For example, in the past month, he has been waking up a lot earlier in the morning than usual, has not been able to get back to sleep and has been sleeping a lot more than usual. Ms. Davies also indicated that Joe has felt more tired than usual and has had more trouble concentrating than normal during the past month. Ms. Davies indicated that she is not aware of recurrent thoughts of death or suicide, or of a suicide attempt or plan. She did indicate that these depressive symptoms are causing clinically significant distress and are affecting his performance at school. She also indicated that these symptoms are not due to the effects of a substance or a general medical condition or that the symptoms could be better accounted for by bereavement. It should be noted that Joes depressive symptoms could be explained by his difficulties adapting to his parents marital separation. With respect to a Major Depressive Episode in the past, Ms. Davies indicated Joe does meet the diagnostic criteria. She indicated that five or more depressive symptoms were present during the same two week period. She did not indicate that Joe was in a depressed mood most of the day, nearly every day, but did indicate that he was markedly less interested in all or almost all activities most of the day. Ms. Davies indicated that Joe had felt tired, a lot more than usual, that he felt both worthless and excessively guilty, and had trouble concentrating more than usual. She indicated that Joe had not shared thoughts of death, suicidal attempts, ideation or planning. Joes symptoms had caused significant distress and impairment at home and at school. In addition, these symptoms were not due to the effects of a substance or a medical condition and were not better explained by bereavement. It should again be noted that Joes depressive symptoms became noticeable after his parents separation and could be explained by his difficulties adjusting to his parents separation.

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DAVIES, Joe 15 of 26 In regards to Dysthymic Disorder, Ms. Davies indicated that he does meet the diagnostic criteria. Joes depressed (or irritable) mood has been present for more days than not for at least one year. She indicated that Joe has demonstrated two or more symptoms of depression such as sleep difficulties and that he has had trouble keeping his mind on things (or trouble making up his mind about things). Ms. Davies indicated that during the one year period of the disturbance, Joe has never been without symptoms for more than two months at a time. She also indicated that these symptoms have caused difficulty at home and at school during the past year. Again, Joes Dysthymic symptoms became noticeable in the past year, while he was attempting to adjust to his parents separation. In regards to Generalized Anxiety Disorder, Ms. Davies responses indicate that Joe does not meet the diagnostic criteria. Joe has not been excessively anxious or worried about a number of events or activities for more days than not for at least 6 months. Parent - Father Joes father, Mike Davies completed the DICA-IV to evaluate reported concerns related to Attention-Deficit/Hyperactivity Disorder (ADHD), depression, and dysthymia. In regards to Attention Deficit Hyperactivity Disorder (ADHD), Joes father indicated that Joe does not meet diagnostic criteria. While he does exhibit six or more symptoms of inattention that are present to a degree that is maladaptive and inconsistent with Joes developmental level (e.g. Joe doesnt seem to be listening even when spoken to directly by parents or teachers, forgets to do things, or forgets exactly what his parents ask him to do at home), he did not indicate that Joe displays any symptoms of hyperactivity or impulsivity which is similar to Joes mothers ratings. Some of these inattentive symptoms were present in Joe before the age of seven and his inattention has caused impairment at school, but that the impairment is not present in more than one setting. In addition to currently not meeting the diagnostic criteria for ADHD, Mr. Davies indicated that Joe also did not meet the criteria for ADHD in the past. In regards to a present Major Depressive Episode, Mr. Davies indicated that Joe does not currently meet the diagnostic criteria. He did indicate that Joe experiences feelings of worthlessness and inappropriate guilt. For example, Joe felt that everything he did was wrong or that nothing he did would be any good and felt that everything was his fault. Mr. Davies also indicated that Joe exhibited a diminished ability to concentrate, for example, having trouble keeping his mind on what he is supposed to be doing or seeming to have his thoughts coming a lot more slowly than usual. While Mr. Davies indicated that Joe is exhibiting some depressive symptoms, the symptoms are not severe enough to warrant the diagnosis of a Major Depressive Episode. Mr. Davies indicated that Joe has also not met the diagnostic criteria for a Major Depressive Episode in the past. Joe did not display any of the previously mentioned behaviours in the past In regards to Dysthymic Disorder, Mr. Davies indicated that Joe has not met any of the criteria. During the interview, however, Mr. Davies indicated that he has not seen Joe smile for a year. While his father did not indicate that Joe met diagnostic criteria for Dysthymia, discussion revealed that Joe had not smiled in a year and had exhibited Dysthymic characteristics since the fall of 2010.

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DAVIES, Joe 16 of 26 The results from his Ms. Davies completion of this structured interview suggest that Joe does meet criteria for Attention-Deficit/Hyperactivity Disorder, Major Depressive Disorder (past and present), and Dysthymic Disorder. In contrast, the results from his fathers completion of this structured interview suggest that Joe does not meet the criteria for any of these disorders. Both parents indicated that Joe is experiencing symptoms of depression but they differ in regards to the level of dysfunction these feelings are currently causing Joe. Ms. Davies may be more sensitive to Joes depressive symptoms as she has been diagnosed with depression and is currently on medication to treat it. Additionally, both parents indicate that Joe is more open with his mother and may be sharing his feelings more freely with her. Both parents also indicated that while Joe has always had difficulties sustaining attention, his attention difficulties have become more pronounced since the separation. Joes depressed mood may be exacerbating his pre-existing difficulties with attention, likely compounding his difficulties functioning at school. SUMMARY & DIAGNOSIS: Joes overall cognitive skills and abilities are in the Average range. His ability to understand and reason verbally is a relative strength, while he finds reasoning with visual-spatial information more challenging. Joes ability to retain auditory information in his short-term memory while he manipulates it is at the level expected for an individual his age, while his processing speed is a relative weakness as he had more difficulty completing simple visual spatial tasks quickly and efficiently. Memory is an area of relative strength for Joe. He is consistently able to remember non-meaningful and meaningful information when presented visually and verbally as well as immediately and after a short delay. In addition, he is able to both recall and recognize this information accurately. Joes performance on attention and executive functioning tasks provide some insight into his ability to plan, organize, change and control his behaviour. Joes ability to initiate tasks and switch between tasks is relatively well developed and he was able to perform tasks with suitable levels of accuracy and speed. However, he had difficulty self-monitoring his performance and made fewer self-corrections than would be expected for his age. He also experienced some difficulty inhibiting his responses when the tasks got more complex. Joes difficulties with self-monitoring and inhibition may influence his academic performance. An example of this is reflected in information from his teacher indicating that he sometimes completes incorrect lessons despite having the correct lesson listed in his agenda. In the past year, Joe also required several individual prompts to get materials out for class. Effective self-monitoring strategies may help Joe cue himself as to whether or not he is completing a task correctly. Joes academic skills in reading, mathematics, oral language, and written expression were demonstrated to be comparable to those of his peers. However, reports from his teachers and parents clearly suggest that he is currently not able to perform at this level in the classroom. In particular, his teachers note that he can tell a story or answer a question orally but has difficulty organizing written responses as well as using correct grammar and spelling. They also note that Joe can answer math questions accurately soon after a lesson but has difficulty transferring those skills or working independently. The discrepancy between what he was able to achieve during the assessment and what he is able to achieve in the school environment may be explained by attention

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DAVIES, Joe 17 of 26 difficulties. This assessment provided a unique one-on-one, low distraction environment in which tasks were presented starting with items that Joe could readily complete and then gradually became more difficult. This presentation of material helped Joe complete academic tasks to the best of his ability, but is difficult to provide in a classroom. Rating scales completed by both teachers and parents provide further evidence that Joe experiences difficulties sustaining attention. In addition, Joes tendency to withdraw from social interaction, difficulties self-monitoring his performance as well as his difficulties with functional communication skills would be more pronounced in a busy regular classroom environment than in a formal assessment environment. These characteristics would compound his attention difficulties, makes him less likely to seek assistance when he needs it, and make it less likely that a teacher would notice, as Joe does not engage in disruptive behaviour. Emotionally, Joe appears to be having a significant amount of difficulty adapting to his parents separation. His parents note that he frequently appears to be in a depressed mood, and indicated that he has shared feelings of worthlessness with them. They also stated that Joe appears to have inappropriately guilty feelings about his parents separation. Joe has been having more difficulties concentrating and being successful at school since his parents separation and his subsequent decline in mood. Overall, Joe also currently exhibits many behaviours that are congruent with those present in specific mood disorders, but these behaviours currently appear to be better explained by his difficulties with adjusting to the separation. Given the results of the current assessment, Joe meets the following criteria from the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR): Axis I Axis II Axis III Axis IV Axis V 314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type V62.89 Phase of Life Problem V71.09 No diagnosis None None GAF = 65

The Phase of Life Problem listed above refers to the difficulties Joe is having adjusting to his parents separation. At this time, his depressive symptoms are more easily explained by the separation than by a specific mood disorder, so recommendations will focus on interventions to help him adapt to the separation. In addition, Joes depressive symptoms may be making his difficulties paying attention at school more severe. Joes mood and behaviour should be monitored closely. If his mood does not improve after intervention to help him adjust to his parents separation, diagnosis of a mood disorder should be considered.

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DAVIES, Joe 18 of 26 RECOMMENDATIONS: Based on the current assessment, the following suggestions are offered for consideration: Emotional Well-Being Counseling may be very beneficial in positively impacting Joes emotional well-being. There a variety of counseling options available. Exploring one of the following options may be useful. o The Calgary Counselling Centre offers individual and group counseling for children of parents who are experiencing a separation or divorce. The Children of Divorce program (10 weeks) encourages the involvement of the entire family (children and parents), and focuses on several objectives to aid the family in adjusting to change as a result of the separation or divorce. These include developing an emotionally secure relationship between the child and the parents, facilitating shared parenting, assisting children in understanding the new family dynamics, and providing direction for building healthy, modified family units, among others. Fees are based on a sliding scale. http://www.calgarycounselling.com/programs/children_divorce.htm o Many families of children with ADHD find family counseling helpful. Often, the goals of counseling are to help set up a consistent behavior management system in the home, help the child deal with the sense of frustration that often accompanies this condition, and help siblings cope with the child's behavioral differences and need for special attention. Also, counseling can provide support and education for the parents in a frustrating and puzzling situation, while helping them to develop realistic expectations for their child. The following resources may be helpful in finding an appropriate service, such as support groups: CHADD Calgary: http://members.shaw.ca/chaddcalgary/ The LDAA: http://www.ldaa.ca/ o Joe may benefit from attending counseling with a qualified Psychologist who practices cognitive behavioral therapy (CBT) as his parents indicate that he experiences several negative emotions and thought patterns (e.g., irritability, worry, and guilt), which are significantly impacting him at school and at home. The aim of CBT is to provide an individual with strategies to enhance behavioral, cognitive, and emotional management skills, resulting in a positive impact on an individuals mood. CBT interventions normally include education about the nature of depression, identification of feelings, increasing involvement in pleasurable activities and problem solving. CBT teaches new behaviors, such as adaptive self-statements and coping skills to replace the distressing thoughts and feelings that the child is currently experiencing which are negatively affecting their mood. Explain to Joe that talking about his feelings with someone he trusts can be helpful. o He may benefit from identifying a teacher or other adult at school who he can connect with and who can serve as a mentor to provide positive feedback. o In school or at home, if it is apparent that Joe is feeling down it can be helpful to have a parent or teacher acknowledge Joes feelings by saying something like You

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DAVIES, Joe 19 of 26 look very sad today, can we talk about it? and help Joe generate some possible alternatives to dealing with his problem(s). Inattention Home Designate a consistent time and place to complete homework assignments. Homework should be completed away from distractions and nearby a parent. Encourage Joe to monitor his own on-task behavior and have a parent provide redirection as needed. Home and School Periodically check for instruction and/or concept understanding by having Joe explain the instructions and/or concept in his own words. This may be more beneficial for those tasks of greater complexity. Provide Joe a visual schedule of activities and checklists of things he needs to remember and activities that are coming up (e.g., checklists can be used for the steps of preparing for school, items to bring to or from school, or other daily routines and activities). Break down larger tasks into smaller, easier to manage components as Joe may find it easier to stay focused on these smaller, more manageable tasks. Provide this breakdown through using a visual checklist to remind Joe what is expected of him. School Incorporating Joes interests into assignments by giving him opportunities for choice (e.g., topic activity, order or tasks and materials to be used) and making tasks personally relevant may be beneficial in helping Joe maintain his attention and focus on the task. Explain to Joe what will be coming, so that he is aware of the behavior or attention expectations required of him. This includes the length of time required to stay on task or what successful work will look like. Using a visual timer or reading a clock may be helpful. Give appropriate verbal praise to let Joe know when he is behaving appropriately. Joe may benefit from being given preferential seating within the classroom to maximize his attention to instruction (i.e. seating away from distractions (pencil sharpener, door, window, etc.) in a low traffic area of the classroom). Joe may benefit from learning self-monitoring strategies, where he is taught to reflect upon his behaviour and performance, in order to support productive behavior in the classroom. (See Appendix C for self-monitoring approach example). o Self-monitoring strategies may be more effective for Joe when they address one positive behavior at a time, have clear and consistent instructions and expectations, and encourages his active participation in the process of learning the strategies (e.g., earning preferred activities and/or special privileges). o Provide positive reinforcement, such as low-key verbal praise (e.g., Great job!) and/or a reward system (e.g., gain points to be redeemed for special treat or activity) for his efforts. Additional suggestions for effective strategies for children with ADHD-I, which may be beneficial for Joe, can be found from: o The ADHD Book of Lists: A Practical Guide for Helping Children and Teens with Attention Deficit Disorders. Author: Sandra F. Rief. o LD Online: http://www.ldonline.org/

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DAVIES, Joe 20 of 26 Academic Strategies As Joe demonstrates difficulty with visuospatial processing, providing him with an outline of topics to be covered (along with key words) or a copy of class notes (rather than having him copy them down) may result in Joe paying closer attention to the lesson. Joes processing speed difficulties suggest he may take longer to learn the same amount of material compared to his peers. Therefore, providing him with accommodations such as extra time on tests or shorter assignments may be beneficial to his learning. o Help Joe become an advocate for himself by discussing possible accommodations that he may require on assignments to be successful. When Joe is showing signs of frustration in completing a task, it may be helpful to have an adult guide Joe through talking out the problem or creating a verbal script (e.g., talk through the steps required to solve a math problem and the reason for each step). o It may be beneficial for Joe and his teacher to develop a code word or signal Joe can use to let his teacher know he is feeling frustrated. Reading Comprehension: Encourage Joe to use context clues within the text (e.g., definition/restatement, examples, comparison, contrast, inference) to help him understand the meaning of unfamiliar words. Help Joe gain competency in monitoring his own comprehension and recognize when a breakdown in understanding occurs (e.g. provide Joe with a short text that contains some type of inconsistency. Ask him to retell that passage and discuss the contradiction). To help Joe read for understanding, provide him with focus questions prior to reading and encourage him to answer the questions while reading. Written Expression According to Joes teachers, he displays significant difficulty with writing. These strategies could be beneficial in addressing these challenges. Use sentence-combining exercises to help Joe write longer, more complex sentences. Ask Joe to expand orally on a sentence that he has written, adding descriptive words and phrases, additional details or more explicit adjectives. Have Joe then rewrite his sentence, incorporating his new expressions. Encourage Joe to read his paper aloud to himself when proofreading. This will help him detect usage errors. Encourage Joe to use graphic organizers (e.g., story webs) for both narrative and expository writing. It will likely be important for Joe to express his ideas first and then edit his writing after; a scribe could be used to promote expression of the story rather than the skills of writing. It may be worthwhile to explore software options (e.g., Read, Write, Gold or Dragon Naturally Speaking), which would allow Joe to increase his written output as well as help with the mechanics of writing, such as spelling and grammar. Math According to Joes parents, he experiences difficulty when working on math homework. These strategies may be beneficial in helping to reduce his frustration. Encourage Joe to use scratch paper whenever he works on word problems to decrease his tendency to attempt word problems mentally.

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DAVIES, Joe 21 of 26 Before Joe takes home math assignments, ensure he understands the directions and process for solving the problems. This should include having Joe explain the directions and process in his own words to ensure his understanding. It may also be beneficial for Joe to write out the steps in order to help him remember and give him with a visual prompt to refer to at home. Place a limit on the amount of time Joe is to work on math homework in order to maintain motivation and reduce frustration. If possible, grade his work on a percentage basis, using the number of items he has completed as the total number of possible points.

It was a pleasure to have had the opportunity to have worked with Joe. I trust that the information contained in this report, as well as the recommendations provided above, will aid in providing him with the most appropriate educational and social-emotional opportunities. If you have any questions regarding this report or if you require any assistance in implementing the programming suggestions, please do not hesitate to call me.

_______________________

_____________________________

Tara Crumpler, B.A. Doctoral Student, U-CAPES Clinician

Adam McCrimmon, Ph.D Registered Psychologist

______________________________

Joanna Johns, B.Sc. B Ed. M.Ed. Student

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

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DAVIES, Joe 22 of 26 Appendix A. Wechsler Intelligence Scale for Children, 4 Edition The Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) is an individually administered, comprehensive clinical instrument for assessing the intellectual abilities of children ages 6 years, 0 months through 16 years, 11 months. The WISC-IV provides composite scores that represent intellectual functioning in specified cognitive domains (i.e., Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Processing Speed Index (PSI)). Lastly, the WISC-IV provides a composite score that represents a childs general intellectual ability (i.e., Full Scale IQ (FSIQ)). Percentile scores, scaled scores, and confidence intervals are also provided to assist in interpretation. The FSIQ and Index scores have a mean of 100 and a standard deviation of 15. Each of the subtests has a mean of 10 and a standard deviation of 3. The subtests can be broken down as follows:
th

Verbal Comprehension Index (VCI): is composed of subtests measuring verbal abilities utilizing reasoning, comprehension and conceptualization. Similarities, Vocabulary and Comprehension are the three core subtests that comprise the VCI, and Information and Word Reasoning are the two supplemental subtests of the VCI. Perceptual Reasoning Index (PRI): is composed of subtests measuring perceptual and fluid reasoning, spatial processing, and visual-motor integration. Block Design, Picture Concepts and Matrix Reasoning comprise the three core subtests of the PRI, and Picture Completion is the sole supplemental subtest of the PRI. Working Memory Index (WMI): is composed of subtests measuring attention, concentration and working memory. Digit Span and Letter-Number Sequencing comprise the two core subtests of the WMI and Arithmetic is the sole supplemental subtest of the WMI. Processing Speed Index (PSI): is composed of subtests measuring the speed of mental and graphomotor processing. Coding and Symbol Search are the two core subtests that comprise the PSI, and Cancellation is the sole supplementary subtest of the PSI. The results of the Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Processing Speed Index (PSI) are reported in the following tables. The scores on the WISC-IV have a mean of 100 and a standard deviation of 15.

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DAVIES, Joe 23 of 26 Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) Composite Standard Scores Summary Composite Scale Standard Score 95% CI Percentile Verbal Comprehension Index 104 96-111 61 Perceptual Reasoning Index 81 75-91 10 Working Memory Index 97 89-105 42 Processing Speed Index 80 74-90 9 Full Scale IQ (FSIQ) 88 83-94 21

Classification Average Low Average Average Low Average Low Average

Subtest Scores Verbal Comprehension Index Similarities Vocabulary Comprehension Perceptual Reasoning Index Block Design Picture Concepts Matrix Reasoning Picture Completion Working Memory Index Digit Span Letter-Number Sequencing Processing Speed Index Coding Symbol Search

Subtest Scaled Scores Summary Scaled Score Percentile 9 10 13 5 8 8 5 9 10 6 7 37 50 84 5 25 25 5 37 50 9 16

Classification Average Average High Average Borderline Average Average Borderline Average Average Low Average Low Average

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DAVIES, Joe 24 of 26 Appendix B. Wechsler Individual Achievement Test, 3 Edition The Wechsler Individual Achievement Test, Third Edition (WIAT-III) is a rich and reliable source of information about an individuals academic skills and problem-solving abilities that can be used to guide appropriate intervention. It is a comprehensive yet flexible measurement tool useful for achievement skills assessment, learning disability diagnosis, special education placement, curriculum planning, and clinical appraisal for preschool children through adults. The WIAT-III provides composite scores that represent academic ability in several domains (i.e., Reading, Mathematics, Written Communication, and Oral Communication). Percentile scores, scaled scores, and confidence intervals are also provided to assist in interpretation. The Composite and Scaled scores have a mean of 100 and a standard deviation of 15. The composites can be broken down as follows: Total Reading Composite: is composed of subtests measuring pre-reading, reading, and decoding skills. Word Reading, Reading Comprehension, Pseudoword Decoding, and Oral Reading Fluency are the subtests in this area. (Note: Oral Reading Fluency is not used in the calculation of the Total Reading Composite for students in Kindergarten and Grade 1). Basic Reading Composite: Word Reading and Pseudoword Decoding are the two subtests in this area. Reading Comprehension & Fluency: Reading Comprehension and Oral Reading Fluency. Mathematics Composite: is composed of subtests measuring the ability to evaluate and write numbers, to solve written calculation problems, identify geometric shapes, solve multi-step problems, and identify mathematical patterns. Numerical Operations and Math Reasoning are the two subtests in this area. Math Fluency: is composed of subtests measuring how quickly and accurately students can complete math questions. Separate scores can be derived for Addition, Subtraction and Multiplication (Grades 3-12). Written Expression Composite: is composed of subtests evaluating spelling and written communication including sentence and paragraph construction. Spelling, Alphabet Writing Fluency (Grades K-2), Sentence Composition (Grades 1-12), and Essay Composition (Grades 3-12) are the subtests in this area. Oral Language Composite: is composed of subtests measuring the ability to listen for details, generate a word that matches a given picture and oral description, generate stories from visual cues, and generate directions from visual or verbal cues. Listening Comprehension and Oral Expression are the two subtests in this area.
rd

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DAVIES, Joe 25 of 26 Wechsler Individual Achievement Test, Third Edition (WIAT-III) WIAT-III Subtest and Composite Scores Summary Subtest or Composite ORAL LANGUAGE Oral Language Composite Listening Comprehension Oral Expression READING Total Reading Composite Reading Comprehension Word Reading Pseudoword Decoding Oral Reading Fluency WRITTEN EXPRESSION Written Expression Composite Sentence Composition Spelling Essay Composition MATHEMATICS Mathematics Composite Math Problem Solving Numerical Operations *Math Fluency Composite Math Fluency Addition Math Fluency Subtraction Math Fluency Multiplication TOTAL ACHIEVEMENT Standard Score 95% CI Percentile Classification

94 91 100

84-104 79-103 88-112

34 27 50

Average Average Average

94 89 106 98 94

90-98 79-99 100-112 91-105 87-101

34 23 66 45 34

Average Low Average Average Average Average

90 82 92 103

83-97 72-92 86-98 93-113

25 12 30 58

Average Low Average Average Average

93 94 94 99 105 101 91

86-100 86-102 85-103 93-105 94-116 91-111 81-101

32 34 34 47 63 53 27

Average Average Average Average Average Average Average

92

88-96

30

Average

*not included in the Total Achievement Score

Empowering People Building Strengths

DAVIES, Joe 26 of 26 Appendix C Sample Self-Monitoring Approach

The following self-monitoring approach may be beneficial for Joe in the home, school, or community environment: (1) Identify and Define the Behaviour of Concern In this first step a target behaviour is discussed, for example, completion of assignments during class time. The target behaviour must be agreed upon by the teacher and Joe. (2) Design the Self-Monitoring Procedures, Including a Monitoring Form In this step, Joe is provided with a simple self-recording data sheet that indicates the blocks of time to be monitored. This form would include name, date, the time blocks and a way to record if the targeted behaviour was present or not. For the example of completing assignments during class, there may be two columns, completed and not-completed, where Joe could indicate the status of the assignment provided during class. (3) Teach the Student the Self-Monitoring Procedures Provide Joe with direct instruction on how to complete the self-monitoring form. The teacher may model, coach, and role-play in order to explain the monitoring form. At the beginning of each time block, Joe should be provided with a reminder to complete the form. The teacher may select to use reinforcement along with the self-monitoring form to encourage Joe to complete the form and build self-monitoring skills. For example, the teacher may setup that if Joe is able to successfully record a time block on the selfmonitoring forms, he may earn a preferred activity (i.e., computer time at the end of class). (4) Monitor Student Progress Before introducing Joe to self-monitoring strategies, it is important to determine how often the target behaviour occurs. This baseline of Joes behaviour will help when comparing his performance before and after teaching self-monitoring strategies. By doing this, the teacher will be able to evaluate if the self-monitoring strategies are having a positive impact and increasing Joes productivity in class. The teacher will be able to modify the strategies based on this information. Another important component is for Joe to track his own progress, for example, graphing the percentage of assignments completed during class per day. In this step, the teacher and Joe collect data independently, and review their findings together. (5) Maintenance and Follow-Up When Joe is consistently using self-monitoring strategies and the result is an increase in the desired behaviours, the self-monitoring strategies should be faded over time, as the goal is for Joe to actively engage in self-monitoring strategies without support or reinforcement from teachers, parents, or community members. To fade the self-monitoring strategies, the time blocks may be slowly gradually increased from several times a day, to a few times per day, until it is not occurring at all, and Joe is able to reflect upon his thoughts and behaviours independently.

Empowering People Building Strengths