Storm, Johnny Page 1 of 13

University of Calgary

Name: Johnny Storm Parents: Raphael and Tracey Storm Age: 10 Years, 9 Months Address: 14 City Drive Grade: 5 City: Chicago, IL School: Home Schooled Telephone: (149) 555-7421 Assessment Dates: Feb. 28th, March 11th, 18th, 2008 Evaluators: Adam McCrimmon, M.A., Registered Provisional Psychologist #584p

PSYCHOEDUCATIONAL SUMMARY 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 the related judgments and decision- making. The intent of this report is to provide opinions and recommendations in the context o f legal decision-making in this particular matter, 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.

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Reason for Referral Johnny was referred for a psychoeducational assessment by (his) mother, Tracey Storm. During the intake interview, concerns regarding learning and academic difficulties were expressed. Specifically, Johnny struggles with word reading and understanding of phonetics, and finds written expression difficult. He has had mild speech and language difficulties since an early age, and has received group reading assistance in Grade 4, however he continues to struggle to keep pace with his classmates as it pertains to reading, writing and math. Background Information Background information was gathered from a number of sources including Mr. and Ms. Storm. Family Information Information regarding the Storm family was gathered during a semi-structured interview and information provided by the parents in the Structured Developmental History (SDH) form of the BASC-2. Johnny, a 10-year-old English-speaking male, is the second of four children born to Raphael and Tracey Storm of Chicago, Il. According to Mr. and Ms. Storm, Johnnys older sister, who is in grade 7, demonstrates many of the same academic difficulties as Johnny. His younger brother, who is currently in grade 3, reportedly demonstrates behavioural issues. The youngest sibling currently is in pre-school. Family Psychological or Educational History Mr. Storm is currently employed as an operations manager, while Ms. Storm is a full-time caretaker and educator for her children. Both Mr. and Ms. Storm completed Grade 12. Ms. Storm indicated that neither parent experienced any academic difficulties. Ms. Storm reported that she experienced post-partum depression and continues to experience symptoms of anxiety. Prenatal, Perinatal and Early Developmental History Mr. and Ms. Storm provided information regarding Johnnys developmental history during the semi-structured interview and through the SDH form of the BASC-2. The pregnancy was a planned one. No alcohol and 4-7 cigarettes per day were consumed during the pregnancy. Johnny was born at 40 weeks

Storm, Johnny Page 3 of 13 gestation weighing 6 pounds, 14 ounces, without complications. The AGPAR scores was not provided by either parent. Johnny achieved the majority of developmental milestones in a typical sequence, however he experienced mild speech and language difficulties since an early age. Medical History Mr. and Ms. Storm indicated that Johnny experienced inner ear problems from an early age, and required myringotomy tubes placed at 18 months of age. These were re-applied when he was 3, 4, 5, and 6 years old. Furthermore, at the age of 2, Johnny underwent a tympanoplasty to correct a perforated eardrum. Educational History According to Mr. and Ms. Storm, Johnny began school at kindergarten. He continued in the public school system until Grade 4. Throughout this time, Johnny received group reading assistance in response to his reading struggles, however no significant progress in this area was noted. As well, he received speech and language (SLP) support for articulation and vocabulary development. In September 2007, Johnny was switched to a home-school setting for his Grade 5 year. Previous Assessments Johnny participated in a speech and language assessment in the winter of 2005. Results of this evaluation indicated mild difficulties with expressive language There have been no previous psychological or psychoeducational assessments. Assessment Methods Given the referral concerns and information gathered through the interview, an evaluation of cognitive, academic, memory, visuospatial, language, attention, and behavioral difficulties was conducted. This included:

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SEMI-STRUCTURED INTERVIEW Tracey Storm, Mother DIRECT ASSESSMENT Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV) Wechsler Individual Achievement Test - Second Edition (WIAT-II) KeyMath Revised/Updated Canadian Norms (KeyMath R/NU) Childrens Memory Scale (CMS) NEPSY: A Developmental Neuropsychological Assessment Second Edition (selected subtests) (NEPSY-II) Clinical Evaluation of Language Fundamentals - Fourth Edition (CELF-4) Continuous Performance Test Second Edition (CPT-II) OTHER REPORTS Behavior Assessment for Children, Second Edition (BASC-2) (PRS- Parent Rating Scales completed by Tracey Storm) (SRP Self Report-Child completed by Johnny) February 16th, 2008 February 28th, 2008 February 28th, 2008 March 11th, 2008 March 11th, 2008 March 11th, 2008 February 28th, 2008

March 11th, 2008 March 18th, 2008

Assessment Observations Johnny was open and engaging during initial contact. He expressed some hesitation to participate in the evaluation process immediately upon introduction, however was receptive to the evaluators explanation regarding the purpose and nature of the assessment. Johnny struggled on some areas of testing

Storm, Johnny Page 5 of 13 and became visibly frustrated, however he continued to persevere throughout. It is believed that the results reported are an accurate reflection of Johnnys current skill level in the areas evaluated. Assessment Findings Findings reported in this section will be discussed in terms of percentile rank (PR). PR is used in comparing Johnnys score to the scores of other children similar to him (i.e., age, grade) who have taken the test. PR will provide a scores denoting the percentage of children achieving a score that is less than or equal to Johnnys score. It should not be interpreted to mean the percentage of questions Johnny answered correctly. A PR between the 25th and 75th percentile signifies ability in the average range. A PR above 85 is considered to be a personal strength whereas a PR below 11 is considered to be a relative area in need of support. General Intellect General intellectual functioning refers to an individuals ability to process information. Johnnys intellectual functioning was evaluated using the Weschler Intelligence Scale for Children Fourth Edition (WISC IV). Johnny demonstrated differing abilities assessed by this measure. As such, each of these will be explored independently. Johnnys ability with verbal information was in the average range at the 27th percentile. He is able to process and reason with information he receives verbally with little difficulty. Johnnys ability to process and reason with non-verbal (visual) information was in the below average range at the 13th percentile. Given this, Johnny will struggle somewhat when presented with visual information in the classroom. Specifically, Johnny demonstrated difficulty on tasks asking him to manipulate coloured blocks to re-create a design. He scored in the extremely low range on this task at the 4th percentile. Johnnys scores in the Picture Concepts subtest and the Matrix Reasoning subtest both fell in the average range. Johnnys working memory ability, or the ability to hold information in memory and process it, was in the borderline range at the 6th percentile. Given this, Johnny will have significant difficulties retaining and manipulating information he receives in the short-term at a level equivalent to his peers. His score on the digit span subtest was in the extremely low range at the 5th percentile, while his score on the letternumber sequencing subtest fell in the low-average range, with a percentile score at the 7th percentile. Johnnys processing speed, or the ability to rapidly process information, was in the average range at the 58th percentile. He is able to process information as quickly as his peers.

Storm, Johnny Page 6 of 13 Finally, Johnnys Full Scale IQ score was in the low-average range at the 16th percentile. This indicates that his intellectual functioning is at a level slightly below that of his peers. In total, Johnny presents as an individual who is capable of receiving verbal information and processing it quickly. However, he demonstrates modest difficulties in processing and reasoning with non-verbal (visual) information, and has significant difficulties with retaining, recalling and processing information tasks, especially if the information is presented to him visually. Academic Achievement Johnnys academic skills, including reading, mathematics, and writing were assessed with the Weschler Individual Achievement Test Second Edition (WIATII), the KeyMath Revised/Updated (Canadian Norms), the Clinical Evaluation of Language Fundamentals Fourth Edition (CELF-4), and Peabody Picture Vocabulary Test Fourth Edition (PPVT-4). Administration of the WIAT-II revealed that Johnnys reading ability was in the borderline range at the 4th percentile. He experienced difficulty in asking him to sight-read words of increasing difficulty, scoring in the borderline range on this subtest. He also demonstrated difficulties on a task asking him to read a list of nonsense words, which requires an understanding of phonetics. Johnny scored in the borderline range on this task also. Johnnys ability to express himself through written language was in the extremely low range at the 2nd percentile. Within this, he demonstrated significant difficulties with his ability to spell words, and his scores in this subtest fell within the borderline range. However, his ability to express concepts and ideas was better developed in the low-average range. Furthermore, administration of the CELF-4 receptive language composite scale resulted in scores in the borderline range at the 5th percentile. Further to this, receptive vocabulary scores on the PPVT-4 fell in the low-average range at the 23rd percentile. This measures his verbal ability, independent of his reading ability. As such, Johnny may experience more difficulties than his peers in expressing ideas and concepts in writing, while having more difficulties than his peers at also reading, understanding and processing verbal information presented to him. Johnnys mathematics composite scores were in the borderline range at the 3rd percentile. He demonstrated difficulties with numerical operations, which measures his knowledge of general arithmetic and mathematical concepts; and math reasoning, which measures his ability to problem-solve with mathematical terms. Scores across both subtests fell in the borderline range. As such, he will struggle to maintain pace with his peers and likely experience frustration in this setting. Administration of the

Storm, Johnny Page 7 of 13 KeyMath-R/NU (Canadian Norms) confirmed difficulties across a number of areas. Johnny scored in the borderline range at the 8th percentile in the basic concepts composite scale, which measures an individuals ability to understand numerical systems including fractions and spatial relations. Further to this, Johnny scored in the borderline range at the 5th percentile in the operations composite, with particular difficulties in the subtraction (5th percentile borderline range) and mental computation (5th percentile borderline range) subtests. Scores on the applications composite scale fell in the below average range at the 9th percentile. This indicates problems grasping information related to measurement, time and money, estimation, interpreting data and problem solving. These scores further lend credence to Johnnys struggles with mathematics concepts. In total, Johnny struggles with reading and math concepts, and to a lesser extent with written language tasks. It should be noted that these skills are primarily visually oriented, and therefore his difficulties in these areas are not unexpected given his demonstrated struggles in reasoning with visual information in particular. Memory Johnnys ability to hold information in his mind temporarily and recognize or recall this information was assessed using the Childrens Memory Scale (CMS). His ability to immediately remember visually-presented information was in the average range at the 58th percentile while his ability to remember visual information following a delay was in the average range at the 66th percentile. When presented with information verbally, his ability to remember it immediately was in the average range as well at the 66th percentile, however it improved following a delay to the high average range at the 84th percentile. Specifically, his scores in the word pairs long delay subtest fell in the above average range. Taken together, Johnny does well to consolidate information presented to him, and has particular strength in the area of verbal recollection, i.e., recalling information presented in the verbal format. Johnnys scores in the attention/concentration composite fell in the borderline range at the 3rd percentile. This measures working memory, attention and processing speed. His scores fell in the low range in the numbers total subtest, while his scores in the sequences total subtest fell in the below average range. This indicates that he will struggle to keep up with his peers as it pertains to his ability to focus on numerical information presented to him, consolidate it, recall information, and process information as quickly as his peers.

Storm, Johnny Page 8 of 13 In total, Johnny appears to possess effective memory skills for either visual or verbal information when able to concentrate on the information presented. Likely he will require extra time to consolidate new information in a low-distraction environment, and may benefit from cues to keep him on task. His performance improves when asked to recall verbal information especially rather than in a recognition situation. Visual-Spatial Abilities Visual-spatial processing involves a host of related components including abilities to solve nonverbal problems, represent objects mentally, discriminate between objects, distinguish between left from right, understand the relationship between objects in space, etc. Johnnys thinking ability was measured with A Developmental Neuropsychological Assessment Second Edition (NEPSY-II). Within this, his scores in the attention/executive subtests were in the average range, with Inhibition Switching Total Completion Time scores in the high-average range. Administration of the language subtests led to scores in the below average range in phonological processing, with scores in the low-average range for speeded naming combined. Johnny scored in the average range for repetition of nonsense words and speeded naming completion time. Johnny struggled with the arrows subtest, scoring in the extremely low range, while ironically, he scored in the superior range in the design copying subtest. Sustained Attention Sustained Attention is the ability to stay on task during continuous or repetitive activity. In the classroom there are many tasks that require Johnny to focus and remain on task in spite of numerous distracters within the environment. These activities may be continuous, uninteresting and repetitive, such as completing arithmetic calculations, for example. For this task, he looked at a computer screen that had letters pop up in varying intervals. He was required to press the space bar on the keyboard as quickly as possible after each letter except for the letter X. The task was administered twice to test for consistency. The Confidence Index indicates that there is an equal likelihood that Johnnys performance matches either a clinical or non-clinical profile. Examining Johnnys performance further showed an indication of Commission percentage errors and Detectability errors, which both fell within the markedly atypical range, respectively. He had good performance scores on the Hit Rate Block Change and Hit SE ISI Change measures, respectively. Johnnys score on the Summary of Inattentive Measures indicated

Storm, Johnny Page 9 of 13 Inattention on the Commissions measure and Detectability measure as well. His Summary of Impulsivity Measure score in the Commissions measure fell in the Impulsive range. His performance on all other measures on this test was within the average range. Behavioural Assessment Johnny and his mother completed their respective forms of the Behavioural Assessment for Children, Second Edition (BASC-2) which provides a measure of a childs potential problematic behaviours in the home and school settings. The parental (PRS-A) form indicated that Johnny may be experiencing externalizing problems, such as hyperactivity, aggression and conduct problems; and, internalizing problems, such as depression, and to a lesser extent, anxiety and somatization. Johnnys selfreport (SRP-A) indicated that he experiences problems with respect to his attitude to school, atypicality, locus of control, anxiety, depression, and sense of inadequacy. These all fall within the Internalizing Problems composite. Furthermore, Johnny endorsed two other items indicating he experiences difficulties with attention problems and hyperactivity. As such, it is highly likely that this negatively impacts upon his academic performance. Summary of Findings Johnny presents as an open and engaging young boy experiencing academic difficulties. He is a boy of low-average ability, and may require extra support and assistance in grasping new concepts and acquiring skills compared to his same-aged peers. As such, it is expected that his learning rate will be slower than many of his classmates. He struggles when required to process visual information especially, and has difficulties in retaining and/or recalling visual information. In the academic setting, Johnny has difficulty with reading and arithmetic tasks both of which are symbolically based. He demonstrates an unawareness of many phonological processes and mathematical operations, and struggles with the ability to hold information in memory and process it, i.e., working memory. Despite this, he is very capable of expressing himself verbally, and can excel when doing so. He does demonstrate externalizing problems such as aggression, hyperactivity, and conduct problems; and internalizing problems such as symptoms of depression , anxiety and atypicality, and these are likely influenced by his perceptions of his academic skills and associated barriers to success.

Storm, Johnny Page 10 of 13 Diagnostic Summary Taken together, the results of this assessment suggest that Johnny has a non-verbal learning disorder (NLD). This is characterized by a persistent difficulty in processing and understanding information presented non-verbally. For example, reading and mathematics are difficult due to their underlying symbolic structure. The ability to understand and form concepts and abstract reasoning is difficult and individuals may find it challenging to generalize learned concepts to other appropriate contexts. It appears that Johnny encompasses many of the aforementioned academic characteristics. Individuals with NLD frequently demonstrate physical awkwardness and have difficulties with perception and comprehension of non-verbal cues or communication, including gestures, tone of voice, body language, etc. This may result in increased problems associated with social interaction. This may further lead to a manifestation of symptoms of anxiety, depression, and self-esteem issues as these individuals become more aware of their challenges. This certainly appears to be true with respect to Johnnys behavioural presentation. In addition to this, the results of this assessment indicate that Johnny demonstrates a possible reading learning disability. His skills with word reading and phonological awareness remain largely undeveloped. This results in significant difficulties with reading. It is hoped that with an increased understanding of specific areas in need of support and efforts to address them, that these feelings of academic anxiety will subside. Recommendations In light of the results of the standardized evaluation and the behavioural patterns shown, the following are recommended for Johnny: 1. Reading/writing/arithmetic Johnny struggles with reading as a result of a lack of phonemic awareness, rules of written language, and sight-word knowledge. To address this, it is recommended that Johnny participate in an extra-curricular reading program that addresses his specific needs in this regard. Furthermore, Johnny should be encouraged to read more often by allowing him opportunities for choice as it pertains to reading materials that he finds interesting, i.e., the sports section of the daily newspaper, etc. This could be encouraged further by engaging him in fun activities that involve reading practice. Examples of this may include participation in

Storm, Johnny Page 11 of 13 specific board games such as Scrabble, or trivia games; word-based video games, such as Pokemon, etc., and crossword puzzles. In addition, Johnny should be encouraged to read as often as possible, ideally on a daily basis, so that he can practice and improve his skills in this area. It is important to consider that he should not be placed in a position to fail by being asked to read material that is too advanced for him. Rather, his motivation to continue reading will be piqued by realizing small successes, especially at the early stages of the trial process. His success in this area will encourage him to continue reading at gradually more advanced levels. Consideration should be given to providing Johnny with extra time to complete tests or assignments in the written format to accommodate his deficits in this area. Failing that, consideration should be given to the possibility of having test materials and assignments dictated into an audio format. This would help compensate for his reading struggles and encourage a more accurate reflection of his learning across subject areas. Additionally, the Learning Disabilities Association should be contacted in order to determine available resources and programs that may be of assistance to Johnny. Similarly, Johnnys writing problems can be addressed by encouraging him to practice his writing skills on a regular basis. This too should be done in a way that is interesting and fun for him, i.e., by establishing a pen-pal relationship, by writing short stories related to subject areas that are interesting to him, writing daily emails to friends or relatives, etc. It may also be of benefit to encourage the use of a computer, which would serve as a motivational tool, i.e., reinforcer, while being functional insofar as he can utilize a word processing program that has available spell-check, thesaurus and dictionary features. Finally, Johnny would benefit from extra practice with arithmetic exercises and activities. It may be useful to consider the services of a tutor to spend time with him on a daily basis for the purposes of arithmetic practice. Ideally, Johnny should be encouraged to use functional and relevant life examples as a source for arithmetic motivation. In other words, he should practice math exercises in such a way that they are meaningful, and therefore interesting to him. The services of a tutor would be helpful in gradually encouraging him to attempt problems that he may initially find daunting, while providing reinforcement for his efforts, and ongoing feedback as it pertains to the areas of need. 2. Cognitive Strategies

Storm, Johnny Page 12 of 13 Metacognition refers to an individuals understanding of his/her own learning processes and effective learning strategies. Most people acquire the ability to recognize how they learn best, what strategies are most effective for their learning, and what strategies are least effective. Given his demonstrated difficulties, it will be important for Johnny to recognize when he is not learning presented material and seek out assistance for alternate avenues for increasing his understanding. This can include simple tasks such as asking the teacher (his mother) for clarification or help. These efforts must be verbally reinforced, while also being reinforced by tending to his request whenever possible. This will encourage him to request assistance freely, as necessary, thereby limiting the impact of possible social and self-esteem barriers associated with doing so. It is important for Johnny to identify which learning strategies are best suited for him and utilize these strategies appropriately, as often as required. 3. Environmental (Classroom) Modifications Johnny demonstrates difficulty when information is presented visually. As such, it is important to consider presenting information in a multi-modal format, i.e., verbal, gestural, hands-on, etc. This will enhance his ability to understand and process information presented to him by providing multiple methods by which information is received. For example, math class can be taught via the use of verbal instruction, in conjunction with the use of manipulatives and visual cues. Furthermore, Johnny will also benefit from access to an available audiotape recorder so that he can review material and content, as necessary, as a means of consolidating information. If possible, copies of materials should be provided directly to him to review at his own pace, and if feasible, the services of a tutor or study buddy may be helpful in encouraging active involvement and effective study habits as it pertains to academic tasks. Finally, the use of a highly structured daily schedule would be helpful in encouraging effective study habits, and completion of academic tasks by increasing levels of consistency, predictability and security. 4. Motivation It is highly recommended that Johnny be reinforced regularly contingent upon meeting preestablished academic demands. This may include daily task completion goals, goals associated with identifying and requesting help when required, remaining focused and staying on task,

Storm, Johnny Page 13 of 13 etc. It is important to encourage Johnny to persevere through the ongoing academic barriers he must face, while fostering a sense of accomplishment and success. Established goals should be challenging, yet achievable, so as to encourage successful outcomes. Lastly, Johnnys strengths, academic or otherwise, should be stressed so that he does not feel overwhelmed and his experiences remain positive. He should be encouraged to engage in and pursue activities that he enjoys and succeeds in. 5. Psychological Functioning It is advisable to seek out the services of a counselor with expertise on childhood externalizing and internalizing disorders, and behaviour consultant. Johnny may benefit from participation in a psychoeducational group, and ongoing consultation to address his issues with aggression and outburst behaviours, and symptoms of depression and selfesteem issues. Further to this, it is advisable to seek out a developmental pediatrician in order to determine to what extent Johnny would benefit from medication therapy. Thank you for the opportunity to work with this pleasant young man. Sincerely,

Pat Veleno, B.Sc. Masters Student