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Date(s) of Assessment: May 6 & 22, June 5 & 8, 2015
Date of Report: June 10, 2015

Doe, John

Birthdate (M-D-Y):
School Contact:

13 years, 3 months
7 – regular education
YYY & ZZZ Doe (Adoptive Parents)

John is a Grade 7 student at Xxxx and has a history of difficulties in his
learning, despite the support and instruction provided in his current and previous school
placements. In addition, concerns have been raised with regards to John ’s attention,
impulsivity and behavioral responses to academic and daily expectations. A
psychological assessment was undertaken to assist in the planning and programming
recommendations for John and identify possible factors that represent obstacles to his
Kindergarten (2006-2007): xxxx
Kindergarten – Grade 7 (September 2007-May 2015): xxxx
John ’s background history was compiled via telephone interview with Mrs. Doe
on May 4, 2015 and review of archival documentation on his school file. John lives at
home with his adoptive parents, Mrs. and Mr. Doe, as well as his adoptive siblings, older
sister Jane Doe (14) and younger brother John Doe (7). The main language spoken in
the home is English.
Mrs. Doe described John ’s prenatal, birth, medical, and developmental histories
to the best of her knowledge. Mrs. Doe indicated John ’s mother consumed alcohol

Doe, John

and used marijuana during her pregnancy. John
was born with marijuana in his
system. Details of any complications or difficulties with the pregnancy, labor and delivery
were not known. John
was apprehended at birth and placed in foster care with his
current family when he was 10 days old. He was apprehended from his mother’s care
due to neglect and an inability to provide adequate care. His foster parents adopted him
in 2012. Mrs. Doe reported that John was hospitalized and placed on a feeding tube
shortly after birth, as he did not have a good sucking reflex. It was also noted that John
did not attain his developmental milestones on time. He was delayed with his speaking,
walking, and using 2-3 word sentences.
Mrs. Doe described John
as a loving and caring child who becomes easily
angered and frustrated. John reportedly enjoys school and has expressed interest in
social studies. Mrs. Doe indicated that homework expectations were challenging John
too much, causing him to become frustrated at home so she requested that John no
longer receive any. As requested by the school, John is also exempt from exams, but
writes classroom tests with modifications. Socially, Mrs. Doe reported that John does
not have many friends. It was noted that he sometimes self-harms and exhibits general
acting out behaviors when angry or upset. Mrs. Doe indicated that self-harming
behaviors include banging his head on hard surfaces, for example the wall, and choking
himself. Identified triggers include his brother John
Doe, transitions and change, as
well as when he has to stop doing an activity he enjoys, such as playing video games.
Generally, John
has had good physical health through his childhood, but
experiences a great deal of discomfort associated with eczema in his ears. John has
been hospitalized several times. Two hospitalizations have been due to side effects
associated with his medications, which were said to cause him to experience visual and
auditory hallucinations. While another hospitalization was due to wax build up in John ’s
ears. Though John has eczema in his ears, as well as issues with wax build up, his
hearing is reportedly normal as well as his vision. Mrs. Doe reported that John has a
fussy appetite, often sneaking snacks and junk food outside of regular eating hours.
She also noted that it is not out of the ordinary for John to request a separate meal for
dinner if he does not like what is being prepared. John also has difficulties sleeping,
requiring the use of melatonin and Clonidine to help him fall asleep. On average, Mrs.
Doe indicated she believes John sleeps approximately 4-6 hours a night. In addition to
Clonidine, John
also currently takes Vyvanse. This helps manage symptoms
associated with ADHD.
John was initially assessed for his speech and language development in June
2003, at the age of 17 months. He was referred for an assessment due to a limited use
of language, as well as difficulties with understanding his speech. In order to address
these speech and language difficulties, he began receiving SLP supports. John began
attending SLP therapy sessions to improve his speech articulation and moderate
language delay. School files indicate that he began receiving these supports in 2003,
and it was noted that excellent progress had been made with only mild language delays
being reported. However, John was suspended from SLP services in June 2013, due
to minimal engagement.

Doe, John

In addition to speech and language assessments, John has been referred for
formal psychological testing on a number of occasions. In February 2005, psychologist
B assessed John with regards to concerns regarding aggressive behaviors, disruptive
conduct, oppositional and defiant behaviors, and difficulties with inattention,
hyperactivity, and impulsivity. John was assessed again in October 2005 by Dr. L, to
determine if he presented with ADHD, ODD, and/or Autism. Findings from this
assessment determined that the probability that John
had ADD was significantly
higher than the rest of the population, but a diagnosis of Autism and ODD were ruled
out. In May 2006 John was referred for a psychiatric consultation by Dr. P, due to a
suspected stimulant psychosis. Dr. P diagnosed John
with severe ADHD and
recommended a change to his medication. While attending Kindergarten at XXXX in the
fall of 2006, John
was referred for assessment again for concerns about his
aggression and physical safety. He was assessed by Dr. T in October 2006. Dr. T
suggested that John
exhibits behaviors that are consistent with a Severe
Behavioral/Emotional Disability, as defined by Alberta Education, as well as oppositional
and conduct disorder type problems, hyperactivity, aggression, and depression. In
September 2007, John repeated Kindergarten, but switched to XXXX with the Calgary
Catholic School Division. He was assessed again, but this time by psychologist R. Mrs.
R did not provide a diagnosis, but indicated that John met the diagnostic criteria for a
Code 42, Severe Emotional and Behavioral Disability. In April 2008, John
assessed by Dr. Y. Dr. Y determined that John
scored in the Clinically Significant
range in terms of oppositional behaviors, hyperactivity, anxious-shy behavior, emotional
liability, and on the ADHD index. Dr. Y provided a diagnosis of ADHD and ODD.
In November 2008 and January 2009, John
was formally referred for a Fetal
Alcohol Syndrome (FAS) Evaluation at MediGene Services. He was assessed by a
team of clinicians including Dr. J (Geneticist/Pediatrician), S (Registered Psychologist),
T (Registered Nurse/Clinical Coordinator), and J (Special Education Teacher/Program
Manager). John
was thoroughly assessed over several domains including his
cognitive functioning, his behavioral functioning, and his adaptive functioning. Through
the assessment it was determined that John met criteria for FAS, as he demonstrated
mild facial abnormalities, he has significant deficits in three or more areas of brain
functioning (CNS) damage, and it was identified that there was prenatal alcohol
Most recently, in December 2014, John was admitted to Child and Adolescent
Mental Health Urgent Services. John
was admitted to Child and Adolescent Mental
Health Urgent Services by his mother due to a violent outburst on his younger brother
Doe. As per discharge recommendations from Child and Adolescent Mental
Health Urgent Services dated December 11, 2014 Dr. W diagnosed John with ADHD,
ODD, and FASD (previous). As part of the discharge, it was recommended that John
receive an updated psycho-educational assessment as well as an updated OT
A review of John ’s school file indicates that in Kindergarten at Xxxx John was
placed on an Individual Program Plan (IPP) that incorporated instructional
accommodations (e.g. seating away from distraction, quiet class) and assessment

Doe, John

accommodations (e.g. more time, simplified testing material). John ’s file indicates that
he has received a significant amount of support throughout his school years with a full
time aide and program modifications. John is currently enrolled in Grade 7 at Xxxx. He
receives a full time instructional assistant each week, and she has been working with
him since Kindergarten. While John
is currently not assigned homework and tests,
teacher comments indicate that they believe his academic abilities are significantly
below grade level. John ’s school file indicates that as of June 2014 his reading level is
end of grade 2 and his spelling is equivalent to grade 2.3. Accommodations he currently
receives include individual instruction with his teaching assistant, direct teaching of
strategies, positive reinforcement, incentives, extra time to complete assignments,
access to a quiet work room when he is struggling to remain on task, and frequent
breaks as needed. Teacher comments indicate that while these accommodations have
been helpful John
continues to struggle with his transition in junior high school. He
currently struggles with his emotional regulation, and gets frustrated easily. Socially he
also struggles, he has been observed talking to himself or into space, and demonstrates
overall strange behaviors.

Doe, John


Student cumulative file review;
Parent interview;
Student interview;
Peabody Picture Vocabulary Test – 4th Edition (PPVT-4 Form A);
Expressive Vocabulary Test – 2nd Edition (EVT-2 Form A);
Wechsler Intelligence Scale for Children – 4th Edition (WISC-IV);
Wechsler Individual Achievement Test – 3rd Edition (WIAT-III).
John was seen for assessment on three half days; he willingly came and met
with the examiner and presented as friendly and mildly distracted. Rapport was readily
established, though the examiner offered treats and rewards for compliance throughout
all days of testing. John was well groomed and comfortably dressed on the days he
was seen. John is right-handed and his conversational English was generally
understood. During John ’s informal interview, he correctly identified information about
himself such as his age, favorite teacher’s name, school, and grade. John indicated
liking school, particularly social studies and gym. In terms of his social functioning, he
indicated that he does not have many friends at school and prefers the company of his
aide, C. In terms of his family, John accurately identified the people he lives with and
spoke positively about his parents, particularly Mrs. Doe, but indicated that he does not
get along with his brother, John Doe. John went on to explain that he and John
Doe often engage in physical and verbal altercations, requiring his mother to separate
the two.
Assessment Observations
During the formal test administrations, John ’s general attitude toward the
assessment appeared neutral, but he needed firm expectations, movement breaks
throughout, and incentives to manage his participation. There was evidence of attention
difficulties, impulsivity and physical restlessness; these were managed with verbal
redirection and reminders of incentives. Additionally, John would perseverate on
topics, which required the examiner to redirect the conversation and remind John that
these topics could only be discussed during testing breaks. With encouragement, John
persevered on items; though it was observed that John would make unusual noises
when asked more difficult expressive language items. It was also observed that when
John felt agitated or avoidant of a topic he would pick his ears. John ’s hearing and
vision did not present any concerns. Given the established rapport and general effort
that John exhibited during the testing sessions, the results obtained on this
assessment are judged to be a reliable and valid indication of his current functioning.

Doe, John

NOTE: Individual scores should not be regarded as absolute but rather, reflect a range
that the student's abilities lie within. Standard Scores are used to describe a
student’s performance and the extent that it differs from the population average;
average range standard scores generally fall within the range between 90-110.
Percentile ranks indicate the percentage of students/scores that occur at or below that
particular score. For example; a student obtaining a percentile rank of 75 performed as
well or better than 75 percent of the students in the comparison group/norm sample.

Test 1 - The Developmental Test of Visual-Motor Integration –5 th Edition (VMI-6)
The VMI-6 is a screening test of eye-hand coordination where the student is required to
copy increasingly complex geometric drawings.
The VMI-6 results will not be reported. John is currently receiving OT supports
to assist with his organization, self-care, social and written work issues. indicated that
he was recently assessed using the VMI-6. This measure was used as a rapport
building exercise. Please refer to his cumulative file for further information regarding OT
findings and recommendations.
Test 2 - Peabody Picture Vocabulary Test – 4th Edition Form A administered
(PPVT-4). The PPVT - 4 is a test of listening comprehension for spoken English. It is
designed as a measure of a student's vocabulary acquisition that does not require a
spoken response.
On the PPVT-4, John scored at the 25th percentile (standard score: 90). His
receptive vocabulary abilities are classified in the Average range compared to children
of a similar age. John ’s receptive language abilities would be considered equivalent to
an individual of approximately 11 years-2 months old. This suggests John has a good
understanding for individual spoken terminology, compared to others his age.
Test 3 - Expressive Vocabulary Test – 2nd Edition Form B administered (EVT-2)
The EVT-2 is a measure of expressive vocabulary knowledge and word retrieval. It
requires a one-word answer from the student.
On the EVT-2, John scored at the 1st percentile (standard score: 66). John ’s
expressive vocabulary abilities are within the Extremely Low range, compared to others
his age. John ’s expressive vocabulary abilities would be considered equivalent to a
child of approximately 6 years-8 months old. John was observed to make odd noises
when asked difficult questions that he did not know. He often appeared agitated during
difficult questions, and more inattentive and distracted behaviours were observed.
A statistically significant discrepancy exists between John ’s receptive and
expressive language results, that is, John ’s understanding of spoken vocabulary is
significantly stronger than his ability to express himself through spoken vocabulary. In

Doe, John

the traditional classroom, this suggests that John will likely understand grade level
vocabulary in discussions, however he will have difficulties expressing himself verbally
or participating in classroom discussions.
Test 4 - Wechsler Intelligence Scale for Children – 4th Edition (WISC-IV)
- Canadian Norms.
The Wechsler Intelligence Scale for Children – 4thEdition is a standardized test
designed to measure various skills related to intellectual functioning. The test is divided
into four Indexes (Verbal Comprehension, Perceptual Reasoning, Working Memory, and
Processing Speed). The Verbal Comprehension Index is a measure of verbally
acquired knowledge, verbal reasoning, comprehension and conceptualization. The
Perceptual Reasoning Index assesses fluid reasoning or non-verbal problem solving
and perceptual organization. The Working Memory Index represents a measure of
one’s ability to hold, manipulate or perform an operation on verbally presented
information. The Processing Speed Index is a measure of the speed which simple or
routine visual information can be accurately processed. The combination of the four
Indexes gives an overall estimate of intellect, a Full Scale IQ. It is important to
recognize that the WISC-IV measures only a portion of the competencies involved in
human intelligence and is an important factor in the prediction and understanding of
school achievement.
John ’s Verbal Comprehension Index score (2nd percentile, VCI: 69) is classified
in the Extremely Low range, compared to others his age. More specifically, John
measured in the Extremely Low range at the 1st percentile on a task measuring his
ability to solve problems involving judgement and conventional standards
(Comprehension). Comprehension was an area of weakness for John (base rate: 25%). He had difficulties responding to questions and formulating coherent responses.
Throughout the Comprehension subtest John would provide simple responses without
elaboration or not make an attempt to respond and state, “I don’t know.” When probed
to elaborate or make a guess he would say, “I don’t want to because I don’t know.” John
measured in the Borderline range at the 5th percentile on a task that required him to
demonstrate his understanding and express the meaning of individual words
(Vocabulary). On the Similarities subtest, which measured his ability to explain the
relationship between two objects or concepts John performed in the Low Average
range at the 9th percentile. During verbal tasks, John was observed to become agitated
and distracted. He would engage in avoidant behaviours, such as picking his ears or
ignoring the examiners questions, and would often make no attempts to respond to
questions until prompted to do so. Once prompted, John would often respond by
saying, “I don’t know.” Based on his performance it is clear that expressive language
tasks are markedly difficult for him, and in a classroom he will have difficulties working
with verbal concepts and acquiring verbal information, particularly engaging in
classroom discussions and tasks that require verbal responses.
John ’s Perceptual Reasoning Index score (68th percentile, PRI: 107) is classified
in the upper limits of the Average range compared to Canadians of a similar age. He
measured in the High Average range at the 84 th percentile on a task that examined his

Doe, John

ability to analyze and synthesize visual-spatial information (Block Design). Block Design
was a relative Strength for John , (base rate 1-2%). He was able to quickly and
accurately manipulate the blocks to recreate the pictorially presented design. On a task
that measured his abstract concept formation and categorical reasoning (Picture
Concepts) he performed in the Average range at the 63 rd percentile. Similarly, he
measured in the Average range at the 37th percentile on a task examining problem
solving using pattern completion, classification, analogical and serial reasoning (Matrix
Reasoning). Overall, John ’s ability to interpret and organize visually perceived
information is significantly stronger compared with his verbal abilities (base rate: 0%).
Therefore, in a classroom setting, he will be more capable of learning and
demonstrating his learning through visual-kinesthetic modalities, as opposed to through
auditory or verbal modalities.
John ’s Working Memory Index score (1st percentile, WMI: 65) is classified in the
Extremely Low range compared to others his age. The Working Memory Index
measures the ability to retain and manipulate information in short-term memory. John
measured in the Low Average range at the 16 th percentile on a task that required him to
repeat a series of numbers presented orally (Digit Span). Conversely, he measured in
the Extremely Low range, below the 1 st percentile, on a task that required him to
sequentially order a series of numbers and letters presented orally to him (LetterNumber Sequencing). The Letter-Number Sequencing subtest was an area of
weakness for John (base rate: <1%), as he had significant difficulties remembering and
manipulating numbers and letters mentally. During the initial task John appeared
focused on the task and made eye contact while the examiner orally presented
numbers. During the latter task, he was observed correctly responding when one
number and one letter were presented; however, when multiple numbers and letters
were presented, he appeared to become confused and recalled groups of numbers and
letters in reverse order to which they were presented and substituted similar sounding
letters. These scores indicate that within the classroom environment, John will
encounter difficulties when faced with activities that involve lengthy and multi-step
directions or operations and mental manipulation, such as mathematics and writing.
On the Processing Speed Index, John ’s score (58 th percentile, PSI: 103) was in
the Average range compared to Canadians of a similar age. John measured in the
Average range on a task requiring him to visually scan and discriminate between
symbols (Symbol Search). Similarly, he measured in the Average range on a task that
required him to learn and copy novel codes with speed and accuracy (Coding). During
the Coding subtest, John was observed using the key as a guide, repeatedly
referencing back to the numbers and symbols, this was an area of relative strength for
him. Overall, these scores indicate that in the classroom environment, John will perform
comparably to others his age on tasks that have a time limit.
Comparison of these four Indexes reveals a statistically significant and
meaningful difference between John
’s Perceptual Reasoning and Verbal
Comprehension Indexes (base rate: 0%) and Perceptual Reasoning and Working
Memory Indexes (base rate: 0%). As well as statistically significant differences between
his Processing Speed and Verbal Comprehension Indexes (base rate: 3.6%) and

Doe, John

Processing Speed and Working Memory Indexes (base rate: 1.2%). More specifically,
his Perceptual Reasoning is better developed in comparison to his Working Memory
and Verbal Comprehension Indexes. This suggests that John has weaknesses with
auditory working memory and expressing verbal information, both of which likely
present meaningful obstacles to his learning. Additionally, there was a significant
discrepancy between the Coding and Letter-Number Sequencing subtests within the
Working Memory and Processing Speed Index (base rate: 3.5%). The Block Design
subtest presented as a relative strength (base rate: 1-2%). John ’s overall cognitive
abilities as measured on the WISC-IV (indicated by the Full Scale IQ; FSIQ) will not be
reported here due to vast differences between his Index scores. As such, John ’s
Perceptual Reasoning Index was used as a predictor of his academic achievement.
John ’s visual perceptual abilities are well established, as evidenced by his Average
score on the Perceptual Reasoning Index (PRI).
Test 5 - Wechsler Individual Achievement Test – 3rd Edition (WIAT-III)
- Canadian Norms (Age-Based)
The Wechsler Individual Achievement Test – 3 rd Edition is a standardized test of
academic achievement and functioning. The test is divided into Reading, Mathematics,
Written Expression, and Oral Language areas.
Given the reported difficulties with John ’s academic skills, selected subtests of
academic achievement from the WIAT-III were administered to gain an understanding of
his strengths and weaknesses relevant to formal schooling.
John ’s Basic Reading composite, summarizing his performance across word
reading, pseudoword decoding and reading comprehension measured in the Extremely
Low range at the 1st percentile (Standard Score: 62). John was given tasks to assess
his accuracy in reading single words and nonsense words aloud. On the single word
reading task, John scored in the Extremely Low range at the 1 st percentile (Word
Reading Standard Score: 63). Similarly, he found it difficult to decode and read words
that are not real words but are similar in form to English words. On this subtest, he
scored in the Extremely Low range at the 1 st percentile (Pseudoword Decoding
Standard Score: 62). John was observed to leave end sounds off of words. He also
substituted similar sounds on several occasions (e.g. pled for pleb)
John ’s Reading Comprehension measured at the 10 th percentile, in the
Borderline range (Standard Score: 81). For the Reading Comprehension subtest, John
was required to read grade-appropriate passages (either orally or silently) and answer
comprehension questions by providing an oral response. John chose to read the
passages presented to him silently and was observed to read portions of the passage
and refer to the passage when answering comprehension questions. It is important to
note that John chose to read each passage silently and appeared to read at a very
slow rate. He presented as distracted and when asked comprehension questions, he
was inconsistent with whether or not he referred back to the passage to try and find the

Doe, John

John ’s overall Mathematics composite score, which summarizes his abilities in
numerical operations and math problem solving, was within the Borderline range at the
4th percentile (Standard Score: 73). The Math Problem Solving subtest measures
problem-solving skills in basic concepts and everyday applications. John ’s skills in this
area measured at the 4th percentile, which falls in the Borderline range (Math ProblemSolving Standard Score: 74). He demonstrated difficulties working with word problems
and fractions. Similarly, on the Numerical Operations subtest, which measures
mathematical calculation skills, John scored in the Borderline range at the 4 th percentile
(Numerical Operations Standard Score: 73). On this subtest John demonstrated
difficulties with multiplication and division.
A sample of John ’s written output was provided by the school and evaluated by
the examiner. Through an examination of John ’s written work it becomes clear that
John demonstrates impairments with his written expression. He is given significant
supports and modifications for his written work, and when done relatively independently
there is evidence that he struggles significantly. John ’s writing samples demonstrate
abilities that are significantly below grade level. Difficulties that John has with writing
include spelling errors, run on sentences, and grammatical errors. His writing also
suggests that he has difficulties generating ideas. For example, on an assignment that
required John to discuss his favorite video game, it took John 45 minutes to create two
Currently, John is achieving significantly weaker in terms of his reading, written
expression and math than what might be predicted from his intellectual ability (PRI). As
such, John likely has difficulty completing grade level expectations. The difference
between John ’s level of reading achievement and what would be expected given his
PRI is seen at or less than 1% of the population his age. Similarly, John ’s level of
mathematics and what would be expected given his PRI is seen at or less than 1% of
the population his age. As such, it is quite uncommon for an individual with John ’s
cognitive abilities (PRI) to experience as much difficulty as he does in the areas of
reading, written expression and mathematics.
John is a 13-year-old boy enrolled at Xxxx; he is currently in the regular grade 7
program receiving a number of supports and modifications to his curriculum. John lives
with his adoptive parents, Mr. and Mrs. Doe, and his adoptive siblings. Mrs. Doe
indicated that John was delayed with the attainment of early developmental milestones.
John was referred to MediGene services in 2008 for a formal Fetal Alcohol Syndrome
Evaluation. He was seen by a multidisciplinary team, and it was determined that he
meets criteria for FAS. In conjunction with the FAS diagnosis, John was assessed by,
Dr. W and he diagnosed John with Attention Deficit Hyperactive Disorder and
Oppositional Defiance Disorder. He is prescribed Vyvanse and Clonidine; medications
are monitored by Dr.L.
John is described as a kind and loving individual, who is easily frustrated. John
reportedly enjoys school and attends regularly. When asked about things he enjoys,

Doe, John

John stated that he likes playing video games and partaking in games outdoors;
specifically, John suggested that he is good at soccer and enjoys running and kicking
the ball. Socially, Mrs. Doe reported that John does not have many friends.
A Psycho-educational assessment was undertaken to assist in the planning and
programming recommendations for John and identify possible factors that represent
obstacles to his progress, as he transitions to a new school. For the test
administrations, John worked adequately with good rapport and the results of the
assessment are judged to be a valid and reliable indication of his current functioning.
An overall evaluation of John ’s receptive and expressive vocabulary skills
indicates that there is variability amongst his abilities. John ’s receptive language
abilities are classified in the Average range, while his expressive language abilities are
in the Extremely Low range. John ’s understanding of spoken vocabulary is significantly
stronger than his ability to express himself through spoken vocabulary, which likely
causes significant frustrations for him. In the traditional classroom, this suggests that
John will likely have difficulties participating in discussions or question-answer
activities. On tests of intellectual abilities, his Verbal Comprehension and Working
Memory Indexes were classified in the Extremely Low range. Conversely, he scored in
the Average range on the Perceptual Reasoning and Processing Speed Indexes
compared to others his age. Comparison of these four indexes revealed statistically
significant and meaningful differences between the Perceptual Reasoning and Verbal
Comprehension Indexes, Perceptual Reasoning and Working Memory Indexes, Verbal
Comprehension and Processing Speed Indexes, and Working Memory and Processing
Speed Indexes. Specifically, retaining and manipulating information in short-term
memory is challenging and likely impacts his performance in writing as well as
mathematics. Writing is a highly complex operation involving the coordination of
attention, memory, visual processing, and language to name a few. In response to
weakness demonstrated in John ’s working memory, it is likely that he will experience
challenges keeping in mind the next points he wants to make while writing the first point.
Impairments in working memory impacts mathematical skills in that memory serves as a
‘blackboard’ that supports number representations such as place value and alignment in
columns and arithmetic. This suggests that John has less room on his ‘mental
blackboard’ to keep in mind relevant numerical information and as such, it is likely that
he will experience difficulties completing numerical operations and problem solving.
Additionally, John demonstrated marked difficulties with his verbal abilities, specifically
his expressive language skills. While John has adequately developed receptive
language skills, his difficulties with putting his thoughts into words are likely causing
significant frustrations for him. These expressive language deficits are also likely
impacting his writing abilities, as writing involves many higher order functions including
the ability to express oneself through language. While findings from this assessment
indicate weak expressive language abilities as well as weak working memory, it is the
writer’s belief that John ’s mental health is also significantly impacting his overall
cognitive abilities. Therefore, it is believed that this may be an underestimate of his
abilities, as previous assessments revealed significantly higher findings overall. An
individual’s cognitive abilities are believed to be static, with minor fluctuations, however
John ’s have gone down a significant amount leading the examiner to believe there are
other factors that are likely contributing to his difficulties.

Doe, John

Therefore, John ’s difficulties functioning within a school environment are likely
the result of a combination of factors. John ’s academic deficits in reading, written
expression and math suggest the demands for those types of academic learning may
be difficult for him. John is likely to acquire skills and concepts more successfully if
structure, demonstration, and opportunities for repetition/practice are incorporated into
his routines. Multi-modal instruction (e.g., verbal, visual, tactile) may promote the
acquisition of new skills and learning. John ’s mental health is also likely contributing to
difficulties he is having functioning in the school environment. John ’s transition into
grade 7 has been challenging. He has been having difficulties adjusting to the
coursework and routine, and these struggles are likely contributing to his behavioral
issues as well as academic difficulties. Additionally, John was also recently hospitalized
in December 2014, which likely caused him a significant amount of stress, which may
factor in to his current functioning. When considering John ’s abilities, it is important to
consider his mental health and how that may be impacting him. However, overall John
is believed to demonstrate Average intellectual ability (PRI). There is a discrepancy
between John ’s level of intellectual functioning (PRI) and his current levels of
academic achievement in reading, writing and math. John ’s history of receiving
individual help and being supported by a Learner Support Plan suggests that his
academic abilities are still considerably lower than his cognitive abilities. So, given that
John has average intellectual ability, limited progress, and a significant lag noted in his
reading, writing and math skills compared to his intelligence, John is a student who
meets the criteria of a student with a Learning Disability in Reading, Mathematics,
and Written Expression according to Alberta Education criteria.
John ’s diagnosis of Attention Deficit Disorder, Oppositional Defiance Disorder,
and his intellectual abilities may be related to an extent to the diagnosis of Fetal Alcohol
Spectrum Disorder; individuals with these disorders often have resulting atypical
neurological development or functioning. Further, these individuals are challenged with
emotional/behavioral difficulties at least in part due to the relationship between brain
and behavior. Specifically, individuals with ADHD and FAS demonstrate impairments
with their executive function. The executive function is a higher order cognitive function
that is responsible for emotional regulation, planning and organizing, memory, and
attention to name a few. It is important to consider that John ’s damaged neurological
development; particularly his executive function is likely resulting in his inability to selfregulate his emotions, as such John becomes easily angered and frustrated. Executive
Function deficits are also likely contributing to other areas of difficulties, such as with his
memory and verbal abilities. While, the purpose of this assessment was to get an
updated understanding of his cognitive abilities and his learner profile, it is believed to
be an underestimate of his abilities. John ’s cognitive abilities have dropped
substantially since his last assessment, and this may be attributed to his current mental
health state. John has had a difficult year with his transition into junior high school and
with his hospitalization in December 2014. It is the writer’s belief that if his mental health
difficulties are adequately dealt with his cognitive abilities may become more stable.
However, John has a complex presentation that will demand a coordinated and
comprehensive approach to support his functioning and progress.

Doe, John

The following recommendations are offered to support John ’s functioning and
1. The professionals involved with John ’s case should be provided with a copy of
this report or be made aware of the assessment results to assist with the
coordinated care and treatment of John .
2. Given John ’s diagnosed Fetal Alcohol Spectrum Disorder, his teachers may find
it useful to refer to instructional strategies outlined in: Programming for Students
with Special Needs, Book 10: Teaching Students with Fetal Alcohol Spectrum
Disorders (2000).
3. Continuous monitoring of John ’s Language abilities should be made to ensure
his expressive language deficits are not central to his impairments.
4. Attempts to monitor/gauge John ’s level of frustration should be made to prevent
him from becoming overwhelmed and perhaps behave inappropriately. Periodic
inquiries with John , rating scales and observations of agitation may be useful in
this regard. Teaching John to utilize a signal when he is approaching frustration
and allowing breaks may assist in de-escalating some situations.
5. Clearly stated expectations and predictability will promote his sense of safety and
trust. This will also assist with managing his behaviors, as he will know what is
and is not acceptable behavior from the start.
6. Academic programming should ideally be individualized to the level and pace
that John is working at, and as such, attempts should be made to ensure his
understanding and retention of information and concepts prior to moving on.
7. Use of multi-modal teaching methods (i.e. visual, auditory, tactile) may promote
John ’s acquisition of skills and concepts. Ideas might include:
 Use pictures or graphics to communicate meaning of words.
 When using oral language, combine it with a visual representation of
the concept/object.
 Use videos, comic strips and social stories to support comprehension.
8. John would benefit from programming to develop his overall competence with
language. Some suggestions include:
 Checking and re-checking his understanding.
 Utilizing short, concrete terms and instructions.
 Paraphrasing and retelling.
 Opportunity for participation in a small group and 1:1 discussions.
 Encourage elaborated responses.
 Using response starters or oral cloze exercises.
 Introduce synonyms and antonyms to expand his vocabulary and
support comprehension.
 Use of visual supports and/or multiple-choice formats may be
particularly useful.
 Teach new vocabulary in the context of information that John already
knows about the topic. Make explicit links to known vocabulary,
information, and concepts.
 Stress the relationship between concepts and objects, the ways they
are similar and different.

Doe, John

9. John would benefit from opportunities for exposure to social interaction and
recreation on a regular basis through his school program and the community.
10. A structured/formal social skills program may benefit John in developing a
repertoire of appropriate responses and patterns of interaction with others.
Teaching social rules and exposure to opportunities for social interaction with
peers may be beneficial.
11. Many phonological awareness tasks require a series of words, syllables, and
sounds to be held and manipulated in memory. Due to John ’s significantly weak
memory span and short-term memory, he may have more difficulty than
anticipated when working on some of these tasks and will require modifications.
Because he has some knowledge of letter-sound correspondence, ease the
burden on memory by incorporating the use of letters to represent sounds.
12. John ’s weaknesses with reading might benefit from:
 Direct instruction with high frequency words.
 Direct instruction with common syllables.
 Direct instruction and assessment of correspondence of soundletter/letter combinations.
 Identify known parts within longer words.
 Use word family (e.g., “ack”, ”ick”, “ake”, “ight”) activities.
 Relate new ideas to familiar or already known information.
 Question John after he reads and encourage him to verbalize his
 Guided reading and repeated reading of the same texts.
 Differentiating the level of books he is required to read (e.g., different
students read different books suited to their level within the same
 Engaging in choral reading. Choral reading occurs when you hold the
book together and ask John to read along with you. Begin reading in a
voice that is slightly louder and faster than his. As he becomes more
comfortable with reading the text, lower your voice and slow down your
reading speed. If the child slows down, increase your volume and
speed again.
 Engaging in echo reading. Echo reading occurs when a teacher or
parent reads aloud a line of text. Ask John to read the same line.
Continue taking turns reading and rereading the same lines. When
John begins to read with more expression and fluency, suggest that
he read aloud on his own.
13. John ’s written language abilities may benefit from:
 Writing every day lists and letters such as grocery lists, greeting cards,
letters to family or friends, notes on family calendars, and so forth. By
creating lists and letters that are used everyday, John will not feel as
though they are “make-work” projects, but rather projects where he is
accomplishing a useful task. If John would like to request something,
he could do it in writing. For instance, he could write on lined Post-It
notes if he would like to play outside. By incorporating little bits of

Doe, John

writing into every facet of life, John will be continually practicing his
writing and printing skills.
 Allowing John extra time to complete written work or shorten the
amount of questions he is required to complete.
 Providing worksheets with fill-in answers as much as possible, rather
than having John copy questions from the board/overhead into his
 Providing John with alternative means of expressing himself. Posters
that include some writing along with drawings or cut-out pictures will
reduce the amount of written material John will need to produce.
14. The following suggestions may be useful in promoting John ’s progress in
 Using concrete objects for demonstrations will help John visualize
 Incorporating practical uses for mathematics such as store purchases,
measuring, and using money.
 Including repetition and drill practice for basic facts and operations
(e.g. flash cards).
 Ensuring concepts are understood prior to moving on.
 Provide key examples or models to work from.
 Provide John with extensive guided practice in reading [addition,
subtraction] word problems, setting them up with manipulatives and
then as computation problems, and solving them. Use problems that
incorporate many types of objects (e.g., eggs, nickels, miles, minutes).
Try to use situations that would be familiar to John as well as practical
(e.g., paying for his family to see a movie at $3.00 each). This will allow
John to practice his application of basic calculations on a day-to-day
basis, inside and outside of the school setting
15. John ’s attention and concentration skills may benefit from:
 Chunking tasks into manageable parts and by giving clear, concise
 Minimizing distractions and sensory “noise.”
 Establishing eye contact as an indication he is listening/attending.
 Allowing for movement breaks between work/instruction periods and
when John is becoming restless.
 Being specific about when to talk and when not to talk. Although
children who have difficulties with impulse control may frequently
forget these instructions, they can be coached to stop and notice
what’s going on around them.
 Framing the visual material you want John to be focused on with your
hands or by drawing a colored box around it.
 Using positive reinforcement and behavior modification
techniques/incentives (e.g., table points for being attentive and ontask, individual charts, contracts and stickers, etc.).

Doe, John

Providing a “fidget” toy (e.g., stress ball) for John to squeeze to
provide physical movement without being a distraction. Alternatively,
he could be allowed to “doodle” to help keep him aroused and alert.
16. The following suggestions may be useful in assisting with John ’s transition
 Create a highly structured environment
 Cue as to when an activity is to be ended
 Pair tactile, verbal and visual cues when counting down the end of an
 Use flashcard to signal the remaining time left in an activity
 Verbally praise student for properly closing an activity
17. When giving John directions, incorporate visual illustrations as much as
possible. For example, use gestures, draw on the board, or model the steps of a
18. Provide intensive repetition, practice, and review in learning activities. To
promote retention, provide activities to reinforce the skills or content at frequent
and regular intervals, gradually increasing the intervals to less frequent and
19. Use graphic organizers to teach new concepts and information. When John can
picture how the ideas are interrelated, he will be able to store and retrieve them
more easily.
20. Given John ’s academic challenges, alternative activities/modalities should be
considered in assessing his learning. Accommodations such as additional time,
scribing, and access to assistive technology may promote his functioning in
21. Trial assistive technology programs that target skill remediation as well as
compensation for his difficulties.
22. Teach self-advocacy skills for the future.
23. School personnel and family should monitor the presence of emotional distress
and frustration in John ’s behaviors to be noted include the following:
 Mood swings, increasing irritability or withdrawal, excessive fear, worry, or
 Somatic complaints such as stomach and headaches, increased sleep
disturbances or changes in appetite.
 Low frustration tolerance/frequency of social problems.
Catholic School District personnel from the Instructional Support Team should be
accessed for consultation and further exploration if appropriate.
NOTE: Due to the developing and changing nature of children, the information and
recommendations contained in this report are meant for current use. Reference to or
use of this report in future years should be made with caution.


Doe, John

A meeting was held at Xxxx on June 17, 2015 to discuss John ’s assessment results; in
attendance were Mrs. Doe (adoptive mother), Mrs. XXX, Mrs. XXX (Registered
Psychologist), and Danni Kerr (Practicum Student). The information contained in this
report was discussed in detail with particular attention to John ’s current intellectual
functioning and academic achievement. Recommendations and support in John ’s
classroom were generally discussed, as well as his placement at XXX. A copy of this
finalized report will be placed on John ’s student file, and a copy will be provided to Mr.
and Mrs. Doe for their records.

Standard Scores
Confidence Interval 95%























Verbal Comprehension Index


69 (Range: 64 to 78)

Perceptual Reasoning Index
Working Memory Index


65 (Range: 60 to 76)


Processing Speed Index


Receptive Vocabulary
Expressive Vocabulary


107 (Range: 98 to 115)

103 (Range: 94 to 111)
90 (Range: 83 to 97)
66 (Range: 59 to 73)

Note: The Standard Scores on the normal curve provide an estimation of a student’s current skills and
abilities reported at the 95th confidence interval. If STUDENT were tested 100 times, his/her true score would
fall within this range 95 times. Average scores typically fall between 90 and 109. The percentile rank shows
how high each student ranks in the national comparison group. If the percentile rank were 45, for example, it
would mean that STUDENT scored higher than approximately 45 out of 100 students of same age.

Doe, John



Attachment to Psychological Report:
Date(s) of Assessment: May 5 & 22, June 5 & 8, 2015
Date of Report: June 10, 2015

Doe, John

Birth date (M-D-Y):
School Contact:

13 years, 4 months
7 - regular program
Mr. and Mrs. Doe (Adoptive parents)

313.81 Oppositional Defiant Disorder
314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type
315.00 Reading Disorder
315.1 Mathematics Disorder
315.2 Disorder of Written Expression
Fetal Alcohol Spectrum Disorder
John ’s diagnoses, the extent that they interfere in his functioning and the level of
support afforded him, indicate that he meets Alberta Education criteria for designation
as a student with a Severe Physical or Medical Disability.