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Psycho Educational Evaluation:

Date: September 14, 2010

Examiner: Mehri Jelokhani

Identifying Information:

Name: Client’s Name Maria Hernandez


Age: 12
DOB: November 20, 1997
Gender: Female
School:
Grade: Fifth
Language: Primary language at home Spanish / fluent in English
Residence: Los Angeles
Referral: Educational Therapist and classroom teacher / I.E.P. Reports
Reason for Referral: Maria is falling behind in making academic progress.

Tests Administered:
Cognitive Test
Wechsler Intelligence Scale for Children, (WISC-IV)—1/13/2010, 1/22/2010
Educational Achievement Test
Woodcock Johnson Test of Achievement-III—1/27/2010, 1/31/2010
Gray Oral Reading Test (GORT)—02/14/2010
Clinical Evaluation of Language Fundamentals-4 (CELF4)—02/14/2010
Visual/Motor Processing Tests
Bender Gestalt Test of Visual Motor Integration—01/31/2010
Developmental Test of Visual Perception-2 (DTVP-2)—01/22/2010
Auditory Processing Tests
Test of Auditory Processing Skills (TAPS-3)—01/31/2010

Background Information

Sources of information used for this report: Maria’s teacher Mr. Soloman, along with the educational

therapist and I.E.P. report, provided the background information. Maria’s mother also provided

information through a Spanish interpreter.

Developmental History: Maria lives in a small apartment with her mother and nineteen year old

brother. Her father abandoned the family when she was eight years old. Maria is bilingual in Spanish

and English. Her mother has very little education, is illiterate, and speaks only Spanish. She works

sporadically as a housekeeper.

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Medical History: Maria was born via vaginal birth with no complications. However, she developed a

cancerous tumor in her kidney when she was only one and a half years old. Her diseased kidney was

removed when she was two, and she had follow up radiation and chemotherapy treatments for seven

months afterwards. She has experienced no further complications or recurrence of her cancer, and her

health since then has been normal.

Social History: Maria is a quiet and shy child. Her mother is very protective of her and only allows her

to play with her cousins at home. Maria has very few peer relations, and really only has one friend at

school. Maria has poor social skills and exhibits anxious or insecure behaviors in social situations. Her

poor social skills may also be reinforced by having few friends, and parents who are separated. She is

well behaved at home and at school and does not cause any trouble.

Educational History: She attended kindergarten at age of five years-old, and her cognitive difficulties

became apparent in first grade, which she had to repeat. She has had trouble ever since keeping up in

school. She is currently in the fifth grade, but she is falling behind and failing in all of her academic

subjects. Her teacher reports that she works hard in the classroom and tries her best, and tries to improve

her grades by participating in group study skills. She also receives 200 minutes of additional help each

week according to her Individual Education Plan until the end of 5th grade. She has difficulties in written

and oral comprehension, language, reading and math.

Mental Health History: Maria appears to be a normal child with normal development, and has never

had a psychological assessment for a mental health disorder.

Family History: Neither parent shows signs of or has been treated for mental health disorders. There

are no signs of sexual abuse or domestic violence in the family. Maria’s father did struggle with drug

and alcohol abuse. His abandonment of the family had an obvious negative impact. He left after losing

his job with a major corporation. Maria’s brother is a fairly good student. He pushes Maria to do better

in her school work, but sometimes it hurts her feelings because she is trying her best and her brother

does not provide the proper support she needs.


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Prior Testing: Although she was not tested after failing first grade, she was tested in 5th grade for the

IEP. Issues were identified in math, reading and oral language.

Testing Behavior: Maria was obedient and followed all the parameters and rules of the testing. She

participated when she was asked to do so with the proper attitude. She asked me anytime she didn’t fully

understand the testing, and I gave her all the help that was permitted by the testing procedure.

Test Results—Cognitive/Perceptual

Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV)

The Wechsler Intelligence Scale for Children-IV (WISC-IV) is the latest revision of a widely used

instrument for measuring children’s mental abilities. The sub tests of the WISC-IV tap many different

cognitive abilities, and together provide information about a child’s individual strengths and

weaknesses. Global composite scores, or areas of functioning, are described in terms of Verbal,

Performance, Processing Speed and Full Scale IQ. It is also an appropriate instrument for practitioners

and clinical researchers in assessing children’s intelligence and general cognitive functioning. When

used with other assessment tools, it can be useful in identifying giftedness, mental retardation, and

cognitive strengths and weaknesses. The test results can be useful in treatment planning, in placement

and provision of clinical or educational services, and can add important information to a

neuropsychological evaluation. The WISC-IV is an individually administered clinical instrument for

assessing cognitive ability

in children between the ages of 6 years and 16 years 11 months. The test provides sub test

and composite scores which represent intellectual functioning in specific cognitive domains as

well as a composite score which represents general intellectual ability. The WISC-IV takes from

1½ to 2 hours to complete.

The main benefits include: 1.Early identification of reading & learning issues. 2. Useful in

identifying learning disabilities. 3. Understanding of an individual’s learning profile.

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4. Helps identify gifted children. 5. The assessment also helps schools make appropriate

accommodations and develop learning plans for individual students. 7. The ability to determine

learning processes, which include both strengths and weaknesses and the impact that they might have

on individual student performance.

Verbal Comprehension Subtests Scaled Percentile Range of Confidence


score Rank Classification Interval (%95)
Similarities 7 16 Below average
Vocabulary 3 1 Extreme Low
Comprehension 7 16 Below Average
(Information) 5 5 Borderline
(Word Reasoning) 4 2 Borderline
Perceptual Reasoning Subtests
Block Design 5 5 Borderline
Picture Concepts 5 37 Borderline
Matrix Reasoning 7 16 Below average
(Picture Completion) 5 5 Borderline

Working Memory Subtests


Digit Spans 8 25 Average
Letter-Number Sequence 8 25 Average
(Arithmetic) 6 9 Below average
Processing Speed
Coding 8 25 Average
Symbol Search 4 2 Borderline
(Cancellation) 8 25 Average

The WISC allows the psychologist to identify learning patterns. It has four main

components that are referred to as Indexes. These are called the Verbal Comprehension Index,

the Perceptual Reasoning Index, the Working Memory Index and the Processing Speed Index.

Within each of these four domains are a variety of sub tests that form the index score.

Index Scores Scaled Percentile Range of Confidence


score Rank Classification Interval (%95)
Verbal (VCI) 75 5 Borderline – 70-83
Low Average
Perceptual Reasoning (PRI) 82 12 Borderline – 76-91
Average
Working Memory (WMI) 88 21 Low Average- 81-97

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Average
Processing Speed (PSI) 78 7 Borderline – 72-90
Average
Full Scale IQ (FSIQ) 75 5 Borderline- Low 71-81
Average

FSIQ: Is the full scale intelligence quotient which gives you the level and range of where the client is

standing. This scale is divided into five levels and they are:

70-79 Borderline

80-89 Low Average

90-109 Average

110-119 High Average

120 Very Superior

Her FSIQ score is 75, which is in the middle of Borderline range.

Verbal Comprehension Index (VCI) measures verbal concept formation. It assesses children's ability

to listen to a question, draw upon learned information from both formal and informal education, reason

through an answer, and express their thoughts aloud. It can tap preferences for verbal information, a

difficulty with novel and unexpected situations, or a desire for more time to process information rather

than decide "on the spot.” This test is a good predictor of readiness for school and achievement

orientation, but can be influenced by background, education, and cultural opportunities. Maria has a

score of 75 on this section.

The sub tests include:

* Vocabulary: word knowledge and retrieval- Maria’s score of 3 puts her in Extreme Low range

* Similarities: Verbal concepts and reasoning- Maria’s score of 7 puts her in Below Average range

* Comprehension: social knowledge and awareness- Maria’s score of 7 puts her in Below Average

range

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* Information: recall of verbally-encoded, factual information- Maria’s score of 5 puts her in

borderline range.

* Word Reasoning: general reasoning ability- Maria’s score of 4 puts her in borderline range.

Perceptual Reasoning Index (PRI) measures Non-verbal and fluid reasoning, perceptual and fluid

reasoning, spatial processing, and visual- motor integration. It assesses children's ability to examine a

problem, draw upon visual- motor and visual- spatial skills, organize their thoughts, create solutions, and

then test them. It can also tap preferences for visual information, comfort with novel and unexpected

situations, or a preference to learn by doing. Maria’s score is 82 for this section.

The sub tests include:

* Block Design: visual spatial reasoning and visual-constructional ability. Maria’s score of 5 puts her

in borderline range.

* Matrix Reasoning: nonverbal reasoning and concept formation. Maria’s score of 5 puts her in

borderline range.

* Picture Concepts: abstract, categorical reasoning. Maria’s score of 7 puts her in below average

range.

* Picture Completion: attention to visual detail. Maria’s score of 5 puts her in borderline range.

1. Block Design - visual abstract ability. Analysis of whole into component parts, spatial

visualization, nonverbal concept formation, visual-motor coordination and perceptual

organization, capacity for sustained effort; concentration, visual motor-spatial coordination;

manipulative and perceptual speed.

2. Picture Concepts - measures a child's ability to categorize

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3. Matrix Reasoning - measures a child's non-verbal reasoning ability, visual-spatial reasoning,

abstract reasoning visual organization, simultaneous processing of visual-spatial information and

analysis of wholes into component parts.

4. (Picture Completion) - attention to visual detail, panning ability, anticipation of consequences,

temporal sequencing and time concepts, Accurately understanding nonverbal interpersonal

situations, ability to comprehend a total situation and evaluate its implications, visual

organization and perception of essential visual cues, speed of associating and planning

information.

Working Memory Index (WMI) assesses a child’s ability to memorize new information, hold it in

short-term memory, concentrate, and manipulate that information to produce some result or reasoning

processes. It requires working memory processes to manipulate orally presented verbal sequences or to

simply recall orally presented sequential information. It is important in higher-order thinking, learning,

and achievement. It can tap concentration, planning ability, cognitive flexibility, and sequencing skill,

but is sensitive to anxiety too. It is an important component of learning and achievement, and ability to

self-monitor. Maria has a score of 88 on this section.

The sub tests include:

* Digit Span – Digits Backward: Auditory working memory. Maria’s score of 8 puts her in average

range.

* Letter-Number Sequencing: shorter string lengths indicate memory – longer reflect auditory

processing. Maria’s score of 8 puts her in average range.

* Arithmetic: auditory short-term memory, auditory working memory, fact retrieval. Maria’s score of

6 puts her in below average range.

Processing Speed Index (PSI) assesses children's abilities to focus attention and quickly scan,

discriminate between, and sequentially order visual information. It requires persistence and planning

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ability, but is sensitive to motivation, difficulty working under a time pressure, and motor coordination

too. It requires visual perception and organization, visual scanning, and the ability to use hands and eyes

together efficiently. The attention factor is two minutes. It Cultural factors seem to have little impact on

it. It is related to reading performance and development too. It is related to Working Memory in that

increased processing speed can decrease the load placed on working memory, while decreased

processing speed can impair the effectiveness of working memory. Maria’s score is 78 for this section.

The sub tests include:

* Coding: speed and accuracy (fine motor control); incidental learning. Maria’s score of 8 puts her in

average range.

* Symbol Search: mental processing speed and accuracy. Maria’s score of 4 puts her in borderline

range.

* Cancellation: processing speed, visual selective attention, visual neglect, vigilance. Maria’s score

of 8 puts her in average range.

Summary

Maria’s Verbal Comprehension Index (VCI) score is 75 indicating a borderline score on her ability to

listen to questions and reason through answers. Cultural and language factors may be considered as the

contributing elements to this low score. English not being her primary language at home and Hispanic

cultural norms about self-expression in front of authority figures, for example need to be considered.

Her Perceptual Reasoning Index (PRI) score is 82. Maria’s fluid and non-verbal reasoning score is low

average which is a higher score than verbal comprehension, yet still below the average ability in this

area. Maria’s Block Design, visual spatial reasoning, and visual-constructional ability also indicate low

score for this area which may also be due to below average fine motor ability. Working Memory Index
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(WMI) score is 88 which indicates low-average ability in memorizing new information. Processing

Speed Index (PSI) score is 78, indicating borderline score on Processing speed. The requirement for

hands and eye coordination may also point to possible deficiencies in motor abilities.

Maria’s full scale (FSIQ) test score is 75 which indicate an overall borderline score in this test. The

cultural and language factors are not measured by this test and issues such as attitude toward authority,

education, gender role expectations, and types of tasks presented in the test are all culturally factors

which may influence the accurate representation of the child’s ability by these test scores.

Testing Results Educational

Reading

The Woodcock Johnson Test of Achievement and the GORT-4 Gray Oral Reading Tests, fourth edition;

were administered to Maria in order to assess her reading ability.

Reading WJA

Reading Test Standard Percentile Range Of


Score Rank Classification
Letter Word 96 38 Average
Reading Fluency 96 40 Average
Passage 72 3 Borderline
Comprehension
Word Attack 114 83 High Average
Reading Clusters
Broad Reading 87 19 Low Average
Basic Reading Skills 104 60 Average

The Woodcock-Johnson III – Third Edition WJ III is a battery of tests which measures cognitive

abilities and academic achievement skills. The advantages of this test includes: it is not timed, therefore

less pressure due to time limitations; it can be used for children with reading disabilities and those who

have trouble concentrating. This test is designed for ages 2 to 90. This test can help pinpoint a student's
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areas of strength and of concern, their learning style, their aptitude in academic areas, and any presence

of visual perceptual difficulties.

Letter-word identification: In this section of the test, subject’s ability to recognize and identify

letters (words and understanding their meaning is not required) is measured. Maria’s ability to identify

letters and words was measured by Letter-word Identification portion of this test. Maria’s score of 56

shows puts her slightly under her age group and indicates average functioning.

Reading Fluency: requires the ability to quickly read as many simple sentences and then circle

Yes or No for true or false within 3 minutes. Maria’s raw score of 49, indicates average functioning

level for Maria at this portion of the test.

Passage Comprehension: measures the ability of the subject to understand and comprehend what

she or he reads. The items on this test require the subject to read a short passage and then to identify a

key word that is missing in order to make sense of the passage. The items are designed with a

progressive level of difficulty. Maria’s raw score of 23 indicates borderline level of functioning in this

area, putting her well below her age group.

Reading-Gray Oral Reading Tests (GORT)

GORT Standard Scores Percentile Range


Rate 9 37 Average
Accuracy 8 25 Average
Fluency 9 37 Average
Comprehension 7 16 Low Average
Score
Oral Reading 85 21 Low Average
Quotient

The Gray Oral Reading Tests, Fourth Edition (GORT-4) provides an efficient and objective measure of

oral reading skills by diagnosing specific reading strengths and weaknesses, and document student

reading growth as a result of special intervention. GORT-4 can also serve as a measurement device for

research into the reading abilities of school-aged children. GORT-4 measures oral reading rate,
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accuracy, and comprehension. On the GORT-4, after the child reads a series of passages aloud, the

child’s oral reading is scored for rate and accuracy. Information about rate and accuracy is important

because children who read slowly take longer to complete assignments and understand and remember

less of what they have read. After reading each passage, the child is asked to answer multiple choice

questions that are read by the examiner.

GORT4 is designed for testing ages 6 to 18 years and 11months. GORT4 has four components:

Rate: this section reflects the amount of time taken by a student to read a story. Maria’s score of 9 puts

her in average range of functioning.

Accuracy: measures the student's ability to pronounce each word in the story correctly. Maria’s score of

8 puts her in average range of functioning.

Fluency: is based on the combination of scores from student's Rate and Accuracy. Maria’s score of 9

puts her in average range of functioning.

Comprehension: is based on the appropriateness of the student's responses to questions about the

content of each story read. Maria’s score of 7 puts her in low-average range of functioning.

Overall Reading Ability: is based on a combination of a student's Fluency (i.e., Rate and Accuracy),

and Comprehension Scores. Maria’s score of 85 puts her in low-average overall range of functioning.

Summary:

Maria’s scores of 9 on rate, 8 on accuracy, and 9 on fluency sections of GORT-4, demonstrates an

average amount of time to read the story and pronounce each word correctly. Her scores of 7, on

Comprehension which is her ability to respond to the questions based on the content of the story is

within low average range. Her overall reading ability based on combination of all above section is 85

which is within low average range. Maria’s lower ability to show comprehension of the content of the

story lowers the overall scores on this test, while she did better in the section related to her ability to

read and pronounce the words correctly.


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Clinical Evaluation of Language Fundamental—4 (CELF4)

The CELF4 is used to identify and evaluate language and communication disorders in children and

adolescents. Maria’s scores were as follows:

Subtest Scaled Score Percentile Range Of


Rank Classification
Concepts & Following 2 4 Ex. Low
Directions
Recalling Sentences 2 4 Ex. Low
Formulated Sentences 5 5 Borderline
Word Classes—Receptive 6 9 Low Average
Word Classes—Expressive 6 9 Low average
Word Classes—Total 6 9 Low average

The CELF-4 is an individually administered language test that evaluates a student’s general language

ability and determines if a language disorder is present. If a language disorder is identified, further in-

depth testing provides information about the nature of the disorder, language strengths and weaknesses,

language content, and language modalities. For Maria’s Core Language score, the following subtests

were administered:

• Concepts & Following Directions: identifies pictures of geometric shapes in response to orally

presented direction. This subtest evaluates a student's ability to interpret, recall and carry out

oral commend as of increasing length and complexity containing specific linguistic concepts.

Maria’s score 2 is in extremely low range in this subtest.


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• Recalling sentences: imitation of orally presented sentence. This subtest evaluates a student's

ability to recall and repeat spoken sentences of increasing length and complexity without

changing the words or word meaning and no visual stimuli. Maria’s score 2 is in extremely low

range in this subtest.

• Formulated Sentences: given target word and picture stimulus and asked to form sentence.

Maria’s 5 score is in borderline range in this subtest.

• Word Classes – Receptive: picks 2 out of 3 or 4 words orally presented that go together. Maria’s

score 6 is in low average range in this subtest.

• Word Classes – Expressive: lists as many words within given category as possible in 1 minute.

Maria’s score 6 is in low average range in this subtest.

Index Standard Percentile Range


Score Rank
Core Language 62 1 Ex. Low
Receptive Language 67 1 Ex. Low
Expressive Language 65 1 Ex. Low
Language Memory 65 <1 Ex. Low

Core Language

Maria was administered four core subtests of the Clinical Evaluation of Language Fundamentals–

Fourth Edition (CELF–4) from which her Core Language score was derived. The Core Language score

is considered to be the most representative measure of Maria’s language skills and provides a reliable

way to quantify a student’s overall language performance. Maria received a Core Language score of 62.

This places Maria in the Extreme Low range of functioning

Receptive Language

The Receptive Language index is a cumulative measure of Maria’s performance on two or three

subtests designed to best probe receptive aspects of language including comprehension and listening.

Maria received a Receptive Language index of 62.This places Maria in the very low range of

functioning.
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Expressive Language

The Expressive Language index is a cumulative measure of Maria’s performance on the three subtests

that probe expressive aspects of language including oral language expression. For Maria’s Expressive

Language index, the following subtests were administered: Recalling Sentences, Formulated Sentences,

and Word Classes –Expressive. Maria received an Expressive Language index of 65. This places Maria

in the Extreme Low range of functioning.

Language Memory

The Language Memory index is a cumulative measure of Maria’s performance on the subtests designed

to probe memory dependent language tasks. Maria received an Expressive Language memory index of

65. This places Maria in the Extreme Low range of functioning.

Summary Oral Language

Maria received a Core Language score of 62, Receptive Language index of 62, Expressive Language

index of 65, and language memory of 65; placing Maria in the very low range of functioning in all these

areas. Maria’s extreme low scores on language ability and communication positively co-relates with

Maria’s Verbal Comprehension Index (VCI) score of 75 which placed her in borderline range on her

ability to listen to questions and reason through answers. Maria’s performance on CELF_4, points to

strong presence of language disorder.

Test Results—Auditory Processing

Test of Auditory Processing Skills (TAPS-3)

The TAPS-3 is a measure of auditory processing ability. It examines auditory attention, basic phonemic

skills, auditory memory and auditory cohesion. The TAPS-3 was given to determine if auditory-

perceptual difficulties are interfering with Maria’s ability to comprehend spoken language and/or

contributing to her difficulties in the classroom.

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Subtest Scaled Score Percentile Range of
Rank Classification
Word Discrimination 9 37 Average
Phonological Segmentation 10 50 Average
Phonological Blending 7 16 Low Average
Number Memory Forward 9 37 Average
Number Memory Reversed 8 25 Average
Word Memory 3 1 Ex. Low
Sentence Memory 5 5 Borderline
Auditory Comprehension 8 25 Average
Auditory Reasoning 2/5 <1/5 Ex. low/borderline

Test of Auditory Processing Skills (TAPS-3) can help you diagnose auditory processing difficulties,

imperceptions of auditory modality, language problems, and/or learning disabilities in both children and

teens. The TAPS-3 offers seamless coverage for ages 4 through 18 years, measuring what children and

teens do with what they hear. The TAPS-3 includes the following subtests

• Word Discrimination: Individuals are asked to listen with their backs turned or eyes

closed, to pairs of words spoken by the examiner. The words in each pair are of equal

length but differ on one phoneme (e.g., dog – log, compute – commute, eliminate -

illuminate). Individuals then indicate whether they heard the same word twice by saying,

“same” or two different words by saying, “different.” Maria’s score for this subtest is 9,

which puts her in average range.

• Phonological Segmentation: requires individuals to correctly delete specific

syllables or sounds from words. The examiner says a target word, asks the examinee

to repeat it, and then asks the examinee to repeat it again while deleting one of the

sounds. There are 35 items of increasing difficulty, and individuals are required to

delete either an initial, medial, or final sound in the target words. Maria’s score for

this subtest is 10, which puts her in average range.

• Phonological Blending: requires individuals to listen to a series of phonemes and

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then blend these sounds into a word. The examiner presents the phonemes at the rate

of approximately two sounds per second (e.g., c – a – t). The examinee must then say

the word. The difficulty of the items increases as the words become longer, requiring

increased auditory closure abilities. Maria’s score for this subtest is 7, which puts her

in low-average range.

• Number Memory Forward: Individuals are required to listen to a series of digits

presented orally by the examiner, at a rate of one digit per second. Maria’s score for

this subtest is 9, which puts her in average range.

• Number Memory Reversed: requires individuals to say the sequences of a series of

digits in backward order. Maria’s score for this subtest is 8, which puts her in

average range.

• Word Memory: This subtest is a list-learning task. It presents individuals with

increasingly longer sequences of meaningfully unrelated words said by the

examiner, again at a rate of one per second. Once the list has been presented,

individuals are required to repeat the words in the same order. Maria’s score for this

subtest is 3, which puts her in extreme=low range.

• Sentence Memory: This task requires individuals to listen to increasingly longer

sentences said by the examiner and repeat these verbatim. Maria’s score for this

subtest is 5, which puts her in borderline range.

• Auditory Comprehension: requires individuals to listen to short stories and

demonstrate understanding of those stories by answering brief questions. The

answers to the questions are found directly in the content of the stories. Maria’s

score for this subtest is 8, which puts her in average range.

• Auditory Reasoning: requires individuals to listen to short stories and demonstrate

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understanding by answering questions about them. However, the examinee must use

information contained within the story as well as some common-sense and social

knowledge in order to answer the questions. The answers to the questions are not

found directly in the stories but can be inferred from the information given. Maria’s

score for this subtest is 2/5, which puts her in extreme low/borderline range.

Indices Standard Score Percentile Range of


Rank Classification
Overall 84/86 14/18 Low Average
Phonologic 94 34 Average
Memory 81 10 Low Average
Cohesion 75 5 Borderline

Summary

Maria’s TAPS-3 overall score of 84/86 indicates a low average range in auditory processing skills.

Her phonologic score of 94, puts her in average range, her memory score of 81 puts her in low-

average range, and cohesion score of 75 puts her in borderline range of classification. However,

since in addition to attention, memory, and comprehension, this tasks presented in this test requires

some logic and reasoning abilities. Thus, as auditory cohesion would require attention, language

processing, and reasoning skills, it could be difficult to differentiate specific deficits in auditory

cohesion from broader cognitive deficits or speech and language impairments.

Test Results—Visual-Motor Ability

Bender-Gestalt II Test of Visual Motor Integration

The Bender-Gestalt II is a test of visual-motor integration skills. Twelve cards with simple to more

complex geometric shapes were presented, and Maria was asked to copy the designs (Gestalt figures)
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―exactly as seen on the card. The test assesses visual processing accuracy as well as fine motor ability.

This assessment is suitable for individuals three and older. The Bender Gestalt II is a test that assesses

visual processing accuracy as well as fine motor ability. This test is typically given to patients with brain

injuries to assess possible brain damage. The patient is given a number of cards with varying graphics

and asked to copy the designs to the best of their ability. Maria’s score of 107 was in the 67.96

percentile placing her in the below average category for copy observations. A recall task was

administered immediately after the administration of the copy phase was concluded. Maria tested for a

standard score of 97 in 1.52 second, placing her in the 42.07 percentile.

Developmental Test of Visual Perception-Adolescent and Adult (DTVP-A)

The DTVP-A is a battery of six subtests that measure different but interrelated visual-perceptual and

visual-motor abilities. The battery, which is designed for use with individuals ages 11.0 through 74.11,

has empirically established reliability and validity.

Subtest Scaled Score Percentile Range of


Rank Classification
Copying 9 37 Average
Figure-Ground 8 25 Average
Visual-Motor Search 7 16 Low Average
Visual Closure 8 12 Average
Visual-Motor Speed 6 9 Low Average
Form Constancy 9 37 Average

• Copying: Individuals are shown a simple figure and asked to draw it on a piece of paper.

The figure serves as a model for the drawing. Maria’s score of 9 is in average range for

this subtest.

• Figure-Ground: Individuals are shown stimulus figures and asked to find as many of the

figures as they can on a page where the figures are hidden in a complex, confusing

background. Maria’s score of 8 is in average range for this subtest.

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• Visual-Motor Search: The individual is shown a page covered in numbered circles,

randomly arranged on the page. The individual connects the circles with a line, in

numerical sequence, as quickly as possible. Maria’s score of 7 is in low-average range

for this subtest.

• Visual closure: Individuals are shown a stimulus figure and asked to select the exact

figure from a series of figures that have been incompletely drawn. Maria’s score of 8 is

in average range for this subtest.

• Visual-Motor Speed: Individuals are shown (a) four different geometric designs, two of

which have special marks in them, and (b) a page filled completely with the four designs,

none of which have marks in them. Maria’s score of 6 is in low-average range for this

subtest.

• Form Constancy: Individuals are shown a stimulus figure and asked to find it in a series

of figures. In the series, the targeted figure will have a different size, position, and/or

shade, and it may be hidden in a distracting background. Maria’s score of 9 is in average

range for this subtest.

Composite Scores or Indexes: The most reliable scores for the DTVP-A are the indexes. These scores

are found by adding the standard scores of the subtests that comprise a composite and converting the

sum to an index.

Composite Indices Standard Percentile Range of


Score Rank Classification
General Visual Perception 85 16 Low Average
Motor-Reduced Visual 89 23 Low Average
Perception
Visual-Motor Integration 83 13 Low Average

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- General Visual-Perceptual Index: The GVPI is the best measure of what the majority of people

mean when they say “visual perception.” Data from six subtests, each of which measures a

different type of visual perception in a different manner, contribute to the GVPI. When GVPIs

are below 90, examiners need to pay more attention to the clinically important indexes-the

Motor-Reduced Visual Perceptual Index (MRPI) and the Visual-Motor Integration Index

(VMII). Examination of these indexes may help explain the causes for low GVPIs.

- Motor-Reduced Visual Perception Index: Of all of the DTVP-A indexes, the MRPI is the

“purest” and most direct measure of visual perception in that only minimal motor skills (e.g.,

pointing) are required to show perceptual competence. This index is formed by combining the

standard scores from the Figure-Ground, Visual Closure and Form Constancy Subtests.

- Visual-Motor Integration Index: to do well on this composite, individuals must perform

complex eye-hand coordination tasks. Low scores do not necessarily indicate poor visual

perception; they may mean that the individuals have awkward hand movements or that they have

difficulty coordinating hand-to-eye movements. This index is formed by combining the standard

scores of the Copying, Visual-Motor Search, and Visual-Motor Speed Subtests.

Summary

Maria’s scores in DTVP-A copying, figure-ground, visual closure, and form constancy subtests

are in average range, while her scores on visual-motor search and visual motor speed are in low

average range. Therefore all composite scores for Maria in this test are in low-average range.

Maria did better on the Bender Gestalt II test than on the DTVP-A.

Test Results—Attention

Brown Attention-Deficit Disorder Scales (Parent and Self Report Forms 8 – 12)

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The Brown Attention-Deficit Disorder Scales (Brown ADD Scales) are instruments designed to elicit

information that may indicate impairment in executive functions related to Attention-

Deficit/Hyperactivity Disorders (AD/HD). The scales provide descriptions of interrelated cognitive,

affective, and behavioral symptoms often characteristic of persons diagnosed with Attention-

Deficit/Hyperactivity Disorders. A score over 60 is an indication of a significant problem. The following

scores were obtained from the Brown ADD Scales Self Report Form 8-12, which was completed by

Maria herself, with the examiner reading the questions aloud to her. These scores reflect Maria’s

perceptions of her own behavior. Typically, a form is also given to a parent to fill out, but due to

language constraints, this was not done.

Brown Scale Clusters T-Score Significant


Self
Activation 43
Focus 39
Effort 46
Emotion 40
Memory 50
ADD Inattention Total 45
Action 42
ADD Combined Total Score 43

Activation is a measure of Maria’s ability to organize and prioritize her workload. Focus measures her

ability to sustain and shift attention to tasks. Effort measures her ability to regulate alertness and sustain

effort and processing speed. Emotion is a measure of Maria’s ability to manage frustration and modulate

her emotions. Memory measures her working memory and the ability to recall information. The ADD

Inattention Total is derived from the first 5 cluster scores. Action measures her ability to monitor and

self-regulate her actions. The ADD Combined Total Score is derived from all six cluster scores.

Test Results—Memory

Wide Range Assessment of Memory and Learning-2 (WRAML2)

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The WRAML2 is a carefully standardized psychometric instrument which allows the user to evaluate an

individual's memory functioning. The WRAML2 affords evaluation of both immediate and delayed

memory ability, as well as the acquisition of new learning. The Wide Range Assessment of Memory and

Learning-2 (WRAML2) were used to evaluate Maria’s ability to actively learn and memorize a variety

of information. The results of this test are presented in the table below:

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WRAML2 Subtest Scaled Score Percentile Rank Range of Classification
Story Memory 8 25 Average
Design Memory 6 9 Below average
Verbal Learning 10 50 Average
Picture Memory 6 9 Below average
Finger Windows 10 50 Average
Number Letter 5 5 Borderline
Story Memory Recall-Delayed 8 25 Average
Verbal Learning Recall-Delayed 10 50 Average
Story Recognition 9 37 Average
Design Recognition 4 2 Borderline
Picture Memory Recognition 11 63 Average
Verbal Learning Recognition 10 50 Average
WRAML2 Index Scores Index Score Percentile Rank Range of Classification
Verbal Memory 94 34 87-101 Average
Visual Memory 76 5 69-86 Borderline
Attention/Concentration 70 2 63-86 Borderline
General Memory 74 4 68-81 Borderline
Verbal Recognition 96 39 87-106 Average
Visual Recognition 84 14 74-104 Low Average
General recognition 89 23 79-102 Low Average

Maria’s overall General Memory Index score was 74, which is in the range. The General Memory

Index score is derived from the first six subtest scores. The Verbal Memory Index is an assessment of

her memory capacity on a meaningful verbal memory task (stories) and a verbal rote memory task

(list of words). Her Verbal Memory Index score was 94, in the 34 percentile and the 87-101 range.

The Visual Memory Index assessed her ability to proceed from rote memory demands to memory

demands with increasingly meaningful material presented visually. Her Visual Memory Index score

was 76, in the 5 percentile and the 69-86 range.

The Attention/Concentration Index assessed her ability to perform memory tasks that were dependent

upon attending to and concentrating on the task to be learned for immediate recall. Her

Attention/Concentration Index score was 70, in the 2 percentile and the 63-86 range.

All of the above subtests were measures of immediate recall—memory tested immediately after

presentation of the stimulus. Two subtests, Story Memory Recall-Delayed and Verbal Learning

Recall-Delayed, look at delayed memory. Story Memory Recall-Delayed required Maria to recall as

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many elements as she could of the stories presented earlier (delay was approximately 10 minutes).

Verbal Learning Recall-Delayed required Maria to recall as many of the words from the list presented

earlier as possible. All of the above tasks are ―recall‖ tasks,requiring M aria to generate the

information on her own. She was also given four ―recognition‖ tasks thatw ere com bined to give a

General Recognition Index score of 89, in the 23 percentile and the 79-102 range.

Core components of WRAML2:

Visual Memory Index

Verbal Learning Subtest: This subtest evaluates auditory memory of meaningful verbal information

that is without context.

Story Memory Subtest: This subtest evaluates auditory memory of extended meaningful verbal

material.

Visual Memory Index

Picture Memory Subtest: This subtest evaluates visual memory using skills to detect changes in

specific features or details, specifically, four different “familiar” scenes.

Design Memory Subtest

This subtest evaluates short-term visual retention of semi-meaningful visual information by using a

brief exposure to simple geometric shapes and then having the client redraw them in their proper

locations. The task evaluates a client’s ability to remember new, relatively unrelated visual

information.

Attention/Concentration Index

Finger Windows Subtest: This subtest evaluates short-term memory of rote, visual sequential

pattern. The task evaluates a client’s ability to actively remember rote and sequential visual

information.

Number Letter Subtest:

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This subtest evaluates a client’s ability to remember sequential, rote auditory information using the

familiar digit-span format. This task uses letters as well as digits.

General Memory, Verbal Recognition, Visual Recognition, and General recognition Index

All of these subtests assess immediate memory, which is, the immediate recall after an initial

exposure to visual or auditory information.

Story memory recall and Story memory Recognition Subtests:

Subtest procedure: Approximately twenty minutes after administration of the original story memory

subtest the client is asked to retell as much of each story as possible.

Verbal Learning Recall and Verbal Learning Recognition Subtests:

Subtest procedure: Approximately twenty minutes after administration of the verbal learning subtest,

without warning, the client is asked to again recite the list of isolated words.

Design Memory Recognition Subtest:

Subtest Procedure: About twenty minutes after performing the design memory subtest, the design

memory recognition subtest may be administered. The client is shown consecutive pages on which

appear numerous designs and she/he is asked to decide whether each design was or was not on the

cards he/she saw earlier.

Picture Memory Recognition Subtest:

Subtest procedure: fifteen to twenty minutes following the original picture memory subtest, the client

inspects mini-pictures and is asked whether the picture was part of a scene viewed earlier in the

session.

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