Clinical Psychologist

Phone: (92) (042) 36652116, 0333-4606602

Email: sidmalikatta@gmail.com
44-45, Cavalry Ground Ext، Lahore, 54810

“ConfidentialPsychological Assessment Report”

Following psychological assessment report is intended as a communication
between psychologist and examinees parents. This report includes sensitive
information that is likely to be misinterpreted by those without necessary training.
Authorization for use of this report is limited to the examinee and their
designated consultants. Any further use requires permission of the examinee or
their legal guardian.

The author is a licensed clinical psychologist registered with Pakistan Association of Clinical
Psychologists.
Sidra Malik: Clinical Psychologist

Appointment Cell; 0333-4606602 Ph; 44-45 Cavalry Ground Ext,

042-36652116-18 Lahore Cantt.
 Assessment Report
Name Zainab Majid
Class 5th
School Beaconhouse School System
Birth order 1st
No of siblings 3
Date of birth 31-Dec-2009
Assessment date 17-Dec-2022
Chronological age 12 years 11 months
Informant Mother

This report is based on informal and formal assessment and observation in individual and
family session by consultant psychologist in the clinic.
Reason for referral
Zainab Majid is 12 years 11 months old girl, who was referred from Beacon House for
psychometric evaluation as parents were concerned regarding her poor attention/concentration,
reading/writing problem, poor memory, spelling mistakes; easily distract and also poor
classroom performance.
Family’s Concerns
• Poor attention/ concentration
• Lack of reading and writing skills
• Spelling mistakes
• Poor memory
• Poor eye-contact
According to mother since first entering school, Zainab has experienced difficulties with school
work completion, inattentiveness and distractibility, spelling mistakes and poor focus in class
work. Zainab’s mother describes her as a hard-working, cooperative student, but she indicates
that homework responsibilities have been an issue. They also note that she is a very reluctant
reader, and has consistently scored lower than average on reading comprehension and vocabulary
tests.

Appointment Cell; 0333-4606602 Ph; 44-45 Cavalry Ground Ext,

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 According to zainab’s parents she had difficulties with focusing, and understanding class
lessons. They recognize that she is able to 'hyper focus' on some activities of interest, however
she often has difficulty sustaining her attention at school. Her parents and teacher indicate that
zainab is restless, and often requires reminders to help her stay on task.
Her mother reports that she did not have any difficulties at home with following routines
and remembering instructions. Her parents described that she did not show any emotional
reactivity as well as confrontational behaviors demonstrated both at home and at school. She
generally interacts well with her peers.
Birth History
Zainab was born at term by caesarean section. There is no history of perinatal asphyxia or
any other difficulties later during infancy. Her birth weight was normal.
Developmental Milestones
Zainab’s early motor milestones were delay.
Developmental milestones Motor: Childs Age of Achievement

Neck holding 3 Months

Sitting 9 Months
Crawling Not achieved
Standing with support 1 year
Standing without support 14 months
Walking 1.5 year
Gets up/down stairs 2.5 Years
Jumping 3 Years
Imitation 1 Years
Fine motor 15 Months
Vision and hearing
Focus 5 Months
Eye hand coordination 9 Months
Follow voices 5 Months
Social
Smile 3 Months

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042-36652116-18 Lahore Cantt.
 Reach out for objects and people 9 Months
Speech 2.5 years (3 words)

Toilet Training
Zainab is not fully toilet trained.
Past Medical History
Not reported.
Possible Social Stressor: not observed.
Schooling History
zainab started her school at the age of 3 years. Her class teacher’s concerns are her poor
attention towards class activities, poor classroom performance, poor concentration, lack of
command following. She needs more time and individual attention to help her understand and
learn. Then she changed her school, but according to her mother there was no visible
improvement that’s why they changed her school and admitted her in Beacon House School
System.
Behavioural Observation
Zainab is a pleasant and energetic child. She was adequately dressed and groomed.The
client was observed in two sessions of evaluation with Psychologist. The client was observed
through non-participant and participant observation. She was active in clinic some of the time
talking aimlessly. She uses to complete tasks given by psychologist and Anxiousness was also
observed in Zainab’s conversation. Some of the time she was observed engrossed in her own
world. She took part in all her activities but her attention span was poor and she completes her
activities by repeated commands from mother and clinical psychologist. The mother engaged the
child in the activity.
The client tried to took note of therapist’s instruction with her full attention and maintained eye
contact during the activity. The client answered the entire question through verbal language
Language
Zainab communicates during sessions. She answered the questions asked by
psychologist.
Activity level and mood
Zainab was sometimes anxious, inattentive and restless during the session.

Appointment Cell; 0333-4606602 Ph; 44-45 Cavalry Ground Ext,

042-36652116-18 Lahore Cantt.
Abnormal obsessive or rigid behaviour
Not observed.
Sensory response
No unusual sensory response was noticed during the assessment.
Imitation
She was able to imitate gestures during sessions.
Communication and command following
Zainab’s command following and auditory comprehension assessment showed that the
pattern of understanding language is improved as reported by child’s mother. Her command
following was also good and needs repetitive prompts from parents.
ASSESSMENT DONE
Informal Assessment
• Clinical interview and behavioral observation.
Clinical Interview. Clinical interview is a face to face encounter in which clinician asks
questions of client’s problem, their responses and reactions. Clinician collects the detailed
information about the client’s problem, feelings, lifestyles, relationships and other personal
history (Comer, 2008). A detailed semi structured clinical interview was conducted with the
child’s parents in which the client’s problematic complaints were discussed and the ratings were
taken accordingly.
Formal Assessment
• Portage Guide to Early Education PGEE (Forhman&hillard, 1976).
• Vineland Adaptive Behavior Scale -3
• Solloson Intelligence Test SIT (Richard L. Slosson)
Portage Guide to Early EducationPGEE (Forhman&hillard, 1976). was administered on the
child in order to assess the client’s development in different areas like socialization, language,
self-help, cognition and motor. The client’s informant was asked some questions while the task
which required performance of the client were asked to do by the client with the help of parents.
Following are the quantitative and qualitative analysis of the client results in PGEE

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042-36652116-18 Lahore Cantt.
Quantitative analysis
Functional level and deficits in the area of PGEE
Area Functioning level Deficits
Socialization Age appropriate ….
Language 2-3 years 10 years
Self help 3-4 years 9 years
Cognition 3-4 years 9 years
Motor 4-5 years 6 years
Qualitative analysis
The overall discrepancy between the child’s age and age achieved on the PGEE was
found to be 9 years. In the area of socialization, the child's functional level was age appropriate.
She can watch person moving directly in line of vision, she can smile in response to attention by
adults. She can reach for familiar person and offered objects. She can shake and squeeze objects
placed in hand and making sounds unintentionally. However, she can play with 2-3 peers. She
can greet peers and familiar adults when reminded and moreover she can wait for her needs to be
met when she was placed in a changing table or chair.
In Communication, her functional level was according to the child of 2-3 years of age.
She could point to all body parts on self. Shecan point to twelve familiar objects when named
and she could name 4 toys. However, she can tell about immediate experience. She can tell her
full name on request and she also can tell how common objects were used.
Her functioning level with respect to self-help skills was age appropriate.She could eat
food fed by herself. Moreover, she could feed herself. She was also completely toilet trained and
took a bath on her own. She could put on and take off shoes and she could eat table food with
spoon independently
Her cognitive functioning was equivalent to 3-4 year’s child. She could places objects in
a container while counting. She couldpoint to body parts and she could point to self when asked.
However, she can find specificbook on request. She can draw a vertical line in imitation and she
can match colors.
The child was functioning at the age of 4-5 she could rolls a ball in imitation. She could
moves from sitting to standing postures however; she can hoop on one foot, but can jump from
height of eight inch and can jump forward and backward and can climb up and slides down.
 Vineland Adaptive Behavior Scale -3
The Vineland-3 is a standardized measure of adaptive behavior the things that people do to
function in their everyday lives. The Vineland-3 focuses on what he or she actually does in daily
life.
The Client was administered following subtests of the Vineland Adaptive Behavior Scale (Third
Edition) it can be grouped into the board areas of communications, practical daily living skills,
and relating to other people. Learning about a child’s adaptive behaviors and skills is part of a
process, assessment that can help in planning for her education and special needs at home or in
school.
Quantitative Analysis
Comprehensive Teacher Form Score Report
Subscale Age Equivalent (AE) Growth Scale Value (GSV)
Receptive(rec) 3:0 88
Expressive(exp) <3:0 22
Written (wrn) 5:0 75

COMMUNICATION (COM)
Sum of v-scale Scores: 5
Personal (per) 3:0 75
Numeric(num) 5:9 81
SchoolCommunity (sc) 3:1 63

DAILY LIVING SKILLS (DLS)

Sum of v-scale Score: 11

Interpersonal <3:0 78
Relationship (ipr)
Play and Leisure (pla) <3:0 70
Coping skills (cop) 5:1 93

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 SOCIALIZATION (SOC) Sum of v-Scale Scores: 20
Comprehensive Parent/Caregiver Form Score Report
Age Equivalent(AE) Sum of v-scale Scores: Growth Scale Value (GSV)
Receptive(rec) 3:6 108
Expressive(exp) 4:10 106
Written (wrn) 3:8 52

Total 23

COMMUNICATION (COM)

Personal (per) 3:8 95

Domestic(dom) 4:0 54
Community (cmm) <3:0 48

DAILY LIVING SKILLS (DLS)

Sumof v-scale Scores;15
Interpersonal 1:8 75
Relationship (ipr)
Play and Leisure (pla) 0:7 48
Coping skills (cop) 3:0 70

SOCIALIZATION (SOC) Sum of v-Scale Scores: 16

ABC and Domain Score Summary in Teacher Form

ABC Standard Score(SS) Confidence Interval Percentile Rank
Adaptive Behavior 45 41-49 <1
Composite
Domains
Communication 27 22-32 <1
Daily Living Skills 33 26-40 <1
Socialization 57 53-61 <1

Appointment Cell: 03334606602 Ph: 042- 44-45 Cavalry Ground Ext, Lahore Cantt.
Email:sidmalikatta@gmail.com 3662116-18
ABC and Domain Score Summary in Parent Form
ABC Standard Score(SS) 90% Confidence Interval Percentile Rank
Adaptive Behavior 46 44-48 <1
Composite
Domains
Communication 60 57-63 <1
Daily Living Skills 47 44-50 <1
Socialization 48 45-51 <1

Qualitative analysis; on the bases of formal assessment it is asserted that her adaptive level in
sub domain v-scale scores is ‘‘low’’.
The Adaptive Behavior Composite (ABC) provides an overall summary measure of adaptive
functioning. Her ABC standard score is 45, with a 90% confidence interval of 41 to 49. Her
percentile rank of <1 means that her score was less than 1% of individuals. The Communication
domain measures how well exchanges information with others. This includes taking in
information, expressing herself verbally, and reading and writing. Her Communication standard
score in Teacher form is 27, with a 90% confidence interval of 22 to 32. This corresponds to a
percentile rank of <1. The Daily Living Skills domain assesses performance of the practical,
everyday tasks of living that are appropriate in the home setting. Such tasks include various
aspects of self-care (e.g., dressing, hygiene), using numeric concepts, and meeting expectations
at school. Her standard score for Daily Living Skills is 33, with a 90% confidence interval of 26
to 40 and a percentile rank of <1. Zainab’s score for the Socialization domain reflects her
functioning in social situations. This domain covers her interpersonal relationships, play and
leisure activities, and coping skills in social situations. Her Socialization standard score is 57,
with a 90% confidence interval of 53 to 61. The percentile rank is <1. Her Communication
standard score in Parent form is 60, with a 90% confidence interval of 57 to 63. This corresponds
to a percentile rank of <1.Her standard score for Daily Living Skills in Parent form is 47, with a
90% confidence interval of 44 to 50 and a percentile rank of <1. Her Socialization standard score
in parent form is 48, with a 90% confidence interval of 45 to 51. The percentile rank is <1.

Appointment Cell: 03334606602 Ph: 042- 44-45 Cavalry Ground Ext, Lahore Cantt.
Email:sidmalikatta@gmail.com 3662116-18
Solosson Intelligence Test SIT-4 (Richard L, Slosson): is a verbal screening measure of
cognitive ability for children and adults. Following domains are measured in Slosson Intelligence
Test General Information (GI), Comprehension (CO), Quantitative (QN), Similarities and
Differences (SD), Vocabulary (VO) and Auditory Memory (AM).
Quantitative Analysis
Table shows age in months and IQ score
Ages Age in Months
Chronological age (CA) 12 years 11 months
Chronological age in months (CA) 155 months
Mental age (MA) 4 years 4 months
Mental age in months (MA) 52 months
Difference between CA & MA 103 months
Intelligencequotient (IQ) Less than 20
The client’s intelligent quotient was less than 20 which indicate that client have
moderate-severe level intellectual disability which can be related to her history given by mother
and also her performance on SIT conducted during evaluation. The difference between client’s
chronological age and mental age was 103 months. Zainab was observed as lost in his own world
during sessions and he was observed easily distract during evaluation it might be the reason the
difference between her mental and chronological age was observed. The client shows great
difficulty in academic performance and concentration which can also be related to the difference
observed in chronological and mental age. She was also not able to solve some intellect related
problem.
Developmental/ Educational Recommendations
According to child’s functioning level a structured, self-contained and small placement
will be better for her. Such place should have appropriate place of learning and understanding,
the use of appropriate behavioral modification techniques and appropriate academic curricular
will help the child.
Behavior Modification Techniques (Miltenberger, 2012) will help to analyze and modify
child's problematic areas by using following techniques:
• Positive Reinforcement (Miltenberger, 2012) will help to achieve the desirable behaviors
by providing her pick and drop game, and taking her to walk.

Appointment Cell: 03334606602 Ph: 042- 44-45 Cavalry Ground Ext, Lahore Cantt.
Email:sidmalikatta@gmail.com 3662116-18
 • Prompting (Miltenberger, 2012). Prompting can be done by providing physical,
modeling verbal and gestural aids to help the child to learn attention, concentration.
• Shaping (Miltenberger, 2012). Shaping can be done in order to make the child learn the
task and rewarded on closer approximation of the task.
Individualized Training Program (ITP) of the child will help to teach her new skills of
memorization, learning concepts in easy way, language, cognitive and motor areas.
• Even within small self-contained class she will benefit from direct help with staying
focused and remaining on task. She needs some extra time and repeated commands to
catch and process new information.
Study Skills (Cortell, 2013).Study Skills will help the child to address the academic difficulties
that she faced in school. The following study skills will be helpful.
Mind Mapping(Cottrell, 2013). To further facilitate client in memorization of long questions,
mind mapping was used. The mind map was graphical way to represent ideas and concept. It was
a visual thinking tool that helped structuring information, helped to analyze, comprehend,
synthesize, recall and generate the ideas.
Time Management(Ruddell & Ruddell, 2009). To improve client‟s time management and
help her plan her time, it can be taught about time wasters and can be identified from client to
make her realized the factors that were affecting his studies. Through 10 minute strategy, In
which it can be taught to keep continue an activity for 10 minutes, no matter how unpleasant the
task is. After 10 minutes you may find you want to continue the task. Along with this client will
explain the importance of making daily planner to be followed to manage time. Daily time
planner will be included in daily activity chart to deal with her emotional as well as study related
issues.
Attention and Concentration (Ruddell & Ruddell, 1999). To improve her academic performance
and to build her interest and motivation towards studies, she should initially explained strategies
to improve her attention and concentration. She will tell about the common distractions and
environmental stimuli that divert attention towards studies that must be avoided to improve
attention. Give common tip to client included create a study spot, take mental snapshot and
taking breaks during studies.
Include Physical Activity Kids who struggle with attention often do better if they are given
brief breaks for active play. Taking a break to bounce on an exercise ball, breaking up learning
Appointment Cell: 03334606602 Ph: 042- 44-45 Cavalry Ground Ext, Lahore Cantt.
Email:sidmalikatta@gmail.com 3662116-18
into chunks, and outdoor play times, or providing a quick stretching or jumping jacks break in
the classroom (races, jump rope or hula-hooping contests, a game of tag, Frisbee or volleyball or
other games that encourage physical activity)

Have "Attention Breaks” Teach the child or children what "paying attention" means and
how it looks. Practice attentive behavior in non-threatening, non-crucial times during the school
day. Then, at periodic intervals, have practice attention breaks.
Adjust Time Frames Using timers, have the student who is struggling with attention show
his/her workafter a short period of time. This breaks up the task and allows the child to
keepworking without feeling completely overwhelmed.

Remove Visual Distractions When a child is struggling with a difficult task, clutter in the
classroom or on the desk can make it impossible to keep his/her brain where it needs to be.
Remove unnecessary clutter and visual experiences from the workspace. This gives the child
fewer excuses for not focusing on the task at hand.

Relaxation and Positive Imagery:Combining simple relaxation techniques such as deep

breathing with positive visual imagery helps the brain to improve or learn new skills. Kids can
“imagine” that they are paying attention in class or able to handle teasing, and this can in turn
change their behavior at school.

Crossword Puzzles and Picture Puzzles: Memory and Concentration Games: Children’s
games such as Memory or Simon are great ideas for improving memory and concentration.
Through repeated playing, brain circuits are “exercised” and challenged, which strengthens
connections and thus improves function. Also, there are some free computer games on the
internet that also improve concentration or memory such as Memory and Mosquito Killer. The
Brain/Body Coordination Workout: When we “exercise” them together, we are actually helping
various functions of the brain work more collaboratively.

Your Other Hand (child try doing things with their non-dominant hand)
Practice attentive listening.
You could talk with your child’s teacher about strategies like:

• Dividing tasks into smaller chunks

• Offering one-on-one help when possible

Appointment Cell: 03334606602 Ph: 042- 44-45 Cavalry Ground Ext, Lahore Cantt.
Email:sidmalikatta@gmail.com 3662116-18
 • Giving your child a „buddy‟ who can help them understand what to do
• Planning the classroom so your child is seated near the front of the room and away from
distractions
• Making a visual checklist of your child’s tasks or keeping a copy of the class timetable
where your child can see it
• Doing more difficult learning tasks in the mornings or after breaks
• Giving your child some extra time to finish tasks.

Sidra Malik
Clinical Psychologist

Appointment Cell: 03334606602 Ph: 042- 44-45 Cavalry Ground Ext, Lahore Cantt.
Email:sidmalikatta@gmail.com 3662116-18