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Circle one: Self / Instructor

WAIS_IV Protocol Rubric Test Administrator _________________________ Pseudonym ____________________ Date ________________

Your Strengths: Things to Work On:

Subtest Major Errors Minor Errors Other


Score ☐ Chronological age correct Significant effect on scoring: Minor effect on scoring: ☐ Doesn’t use
Conversion ☐Transferred scores correctly ☐ Chronological age incorrect ☐ Chronological age incorrect pseudonym
& Profile ☐ Converted raw scores correctly ☐ Transferred scores incorrectly ☐ Transferred scores incorrectly ☐ Skipped intro
pages ☐ Summed scores correctly ☐ Converted raw scores incorrectly ☐ Converted raw scores incorrectly directions
☐ Converted sums of scaled scores ☐ Summed scores incorrectly ☐ Summed scores incorrectly
correctly ☐ Converted scaled scores incorrectly ☐ Converted scaled scores incorrectly
☐ Correct %ile ranks and CIs ☐ Incorrect %ile ranks ☐ Incorrect %ile ranks
☐ Incorrect CIs ☐ Incorrect CIs
☐ Missing subtest(s)
Block ☐ Read directions accurately ☐ No basal/missed reversal ☐ Incorrect start point- _____________ ☐ Work on reading
Design ☐ Fluid administration ☐ No ceiling ☐ Didn’t mark reversal directions verbatim
☐ Accurate scoring ☐ Incorrect raw score- _____________ ☐ Missed prompts- ___________________ ☐ Work on fluency
☐ Accurate timing ☐ Significant amount of incorrect ☐ Incorrect scoring- ___________________ with administration
scoring ☐ Work on fluency
☐ Forgot to time with scoring
Similarities ☐ Read directions accurately ☐ No basal/missed reversal ☐ Incorrect start point- _____________ ☐ Work on reading
☐ Fluid administration ☐ No ceiling ☐ Responses not written verbatim- ______ directions verbatim
☐ Accurate scoring ☐ Incorrect raw score- _____________ ☐ Responses illegible- ________________ ☐ Work on fluency
☐ Open queries (“Tell me more…”) ☐ Significant amount of incorrect ☐ No query when needed to- ___________ with administration
☐ Querying when needed and not scoring ☐ Query when not needed- _____________ ☐ Work on fluency
when not needed ☐ Didn’t mark reversal with scoring
☐ Missed prompts- ___________________
☐ Incorrect scoring- ___________________
☐ Didn’t note corrective feedback_______
Digit Span ☐ Read directions accurately ☐ No ceiling ☐ Responses illegible ☐ Work on reading
☐ Fluid administration ☐ Incorrect raw score- _____________ ☐ Didn’t give/mark sample items directions verbatim
☐ Accurate scoring ☐ Significant amount of incorrect (Backward/Sequencing) ☐ Work on fluency
☐ 1-digit per second pacing scoring ☐ Incorrect scoring- ___________________ with administration
☐ Pace too fast or too slow ☐ Work on fluency
with scoring
Matrix ☐ Read directions accurately ☐ Incorrect start point- _____________ ☐ Didn’t mark reversal ☐ Work on reading
Reasoning ☐ Fluid administration ☐ No basal/missed reversal ☐ Didn’t give/mark sample items directions verbatim
☐ Accurate scoring ☐ No ceiling ☐ Missed prompts- ___________________ ☐ Work on fluency
☐ Incorrect raw score- _____________ ☐ Incorrect scoring- ___________________ with administration
☐ Significant amount of incorrect ☐ Work on fluency
scoring with scoring
Vocabulary ☐ Read directions accurately ☐ No basal/missed reversal ☐ Incorrect start point- _____________ ☐ Work on reading
☐ Fluid administration ☐ No ceiling ☐ Responses not written verbatim- ______ directions verbatim
☐ Accurate scoring ☐ Incorrect raw score- _____________ ☐ Responses illegible- ________________ ☐ Work on fluency
☐ Open queries (“Tell me more…”) ☐ Significant amount of incorrect ☐ No query when needed to- ___________ with administration
☐ Querying when needed and not scoring ☐ Query when not needed- _____________ ☐ Work on fluency
when not needed ☐ Didn’t mark reversal with scoring
☐ Incorrect scoring- ___________________
☐ Closed queries (“Can you tell me…?”)
☐ Didn’t note corrective feedback_______
Arithmetic ☐ Read directions accurately ☐ No basal/missed reversal ☐ Incorrect start point- _____________ ☐ Work on reading
☐ Fluid administration ☐ No ceiling ☐ Didn’t mark reversal directions verbatim
☐ Accurate scoring ☐ Incorrect raw score- _____________ ☐ Missed prompts- ________________ ☐ Work on fluency
☐ Accurate timing ☐ Significant amount of incorrect ☐ Incorrect scoring- ___________________ with administration
☐ Repeated items only once scoring ☐ Didn’t note corrective feedback_____ ☐ Work on fluency
☐ Forgot to time with scoring
☐ Repeated items more than once
Symbol ☐ Read directions accurately ☐ Incorrect raw score- _____________ ☐ Didn’t give/mark demonstration items ☐ Work on reading
Search ☐ Fluid administration ☐ Incorrect timing ☐ Didn’t give/mark sample items directions verbatim
☐ Accurate scoring ☐ Significant amount of incorrect ☐ Incorrect scoring- ___________________ ☐ Work on fluency
☐ Accurate timing scoring ☐ Used pencil with eraser with administration
☐ Used pencil without eraser ☐ Work on fluency
with scoring
Visual ☐ Read directions accurately ☐ No basal/missed reversal ☐ Didn’t give/mark demonstration items ☐ Work on reading
Puzzles ☐ Fluid administration ☐ No ceiling ☐ Didn’t give/mark sample items directions verbatim
☐ Accurate scoring ☐ Incorrect raw score- _____________ ☐ Incorrect scoring- ___________________ ☐ Work on fluency
☐ Accurate timing ☐ Significant amount of incorrect ☐ Didn’t mark reversal with administration
☐ Correct Start Point scoring ☐ Missed prompts- _________________ ☐ Work on fluency
☐ Forgot to time with scoring
Information ☐ Read directions accurately ☐ No basal/missed reversal ☐ Incorrect start point- _____________ ☐ Work on reading
☐ Fluid administration ☐ No ceiling ☐ Responses not written verbatim- ______ directions verbatim
☐ Accurate scoring ☐ Incorrect raw score- _____________ ☐ Responses illegible- ________________ ☐ Work on fluency
☐ Significant amount of incorrect ☐ Didn’t mark reversal with administration
scoring ☐ No query when needed to- ___________ ☐ Work on fluency
☐ Query when not needed- _____________ with scoring
☐ Missed prompts- ___________________
☐ Incorrect scoring- ___________________
☐ Didn’t note corrective feedback_______
Coding ☐ Read directions accurately ☐ Incorrect raw score- _____________ ☐ Didn’t give/mark demonstration items ☐ Work on reading
☐ Fluid administration ☐ Incorrect timing ☐ Didn’t give/mark sample items directions verbatim
☐ Accurate scoring ☐ Significant amount of incorrect ☐ Missed prompts- ___________________ ☐ Work on fluency
☐ Accurate timing scoring ☐ Incorrect scoring- ___________________ with administration
☐ Used pencil without eraser ☐ Used pencil with eraser ☐ Work on fluency
with scoring

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