ROBERTS APPERCEPTION TEST FOR CHILDREN Record Booklet Dorothea S. McArthur, Ph.D. and Glen E. Roberts, Ph.D. Published by WESTERN PSYCHOLOGICAL SERVICES 12081 Wishie Bla, Los Angeles, CA 90025-1251 Pblichere aed Dittribatore Child's Name. Date Tested = ___ = - School — Grade. Sex. Date of Birth _ = Parent's Name Age var ao ay Referred by Examiner = Reason for Referral GENERAL OBSERVATIONS: Frequency of Examiner Prompting (_) Little or None ( ) Some () Much Rapport ( ) Good ( ) Variable (_) Poor Typical Time Spent Prior to Response (__) Less than Average (_ ) Average (__) More than Averag Typical Length of Response () Long () Average (_ ) Brief Attention (__) Attentive ( ) Average (_) Distractible Motivation () High ( ) Average ( ) Low Language Spoken at Home (if other than standard English): RemarksSummary Score Sheet Profile Scales Clinical Indicators Seles s|s|_|z g ele |e s| 8/8 £/8ls)2lesl 2]. cad |22) 2,| Ee 2| 3) 2/2) 2/213] 2 [be] 3/3 Number |5¢| 32) 52 2/2] 2)/2| 8/3/25 |23| B] = 25| a8! as é|@| él|2|2/8)2|5 |z2| 2/2 1816 BIG 28/6 | 4 58/6 B/G Be | a Be 4 8 9 08/6 1 12816 1938/6 18/6 5 168/6 Total = b. Interpersonal Matrix iB useee|4.— 4. Aé1| sup-o|sup.cluim|PRoe|RES-1]Res-2|Res-a|anx|acc|DEP| RE,|UNR|ATY [MAL Role itd 6. Mother a (aca lence i. Father Parents ‘Age Family ___[er]es|i [ss Siblings A - = ay AIA cee MAL ‘Schoo! YoY ed Personnel FEF ALA Ones | RES3 | ALALa