a* > RAVEN’ CPM Record Form Coloured Progressive Matrices eee Ten tay Name _ Gender Om Cr [Date Tested | School School Year eee Examiner ' a | Behavioural Observations _ ee Summary of Scores Raw Score Confidence Interval ‘Total Raw Score (75%, 97.5%, 99.9%) Circle one +] Standard Score Confidence Interval : Standard Score (75%, 97.5%, 99.9%) Circle one Percentile Rank Age Equivalent CPMICVS Discrepancy Score (optional) Cumulative Percentage* 250% CPM Standard Score CVS Standard Score at .01 level CPM -CVS (absolute difference) Difference greater than 10 Yes [_] No If No’ then difference is not statistically significant 28% - 49% t | * Increased shading donotes increasing probability clinically significant difference. "9 4 Cope © (2004) by NCS Peano ‘Aseason opr ©2012) by NCS Pesan ne> g @ RAVEN’ CPM Record Form Coloured Progressive Matrices Place a single line across the examinee’s response. If you make a mistake or the examinee changes their mind, put a cross (X) through that answer and a single fine across the new answer tf the examinee skips an item, make sure you miss out the item on this Record Form Work downwards through each column. SETA SETA, 1 PRB . IDs) * BEB d 2 O T DH * BED ; 7 3 DD 3 [p16 4 DBD ag : wpe (aS(55169 s MRD = . Be * RES : 6 DDD 5 ‘ i} . s DRS (a(55t6) ° DDD . false : RRS 10 (DBE / rte) Ree TC EDEDIED) _ 2 DDD Isto BRP Total Set B Lo