Response
Sheet
CAPs
TM
Clinical Assessment of Pragmatics
Adriana Lavi, PhD, CCC-SLP
Name Gender Grade
Female Male
School Year Month Day
Date tested
Examiner’s name
Date of birth
Examiner’s title
Age
Instructions
Use this Response Sheet to write the examinee’s verbal responses if needed for your reference in scoring the test
at a later time or to keep for your records.
EXAMPLES
1.
2.
3.
4.
Copyright © 2018–2020 by Western Psychological Services. Permission is granted to qualified individual users of the WPS Online Evaluation System
to reproduce this form for the sole purpose of collecting a client’s CAPs responses. No other use—including and not limited to adaptation and/or
translation—may be made without the prior written permission of WPS (rights@[Link]). All rights reserved. 9 8 7 6 5 4 3 2 1 1
INSTRUMENTAL PERFORMANCE APPRAISAL
1.
2.
3.
4.
5.
6.
7.
8.
Copyright © 2018–2020 by Western Psychological Services. Permission is granted to qualified individual users of the WPS Online Evaluation System
to reproduce this form for the sole purpose of collecting a client’s CAPs responses. No other use—including and not limited to adaptation and/or
translation—may be made without the prior written permission of WPS (rights@[Link]). All rights reserved. 9 8 7 6 5 4 3 2 1 2
SOCIAL CONTEXT APPRAISAL
1.
2.
3.
4.
5.
6.
7.
8.
Copyright © 2018–2020 by Western Psychological Services. Permission is granted to qualified individual users of the WPS Online Evaluation System
to reproduce this form for the sole purpose of collecting a client’s CAPs responses. No other use—including and not limited to adaptation and/or
translation—may be made without the prior written permission of WPS (rights@[Link]). All rights reserved. 9 8 7 6 5 4 3 2 1 3
PARALINGUISTIC DECODING
1.
2.
3.
4.
5.
6.
7.
8.
Copyright © 2018–2020 by Western Psychological Services. Permission is granted to qualified individual users of the WPS Online Evaluation System
to reproduce this form for the sole purpose of collecting a client’s CAPs responses. No other use—including and not limited to adaptation and/or
translation—may be made without the prior written permission of WPS (rights@[Link]). All rights reserved. 9 8 7 6 5 4 3 2 1 4
INSTRUMENTAL PERFORMANCE
1.
2.
3.
4.
5.
6.
7.
8.
Copyright © 2018–2020 by Western Psychological Services. Permission is granted to qualified individual users of the WPS Online Evaluation System
to reproduce this form for the sole purpose of collecting a client’s CAPs responses. No other use—including and not limited to adaptation and/or
translation—may be made without the prior written permission of WPS (rights@[Link]). All rights reserved. 9 8 7 6 5 4 3 2 1 5
AFFECTIVE EXPRESSION
1.
2.
3.
4.
5.
6.
7.
8.
Copyright © 2018–2020 by Western Psychological Services. Permission is granted to qualified individual users of the WPS Online Evaluation System
to reproduce this form for the sole purpose of collecting a client’s CAPs responses. No other use—including and not limited to adaptation and/or
translation—may be made without the prior written permission of WPS (rights@[Link]). All rights reserved. 9 8 7 6 5 4 3 2 1 6
PARALINGUISTIC SIGNALS
1.
2.
3.
4.
5.
6.
7.
8.
Copyright © 2018–2020 by Western Psychological Services. Permission is granted to qualified individual users of the WPS Online Evaluation System
to reproduce this form for the sole purpose of collecting a client’s CAPs responses. No other use—including and not limited to adaptation and/or
translation—may be made without the prior written permission of WPS (rights@[Link]). All rights reserved. 9 8 7 6 5 4 3 2 1 7
