Nicole Capone



THE PUBLIC SCHOOLSNEW JERSEYCONFIDENTIALPSYCHOLOGICAL ASSESSMENTStudent: Michael SmithSchool: NJ High SchoolD.O.B:4/28/1998Parent/Guardian: N/AAge: 16-5Classification: Other Health ImpairmentAddress: N/ADate(s) of Assessment: 9/22/14, 10/21/14Date of Report: 10/27/141. REASON FOR REFERRAL:The child study team members are conducting Michael’s re-evaluation in order to determine in continued eligibility for special education and related services. 2. METHODS OF ASSESSMENT: Review of RecordsStudent InterviewTeacher FeedbackBehavioral ObservationSentence Completion FormHouse-Tree-PersonWechsler Adult Intelligence Scale-Fourth Edition- (WAIS-IV)Behavior Assessment System for Children, 2nd Edition, Teacher Rating ScalesBehavior Assessment System for Children 2nd Edition, Self-ReportConners 3rd Edition- Teacher Assessment ReportConners 3rd Edition- Self Report Short Form Assessment Report 3. BACKGROUND INFORMATION:Michael Smith is a 10th grade student enrolled in the Resource program at New Jersey High School. His current schedule for Chemistry, English 10, Geometry, Science, English, and Math is in a pull out resource classroom. Currently Michael meets eligibility for Special Education and Related Services under the criteria of Other Health Impairment.Review of records indicates Mrs. Smith referred Michael for an initial evaluation of the Child Study Team in 2005 while he was a student at Elementary School. Mrs. Smith noted in her request that Michael had exhibited academic delays since pre-school and that she had expected he would make progress with time; however, he exhibited insufficient academic progress. Further review or records indicates developmental milestones were met in a timely fashion. Michael had no significant health issues in infancy or early childhood. Michael attended preschool for one year at the Elementary School. He moved to Elementary for kindergarten. During preschool and kindergarten, teachers noted that Michael was delayed when compared to his peers and that he failed to grasp the basic skills for his age level. Similar concerns were voiced during first grade. At the time of referral in 2005, attention difficulties and reading/writing problems were the main concerns expressed by both Michael’s mother and teacher. Michael was noted to have adequate self-help skills but needed reminders to properly care for himself and his belongings. Socially, Michael was able to make friends and maintain friendships. No significant behavioral issues were noted during school. Michael has a diagnosis of ADHD-Combined Type made by Dr. Isabel Carotenuto, a pediatric neurologist. Dr. Carotenuto noted an impulsive motor style and slightly elevated activity level reflected by observation and questionnaire. Mrs. Smith reports Michael has started taking medication again in September 2014. The family is working with Dr. Farheen Fahim to determine proper medication and dosage for Michael. As of October 21, 2014 Michael is taking 20mg of Ritalin daily. ASSESSMENT RESULTS:INTERVIEW WITH THE STUDENT: Michael was interviewed by, Nicole Capone, School Psychologist Intern on 9/22/2014. Michael came willingly to the testing session and easily warmed up to the examiner. He answered all questions appropriately but used minimal detail. Michael stated he resides with his mother, father and younger brother (11 years old), he also revealed he had two older brothers in their twenties. He reported to get along with his family most of the time. When asked about school, he reported his favorite subject to be science and his least favorite subject to be math because it was “difficult”. When asked to elaborate Michael repeated that it was difficult and he was not sure why exactly. In the future Michael hopes to become a police officer. His plan is to initially take the state test and go to college. During his free time, Michael discusses enjoying “hanging out wit h friends” and playing football. TEACHER FEEDBACK-Michael’s American Literature Teacher reports he is receiving an A in her class. She also stated he completes all assignments and works hard especially on his writing. He is polite and very helpful to the other students in classMichael’s Geometry Teacher stated he is a pleasure to have in class. He usually follows lessons carefully and completes independent work well. Michael participates often voluntarily, and is able to explain his processes to other students. One area for Michael to work on would be to regularly complete his homework. At the end of last week Michael had a 65% HW average, but he completed both of the two recent assignments, which brought his average up to 68%. This positive trend is a good choice on Michael's part! It would be wise for him to continue.BEHAVIORAL OBSERVATION DURING ASSESSMENT- During Psychological Assessments (9/22/2014):Michael arrived to the testing room in age-appropriate attire. Throughout the testing, Michael was cooperative and respectful. When it was unclear to Michael why some things were being done during testing he voiced his concerns. All of Michael’s questions were answered and he appeared satisfied with the explanation. Michael worked quickly on most tasks and appeared motivated to perform well; he attempted all of the tasks presented. On one particular task (Arithmetic) Michael was given the option to repeat instructions; he often asked and took a moment to process the information before giving his answer. During Second Psychological Assessments (10/21/14):Michael accompanied the examiner willingly to the second testing session. The examiner explained there was a significant difference between his testing that had taken place in September versus his academic testing done in October. It is possible the differences may have been to new medication (Ritalin). The examiner discussed with Michael she wanted to obtain an accurate reflection of his skills. He appeared okay with this decision. The examiner asked Michael if he had seen a difference in the classroom, now taking the medication. He stated, “In school it is helping me focus more”. During the testing session Michael appeared focused and motivated to do well. On one task Michael was asked to repeat a sequence of letters and numbers presented verbally to him. He took his time organizing the sequence appropriately. During the initial testing session Michael was asked to complete a similar task and fell below age level expectations. This particular task weighs heavily on attention and focus and was a good comparison between Michael’s testing sessions.Structured Assessment (9/15/14):Michael was observed by, Nicole Capone School Psychologist Intern, on September 15, 2014 during his Algebra II Class. There were ten students, one teacher (Ms. O’Neill) and one instructional assistant present. Michael sat in the front of the classroom, second seat in and had a clear view of the board. As students walked in there was a problem of the day displayed on the board. Students were instructed to copy down the problem and begin working on it independently. After ten minutes Michael had copied minimal information from the board and had not begun solving the problem. Today this was reviewing geometry lessons. Ms. O’Neill checked in with each student to give points for “being prepared for class”. The requirements are coming to class with a writing utensil, calculator, and notebook. Michael was fully prepared for class receiving three points. A student then entered the class late. Michael became distracted and looked away from his work. This was common throughout the lesson. However, after several minutes Michael was able to continue on task. Ms. O’Neill began going over the problem of the day on the board. When called upon Michael was able to answer questions correctly and appropriately.FORMAL INTELLIGENCE –Previous Testing: 2011WECHSLER INTELLIGENCE SCALE OF CHILDREN– FOURTH EDITION (WISC-IV)ScaleComposite ScorePercentileRankQualitativeDescriptionVerbal Comprehension (VCI)8516Low AveragePerceptual Reasoning (PRI)8212Low AverageWorking Memory (WMI)11686High AverageProcessing Speed (PSI)9742AverageFull Scale (FSIQ)9025AverageMean = 100 Standard Deviation = 15Current Evaluation Results:WECHSLER ADULT INTELLIGENCE SCALE– FOURTH EDITION (WAIS-IV)ScaleComposite ScorePercentileRankConfidence IntervalQualitativeDescriptionVerbal Comprehension (VCI)831378-89Low AveragePerceptual Reasoning (PRI)77672-84BorderlineWorking Memory (WMI)11787109-123High AverageProcessing Speed (PSI)974289-106AverageFull Scale (FSIQ)892385-93Low AverageMean = 100 Standard Deviation = 15Composite Scores SummaryVerbal Comprehension Subtest Scores SummarySubtestsScaledScorePercentileRankSimilarities69(Vocabulary)55Information69Comprehension937 Mean = 10 Standard Deviation = 3 Scores in Parenthesis were not included in the FSIQ Perceptual Reasoning Subtest Scores SummarySubtestsScaledScorePercentileRankBlock Design69Matrix Reasoning69Visual Puzzles69Mean = 10 Standard Deviation = 3Working Memory Subtest Scores SummarySubtestsScaledScorePercentileRankDigit Span1050(Arithmetic)716Letter-Number Sequencing 1698Mean = 10 Standard Deviation = 3Scores in Parenthesis were not included in the FSIQ Processing Speed Subtest Scores SummarySubtestsScaledScorePercentileRankSymbol Search825Coding1163Mean = 10 Standard Deviation = 3The Wechsler Adult Intelligence Scale–Fourth Edition (WAIS-IV) was administered to Michael. This is an individually administered instrument used to assess the cognitive functioning of adolescents and adults. Tasks examine diverse skills such as verbal reasoning, vocabulary knowledge, social judgment, visual spatial reasoning, visual constructive integration, and working memory. The following results should be interpreted with caution. Due to Michael’s score differences between his substest scores during his initial testing session to the subtest scores on his second testing session, the following scores may not be an accurate reflection of his cognitive skills. The WAIS-IV is comprised of four composite scores, which combine to yield the Full Scale IQ. The Full Scale IQ (FSIQ) is derived from a combination of four index scores and is considered the most representative estimate of global intellectual functioning. On the WAIS-IV, Michael’s general cognititve ability is within the Low Average range of intellectual functioning, as measure by the FSIQ. His overall thinking and reasoning abilities exceed only approximatly 23% of indidviudals his age (FSIQ=89; 95% confidence interval= 85-93). Michael performed slightly better on verbal than on nonverbal tasks, but there is no meaningful difference between Michael’s ability to reason with and without the use of words. Verbal ComprehensionThe Verbal Comprehension Index is composed of three subtests measuring verbal abilities utilizing reasoning, comprehension, and conceptualization. Michael’s verbal reasoning abilities are in the borderline range and above those of only 13% of his peers (VCI = 89; 95% confidence interval= 85-91). Michael’s performance on the verbal subtests present a diverse set of verbal abilities, as he performed much better on some verbal tasks than others. The degree of varibabilty is unusal. Michael demonstrated his weakest performance among the verbal reasoning tasks on the information subtest. His performance on this subtest was well below most of his peers. The information subtest required Michael to respond orally to questions about common events, objects, places, and people. The subtest is primarily a measure of his fund of general knowledge. Performance on this subtest also may be influenced by cultural experience and quality of education, as well as his ability to retrieve information from long-term memory. Although not included in his FSIQ Michael displayed difficulty on the Vocabulary subtest. On Vocabulary students are able to receive partial credit on items. For Michael, he received full credit on all his correctly provided scored items. However when words became unrecognizable to him he was not able to receive any credit. Overall Michael either knew the words well or not at all. This subtest score could be influenced by motivation or attention at the time of the subtest. Perceptual ReasoningThe Perceptual Reasoning Index is composed of subtests designed to measure fluid reasoning in the perceptual domain with tasks that assess nonverbal concept formation, visual perception and organization, visual-motor coordination, learning and the ability to separate figure and ground visual stimuli. Michael’s nonverbal reasoning abilities as measured by the Perceptual Reasoning Index are in the Borderline range and above only those of 6% of his peers (PRI = 77; 95% confidence interval= 72-84). Stephanie performed comparably on the perceptual reasoning subtests contributing to the PRI, suggesting that his visual-spatial reasoning and perceptual-organizational skills are similarly developed.Working MemoryThe Working Memory Index is composed of subtests measuring attention, concentration, and working memory. Michael’s ability to sustain attention, concentrate, and exert mental control is in the Average range. He performed better than 87% of his peers on the Working Memory Index (117; 95% confidence interval=109-123). It is important to note the significant difference between the two subtests that compose the WMI; this difference suggests that a single score may not be the most accurate representation of Michael’s auditory working memory abilities. Michael’s abilities to sustain attention, concentrate, and exert mental control are better developed than his nonverbal and verbal reasoning abilities. Good mental control may facilitate the processing of complex information and ease the learning of new material. Processing SpeedThe Processing Speed Index is composed of subtests measuring perceptual discrimination, speed of mental operation, psychomotor speed, attention, concentration, short-term visual memory, visual-motor coordination and cognitive flexibility. Processing speed is a measure that is not related with intelligence, per se. Rather than indicating how a student thinks about information, it is a measure of the speed and efficiency with which a student both “inputs” and “outputs” information. It is a skill, however, that can impact a student’s academic performance, particularly if speed and quantity of output is emphasized.Michael's ability in processing simple or routine visual material without making errors is in the Average range when compared to his peers. He performed better than approximatley 42% of his peers on the processing speed tasks (Processing Speed Index = 97; 95% confidence interval 89-106). Michael’s performance amongst subtests were variable; therefore, the PSI score should be interpreted with caution. Michael performed higher on Coding (scaled score=11). An area of stregnth for Michael was on the Coding subtest. Coding is more demaindidng of fine-motor skills, short-term momory, and learning abilitiy, when compared to Symbol Search (scaled score=8). Symbol search is more demanding of attention to detail and visual disrtimination. Processing visual material quickly, he perfoms well as compared to his vrebal and nonverbal reasoning ability. Processing speed is an idication of the rapidity with which Michael can mentally process simple or routine information without making errors. INFORMAL ASSESMENT – The Conners 3rd EditionThe Conners’ Rating Scale 3rd Edition (Conners – 3) was used to assess Michael’s behavioral functioning. The Conners--3 is a standard instrument for the assessment of attention-deficit/hyperactivity disorder (ADHD) and related problem behaviors in children and adolescents. The Conners-3 evaluates problem behaviors by obtaining (and combining, if possible) reports from teachers, parents (or alternate caregivers), and adolescents. The Connors Report Forms were administered to Michael, and his two teachers for Math and English. The results of the completed surveys are below.The following table summarizes the results of Michael’s assessment of himself and provides general information about how he compares to the normative group.Clinical Scales GuidelineT ScoreElevated Concerns70 & above Slightly More Concerns60-69Typical Concerns41-59ScaleT-score(Percentile)GuidelineCommon Characteristics of High ScorersInattention41Average Score (Typical levels of concerns)N/AHyperactivity/Impulsivity43Average Score (Typical levels of concerns)N/ALearning Problems48Average Score(Typical levels of concern)N/ADefiance/Aggression47Average Score(Typical levels of concern)N/AFamily Relations42Average Score(Typical levels of concern)N/AThe following table summarizes the results of Michael’s Teachers assessment of Michael and provides general information about how he compares to the normative group.ScaleMath EnglishCommon Characteristics of High ScorersT-score GuidelineT-score GuidelineInattention65Elevated Score40 AverageMay have poor concentration and attention; difficulty keeping his mind on work; careless mistakes; easily distracted. May give up easily or be easily bored. May avoid schoolworkHyperactivity/Impulsivity56Average44AverageN/ALearning Problems/Executive Functioning Total60High Average Score41AverageMay have difficulty learning and/or remembering concepts. May need extra instructions. May have executive deficits.Learning Problems (LE Subscale)63High Average Score41AverageAcademic struggles. May have difficulty learning and/or remembering concepts/ May need extra instructions. May have executive deficits.Executive Functioning(LE Subscale)55Average41AverageN/A.Defiance/Aggression48Average45AverageN/A Peer Relations51Average47AverageN/AThe results of the Connors – 3 rating scales displayed some inconsistencies among raters, which are important to recognize. Michael and his teacher, Ms. Davis reported typical concerns for a male student his age among all clinical scales. However, English who had Michael as a student last year reports some concerns in the areas of inattention, learning problems, and learning problems due to executive functioning.The Behavior Assessment System for Children-, Second EditionThe BASC-2 is a norm-referenced, standardized behavioral assessment system, which aids in the identification of both problem behaviors and adaptive skills in children and adolescents. Michael’s assessment consists of two teachers, and self-report rating scales. The Teachers Rating Scale (TRS-A), and the Self-report Scale (SRP-A) were used to assess Michael’s problem behaviors and adaptive skills exhibited in recent months. The scales are comprised of test items which offer descriptions of behaviors and ask the respondent to rate the frequency of occurrence based on a 4-point scale (N = never, S = sometimes, O = often, A = almost always), and the Self-Report scale also contains True or False questions (T = true, F = false).Each completed form provides an overview of Michael’s behavior across a number of domains. The TRS-A assesses Externalizing Problems (i.e., hyperactivity, aggression, conduct problems), Internalizing Problems (i.e., anxiety, depression, somatization), Behavior Symptoms Index (global estimate of behaviors) and Adaptive Skills (i.e., adaptability, social skills, leadership, study skills, and functional communication). Additionally, the TRS-A provides scores for a School Problems domain (i.e., learning problems, attention problems). All raw scores are compared to a nationally representative norm sample of same-gender, same-age peers in order to obtain T scores and percentile ranks. T-scores have a mean of 50 and a standard deviation of 10; the majority of scores fall within one standard deviation of the mean (i.e., 40-60). Percentile ranks indicate the percentage of the norm sample that received a score at or below Michael’s score.Problem behaviors and adaptive skills are measured by, clinical and adaptive scales. Scores that fall in the Clinically Significant range on these scales indicate a high level of maladjustment, whereas scores that fall in the At-Risk range indicate a significant problem that may not be severe enough to require formal treatment or a potential or developing problem that needs to be monitored (see table below for indication of these score ranges).Clinical ScalesAdaptive ScalesT ScoreClinically SignificantVery High70 & aboveAt-RiskHigh60-69AverageAverage41-59HighAt-Risk31-40Very HighClinically Significant30 & belowMichael’s Self-Assessment of her Behavioral FunctioningIn comparison to the normative group (BASC-2)ScaleClassificationImplicationsSchool ProblemsTypical ConcernsN/AInternalizing ProblemsTypical ConcernsN/AInattention/HyperactivityTypical ConcernsN/APersonal AdjustmentTypical ConcernsN/AEnglish Teacher assessments of Michael’s behavioral functioningIn comparison to the normative group (BASC-2)ScaleClassificationImplicationsTeacher One ratingsExternalizing ProblemsTypical ConcernsN/AInternalizing ProblemsTypical ConcernsN/ASchool ProblemsAt-RiskEnglish teacher reports Michael’s T score on Attention problems fell with the Clinically Significant range, implying in the classroom he often becomes easily distracted from classwork. Adaptive SkillsClinically Significant English teacher reports Michael’s T Score on adaptability placed him in the At-Risk range, suggesting Michael has trouble with adjusting to new situations (teachers, classes, etc.) He also fell in the At-Risk range for social skills, implying Michael does not often show interest in others. Additionally, Michael’s T score on Leadership fell in the Clinically Significant range suggesting he cannot make decisions under pressure she may have trouble making decisions and getting people to work together. Math Teacher’s assessments of Michael’s behavioral functioningIn comparison to the normative group (BASC-2)ScaleClassificationImplicationsTeacher One ratingsExternalizing ProblemsTypical ConcernsN/AInternalizing ProblemsTypical ConcernsN/A School ProblemsTypical ConcernsN/AAdaptive SkillsTypical Concerns*Ms. Davis reports Michael’s T Score on Functional communication skills falls within the At-Risk range, implying Michael does not respond appropriately when asked questions and sometimes has trouble discussing personal experiences.Michael’s social/emotional functioning was further assessed by an interview with the student, sentence Completion Task, and drawings with inquiry. These assessments suggest that Michael is an adolescent with typical ideas, desires, and interests. For example, he enjoys spending time with friends, playing sports and relaxing. However, Michael’s drawings reveal similar themes to those found on the BASCs and Conners. For example, his drawings suggest possible impulsivities and some immaturity. The Sentence Completion task was a continuation of these themes.5. SUMMARY:Michael Smith is a 17-year old student who is currently in his 11th grade year at New Jersey High School. He is enrolled in the Resource Program and meets eligability for Speical Education as Other Health Impairment, ADHD. These assessments were done as part of his re-evalution for Speical Education, as well as to obtain his current levels of social/emtional functioning specifically in the area of attention.Michael’s general cognitive ability, should be interpreted with caution. Due to Michael’s score differences between his substest scores during his initial testing session to the subtest scores on his second testing session, the following scores may not be an accurate reflection of his cognitive skills. As estimated by the WAIS–IV, Michael overall cogntivie abilities fell in the Low Average Range (FSIQ = 89). His general verbal comprehension abilities were in the Low Average range (VCI=83) and his general perceptual reasoning abilities were in the Borderline range (PRI=77). Michael’s ability to sustain attention concentrate, and exert mental control is in the high average range (WMI=117). Due to variability between the two subtests that compose the WMI, caution is recommended when interpreting this single score. His ability in processing simple or routine visual material without making errors is in the Average range when compared to his same aged peers (PSI=97). The results of the Connors – 3 rating scales indicate that Michael’s math teacher reported high level of concern with inattention and learning problems indicating some academic struggles. She reported last year Michael sometimes gave up easily needed extra instructions and made careless mistakes in the classroom. His English teacher however, reported no concern in any area. Michael’s social emotional functioning was assessed using the BASC-2 Teacher and Self Reports. The results of theses reports were inconsistent among raters. However there were some consistencies to be discussed. Both teachers indicated concerns with Michael’s adaptive skills specifically his ability to make decisions and communicate verbally his needs in the classroom. It is important Michael build these skills to advocate for himself in the future. His social/emotional functioning was further assessed by an interview, sentence Completion Task, and drawings with inquiry. These assessments suggest that Michael is an adolescent with typical ideas, desires, and interests. For example, he enjoys spending time with friends, playing sports and relaxing. However, Michael’s drawings reveal similar themes to those found on the BASCs and Conners. For example, his drawings suggest possible impulsivities and some immaturity. The Sentence Completion task was a continuation of these themes. Overall, Michael presented as a typical eleventh grade male student. He was compliant and cooperative throughout testing sessions. The details of supports will be determined at his evaluation meeting upon review of all relevant assessments. I certify that the above information reflects my conclusions.___________________________________________________________Nicole Capone, School Psychologist InternDate ................
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