STUDENT SERVICES

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|[pic] |HANOVER SCHOOL DIVISION | |

| |STUDENT SERVICES |Pat Burgess, Director |

| |P.O. Box 2110 |( (204) 326-9829 |

| |Steinbach, Manitoba |( FAX: 326-2353 |

| |Canada R5G 1N6 |Email: burgessp@hsd.ca |

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School Psychologist's Report

-CONFIDENTIAL-

|Student’s Name: | |

|Date of Birth: | |

|Chronological Age: | |

|School: | |

|Grade Level: | |

|Parents (Guardians): | |

|Address: | |

|Phone Number: | |

|Referred by: | |

|Date of Report: | |

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Reason for Referral

$ST was referred to the school psychologist because

Background Information

Home and Family: $ST is the second third oldest youngest of children in his her family. His Her father works as a , whereas his her mother is a homemaker works as a

Developmental History:

Medical History:

School History:

Sources of Assessment Data

Wechsler Intelligence Scale for Children - Third Edition (WISC-III)

Wechsler Preschool and Primary Scale of Intelligence – Third Edition (WPPSI-III)

Wechsler Adult Intelligence Scale - Third Edition (WAIS-III)

Cognitive Assessment System (CAS)

Conners' Continuous Performance Test-Second Edition (CPT-II)

Matrix Analogies Test (MAT)

Draw-A-Person Test (DAP)

The Developmental Test of Visual-Motor Integration (VMI)

Bender Visual-Motor Gestalt Test (Bender)

Test of Visual-Perception Skills (TVPS)

Test of Visual Perception Skills: Upper Level – Revised (TVPS:UL-R)

The Phonological Awareness Test (PAT)

Comprehensive Test of Phonological Processing (CTOPP)

Scales of Independent Behaviour - Revised (SIB-R)

Vineland Adaptive Behaviour Scales (VABS)

Checklist of Adaptive Living Skills (CALS)

Wechsler Individual Achievement Test – Second Ed. (WIAT-II)

The Boder Test of Reading-Spelling Patterns (BT)

Test of Written Language - Second Edition (TOWL-2)

KeyMath - Revised : Form B (KM-R)

Woodcock-Johnson - Revised : Achievement Battery (WJ-R:A)

The Study Skills Inventory (SSI)

The Sixteen Personality Factor Questionnaire (16 PF)

The Children’s Personality Questionnaire (CPQ)

Minnesota Multiphasic Personality Inventory - Adolescent (MMPI-A)

The Jesness Inventory (JI)

The Mooney Problem Check List (MPCL)

Issues Checklist (IC)

Conflict Behaviour Questionnaire (CBQ)

Self-Perception Profile for Children (SPPC)

Piers-Harris children’s Self-Concept Scale (PH)

The Revised Children's Manifest Anxiety Scale (RCMAS)

Multidimensional Anxiety Scale for Children (MASC)

Weinberg Depression Scale for Children and Adolescents (WDSCA)

The Children's Depression Inventory (CDI)

The Suicidal Ideation Questionnaire (SIQ)

Sentence Completion (SC)

Draw-A-Person: Screening Procedure for Emotional Disturbance (DAP:SPED)

The House-Tree-Person (HTP)

The Kinetic Drawing System (KDS)

Conners Teacher Rating Scale - Revised (CTRS-R)

Conners Parent Rating Scale - Revised (CPRS-R)

Conners-Wells’ Adolescent Self-Report Scale (CASS)

Home Situations Questionnaire - Revised (HSQ-R)

School Situations Questionnaire - Revised (SSQ-R)

Devereux Scales of Mental Disorders (DSMD)

Child Behaviour Checklist (CBC)

Teacher Report Form (TRF)

Youth Self-Report (YSR)

Social Skills Rating System - Teacher (SSRS-T)

Social Skills Rating System – Parent (SSRS-P)

The Childhood Autism Rating Scale (CARS)

The Autism Behaviour Checklist (ABC)

The Autistic Continuum (TAC)

POP Teacher Checklist (POP-T)

POP Parent Checklist (POP-P)

Classroom Observation

Classroom Work Samples

Parent Interview

Student Interview

Teacher Interview

Cumulative Record Review

Background Information Form

Behavioural Observations

Classroom Observations: $ST was observed in the classroom setting on

Playground Observations: $ST was observed during recess on

Observations During Testing: During the individual testing sessions, $ST

Cognitive-Perceptual Functioning

At the chronological age of years months, $ST obtained a Full Scale IQ on the WISC-III that placed him her within the " " classification of intelligence. The chances are 90 out of 100 that the range of scores from to includes his her true Full Scale IQ. His Her overall performance is better than or equal to percent of the other children adolescents his her age in the Canadian standardization sample. His Her estimated mental age was roughly years months at the time of testing. These results are considered a valid estimate of $ST's general intellectual ability, since the testing conditions were favourable, and he she put forth a good effort.

$ST’s WISC-III Verbal Scale IQ of was significantly lower higher than his her Performance Scale IQ of . This suggested that his her Verbal Comprehension ability is significantly higher lower than his her Perceptual Organization ability.

The CPT-II was used as a clinical measure of attention span. This 14-minute test requires that the student press a computer keyboard spacebar each time a letter flashes on the monitor screen, except for the letter “X.” The test was administered on at a.m. p.m. Compared to other students of the same age and gender, $ST (with other students having a chronological age that was equivalent to $ST’s estimated mental age on the WISC-III), he she obtained an overall index of

On the Bender, $ST’s fine visual-motor coordination was like that of students between the ages of to . His Her overall performance was better than percent of the other students his her age in the Koppitz standardization sample. He She used his her right left hand to copy the geometric designs in minutes, which was faster slower than normal. The types of errors shown included . Various emotional indicators suggested .

On the VMI, $ST’s fine visual-motor coordination was like that of students between the ages of to . His Her overall performance was better than percent of the other students his her age in the standardization sample. He She used his her right left hand to copy the geometric designs in minutes, which was faster slower than normal. The types of errors shown included .

On the TVPS, $ST’s overall visual perception was better than percent of other student’s his her age in the standardization sample. His Her median age-equivalent score was years months. Relative strengths were demonstrated in Conversely, relative weaknesses were shown in

The PAT was used to measure $ST’s phonological awareness. This area of auditory processing has been shown through research to significantly correlate with word recognition (decoding) and spelling achievement. In particular, this test measures a student’s ability to mentally manipulate basic sound units heard within words (e.g., syllables, phonemes), along with facility in reading graphemes and nonsense words. Compared with other children his her age, $ST’s overall performance was better than or equal to percent of them. His Her overall ability was like that of children at the age of years months. Difficulties were exhibited in rhyming segmenting isolating deleting substituting blending

Adaptive Functioning

The SIB-R was used to assess $ST's level of independence and adaptive functioning. The SIB-R defines functional independence and adaptive behaviour as an individual's ability to effectively meet social and community expectations for establishing personal independence, maintaining physical needs, conforming to social norms, and sustaining interpersonal relationships. At the chronological age of years months, $ST obtained the following adaptive functioning scores.

|Skill |Standard |Age- |Age-based |Skill |

|Area |Score |Equivalent |Percentile |Level |

|Motor Skills: | | | | |

|Social Interaction & | | | | |

|Communication Skills: | | | | |

|Personal Living Skills: | | | | |

|Community Living Skills: | | | | |

|Broad Independence: | | | | |

When $ST's adaptive skills were further analyzed, the following pattern of strengths and weaknesses were observed.

Strengths Weaknesses

Academic Functioning

At the chronological age of years months, and at the grade placement of , $ST obtained the following academic achievement scores on the WIAT-II.

|WIAT-II |Standard |Age-based |Age-Equivalents |Grade- |

|Subtests |Scores |Percentiles | |Equivalents |

|Pseudoword Decoding | | | | |

|Word Reading | | | | |

|Reading Comprehension | | | | |

|Composite Reading | | | | |

|Spelling (from dictation) | | | | |

|Written Expression | | | | |

|Comp. Written Language | | | | |

|Numerical Operations | | | | |

|Math Reasoning | | | | |

|Composite Mathematics | | | | |

|Listening Comprehension | | | | |

|Oral Expression | | | | |

|Comp. Oral Language | | | | |

When $ST's WISC-III Full Scale IQ was used as a predictor of achievement on the WIAT-II, a significant aptitude-achievement discrepancy was found between his her predicted and actual scores. Only percent of the standardization sample had an aptitude-achievement discrepancy as large as the one obtained by $ST. This suggested that $ST has a specific learning disability in .

On the Word Reading subtest, $ST had trouble with the following:

|Word Reading Skills |% Correct |

|Identifying Alphabet Letters | |

|Identifying Rhyming Words | |

|Identifying Beginning Sounds | |

|Identifying Ending Sounds | |

|Identifying Letter-Sound Associations | |

|Word Recognition | |

|Word Reading Behaviours |Always |Seldom |Never |

|Laboriously “sounds out” words | | | |

|Pronounces words automatically | | | |

|Substitutes a visually similar letter | | | |

|Provides non-word responses for rhyming words | | | |

|Self-corrects errors | | | |

|Makes accent errors | | | |

|Adds, omits, or transposes syllables when reading words | | | |

On the Pseudoword Decoding subtest, $ST had difficulty with the following:

On the Reading Comprehension subtest, the following results were obtained:

|Reading Comprehension Skills |No. of Items |% Correct |

|Predicting Events and Outcomes | | |

|Drawing Conclusions | | |

|Recognizing Stated Detail | | |

|Recognizing Implied Cause and Effect | | |

|Using Context To Determine Word Meaning | | |

|Recognizing Implied Detail | | |

|Recognizing Stated Cause and Effect | | |

|Identifying The Main Idea | | |

|Sequencing Events | | |

|Making Inferences | | |

$ST had the following difficulties on the Spelling subtest.

|Spelling Skills |No. of Items |% Correct |

| | | |

| | | |

| | | |

| | | |

| | | |

| | | |

| | | |

The following impressions were arrived at from observations during and after his spelling test.

|Spelling Behaviours |Always |Often |Seldom |Never |

|Makes spelling errors on contractions | | | | |

|Has difficulty with consonant letter cluster/sound | | | | |

|relationships | | | | |

|Makes spelling errors in medial position of words | | | | |

|Omits suffixes that mark tense or part of speech markers | | | | |

|(e.g., -ed, -ly) | | | | |

|Makes spelling errors at the beginning of words | | | | |

|Makes spelling errors at the ending of words | | | | |

|Spells phonetically | | | | |

|Has difficulty with single consonant letter/sound | | | | |

|relationships | | | | |

|Writes and rewrites a word several times to determine which| | | | |

|“looks” right | | | | |

|Self-corrects errors | | | | |

|Writes the incorrect homonym | | | | |

On the Math Reasoning subtest, $ST obtained the following results.

|Math Reasoning Skills |No. of Items |% Correct |

|Recall and apply basic multiplication and division facts and procedures | | |

|Compare and order fractions | | |

|Relate fractions to decimals | | |

|Solve multiplication and division problems using fractions and decimals | | |

|Use patterns to make predications and generalizations | | |

|Select and use appropriate formulas to sole problems involving length and area | | |

|Multi-step problems | | |

|Apply calculation skills using decimals to sole problems involving money | | |

On the Numerical Operations subtest, $ST obtained the following results.

|Numerical Operations Skills |No. of Items |% Correct |

|Subtraction – multi-digits – with regrouping | | |

|Subtraction – with regrouping using decimals | | |

|Division – using single digit divisor – with regrouping | | |

|Subtraction of simple fractions with different denominators | | |

|Multiplication – multi-digits | | |

|Division – using multi-digits – with regrouping | | |

|Calculating with exponents | | |

|Multiplication – using decimals | | |

|Calculating square root | | |

|Addition of negative integers | | |

Instructional Preferences

The table below includes information about how $ST likes to be taught and evaluated. Those statements followed by an “X” indicate possible areas of instructional adaptation that might increase $ST’s academic achievement in class.

$ST prefers to:

|Work in a group |X |Work alone | |

|Sit near the front, close to the teacher | |Sit near the back, away from the teacher | |

|Learn by touching and handling things | |Learn by watching the teacher demonstrate | |

|Work in a quiet classroom | |Work with some noise in the background | |

|Have the teacher come to his her desk to provide help | |Go to the teacher’s desk to get help | |

|Learn by watching the teacher demonstrate | |Learn by listening to the teacher explain | |

|Discuss new ideas as a class | |Read about new ideas | |

|Watch a video to learn about something | |Listen to the teacher explain something | |

|Draw pictures to remember an idea. | |Write words to remember an idea. | |

|Tell the teacher what he she knows to demonstrate what’s | |Draw about what he she knows to demonstrate what’s been | |

|been learned. | |learned – e.g., diagrams, maps, murals, etc. | |

|Build something to demonstrate learning. | |Act in a play to demonstrate learning. | |

|Do multiple choice tests | |Do written short answer tests | |

|Do matching test items | |Do fill-in-the-blank test items | |

|Write an essay test | |Write a short answer test | |

|Do a harder open book test | |Do an easier closed book test | |

|Complete two big projects | |Complete four small projects | |

|Do an individual presentation | |Do a group presentation | |

When asked to rate how much he she likes various school subjects and activities, $ST gave the following ratings out of 10:

Motivational Interests

$ST identified several motivational interests that may be incorporated into his her educational program through activation of prior knowledge, choice of curricular topics and books, instructional examples, and back-up reinforcement choices. For example, $ST likes

Social-Emotional Functioning

$ST’s parents completed the CBC on 2002. The results are reported in T-scores (Mean = 50; SD = 10). T-scores from 67 – 70 are considered “borderline,” whereas scores > 70 are considered “clinically significant.” Scores from the CBC are plotted on the graph below with square data points. Their His Her ratings resulted in a Total T-score of , which suggested . Moreover, his her T-score of on the “Internalizing” scale was significantly greater lower than his her T-score of on the “Externalizing” scale. This suggested that

Scores on the individual Problem Scales resulted in the following profile compared with other elementary-aged adolescent boys girls.

Additional problems on the CBC supplementary scale included

$ST’s teacher(s) the TRF on 2002. The results are reported in T-scores (Mean = 50; SD = 10). T-scores from 67 – 70 are considered “borderline,” whereas scores > 70 are considered “clinically significant.’ Scores from the TRF are plotted on the graph below with diamond data points. Their His Her ratings resulted in a Total T-score of , which suggested . Moreover, his her T-score of on the “Internalizing” scale was significantly greater lower than his her T-score of on the “Externalizing” scale. This suggested that

Additional problems on the TRF supplementary scale included

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$ST’s parents completed the CPRS-R on . Their ratings of his her behaviour resulted in borderline (61 – 65) and clinically significant (> 65) scores on the following scales:

Scores from the CPRS-R are plotted on the graph below with square data points.

$ST’s teacher(s) completed the CTRS-R on . Their His Her ratings of his her behaviour resulted borderline (61 – 65) and in clinically significant (> 65) scores on the following scales:

Scores from the CTRS-R are plotted on the graph below with diamond data points.

[pic]Descriptions for each of the scales shown in the graph above are presented in the Appendix at the end of this report.

The following results were obtained from the POP Checklists:

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The SSRS-T was used to examine $ST’s social skills, problem behaviour, and academic competence. The results are depicted in the table below.

| |Social |Problem |Academic |

| |Skills |Behaviours |Competence |

|Standard Score | | | |

|Percentile Rank | | | |

The results derived from his her teacher’s ratings suggest that $ST has assertive and cooperative social skills than other boys girls his her age, whereas his her self-control skills fall within the range. Cooperative skill deficits include the following: Self-control skills deficits included the following: (a) Assertive skill deficits included the following: (a) # problem behaviours were identified by $ST’s teacher: Regarding his her academic competence, $ST is at the percentile.

Summary and Conclusions

$ST is a -year-old boy girl male female who functions overall within the classification of intelligence.

Recommendations

__________________________

Ron Teffaine, M.Ed. CSC

School Psychologist

|Level I: |Disability Code: |

c.c.: Pat Burgess, Student Services Director

Jennifer Tsouris, Speech-Language Pathologist

Wendy Smook-Bataluk, Speech-Language Pathologist

Gillian Bloomfield, Speech-Language Pathologist

Geraldine Harder-Robson, Crisis Counsellor

Corrine Hildebrandt, Occupational Therapist

Lorie Lenchyshyn, Behaviour Support Teacher

Brigette Hildebrand, Elementary Social Worker

Norm Hiebert, Agency Liaison Social Worker

parents

File

School - After reading report, please initial below and circulate as follows:

| | |Classroom |Resource |Guidance |Pupil Support |

| |Principal |Teacher(s) |Teacher |Counsellor |File |

| | | | | | |

|Initial: | | | | | |

Appendix

|CPRS-R or CTRS-R |Scale |

|Problem Scales |Descriptions |

|A. Oppositional |Are likely to break rules, have problems with authority, are easily annoyed |

|B. Cognitive Problems/ Inattention |Are likely to be inattentive, have organizational problems, have difficulty completing |

| |tasks, have concentration problems |

|C. Hyperactivity |Have difficulty sitting still for very long, feel restless and impulsive |

|D. Anxious-Shy |Have atypical amount of worries and fears; prone to be emotional and sensitive to |

| |criticism, anxious in unfamiliar situations, are shy and withdrawn |

|E. Perfectionism |Set high goals for themselves, are very fastidious about the way they do things, are |

| |obsessive about their work |

|F. Social Problems |Are likely to perceive that they have few friends, have low self-esteem and |

| |self-confidence, feel socially detached from their peers |

|G. Psychosomatic |Report atypical amount of aches and pains |

|H. ADHD Index |Identifies children/ adolescents “at risk” for ADHD |

|I. Restless-Impulsive |This subscale indicates restlessness, impulsivity, and inattentiveness |

|J. Emotional Lability |Individuals with high scores on this subscale are prone to more emotional |

| |responses/behaviours (e.g., crying, anger, etc.) than is typical |

|L. DSM-IV Inattentive |High scores indicate an above average correspondence with the DSM-IV diagnostic criteria |

| |for Inattentive type ADHD |

|M. DSM-IV Hyperactive-Impulsive |High scores indicate and above average correspondence with the DSM-IV diagnostic criteria|

| |for Hyperactive-Impulsive type ADHD |

|N. DSM-IV: Total |High scores indicate an above average correspondence to DSM-IV criteria for combined |

| |Inattention and Hyperactive-Impulsive type ADHD |

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