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Psychoeducational Report

___________________________________________________________________________________________________________________________________________________________

CLIENT NAME: BOY, Biker
BIRTHDATE:
AGE: 8 years, 5 months
SCHOOL:
GRADE: Two (recently completed)

DATES OF ASSESSMENT: Date, 2012.
DATE OF REPORT: Date, 2012.

ASSESSED BY: Name, B.A.
Name, B.A.
Shelina Hassanali, B.S.W.
Name, B.A., B.Ed.
Name, B.A.



Statement of Confidentiality

All psychological assessments are confidential in nature as they contain private information,
which may be used inappropriately by others. To protect the privacy and ensure confidentiality
of the persons involved, please ensure that this report is only circulated to those who are
considered essential to related judgments and decision-making. The intent of this report is to
provide opinions and recommendations in the context of psychological intervention, educational
and vocational decision-making, and any use of this report outside of that purpose should only
be done with the informed consent of the parties and in consultation with the writer.

REASON FOR REFERRAL:
Biker was referred to U-CAPES by Dr. Name because of concerns with memory and academic
achievement. Bikers parents reported that Biker has experienced these difficulties since
kindergarten, and they would like to know how they can best support his learning.
BOY, Biker 2 of 22
BACKGROUND INFORMATION:
Background information was obtained from an interview with Mr. Boy and an interview with
Biker. Additional information was obtained from conversation with Mrs. Boy, questionnaires,
and reports from previous assessments.

Biker is 8 years old and lives with his father and mother, in City, Province. Biker has two older
sisters and a younger sister, whom Biker was reported to get along well with. Biker is described
as an imaginative, hardworking, humorous boy with minimal behavioural concerns. Biker
reported that he enjoys dirt biking and spending time with his father at his tire shop. The family
recently moved from City to an acreage in City; Biker seemed pleased with the move and there
were no concerns noted with making new friends. Mr. Boy reported that although Mrs. Boy
loved school as a child, he struggled with reading and writing; difficulties that were also noted in
his father.

Developmental and Medical History
Mrs. Boy reported that her pregnancy with Biker was generally unremarkable; however, she
mentioned that she had high blood pressure near the end of the last trimester. Mrs. Boy reported
that she did not use alcohol or drugs during pregnancy. Biker was born at full term with an
induced delivery, whereby Bikers arm was broken to safely deliver him. According to Mrs.
Boy, Biker was an alert and easy to soothe infant, and he met all of his developmental milestones
within the appropriate timeframe. Mrs. Boy reported that Biker was recently diagnosed with a
visual perception disorder, which resulted in difficulties with visual memory and hand-eye
coordination. Although Biker has received support from an optometrist and occupational
therapist he still has difficulties around memory. Additionally, Biker wears glasses in school to
help him see the board and at home when completing homework. Bikers last vision exam was
in June 2012, and although he has not had a hearing exam, no hearing concerns were noted.

Educational Information
According to Mr. Boy, Biker has struggled in school since kindergarten. Mrs. Boy reported that
Biker had a hard time forming and recognizing letters in kindergarten, so they decided to slowly
transition him into Grade 1. Specifically, Biker was enrolled in kindergarten in the morning and
Grade 1 in the afternoon for a full year before he entered Grade 1. In the fall, Biker will be
attending Grade 3 at School. Mrs. Boy reported that although Biker does not have a lot of
homework, he enjoys reading motocross and rhyming books with her at home. Furthermore,
Biker reported that if he does not understand the teachers directions he often asks his peers who
are able to explain things in kid language. Biker also related that his favourite subjects are
recess, snack, and Gym, and that he wishes he could have a full day of these subjects.

Present Personality and Behaviours
Mr. Boy reported that Biker is an active and outgoing boy who enjoys being outside. Biker
indicated that he enjoys dirtbiking and quadding with his father, as well as camping with his
family. Additionally, Biker reported that he likes to play video games, listen to music, and watch
silly television shows with his parents. Biker has many friends with whom he likes to play Star
Wars games like lightsabers. According to Mr. Boy, discipline at home is consistently carried
out by both parents through loss of privileges or grounding. When asked what he wants to be
when he grows up, Biker replied that he wants to be just like his dad and run a tire shop. There
were no concerns reported with his sleeping habits or appetite.
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Previous Assessments
Biker has had a previous school-based standardized assessment in January 2011. The results
from the Woodcock Johnson III Tests of Achievement indicated that his reading and writing
abilities were within the Very Low range (<1st percentile). Bikers mathematical skills were in
the Low Average range (12th percentile) and his oral language abilities were within the Average
range (50th percentile). It was reported that Biker demonstrated difficulties in the areas of
phonological awareness and decoding.

In September and October, 2010, Biker had an Occupational Therapy Assessment. The results
from the Beery-Butenica Developmental Test of Visual-Motor Integration (VMI) 5
th
Ed.
Indicated that Bikers Visual-motor, Visual-perceptual, and Fine-motor coordination were all
within the Average range. On The Test of Visual-Perceptual Skills (3
rd
Ed.) (TVPS-3) Bikers
visual memory, visual form constancy, and visual sequential memory were extremely low, which
may further explain the difficulties he is having with letter recognition and naming. As such,
Occupational Therapy goals were put in place.

This is Bikers first psycho-educational assessment.


ASSESSMENT INSTRUMENTS:
Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV)
Wechsler Nonverbal Scale of Ability (WNV)
Wechsler Individual Achievement Test Third Edition (WIAT-III)
Tests of Early Reading Ability Third Editions (TERA-3)
Tests of Early Math Ability Third Edition (TEMA-3)
Peabody Picture Vocabulary Test-4
th
Edition Form (PPVT-IV)
Expressive Vocabulary Test, Second Edition (EVT-2)
Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF-4)
Childrens Memory Scale (CMS)
Beery-Buktenica Developmental Test of Visual-Motor Integration - Sixth Edition (Beery
VMI)
Behavior Assessment System for Children (BASC-2) Parent Rating Scale
Conners Third Edition (Conners-3) Parent Rating Scale
Behavior Rating Inventory of Executive Function (BRIEF) Parent Rating Scale

ASSESSMENT OBSERVATIONS:
Testing was completed at Place on Dates. Biker easily separated from his father and quickly
developed rapport with examiners. He put his glasses on for assessment activities. Biker
participated in all activities in a compliant and respectful manner, and he often assisted
examiners with putting test material away. Although Biker was persistent and thoughtful on all
tasks, he particularly enjoyed tasks with building components and/or visual stimuli. On the
second and third day of assessment, Biker eagerly volunteered information and engaged in
conversation about dirt biking and camping with examiners. Biker displayed fidgeting and off
task behaviours at times, however, he was easily redirected to the task at hand. It is believed
that the results of this assessment are an accurate reflection of Bikers current abilities.
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ASSESSMENT RESULTS
Intellectual Assessment
Bikers intellectual abilities were assessed with the Wechsler Intelligence Scale for Children
Fourth Edition (WISC-IV) and the Wechsler Nonverbal Scale of Ability (WNV). Bikers varied
performance across WISC-IV indexes suggests that an overall full scale IQ would not be
representative of Bikers intellectual abilities.

Verbal Comprehension
The Verbal Comprehension Index describes Bikers ability to reason with language. Bikers
performance across verbal thinking tasks (Borderline range, 6
th
percentile) indicates that his oral
reasoning abilities are lower than most of his same age peers. Specifically, Biker demonstrated
difficulty using language to identify similarities between two concepts (Borderline range, 5
th

percentile) and orally defining words (Low Average range, 9
th
percentile). This suggests that
Biker has more difficulty understanding vocabulary and orally expressing his ideas than most
same age peers. Bikers best verbal reasoning performance was on a task requiring an oral
description of appropriate social judgement (Low Average range, 16
th
percentile). In everyday
childhood activities, Biker may have difficulty understanding verbal instructions and questions,
as well as providing verbal responses.

Perceptual Reasoning
Bikers performance across nonverbal problem solving tasks (e.g., patterns, pictures, and visual
puzzles) was within the Average range (68
th
percentile). On a task requiring Biker to identify
pictures that were conceptually similar, he performed within the Average range (37
th
percentile).
When asked to select a picture or design to complete a logical pattern or puzzle, Biker performed
within the High Average range (84
th
percentile). He also demonstrated Average performance
(63
rd
percentile) on a task requiring him to identify how a pictured item or scene was incomplete.
On a task requiring the manipulation of physical blocks to replicate a design, Biker was able to
recreate patterns correctly but was unable to follow oral instructions, and continuously built his
designs on a significant tilt. Therefore, his performance on the block task could not be
calculated. Overall, Biker's ability to reason and problem solve without words is an area of
strength for him.

Working Memory
Biker's overall ability to hold orally presented information in his memory, mentally manipulate
the information, and then verbalize it fell within the Low Average range (9
th
percentile). He
demonstrated a Low Average performances tasks requiring the oral repetition of a series of digits
(9
th
percentile) and the reorganization and oral repetition of mixed digits and letters (16
th

percentile). Overall, Bikers general working memory capacity is slightly below that of his same
age peers.

Processing Speed
Biker's ability to quickly process simple visual information and provide a motor response fell
within the Low Average range (13
th
percentile). He demonstrated difficulty on a task requiring
quick visual processing and fine motor control, as he slowly scanned number-symbol pairs in
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order to copy required symbols (Borderline range, 5
th
percentile). On a task with less fine motor
requirements, scanning arrays of visual designs to indicate if a specific design was present, he
preformed within the Average range (37
th
percentile).

Wechsler Nonverbal Scale of Ability (WNV)
Bikers nonverbal intelligence (e.g. reasoning without words) was assessed in order to determine
whether his language skills negatively impacted his overall performance on the WISC-IV.

Bikers overall performance on the WNV, as reported by the Full Scale Score, fell within the
Average range (53
rd
percentile), indicating that his nonverbal cognitive abilities are equal to, or
better than, 53 percent of children his age.

When Biker was asked to select a response to complete a visual puzzle, his performance was
within the Average range (63
rd
percentile). Biker had some difficulty copying symbols that were
paired with geometric shapes, performing in the Low Average range (16
th
percentile). It should
be noted that this task relies on fine motor skills, which may have hindered Bikers performance.
When Biker was asked to reproduce and a sequence of numbers both forwards and backwards he
performed within the Average range (68
th
percentile). Biker was also asked to arrange pictures
in sequential order to tell a story, performing within the Average range (68
th
percentile). Overall,
Bikers ability to reason nonverbally on these tasks was more similar to his PRI on the WISC-IV
than his VCI, indicating that performance is impacted when language abilities are required.

Academic Assessment
Bikers academic achievement was assessed to determine his current abilities in the areas of
Reading, Mathematics, Written Language, and Oral Language. The Wechsler Individual
Achievement Tests Third Edition (WIAT III), Tests of Early Reading Ability Third Edition
(TEMA-3), Tests of Early Math Ability Third Edition (TEMA-3), Peabody Picture Vocabulary
Test Fourth Edition (PPVT-4), Expressive Vocabulary Test Second Edition (EVT-2), the
Clinical Evaluation of Language Fundamentals Fourth Edition (CELF-4), and informal reading
and writing measures were administered to obtain an understanding of Bikers functioning in the
aforementioned areas.

Bikers overall performance across all WIAT III academic tasks could not be calculated, due to an
incalculable score on a reading task. However, reading, writing, and mathematics performances
were significantly below what would be predicted based upon his nonverbal reasoning abilities.
Bikers academic abilities will be described in separate academic areas.

Reading
Biker was unable to complete all required reading tasks on the WIAT III, therefore his overall
reading ability could not be calculated. Bikers Basic Reading Skills, including quick word
recognition (Low range, 1
st
percentile) and decoding nonsense words (Below Average range, 5
th

percentile), were within the Below Average range (3
rd
percentile). He performance on Early
Reading tasks, such as identifying letter sounds and rhyming, was also within the Below Average
range (13
th
percentile). Biker demonstrated a strategy of sounding out each letter, but was unable
to link the sounds together to form a word. In a Reading Comprehension task, measuring Bikers
ability to understand written text, he used picture cues to support his understanding and
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performed within the Below Average range (3
rd
percentile). He was more successful with oral
multiple-choice questions (i.e., John or Steve?) than questions requiring self-generated answers.
Biker demonstrated significant difficulty on an oral reading task designed to measure reading
accuracy and fluency. Verbally expressing his frustration, Biker was not able complete the
Grade 2 or Grade 1 reading tasks because of an inability to decode the words and time
limitations.

On the TERA-3, Bikers overall reading composite was calculated to be in the Very Poor range
(1
st
percentile). His performance in the Alphabet subtest (Below Average range, 9
th
percentile)
demonstrated difficulties with reversals (e.g., d for b) and a limited knowledge of letters. On a
task considering Bikers knowledge of book conventions (e.g., where to find the title, when to
turn the page, where the text begins), he performed in the Below Average range (9
th
percentile).
Of note, he was unable to use his finger to follow along a short text that was being read to him
and he could not identify sentences that had grammatical errors. For the reading comprehension
task in this measure, Biker performed in the Very Poor range (1
st
percentile).

Informal reading tasks provided further indications of Bikers current reading related abilities. In
an alphabet recognition task (e.g., pointing to letters that were presented orally), Biker made the
following errors: j for g, b for d, d for b, q for p, and w for q. Additionally, the Dolch sight word
assessment was administered and compared with results from a school-based assessment from
January 2011. Biker demonstrated that he was able to read 49/220 Dolch words, including 23/40
pre-primer words. This performance indicates an increase from the 2/40 pre-primer words he
previously knew, but demonstrates very limited progress over 1 years.

Mathematics
Bikers overall performance in Mathematics tasks on the WIAT III was within the Below
Average range (5
th
percentile). He demonstrated more difficulty with contextual mathematical
problem solving (Low range, 2
nd
percentile) than basic paper and pencil calculations (Below
Average range, 12
th
percentile). Additionally, Biker demonstrated accuracy without speed in
timed addition (Below Average, 3
rd
percentile) and subtraction (Below Average 13
th
percentile)
fluency tasks.

Bikers abilities in mathematics were further investigated with the TEMA-3, where his overall
math ability score was in the Very Poor range (1
st
percentile). Biker demonstrated
inconsistencies in counting up to 100, by skipping different sets of tens (e.g., missing the 40s)
and difficulties reading two and three digit numerals. He was able to count orally by tens to 100
automatically, but had no strategies for counting beyond 100. When asked to tell the examiner a
number that followed a specific number, Biker orally counted by ones to find the answer. On
written tasks of the TEMA-3, Biker reversed 2, 3, 4, and 9.

As Biker wrote digits backwards on TEMA-3 tasks and over 80% of his WIAT-III calculations,
the examiner asked him to write out numbers from 1 to 10. In this sample, Biker demonstrated
inconsistencies in digits reversal, as he reversed digits that he not reversed on the calculation
task.

Written Expression
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Bikers overall performance on the written expression tasks of the WIAT III was within the
Below Average range (4
th
percentile). Spelling was the most challenging task in the area of
written expression for Biker, as he demonstrated Low abilities (1
st
percentile). Generating
written sentences was also challenging, with Below Average performances in sentence
composition (5
th
percentile) and sentence building (4
th
percentile). Biker was able to do better
when he had written sentences as visual cues, as in the sentence combining task (Below Average,
9
th
percentile). When writing tasks became too difficult for him (e.g., not knowing how to use a
word for sentence building), Biker would not attempt the item. His best performance in writing
was writing the alphabet quickly (Average range, 25
th
percentile), with 10 letters written
correctly within 30 seconds.

An informal alphabet writing task, using both upper and lower case letters, indicated that Biker
has some difficulty with writing the alphabet. Specifically, he missed the letter N, did not
produce the correct lower case letters for h, j, k, and u, and reversed the letters D, Z, p, q, and z.

Oral Language
Bikers performance across receptive (e.g., listening) and expressive (e.g., speaking) oral
language tasks on the WIAT III was within the Average range (19
th
percentile). Biker performed
within the Average range (25
th
percentile) on listening tasks requiring him to point to a picture
that matched an oral vocabulary word as well as to remember and understand oral passages (i.e.,
conversations and commercials). Bikers performance on the PPVT-4 (Average range, 27
th

percentile) is commensurate with listening comprehension tasks on the WIAT III. It is notable
that Biker had more difficulty identifying nouns than verbs and adjectives. Bikers performances
on WIAT III word retrieval and language rule tasks were within the Average range (19
th

percentile). This is commensurate with Bikers performance on the EVT-2 (Average range, 27
th

percentile), although he demonstrated difficulty with retrieval of words for common household
objects, food items, and shapes.

Language Assessment
The Clinical Evaluation of Language Fundamentals Fourth Edition (CELF-4) was administered
to explore language development. Bikers core language performance was Very Low (1
st

percentile) indicating difficulty with general listening and speaking abilities. His performances
across speaking tasks were also Very Low (1
st
percentile). Biker demonstrated his best
performances on demonstrating linguistic structures within an oral fill-in-the-blank activity (9
th

percentile) as well as repeating sentences verbatim (9
th
percentile). In a listening task, Biker
repeated the examiners instructions independently but then demonstrated difficulty following
the directions (1
st
percentile). Biker demonstrated the most difficulty with producing complete
sentences using a picture and oral word prompt (0.1 percentile).

Memory Assessment
The Childrens Memory Scale (CMS) was administered to determine Bikers short and long-term
memory of both verbal and visual information. Bikers performances across various types of
memory tasks indicated a Low Average general memory (21
st
percentile) compared to other
children his age.

Verbal Memory
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When presented with oral information, Biker demonstrated Low Average performance in both
immediate memory (16
th
percentile) and delayed memory (12
th
percentile). His immediate recall
of contextual verbal information (e.g., short stories; Average range, 37
th
percentile) was better
than non-meaningful verbal information (e.g., paired words; Low Average range, 9
th
percentile).
After a delay, Biker demonstrated Low Average recollections of both contextualized and non-
meaningful verbal information (16
th
percentile for each). When provided with recognition tasks
(e.g., answering yes/no questions) for both types of verbal information, Bikers performance was
within the Low Average range (21
st
percentile). His recognition of contextualized story
components was within the High Average range (84
th
percentile) whereas his recognition of non-
meaningful word pairs was within the Impaired range (1
st
percentile).

Visual Memory Indexes
Bikers performances on memory tasks for visual information were within the Average range for
both immediate memory (66
th
percentile) and delayed memory (42
nd
percentile). He
remembered non-meaningful visual information (e.g., the location of dots on a grid) better than
meaningful visual information (e.g., faces). On the dot location tasks, Biker demonstrated High
Average performances for both immediate (84
th
percentile) and delayed recall (75
th
percentile).
On the facial recognition task, his performances were within the Average range for immediate
recognition (37
th
percentile) and the Low Average range for delayed recognition (16
th
percentile).

Learning
Bikers performances on non-meaningful dot and word pair tasks provide information on his
learning, as both tasks included three learning trials for the same stimuli. His overall learning
performance was within the Average range (34
th
percentile). He performed better in learning
non-meaningful visual information (High Average range, 75
th
percentile) than non-meaningful
verbal information (Low Average range, 9
th
percentile).

Fine Motor and Visual Perception Assessment
The Beery-Buktenica Developmental Test of Visual-Motor Integration Sixth Edition (Beery
VMI) and selected visual perceptual processing tasks from A Developmental
Neuropsychological Assessment - Second Edition (NEPSY-II) were administered to determine
Bikers current visual perceptual and fine motor abilities.

Bikers performance on the Arrows task of the NEPSY-II, requiring the identification of arrows
pointing to the center of a target, was within the Above Expected Level range (84
th
percentile),
indicating his ability to accurately judge line orientation. Similarly, his performance on a block
construction task (e.g., replicating a structure illustrated in a picture) was within the Above
Expected Level range ( 91
st
percentile). This block construction result suggests that Bikers
difficulty with the block task on the WISC-IV was related to understanding directions and not
with block construction. On a task requiring Biker to examine an array of shapes on a grid and
identify matching shapes that may be rotated, he performed within the At Expected Level (63
rd

percentile). However, on the visual perception task of the Beery VMI that requires the selection
of a target shape from a vertical array of similar shapes with minor changes in detail, Biker
performed within the Below Average range (10
th
percentile). He had the most difficulty on this
task when the shapes were smaller. Taken together, these results indicate that Bikers
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visuospatial processing is at or above that of same aged peers, but he has difficulty sensing or
perceiving detail differences in smaller visual stimuli.

Bikers fine motor skills were assessed with the Beery VMI. His performance on the visual and
motor integration task was within the High Average range (84
th
percentile), indicating an ability
to accurately perceive and generally replicate visual figures. However, on the fine motor
coordination task, Bikers performance was within the Below Average range (18
th
percentile) as
he demonstrated difficulty keeping his pencil within the indicated path. This suggests that he has
difficulty with precise pencil control, but he can replicate shapes accurately when size and
preciseness of line is not limited.

Executive Functioning Assessment
Executive functions are a collection of cognitive processes that are responsible for purposeful,
goal-directed, problem-solving behavior. Bikers executive functions were assessed through the
Behavior Rating Inventory of Executive Function (BRIEF), which provides an observers
perspective of executive function in daily life activities.

Behavior Rating Inventory of Executive Function (BRIEF) Parent Rating Scale
Mrs. Boy completed the parent form of the BRIEF. No executive functioning areas were rated as
significantly elevated. According to Mrs. Boys ratings, Biker is able to control his cognitive
processes through inhibiting responses, controlling emotions, self-monitoring, and taking
initiative on tasks. According to this rating and the observations of Biker during the assessment,
Biker has the ability to maintain cognitive control of his external behavior and internal
metacognitive functions.

Behavior Assessment
To examine Bikers behaviors in the home environment, the Behavior Assessment System for
Children Second Edition (BASC-2) and the Conners Third Edition (Conners-3) were
completed by Mrs. Boy.

Behavior Assessment System for Children (BASC-2)
Mrs. Boys ratings indicated that Biker had no difficulties with either externalizing (e.g.,
aggression) or internalizing (e.g., withdrawal) behaviour. Furthermore, Mrs. Boy reported that
Bikers adaptive skills, specifically his leadership and social skills, are a significant strength for
him.

Conners Third Edition (Conners-3)
The Conners-3 was used to compare Bikers behaviours to other typically developing boys his
age. The scale examines whether Biker is displaying symptoms consistent with behavioural
disorders in childhood, such as Attention Deficit Hyperactivity Disorder.

According to Mrs. Boy, Biker displays typical levels of behavioural, inattentive, or hyperactive
symptoms in the home. However, Mrs. Boy indicated that Learning Problems were within the
Very Elevated range for Biker as he often has difficulty learning and remembering concepts.

SUMMARY
BOY, Biker 10 of 22

Biker was referred for psychoeducational assessment through Dr. Name for persistent difficulty
with memory and academic development since beginning school. There is a family history of
school-related reading and writing difficulties with Bikers father and paternal grandfather. He
has no signs of externalizing or internalizing behaviour problems.

In 2010, an occupational therapist determined that Biker had a mild delay in visual perceptual
skills and designed specific program goals for him. In the current assessment he demonstrated
rotations in spatial orientation tasks but displayed accuracy on visual perceptual tasks. In fact,
Bikers visual perceptual abilities and reasoning skills were similar to those of other children his
age. His verbal reasoning, however, was significantly lower than visually-mediated reasoning;
therefore, Bikers nonverbal reasoning is most representative of his intellectual ability. This
assessment considers Bikers intellectual ability, as indicated by his PRI on the WISC-IV and
WNV scores, to be commensurate with same-aged peers.

Academically, Biker has pervasive and marked difficulties in reading, writing, and mathematics.
With regards to reading, Biker struggles to recognize and decode simple words which then
affects his comprehension. Furthermore, Biker is not making expected annual gains in learning
sight words. He demonstrated emotional upset during the assessment, reflecting an indication
that he is aware and possibly distressed because of his reading difficulties. Writing tasks were
also significantly difficult for him, with reversals, letter-sound relationships, and alphabet
memory affecting his ability to communicate through writing. In mathematics, both problem-
solving and written calculation tasks were extremely difficult for Biker. His reading, writing,
and mathematics abilities are significantly below what would be expected given his average
nonverbal intellectual ability. His difficulties across academic areas will impact his functioning
both at school and in the community.

When considering memory, Biker is much better able to recall and recognize visual information
than verbal information. Although he had difficulty with remembering verbal information, he
performed better when the information was contextualized, as in a story format, and he could
select an answer rather than generating his own response. Additionally, repetition with visual
information will benefit Bikers learning, but rote learning of verbal information is not helpful.
Biker has more difficulty with holding and manipulating auditory information than others his
age.

Across a wide range of visual perceptual tasks, Biker demonstrated below average to above
average abilities. He appeared to have the most difficulty sensing or perceiving fine details in
small designs, but his overall visual processing is appropriate for his age. He is able to use a
pencil appropriately to respond to visual tasks, but displayed some difficulty when needing to
control his pencil very precisely. Taken together with observed letter reversals, his fine motor
skills appear to be impacting his ability to perform pencil and paper tasks, such as copying
figures or words quickly and accurately.

Although Bikers vocabulary and general oral language screen appeared to be commensurate
with age level expectations, when picture cues are not available his receptive and expressive
language abilities (e.g., following specific oral instructions, generating oral sentences, and
BOY, Biker 11 of 22
following English syntax) are impaired. This difficulty with language may be foundational to
other observed difficulties in developing reading and writing skills, his auditory memory, and
verbal reasoning. Bikers results on the CELF-IV indicate a disordered language performance.

Given the results of the current assessment, Biker meets the following criteria from the
Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-
IV-TR):

Axis I 315.32 Mixed Receptive-Expressive Language Disorder
315.00 Reading Disorder
315.1 Mathematics Disorder
315.2 Disorder of Written Expression
Axis II V71.09 No Diagnosis
Axis III None
Axis IV None
Axis V GAF = 65 (current)


RECOMMENDATIONS:
NOTE: Due to the developing and changing nature of an individuals skills and abilities, the results and
recommendations contained in this report are intended for current use. Care must be taken not to characterize an
individual based on statements in this report, and not to assume that such statements apply indefinitely. Any
reference to these results and recommendations in the future should be made with caution.

Based on the current assessment, the following suggestions are offered for consideration. Bikers
teachers and parents may already be implementing some of these strategies so it is expected that
they choose recommendations that best fit with classroom and home routines.

1. Further referrals to support Bikers development related to learning and functioning in
school and home environments are suggested.
- A hearing assessment is recommended to investigate if hearing is involved in Bikers
language difficulties.
- A referral to a Speech Language Pathologist is suggested to investigate specific
language modalities that may be affected and to provide strategies and precise
interventions.
- A referral to an Occupational Therapist is suggested to further investigate pencil
coordination difficulties and provide appropriate recommendations for developing fine
motor skills.

2. Bikers expressive and receptive language difficulties mean that it will be hard for him to
understand, learn, and communicate effectively through language. The following are suggested
as strategies or activities to support and develop communication skills:
- To support listening skills, it is suggested that oral communication be linked to a
context to make it meaningful for Biker, the length of the information be shortened, and
that visuals (e.g., pictures, models, or real examples) are presented along with oral
information. Additionally, providing less instructions at a time (e.g., one or two steps)
may assist with Bikers ability to accurately complete the steps.
BOY, Biker 12 of 22
- Labels of objects and definitions can be developed through pairing words with pictures
and context. For example, picture cards of various foods can be discussed and sorted
according to categories (e.g., meats, fruits, food color, sweet/sour). He can be
encouraged to repeat the names of the pictures and guided in describing how each
belongs within a particular category. Alternatively, he could classify objects within the
home, out in the yard or in his dads tire shop with guidance in how to verbalize the
names and categories of objects.

- Biker can be encouraged to add details to his conversations with follow-up questions.
For example, if he said, I made my breakfast today, he could be asked, What did you
make?

- To encourage Biker to generate complete sentences with proper syntax, adults can
repeat a corrected version of the sentence back to him so he hears proper sentence
structure. For example, if he says, Outside it rainded the adult could say, Yes, it
rained outside. Additionally, repetition of the corrected sentence could then occur. For
example, after repeating the sentence with the correction, the adult could say, Can you
say, It rained outside?

- Series of pictures can also support the generation and development of oral sentences.
The pictures can provide all parts of the sentence (e.g., subject, verb, object) and provide
a meaningful context to support the sentence generation. A wealth of instructional and
intervention materials, including picture cues and games, can be found through
Linguisystems.

- Play language games with Biker, to provide motivation for using language. For
example, play I spy or practice a number of jokes or riddles.

- Provide attention to Biker when he shares orally and provide encouragement to increase
the frequency and quality of his oral communication.

3. Intensive remediation is suggested to develop Bikers reading abilities.
- Biker will need to master the recognition and recollection of all letters as well as the
letter-sounds. It may benefit Biker to have multi-modal instruction (e.g., using
simultaneous verbal, visual, and kinaesthetic presentation) to learn these foundational
building blocks of reading. Recognition of letters is suggested prior to working on
recollection of letters. For example, to work on recognition, Biker could be asked to
point to the letter m or the letter that makes the /m/ sound on an alphabet strip. Later, he
could be asked, What letter is this? or What sound does this letter make?

- To develop letter-sound relationships, sample tasks can include identifying all letters in
a text that make the /s/ sound or exploring patterns in word families (e.g., day, say, may).
Additional activities can include tasks that promote careful listening to words, such as
asking questions like: What is the beginning sound of , What is the ending sound of
, Do these words rhyme?, and What sounds do you hear in this word?

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- Continue working with Biker on his sight words (words frequently used within written
text), such as the list of Dolch words. Visual repetition of the sight word (e.g., on a
flashcard) with its shape highlighted may be helpful for Biker. When compiling a stack
of flashcards for Biker to work on, it is important to introduce each word and shape of
word separately, limit the number of flashcards to a manageable number for Biker, and
include a large number of words that he already knows (e.g., 80% already known). This
will reduce frustration in completing the flashcards and work on increasing the
automaticity of the already known words. Additionally, Biker can look through texts to
search for and possibly count specific sight words, such as the or and. This way he is
becoming comfortable looking through texts without the difficulty of having to read the
entire text, and recognizing specific target words.

- Multi-sensory, structured phonics instruction is suggested, such as the Orton-
Gillingham approach. Building upon letter-sound knowledge, decoding (sounding out)
and encoding (spelling) skills are developed simultaneously through mastery learning of
English language phonemic rules.

4. Biker will need remediation and accommodations to support development in writing. The
following strategies are suggested.
- Because Biker has difficulties with multiple letter reversals, a visual alphabet strip can
be a constant, accessible resource tool that he can use to check the correct formation of
letters. Tricky reversals, such as b and d, can utilize visuals to help Biker remember
the directionality of the letters. For example, the word bed has the shape of a bed (with
a headboard and footboard), and b comes before d in the alphabet.

- Provide structured practice for writing with success each day, such as writing his name
and date on schoolwork.

- Provide separate opportunities to practice printing skills and composition skills.
Printing skills can focus on fine motor skills as well as developing letter knowledge
through structured instructional programs. Composition, on the other hand, can include
accommodations to reduce the demands due to fine motor or alphabet knowledge.
Scribing, reduced volume of written work, increased time to complete writing, and
assistive technologies that match task demands (e.g., voice recordings, computer
software) are suggested as accommodations.

- Provide word banks on worksheets to provide the correct spelling for words to use on
the page. For example, Biker may need to write words under each picture to label what it
is, or describe the picture in a patterned sentence. At the top of the page, all the needed
words would be provided. For a picture of a hat, Biker could copy the word hat from
the word bank or construct the patterned sentence This is a hat from the words
provided. Alternatively, a personal spelling dictionary or classroom word wall can also
be used as writing resources.
- When assessing for knowledge, replace written tests with oral multiple choice supported
by pictures.

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5. To assist with development in mathematics, the following strategies are suggested:
- Use visuals, manipulatives or real objects when learning or completing calculations.
Demonstrate how to effectively use these to explain mathematical concepts, complete
calculations, and solve mathematical problems. Replace any finger-counting with
manipulative use, as a more efficient strategy. Bikers perceptual reasoning is
appropriate for his age level, so a visual-perceptual approach to mathematics may benefit
his development.

- Work on place value concepts by using manipulatives and trading a group of 10 ones
into one group of 10. This can be done with popsicle sticks, place value blocks, or, to
make it more meaningful, pennies and dimes. Biker may benefit from using place value
visual aides to assist with his counting and reading of numbers. Encourage Biker to
count aloud using manipulatives, so prompt correction can occur if there is a mistake in
counting. Particular work needs to be done moving into the next group of ten (e.g., 39 to
40), counting up beginning from any number, and counting backwards.

- Work on digit and number recognition, including the recognition of correctly formed
and reversed numbers. Encourage Biker to check work for reversed numbers and correct
them by matching his digits with the numbers on a numberline, ruler, clock or other
handy resource.

6. As Biker is becoming more aware of his difficulties within academic areas, it is important to
consider his self-esteem and continue to provide activities that build upon his interests and areas
of personal strength.
- Continue to provide opportunities to have fun, such as dirt-biking and quadding.

- Continue to provide opportunities for Biker to learn through seeing and doing real-life
activities that have meaning and contribute to others well-being. This may include
watching or helping his father in the tire shop or doing something of particular interest or
value within his home, yard, or community. Within school, this may include special
classroom duties.

- Continue to spend family time together and demonstrate interest and support with his
daily life activities, including schooling.



It was a pleasure to have had the opportunity to work with Biker. We trust that the information
contained in this report, as well as the recommendations provided above, will aid in providing
him with the most appropriate educational opportunities.






Psychoeducational Report

________________________
Name, B.A.
Masters Student, U-CAPES
clinician
________________________
Name, B.A., B.Ed.
Masters Student, U-CAPES
clinician
________________________
Name, B.A., M.Sc.
Registered Psychologist






Appendix A: Descriptions of Assessment Instruments.



A Developmental Neuropsychological Assessment - Second Edition (selected subtests)
(NEPSY-II)
The Developmental Neuropsychological (NEPSY-II) assessment is a measure of an individuals
neuropsychological functioning. It incorporates six domains: Attention and Executive Functioning,
Language, Social Perception, Visuospatial Processing, Memory and Learning, and Sensorimotor.
Often, a clinician chooses to only administer the subtests most relevant to the individual clients
needs.

Beery-Buktenica Developmental Test of Visual-Motor Integration - Sixth Edition (Beery
VMI)
The Beery-Buktenica Developmental Test of Visual-Motor Integration - Sixth Edition (Beery VMI)is
a standardized test that examines a childs ability to accurately integrate visual skills, visual
perceptual skills and motor skills to produce visual models using paper and pencil.

Behavior Assessment System for Children (BASC-2)
The BASC-2 is an assessment tool that evaluates the behavior and self-perceptions of children ages
4 to 18 years. It measures numerous aspects of behavior and personality including positive
(adaptive) as well as negative (clinical) dimensions. The BASC-2 provides information about a
child from a variety of sources, allowing for a more complete understanding of the child. On the
BASC-2, scores that fall in the Clinically Significant range suggest a high level of maladjustment.
Scores in the At-Risk range identify either a significant problem that may not be severe enough to
require formal treatment or the potential of developing a problem that needs careful monitoring.

Behavior Rating Inventory of Executive Function (BRIEF) Parent Rating Scale
The Behavior Rating Inventory of Executive Function (BRIEF) is a questionnaire for parents and
teachers of school aged children that enables professionals to assess executive functioning
behaviors in the school and home environments. It is designed to measure: inhibition, shifting set,
emotional control, ability to initiate tasks, working memory, planning/organizing abilities,
organization of materials, ability to monitor behavior in children 5 to 18 years of age. Scores 1.5
standard deviations above the mean should be examined for clinical significance.


Childrens Memory Scale (CMS)
The Childrens Memory Scale (CMS) is a standardized test that evaluates the important processes
involved in learning and memory and compares performance to that of others of the same age. A
General Memory and Index score can be derived from the core subtests. Results are interpreted in
accordance with United States norms.

Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF-4):
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The Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF-4) is an individually
administered clinical tool for the identification, diagnosis and follow-up evaluation of language
and communication disorders in students 5-21 years old.

Conners Third Edition (Conners-3)
The Conners-3 uses observer ratings to help assess a childs behavior related to inattention,
hyperactivity/impulsivity, learning problems, executive functioning, aggression, and peer relations.
In addition, the scale provides a total score indicative of an attention or behavioral disorder.
Scores in the Very Elevated range indicate a possible significant problem and scores in the
Elevated range indicate a possible concern.

Expressive Vocabulary Test, Second Edition (EVT-2)
The Expressive Vocabulary Test, Second Edition (EVT-2) is designed to measure expressive
vocabulary and word-retrieval abilities, or the ability to retrieve and pronounce the correct word
in order to communicate verbally.

Peabody Picture Vocabulary Test, Fourth Edition (PPVT-IV)
The Peabody Picture Vocabulary Test-4
th
Edition (PPVT-IV) is a test of listening comprehension
for spoken English. It is designed to measure a students vocabulary acquisition that does not
require a spoken response.

Test of Early Mathematics Ability Third Edition (TEMA-3)
The Test of Early Mathematics Ability, Third Edition (TEMA-3) is a test of informal and formal
mathematical knowledge. It is designed to measure a students numbering skills, number-
comparison facility, numeral literacy, mastery of number facts, calculation skills, and
understanding of concepts.

Test of Early Reading Ability Third Edition (TERA 3)
The Test of Early Reading Ability, Third Edition (TERA-3) is designed to measure reading ability
in young children. It focuses on the mastery of early developing reading skills.

Wechsler Individual Achievement Test Third Edition (WIAT-III)
The WIAT-III is a standardized test of achievement and functioning for individuals in Kindergarten
through adulthood. The WIAT-III is an individually administered measure that examines
performance in the areas of Reading, Mathematics, Language, and Writing. These areas are
combined to provide an overall achievement score. Canadian norms were used to score this
measure.


Wechsler Intelligence Scale for Children- Fourth Edition (WISC-IV)
The Wechsler Intelligence Scale for Children- Fourth Edition (WISC-IV) is a standardized
intelligence test consisting of a series of ten core subtests and five optional subtests designed to
measure the intellectual functioning of an individual as compared to others of the same age. A Full
Scale Intelligence Quotient (FSIQ) is derived from the combined results of the core subtests. The
WISC-IV also provides four factor-based scores, including Verbal Comprehension, Perceptual
BOY, Biker 18 of 22


Reasoning, Working Memory and Processing Speed. Canadian norms were used to score this
measure.

Wechsler NonVerbal Scale of Ability (WNV):
The Wechsler NonVerbal Scale of Ability (WNV) is an assessment tool that examines multiple
dimensions of cognitive ability through nonverbal means. The WNV is especially appropriate for
individuals who have language-related difficulties, such as those who are English as a Second
Language. Instructions are given through pictorial representations, allowing ease of understanding
without language requirements.

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Appendix B. Wechsler Intelligence Scale for Children, 4
th
Edition

The Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) is an individually
administered, comprehensive clinical instrument for assessing the intellectual abilities of children
ages 6 years, 0 months through 16 years, 11 months. The WISC-IV provides composite scores that
represent intellectual functioning in specified cognitive domains (i.e., Verbal Comprehension Index
(VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Processing Speed
Index (PSI)). Lastly, the WISC-IV provides a composite score that represents a childs general
intellectual ability (i.e., Full Scale IQ (FSIQ)). Percentile scores, scaled scores, and confidence
intervals are also provided to assist in interpretation. The FSIQ and Index scores have a mean of
100 and a standard deviation of 15. Each of the subtests has a mean of 10 and a standard deviation
of 3. The subtests can be broken down as follows:

Verbal Comprehension Index (VCI): is composed of subtests measuring verbal abilities utilizing
reasoning, comprehension and conceptualization. Similarities, Vocabulary and Comprehension are
the three core subtests that comprise the VCI, and Information and Word Reasoning are the two
supplemental subtests of the VCI.

Perceptual Reasoning Index (PRI): is composed of subtests measuring perceptual and fluid
reasoning, spatial processing, and visual-motor integration. Block Design, Picture Concepts and
Matrix Reasoning comprise the three core subtests of the PRI, and Picture Completion is the sole
supplemental subtest of the PRI.

Working Memory Index (WMI): is composed of subtests measuring attention, concentration and
working memory. Digit Span and Letter-Number Sequencing comprise the two core subtests of the
WMI and Arithmetic is the sole supplemental subtest of the WMI.

Processing Speed Index (PSI): is composed of subtests measuring the speed of mental and
graphomotor processing. Coding and Symbol Search are the two core subtests that comprise the
PSI, and Cancellation is the sole supplementary subtest of the PSI.

The results of the Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning
Index (PRI), Working Memory Index (WMI) and Processing Speed Index (PSI) are reported in the
following tables. The scores on the WISC-IV have a mean of 100 and a standard deviation of 15.

NOTE: Due to the developing and changing nature of an individuals skills and abilities, the results
and recommendations contained in this report are intended for current use. Care must be taken not
to characterize an individual on the basis of statements in this report, and not to assume that such
statements apply indefinitely. Any reference to these results and recommendations in the future
should be made with caution.



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Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV)

Composite Scores Summary
Composite Scale Standard
Score
95% CI Percentile Classification
Verbal Comprehension Index 77 71-86 6 Borderline
Perceptual Reasoning Index 107 98-115 68 Average
Working Memory Index 80 74-90 9 Low Average
Processing Speed Index 83 76-93 13 Low Average
(Full Scale Intelligence Quotient) (84) (79-90) (14) (Low Average)



Subtest Scores Summary
Subtests Scaled
Score
Percentile Classification
Verbal Comprehension
Similarities 5 5 Borderline
Vocabulary 6 9 Low Average
Comprehension 7 16 Low Average
Perceptual Reasoning
Block Design 4 2 Borderline
Picture Concepts 9 37 Average
Matrix Reasoning 13 84 High Average
(Picture Completion)
Working Memory
11 63 Average
Digit Span 6 9 Low Average
Letter-Number Sequencing 7 16 Low Average
Processing Speed
Coding 5 5 Borderline
Symbol Search 9 37 Average









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Appendix C. Wechsler Individual Achievement Test, 3
rd
Edition

The Wechsler Individual Achievement Test, Third Edition (WIAT-III) is a rich and reliable source of
information about an individuals academic skills and problem-solving abilities that can be used to
guide appropriate intervention. It is a comprehensive yet flexible measurement tool useful for
achievement skills assessment, learning disability diagnosis, special education placement,
curriculum planning, and clinical appraisal for preschool children through adults. The WIAT-III
provides composite scores that represent academic ability in several domains (i.e., Reading,
Mathematics, Written Communication, and Oral Communication). Percentile scores, scaled scores,
and confidence intervals are also provided to assist in interpretation. The Composite and Scaled
scores have a mean of 100 and a standard deviation of 15. The composites can be broken down as
follows:

Total Reading Composite: is composed of subtests measuring pre-reading, reading, and decoding
skills. Word Reading, Reading Comprehension, Pseudoword Decoding, and Oral Reading Fluency
are the subtests in this area. (Note: Oral Reading Fluency is not used in the calculation of the Total
Reading Composite for students in Kindergarten and Grade 1).
Basic Reading Composite: Word Reading and Pseudoword Decoding are the two subtests in this
area.
Reading Comprehension & Fluency: Reading Comprehension and Oral Reading Fluency.
Mathematics Composite: is composed of subtests measuring the ability to evaluate and write
numbers, to solve written calculation problems, identify geometric shapes, solve multi-step
problems, and identify mathematical patterns. Numerical Operations and Math Reasoning are the
two subtests in this area.
Math Fluency: is composed of subtests measuring how quickly and accurately students can
complete math questions. Separate scores can be derived for Addition, Subtraction and
Multiplication (Grades 3-12).
Written Expression Composite: is composed of subtests evaluating spelling and written
communication including sentence and paragraph construction. Spelling, Alphabet Writing Fluency
(Grades K-2), Sentence Composition (Grades 1-12), and Essay Composition (Grades 3-12) are the
subtests in this area.
Oral Language Composite: is composed of subtests measuring the ability to listen for details,
generate a word that matches a given picture and oral description, generate stories from visual cues,
and generate directions from visual or verbal cues. Listening Comprehension and Oral Expression
are the two subtests in this area.




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Wechsler Individual Achievement Test Third Edition (WIAT-III)

Composite Scale Scores Summary

Composite Scale Standard
Score
95% CI Percentile Classification
Oral Language 87 77-97 19 Average
Basic Reading 71 68-74 3 Below Average
Written Expression 73 65-81 4 Below Average
Mathematics 75 68-82 5 Below Average
Math Fluency 77 69-85 6 Below Average
Total Achievement n/a n/a n/a n/a


Subtest Scores Summary

Subtest Scores Standard Score Percentile Classification
Reading
Word Reading 66 1 Low
Early Reading Skills 83 13 Below Average
Reading Comprehension 71 3 Below Average
Pseudoword Decoding 75 5 Below Average
Mathematics
Math Problem Solving 69 2 Low
Numerical Operations 82 12 Below Average
Math Fluency Addition 71 3 Below Average
Math Fluency Subtraction 83 13 Below Average
Written Language
Sentence Composition 76 5 Below Average
Sentence Combining 80 9 Below Average
Sentence Building 74 4 Below Average
Spelling 64 1 Low
Alphabet Writing Fluency 90 25 Average
Oral Language
Listening Comprehension 90 25 Average
Oral Expression 87 19 Average
Expressive Vocabulary 80 9 Below Average
Oral Word Fluency 95 37 Average
Sentence Repetition 95 37 Average

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