Psychological Report for M, Billy

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PSYCHOLOGICAL ASSESSMENT REPORT

CLIENT NAME: M, Billy

BIRTHDATE:
AGE: 12 years, 6 months
SCHOOL:
GRADE: Seven
DATES OF ASSESSMENT: January 10, February 10, February 24, 2014
DATE OF REPORT: March 13, 2014
ASSESSED BY: Alicia Marchini

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:
Billy was referred for a psychoeducational assessment by his teachers at *** Elementary
School for an update of his cognitive and academic skills, in preparation for his transition
from elementary to secondary school, to determine intervention strategies to address
ongoing concerns regarding his writing and reading abilities and to ascertain potential
identification(s) of learning issues.
ASSESSMENT MEASURES UTILIZED:
Review of Ontario Student Record (OSR)
Consultation with Parent
Consultation with Teachers
Wechsler Intelligence Scale for Children 4th Edition (WISC-IV)
Wechsler Individual Achievement Test 3rd Edition (WIAT-III)
BACKGROUND INFORMATION:

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The following was obtained through phone interviews with Billys mother, Mrs. M, and
his teachers, school reports, and file review.
Billy lives with his parents, older sister, as well as his younger brother and sister. His
grandmother has reportedly begun coming to Billys home to look after him and his
siblings, since she has returned from her home country. Billys family history is positive
for autism in the immediate family (i.e., sibling). Mrs. M reported that Billy had kidney
problems in utero, as both of his kidneys were not working at birth, and in May 2009,
Billy underwent kidney surgery. Billy also had a heart murmur that has since been
resolved. Currently, Billys physical health is good, and he wears eyeglasses or contacts
to correct his vision. As an extracurricular activity, Billy plays on a hockey team, and he
also enjoys watching hockey on television. At home, Billy enjoys playing video games
and reading. Mrs. M noted that Billy does his homework and projects at home, but he
has difficulty doing so at school. She is concerned with his organization, particularly the
organization of his thoughts when writing. Mrs. M explained that Billy does not edit his
written work. Billy was described as a kind boy who defends others but can get down on
himself.
ONTARIO STUDENT RECORD (OSR) REVIEW:
Billy has attended *** Elementary School since Junior Kindergarten. In kindergarten,
Billy received support from a Child and Youth Worker to develop his social skills and aid
in maintaining attention. In grade one (February 2008), Billy began Occupational
Therapy with the School Health Support Services (SHSS) Program to address his
awkward right-handed pencil grasp, poor quality of written output, and difficulty with
letter formation, spacing, and use of lines. Billy was discharged from the SHSS Program
in grade two (February 2009), as his goals were met. Difficulties with hyperactivity,
attention, and anger in grade one (April 2008) led to a psychological assessment that
evaluated his cognitive abilities, academic skills, and behaviour. The psychological
report noted that Billys overall intelligence was in the Average range, although
weaknesses were identified in his visual-spatial abilities, organizational skills, and motor
coordination. He also performed poorly on timed tasks requiring sustained attention and
concentration. Academically, Average range scores were produced. Behaviour rating
scales completed by Billys parents and teacher indicated significant concerns regarding
hyperactivity, restlessness, impulsivity, and mood swings in both the home and school
environments. As such, Billy was diagnosed with Attention Deficit/Hyperactivity
Disorder Hyperactive Impulsive Type. Billy also has a history of intervention for
speech and language difficulties. He was referred for a speech assessment, which
occurred in grade two (October 2008), as Billy demonstrated articulation difficulties with
s, z, sh, ch, j, th, l sounds. Billy had a significant crossbite and he wore an
appliance to correct it. Due to his atypical jaw alignment, he did not receive speech
therapy because it was believed that his speech would self-correct once the crossbite was
fixed. Although Billy is placed in a mainstream class, he receives daily support from the
schools Special Education Resource Teacher, as well as support from the use of assistive
technologies, scribing, and additional time to complete tasks. Billy has been on an
Individualized Education Plan (IEP) since grade two. His current IEP encompasses

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modified curriculum for Reading and Writing in the area of Language (at the grade six
level) and accommodations for Core French and Mathematics (at the grade seven level),
such as extra time and scribing. According to his IEP, Billys identified needs include
reading comprehension, reading fluency, written expression, organizational skills, and
maintaining attention. His outlined strengths include oral expression, homework
completion, cooperation, and athleticism, and inquisitiveness.
Billys school grades fell primarily within the B range in English and range from A to C
in Mathematics. In grade six, Billy completed EQAOs provincial tests with
accommodations. His achievement in mathematics and reading met the provincial
standard (Level 3 range), though his achievement in writing approached provincial
standard (Level 2 range). His teachers have noted that Billy is easily distracted, requires
prompts to stay on task and complete tasks, and has difficulties with problem solving,
conflict resolution, and organization.
OBSERVATIONAL DATA:
Billy was friendly, polite, and cooperative during testing sessions and actively engaged in
interactions with the clinician. He was talkative and used a breadth of words, exhibiting
a broad vocabulary. Billy maintained adequate eye contact, participated in all assessment
tasks presented, and easily shifted his attention when it was required of him. He listened
well to instructions and followed them with precision. When faced with difficult tasks,
he demonstrated persistence and remained relaxed. Billy was conscientious and tried
different strategies to accomplish tasks, which became apparent in his self-talk. Billy
demonstrated a thumb wrap pencil grasp (i.e., held his pencil in a tripod grasp with his
thumb wrapped over his index finger) and mentioned that his palm hurt after writing a
few sentences. Overall, Billy was personable and an excellent worker.
ASSESSMENT RESULTS:
When reading the following results, please note that a percentile score refers to an
individuals placement on a test relative to others of the same age (i.e., the higher the
percentile, the better the performance). For example, a score at the 60th percentile
indicates that, when compared to same-age peers from the general population, this
students performance was as strong as, or stronger than, 60 out of 100 of his/her sameaged peers.
Cognitive Functioning:
The WISC-IV was administered to evaluate Billys cognitive functioning abilities. In
addition to providing information about specific skills, an overall measure of cognitive
abilities (Full Scale Score) can be derived from the WISC-IV. Billys overall
performance on the WISC-IV fell within the Average range (at the 37th percentile), as
compared to Canadian children of his age. Please see Appendix 1 for a description of this
test and for Billys test results.

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Expressive & Receptive Vocabulary: Billys demonstrated variability in his performance

on tasks that measured verbal comprehension (i.e., his ability to use and understand oral
language). As such, his overall verbal comprehension score is not interpretable and,
therefore, is not reported. Billy performed within the Average range on a measure of
expressive vocabulary that required him to provide oral definitions of words (50th
percentile). However, on a task that placed higher demands on Billys expressive
language, he performed within the Low Average range (25th percentile). This task was a
measure of reasoning about information and consequences pertaining to socially related
situations. Conversely, on a task that required him to identify the primary similarity
between the meanings of pairs of words (e.g., dog and cat are both animals), Billy
performed within the Above Average range, indicating that verbal reasoning is a relative
strength for Billy (84th percentile). He completed this task with ease and answered with a
sense of confidence in his voice. Similarly, Billy performed within the High Average
range on a task that measured his understanding of oral language and ability to listen to
detail (77th percentile). It required him to select a picture to match a given oral statement.
On a task that required him to listen to short recordings and answer questions about what
he heard, Billy performed within the Average range (66th percentile).
Visual & Fluid Reasoning: Billys overall performance on tasks that required him to use
visual organization and problem solving fell in the Average range (32nd percentile). Billy
performed within the Average range on a measure of fluid reasoning, where he was
presented with a partially filled grid and had to select the item to properly complete it
(50th percentile). Billys performance on a measure requiring him to select a picture from
two or three rows to form a group with a common characteristic fell within the Average
range as well (50th percentile). He appeared to be confident in his responses on this task,
as he answered promptly and with assertiveness. Billys poorest performance within this
index was on a task that required him to reproduce two-dimensional geometric designs
using coloured blocks on a measure of visual-spatial reasoning. Billy performed within
the Below Average range (16th percentile). On this task, he appeared to try different
methods, such as attempting to replicate one part of the given geometric design at a time.
Verbal Working Memory: Billys demonstrated variability in his performance on working
memory tasks (i.e., ability to hold orally-relayed information in his memory and
manipulate that information). As such, his overall working memory score is not
interpretable and, therefore, is not reported. Billys strongest performance within this
index was on a task that required him to organize and repeat a sequence of numbers in
ascending order and a series of letters in alphabetical order. He performed within the
Above Average range, indicating that Billys ability to mentally retain and manipulate
numbers and letters was a relative strength (84th percentile). However, on a task that
required him to attend to and hold information in short-term memory while performing
an operation with it, such as repeating digits in a particular order, Billy performed within
the Low Average range, overall (25th percentile). More specifically, Billy performed in
the Average range (37th percentile) when repeating digits from lowest to highest, and in
the Low Average range (25th percentile) when repeating digits from highest to lowest; yet,
it is important to note that his performance on these two tasks was not significantly
different.

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Visual Information Processing: Billys overall performance on tasks requiring him to

quickly process visual information without making errors fell within the Low Average
range (21st percentile). Billy was required to draw the given symbols under their
corresponding numbers, as indicated on the page in a reference box. On another task, he
had to search for two target symbols in a series of five symbols. Billy performed within
the Low Average range (25th percentile) on these tasks, which measured visual-motor
coordination (i.e., ability to coordinate vision with body movements, such as writing),
visual perception, and visual memory (i.e., ability to remember visual information).
Academic Functioning
Reading:
Billys overall reading skills fell within the Below Average range (10th percentile). The
information below describes Billys performance on specific reading skills.
Phonological Awareness: On a task that required him to read isolated words aloud, Billy
performed within the Below Average range (13th percentile). A couple of Billys errors
resulted from saying the root word (i.e., playful instead of playfully) or from adding
a word ending (i.e., photography instead of photograph). Other errors included
missing a letter sound (e.g., eliminating the i sound in radiant) and guessing the word
based on the first few letter sounds.
Decoding: When Billy was required to use phonetics to sound out non-words, his
performance fell within the Below Average range (16th percentile). Billy switched letter
sounds when sounding out some of the non-words (e.g., culrt instead of clurt). He
also added and changed letter sounds for some of the non-words, which contributed to his
Below Average performance.
Fluency: Billys performance on a measure of reading speed and accuracy fell within the
Below Average range (8th percentile). The errors that he made when reading words and
non-words manifested during this task, as he changed and added words, and also
pronounced words wrong when he read the provided passages.
Comprehension: On a task that measured Billys understanding of written passages, he
performed within the Average range, which was his strongest performance within the
academic domain of reading (27th percentile). Billy used his finger to guide his silent
reading during this task and he referred to the passages that he read after the question was
presented to search for an appropriate response. It is important to note the limited
ecological validity of this task (i.e., the task is not representative of school demands),
which can help explain the difference between Billys performance on this task and in his
difficultly with tasks at school that require him to understand written material and answer
questions about what he has read.
Mathematics: Billys overall performance on tasks involving mathematics fell within the
Below Average range (16th percentile). When asked to answer written math equations
(e.g., addition, subtraction, algebra, geometry), Billy performed within the Below

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Average range (14th percentile). Billy answered equations that involved one operation
with ease (e.g., only addition or only subtraction); however he skipped questions that
involved two operations (e.g., division and addition) and questions that required him to
complete several steps in order to arrive at an answer. On a timed task that required Billy
to answer basic addition and multiplication questions, Billy performed within the Low
Average range (25th percentile and 21st percentile, respectively); however, he performed
within the Average range on subtraction questions (39th percentile). Billy provided the
correct answer for all basic mathematical equations (i.e., simple addition, subtraction,
multiplication), yet his speed of completion contributed to Low Average scores on
addition and multiplication questions. Billy also performed within the Low Average
range on a measure of math problem solving abilities, which included word problems,
interpreting graphs, and using patterns, (23rd percentile).
Written Expression: Billys overall written performance fell within the Low Average
range (19th percentile). His word spelling performance fell within the Below Average
range (9th percentile). Billy used phonetic spelling, as he spelled the word according to
the way he would say it. For example, he spelled the word stationary as stashnare
and budget as buget. This appeared to be the main cause of his errors. Billy
performed within the Low Average range on a timed task that required him to write a
short essay about his favourite game (19th percentile). Although he began the essay
promptly, wrote at a steady pace, and was provided with warnings regarding the
remaining completion time, Billy noted that he did not have enough time to finish his
essay. On a task that required Billy to generate sentences that included a given word, he
performed within the Average range (45th percentile). Billy used three words incorrectly
in his sentences (e.g., homophone error), and his written sentences included one
capitalization error, one punctuation error, and poor sentence structure. Billys strongest
performance was on a task that required him to combine given sentences, as he
performed within the High Average range (75th percentile).
SUMMARY:
Billy is a pleasant 12-year-old boy experiencing challenges with learning at school. Billy
was referred for a psychoeducational assessment due to ongoing concerns with reading
and writing, in preparation for his transition from elementary school to secondary school.
Billys parent and teachers reported a long-standing history of struggles with reading and
writing. Billy was previously diagnosed with Attentional Deficit Hyperactivity Disorder
Hyperactive/Impulsive Type in grade one, due to difficulties with attention,
concentration, social/emotional functioning and learning at both home and school;
however reassessment was beyond the scope of this evaluation.
Billys performance on tests of cognitive functioning indicated that his overall intellectual
potential in the Average range (37th percentile). With respect to his verbal and non-verbal
abilities, Billy demonstrated adequate verbal reasoning and strong pattern recognition
skills. Conversely, he demonstrated poor visual-spatial abilities, which is indicated by his
Below Average performance on a task that required him to reproduce two-dimensional
geometric designs using coloured blocks (16th percentile). Billy showed Average working

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memory on verbal-based tasks, but weakness was noted in his processing speed (e.g.,
visual-motor coordination, visual perception). As such, he may also encounter
difficulties copying information from charts, the blackboard, or textbooks, as this will
require him to process visual information while performing a motor task (i.e., writing).
Academically, Billy showed strong listening comprehension and verbal expression,
which was also observed in general conversation with the clinician throughout the
assessment. Conversely, weakness was noted in his mathematical skills. This weakness
is likely due to Billys weak processing speed, as his speed of completing simple math
equations led to weaker performance and he encountered difficulty with solving math
equations that involved several steps or processes. Billys overall reading skills were
weak, with particular weakness noted in reading fluency, decoding, and phonological
awareness. With respect to written expression, Billys spelling was poor; however, his
ability to combine and generate sentences was adequate. His weakness in reading and
spelling is likely due to issues with phonological processing, which is evidenced by his
substitution of words with the same first letter when reading, as well as his difficulty
sounding out words and encoding words (i.e., determining and interpreting the sounds in
the verbal representation of a word in order to spell it).
DIAGNOSIS:
Given the results of the current assessment, Billy meets criteria from the Diagnostic and
Statistical Manual of Mental Disorders Fifth Edition (DSM-V) for the following
diagnostic categories:
315.00 (F81.0) Specific Learning Disorder with Impairment in Reading:
Word reading accuracy
Reading rate or fluency
Reading comprehension
315.1 (F81.2)

Specific Learning Disorder with Impairment in Mathematics:

Number sense
Memorization with arithmetic facts
Accurate or fluent calculation
Accurate math reasoning

RECOMMENDATIONS:
Based on the current assessment, the following suggestions are offered for consideration.
It is important to note that these are intended only as guidelines to indicate the type of
strategies and approaches that may be used to further address Billys instructional needs.
It is not expected that all of the provided intervention strategies be implemented. I am
also available to meet with Billys parents and teacher to further discuss the
implementation of these recommendations.

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School Recommendations:

Provide on-going involvement of the school support staff (i.e., daily support from
the schools Special Education Resource Teacher), both for the development and
remediation of reading and mathematic skills but also to assist with struggles of
attention, organization, and written expression.

Continue to provide Billy with extra time to complete reading, writing, and
mathematical tasks due to his weak processing speed.

Consider pursuing a follow-up consultation with an occupational therapist to provide

Billy with additional suggestions for addressing his pencil grasp.

Reading:

Provide one-to-one intervention through school education programs, such as Later

Literacy and Targeted Reading Intervention, for the development and remediation
of Billys reading skills.

Provide opportunity for use of Assistive Technology (AT), such as Kurzweil 3000,
which scans printed documents and reads the text aloud. Offer Billy age and
level-appropriate reading materials that include topics of interest to him and
enable him to listen to them and follow along using Kurzweil 3000.

Give Billy an oral summary (i.e., main ideas of the plot, and brief description of
the setting and context) of the material he is to read or which will be read to him,
via computer software or through videos or films, and where possible, connect it
to an experience in his own life, to provide him with a context for understanding
the information presented in the material.

Provide direct instruction on how to identify the main idea, specific details, cause
and effect, and elements of contrast and comparison while reading (e.g., effective
highlighting of material, including answers to the five Ws).

Mathematics:

Use a word-problem mnemonic, such as RIDE (Read the problem, Identify the
relevant information, Determine the operation and unit for the answer, Enter the
correct numbers and calculate, then check the answer), to provide Billy with a
framework for solving word problems. The mnemonic will remind him to work
step-by-step through a word problem. Some word-problem mnemonics can be
used for problem solving beyond basic word problems.

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Allow Billy to use a calculator for mathematical equations that involve several steps
or multiple operations to assist him in the speed and accuracy of his responses.

Writing:

Provide Billy with direct instruction on developing his ideas prior to beginning
the writing process. In this regard, graphic organizers, semantic webbing, flow
charts, expanded lists and story outlines in point form, as well as mapping and
scaffolding techniques could help him organize and expand his thoughts in written
language.

Use Assistive Technology to assist Billy in writing (e.g., Inspiration, WordQ).

Parents are encourage to:

Contact Learning Disability Association (http://www.ldac-acta.ca) for further

information on Billys specific learning disabilities, as well as the available
supports and educational opportunities for those with learning disabilities.

Continue to celebrate Billys strengths by offering opportunities for him to

participate in extra-curricular activities when possible (e.g., clubs, camps, lessons) in
the areas of sports, leadership, etc.

Assist Billy in choosing level-appropriate reading material by using the Five

Finger Rule:
1 Open to a page of the book
2 Begin reading
3 Each time you come to a word you do not know, hold up one finger
4 After you finish reading the page, check to see how many fingers you
are holding up
1 finger = too easy, try another book
2 3 fingers = just right
4 5 fingers = too hard, try another book
Encourage Billy to choose reading material that deal with topics of his interest
and to read on a daily basis.

It was very much a pleasure to work with Billy. If there are any further questions
regarding the report, please do not hesitate to contact me.
Alicia Marchini
Examiner

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Appendix 1.A. Wechsler Intelligence Scale for Children, 4th Edition

The Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV) was used to
assess Billys cognitive abilities as compared to others of the same age. The WISC-IV is
a broad measure of intellectual functioning and school related abilities that is comprised
of four separate indices. Specifically, the WISC-IV assesses both verbal (Verbal
Comprehension Index) and nonverbal (Perceptual Reasoning Index) reasoning abilities,
as well as his ability to hold and manipulate information (Working Memory Index) and
processing speed of visual information (Processing Speed Index).
Test results should be interpreted with the support of a registered psychologist. Please
refer to Appendix 2 for descriptions of the classifications.
Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV)
Composite Scale Scores Summary
Composite Scale

Standard
Score

Verbal Comprehension
Perceptual Reasoning
Working Memory
Processing Speed
Full Scale IQ

102
93
103
88
95

95%
Confidence
Interval
95-109
85-102
95-111
81-98
90-101

Percentile

Classification

55
32
58
21
37

Average
Average
Average
Low Average
Average

WISC-IV Subtest Scores Summary

Subtest Scores
Standard
Percentile
Score
Verbal Comprehension Index
Similarities
13
84
Vocabulary
10
50
Comprehension
8
25
Perceptual Reasoning Index
93
32
Block Design
7
16
Picture Concepts
10
50
Matrix Reasoning
10
50
Working Memory Index
Digit Span
8
25
Digit Span Forward
8
25
Digit Span Backward
9
37
Letter-Number
13
84
Sequencing
Processing Speed Index
88
21
Coding
8
25
Symbol Search
8
25

Classification
Above Average
Average
Low Average
Average
Below Average
Average
Average
Low Average
Low Average
Average
Above Average
Low Average
Low Average
Low Average

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Appendix 1.B. Wechsler Individual Achievement Test, 3nd Edition

The Wechsler Individual Achievement Test Third Edition (WIAT-III) is an individually
administered assessment tool that evaluates the basic academic levels in the areas of
Reading, Mathematics, Written Language and Oral Language. The WIAT-III is a
standardized test that compares a students results to a normative group of the same age.
Test results should be interpreted with the support of a registered psychologist. Please
refer to Appendix 2 for descriptions of the classifications.
Wechsler Individual Achievement Test, Third Edition (WIAT-III)
Composite Scale Scores Summary
Composite Scale
Total Reading
Basic Reading
Reading Comprehension & Fluency
Mathematics
Math Fluency
Written Expression Composite

Standard
Score
81
84
81
85
91
87

95%
Confidence
Interval
77-85
80-88
74-88
78-92
85-97
80-94

Percentile
10
14
10
16
27
19

WIAT-III Subtest Scores Summary

Subtest Scores
Standard Score
Percentile
Reading Composite
81
10
Word Reading
83
13
Pseudoword Decoding
85
16
Reading Comprehension
91
27
Oral Reading Fluency
79
8
Mathematics Composite
85
16
Numerical Operations
84
14
Math Problem Solving
89
23
Math Fluency Composite
91
27
Math Fluency Addition
90
25
Math Fluency Subtraction
96
39
Math Fluency Multiplication
88
21
Written Expression Composite
87
19
Spelling
80
9
Sentence Composition
104
61
Essay Composition
87
19
Oral Language
Listening Comprehension
111
77

Classification
Below Average
Below Average
Below Average
Below Average
Average
Low Average

Classification
Below Average
Below Average
Below Average
Average
Below Average
Below Average
Below Average
Low Average
Average
Low Average
Average
Low Average
Low Average
Below Average
Average
Low Average
High Average

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Appendix 2. Description of Classifications

Classification
Very Superior

Percentile
>99.9 98

Well Above Average

97 95

Above Average

95 84

High Average

83 75

Average

74 26

Low Average

25 18

Below Average

17 5

Far Below Average

53

Mild Impairment/Delay
Moderate to Severe Impairment/Delay

2 0.1
0.1 <0.1