Running head: ASSESSMENT REPORT: BOBBY DRAKE

Case Study #2 Assessment Plan: Bobby Drake Jo Friesen University of Calgary

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CLIENT NAME: AGE: GRADE:

DRAKE, Bobby 12 years, 3 months 6/7

REASON FOR REFERRAL: Bobby was referred for assessment due to some behavioural difficulties and concerns that he may not be reaching his full academic potential. His mother, Mrs. Francine Drake, initiated the referral. BACKGROUND INFORMATION: Bobby is 12 years old, and currently alternates his time between two households. His parents share custody, and he alternates weeks between his mother and step-father, and his father, who lives with his girlfriend. He has a 10-year-old brother, who shares the same custody arrangement. At his mothers home, he as a 4-year-old half-brother and his mother is currently 36 weeks pregnant with another boy. At his fathers home, there are two more half-brothers aged 19 and 1.Mrs. Drake described her household as loud and fast-paced, but relatively calm and reported that Bobby gets along quite well with all of his siblings, particularly the younger ones. She also reported that her relationship with Bobbys father is relatively stable. Mrs. Drake has a Bachelor of Education degree and currently works as a teacher. Mr. Drake reported no significant difficulties in school and as a trade certificate. On her side of the family, Mrs. Drake reported a history of anxiety and depression, as well as Bipolar Disorder in her extended family. She also reported issues with drug and alcohol use on the paternal side of the family. During her pregnancy with Bobby, Mrs. Drake reported she smoked cigarettes and consumed alcohol during the first 12 weeks before she knew she was pregnant. She also developed gestational diabetes and endured an extended labour with Bobby. Bobby was born full-term, and despite a slight jaundice diagnosis at birth, he did not require phototherapy. According to Mrs. Drake, Bobby met all his fine and gross motor developmental milestones on time, but did have some speech delays (only a few words by age two). There are no concerns about his hearing. He is required to wear glasses, but did not wear them during the assessment session. However, he did not seem to have any issues with his vision without his glasses. Bobby has no history of hospitalization or allergies, but he did break his hand during a fight at school last year. Bobby was recently diagnosed with Attention-Deficit/Hyperactivity Disorder by his pediatrician, Dr. Janice Heard. Dr. Heard prescribed Ritalin, however Bobby is not taking the medication during the current summer school break. Bobby just finished Grade 6, and he reports that he does well in science, and enjoys art and music. His least favourite subject is Spanish, which he says he does not do well in. In the classroom,

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teachers have reported some impulsive behaviour in the past, but no academic concerns. Mrs. Drake reported ongoing behavioural difficulties, including some violent incidents, two of which have led to school suspensions in the past year. Bobby has received additional support services since Grade 1. This has included a behavioural support plan in Grade 5 (which had limited classroom follow through), and support from the Student Health Partnership (also during Grade 5) and the Community Outreach in Pediatrics/Psychiatry and Education (COPE) program (during Grade 6). Socially, Mrs. Drake did not report any concerns. Bobby stated that he has several friends and enjoys spending time with other people. He reported some arguments with friends, but said they didnt affect his relationships. Outside of school, Bobby says he to skateboard and enjoys video games and spending time with his friends. ASSESSMENT INSTRUMENTS: Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) Woodcock-Johnson III Test of Cognitive Achievement (WJ III COG) Wechsler Individual Achievement Test, Second Edition (WIAT-II) The Childrens Memory Scale (CMS) A Developmental Neuropsychological Assessment Second Edition (NEPSY-II) Connors Continuous Performance Test (CPT-II) Conners Third Edition (Conners-3) ASSESSMENT OBSERVATIONS: During the assessment process, Bobby was co-operative and friendly. He was initially a bit quiet, but he soon warmed up and was willing to talk about his interests. Throughout the testing, Bobby was willing to participate in all activities, but he did show signs of boredom as the day went on and his interest seemed to wane. He would ask when we would be finished, and at times put his head down on the table, and moved it back and forth. Bobby was quite fidgety and restless, including tapping his fingers and toes, and seemed to have difficulty maintaining attention and focus. He was impulsive with some of his answers, and at times needed prompting to listen to all of the instructions. Overall, Bobby was pleasant to work with and he willingly participated in all tasks. However, his difficulty with attention on a number of tasks may have resulted in scores that underestimate his current level of cognitive and academic functioning.

ASSESSMENT RESULTS AND INTERPRETATIONS:

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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 Reasoning, Working Memory and Processing Speed. Canadian norms were used to score this measure. The WISC-IV is a measure of overall cognitive abilities and yields scores which are considered reliable and valid. Bobbys performance on the WISC-IV showed a Full Scale Intelligence Quotient (FSIQ) in the average range, falling at the 39th percentile. This means that Bobbys overall score was equal to, or higher than, 39 percent of children his age. There are four scores that contribute to the overall FSIQ score, which will each be discussed individually. The Verbal Comprehension Index (VCI) is a measure of Bobbys verbal abilities in regards to comprehension, reasoning and communication. Bobbys VCI score indicates he is in the Average range, at the 39th percentile, which demonstrates abilities typical of a child his age. He performed in the Average range on all of the subtests in this section. Bobby scored at the 37th percentile in the Similarities task, which required him to describe how two objects were alike. He was at the 25th percentile for the Comprehension task, in which he answered questions about general principles and social situations. He scored at the 63rd percentile for Vocabulary, in which he was asked to define words that were read aloud to him. The Perceptual Reasoning Index (PRI) is a measure of Bobbys ability to organize and interpret visual information and problem solve. Bobbys PRI score indicates he is in the Average range, at the 73rd percentile, which demonstrates abilities typical of a child his age. His scores in this area also show this is an area of strength for Bobby. He scored in the High Average range for Block Design (84th percentile) which requires him to assemble coloured blocks to recreate specific designs. On the Picture Concepts subtest, which asked him to look at groups of pictures and choose one from each group to make a logical set, Bobby scored in the Average range (75th percentile). Finally, on the Matrix Reasoning task, he scored in the Average range, at the 37th percentile. This task requires him to look at a matrix that is missing a piece and choose the correct piece from a group of options.

The Working Memory Index (WMI) is a measure of Bobbys ability to store and manipulate information, to concentrate and to remain attentive. Bobbys WMI score indicates he is in the Average range, at the 42nd percentile, which demonstrates abilities typical of children his age. Bobby did show significant discrepancy in his performance on the subtests in this section. He

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scored in the Low Average range (16th percentile) on the Digit Span tasks, in which he was asked to repeat a series of numbers forwards and backwards. However, he scored in the Average range (75th percentile) on the Letter-Number Sequencing task, which required him to recall a mixed sequence of letters and numbers in ascending numerical order, followed by alphabetical order. The Processing Speed Index (PSI) is a measure of Bobbys ability to process information quickly, and involves concentration and eye-hand co-ordination. Bobbys PSI score indicates he is in the Low Average range, at the 16th percentile. On the Coding subtest, Bobby scored in the Average Range (25th percentile). This test required him to work as quickly as possible to copy symbols associated with a given key. He scored in the Low Average range (16the percentile) on the Cancellation task, in which he was asked to quickly scan a page and mark target items. Woodcock-Johnson III Tests of Cognitive Achievement (WJ III COG) The Woodcock-Johnson III Tests of Cognitive Abilities (WJ III COG) are divided into two batteries: the Standard Battery (tests 1 through 10) and the Extended Battery (tests 11 through 20). This assessment instrument provides a comprehensive set of individually administered tests for measuring intellectual abilities. Depending on the purpose of the assessment, the examiner can administer the Standard Battery alone or in conjunction with the Extended Battery. The clusters or grouping of tests are the primary source for interpretive information to help identify performance levels and individual strengths and weaknesses. Norms are provided for individuals ranging in age from 2 to over 90 years. Selected sub-tests of the WJ III Cog were administered to Bobby in order to gain a better understanding of his cognitive efficiency and his cognitive fluency. His overall Cognitive Efficiency score was in the Average range, at the 46th percentile. This score is a measure of two components, Processing Speed and Short-term Memory. Bobbys Processing Speed score was in the Average range (75th percentile), but he showed some discrepancy on the individual tasks. His score on Visual Matching was in the Average range (32nd percentile), but he scored in the Superior range on Decision Speed (95th percentile). On the Short-Term Memory tasks, he scored in the Average range overall (31st percentile), with scores in the Average range on both subtests. Finally, Bobby completed tasks designed to measure his Cognitive Fluency, for which he received an overall score in the Average range, at the 57th percentile. However, within the tasks, Bobby showed very different abilities. He scored in the Low-Average range on Retrieval Fluency (24th percentile) and Rapid Picture Naming (23rd percentile), but in the Superior range for Decision Speed (95th percentile). These scores indicate that while Bobby is able to work and process information very quickly, he does not always do so accurately.

Wechsler Individual Achievement Test - Second Edition (WIAT-II) The Wechsler Individual Achievement Test - Second Edition (WIAT-II) is a standardized test of achievement and functioning for individuals in Kindergarten to grade 12. The WIAT is an

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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. Reading In Reading, Bobby scored in the Average range overall (68th percentile), although he showed significant range on the individual subtests. Bobby scored in the Superior range (95th percentile) on the Word Reading subtest, and Average range (75th percentile) on the Pseudoword Decoding task. On the Reading Comprehension task, he scored in the Low Average Range (16th percentile). These scores indicate that while Bobby has good word reading and decoding skills, he often does not understand what he is reading. Mathematics In Mathematics, Bobby scored in the High Average range at the 81st percentile. He scored in the Superior range (92nd percentile) on the Numerical Operations task, and in the Average range (61st percentile) on the Math Reasoning task. These scores indicate that mathematics is an area of strength for Bobby. Written Language In Written Language, Bobby scored in the Average range, at the 68th percentile. His scores on the subtests were both in the Average range with him at the 66th percentile for Spelling and the 75th percentile for Written Expression. These scores indicate that Bobbys abilities in this area are developing at a rate that is typical for a child his age. Oral Language In Oral Language, Bobby scored in the Average range, at the 25th percentile. His score in Oral Expression was in the Average range, at the 42nd percentile, but his score for Listening Comprehension was in the Low Average range, at the 23rd percentile. These scores indicate that Oral Language is an area of relative weakness for Bobby, particularly when Bobby is required to process and understand auditory information. 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. The CMS measures how well Bobby was able to hold, store and retrieve information that was presented to him either visually or verbally. Overall, Bobby received a General Memory Score in the Low Average range, at the 21st percentile. Bobby scores on the individual tasks fell across a large range, which indicates that there is value in looking at the individual components of the test.

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Bobby completed two tasks in which he was presented with information visually, and then asked to recall that information both immediately, and after a delay. In the task in which he was asked to recall meaningful information, he performed in the Average range (Immediate: 37th percentile; Delayed: 63rd percentile). However, in the task that dealt with non-meaningful information, Bobby scored in the Extremely Low range on both Immediate (<1st percentile) and Delayed (1st percentile). His overall Visual Immediate score was in the Extremely Low range (2nd percentile) and his overall Visual Delayed score was in the Below Average range (12th percentile). These scores indicate that Bobby is better able to remember visual information that has meaning associated with it, and he does better with retrieving that information after a delay. Bobby also completed two tasks in which he was asked to recall verbal information, both immediately and after a delay. His overall Verbal Immediate score was in the Borderline range (7th percentile) and his overall Verbal Delayed Score was in the Low Average range (21st percentile). In the Stories task, which had him recall a story that was told to him, he was in the Borderline range (5th percentile) for Immediate, and Below Average range for Delayed (9th percentile). In the Word Pairs task, which dealt with non-meaningful information, he scored in the Average range for both Immediate (25th percentile) and Delayed (50th percentile). These scores also indicate that Bobby is better able to retrieve information after a delay, and that he may do better when asked to remember smaller bits of information. The CMS also offers a Learning score, which is a measure of how much improvement is shown over a number of trials. Bobby scored in the Extremely Low range (<1 percentile). This indicates that Bobby may need to learn to use strategies other than repetition to understand and remember information and instructions. On the CMS score for Attention/Concentration Bobby scored in the Average range both overall, and on both subtests. His pattern of scores were the same on the subtests here as they were on the WISC-IV, with a lower score (25th percentile) on the Digit Span task and a higher score (75th percentile) on the Sequencing task. A final score given by the CMS is a Delayed Recognition score. Recognition measures how well Bobby can retrieve information when he is given a cue (versus recall, in which no cue is given). His overall score in this area was in the Low-Average range (21st percentile). Of note though, his Stories Delayed Recognition Score was in the Average range (63rd percentile) while his Word Pairs Delayed Recognition Score was in the Borderline range (5th percentile). These results are opposite of what he scored on the recall sections of these tasks, indicating that cues are a useful aid to him when the information is meaningful and complex. A Developmental Neuropsychological Assessment - Second Edition (selected subtests) (NEPSY-II)

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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. Attention/Executive Functioning Bobby completed selected sub-tests of the NEPSY-II, specifically those designed to measure his levels of attention and executive functioning. Bobby scored in the Average range (63rd percentile) on the Animal Sorting task, which involves sorting cards into groups using different selfdetermined criteria. He showed some discrepancies in his scores on the next task, the Auditory Attention and Response Set task. On the portion of the task that evaluates his ability to selectively attend to auditory information and to sustain his attention, he scored in the Average range, at the 75th percentile. He also performed in the Average range on the second part of the task, designed to assess his ability to shift his attention, with an overall score at the 75th percentile. However one of his scores on this task did fall much lower, at the 25th percentile. In the Design Fluency task, Bobby scored in the Above Average Range, with a score at the 91st percentile. This task assesses behavioural productivity based on a childs ability to generate unique designs on the task. The final task, Inhibition, assessed Bobbys ability to inhibit his automatic responses and choose new responses by having him name either a shape or arrow direction, depending on the colour of the item. While Bobby scored within the Average range on the majority scores on this task, he scored in the Borderline range (5th percentile) for Total Errors, and in the Below Average range (9th percentile) on Naming Combined. A strength for him was in the Inhibition Completion Time, in which he scored in the Superior range (95th percentile). In general, he seemed to be able to complete the tasks very quickly, however he often made many mistakes in the process. Conners Continuous Performance Test II (CPT II V.5) The Conners Continuous Performance Test II (CPT) was designed for use in detecting difficulties with inattention, especially that of attention deficit hyperactivity disorder. This test requires the respondent to view alphabet letters appearing on the computer screen, with the requirement that the test-taker press the space bar for all letters except X. The letters and the Xs appear at varying rates and the task occurs for approximately fifteen minutes. The Confidence Index, as denoted immediately below, indicates the degree of fit with most clinical samples (e.g., ADHD) versus those without a clinical problem. The CPT II is a computerized test, which is used to measure difficulties with attention. Bobby completed this particular task twice, in order to check the consistency of his results. Both of his test results (84.59% clinical, 87.85% clinical) are consistent with a clinical profile of ADHD. There were a number of indicators of Bobbys inattention throughout the test. On both trials he responded to non-targets more frequently than was expected for his age and gender, and he was erratic in his responses, which are both indicative of poor attentional capacity. He was inconsistent

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in his reaction time, which can indicate difficulty monitoring his level of arousal. Bobby also displayed varying levels of interest throughout both trials, at times focused and engaged, and at times looking away and tipping his chair back. Additionally, on the second trial, he failed to respond to more target letters, which could be a result of reduced motivation during the second attempt 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. The Conners-3 was completed by both Bobby and his mother, Mrs. Drake. Mrs. Drakes ratings on the Content scales placed Bobby in the Clinical range for inattention, hyperactivity/impulsivity, and defiance aggression, and in the At-Risk range for executive functioning. Mrs. Drake endorsed the following items: doesnt pay attention to details, makes mistakes, acts as if driven by a motor, uses a weapon, actively refuses to do what adults tell him to do. Mrs. Drakes ratings on the DSM-IV Symptoms scale indicated that Bobby probably met criteria for: ADHD Predominately Inattentive Type, ADHD Predominately Hyperactive-Impulsive Type, Conduct Disorder, and Oppositional Defiant Disorder Bobbys ratings on the Content scales placed him in the At-Risk range for hyperactivity/impulsivity. He endorsed the following items: often runs or climbs even when he is not supposed to, has trouble doing things quietly, has trouble waiting for his turn, interrupts other people. Bobbys ratings on the DSM-IV Symptoms scale were in the Clinical range for ADHD Predominantly Hyperactive-Impulsive Type.

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FORMULATIONS/SUMMARY: Although initially quiet, Bobby came across as a friendly and co-operative young man. His cognitive abilities are in the Average range, and indicate that he is able to perform at the same level as his peers. He did show some weakness in processing speed, with a pattern that showed that although he was able to work quickly, he often made many errors. This indicates that he may need to be given extra time to complete some tasks and encouraged to slow down in order to monitor and check his work. Academically, Bobby is performing in the Average range. He shows particular strength in his ability to use and understand numerical operations and in his word reading ability. However, he demonstrated some difficulties with comprehension, both with reading and with oral language. This indicates that Bobby may need extra support to ensure that he understands what he reads and what he hears. Bobbys memory abilities are in the Low Average range, which indicate that he may not be able to store and retrieve information as well as many of his peers. His pattern of scores demonstrated that he did better with retrieval after a delay, indicating that he may need additional time to process information, rather than be asked to respond immediately. He also did better recalling basic information without cues, but benefited from cues to retrieve more complex, meaningful information. Repeated trials did not help him to remember information, which indicates that he may benefit from learning to use other memory strategies, rather than be expected to learn through rote memorization. On tasks designed to measure Bobbys attention and executive functioning, he generally performed in the Average range. The variability in his scores again indicated that he was able to work quickly, but that he made a large number of errors. On a sustained attention task, he scored in the clinical range for ADHD and showed a general pattern of inconsistency in terms of his response style, his response time and his focus. Results from the Conners-3 indicate that both Mrs. Drake and Bobby place him in the clinical range for hyperactivity/impulsivity and for ADHD Predominantly Hyperactive-Impulsive Type. Mrs. Drake further rated Bobby as clinical for inattention and defiance/aggression and indicated he may meet the criteria for Conduct Disorder and Oppositional Defiance Disorder. At this time, Bobby is demonstrating good academic abilities that are consistent with his overall cognitive abilities. His overall pattern of test results reinforces his previous ADHD diagnosis.

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RECOMMENDATIONS: As a result of this evaluation of Bobbys current level of functioning, the following recommendations are suggested: Academic: In general, Bobby is functioning very well academically. However, he shows some indication that he does not understand what he reads or hears as well as might be expected for someone his age. He also shows signs that indicate he may rush through tasks and make errors due to speed, rather than ability. Some recommendations are: Help Bobby to develop strategies that are specifically designed to help him to take more time and care with his work. This may include explicitly teaching him how to check his work and requiring him to redo incorrect work, so that he can learn the value of taking the time to do it correctly the first time. If Bobby is generally rushing because he feels he is short of time, he may need to be given extra time for some tasks, especially those requiring reading comprehension. Bobby will benefit from being taught how to use a variety of memory techniques in order to strengthen and support his low memory capacity. Since Bobby is struggling with comprehension, he will need support from home and school to help him to check that he understands what he is reading. This may include specific strategies such as having him answer comprehension questions after short passages of reading or asking him to explain what he is reading. When verbal instructions and information, his teacher and both sets of parents may need to realize that repetition will not necessarily help Bobby to remember better. They are encouraged to work with Bobby to develop additional strategies to ensure he understands what he is told and intentionally check in with him on his understanding. Behavioural/Attention: Bobbys behaviour and results on attention tasks are consistent with what might be expected of a child with ADHD. He will need support to help him to control his impulsive behaviour, focus his attention and deal with some aggressive tendencies. While they were not seen during the assessment process, Mrs. Drake reports a pattern of aggressive behaviour, including a fight at school that resulted in Bobby breaking his hand. It is recommended that Bobby be supported to develop some coping skills that will help him to learn to resolve conflicts and/or frustrations in a more productive manner. This may include teaching specific strategies or enrolling Bobby in a program that works through a series of steps with him. It seems that Bobby may have participated in similar programs in the past, and an evaluation of his participation and progress in those programs may help determine how best to proceed.

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Bobby needs to develop an understanding of his needs and learn to advocate for himself in those situations when he is struggling. For example, learning to ask for information again if he doesnt understand it (whether due to memory concerns or due to inattention), asking for more time when needed, or asking for an opportunity to try a task again. He may benefit from being asked to take responsibility to get himself back on task, and it may help him to work with a buddy who is capable of keeping him focused. Regular communication between Bobbys teacher and both sets of parents will help to provide consistent expectations and consistent consequences for inappropriate or impulsive behaviour.

It was a pleasure to work with Bobby. Hopefully this assessment information will provide a better understanding of Bobbys strengths and areas of weakness, which will in turn offer a better picture of how to best support him.

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Appendix 1: Cognitive Scores WISC-IV, WJ III COG Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) Composite Scale Scores Summary Composite Scale Std Score 95% CI Percentil Classification e Verbal Comprehension Index 96 89-104 39 Average Perceptual Reasoning Index 109 100-116 73 Average Working Memory Index 97 89-105 42 Average Processing Speed Index 85 78-95 16 Low Average Full Scale IQ 96 91-102 39 Average Subtest Scores (S.S.) Summary Subtests S.S. Percentile Classification Verbal Comprehension Index Similarities 9 37 Average Vocabulary 11 63 Average Comprehension 8 25 Average Perceptual Reasoning Index Block Design 13 84 High Average Picture Concepts 12 75 Average Matrix Reasoning 9 37 Average Working Memory Index Digit Span 7 16 Low Average Letter-Number Sequencing 12 75 Average Processing Speed Index Coding 8 25 Average Cancellation 7 16 Low Average WJ-III Cog Subtests S.S. Percentile Classification Cognitive Efficiency 99 46 Average Processing Speed 110 75 Average Visual Matching 93 32 Average Decision Speed 125 95 Superior Short-Term Memory 93 31 Average Numbers Reversed 98 43 Average Memory for Words 91 28 Average Cognitive Fluency 103 57 Average Retrieval Fluency 89 24 Low-Average Rapid Picture Naming 89 23 Low-Average Decision Speed 125 95 Superior

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Appendix 2: Academic Scores WIAT-II Wechsler Individual Achievement Test, Second Edition (WIAT-II) Composite Scale Scores Summary Composite Scale Standard Score Reading Composite 107 Mathematics Composite 113 Written Language Composite 107 Oral Language Composite 90 Total Achievement 104

95% CI 103-111 106-120 99-115 79-108 100-108

Percentile 68 81 68 25 61

Classification Average High Average Average Average Average

WIAT-II Subtest Scores Summary Subtest Scores Standard Score Reading Composite Word Reading 125 Reading Comprehension 85 Pseudoword Decoding 110 Mathematics Composite Numerical Operations 121 Math Reasoning 104 Written Language Composite Spelling 106 Written Expression 110 Oral Language Composite Listening Comprehension 89 Oral Expression 97

95% CI 118-132 78-92 103-117 113-129 94-114 98-114 97-123 76-102 85-109

Percentile 95 16 75 92 61 66 75 23 42

Classification Superior Low Average Average Superior Average Average Average Low Average Average

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Appendix 3: Memory Scores - CMS Childrens Memory Scale Scores (S.S.) Summary Subtests S.S. Visual Immediate 69 Dot Locations 1 Faces 9 Visual Delayed 82 Dot Locations Delayed 3 Faces Delayed 11 Verbal Immediate 78 Stories 5 Word Pairs 8 Verbal Delayed 88 Stories 6 Word Pairs 10 Attention/Concentration 100 Numbers 8 Sequences 12 Learning 63 Word Pairs Learning 7 Dot Locations Learning 1 Delayed Recognition 88 Stories Delayed Recognition 11 Word Pairs Delayed Recognition 5 General Memory 88

Percentile 2 <1 37 12 1 63 7 5 25 21 9 50 50 25 75 <1 16 <1 88 63 5 21

Classification Extremely Low Extremely Low Average Below Average Extremely Low Average Borderline Borderline Average Low-Average Below Average Average Average Average Average Extremely Low Low-Average Extremely Low Low-Average Average Borderline Low-Average

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Appendix 4: Executive Functioning Scores NEPSY-II

NEPSY-II Scores (S.S.) Summary Subtests Attn/Exec Domain Animal Sorting Total Correct Animal Sorting Combined Auditory Attention Total Correct Auditory Attention Combined Response Set Total Correct Response Set Combined Design Fluency Total Inhibition - Naming Completion Time Inhibition - Naming Combined Inhibition - Inhibition Completion Time Inhibition - Inhibition Combined Inhibition - Switching Completion Time Inhibition - Switching Combined Inhibition Total Errors

S.S. 11 11 12 12 8 12 14 12 6 15 9 11 8 5

Percentile Classification 63 63 75 75 25 75 91 75 9 95 37 63 25 5 Average Average Average Average Average Average Above Average Average Below Average Superior Average Average Average Borderline