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1318 Years
Comparative Report
Youth's Name/ID:
Gender:
Birth Date:
John Sample
Male
July 15, 2001
LE
P
Parent Teacher 1 Teacher 2
Youth's Name/ID: John Sample John Sample John Sample
M
Administration Date: November 1, 2015 November 4, 2015 November 5, 2015
Age: 14 years 14 years 14 years
Grade: 9 9 9
A
School: Springeld High School Springeld High School Springeld High School
Rater's Name/ID: Mrs. Sample Mrs. Wilson Mrs. Phillips
Relationship to Youth: mom
S
Class(es) Taught: math science
Time Known Youth: 3 months 3 months
Examiner: Dr. M Dr. M Dr. M
Data Entered By: M. M. M. M. M. M.
Note about comparing Parent raters to Teacher raters: Teachers do not rate items on the Domestic, Family, or Self-Care scales; comparisons between
the Parent and Teacher ratings are not made for these scales or for the Total Score.
This Comparative Report is intended for use by qualified individuals. Parts of this report contain copyrighted material, including test items. If it is
necessary to provide a copy of the report to anyone other than the examiner, sections containing copyrighted material must be removed.
RSI Scales
85
Parent
80 Teacher 1
Considerable
Impairment Teacher 2
75
70
Moderate
Impairment
65
Mild
E
Impairment
60
T-score
55
L
50
45
P
No
Impairment
40
35
M
30
25
Total Score
S 85
80
A Considerable
Impairment
Parent
Teacher 1
Teacher 2
75
70
Moderate
Impairment
65
Mild
Impairment
60
T-score
55
50
45
No
Impairment
40
35
30
25
RSI Scales
E
Social Moderate Considerable Considerable T1 > P
Classication
Impairment Impairment Impairment
L
T-score 44 45 45
Mobility No No No No signicant differences
Classication
Impairment Impairment Impairment
P
T-score 69
Domestic scale does not Domestic scale does not
Domestic Moderate No comparison possible
Classication appear on the Teacher Form. appear on the Teacher Form.
Impairment
T-score 68
Family scale does not appear Family scale does not appear
Family No comparison possible
M
Moderate on the Teacher Form. on the Teacher Form.
Classication
Impairment
T-score 55
Self-Care scale does not Self-Care scale does not
Self-Care No No comparison possible
A
Classication appear on the Teacher Form. appear on the Teacher Form.
Impairment
Total Score
Scale
Total Score
T-score
Classication
S Parent
11/1/2015
67
Moderate
Impairment
Signicant Differences
Between Parents
No comparison possible
Teacher 1
11/4/2015
77
Considerable
Impairment
Teacher 2
11/5/2015
72
Considerable
Impairment
Signicant Differences
Between Teachers
No signicant difference
80 Considerable
Impairment
75
70 Moderate
Impairment
65 Mild
Impairment
60
T-score
E
55
50
L
45
No
Impairment
40
P
35
30
25
M
Parent Teacher 1 Teacher 2 Parent Teacher 1 Teacher 2
11/1/2015 11/4/2015 11/5/2015 11/1/2015 11/4/2015 11/5/2015
85
80
75
70
S
MOBILITY
A DOMESTIC
Considerable
Impairment
Moderate
Impairment
65 Mild
Impairment
60
T-score
55
50
45
No
Impairment
40
35 ** **
30
25
Parent Teacher 1 Teacher 2 Parent Teacher 1 Teacher 2
11/1/2015 11/4/2015 11/5/2015 11/1/2015 11/4/2015 11/5/2015
80 Considerable
Impairment
75
70 Moderate
Impairment
65 Mild
Impairment
60
T-score
55
E
50
45
L
No
Impairment
40
35
P
** ** ** **
30
25
Parent Teacher 1 Teacher 2 Parent Teacher 1 Teacher 2
M
11/1/2015 11/4/2015 11/5/2015 11/1/2015 11/4/2015 11/5/2015
Total Score
A
Teachers do not rate items on the Domestic, Family, or Self-Care scales; therefore, the Total Score for Teacher raters is calculated using
a different combination of scales than those used for Parent raters and, as such, these scores are presented separately.
S
TOTAL SCORE
85
80 Considerable
Impairment
75
70 Moderate
Impairment
65 Mild
Impairment
60
T-score
55
50
45
No
Impairment
40
35
30
25
Parent Teacher 1 Teacher 2
11/1/2015 11/4/2015 11/5/2015
SCHOOL/WORK
Johns School/Work scale score reects his level of impairment when acquiring and applying knowledge at school and/or
work.
A Considerable Impairment rating was obtained from the following raters: Parent (T-score = 76, 95% CI = 68-79, 99th
percentile rank); Teacher 1 (T-score = 85, 95% CI = 78-87, 99th percentile rank); Teacher 2 (T-score = 80, 95% CI = 73-83,
99th percentile rank).
Comparison of scores between raters shows that Teacher 1 ratings were signicantly higher than Parent ratings.
E
SOCIAL
L
The Social scale score describes how impaired John is when interacting and communicating with others.
A Considerable Impairment rating was obtained from the following raters: Teacher 1 (T-score = 79, 95% CI = 70-82, 99th
P
percentile rank); Teacher 2 (T-score = 73, 95% CI = 64-77, 99th percentile rank).
A Moderate Impairment rating was obtained from the following rater: Parent (T-score = 65, 95% CI = 56-70, 93rd
percentile rank).
M
Comparison of scores between raters shows that Teacher 1 ratings were signicantly higher than Parent ratings.
A
MOBILITY
John's Mobility scale score reects the extent of his impairment when physically moving, such as running and kneeling.
S
A No Impairment rating was obtained from the following raters: Parent (T-score = 44, 95% CI = 38-52, 27th percentile
rank); Teacher 1 (T-score = 45, 95% CI = 40-51, 31st percentile rank); Teacher 2 (T-score = 45, 95% CI = 40-51, 31st
percentile rank).
DOMESTIC
The Domestic scale score reects John's level of impairment when completing household tasks, such as helping around the
house and completing chores.
A Moderate Impairment rating was obtained from the following rater: Parent (T-score = 69, 95% CI = 59-73, 97th
percentile rank).
Comparisons between parent and teacher raters could not be made because the Domestic scale does not appear on the
Teacher Form.
A Moderate Impairment rating was obtained from the following rater: Parent (T-score = 68, 95% CI = 57-72, 96th
percentile rank).
Comparisons between parent and teacher raters could not be made because the Family scale does not appear on the Teacher
Form.
SELF-CARE
E
The Self-Care scale score reects the extent of John's impairment in caring for himself, including the areas of feeding,
dressing and maintaining personal hygiene.
L
A No Impairment rating was obtained from the following rater: Parent (T-score = 55, 95% CI = 45-62, 69th percentile
rank).
Comparisons between parent and teacher raters could not be made because the Self-Care scale does not appear on the
P
Teacher Form.
TOTAL SCORE
M
Johns Total Score indicates his level of overall impairment.
A
A Moderate Impairment rating was obtained (T-score = 67, 95% CI = 62-70, 96th percentile rank).
S
A Considerable Impairment rating was obtained from the following raters: Teacher 1 (T-score = 77, 95% CI = 71-80, 99th
percentile rank); Teacher 2 (T-score = 72, 95% CI = 67-75, 99th percentile rank).
Comparisons between parent and teacher raters could not be made because Domestic, Family, and Self-Care scales do not
appear on the Teacher Form.