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Greater Randolph Interlocal Cooperative

325 S. Oak St., Suite L 103
Winchester, IN 47394
Phone (765) 584-7602 FAX (765) 584-7544

REPORT FOR PSYCHOEDUCATIONAL EVALUATION

CONFIDENTIAL

Name: Student Address: 1234 ABC Drive

Date of Birth: 2/10/2007 City, IN 12345
Age: 9 years, 9 months School: ABC Elementary School
Parent(s)/Guardian: Parent Grade: 3
Phone Number: 123-456-7890 Evaluation Date(s): 12/02/16, 12/05/16
Prepared By: Haley Wilde

Reason for Referral:

Student was referred for a psychoeducational evaluation to consider special education under the
categories of Specific Learning Disability and Other Health Impairment.

Background Information:
Student is a 9-year, 9-month-old female in third grade at ABC Elementary School. Student
currently resides with her biological mother, adoptive father, and younger sister in City, Indiana.
Parent reported Student has an older stepbrother and stepsister who stay with the family every
other weekend. Parent provided Students developmental, medical, and social histories as well as
a previous neuropsychological report.

Medical History
Parent reported Students length of gestation as 37 weeks and delivery as normal and without
complications. Parent reported having gestational diabetes during pregnancy, as well as one
injection of morphine for pneumonia. Parent reported Students blood sugar dropped to 29
following birth. Parent reported Student had a heart murmur and congenital cataracts in her right
eye, but does not require glasses. Student had tubes in her ears when she was 2 years old but
hearing problems were denied at the time of the report. Parent reported Student had staring spells
one to two times per week at home and that Student was hard to rouse during those spells. Parent
reported Student had been receiving outpatient counseling at ABC Clinic with Dr. Smith for the
last 6 months, with treatment focusing on concentration skills and anger management.
Documentation from Dr. Smith indicated Student had been diagnosed with Attention-
Deficit/Hyperactivity Disorder, Combined Type, Anxiety Disorder, Not Otherwise Specified, and
Separation Anxiety Disorder.

Student is currently taking prescription medication Ritalin to help with Attention-

Deficit/Hyperactivity Disorder symptoms. Students 504-plan documentation reported the
medicine is helping her focus, remain on task, and avoid frustration with academics. Student
takes the medication after lunch.
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Academic History
Records indicated Student was administered the Wechsler Preschool and Primary Scale of
Intelligence Third Edition (WPPSI-III) in November of 2012. Her overall cognitive ability fell
in the Average range (FSCS=90). Her verbal, performance, and processing speed scores were all
in the Low Average to Average range. Student was administered the Woodcock-Johnson Third
Edition Tests of Achievement (WJ-III-ACH) Form B in November of 2012. Her reading, math,
and language skills fell in the Low Average to Average range. Student was also administered the
Childrens Memory Scale (CMS). Her performance on delayed recognition,
attention/concentration, short-term visual, short-term verbal, long-term visual, and long-term
verbal performances were in the Average range, however her ability to learn both visual and
verbal information when given repeated trials was in the Low Average range. Dr. Smith noted
verbal impulsivity as well as basic math calculation skill impairment for Students age and
education background. Dr. Smith also noted Student had some difficulty following multi-step
directions.

Students teacher, Mrs. Jones, reported Student currently has moderate difficulty with reading.
She reported Student can write her name, identify all letters and numbers, write all letters and
numbers, and has adequate pencil grasp. She also reported Student has difficulty with
sound/symbol relationships, discriminating similar sounds, blends, letters, or words, following
oral directions, and using phonics to spell or read. Mrs. Jones reported Student confuses similar
letters, confuses letter order in words when reading, reverses letters, and has difficulty copying
from her desk. She also reported Student has difficulty expressing ideas, understanding abstract
words or concepts, expressing sequence of events, avoids responding orally in class, and has
poor or inconsistent verbal memory. Mrs. Jones reported Student has difficulty learning new
vocabulary words, difficulty with phonetic skills, structural skills, and comprehending what is
read. She also reported Student reads word-to-word or at a slow rate.

Mrs. Jones also reported Student has slight difficulty with mathematics. She reported Student has
difficulty memorizing basic math facts, computations, and story problems. However, she
reported Student can solve math problems if they are read to her. Mrs. Jones reported Student has
good attendance. Additionally, Mrs. Jones reported Student requires help with gathering her
materials at the end of the day and filling out her planner.

Student was placed on a 504 plan based on academic eligibility. Students 504-plan duration is
reported as August 2016 through June 2018, with the review date established as Fall 2017 or
earlier if needed. Students 504 plan provides accommodations including small group settings for
tests, extended time for test taking (50% extra time), and tests read aloud except those that
measure reading comprehension.

Social-Emotional History
Mrs. Jones reported Student is generally cooperative, obedient, friendly, displays a positive
attitude toward school, and has a good sense of humor. She reported Student puts forth good
effort, is usually a good sport, and reacts positively to correction. Mrs. Jones reported Student
displays many interests, appears happy most of the time, and is liked by other children. Mrs.
Jones also reported Student sometimes fails to ask for help when it is really needed and has
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difficulty maintaining her desk and belongings. She reported Student performs better in one-on-
one situations.

Dr. Smiths neuropsychological report from November of 2012 indicated Student was referred
for an evaluation due to behavioral issues, inattentive behaviors, and anger issues. Students
mother and kindergarten teacher at the time, Ms. John, completed Attention Deficit Disorder
Evaluation Scales Third Edition (ADDES-3). Parent rated Student in the severe range on the
scale measuring hyperactive-impulsive behavior and Ms. John rated Student in the average range
for hyperactive-impulsive behavior. On the scale measuring inattentive behaviors, Parent rated
Student in the mild range, and Ms. John rated Student in the severe range.

It was noted that Students selective attention and ability to maintain attention on tasks requiring
sustained attention were impaired. Parent and Ms. John also completed the Behavior Assessment
System for Children, Second Edition (BASC-2). Parents responses indicated Student exhibited
Clinically Significant levels of hyperactivity and somatization. Parent responses also indicated
Student exhibited At-Risk levels of anxiety, depression, atypical behaviors, withdrawal, attention
problems, and deficits in adaptability and social skills. Ms. Johns responses indicated Student
exhibited Clinically Significant levels of attention problems.

Dr. Smiths neuropsychological evaluation reported overall significant levels of inattention,

hyperactivity, impulsivity, and executive function impairment consistent with ADHD. Dr. Smith
reported Student demonstrated mild difficulty with basic reading and spelling skills, however,
her performance was consistent with her ability level, which was not consistent with a learning
disorder. Students difficulty with separating from her mother was reported and observed during
the evaluation. Although concerns about oppositional and defiant behaviors were reported during
the initial interview, significant concerns were not identified on objective rating forms or during
the evaluation. Dr. Smiths neuropsychological report provided diagnoses of Attention-
Deficit/Hyperactivity Disorder, combined type, Anxiety Disorder, not otherwise specified,
Separation Anxiety Disorder, as well as reported right cataracts, changes in family structure and
living arrangements, academic problems, and conflict with family members.

Behavioral Observations:

Classroom Observations
Student was observed in Mrs. Jones third grade classroom during the late morning. The majority
of students, including Student, sat on stability balls at their desks instead of regular chairs.
Students desk was near the teachers desk and facing inward with four other students. It was
noted that Students desk cubby appeared slightly disorganized compared to the cubbies of peers
seated near her. Papers, folders, and materials appeared loose and out of order rather than neatly
stacked like her peers were. The class was working in groups on a text features activity that
required them to read, problem solve, and solve a puzzle within their group. To solve the puzzle,
the students had to move a collection of cards in a particular order so that terms related to text
features lined up with their correct definitions. Student remained standing for the majority of the
group activity and was a very active participant in her group. She appeared to put forth optimal
effort toward solving her groups puzzle, voiced her opinion often, and picked up the cards as she
and her peers attempted to solve their puzzle. It was noted that Student argued with one of her
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male peers over the cards being correct twice during the activity. Student did not want to move
on from that card and give it to her peer until she had it confirmed by Mrs. Jones to be sure it
was correct. Student raised her hand and called over Mrs. Jones several times during the activity
to get cards checked.

Following the puzzle activity, the class was instructed to work on various activities while the
teacher lead one of the classs reading groups. Student and a peer sat along the wall together to
work on what appeared to be spelling skills. The peer recited words out loud and Student would
write them out on a white board. The pair did this for several minutes before switching roles. It
was noted that the peer had to clarify the word Student was trying to read several times because
she struggled to sound it out fluently. For example, Student attempted to read the word
entertain aloud, but read en-tra-tain instead. Student also engaged in the classs silent reading
time independently at her desk. The book appeared to have both text and pictures. Student
appeared to follow the words with her finger and although she read silently, mouthed the words
as she read.

Testing Observations
Testing occurred in a quiet, well-lit room during one session. Student was well groomed and
appropriately dressed for the occasion. Student was friendly and conversational upon initial
meeting. Overall, a good rapport was established and maintained throughout the testing session.

Student was cooperative and compliant throughout testing. She followed instructions and was
able to stay on-task throughout the session, with the exception of several occasions during which
she required prompting. She remained seated with appropriate attention to materials and to
directions when they were being given. Occasionally Student shifted in her seat and pulled her
legs up underneath her. Student appeared to give full effort on most tasks by continuing to work
until the time limit was reached or until she was finished with the task. It should be noted that a
brief announcement was made over the school speakers during one of the subtests, however, did
not appear to affect Students performance. Overall, it is considered the current evaluation is a
typical representation of Students ability to complete tasks and interact with her environment.

Instruments and Methods Used:

Adaptive Behavior Assessment SystemThird Edition (ABAS-3)
Behavior Assessment System for ChildrenThird Edition (BASC-3)
Behavioral Observations
Record Review
Social/Developmental History
Wechsler Individual Achievement Test Third Edition (WIAT-III)

Assessment Results and Clinical Impressions:

Academic Achievement
Wechsler Individual Achievement Test Third Edition (WIAT-III)
Student was administered the Wechsler Individual Achievement Test Third Edition (WIAT-III)
to obtain an estimate of her overall achievement in the areas of oral language, reading, written
expression, and math. The average range of standard scores is 85-115.
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Wechsler Individual Achievement Test Third Edition (WIAT-III)

(Mean = 100, Standard Deviation = 15)
Composite Standard Percentile 95% Descriptive
Score Rank Confidenc Classification
e Interval
Total Achievement 90 25 86-94 Average
Oral Language 98 45 89-107 Average
Listening Comprehension 104 61 92-116 Average
Oral Expression 94 34 83-105 Average
Total Reading 79 8 74-84 Below Average
Basic Reading 84 14 81-87 Below Average
Reading Comp. & Fluency 77 6 68-86 Below Average
Reading Comprehension 86 18 73-99 Average
Early Reading Skills 90 25 81-99 Average
Word Reading 80 9 76-84 Below Average
Pseudoword Decoding 88 21 84-92 Average
Oral Reading Fluency 76 5 68-84 Below Average
Written Expression 98 45 91-105 Average
Essay Composition 112 79 102-122 Average
Sentence Composition 105 63 95-115 Average
Alphabet Writing Fluency 98 45 82-114 Average
Spelling 81 10 74-88 Below Average
Mathematics 94 34 86-102 Average
Math Problem Solving 87 19 76-98 Average
Numerical Operations 102 55 93-111 Average
Math Fluency 84 14 76-92 Below Average
Math Fluency-Addition 91 27 78-104 Average
Math Fluency-Subtraction 72 3 62-82 Below Average
Math Fluency-Multiplication 95 37 86-104 Average

Total Achievement
Students Total Achievement skills fell within the Average range (Total Achievement = 90) and
ranked at the 25th percentile, indicating her performance was similar to or better than 25% of
children her age in the standardization sample. While scores can fluctuate from day to day, there
is a 95% probability her true skills set is between 86-94.

Oral Language
Students overall language skills fell within the Average range (Oral Language = 98). Her basic
receptive language skills (Listening Comprehension = 104) and basic expressive language skills
(Oral Expression = 94) were in the Average range. Student is expected to perform similar to her
same-age peers on tasks requiring her to understand spoken language and tasks requiring her to
use spoken language.
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Total Reading
Students overall reading skills fell within the Below Average range (Total Reading = 79).
Students pre-reading skills (Early Reading Skills = 90), skills used to understand what she has
read (Reading Comprehension = 86), and phonetic decoding skills (Pseudoword Decoding = 88)
fell within the Average range. Her skills used to read individual sight words presented in
isolation (Word Reading = 80) and skills used to read short passages fluently and efficiently
(Oral Reading Fluency = 76) were in the Below Average range. Student is expected to perform
similar to her same-age peers on tasks related to pre-reading skills, comprehension, and phonetic
decoding, but below her same-age peers on tasks involving sight words and fluency.

Written Expression
Students overall writing skills fell within the Average range (Written Expression = 98). On tasks
requiring Student to combine sentences and construct novel sentences (Sentence Composition =
105), she performed in the Average range. It was noted that Student had some difficulty
constructing a sentence correctly based on a target word and took longer than expected to come
up with sentences. Students skills used to organize and express her thoughts on paper (Essay
Composition = 112) were also in the Average range. It appeared Student made frequent, but
inconsistent, spelling errors. For example, she misspelled the word build, spelling it as both
billed and bilt within her essay. Students skills used to spell words presented in isolation
(Spelling = 81) were in the Below Average range. These findings suggest Student will perform
similar to her peers on some written tasks, but below her same-age peers on tasks that require
spelling.

Mathematics
Students overall math skills fell within the Average range (Mathematics = 94). Her skills in
applying math concepts to solve practical, real-world math problems (Math Problem Solving =
87) and skills in completing increasingly complex paper and pencil math computations
(Numerical Operations = 102) were in the Average range. Students performance suggests she
will perform similar to her same-age peers on math related tasks.

Math Fluency
Students overall math fluency skills fell within the Below Average range (Math Fluency = 84).
Her skills in quickly solving simple addition problems (Math Fluency-Addition = 91) and
multiplication problems (Math Fluency-Multiplication = 95) under specified time constraints
were in the Average range. Her skills in quickly solving simple subtraction problems under
specific time constraints (Math Fluency-Subtraction = 72) fell in the Below Average range.
Student is likely to perform similar to her same-age peers when completing addition and
multiplication problems quickly, but below her same-age peers when completing subtraction
problems quickly.

Behavioral and Emotional Functioning

Behavior Assessment System for Children Third Edition (BASC-3)
The Behavior Assessment System for Children Third Edition (BASC-3-Child form) is an
objective personality measure assessing overall emotional adjustment and behavioral
functioning. The BASC-3 uses both At-Risk and Clinically Significant classifications to signify
areas of concern. At-Risk scores indicate areas that have not reached the clinical level but
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warrant monitoring. Clinically Significant scores indicate areas where problems have reached a
level that warrants intervention. Parent completed the Parent Rating Scales and Mrs. Jones
completed the Teacher Rating Scales.

Behavior Assessment System for Children Third Edition (BASC-

3 Child Form)
(Mean = 50, Standard Deviation = 10)
Validity Index Parent Teacher
Ms. Parent Mrs. T

F Scale Acceptable Acceptable

Response Pattern Acceptable Acceptable
Consistency Acceptable Acceptable
Composite T-Score T-Score
Externalizing Problems 57 42
Internalizing Problems 68* 70**
School Problems - 72**
Behavior Symptoms Index 57 49
Adaptive Skills 48 39*
Clinical Scale
Hyperactivity 55 41
Aggression 54 43
Conduct Problems 59 43
Anxiety 70** 52
Depression 53 42
Somatization 71** 102**
Attention Problems 72** 63*
Learning Problems - 78**
Atypicality 51 55
Withdrawal 46 51
Adaptive Scale
Adaptability 42 46
Social Skills 54 48
Leadership 52 34*
Study Skills - 32*
Activities of Daily Living 46 -
Functional Communication 47 44
* At-Risk
** Clinically Significant

Parents responses indicated Student displays At-Risk levels of internalizing problems, which
include Clinically Significant levels of both anxiety and somatization. Mrs. Jones responses
indicated Clinically Significant levels of internalizing problems, specifically somatization.
Parents responses indicated Student displays Clinically Significant levels of attention problems
and Mrs. Jones responses indicated At-Risk levels of attention problems for Student. Mrs. Jones
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responses indicated Student displays Clinically Significant levels of school problems,

specifically learning problems. Mrs. Jones responses also indicated At-Risk levels of adaptive
skills. Her responses indicated Student displays At-Risk levels of leadership and study skills.

Critical items endorsed by Parent were as follows: Is a picky eater, (Sometimes), and, Has
panic attacks, (Sometimes). There were not any critical items endorsed by Mrs. Jones.

Adaptive Functioning
Adaptive Behavior Assessment System Third Edition (ABAS-3)
The Adaptive Behavior Assessment System-Third Edition (ABAS-3) was used to assess
Students ability to adapt to environmental demands and perform daily activities essential to
home and school environments. Average standard scores for composites and subscales fall
between 90 and 109. Parent completed the ABAS-3 parent form and Mrs. Jones completed the
ABAS-3 teacher form.

Adaptive Behavior Assessment System Third Edition, Parent Rating (ABAS-3)

(Mean = 100, Standard Deviation = 15)
Skill Area Rater: Parent

Standard Percentile 95% Qualitative

/Scaled Rank Confidence Description
Score Interval

General Adaptive Composite 84 14 80-88 Below Average

Conceptual Composite 80 9 74-86 Below Average

Communication 8 Average

Functional Academics 6 Below Average

Self-Direction 6 Below Average

Social Composite 86 18 80-92 Below Average

Leisure 6 Below Average

Social 9 Average

Practical Composite 90 25 84-96 Average

Community Use 8 Average

School/Home Living 10 Average

Health and Safety 6 Below Average

Self-Care 10 Average
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Adaptive Behavior Assessment System Third Edition, Teacher Rating (ABAS-3)

(Mean = 100, Standard Deviation = 15)
Skill Area Rater: Mrs. Jones

Standard Percentile 95% Qualitative

/Scaled Rank Confidence Description
Score Interval

General Adaptive Composite - - - -

Conceptual Composite 87 19 82-92 Below Average

Communication 9 Average

Functional Academics 6 Below Average

Self-Direction 9 Average

Social Composite - - - -

Leisure 13 Above Average

Social - -

Practical Composite 109 73 103-115 Average

Community Use 14 Above Average

School/Home Living 8 Average

Health and Safety 12 Average

Self-Care 12 Average

General Adaptive
Responses indicated Parent perceived Students general adaptive functioning at home to be
within the Below Average range (GAC = 84), which ranked in the 14th percentile. Due to the
number of skipped social composite items on the teacher ABAS-3 form, Mrs. Jones perceived
GAC for Student could not be scored. The GAC is composed of scores from conceptual, social,
and practical skill domains, and it is useful to consider Students adaptive functioning in each of
these areas.
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Conceptual
The Conceptual Composite consists of skills, which estimate communication, functional
academics, and self-direction. Parent rated Students conceptual skills to be within the Below
Average range (Conceptual Composite = 80). Mrs. Jones also rated Students conceptual skills to
be within the Below Average range (Conceptual Composite = 87), however, the upper end of the
below average range.

Social
The Social Composite consists of skills necessary to successfully interact with others in a variety
of settings and situations. Parent rated Students social skills to be within the Below Average
range (Social Composite = 86), however, on the upper end of the below average range. A
composite score could not be generated due to the number of skipped items on the teacher form.

Practical
The Practical Composite consists of skills necessary for school and home living, understanding
of health and safety precautions, self-care, and use of community resources. Parent rated
Students practical skills as being on the lower end of the Average range (Practical Composite =
90), while Mrs. Jones rated Students practical skills as being on the upper end of the Average
range (Practical Composite = 109).

Summary:
Student is a 9-year, 9-month old female in third grade, referred for a psychoeducational
evaluation to consider special education under the categories of Other Health Impairment and
Specific Learning Disability.

Assessments examining Students academic skills, emotional adjustment, behavioral functioning,

and adaptive functioning were conducted. Evaluation results found her overall academic skills
fell primarily within the Average to Below Average range. Students performance was below
average in reading related tasks and appears to be an area of weakness. Specifically, sight word
identification and fluency appear to be areas of difficulty for Student. Oral language appears to
be an area of personal strength for Student, with her receptive and expressive language skills
being in the average range. Although Students overall written expression score fell within the
average range, her performance suggests specific difficulty with spelling. It is likely that
Students difficulty with spelling will have an impact on her writing skills in other areas.
Students math fluency addition and multiplication skills were average compared to her same-age
peers, her subtraction skills were on the lower end of the below average range, which is most
likely why her overall fluency score was below average. Overall, these findings suggest Student
is expected to perform at a similar level to her same-age peers in academic subjects involving
mathematics, oral language, and writing, with the exception of spelling, but may have more
difficulty with reading tasks.

The results of Students adaptive functioning assessments demonstrated her overall adaptive
functioning to be within the Average to Below Average ranges across settings. Overall, Parent
and Mrs. Jones ratings suggest Students practical skills are average compared to her same-age
peers and her conceptual skills related to functional academics are a particular weakness.
Students weakness in functional academics is reflective of her difficulties in the classroom.
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Assessment results regarding Students emotional adjustment and behavioral functioning found
her to have At-Risk levels of internalizing problems at home, and Clinically Significant levels of
internalizing problems at school. Parents ratings indicated Student displays significant levels of
anxiety at home. Parents ratings indicated Student frequently displays behaviors stemming from
worry, nervousness, and/or fear. These findings were consistent with previous reports from
previous assessment, report, and diagnoses.

Both Parent and Mrs. Jones ratings indicated Student displays significantly high levels of
somatization at home and at school, due to a high number of health-related concerns. Mrs. Jones
ratings indicated Student has headaches often, gets sick, complains about her health, pain, and
physical problems more than often in the school setting. Similarly, Parents ratings indicated
Student sometimes gets sick, has panic attacks, often has headaches, thinks she is sick when
nothing is wrong, and more than often complains about her health. Students high levels of
somatization reported by both her mother and her teacher in the absence of a serious health
problem may be indicative of underlying emotional issues, such as anxiety.

The assessment results also indicated Student displays attention problems, specifically At-Risk
levels at school and Clinically Significant levels at home. These findings are consistent with
Students ADHD diagnosis and previous assessment results. Results also indicated Student
displays Clinically Significant levels of school problems and learning problems. It is likely that
Students difficulty with maintaining necessary levels of attention is interfering with her
academic performance. Additionally, results that indicated Student displays difficulty with
making decisions, studying, staying organized, and turning in assignments. Overall, these
findings suggest Students difficulty paying attention and anxiety may be interfering with her
academic performance, ability to stay organized, and somatic symptoms at school and at home.

Recommendations:
1. It is recommended that a case conference committee meeting be scheduled to discuss the
results of this evaluation.
2. It is recommended that Student receive accommodations including extended time on
assignments, projects, tests, and quizzes.
a. Based on Students difficulty with paying attention, it is recommended that her
seat be near the front of the room and oriented towards the teacher and/or main
teaching area.
b. Based on Students difficulty with reading, it is recommended that these
accommodations be implemented for reading tasks and tasks that require reading
skills.
3. Based on Students difficulties with reading, staying organized, and maintaining
necessary levels of attention, one-on-one tutoring and/or academic support programs
could be beneficial for Students academic performance and study skills.
a. It is recommended that Student continue to receive assistance with organization
and writing in her planner.
b. Interventions that practice sight word identification, spelling, and reading fluency
may be beneficial for Student.
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4. It is suggested that this report be shared with Students pediatrician or the familys
medical doctor.
a. It may be beneficial to consider Students ADHD medication regimen and dosage.
b. Reported somatic symptoms, such as headaches and pain, should be monitored.
5. Counseling through a community counseling agency or private practitioner may be
beneficial. Specific issues to be addressed include anxiety, panic attacks, and somatic
symptoms.