CONFIDENTIAL NEUROPSYCHOLOGICAL and PSYCHO-EDUCATIONAL TESTING EVALUATION

Name: xxxxxxxxxxxx Report Date: xxxxxxxxxxx Date of Birth: xxxxxxxxxx Examiner: Scott Andrews, Ph.D., H.S.P. Age: 12 years, x months Test Site: Psychological Testing Consultants Gender: Female Evaluation Start Date: xxxxxxxxxx School: xxxxxxxx Most Recently Completed Grade: 7th

Reason for Referral: Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx.

Additional comments and concerns expressed by xxxxxxxxxx, xxxxxxxx, xxxxxxx (xxxxxxxxxx 7th grade xxxxxxxx classroom teacher), xxxxxxxxx (xxxxxxx 7th grade xxxxxxxx and xxxxxx classroom teacher), and xxxxxxxx are below.

Father: • “xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx.”

Mother: • “xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx.”

xxxxxxxxxxx – xxxxx’s 7th Grade xxxxxxxxxx Teacher • “xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx.”

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xxxxxxxxxxxxx – xxxxxxxxx’s 7th Grade xxxxxxxxxxx Teacher • “xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx.”

xxxxxx– Self-Report • “xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx.”

The current evaluation will assess xxxxxxxxxxx’s neuropsychological, cognitive, social, emotional, and behavioral functioning for indications of sensory information processing deficits, specific learning disorders and nonneurostructural factors affecting her functioning. It will also attempt to clarify her diagnosis and provide recommendations to enhance xxxxxxxxx’s overall adaptation to the school and home settings.

Evaluation Procedures: Child Behavior Checklist (Informant: father, mother) Child’s History Form (Informant: mother) Conners 3 (Informants: father, mother, self) Kaufman Test of Educational Achievement, Third Edition (KTEA-III) NEPSY Second Edition (A Developmental Neuropsychological Assessment) Teacher Report Form (Informants: 7th grade xxxxxxxxx and xxxxx teachers) Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V) Youth Self-Report for Ages 11-18 (Informant: self)

Clinical Observations and Evaluations: Diagnostic Interview, PTC: xxxxxxxxxx

Collateral Interviews and Review of Records: xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Relevant Background Information: xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx.

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Results of Prior Testing: xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx.

Observations: Xxxxxxxxxxxx is an English speaking, 12-year, x-month-old female who reports being right handed. She was taking no medications over the course of testing. Notably, there are no “hard” neurological signs of visual, auditory, or motor dysfunction reported in Xxxxxxxxxxx’s medical history and none were observed during the course of this evaluation. However, it is notable that her early childhood development is positive for xxxxxxxxxxx. Additionally, xxxxxxxxxxxxxxxx. Nevertheless, Xxxxxxxxxxxx was cooperative, attentive, and motivated in her work style. Moreover, her problem solving behavior can be generally described as slow, deliberate, and purposeful. Overall, her approach and attitude toward the testing and the conditions for testing were positive. As such, the test results appear to be reliable and valid estimations of her current level of functioning.

Test Results:

Cognitive Testing To assess Xxxxxxxxx’s ability to reason and to solve problems, verbally and nonverbally, the Wechsler Intelligence Scale for Children: Fifth Edition (WISC-V) was administered.

WISC–V Results

PRIMARY SUMMARY Composite Score Summary

Composite Sum of

Scaled Scores Composite

Score Percentile

Rank

95% Confidence

Interval Qualitative Description SEM

Verbal Comprehension VCI 18 95 37 88-103 Average 3.67 Visual Spatial VSI 20 100 50 92-108 Average 3.97 Fluid Reasoning FRI 19 97 42 90-104 Average 3.35 Working Memory WMI 22 107 68 99-114 Average 3.97 Processing Speed PSI 21 103 58 94-112 Average 6.00 Full Scale IQ FSIQ 64 94 34 89-100 Average 2.60 Confidence intervals are calculated using the Standard Error of Estimation.

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Subtest Score Summary

Domain Subtest Name Total

Raw Score Scaled Score

Percentile Rank

Age Equivalent SEM

Verbal Similarities SI 24 7 16 9:6 1.08 Comprehension Vocabulary VC 33 11 63 13:6 0.90

(Information) IN - - - - - (Comprehension) CO - - - - -

Visual Spatial Block Design BD 30 9 37 11:2 1.16 Visual Puzzles VP 19 11 63 15:6 0.95

Fluid Reasoning Matrix Reasoning MR 16 7 16 8:2 0.95 Figure Weights FW 26 12 75 16:2 0.67 (Picture Concepts) PC - - - - - (Arithmetic) AR - - - - -

Working Memory Digit Span DS 28 10 50 13:6 0.79

Picture Span PS 35 12 75 16:6 1.12 (Letter-Number Seq.) LN - - - - -

Processing Speed Coding* CD 49 8 25 11:6 1.27 Symbol Search* SS 36 13 84 16:2 1.72 (Cancellation) CA - - - - -

Subtests used to derive the FSIQ are bolded. Secondary subtests are in parentheses.

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PRIMARY ANALYSIS

Index Level Strengths and Weaknesses

Index Score Comparison

Score Difference Critical Value Strength or Weakness Base Rate

VCI 95 100.4 -5.4 8.82 >25%VSI 100 100.4 -0.4 9.32 >25%FRI 97 100.4 -3.4 8.30 >25%WMI 107 100.4 6.6 9.32 <=25% PSI 103 100.4 2.6 12.92 >25%Comparison score mean derived from the five index scores (MIS). Statistical significance (critical values) at the .05 level. Base rates are reported by overall sample.

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Index Level Pairwise Difference Comparisons

Index Comparison Score 1 Score 2 Difference Critical Value Significant Difference Base Rate

VCI - VSI 95 100 -5 10.60 N 38.4% VCI - FRI 95 97 -2 9.74 N 46.4% VCI - WMI 95 107 -12 10.60 Y 21.7% VCI - PSI 95 103 -8 13.79 N 34.5% VSI - FRI 100 97 3 10.18 N 40.8% VSI - WMI 100 107 -7 11.00 N 33.3% VSI - PSI 100 103 -3 14.10 N 44.6% FRI - WMI 97 107 -10 10.18 N 24.3% FRI - PSI 97 103 -6 13.47 N 37.0% WMI - PSI 107 103 4 14.10 N 43.3% Statistical significance (critical values) at the .05 level. Base rates are reported by overall sample.

Subtest Level Strengths and Weaknesses

Subtest Score Comparison

Score Difference Critical Value Strength or Weakness Base Rate

SI 7 10.0 -3.0 2.87 W <=10% VC 11 10.0 1.0 2.45 >25%BD 9 10.0 -1.0 3.06 >25%VP 11 10.0 1.0 2.57 >25%MR 7 10.0 -3.0 2.57 W <=10% FW 12 10.0 2.0 1.94 S <=25% DS 10 10.0 0.0 2.20 PS 12 10.0 2.0 2.97 <=25% CD* 8 10.0 -2.0 3.33 <=25% SS* 13 10.0 3.0 4.42 <=15% Comparison score mean derived from the ten primary subtest scores (MSS-P). Statistical significance (critical values) at the .05 level.

PROCESS ANALYSIS Total Raw Score to Scaled Score Conversion Process Score Raw Score Scaled Score Block Design No Time Bonus BDn 30 9 Block Design Partial Score BDp 40 8 Digit Span Forward DSf 10 11 Digit Span Backward DSb 9 10

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Digit Span Sequencing DSs 9 10 Cancellation Random CAr - - Cancellation Structured CAs - -

Process Level Pairwise Difference Comparisons (Scaled Scores) Process Score Comparison Score 1 Score 2 Difference Critical Value

Significant Difference Base Rate

BD - BDn 9 9 0 3.40 N BD - BDp 9 8 1 3.11 N 40.1% DSf - DSb 11 10 1 3.69 N 41.3% DSf - DSs 11 10 1 3.63 N 42.9% DSb - DSs 10 10 0 3.66 N LN - DSs - - - - - - CAr - CAs - - - - - - Statistical significance (critical values) at the .05 level.

Process Level Pairwise Difference Comparisons (Raw Scores) Process Score Comparison Raw Score 1 Raw Score 2 Difference Base Rate LDSf - LDSb 6 4 2 62.7% LDSf - LDSs 6 5 1 63.9% LDSb - LDSs 4 5 -1 68.7% Base rates are reported by overall sample.

Summary of Test Results: On the WISC-V Composite Score standard scores of 90-109 are considered average, and scaled scores of 8 to 11 (25th to 63rd percentiles) are considered average for the individual tasks.

The WISC-V results show that Xxxxxxxxxxx reasons in the Average range with the use of language, with a Verbal Comprehension Composite Score standard score = 95 (37th percentile). Similarly, she functions in the Average range on nonverbal tasks (Visual Spatial Composite Score standard score = 100, 50th percentile). Finally, Xxxxxxxxxx earned a Full Scale IQ score in the Average range (Full Scale composite score = 94, 34th percentile), suggesting that her estimated overall intellectual level is somewhere between the high end of the Low Average range to the middle of the Average range of functioning for a child her age.

In the Verbal Comprehension domain, Xxxxxxxxxx’s performance was adequate on the Similarities task where she demonstrated Low Average range ability to conceptualize and generalize using language (scaled score = 7, 16th percentile). In contract, she received an Average score on the Vocabulary task which required her to orally define words. Here, Xxxxxxxxxxxx earned a scaled score of 11 (63rd percentile).

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In the Visual Spatial domain, Xxxxxxxx’s ability to analyze abstract visual-spatial material was in the Average range for children her age (Block Design scaled score = 9, 37th percentile). Here, geometric designs are presented using a picture, and Xxxxxxxxxxx recreated the designs using blocks. Next, she was administered a task designed to measure nonverbal reasoning and the ability to analyze and synthesize abstract visual stimuli (Visual Puzzles scaled score = 11, 63rd

percentile). On this task, Xxxxxxxxx views a completed puzzle and selects three response options that, when combined, reconstruct the puzzle. Her performance on the Visual Puzzles task was in the Average range of functioning for her age.

In the area of Fluid Reasoning, Xxxxxxxxxxx earned a score placing in the Average range of functioning for her age (composite score = 97, 42nd percentile). On the first task in this domain, the Matrix Reasoning task, Xxxxxxxxxx was required to reason with purely abstract visual information. Here, she was shown arrays of shapes and asked to pick the one that continued or completed a pictured design. On this task, Xxxxxxxxx’s scaled score of 7 (16th percentile) was in the Low Average range. On another task in the Fluid Reasoning domain, the Figure Weights task, Xxxxxxxxxx’s quantitative fluid reasoning and induction skills were evaluated. On this task, within a specified time limit, Xxxxxxxxxxxx was asked to select the response option that keeps the scale balanced. It required her to apply the quantitative concept of equality to understand the relationship among objects and apply the concepts of matching, addition, and/or multiplication to identify the correct response. Here, Xxxxxxxxxx’s performance on the Figure Weights task was in the High Average range (scaled score = 12, 75th percentile).

In the area of Working Memory, Xxxxxxxxxxx earned a score placing within the Average range (composite score = 107, 68th percentile). On the first task in this domain, she demonstrated Average ability to recall rote auditory information (Digit Span scaled score = 10, 50th percentile). There are three conditions to this task – Digit Span Forward, Digit Span Backward, and Digit Span Sequencing. For Digit Span Forward, Xxxxxxxxxxx is read a sequence of numbers and she recalls the numbers in the same order. This component of the task involves rote learning and memory, attention, encoding, and auditory processing. Xxxxxxxxxxx achieved a scaled score of 11 (63rd percentile) on Digit Span Forward – a score in the Average range for an individual her age. For Digit Span Backward, Xxxxxxxxxxx is read a sequence of numbers and she recalls the numbers in reverse order. Notably, cognitive flexibility, and mental alertness are required when shifting from one Digit Span task to another. Xxxxxxxxxxx again earned a score in the Average range on Digit Span Backward (scaled score = 10, 50th percentile). This condition of the task involves working memory, transformation of information, mental manipulation, and visuospatial imaging. For Digit Span Sequencing, Xxxxxxxxxxxx is read a sequence of numbers and she recalls the numbers in order. This task assesses mental resequencing of auditory information. Here, Xxxxxxxxxx earned a score in Average range of functioning for a child her age (Digit Span Sequencing scaled score = 10, 50th percentile).

Slightly better than her performances on Digit Span Forward and Digit Span Backward, Xxxxxxxxxxx achieved a score in the low end of the High Average range on a similar task requiring her to hold semantically meaningful visual information in her mind and sequence it (Picture Span, scaled score = 12, 75th percentile). Specifically, Xxxxxxxxxxx was asked to view a stimulus page with one or more pictures of nameable objects for a specified time and then she selects the picture(s) (in sequential order, if possible) from options on a response page. Notably, Picture Span measures visual working memory and working memory capacity.

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On the Processing Speed Index tasks, which are timed, pencil and paper tasks, Xxxxxxxxxxxx’s performance placed within the Average range for this Index (composite score = 103, 58th

percentile). For the Coding task, she was asked to copy symbols to match numbers, using a key or “code.” Here, Xxxxxxxxxxx received a score in the Average range (scaled score = 8, 25th

percentile). On another task, the Symbol Search task, Xxxxxxxxxx achieved a score in the middle of the High Average range (scaled score = 13, 84th percentile). Here, she scans a search group and indicates whether one of the symbols in the target group matches. It is a timed visual vigilance and scanning task and, unlike the Coding task, the Symbol Search task requires very little fine motor output.

The Index Level Pairwise Difference Comparisons table (see table on page x) shows that Xxxxxxxxxxx’s abilities in the WISC-V domains are somewhat unevenly developed. Specifically, her abilities in the Verbal Comprehension domain are significantly below her abilities in the Working Memory domain, though the size of the discrepancy (12 standard score points) is not a particularly unusual event in the standardization sample. However, Xxxxxxxxxxxxx’s performance on the Similarities subtest was a significant weakness. Moreover, the size of the weakness has a low base rate in the standardization sample (< 10%). Furthermore, Xxxxxxxxxxxx’s performance on the subtest Matrix Reasoning was a significant weakness, again with a low base rate in the standardization sample (base rate < 10%). Finally, Xxxxxxxxxxx’s performance in the Figure Weights subtest was a strength, though the degree of the strength was not an unusual event in the standardization sample.

Achievement Testing To evaluate Xxxxxxxxxxx’s current level of achievement in several academic subjects, the Kaufman Test of Educational Achievement, Third Edition (KTEA-III) was administered.

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Kaufman Test of Educational Achievement – Third Edition

Core Composite Score Summary Table

Composite/SubtestSubtest

Raw Scores

Sum of Subtest

Standard Scores

Standard Scores

95% Confidence

Interval

Percentile Rank

Descriptive Category

Age Equivalent GSV

Core Composites Academic Skills Battery (ASB) Composite

- 523 84 79 - 89 14 Below average - -

Math Concepts & Applications 58 - 88 83 - 93 21 Below

average 10:6 522

Letter & Word Recognition 64 - 86 80 - 92 18 Below

average 10:2 522

Written Expression 421 - 94 81 - 107 34 Average 11:2 508 Math Computation 45 - 87 80 - 94 19 Below

average 10:6 525

Spelling 49 - 90 82 - 98 25 Average 10:10 526 Reading Comprehension 71 - 78 68 - 88 7 Low 9:7 513

Reading Composite - 164 81 75 - 87 10 Below average - -

Letter & Word Recognition 64 - 86 80 - 92 18 Below

average 10:2 522

Reading Comprehension 71 - 78 68 - 88 7 Low 9:7 513

Math Composite - 175 86 81 - 91 18 Below average - -

Math Concepts & Applications 58 - 88 83 - 93 21 Below

average 10:6 522

Math Computation 45 - 87 80 - 94 19 Below average 10:6 525

Written Language Composite - 184 91 83 - 99 27 Average - -

Written Expression 421 - 94 81 - 107 34 Average 11:2 508 Spelling 49 - 90 82 - 98 25 Average 10:10 526

1 Indicates a raw score that is converted to a weighted raw score (not shown). 2 Indicates that a raw score is based on a below grade level item set.

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Core Composite Score Summary Profile

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Supplemental Composite Score Summary Table

Composite/SubtestSubtest

Raw Scores

Sum of Subtest

Standard Scores

Standard Scores

95% Confidence

Interval

Percentile Rank

Descriptive Category

Age Equivalent GSV

Supplemental Composites

Sound-Symbol Composite - 162 77 71 - 83 6 Low - -

Phonological Processing 33 - 81 71 - 91 10 Below

average 7:4 492

Nonsense Word Decoding 18 - 81 76 - 86 10 Below

average 8:1 495

Decoding Composite - 167 82 78 - 86 12 Below average - -

Letter & Word Recognition 64 - 86 80 - 92 18 Below

average 10:2 522

Nonsense Word Decoding 18 - 81 76 - 86 10 Below

average 8:1 495

Reading Fluency Composite - - - - - - - -

Silent Reading Fluency 35 - 93 82 - 104 32 Average 11:2 508

Word Recognition Fluency - - - - - - - -

Decoding Fluency - - - - - - - - Reading Understanding Composite

- 166 81 74 - 88 10 Below average - -

Reading Comprehension 71 - 78 68 - 88 7 Low 9:7 513

Reading Vocabulary 27 - 88 81 - 95 21 Below average 10:6 519

Oral Language Composite - - - - - - - -

Associational Fluency 39 - 111 93 - 129 77 Above average >19:6 525

Listening Comprehension 231 - 105 92 - 118 63 Average 13:10 524

Oral Expression - - - - - - - - Oral Fluency Composite - 187 92 76 - 108 30 Average - -

Associational Fluency 39 - 111 93 - 129 77 Above average >19:6 525

Object Naming Facility 44 - 76 59 - 93 5 Low 7:1 -

Comprehension Composite - 183 90 81 - 99 25 Average - -

Reading Comprehension 71 - 78 68 - 88 7 Low 9:7 513

Listening Comprehension 231 - 105 92 - 118 63 Average 13:10 524

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Expression Composite - - - - - - - -

Written Expression 421 - 94 81 - 107 34 Average 11:2 508 Oral Expression - - - - - - - - Orthographic Processing Composite

- - - - - - - -

Spelling 49 - 90 82 - 98 25 Average 10:10 526 Letter Naming Facility 62 - 84 70 - 98 14 Below

average 9:1 -

Word Recognition Fluency - - - - - - - -

Academic Fluency Composite - - - - - - - -

Writing Fluency 35 - 101 86 - 116 53 Average 13:2 530 Math Fluency 21 - 84 76 - 92 14 Below

average 9:7 506

Decoding Fluency - - - - - - - - 1 Indicates a raw score that is converted to a weighted raw score (not shown). 2 Indicates that a raw score is based on a below grade level item set.

ASB Composite and Subtest Standard Score Differences

Comparison Difference Critical Value (.01)

Significant Difference

Y/NBase Rate

Academic Skills Battery vs. Phonological Processing 3 12 N >15%

Academic Skills Battery vs. Math Concepts & Applications -4 8 N >15%

Academic Skills Battery vs. Letter & Word Recognition -2 8 N >15%

Academic Skills Battery vs. Math Computation -3 8 N >15%

Academic Skills Battery vs. Nonsense Word Decoding 3 9 N >15%

Academic Skills Battery vs. Writing Fluency -17 20 N >15%

Academic Skills Battery vs. Silent Reading Fluency -9 16 N >15%

Academic Skills Battery vs. Math Fluency 0 12 N - Academic Skills Battery vs. Reading Comprehension 6 11 N >15%

Academic Skills Battery vs. Written Expression -10 14 N >15%

Academic Skills Battery vs. Associational Fluency -27 24 Y <=10% Academic Skills Battery vs. Spelling -6 9 N >15%

Academic Skills Battery vs. Object Naming Facility 8 23 N >15%

Academic Skills Battery vs. Reading Vocabulary -4 11 N >15%

Academic Skills Battery vs. Letter Naming Facility 0 20 N - Academic Skills Battery vs. Listening Comprehension -21 16 Y <=10%

Note. A negative difference indicates that the subtest in the comparison has a higher score than the ASB composite. A significant difference between a subtest score and the ASB means the subtest is either a personal strength (if the difference is negative) or a personal weakness (if the difference is positive). Base rates are not reported when the difference between scores is zero.

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Supplemental Composite Score Summary Profile

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Supplemental Composite Score Summary Profile Continued

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Ability-Achievement Discrepancy Analysis

Ability Score Type: WISC-V: FSIQ Ability Score: 94

Predicted Achievement Method Predicted KTEA-3

Score

Actual KTEA-3

ScoreDifference Critical

Value (.01)

Significant Difference

Y/NBase Rate

KTEA-3 Subtests Phonological Processing 96 81 15 12 Y <=10% Math Concepts & Applications 95 88 7 10 N <=25% Letter & Word Recognition 96 86 10 8 Y <=25% Math Computation 96 87 9 10 N <=25% Nonsense Word Decoding 97 81 16 8 Y <=10% Silent Reading Fluency 97 93 4 16 N >25%

Math Fluency 97 84 13 13 Y <=15% Reading Comprehension 96 78 18 14 Y <=5% Written Expression 96 94 2 16 N >25%

Spelling 96 90 6 9 N >25%

Reading Vocabulary 96 88 8 12 N <=25% Listening Comprehension 96 105 - - - - KTEA-3 Composites Reading 96 81 15 10 Y <=10% Math 95 86 9 9 Y <=25% Written Language 96 91 5 11 N >25%

Academic Skills Battery (ASB) 95 84 11 8 Y <=10% Sound-Symbol 96 77 19 9 Y <=5% Decoding 96 82 14 7 Y <=15% Reading Understanding 96 81 15 10 Y <=10% Oral Fluency 97 92 5 20 N >25%

Comprehension 96 90 6 12 N >25%

Summary of Test Results: The Kaufman Test of Educational Achievement, Third Edition (KTEA-III) is designed to measure academic achievement of individuals ages 4 through 25. Specific areas assessed include math, reading, writing, and oral language skills. On the KTEA-III, standard scores of 90 – 110 are average (25th to 75th percentiles).

The KTEA-III consists of 4 core composites: Academic Skills Battery Composite, Reading Composite, Math Composite, and Written Language Composite. The Academic Skills Battery is a composite that measures an individual’s reading, math, and writing abilities. Within this domain, Xxxxxxxxxxx earned a standard score of 84 (14th percentile), a score in the Below Average range. The 11-point difference between her actual score and her predicted score of 95 (37th percentile) is a rare event in the standardization sample and has a base rate of <10%.

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Next, on the Reading Composite, a measure of reading fluency, reading understanding, decoding, and symbol-sound understanding, Xxxxxxxxxx earned a standard score of 81 (10th

percentile), a Below Average score. This score was significantly below her predicted score of 96 (39th percentile). Additionally, the size of the disparity, 15 standard score points, is an unusual event in the standardization sample and has a base rate of <10%. These results support a diagnosis of Dyslexia (alternate DSM-5 term, Specific Learning Disorder with impairment in reading).

On the Math Composite, a measure of mathematical computation, conceptual understanding, and applications, Xxxxxxxxxxx placed in the Below Average range, with a standard score of 86 (18th

percentile). This score was significantly below her predicted score of 95 (37th percentile). However, the 9-point disparity is not a particularly unusual event in the standardization sample.

Finally, on the Written Language Composite, a measure of language and written expression, Xxxxxxxxxx achieved a standard score of 91 (27th percentile), a score in the Average range. This score did not significantly differ from her predicted score of 96 (39th percentile).

In addition to these broad composites, the KTEA-III provides information on a number of skill- specific domains. Each of Xxxxxxxxx’s scores in these domains is now provided.

The Listening Comprehension subtest is a measure of Oral Language and Comprehension. For this task, Xxxxxxxxxxxx is asked to listen to an auditory passage of information, and to respond verbally to questions about the passage. Here, Xxxxxxxxxxx earned a scaled score of 105 (63rd

percentile), a score in the Average range of functioning for a child her age.

The Associational Fluency subtest is another component of the Oral Language domain. When administered this subtest, Xxxxxxxxxxxx is asked to say as many words in a category as she can within 60 seconds. Here, Xxxxxxxxxx earned a standard score of 111 (77th percentile), a score in the Above Average range of functioning.

Xxxxxxxxxxxxx was administered the subtest Letter and Word Recognition as a measure of her abilities in the Decoding domain. Here, Xxxxxxxxxxxx identifies letters and pronounces words of increasing difficulty. On this subtest, Xxxxxxxxxx earned a score of 86 (18th percentile), a score in the Below Average range. Her actual score was significantly below her predicted score of 96 (39th percentile). However, this 10-point discrepancy is not a particularly unusual event in the standardization sample.

On a second measure of Decoding, as well as a measure of Sound-Symbol abilities, decode nonsense words of increasing difficulty. This task requires individuals to apply knowledge of phonics and sentence structure. On this subtest, Xxxxxxxxxxx earned a standard score of 81 (10th

percentile), which is in the low end of the Below Average range. This score was significantly below her predicted score of 97 (42nd percentile). The 16-point discrepancy is a rare event in the standardization sample (base rate <10%). These results provide support for a diagnosis of Dyslexia (alternate DSM-5 term, Specific Learning Disorder, with impairment in reading – word reading accuracy).

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On another subtest in the Sound-Symbol domain, Phonological Processing, Xxxxxxxxxxx is asked to manipulate sounds by rhyming, blending, matching, segmenting, and deleting sounds. She is then asked to provide an oral response. Here, Xxxxxxxxxx earned a standard score of 81 (10th percentile), which is at the low end of the Below Average range of functioning for an individual her age. This score was significantly below her predicted score of 96 (39th percentile), with a base rate of <10%. This score lends further support to a diagnosis of Dyslexia (alternate DSM- 5 term, Specific Learning Disorder, with impairment in reading – word reading accuracy).

On a measure of Reading Understanding and Comprehension, Xxxxxxxxxx was administered the Reading Comprehension subtest. Reading Comprehension is an untimed subtest requiring individuals to generate responses that demonstrate understanding of the passages read. Xxxxxxxxxxx was first asked to read passages of instructions and respond by performing the action instructed in writing. As the task progresses, individuals are asked literal and inferential questions about the passages. Here, Xxxxxxxxxxx earned a scaled score of 78 (7th percentile), a score in the Low range of functioning for a child her age. This score was significantly below her predicted score of 96 (39th percentile). The 18-point discrepancy between her actual score and her predicted score is a rare event in the standardization sample, with a base rate of <5%. These results lend further support for a diagnosis of Dyslexia (alternate DSM-5 term, Specific Learning Disorder, with impairment in reading – reading comprehension).

Overall, Xxxxxxxxxx’s abilities in the Comprehension domain are in the low end of the Average range, with a standard score of 90 (25th percentile). This score does not significantly differ from her predicted score of 96 (39th percentile).

Xxxxxxxxxx was administered the Reading Vocabulary subtest as a measurement of her Reading Understanding domain abilities. During this subtest, Xxxxxxxxxxx is asked to point to target words with the same meaning as the pictures that she was shown. As the subtest progresses, Xxxxxxxxxxx is asked to read sentences and either say or point to the words in the sentences that have the same meaning as target words. On this subtest, Xxxxxxxxxx earned a score of 88 (21st

percentile), a score in the Below Average range for a child her age. Xxxxxxxxxxx’s predicted score, based on her overall intellectual ability, was 96 (39th percentile). However, this 8-point disparity is not statistically significant.

Overall, Xxxxxxxxxx’s Reading Understanding domain score was 81 (10th percentile), a score in the low end of the Below Average range. Her score was significantly below her predicted score of 96 (39th percentile) and has a base rate of <10%. These results indicate a diagnosis of Dyslexia (alternate DSM-5 term, Specific Learning Disorder, with impairment in reading – reading comprehension).

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On a measure of Reading Fluency ability, Xxxxxxxxxxx is asked to read simple sentences and indicate whether the statements are true or false. She is asked to work as quickly as she can to complete as many items as possible within 2 minutes. Here, on the Silent Reading Fluency subtest, Xxxxxxxxxxx earned a standard score of 93 (32nd percentile), a score that did not significantly differ from her predicted score of 97 (42nd percentile).

On another subtest, Associational Fluency, Xxxxxxxx is asked to name as many words as she can within 60 seconds. This subtest is a measure of abilities in the Oral Language and Oral Fluency domains. On this subtest, Xxxxxxxxxx earned a standard score of 111 (77th percentile), a score in the low end of the Above Average range of functioning.

On another Oral Fluency domain subtest, Object Naming Facility, Xxxxxxxxxxxx is asked to verbally identify objects in pictures as rapidly as possible. Here, Xxxxxxxxxxxx earned a score in the Low range, with a standard score of 76 (5th percentile). Overall, Xxxxxxxxxxxx’s abilities in the Oral Fluency domain are in the low end of the Average range, with a standard score of 92 (30th percentile). This score was comparable to her predicted score of 97 (42nd percentile).

Xxxxxxxxxxxxx is asked to write one sentence for each picture with which she was presented as part of the Writing Fluency subtest in the Writing domain. She is asked to complete as many items as she can within a 5-minute time period. On this task, Xxxxxxxxx earned a standard score of 101 (53rd percentile), which is in the Average range of functioning for a child her age.

Xxxxxxxxxxxx completed the Spelling subtest, a measure of Orthographic Processing abilities. During the subtest, Xxxxxxxxxxxx was asked to spell words with regular and irregular spellings. She earned a standard score of 90 (25th percentile), which placed at the low end of the Average range of functioning. This score was on par with her predicted score of 96 (39th percentile).

Xxxxxxxxxxx was administered the Letter Naming Facility subtest, a measure of her abilities in the Orthographic Processing domain. Here, Xxxxxxxxxxxx is asked to identify both lower case and uppercase letters as quickly as she can during 2 trials. Here, Xxxxxxxxxxxx earned a standard score of 84 (14th percentile), a score in the Below Average range.

Xxxxxxxxxxxx’s abilities within the Expression domain were measured through the subtest Written Expression. Here, Xxxxxxxxxxxx is asked to complete tasks in a story format. Aspects of writing that are measured include capitalization, punctuation, combining sentences, filling in missing words, and writing compound sentences. She is also asked to write an essay based on the story. On this task, Xxxxxxxxxxx earned a standard score of 94 (34th percentile), a score within the Average range of functioning for an individual her age. This score did not differ significantly from her predicted score of 96 (39th percentile).

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Xxxxxxxxxxxx was administered the Math Concepts and Applications subtest as a measure of her abilities in the Math domain. Here, Xxxxxxxxxxx responds verbally to questions requiring her to apply mathematical principles to real-life situations. Math Concepts and Applications measures skills such as number concepts, operations concepts, time and money, measurement, and geometry. On this subtest, Xxxxxxxxxx earned a standard score of 88 (21st percentile), a score at the high end of the Below Average range of functioning. Xxxxxxxxxxxx’s performance on this subtest did not significantly differ from her predicted score of 95 (37th percentile).

On another Math domain subtest, Math Computation, Xxxxxxxxxxxx is asked to complete as many math problems as possible. The skills that are assessed in this subtest include counting, number identification, addition, subtraction, multiplication, division, fractions, decimals, and algebra. Xxxxxxxxxx’ performance on the Math Computation subtest placed within the Below Average range of functioning for an individual her age, with a standard score of 87 (19th

percentile). Her score was comparable to her predicted score of 96 (39th percentile).

Xxxxxxxxxxx was administered the Math Fluency subtest, which assesses her abilities in the Math domain. Here, Xxxxxxxxxxxx is asked to complete as many mathematical problems as possible within 60 seconds. On this task, Xxxxxxxxxxx earned a scaled score of 84 (14th

percentile), a score in the middle of the Below Average range. This score was significantly below her predicted score of 97 (42nd percentile), but the 13-point discrepancy was not a particularly unusual event in the standardization sample (base rate <15%).

Neuropsychological Testing Xxxxxxxxxxx was administered the NEPSY-II as part of her evaluation. The NEPSY–II helps assess academic, social, and behavioral difficulties in children and adolescents. Results obtained from a NEPSY–II assessment can be used to diagnose and aid in intervention planning for a variety of childhood disorders. In particular, a comprehensive understanding of a child’s cognitive limitations can facilitate the development of appropriate Individual Education Plans (IEPs) and guide placement and intervention decisions.

To evaluate Xxxxxxxxxxx’s performance on the NEPSY-II, review both the Classification Description Table, and the Normal Curve Graph below. These tools will serve as a guide to help you obtain a general understanding of Xxxxxxxxxxx’s performance on the assessment. Below the Classification Description Table is a description of each domain Xxxxxxxxxxx was evaluated on. Next to this is a summary of how Xxxxxxxxx performed on the domains that were assessed.

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Classification Description Table Classification Description

Above Expected Level Children whose scores fall within ther range have skills that are more developed than 75% of their peers.

At Expected Level Children whose scores fall within ther range have skills that are equal to 50% of their peers.

Borderline Children whose scores fall within ther range have skills that are not as developed as 75% of their peers.

Below Expected Level Children whose scores fall within ther range have skills that are not as developed as 90% of their peers.

Well Below Expected Level Children whose scores fall within ther range have skills that are not as developed as 98% of their peers.

Summary of Results Domain Description Result

Attention and Executive Functioning

These tests measure how well a child can plan, organize, change, and control behavior.

Xxxxxxxxx's performance in this domain fell between the Well Below Expected Level and At Expected

Language

These tests measure how well a child understands and uses words and sentences to communicate with others.

Xxxxxxxxx's performance in this domain fell between the At Expected Level and Above

Memory and Learning

These tests measure how a child takes in, stores, and remembers information.

Xxxxxxxx's performance in this domain fell between the Well Below Expected Level and At Expected

Sensorimotor

These tests measure how well a child can control hand movements.

Xxxxxxxxxx's performance in this domain fell between the Below Expected Level and At Expected

Social Perception

These tests measure how well a child understands other people’s feelings and thoughts.

Xxxxxxxxxx's performance in this domain fell at the At Expected Level.

Visuospatial Processing These tests measure how well a child sees and arranges visual information.

Xxxxxxxxxx's performance in this domain fell between the Borderline range and Above Expected Level.

Attention and Executive Functioning

Score Name Raw Scores

Scaled Scores

Percentile Ranks (%)

Cumulative Percentages (%) Classification

Animal Sorting Total Correct Sorts 7 10 50 -- At Expected Level

Animal Sorting Total Errors 1 -- 51–75 -- At Expected Level

Animal Sorting Total Repeated Sort Errors 0 -- >75 -- Above Expected Level

Animal Sorting Total Novel Sort Errors 1 -- 11–25 -- Borderline

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Animal Sorting Combined Scaled Score -- 10 50 -- At Expected Level

Auditory Attention Total Correct 27 5 5 -- Below Expected Level

Auditory Attention Combined Scaled Score -- 5 5 -- Below Expected Level

Auditory Attention Total Omission Errors 3 -- 6–10 -- Below Expected Level

Auditory Attention Total Commission Errors 0 -- 26–50 -- At Expected Level

Auditory Attention Total Inhibitory Errors 0 -- 26–50 -- At Expected Level

Response Set Total Correct 32 8 25 -- At Expected Level

Response Set Combined Scaled Score -- 7 16 -- Borderline

Response Set Total Omission Errors 4 -- 26–50 -- At Expected Level

Response Set Total Commission Errors 4 -- 11–25 -- Borderline

Response Set Total Inhibitory Errors 2 -- 26–50 -- At Expected Level

AA vs. RS Contrast Scaled Score -- 9 37 -- At Expected Level

Clocks Total Score 71 11 63 -- At Expected Level

Design Fluency Total Score 33 11 63 -- At Expected Level

Design Fluency–Structured Array Score 15 -- -- 26–75 At Expected Level

Design Fluency–Random Array Score 18 -- -- 26–75 At Expected Level

Inhibition–Naming Completion Time Total 57 6 9 -- Borderline

Inhibition–Naming Combined Scaled Score -- 9 37 -- At Expected Level

Inhibition–Naming Total Errors 0 -- 51–75 -- At Expected Level

Inhibition–Naming Total Self-Corrected Errors 0 -- 51–75 -- At Expected Level

Inhibition–Naming Total Uncorrected Errors 0 -- 51–75 -- At Expected Level

Inhibition–Inhibition Completion Time Total 81 6 9 -- Borderline

Inhibition–Inhibition Combined Scaled Score -- 3 1 -- Well Below Expected Level

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Inhibition–Inhibition Total Errors 9 -- < 2 -- Well Below Expected Level

Inhibition–Inhibition Total Self- Corrected Errors 5 -- 2–5 -- Below Expected Level

Inhibition–Inhibition Total Uncorrected Errors 4 -- 6–10 -- Below Expected Level

Inhibition–Switching Completion Time Total 112 7 16 -- Borderline

Inhibition–Switching Combined Scaled Score -- 6 9 -- Borderline

Inhibition–Switching Total Errors 8 -- 11–25 -- Borderline

Inhibition–Switching Total Self- Corrected Errors 8 -- < 2 -- Well Below Expected Level

Inhibition–Switching Total Uncorrected Errors 0 -- >75 -- Above Expected Level

IN–Naming vs. Inhibition Contrast Scaled Score -- 3 1 -- Well Below Expected Level

IN–Inhibition vs. Switching Contrast Scaled Score -- 9 37 -- At Expected Level

Inhibition Total Errors 17 5 5 -- Below Expected Level

Scaled Scores

Score Name 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Animal Sorting Total Correct Sorts +

Animal Sorting Combined Scaled Score +

Auditory Attention Total Correct +

Auditory Attention Combined Scaled Score +

Response Set Total Correct +

Response Set Combined Scaled Score +

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Clocks Total Score +

Design Fluency Total Score +

Inhibition–Naming Completion Time Total +

Inhibition–Naming Combined Scaled Score +

Inhibition–Inhibition Completion Time Total +

Inhibition–Inhibition Combined Scaled Score +

Inhibition–Switching Completion Time Total +

Inhibition–Switching Combined Scaled Score +

Inhibition Total Errors +

Percentile Ranks

Score Name <2 2-10 11-25 26-75 >75

Animal Sorting Total Errors +

Animal Sorting Total Repeated Sort Errors +

Animal Sorting Total Novel Sort Errors +

Auditory Attention Total Omission Errors +

Auditory Attention Total Commission Errors +

Auditory Attention Total Inhibitory Errors +

Response Set Total Omission Errors +

Response Set Total Commission Errors +

Response Set Total Inhibitory Errors +

Inhibition–Naming Total Errors +

Inhibition–Naming Total Self-Corrected Errors +

Inhibition–Naming Total Uncorrected Errors +

Inhibition–Inhibition Total Errors +

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Inhibition–Inhibition Total Self-Corrected Errors +

Inhibition–Inhibition Total Uncorrected Errors +

Inhibition–Switching Total Errors +

Inhibition–Switching Total Self-Corrected Errors +

Inhibition–Switching Total Uncorrected Errors +

Language

Score Name Raw Scores

Scaled Scores

Percentile Ranks (%) Classification

Comprehension of Instructions Total Score 29 11 63 At Expected Level

Word Generation-Semantic Total Score 43 13 84 Above Expected Level

Word Generation-Initial Letter Total Score 21 10 50 At Expected Level

WG Semantic vs. Initial Letter Contrast Scaled Score -- 9 37 At Expected Level

Scaled Scores

Score Name 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Comprehension of Instructions Total Score +

Word Generation- Semantic Total Score +

Word Generation-Initial Letter Total Score +

Memory and Learning

Score Name Raw Scores

Scaled Scores

Percentile Ranks (%)

Cumulative Percentages (%) Classification

Memory for Designs Total Score 126 9 37 -- At Expected Level

Memory for Designs Content Score 52 8 25 -- At Expected Level

Memory for Designs Spatial Score 30 13 84 -- Above Expected Level

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MD Content vs. Spatial Contrast Scaled Score -- 14 91 -- Above Expected Level

Memory for Designs Delayed Total Score 47 11 63 -- At Expected Level

Memory for Designs Delayed Content Score 19 10 50 -- At Expected Level

Memory for Designs Delayed Spatial Score 10 13 84 -- Above Expected Level

MDD Content vs. Spatial Contrast Scaled Score -- 13 84 -- Above Expected Level

MD vs. MDD Contrast Scaled Score -- 14 91 -- Above Expected Level

Memory for Faces Total Score 13 11 63 -- At Expected Level

Memory for Faces Delayed Total Score 6 3 1 -- Well Below Expected Level

MF vs. MFD Contrast Scaled Score -- 2 0.4 -- Well Below Expected Level

Memory for Names Total Score 21 11 63 -- At Expected Level

Memory for Names Delayed Total Score 8 12 75 -- At Expected Level

Memory for Names and Memory for Names Delayed Total Score 29 12 75 -- At Expected Level

Narrative Memory Free and Cued Recall Total Score 9 7 16 -- Borderline

Narrative Memory Free Recall Total Score 3 7 16 -- Borderline

Scaled Scores

Score Name 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Memory for Designs Total Score +

Memory for Designs Content Score +

Memory for Designs Spatial Score +

Memory for Designs Delayed Total Score +

Memory for Designs +

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Delayed Content Score

Memory for Designs Delayed Spatial Score +

Memory for Faces Total Score +

Memory for Faces Delayed Total Score +

Memory for Names Total Score +

Memory for Names Delayed Total Score +

Memory for Names and Memory for Names Delayed Total Score

+

Narrative Memory Free and Cued Recall Total Score

+

Narrative Memory Free Recall Total Score +

Sensorimotor

Score Name Raw Scores

Scaled Scores

Percentile Ranks (%)

Cumulative Percentages (%) Classification

Fingertip Tapping–Dominant Hand Repetitions Completion Time 10 -- 11–25 -- Borderline

Fingertip Tapping–Dominant Hand Sequences Completion Time 10 -- 26–50 -- At Expected Level

Fingertip Tapping–Nondominant Hand Repetitions Completion Time 12 -- 11–25 -- Borderline

Fingertip Tapping–Nondominant Hand Sequences Completion Time 15 -- 6–10 -- Below Expected Level

Fingertip Tapping–Dominant Hand Combined Scaled Score -- 7 16 -- Borderline

Fingertip Tapping–Nondominant Hand Combined Scaled Score -- 5 5 -- Below Expected Level

Fingertip Tapping–Repetitions -- 7 16 -- Borderline

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Combined Scaled Score

Fingertip Tapping–Sequences Combined Scaled Score -- 7 16 -- Borderline

FT Dominant Hand vs. Nondominant Hand Contrast Scaled Score -- 6 9 -- Borderline

FT Repetitions vs. Sequences Contrast Scaled Score -- 8 25 -- At Expected Level

Scaled Scores

Score Name 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Fingertip Tapping– Dominant Hand Combined Scaled Score

+

Fingertip Tapping– Nondominant Hand Combined Scaled Score

+

Fingertip Tapping– Repetitions Combined Scaled Score

+

Fingertip Tapping– Sequences Combined Scaled Score

+

Percentile Ranks

Score Name <2 2-10 11-25 26-75 >75

Fingertip Tapping–Dominant Hand Repetitions Completion Time +

Fingertip Tapping–Dominant Hand Sequences Completion Time +

Fingertip Tapping–Nondominant Hand Repetitions Completion Time +

Fingertip Tapping–Nondominant Hand Sequences Completion Time +

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Social Perception

Score Name Raw Scores

Scaled Scores

Percentile Ranks (%) Classification

Affect Recognition Total Score 25 9 37 At Expected Level

Affect Recognition Total Happy (H) Errors 0 -- 26–50 At Expected Level

Affect Recognition Total Sad (S) Errors 4 -- 6–10 Below Expected Level

Affect Recognition Total Neutral (N) Errors 0 -- >75 Above Expected Level

Affect Recognition Total Fear (F) Errors 1 -- 26–50 At Expected Level

Affect Recognition Total Angry (A) Errors 5 -- 2–5 Below Expected Level

Affect Recognition Total Disgust (D) Errors 1 -- 51–75 At Expected Level

Scaled Scores

Score Name 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Affect Recognition Total Score +

Percentile Ranks

Score Name <2 2-10 11-25 26-75 >75

Affect Recognition Total Happy (H) Errors +

Affect Recognition Total Sad (S) Errors +

Affect Recognition Total Neutral (N) Errors +

Affect Recognition Total Fear (F) Errors +

Affect Recognition Total Angry (A) Errors +

Affect Recognition Total Disgust (D) Errors +

Visuospatial Processing

Score Name Raw Scores

Scaled Scores

Percentile Ranks (%) Classification

Arrows Total Score 34 14 91 Above Expected Level

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Design Copying Process Total Score 96 12 75 At Expected Level

Design Copying Process Motor Score 38 12 75 At Expected Level

Design Copying Process Global Score 32 10 50 At Expected Level

Design Copying Process Local Score 26 13 84 Above Expected Level

DCP Global vs. Local Contrast Scaled Score -- 13 84 Above Expected Level

Design Copying General Total Score 13 -- 51–75 At Expected Level

Geometric Puzzles Total Score 26 7 16 Borderline

Picture Puzzles Total Score 11 6 9 Borderline

Scaled Scores

Score Name 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Arrows Total Score +

Design Copying Process Total Score +

Design Copying Process Motor Score +

Design Copying Process Global Score +

Design Copying Process Local Score +

Geometric Puzzles Total Score +

Picture Puzzles Total Score +

Percentile Ranks

Score Name <2 2-10 11-25 26-75 >75

Design Copying General Total Score +

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Behavioral Observations

Attention and Executive Functioning

Raw Score

Cumulative Percentages (%)

Percent of Normative Sample (%)

Auditory Attention & Response Set

Inattentive/Distracted–Off Task Behaviors Total 3 11–25 --

Out of Seat/Physical Movement in Seat–Off Task Behaviors Total

0 26–75 --

Inhibition

INN Points to Stimuli Total 0 26–75 --

INI Points to Stimuli Total 0 26–75 --

INS Points to Stimuli Total 0 >75 --

Language

Raw Score

Cumulative Percentages (%)

Percent of Normative Sample (%)

Comprehension of Instructions

Asks for Repetition Total 0 26–75 --

Memory and Learning

Raw Score

Cumulative Percentages (%)

Percent of Normative Sample (%)

Memory for Designs and Memory for Designs Delayed

Rule Violation Total 0 26–75 --

Memory for Faces and Memory for Faces Delayed

Spontaneous Comments Total 0 26–75 --

Sensorimotor

Raw Score

Cumulative Percentages (%)

Percent of Normative Sample (%)

Fingertip Tapping

Visual Guidance Y -- 55

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Incorrect Position Y -- 18

Posturing N -- 92

Mirroring N -- 96

Overflow N -- 91

Rate Change 0 26–75 --

Social Perception

Raw Score

Cumulative Percentages (%)

Percent of Normative Sample (%)

Affect Recognition

Spontaneous Comments Total 0 26–75 --

Summary of Test Results: On the NEPSY II, scaled scores of 8 to 12 and standard scores of 90 - 110 are average (25th to 75th percentile).

The neurological skills evaluated in the Attention and Executive Functioning domain include persistence, the ability to inhibit impulsive responding, auditory and visual attention, planning ability, the ability to adopt, maintain, and change set, and the ability to inhibit the impulse to respond when confronted with conflicting stimuli. The Animal Sort task assesses the ability to formulate basic concepts, sort into categories, and shift from one concept to another. The child sorts picture cards into groups of four, using various self-initiated criteria. Xxxxxxxxxxx’s total correct sorts score was in the At Expected Level range of functioning for a child her age (Animal Sorting Total Correct Sorts scaled score = 10, 50th percentile). On the other hand, Xxxxxxxxxxx made an Above Expected Level number of repeated sort errors (Total Repeated Sort Errors = 0, <75th percentile). Xxxxxxxxxx’s overall performance was in the At Expected Level range (Animal Sorting Combined scaled score = 10, 50th percentile).

Next, on the first part of the Auditory Attention and Response Set task, Xxxxxxxxxxx’s simple auditory attention was in the Below Expected Level range for her age (Auditory Attention Combined scaled score = 5, 5th percentile). Here, she was asked to listen to a long list of words played on a CD, and touch colored circles on a page when she heard target words. It is notable that Xxxxxxxxxxx made a Below Expected Level number of omission errors (Total Omission Errors raw score = 3, 6th – 10th percentile) but an At Expected Level number of commission errors (Total Commission Errors = 0, 26th – 50th percentile). Interpreting these finding, Korkman et al. (2007) stated,

Low scores on Auditory Attention signal problems maintaining attention over time to verbal stimuli. There children may miss important information, respond incorrectly due to inattention, or engage in nonproductive off-task behavior.

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Omission errors reflect poor vigilance and selective attention, whereas commission errors reflect a tendency to react impulsively or to make correct responses but to do so too slowly.

On the second part of this task, the complex auditory attention part of the task, Xxxxxxxxxxx was asked to switch sets, i.e., touch a red shape when she heard the word yellow. Here, Xxxxxxxxxxx performed in the Borderline range on this second part of the task (Response Set Combined scaled score = 7, 16th percentile). Korkman et al. (2007) interpreted this result as follows:

Low scores on Response Set indicated problems sustaining attention when there are multiple pieces of information that must be monitored. The multitasking reduces efficiency of attention and may result in incorrect responses. Children experiencing difficulty on Response Set may have difficulty maintaining attention when competing stimuli are present in a classroom, such as when children are talking or when trying to perform multiple tasks simultaneously (e.g., writing and listening at the same time). Impulsive children may show good attention but respond incorrectly because they respond impulsively without monitoring it for accuracy.

On another task, Xxxxxxxxxx’s planning and organization skills, visuoperceptual and visuospatial skills, and the concept of time in relation to analog clocks were assessed. Here, Xxxxxxxxxx drew the image of a clock and placed the hands where the examiner indicated. For visual items, Xxxxxxxxx read the time on clocks that either have or do not have numbers. Her performance was in the At Expected Level range on this task (Clocks Total score scaled score = 11, 63rd percentile). Next, on the Inhibition-Naming task, Xxxxxxxxx worked with Borderline speed (Completion Time scaled score = 6, 9th percentile) and At Expected Level accuracy (Total Errors raw score = 0, 51st – 75th percentile) when naming black and white shapes and directions of arrows. Her overall performance was in the At Expected Level range of functioning (Inhibition-Naming Combined scaled score = 9, 37th percentile).

Xxxxxxxxxxx next achieved an overall score in the Well Below Expected Level range on the Inhibition- Inhibition task (Combined scaled score = 3, 1st percentile). On this task, Xxxxxxxxxxx was asked to say the other shape’s Xxxxxxxxxxxx or state the opposite direction of the arrow when naming black and white shapes and directions of arrows. This task adds the demand of control of an automatic response and its replacement with a novel response. This creates an additional demand of cognitive flexibility because she must replace a logical response with a novel response. Here, Xxxxxxxxxxx achieved a Borderline score for speed (Completion Time scaled score = 6, 9th percentile) and a Well Below Expected Level score for accuracy (Total Errors raw score = 9, < 2nd percentile). Interpreting this finding, Korkman et al. (2007) state,

A very low Inhibition Total Completion Time score in the presence of a high number of Inhibition Errors indicates a child who is easily drawn into making impulsive errors. The slowing down of the child’s speed does not help him or her gain sufficient cognitive control to reduce error rates.

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Notably, a Below Expected Level number of Xxxxxxxxxx’s errors were self-corrected errors (Total Self-Corrected Errors = 5, 2nd – 5th percentile), and a Below Expected Level number of errors were uncorrected (Total Uncorrected Errors = 4, 6th – 10th percentile). Korkman et al.’s (2007) interpretation of this finding is below.

Very impulsive children will show high rates of errors but, if they have intact self- monitoring they will often catch an error after it occurs. They can’t prevent an error from happening, but they do recognize it when they hear it. This may be a problem in working memory where the child is unable to perform the task and monitor the information coming into working memory simultaneously. The child may be frustrated at her or her own inability to prevent errors from occurring.

On the Inhibition-Switching task, Xxxxxxxxx performed with Borderline speed (Completion Time Total scaled score = 7, 16th percentile) and Borderline accuracy (Total Errors raw score = 8, 11th – 25th percentile). Here, Xxxxxxxxxxxxx was asked to name shapes and directions of arrows alternately depending on the color of the shape or arrow. Overall, Xxxxxxxxxxxx earned a score in the Borderline range on this task (Inhibition-Switching Combined scaled score = 6, 9th

percentile). Additionally, as with Inhibition-Naming task, Xxxxxxxxxxxxx made a Well Below Expected Level number of self-corrected errors on the Inhibition-Switching task (Total Self-Corrected Errors = 8, < 2nd percentile). In contrast, Xxxxxxxxxxxxx made an Above Expected Level number of uncorrected errors (Total Uncorrected Errors = 0, >75th percentile). According to Korkman et al., 2007:

Children with low Switching Completion Time scores and high number of Switching Errors have significant problems with cognitive flexibility. Despite reducing their speed to gain better control over the process, they still make cognitive errors.

High rates of corrected errors indicate problems controlling switching behavior but with self-monitoring behavior present.

Finally, the Inhibition vs. Switching Contrast Scaled Score compares performance on the switching task to performance on the inhibition only task. According to Korkman et al., 2007, “This score is interpreted as the child’s ability to switch, controlling for her or her level of inhibitory skills.” Here, Xxxxxxxxxxxx earned an adequate scaled score of 9 (37th percentile) – a score in the At Expected Level range of functioning for her age.

In the Language domain, Xxxxxxxxxxxx’s receptive language skills, as evaluated by Comprehension of Instructions, were in the At Expected Level range for a person her age (scaled score = 11, 63rd percentile). Here, she was asked to listen to increasingly complex oral instructions that instructed her to point to pictured target shapes, e.g., point to a red circle but first to a blue square.

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The Word Generation task has two parts – Semantic Word Generation and Initial Letter Word Generation. For Semantic Word Generation, Xxxxxxxxxxx was asked to name as many examples of items in a specific category as possible within a 60-second time limit. Then she was asked to name as many items in another category as possible within a 60-second time limit. For Initial Letter Word Generation, Xxxxxxxxxxxxxxx was required to name as many words as she can that begin with one letter within a 60-second time limit and as many words as she can that begin with another letter within a 60-second time limit. Her performance on the first part of the task was in the Above Expected Level range (Word Generation Semantic Total Score scaled score = 13, 84th percentile). On the second part of the task, Xxxxxxxxxxxxx’s performance was in the At Expected Level range for her age (Word Generation Initial Letter Total Score scaled score = 10, 50th percentile).

In the Memory and Learning domain, the Memory for Designs task showed Xxxxxxxxxxxx’s Above Expected Level immediate memory for spatial information (scaled score = 13, 84th

percentile) and At Expected Level range immediate memory for visual detail (scaled score = 8, 25th percentile). Here, Xxxxxxxxxxxxx was shown a grid with four to ten designs on a page, which was then removed from view. Then, she selected the designs from a set of cards and placed the cards on a grid in the same location as previously shown. Her profile of scores includes an Above Expected Level immediate content versus spatial recognition contrast scaled score of 14 (91st percentile). The same contrast was in the Above Expected Level range in the delayed condition (Memory for Designs Delayed Content vs. Spatial Contrast scaled score = 13, 84th percentile). Finally, her overall immediate recall was in the At Expected Level range (Memory for Designs Total Score scaled score = 9, 37th percentile) and her overall recall after a 25-minute delay was in the At Expected Level range for her age (Delayed Total Score scaledscore = 11, 63rd percentile).

Xxxxxxxxxxxx next completed the Memory for Faces task. Here, Xxxxxxxxxxx’s ability to recall pictures of children’s faces immediately following their presentation was in the At Expected Level range (Memory for Faces Total Score scaled score = 11, 63rd percentile). In contrast, after a 20 minute delay, Xxxxxxxxxxxx’s ability to recall children’s faces was in the Well Below Expected Level range (Memory for Faces Delayed Total Score scaled score = 3, 1st

percentile). This resulted in a Memory for Faces vs. Memory for Faces Delayed Contrast scaled score of 2 (0.4th percentile), a Well Below Expected Level. According to Korkman et al. (2007),

If a child performs well on the immediate recall trial but does no perform well 15-25 minutes later on the delayed recall trial, it suggests that the child is able to encode facial features but the memory trace decays quickly.

On another task, the Memory for Names task, Xxxxxxxxxxxx’s ability to learn the association between a visual stimulus and its verbal label was assessed. For this task, Xxxxxxxxxxxx was shown eight cards with drawings of children on them while being read the child’s name. The cards were then shown again and Xxxxxxxxxxxx was asked to recall the name of the child on the card. Here, her performance was in the At Expected Level range for her age over three learning trials (Memory for Names Total Score scaled score = 11, 63rd percentile). Similarly, her retrieval of this information after a 25 minute delay was in the At Expected Level range (Memory for Names Delayed Total Score = 12, 75th percentile). This resulted in an overall Memory for Names and Memory for Names Delayed Total Score scaled score of 12 (75th percentile).

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A review of Xxxxxxxxxx’s performance on other NEPSY-II memory subtests supports the hypothesis that Xxxxxxxxxxx has a primary deficit in Attention and Executive Functioning. Xxxxxxxxxxx’s ability to sustain focus on activities and inhibit her responses are both areas of difficulty. Attempting to multitask, time pressure, and holding substantial information in her mind are likely to intensify these difficulties.

Xxxxxxxxxxxx next completed the Narrative Memory task where she was asked to listen to a story and then was asked to repeat the story. She was then asked questions to elicit missing details from the story. Here, Xxxxxxxxxxx’s ability to listen attentively to extended prose, to comprehend what was heard, and to organize and retrieve this information was in the Borderline range (Narrative Memory Free Recall Total Score scaled score = 7, 16th percentile). Xxxxxxxxxxxx achieved a Borderline score on the free and cued recall portion of the task (Free and Cued Recall Total Score scaled score = 7, 16th percentile) – a Borderline score. Interpreting this finding, Korkman et al. (2007) state:

If the child performs poorly on both Free Recall and Cued Recall, a poor score could result. This could indicate a pervasive language or memory problem where the child is able to comprehend, encode, and recall only limited details. Even when cued with questions, the child cannot provide more details. Everything the child has gleaned from the story is supplied during Free Recall and there are no more details in memory to access in Cued Recall. This type of language difference points to a developmental or acquired language disorder.

Notably, a review of Xxxxxxxxxxxx’s performance on subtests in the NEPSY-II and KTEA-3 Language domains does not support the hypothesis of a developmental or acquired language disorder. There are two possible alternative hypotheses. It may be that Xxxxxxxxxxx’s low scores on the Narrative Memory task reflect nonneurostructural factors (e.g., anxiety or depression) or a memory problem.

The Sensorimotor domain of the NEPSY-II assesses different components of motor functioning, including finger dexterity and fine-motor functioning. On the Fingertip Tapping task, Xxxxxxxxxxx was asked to sequence and coordinate rapid and accurate fine motor (fingertip) movements. Xxxxxxxxxxx earned a Borderline score on the first condition of the Fingertip Tapping task (Fingertip Tapping-Repetitions Combined Scaled Score = 7, 16th percentile) and a Borderline score on the second condition (Fingertip Tapping-Sequences Combined Scaled Score = 7, 16th percentile). Korkman et al., 2007, interprets a child with a low Fingertip Tapping – Repetitions Combined Scaled Score as follows:

A child who performs poorly across hands on Repetitions (low Repetition Combined Scale Score) is likely demonstrating weak fine-motor coordination and dexterity. This child is likely to have difficulty manipulating small and maybe even larger objects, such as materials for the Block Construction subtest. The pincer grip required for efficient grip on a pencil might not be developed in the child; graphomotor tasks may be difficult; and the child may try to work quickly because he or she is aware that accuracy is poor. Conversely, the child may be accurate in drawing lines by performing slowly and laboriously.

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Xxxxxxxxxxxxx also showed different performances between hands. She earned an overall dominant hand scaled score of 7 (16th percentile) – a score in the Borderline range. In contrast, Xxxxxxxxxxx’s nondominant hand scaled score was in the Below Expected Level range (scaled score = 5, 5th percentile). Consequently, Xxxxxxxxxxxx received a Fingertip Tapping Dominant Hand vs. Nondominant Hand Contrast Scaled Score of 6 (9th percentile) – a Borderline score. This test result signals that nondominant hand fine-motor controls and programming are weaknesses compared to dominant hand control and programming. Korkman et al.’s interpretation of poor motor performance by hands is below.

Nondominant hand fine-motor controls and programming are weaknesses compared to dominant hand control and programming.

Collectively, the results of testing in the Sensorimotor Domain suggests that Xxxxxxxxxxx experiences difficulties on fine-motor tasks, particularly when using her nondominant hand.

In the Social Perception domain of the NEPSY-II, Xxxxxxxxxxx was administered the Affect Recognition task. Deficits in this task are sometimes found in children with ADHD, autism spectrum disorders, or other problems, and can result in interpersonal difficulties or poor behavioral control. The ability to encode, recall, and recognize faces is considered to be essential to good social perception and communication. Being able to recognize facial affect, or the emotional states displayed on a person’s face, facilitates appropriate social communication. Deficits in affect recognition may result in behaviors that do not conform to social expectations and may be misinterpreted as being oppositional, odd, or unusual. Overall, results show that Xxxxxxxxxxx’s affect recognition is in the At Expected Level range for her age (scaled score = 9, 37th percentile). However, Xxxxxxxxxx did have difficulty recognizing sad facial expressions (total sad errors raw score = 4, 6th – 10th percentile), as well as angry facial expressions (total angry errors raw score = 5, 2nd – 5th percentile), resulting in a Below Expected Level number of errors recognizing sad and angry facial expressions.

The Visuospatial Processing domain assesses different components of visual-spatial perception and production ability. On the Arrows task, Xxxxxxxxxxx was asked to look at an array of arrows arranged around a target and he indicated the arrow(s) that points to the center of the target. This task is designed to assess the ability to judge line orientation. Here, Xxxxxxxxxxxx worked with accuracy in the Above Expected Level range (Arrows scaled score = 14, 91st

percentile). Next, on the Design Copying task, Xxxxxxxxxxxx was asked to copy increasingly complex geometric forms - a pencil-and-paper task. She performed in the At Expected Level range on this task (Design Copying General Total raw score = 12, 75th percentile). On this task, Xxxxxxxxxxxx’s Design Coping Process Motor score (scaled score = 12, 75th percentile) and Design Copying Process Global score (scaled score = 12, 75th percentile) were both in the At Expected Level range. In contrast, her Design Copying Process Local score (scaled score = 13, 84th percentile) was in Above Expected Level range, resulting in a Design Copying Global vs. Local Contrast score (scaled score = 13, 84th percentile) in the Above Expected Level range.

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Xxxxxxxxxxxx performed in the Borderline range on a task designed to assess, visuospatial analysis, evaluation of directions, and mental rotation (Geometric Puzzles Total Score scaled score = 7, 16th percentile). According to Korkman et al. (2007), “A low Geometric Puzzles Total Score is thought to indicate difficulty with visual-spatial analysis, including mental rotation.” However, a review of Xxxxxxxxxxx’s performance on visuoconstructive tasks (i.e., the WISC-V Block Design subtest and the NEPSY-II Design Copying task) revealed that her performance is better on these tasks. Interpreting this profile Korkman et al. (2007) stated, “If the child’s performance is better on the visuoconstructive tasks, this may indicate that the active inspection is difficult for the child and may relate to poor attention or effort.” This conclusion is supported by Xxxxxxxxxxxx’s low scores on the Inhibition-Inhibition and Auditory Attention and Response Set tasks. In any event, Xxxxxxxxxx’s low score on the Geometric Puzzles task indicates that she may have problems in the ability to understand and use the principles that underlie the positioning of numbers to represent units (e.g., tens, hundreds). “Later, a child may have difficulty with the more complex mathematic processing required for geometry, trigonometry, and calculus” (Korkman et al. 2007).

Finally, on the Picture Puzzles task, Xxxxxxxxx was presented a large picture divided by a grid and four smaller pictures taken from sections of the larger picture. She was asked to identify the location on the grid of the larger picture from which each of the smaller pictures was taken. This task is designed to assess the nonmotor aspects of visual perception. Xxxxxxxxxxxx earned a score in the Borderline range on this task (Picture Puzzles Total Score scaled score = 6, 9th

percentile). Korman et al. (2007) interpret this finding, stating, “A low Picture Puzzles Total Score is thought to indicate difficulties with visual perception and scanning.” However, as with the Geometric Puzzles task, Xxxxxxxxxx’s adequate performance on the WISC-V Block Design subtest and the NEPSY-II Arrows and Memory for Designs tasks contraindicates a visuoperceptual problem or visual reasoning and visual discrimination problems. Consequently, it is this examiner’s opinion that Xxxxxxxx’s poor performance on the Picture Puzzles task may be due to poor attention or working memory deficits.

Emotional, Behavioral and Social Functioning To assess Xxxxxxx’s emotional, social, and behavioral functioning, the Child Behavior Checklist and Conners 3 rating scales were administered. The results are below. Empty boxes in the tables that follow indicate that scores were not clinically significant and, therefore, not entered.

Child Behavior Checklist - Syndrome Scale Scores and DSM-Oriented Scales

Scales Father Mother Xxxxx (7th

Grade xxxxxxxx Teacher)

Xxxxx (7th Grade xxxxxx

Teacher)

Self

Anxious/Depressed

Withdrawn/

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Depressed

Somatic Problems

Social Problems

Thought Problems

Attention Problems

Rule-Breaking Behaviors

Aggressive Behavior

Internalizing Problems

Externalizing Problems

Total Problems

Affective Problems DSM-Oriented Scales)

Anxiety Problems (DSM-Oriented Scales) Somatic Problems (DSM-Oriented Scales) Attention- Deficit/Hyperactivity Problems (DSM- Oriented Scales) Oppositional/Defiant

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Problems (DSM- Oriented Scales) Conduct Problems (DSM-Oriented Scales) Sluggish Cognitive Tempo

Obsessive-Compulsive Problems

Post-Traumatic Stress Problems

Competence Scale Scores for Girls 6-18 – Parent and Self Rating

Scales Father Mother Self

Activities

Social

School

Total Competence

Adaptive Functioning Scales – Teacher Rating

Scales Xxxxxxx (7th

Grade English Language Arts

Teacher)

Xxxxx (7th

Grade xxxxxxTeacher)

Academic Performance

1 Working hard 14th %

2 Behaving

3 Learning 12th %

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4 Happy

Sum of items 1,2,3,4

12th %

Summary of Test Results:

Father: The Child Behavior Checklist (CBCL) was completed by Xxxxxxxxx Xxxxxxxxx, Xxxxxxxxx’s biological father, to obtain his perceptions of Xxxxxxxxx’s competencies and problems. Mr. Xxxxxxxxx reported that Xxxxxxxxx participates in three sports and that she has interests in two hobbies. She belongs to one social organization, team or club. Mr. Xxxxxxxxx reported that Xxxxxxxx has two jobs or chores. He reported that Xxxxxxxxxx has two or three close friends and that she sees friends one or two times a week outside of regular school hours. Mr. Xxxxxxxxx rated Xxxxxxxxxx’s school performance as below average in language arts, average in social studies, average in math, and average in science. Xxxxxxxxxxx’s Total Competence score was in the normal range for parents’ ratings of girls aged 12 to 18. Her scores on the Activities, Social, and School scales were all in the normal range.

On the CBCL problem scales, Xxxxxxxxxxx’s Total Problems, Internalizing, and Externalizing scores were all in the normal range for girls aged 12 to 18. Scores on all rated syndrome scales were in the normal range.

On the DSM-oriented scales, Xxxxxxx’s scores on all rated scales were in the normal range.

On the 2007 scales, Xxxxxxxxxxxxxxx’s scores on all rated scales were in the normal range.

Mother: The CBCL was completed by Xxxxxxxxx Xxxxxxxxx, Xxxxxxxxx’s biological mother, to obtain her perceptions of Xxxxxxxxxxx’s competencies and problems. Ms. Xxxxxxxxx reported that Xxxxxxxxxx participates in three sports and that she has interests in three hobbies. She belongs to two social organizations, teams or clubs. Ms. Xxxxxxxxx reported that Xxxxxxxxxx has two jobs or chores. She reported that Xxxxxxxxx has four or more close friends and that she sees friends three or more times a week outside of regular school hours. Ms. Xxxxxxxxx rated Xxxxxxxxxx’s school performance as below average in language arts, average in social studies, below average in math, and average in science. Xxxxxxxxxxx’s Total Competence score was in the normal range for parents’ ratings of girls aged 12 to 18. Her scores on the Activities, Social, and School scales were all in the normal range.

On the CBCL problem scales, Xxxxxxxxxxx’s Total Problems, Internalizing, and Externalizing scores were all in the normal range for girls aged 12 to 18. Scores on all rated syndrome scales were in the normal range.

On the DSM-oriented scales, Xxxxxxxxxxx’s scores on all rated scales were in the normal range.

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On the 2007 scales, Xxxxxxxxxx’s scores on all rated scales were in the normal range.

Xx. Xxxxx – Xxxxxxxxxx’s 7th Grade xxxxxxxx Teacher The Teacher Report Form (TRF) was completed by Xx. Xxxxx to obtain her perceptions of Xxxxxxxxxxx’s adaptive functioning and problems. Mrs. Xxxxx reported knowing Xxxxxxxx for 10 months. She did not rate Xxxxxxxxxxx’s school performance in any academic subject areas. Xx. Xxxxxxx rated Xxxxxxxxxxx as working hard about average, behaving appropriately about average, learning about average, and happy about average compared to typical students of the same age. Because Xxxxxxxxx’s school performance was not rated, an Academic Performance score was not calculated. Xxxxxxxxxxxx’s Total Adaptive Functioning score was in the normal range.

On the TRF problem scales, Xxxxxxxxxxx’s Total Problems, Internalizing, and Externalizing scores were all in the normal range for girls aged 12 to 18. Scores on all rated syndrome scales were in the normal range. On the Attention Problems subscales, Xxxxxxxxxxx’s scores for both Inattention and Hyperactivity-Impulsivity were in the normal range.

On the DSM-oriented scales, Xxxxxxxxxxxx’s scores on all rated scales were in the normal range. On the Attention Deficit/Hyperactivity subscales, Xxxxxxxxxxxxx’s scores for both Inattention and Hyperactivity-Impulsivity were in the normal range.

On the 2007 scales, Xxxxxxxxxx’s scores on all rated scales were in the normal range.

Xxxxx Xxxxx – Xxxxxxxxxxx’s 7th Grade xxxxxxxx Classroom Teacher The TRF was completed by Xx.. Xxxxxxxx to obtain her perceptions of Xxxxxxxxxxx’s adaptive functioning and problems. Xx.. Xxxxxx reported knowing Xxxxxxxxxxxxx for 9 months. She rated Xxxxxxxxxx’s performance in one subject at grade level. Xx. Xxxxxxxx rated Xxxxxxxxxxxx as working slightly less hard, behaving appropriately about average, learning slightly less, and happy about average compared to typical students of the same age. Xxxxxxxxxx’s Academic Performance score was in the normal range for teachers’ ratings on girls aged 12 to 18. Xxxxxxxxxxx’s Total Adaptive Functioning score was in the borderline clinical range (10th to 16th percentiles).

On the TRF problem scales, Xxxxxxxxx’s Total Problems, Internalizing, and Externalizing scores were all in the normal range for girls aged 12 to 18. Scores on all rated syndrome scales were in the normal range. On the Attention Problems subscales, Xxxxxxxx’s scores for both Inattention and Hyperactivity-Impulsivity were in the normal range.

On the DSM-oriented scales, Xxxxxxxxx’s scores on all rated scales were in the normal range. On the Attention Deficit/Hyperactivity subscales, Xxxxxxxxxx’s scores for both Inattention and Hyperactivity-Impulsivity were in the normal range.

On the 2007 scales, Xxxxxxxxxx’s scores on all rated scales were in the normal range.

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Xxxxxxxxxxxxxxx – Self-Rating The Youth Self-Report (YSR) was completed by Xxxxxxxxxx to obtain her perceptions of her competencies and problems. Xxxxxxxxxx reported that she participates in three sports and that she has interests in two hobbies. She belongs to two social organizations, teams or clubs. Xxxxxxxxxxx reported that she has one job or chore. Xxxxxxxxxx’s responses indicate that she has four or more close friends and that she sees friends three or more times a week outside of regular school hours. Xxxxxxxxxxx rated her school performance as below average in language arts, average in social studies, average in math, and above average in science. Xxxxxxxxxxxx’s Total Competence score was in the normal range for self-reports by girls aged 11 to 18. Her scores on the Activities and Social scales were both in the normal range. Xxxxxxxxxxx’s score on the Positive Qualities scale was in the normal range.

On the YSR problem scales, Xxxxxxxxxxx’s Total Problems, Internalizing, and Externalizing scores were all in the normal range for girls aged 11 to 18. Scores on all rated syndrome scales were in the normal range.

On the DSM-oriented scales, Xxxxxxxxxx’s scores on all rated scales were in the normal range.

On the 2007 scales, Xxxxxxxxxxxx’s scores on the Obsessive-Compulsive Problems and Post-traumatic Stress Problems scales were in the normal range.

Conners 3 Rating Scale

Father

Summary of Results

Response Style Analysis The Positive Impression score (raw score = 1) does not indicate an overly positive response style. The Negative Impression score (raw score = 1) does not indicate an overly negative response style. The Inconsistency Index score (raw score = 8, number of differentials ≥ 2 = 2) indicates a possible inconsistent response style. These scores need to be taken into consideration when interpreting results.

Summary of Elevated Scores The following section summarizes areas of concern for Xxxxxxxxxx based on her father’s ratings on the Conners 3-P. Note that areas that are not a concern are not reported in this summary.

Conners 3–P Content Scales: T-scores The following graph provides T-scores for each of the Conners 3–P Content scales.

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The T-scores for the following Conners 3-P Content scales were very elevated (i.e., T-score ≥ 70), indicating many more concerns than are typically reported: Inattention (T = 78) and Learning Problems (T = 90).

DSM-5 Symptom Scales: T-scores The following graph provides T-scores for each of the DSM-5 Symptom scales.

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The Symptom Count was probably not met; however, the T-score was elevated or very elevated (i.e., T-score ≥ 65) for the following DSM-5 Symptom scale: ADHD Predominantly Inattentive Presentation (T = 70). Although the current presentation is atypical for 12-year-old girls, there are insufficient symptoms reported to meet DSM-5 symptomatic criteria for this disorder.

Impairment Mr. Xxxxxxxxx reports that Xxxxxxxx’s problems seriously affect her functioning very frequently (rating = 3) in the academic setting, and occasionally (rating = 1) in the home setting.

Conners 3 ADHD Index The following graph summarizes Mr. Xxxxxxxxx’s ratings of Xxxxxxx with respect to the Conners 3 ADHD Index.

Among ADHD and general population cases, individuals with ADHD obtained this score 56% of the time.

Screener Items Based on Mr. Xxxxxxx’s ratings, further investigation was suggested/recommended for issues with anxiety.

Conners 3-P Results and IDEA Scores on the Conners 3-P suggest possible consideration for IDEA 2004 eligibility in the following areas: Emotional Disturbance, Other Health Impairment, and Specific Learning Disability.

Mother

Summary of Results

Response Style Analysis Scores on the Validity scales do not indicate a positive, negative or inconsistent response style.

Summary of Elevated Scores The following section summarizes areas of concern for Xxxxxxxxxx based on her mother’s ratings on the Conners 3-P. Note that areas that are not a concern are not reported in this summary.

Conners 3–P Content Scales: T-scores The following graph provides T-scores for each of the Conners 3–P Content scales.

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The T-score for the following Conners 3-P Content scale was very elevated (i.e., T-score ≥ 70), indicating many more concerns than are typically reported: Learning Problems (T = 88).

DSM-5 Symptom Scales: T-scores The following graph provides T-scores for each of the DSM-5 Symptom scales.

Impairment Ms. Xxxxxxxxx reports that Xxxxxxxxxx’s problems seriously affect her functioning occasionally (rating = 1) in the academic setting.

Conners 3 ADHD Index The following graph summarizes Ms. Xxxxxxxxx’s ratings of Xxxxxxxxxx with respect to the Conners 3 ADHD Index.

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Among ADHD and general population cases, individuals with ADHD obtained this score 41% of the time.

Screener Items Based on Ms. Xxxxxxxxx’s ratings, further investigation was suggested/recommended for issues with depression.

Conners 3-P Results and IDEA Scores on the Conners 3-P suggest possible consideration for IDEA 2004 eligibility in the following areas: Emotional Disturbance and Specific Learning Disability.

Xx. Xxxxx– Xxxxxxxxxxxxxxx’s 7th Grade Teacher

Summary of Results

Response Style Analysis Scores on the Validity scales do not indicate a positive, negative or inconsistent response style.

Summary of Elevated Scores The following section summarizes areas of concern for Xxxxxxxxxxxxxxx based on Xx. Xxxxxxxxx’s ratings on the Conners 3-T. Note that areas that are not a concern are not reported in this summary.

Conners 3–T Content Scales: T-scores The following graph provides T-scores for each of the Conners 3–T Content scales and subscales.

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The T-scores for the following Conners 3-T Content scales were very elevated (i.e., T-score ≥ 70), indicating many more concerns than are typically reported: Inattention (T = 85) and Hyperactivity/Impulsivity (T = 87).

The T-score for the following Conners 3-T Content scale was elevated (i.e., T-score = 65 to 69), indicating more concerns than are typically reported: Executive Functioning (subscale) (T = 67).

DSM-5 Symptom Scales: T-scores The following graph provides T-scores for each of the DSM-5 Symptom scales.

The Symptom Counts were probably not met; however, the T-scores were elevated or very elevated (i.e., T-score ≥ 65) for the following DSM-5 Symptom scales: ADHD Predominantly Inattentive Presentation (T = 77) and ADHD Predominantly Hyperactive-Impulsive Presentation (T = 90).

Impairment Xx. Xxxxxx reports that Xxxxxxxx’s problems seriously affect her functioning occasionally (rating = 1) in the academic setting.

Conners 3 ADHD Index The following graph summarizes Xx. Xxxxxx’s ratings of Xxxxxxxxxxx with respect to the Conners 3 ADHD Index.

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Among ADHD and general population cases, individuals with ADHD obtained this score 69% of the time.

Screener Items Based on Xx. Xxxxxxxx’s ratings, further investigation was suggested/recommended for issues with anxiety and depression.

Conners 3-T Results and IDEA Scores on the Conners 3-T suggest possible consideration for IDEA 2004 eligibility in the following areas: Emotional Disturbance, Other Health Impairment, and Specific Learning Disability.

Xxxxxx Xxxxxx – Xxxxxxx’s 7th Grade xxxxxxxxxxxxx Teacher

Summary of Results

Response Style Analysis Scores on the Validity scales do not indicate a positive, negative or inconsistent response style.

Summary of Elevated Scores The following section summarizes areas of concern for Xxxxxxxx based on Xxxxxxx’s ratings on the Conners 3-T. Note that areas that are not a concern are not reported in this summary.

Conners 3–T Content Scales: T-scores The following graph provides T-scores for each of the Conners 3–T Content scales and subscales.

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The T-score for the following Conners 3-T Content scale was very elevated (i.e., T-score ≥ 70), indicating many more concerns than are typically reported: Learning Problems (subscale) (T = 70).

The T-scores for the following Conners 3-T Content scales were elevated (i.e., T-score = 65 to 69), indicating more concerns than are typically reported: Inattention (T = 66) and Learning Problems/Executive Functioning (T = 68).

DSM-5 Symptom Scales: T-scores The following graph provides T-scores for each of the DSM-5 Symptom scales.

Impairment Xx. Xxxxxxx reports that Xxxxxxxxxx’s problems seriously affect her functioning occasionally (rating = 1) in the academic setting.

Conners 3 ADHD Index The following graph summarizes Xx. Xxxxxx’s ratings of Xxxxxxxxxxx with respect to the Conners 3 ADHD Index.

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Among ADHD and general population cases, individuals with ADHD obtained this score 19% of the time.

Conners 3-T Results and IDEA

Scores on the Conners 3-T suggest possible consideration for IDEA 2004 eligibility in the following areas: Emotional Disturbance, Other Health Impairment, and Specific Learning Disability.

Xxxxxxxxxxxxxxx – Self-Rating

Summary of Results

Response Style Analysis Scores on the Validity scales do not indicate a positive, negative or inconsistent response style.

Summary of Elevated Scores The following section summarizes areas of concern for Xxxxxxxxxx based on her ratings on the Conners 3-SR. Note that areas that are not a concern are not reported in this summary.

Conners 3–SR Content Scales: T-scores The following graph provides T-scores for each of the Conners 3–SR Content scales.

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DSM-5 Symptom Scales: T-scores The following graph provides T-scores for each of the DSM-5 Symptom scales.

Conners 3 Index Scores The following graph summarizes Xxxxxxxxxx’s ratings with respect to the Conners 3 ADHD Index.

Among ADHD and general population cases, individuals with ADHD obtained this score 26% of the time.

Screener Items Based on Xxxxxxxxxx’s ratings, further investigation was suggested/recommended for issues with anxiety.

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Conners 3-SR Results and IDEA Scores on the Conners 3-SR suggest possible consideration for IDEA 2004 eligibility in the following area: Emotional Disturbance.

Summary and Clinical Formulation: Xxxxxxxxxxxxxxx is a 12-year, x-month-old girl who is presently living with xxxxxxxx in xxxxxxxx. Xxxxxx, she will be enrolled in the xx grade at Xxxxxxxxx in Xxxxxxxxx. The current evaluation was conducted to assess Xxxxxxxxxxx’s neuropsychological, cognitive, social, emotional, and behavioral functioning for indications of sensory information processing deficits, specific learning disorders, and nonneurostructural factors affecting her functioning. It will also attempt to clarify her diagnosis and provide recommendations to enhance Xxxxxxxxx’s overall adaptation to the school and home settings.

The Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V) results show that Xxxxxxxxx reasons in the Average range with the use of language, with a Verbal Comprehension Composite Score standard score = 95 (37th percentile). Similarly, she functions in the Average range on nonverbal tasks (Visual Spatial Composite Score = 100, 50th

percentile). Finally, Xxxxxxxxxx earned a Full Scale IQ score in the Average range (Full Scale composite score = 94, 34th percentile), suggesting that her estimated overall intellectual level is somewhere between the high end of the Low Average range to the middle of the Average range of functioning for a child her age.

The Index Level Pairwise Difference Comparisons table (see table on page x) shows that Xxxxxxxxxxx’s abilities in the WISC-V domains are somewhat unevenly developed. Specifically, her abilities in the Verbal Comprehension domain are significantly below her abilities in the Working Memory domain, though the size of the discrepancy (12 standard score points) is not a particularly unusual event in the standardization sample. However, Xxxxxxxxxxx’s performance on the Similarities subtest was a significant weakness. Moreover, the size of the Weakness has a low base rate in the standardization sample (< 10%). Furthermore, Xxxxxxxxxxx’s performance on the subtest Matrix Reasoning was a significant weakness, again with a low base rate in the standardization sample (base rate < 10%). Finally, Xxxxxxxx’s performance on the Figure Weights subtest was a strength, though the degree of the strength was not an unusual event in the standardization sample.

During her assessment, Xxxxxxxxxx was administered the Kaufman Test of Educational Achievement, Third Edition (KTEA-III). Her performance indicated weaknesses in the Reading Composite and Academic Skills Battery. Within the Academic Skills Battery, a measure of an individual’s reading, math, and writing abilities, Xxxxxxxxx earned a standard score of 84 (14th

percentile). Her actual score was significantly below her score predicted by her overall intellectual abilities (predicted standard score = 95, 37th percentile). The size of the disparity, 11-standard score points, is a rare event in the standardization sample, with a base rate of <10%.

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The KTEA-III Reading Composite is a measure of reading fluency, reading understanding, decoding, and symbol-sound understanding. Within this domain, Xxxxxxxxxx earned a standard score of 81 (10th percentile), a score in the Below Average Range. The 15-point disparity between her actual score and her predicted score of 96 (39th percentile) is an unusual event in the standardization sample, with a base rate of < 10%. Xxxxxxxxx’s Below Average performance when compared to her predicted score lends support to a diagnosis of Dyslexia (alternate DSM-5 term, Specific Learning Disorder with impairment in reading).

In addition to general composite scores, such as the Reading Composite, the KTEA-III measures an individual’s abilities in specific skills areas. On a measure of Decoding and Sound-Symbol abilities, Xxxxxxxx completed the Nonsense Word Decoding subtest. This task requires individuals to apply knowledge of phonics and sentence structure. On this subtest, Xxxxxxxxxx earned a standard score of 81 (10th percentile), which is in the low end of the Below Average range. This score was significantly below her predicted score of 97 (42nd percentile). The 16-point discrepancy is a rare event in the standardization sample (base rate <10%). These results provide support for a diagnosis of Dyslexia (alternate DSM-5 term, Specific Learning Disorder, with impairment in reading – word reading accuracy).

On another subtest in the Sound-Symbol domain, Phonological Processing, Xxxxxxxxxx was asked to manipulate sounds by rhyming, blending, matching, segmenting, and deleting sounds. Here, Xxxxxxxx earned a standard score of 81 (10th percentile), which is at the low end of the Below Average range of functioning for an individual her age. This score was significantly below her predicted score of 96 (39th percentile), with a base rate of <10%. This score lends further support to a diagnosis of Dyslexia (alternate DSM-5 term, Specific Learning Disorder, with impairment in reading – word reading accuracy).

On a measure of Reading Understanding and Comprehension, Xxxxxxxxxxx was administered the Reading Comprehension subtest. Here, Xxxxxxxxxxx earned a scaled score of 78 (7th

percentile), a score in the Low range of functioning for a child her age. This score was significantly below her predicted score of 96 (39th percentile). The 18-point discrepancy between her actual score and her predicted score is a rare event in the standardization sample, with a base rate of <5%. These results lend further support for a diagnosis of Dyslexia (alternate DSM-5 term, Specific Learning Disorder, with impairment in reading – reading comprehension).

Overall, Xxxxxxxxx’s Reading Understanding domain score was 81 (10th percentile), a score in the low end of the Below Average range. Her score was significantly below her predicted score of 96 (39th percentile) and has a base rate of <10%. These results indicate a diagnosis of Dyslexia (alternate DSM-5 term, Specific Learning Disorder, with impairment in reading – reading comprehension).

On an Oral Fluency domain subtest, Object Naming Facility, Xxxxxxxxx was asked to verbally identify objects in pictures as rapidly as possible. Here, Xxxxxxxxxx earned a score in the Low range, with a standard score of 76 (5th percentile). Xxxxxxxxxx was also

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administered the Letter Naming Facility subtest, a measure of her abilities in the Orthographic Processing domain. Here, Xxxxxxxxxx was asked to identify both lower case and uppercase letters as quickly as she could during 2 trials. Here, Xxxxxxxxxx earned a standard score of 84 (14th percentile), a score in the Below Average range. These results corroborate Xxxxxxxxxx’s poor performance on the CTOPP Rapid Automatized Naming subtest conducted in 2013. In conjunction with her slow speed on the on the NEPSY-II Inhibition-Naming task, these results support a diagnosis of dysnomia (alternate DSM-5 term, Language Disorder).

Xxxxxxxx’s performance on the KTEA-III provides clues as to her learning style. Xxxxxxxxx’s performance in the Written Language and Oral Language domains, provide clues as to Xxxxxxxxx’s learning style. Her performance indicates that she is at her best when formulating sentences in written expression (i.e., identifying the components of a well formulated and syntactically mature sentence), when demonstrating her writing fluency, when showing her listening comprehension skills in response to brief auditory passages of information, and when demonstrating fluency in word associations. On the other hand, Xxxxxxxxx possesses substantial vulnerabilities in phonological processing, nonsense word decoding, and reading comprehension skills as well as overall reading, academic, sound symbol, decoding, and reading understanding skills. These areas should be addressed with targeted instructional support.

Xxxxxxxxxx was administered the NEPSY-II as an additional component of her evaluation. During the test, she exhibited difficulties with executive functioning, particularly related to attention and self-monitoring. For instance, during the Auditory Attention and Response Set tasks, Xxxxxxxxxxx demonstrated a high number of errors (Auditory Attention Total Omission Errors raw score = 3, 6th – 10th percentile) and she earned a Borderline Response Set score (Response Set Combined scaled score = 7, 16th percentile), indicating difficulties sustaining selective attention and monitoring her responses while multitasking. Xxxxxxxxx’s Well Below Expected Level range score on the Inhibition- Inhibition task (Combined scaled score = 3, 1st percentile), Borderline score for speed (Completion Time scaled score = 6, 9th percentile), and Well Below Expected Level score for accuracy (Total Errors raw score = 9, < 2nd

percentile) also indicate impulsive responding, even when slowing her speed. Similarly, Xxxxxxxxxxx’s Below Expected Level number of uncorrected errors on the Inhibition- Inhibition task (Total Uncorrected Errors = 4, 6th – 10th percentile) suggest difficulties with self-monitoring or working memory. Finally, Xxxxxxxxx’s Borderline range speed (Completion Time scaled score = 7, 16th percentile) and Well Below Expected Level number of self-corrected errors (Total Self-Corrected Errors = 8, < 2nd percentile) suggest difficulties with cognitive flexibility.

In addition to the difficulties with attention and self-monitoring that Xxxxxxxxxx displayed during the NEPSY-II, she demonstrated difficulties related to memory. For instance, although her immediate Memory for Faces score (scaled score = 11, 63rd percentile) was in the At Expected Level range, her Well Below Expected Level range score on the delayed condition (Memory for Faces Delayed Total Score scaled score = 3, 1st percentile) indicates fast decay of memory. Similarly, Xxxxxxxxxxx’s Borderline range scores in both the Narrative Memory

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Free Recall condition (scaled score = 7, 16th percentile) and the Narrative Memory Cued Recall condition (scaled score = 7, 16th percentile) suggest difficulties with memory.

During the Fingertip Tapping subtest of the NEPSY-II, Xxxxxxxxxxxx demonstrated mild difficulties. She earned scaled scores of 7 (16th percentile) in the Fingertip Tapping Repetitions and Fingertip Tapping Sequences conditions, both Borderline range scores. According to an interpretation by Korkman et al. (2007), these results suggest mild difficulties with fine-motor coordination and dexterity. Her difficulties in these areas appear more pronounced in her nondominant hand.

Xxxxxxxxxx demonstrated a final area of difficulty on the NEPSY-II subtests Geometric Puzzles and Picture Puzzles. During the Geometric Puzzles subtest, Xxxxxxxxxx’s scaled score of 7 (16th percentile) placed in the Borderline level range. Her performance on the Picture Puzzles subtest also placed in the Borderline range, with a scaled score of 6 (9th percentile). It is this examiner’s opinion that Xxxxxxxx’s poor performance on the Geometric Puzzles and Picture Puzzles task reflects either poor attention or working memory deficits.

In order to assess Xxxxxxxxx’s emotional, social, and behavioral functioning, the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), and Conners 3 were administered. On the CBCL (which was completed by Xxxxxxxxxxxx and both of her parents) and TRF (which was completed by two of Xxxxxxxxxx’s xxxxxxxxx classroom teachers), no clinical elevations were present. However, Xxxxxxxxxx’s mother’s responses on the Conners 3 indicated Learning Problems (T = 88), as did Xxxxxxxxxxx’s father’s responses (T = 90). Additionally, Mr. Xxxxxxxxx’s ratings of Xxxxxxxxxxxx led to elevations of the scales Inattention (T = 78) and ADHD Predominantly Inattentive Type (T = 70). Xxxxxxxxxx’s self-ratings did not produce clinical elevations on any Conners 3 scale. Xx.. Xxxxxx, Xxxxxxxxxxxxxxx’s 7th grade xxxxxxx teacher, provided responses on the Conners 3 that indicated difficulties with Inattention (T = 85), difficulties with Hyperactivity/Impulsivity (T = 87), and borderline difficulties with Executive Functioning (T = 67). The scales ADHD Predominantly Inattentive Presentation (T = 77) and ADHD Predominantly Hyperactive-Impulsive Presentation (T = 90) were also elevated, based on Xx.. Xxxxxxx’s ratings. Xxxxx Xxxxx, Xxxxxxxxx’s 7th grade xxxxxxxxx teacher, also completed the Conners 3. Xx. Xxxxx’s ratings revealed Learning Problems (T = 70) and borderline difficulties with Inattention (T = 66) and Learning Problems/Executive Functioning (T = 68).

Collectively, the results of neuropsychological testing and ratings from knowledgeable respondents on the Connors 3 rating scale support a diagnosis of predominately inattentive type ADHD. It is also likely that Xxxxxxxx’s ADHD symptoms are intensified when participating in mainstream classroom activities, particularly English Language Arts. As is common among children with ADHD, Language Disorder, and Specific Learning Disorders, Xxxxxxxxxx is underachieving relative to her estimated general intellectual potential in multiple academic areas. The primary underlying neuropsychological deficits include a poor capacity for sustained attention, poor executive functioning skills, difficulty accessing words in the memory store and/or a naming problem, working memory problems and the rapid decay of memory trace for auditory information. As with many children with

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Xxxxxxxxxx’s profile her academic trajectory is likely to be very negative without significant supports and effective medication management.

With regard to reading, Xxxxxxxxxx is more proficient at “whole-word” or “sight-word” reading – processing a word directly as a visual unit for meaning – than processing it phonologically. As such, Xxxxxxxxxx can perform adequately when reading familiar or easily recognizable words but has difficulty reading unfamiliar or irregularly pronounced words. This difficulty results from a problem converting a word to sound (using the phonological route) and then processing it for meaning as an auditory unit. This is the only way we can decode new/unfamiliar words to pronounce the set of letters composing the word. Since Xxxxxxxxx appears to have an intact direct route (whole-word or sight-word reading) into the semantic system, the prognosis is better formher than if she were to have deep dyslexia, i.e., impaired phonological route and impaired direct route.

In summary, Xxxxxxxxxxx presents as a moderately to severely learning disabled youngster who is not realizing the full expression of her intellect in several academic areas. The results of the current testing evaluation point to two neurodevelopmental disorders - an untreated predominantly inattentive type ADHD and a developmental phonological dyslexia. Xxxxxxxxxx’s ability to sustain focus on activities and inhibit her responses are both areas of difficulty for her. Notably, patchy or inconsistent academic performance and working memory problems are frequently found among individuals diagnosed with ADHD. Moreover, she struggles with word reading accuracy, reading comprehension, and oral fluency, and she an idiosyncratic memory problem – rapid memory decay (poor consolidation) of auditory information overtime.

DSM-5 Diagnostic Impression 315.00 Specific Learning Disorder with impairment in reading (word reading accuracy and

reading comprehension) – Moderate to Severe 315.39 Language Disorder 314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly inattentive presentation

– moderate

Recommendations: 1. Xxxxxxxxx’s parents should share this report with Dr. Xxxxxx, Ms. Xxxxxx (or other

provider of special education advocacy services as can be acquired through the Federationfor Children with Special Needs or the Council of Parent Attorneys and Advocates), theXxxxxxxxx School District Department of Special Education, and Xxxxxxxxxxx’s schoolteam at Xxxxxxxxxxxxxxxxx.

2. Xxxxxxxxxxxxx’s parents should consider requesting a meeting through the Department ofSpecial Education of the Xxxxxxxxxxxx School District to discuss Xxxxxxxxxx’s eligibilityfor an IEP.

3. It is recommended that Xxxxxxxxxxx be found eligible for an IEP and receive specialeducation services as a result of a Specific Learning Disability (with impairment in reading),

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Communication Disability, and Other Health Impairment.

4. Due to Xxxxxxx’s reading difficulties, placement in an eighth grade class that is taughttraditionally will not be appropriate for Xxxxxxxx. Placement in a partial inclusionprogram is also not recommended.

5. It is this examiner’s opinion that, in order to meet Xxxxxxxxx’s needs and promote effectiveprogress, she requires a school with an academic program designed to serve students withlanguage–based learning disorders and ADHD. A comprehensive language-based learningdisorders program with a small class size, a peer group with comparable deficits andlearning styles, and a highly structured instruction in a fully enriched program throughouther full day is necessary for Xxxxxxxxxx to benefit from her academic instruction. Thisprogram should have staff with training and experience in serving children with reading andlanguage disorders as well as ADHD. Additionally, the program needs to provide aconsistent methodology throughout the year and across the curriculum.

6. It is recommended by this examiner that Xxxxxxxxxx’s IEP team identify that all IEPservices should be provided outside the general education classroom and in a separateschool.

7. Xxxxxxxxxx requires intensive direct instruction in phonics and sight words. It isrecommended that Xxxxxxxxxx receive phonics instruction using a highly structuredsynthetic program that incorporates a strong tactile-kinesthetic component such as theOrton-Gillingham approach, website: http://www.orton-gillingham.com.

8. In order to make effective progress academically, it is recommended that Xxxxxxxxxxxreceive instruction in organizational skills as a 1-to-1 direct service. This service should beprovided by a professional with training and experience in executive function coaching.

9. Xxxxxxxxx’s parents are advised to consult with Dr. Xxxxxxx or a pediatricpsychopharmacologist about a possible trial on stimulant medication. Referrals can beobtained by contacting this office or Dr. Xxxxxxxx’s office.

10. Foreign language waiver.

11. Reevaluation with neuropsychological and psycho-educational testing in one to two yearsis recommended.

Learning Strategies and Accommodations Xxxxxxxxx would benefit from reinforcement and repetition of skills/concepts, small group and/or individual instruction and administration of assessments, multi-sensory teaching including use of visuals, models and hands-on activities, and preferential seating at point of instruction. In addition, specific recommendations include:

• 100% extended time to complete assignments

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• Use of graphic organizers, checklists and reference sheets• Use of a computer including word processing with spell and grammar check• Use of text-to-speech for proofreading• Use of electronic text reader such as Kurzweil• Copy of teacher notes or recording device for note taking• Books on tape and textbooks on tape• Structured organization systems monitored by teacher. In addition, in testing

situations, Xxxxxxxxxx many benefit from frequent breaks.

It was a pleasure to work with Xxxxxx and we wish her well in her future.

Respectfully submitted,

Scott Andrews, Ph.D., H.S.P. Developmental Psychologist Licensed Psychologist Registered Health Service Provider Director