REPORT OF PSYCHOLOGICAL ASSESSMENT
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NAME: Scott Smith
DATE OF BIRTH: 7/8/2012
CHRONOLOGICAL AGE: 6 years 1 month
PARENTS: Mary Smith and Sebastian Smith
GRADE: 1st grade
DATES OF ASSESSMENT: 8/17/2018; 8/27/2018
DATE OF REPORT: 9/3/2018
PSYCHOLOGIST COMPLETING REPORT (Washington Unified School District): Kathryn Johnson, LCP
INDENTIFYING DATA AND REASON FOR REFERRAL
Scott is having some difficulties with behaviors in the classroom, although his academics are average and in some cases are above average. He has some issues with hyperactivity, aggression, and some other atypical behaviors that have his teacher concerned. For example, he sometimes refuses requests to do tasks he does not want to complete.
SOURCES OF INFORMATION
Background information was obtained from his mother, his previous social worker, former psychologist, and previously completed educational and medical reports. This information was obtained from interviews, developmental history, and rating scales as well as medical records. This information appears to be from reliable sources and is considered valid. Current status of his learning and behavior was obtained from observation during testing and from standardized psychological, neuropsychological and achievement tests. The results of the evaluations are deemed as valid per Scott’s engagement with test items that were administered.
Pregnancy and birth history: Scott’s birth was typical after a 40-week pregnancy. He was an 8-pound baby with no apparent concerns at birth.
Developmental history: Scott experienced sleep difficulties as an infant, rarely sleeping for more than 2-3 hours at a time. His appetite was also reported as poor. Developmental milestones were reported as within normal range for language and gross motor development. However, he had poor fine motor coordination, especially for writing. Development of bladder and bowel control at night was also somewhat late.
Medical history: He had the usual childhood illnesses of cough/colds, ear infections, and strep throat.
Testing behavior: Scott needed to be walked into the testing room by a staff member. Per administration protocol for each assessment, Scott was provided breaks to complete the assessment items. Scott often stood during testing and at times would pace before answering a question. He made comments not related to the test items that were derogatory in nature towards the examiner. Testing had to be suspended one day when Scott tried to hit the examiner. Testing took place over multiple days.
Behavior rating scales and interview:
Formal assessment: Behavior Assessment Scale for Children (BASC)
Clinically significant ratings in the areas of:
· Hyperactivity (excessive movement, acts without thinking, calls out in group activities, interrupts adults when he wants something)
· Aggression (threatens to hurt others, hits others, breaks and wrecks things of others)
· Depression (e.g., moods change quickly, easily frustrated and upset, pouts, screams “That’s not fair”)
· Attention problems (e.g., gives up easily, short attention span, easily distracted)
· Withdrawal (e.g., plays alone, refuses to talk, avoids activities with others)
· Atypicality (stares blankly, seems out of touch with reality, repeats thoughts over and over, sings or hums to self, and hears or sees things that are not there)
Home: Scott’s mother and father state he is non-compliant and often displays the behaviors noted in the BASC. He does enjoy video games and computers. He has been fixated on these two activities from an early age.
School: His teacher states he is rarely absent, frequently aggressive, and often noncompliant. Academically, she thinks he is on par with same-age peers. However, his refusal to do work does make it hard for her to gauge.
STANDARDIZED TESTS ADMINISTERED:
Standardized assessments that targeted the domains of intelligence, visual-motor skills, learning processes, academic achievement, and emotional/psychological development.
Wechsler Intelligence Scale for Children-Third Edition (WISC-III)
This test measures current intellectual functioning. Overall cognitive ability in the average range (FSIQ = 103; 58th percentile). Nonverbal ability is significantly better developed (77th percentile; 111) than verbal ability (37th percentile; 95).
Visual Motor Integration Scale
37th percentile; Age equivalent = 4 yrs. 11 months
The types of tasks in this assessment test perceptual and motor skills, which are precursors for writing letters. Scott has shown improvement since initial screening at 3 years, 8 months when he was at the 25th percentile.
Peabody Individual Achievement Test-R (PIAT-R)
Sub Test Range
General Info Above Average
Reading Recognition Above Average
Read. Comp. Above Average
Spelling Above Average
Total Test Above Average
Scott has acquired basic pre-readiness skills in reading (he can identify all upper and lowercase letters in the alphabet; can identify pictures for words beginning with a, b, c, d, f, g, h, l, m, n, s, t; can retell a three-event story and answer a comprehension question after a passage is read). In the math area Scott can orally count to 30, identify all basic shapes, say the names of the days of the week, and answer addition and subtraction facts to five.
Work Samples: Writing
· Only 3 samples were available because Scott refuses to write. Writing is very immature with large, gangly stick figures, no proportions, and very light.
· Pencil grip is incorrect and awkward – refuses to hold pencil correctly – even with cushioned grippers.
· Refuses to write name, letters, or numbers.
OCCUPATIONAL THERAPY EVALUATION
Fine Motor Skill Development:
Bruininks- Osteretsky Test of Motor Proficiency (a standardized battery of motor performance tests; used by OTs, PTs and sometimes P.E. teachers; assesses both gross and fine motor skills) 54th percentile
· Needed prompts and motivator to overcome refusal – did complete test.
· Response speed equivalent is 5 yrs. 8 months.
· Visual motor control equivalent is 4 yrs. 11 months.
· Upper limb speed and dexterity age equiv. – 7 yrs. 2 mo.
· Right hand preference with irregular grasp and tight hold. Demonstrates diminished strength in shoulders and arms. Complains of fatigue after one minute.
Sensory Processing Skills
Areas of definite difference when compared to peers:
· Touch processing (tactile defensiveness, craves touch)
Areas of probable difference when compared to peers
· Sensory seeking behaviors
· Oral sensory processing
· Auditory processing
· Vestibular (related to balance, orientation of the head, etc.) processing
· Multi-sensory processing
· Fine motor skills are below age/grade level. Difficulties with fine motor control and manipulation.
· Sensory processing is a concern. Difficulties interfere with participation in classroom activities, interaction with peers and staff, emotional and behavioral control and attending skills.
OBSERVATIONS IN SCHOOL SETTING
Day 1 – 9:00-11:00 a.m.
· Students were engaged in circle time activities such as calendar (day, date, weather, etc.) When Scott was asked to draw the weather symbol on chart, he refused by strongly stating, “no.” Refused teacher’s offer of help and ran to the table and sat under it. Teacher asked him to come out and join group. Refused and stayed under table until circle time finished (20 minutes).
· Students engaged in various center time activities (e.g., making shapes with clay, alphabet activities, etc.).
· Scott refused to join in any of the activities. His off-task behavior consisted of shouting and screaming that he wasn’t going to do something, throwing things, knocking his chair over, trying to leave the classroom, hiding in the classroom, going under the table.
· He refused to participate in anything the class did 70 minutes of the 90-minute observation. Initially teacher tried to “coax” Scott into joining an activity. Then she ignored his behaviors and interacted with the other students (e.g., asking them questions about their center activity, etc.)
· During the last 10 minutes of the observation Scott engaged in a self-selected activity. Scott went to the Lego table and began to build a Lego structure.
· Peer behaviors included 1 “tussle” (both boys tugging at the same truck during free choice activity) over a toy truck with one boy saying, “I had it first.”
Day 2 – 9:00-11:00 a.m.
Schedule of activities was the same as Day 1.
· During calendar Scott sat outside the group but didn’t verbally yell or interrupt group.
· During center time Scott refused to join his assigned group for alphabet activity. When teacher tried to physically assist him to group Scott kicked and hit at the teacher when she approached him. Whenever the teacher tried to engage or assist Scott to join group (4 different times) he refused verbally with yelling (“I’m not going to!” or “No, no, no”) and threw himself on the floor and finally moved under the table.
· Peers followed teacher directions. No verbal or physical interactions (hitting, throwing, etc.) occurred with peers.
Day 3 – 9:00-11:00 a.m.
Schedule of activities was the same as Day 1.
· During calendar Scott sat outside the group.
· Didn’t join in any center activities.
· 15 occurrences of verbal disruptions (e.g., shouting out, humming, yelling, ”I’m going to hit you”) during the 2-hour observation
· 1 occurrence of tantrum (i.e., threw himself on floor and continued to scream and shout) with duration of 5 minutes.
· 3 physical threats (i.e., threw chair at another student who wouldn’t give him the Legos; pushed child to get out the door, threatened teacher with scissors (pointed scissors at teacher and made a jabbing motion) when she reminded him to be careful.
· There were 5 verbal outbursts (yelling, screaming) and 2 physical outbursts each day. On Day 2 Scott threw a book at teacher and pushed another child out of his way. On Day 3 Scott threw clay at another student, barely missing him, and kicked the teacher when she came over to ask Scott a question.
Recess Observations: Data was collected over 7 days for one 15-minute period each day. (One recess supervisor was assigned to watch Scott at all times and make sure he returned to the building.) Behavior included watching others play, running alone, or sitting on the ground singing and humming. There were no interactions with other students and Scott did not respond to supervisor prompts to join in.
Written permission acquired for the adapted use of:
Wisconsin Department of Public Instruction (2002). DOING IT RIGHT: IEP goals and objectives to address behavior. https://sped.dpi.wi.gov/sped_sbiep
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