PSYCHOLOGICAL EVALUATION JUAN DOE 1 PSYCHOLOGICAL EVALUATION CONFIDENTIAL Name: Juan Doe DOB: XX/XX/2014 Evaluation Date: 02/01/2022 Report Date: 02/11/2022 Examiner: Jane Doe Campus: XXXXXX Elementary Note: The purposes of the evaluation, permission to decline to answer questions, and the limit of confidentiality were explained in age-appropriate language. The following is a summary of significant results from the tests administered. Conclusions are not based on any single test of evaluation, but the overall impression that emerges from all the available data. Psychological testing and educational evaluation have limits in terms of predicting future behavior or progress, particularly at younger ages. School assessments prioritize functional behavior in school and educational implications over clinical interpretations. Assessments for special education are completed to gain information for educational programming, and the scope of the evaluation is limited to this purpose. The LSSP acknowledges responsibility for those test results, statements and recommendations based on her assessment findings. Her signature is not a claim of expertise in professional areas beyond those defined by the practice of psychology in the public schools. REFERRAL INFORMATION A psychological assessment was requested to determine whether Juan Doe qualified for Special Education services under the disability category of Other Health Impairment due to Attention Deficit Hyperactivity Disorder. EVALUATION PROCEDURES Interviews Parent Student Observations Classroom Testing-Individual Assessment INSTRUMENTS BASC-3 - Parent Connor’s 3 - Parent, Teacher BRIEF-2 - Parent Student Questionnaires/Assessment Connor’s Continous Performance Test 3 (CPT-3) Children’s Color Trail Test Student Interview Parent Information The following information was obtained from Juan’s mother, Ms. Maria Doe. Juan currently lives at home with his mother, his father, and siblings. Aside from experiencing gestational diabetes that was managed through dietary changes, Ms. Doe denied experiencing any complications during pregnancy or delivery with Juan. He currently does not take medications, but Ms. Doe did mention that Juan has a teenage cousin who has difficulties with reading and writing and who takes medications to treat inattention. During the 2019-2020 school year, Ms. Doe separated from her husband, which she said significantly affected Juan. During this time, she described Juan as “sensitive” and crying often, sharing that her husband once witnessed Juan crying in front of a mirror and repeatedly saying, “Why am I stupid? Why can’t I learn this?” Because of how significantly their separation appeared to impact Juan, Ms. Doe and her husband decided to live together again; ever since then, she said that Juan’s mood has greatly improved and that he does not cry as often as he did in the past. She described Juan as now being a very sweet, loving child who loves to play soccer and who never makes fun of, bullying, or physically hurts other children. CONFIDENTIAL-Access to psychological records is restricted to those permitted by law who have legitimate educational interest in this record. PSYCHOLOGICAL EVALUATION JUAN DOE 2 When asked about her biggest concerns for Juan’s learning, she reported Juan has difficulty focusing and that he becomes irritated when his school work is too difficult for him, though she denied that she has ever observed Juan having difficulty with hyperactivity or impulsivity. While Juan’s teachers have never complained to Ms. Doe about Juan’s inattention, she reported that she talked with one of Juan’s teachers in December 2021 and that this teacher mentioned that Juan does not take or even attempt to take notes in class (he says it is too hard), that he needs a significant amount of encouragement to start and complete assignments, and that Juan takes longer to complete assignments than most of his classmates (especially when the assignment requires reading or writing). Ms. Doe was not sure how Juan’s mood presents in the classroom when he is required to complete an assignment he perceives to be difficult, but she shared that he becomes frustrated when working on assignments at home if he has difficulty reading the assignment, if he does not understand how to do his homework assignment, or if he does not understand an explanation or instruction. However, Ms. Doe went on to explain that Juan’s frustration with schoolwork has improved since she and her husband ended their separation, though he still will say “I’ll never learn this” when he becomes frustrated with an assignment. Behavioral Observations Juan was observed from 8:46-9:15 AM in Ms. Perez’s homeroom classroom. During the observation, Juan and the class were working on copying definitions for bodies of water and matching these definitions to drawings, although Juan was looking around the classroom and did not appear to be working at the beginning of the observation. As a result, Ms. Perez went to his desk and pointed to where he should write his definitions; Juan then continued to sit and had to be prompted twice to work on his assignment and needed to be reminded twice where he could find the definitions for the assignment. Throughout his time working on the assignment, Juan would look up from his desk and look around the classroom, kicking his legs under his desk. He would also appear to stop writing frequently throughout the observation, despite the fact that his classmates appeared to be able to write for longer periods of time without breaks (although he would appear to start working again whenever Ms. Perez came by his desk). At one point, when Ms. Perez asked the class to look at her, Juan initially did not respond and instead appeared to continue working on his assignment, taking approximately 30 seconds to look up at Ms. Perez. A little later, another student told Juan that she was “going to tell Ms. Perez” on him, but it was unclear what Juan had done to elicit this response from the other student. When Ms. Perez returned to help him again, she commented that his book with the definitions was too far away from his piece of paper, telling him that this would make it difficult to copy the definitions from the book. She then pointed to several items in the book and told and Juan that he only had to complete the items she pointed to–then he would be done. It was unclear if Juan completed the assignment before Ms. Perez announced that it was time for the class to put their materials away and line up to leave for specials; however, Juan immediately got out of his seat and walked to the line when Ms. Perez announced that it was his table’s turn to get in line for specials (though he had to be prompted once to return to his desk and push in his chair). Before he returned back to the line, he started touching another student’s school materials that were on the table next to his, but returned to the line when Ms. Perez announced that it was time for everyone to line up and leave. At the end of the observation, he was walking in line with the rest of his class. Juan was observed a second time from 10:05-10:28 AM in his math class with a substitute teacher. At the beginning of the observation, Juan was seated at his desk sticking his markers together; then the substitute asked the students to get to work. While most of the other students in the class immediately started writing on their worksheets, Juan looked around the classroom and did not begin working on the worksheet until approximately 2 minutes after the other students. He did appear to write something on his worksheet for 1-2 minutes, but then he stopped writing on his worksheet and started looking around the classroom once more. At 10:21, the substitute stood by Juan’s desk and gave him instructions on how to complete the first math problem, telling him to follow the same steps to complete the remaining problems. After the substitute left, though, he stopped writing on his worksheet, instead looking around the room and playing with a piece of paper on his desk. Approximately 3 minutes later, Ms. Perez came into the classroom and went to Juan’s desk, asking him to make his numbers smaller so he could fit his work within the row. She then started explaining the difference between rows and columns to the class, but Juan asked if he could go to the bathroom as soon as Ms. Perez began her explanation. Once Ms. Perez permitted him to go to the bathroom, he returned within 2 minutes. At the end of the observation, Juan was seated at his desk talking with the students seated next to him. CONFIDENTIAL-Access to psychological records is restricted to those permitted by law who have legitimate educational interest in this record. PSYCHOLOGICAL EVALUATION JUAN DOE 3 CURRENT TESTING RESULTS The following information was obtained from parent and teacher questionnaires given to Ms. Doe and Juan’s teachers to complete. Any discrepancy in the results from the respondents could be due to the difference in environments and demands placed on Juan in each and can be seen between the home and school environments and even between different settings at school. Parent and teacher questionnaires are a valid manner to obtain further information about a student but do not comprise the entirety of the evaluation. Behavior Assessment System for Children, 3rd edition (BASC-3) The Behavior Assessment for Children, 3rd edition (BASC-3) is a multi-rater questionnaire system that evaluates the behaviors and emotions of children and adolescents. While the measure cannot be used as the sole basis for diagnosis, the BASC-3 can facilitate differential diagnosis of emotional and behavioral disorders in children and adolescents, including internalizing problems such as anxiety and depression. Scores in the clinically significant range (T-score ≥ 70 for the Clinical Scales; T-score ≤30 for the Adjustment and Adaptive scales) suggest that the rater perceives a high level of emotional, behavioral, or social deficits in the student. High scores on the Emotional Symptoms Index (ESI) are an indicator of a student’s global (broad) emotional disturbance, while the scale scores are indicators of specific areas of difficulty, such as anxiety. Also, high scores on the Behavior Symptoms Index (BSI) indicate a student’s global (broad) behavior problems, while the scale scores indicate specific areas of concern, such as attention problems. Students who fall within the at-risk range (T=60-69 for the Clinical Scales; T=31-40 for the Adjustment and Adaptive scales) are considered to be at-risk for emotional, behavioral, or social impairments, suggesting that the student may be experiencing emotional, behavioral, or social difficulties that are not severe enough to require treatment or that he/she requires monitoring before his/her problems worsen. For the Clinical Scales, scores in the borderline range (e.g., T=60) should be interpreted in conjunction with other sources of information, such as information from interviews or observations. Scores falling within the average range (T=41-59) suggest that the rater perceives no more emotional, behavioral, or social deficits than others of the student’s age or gender. Finally, low scores (T=31-40) and very low scores (T≤30) may indicate that the rater perceives less emotional, behavioral, or social difficulties compared to others of the student’s age or gender. However, low or very low scores should be interpreted in conjunction with the validity indexes. Low or very low scores on the Clinical Scales and a high score on the L index may indicate that the rater is attempting to present the student in an overly positive or idealized manner. Parent Ms. Maria Doe, Juan’s mother, completed the BASC-3 Parent. Ms. Doe’s responses were acceptable on all validity scales. Therefore, the scores can be taken as a valid evaluation of Juan’s behavior. Ms. Doe’s responses are in the at-risk range for the Internalizing Problems Index (T = 61), the Behavioral Symptoms Index (T = 64), and the Adaptive Skills Index (T = 37), and are in the average range for the Externalizing Problems Index (T = 54). For the Clinical and Adaptive scales, Ms. Doe’s responses were in the Clinically Significant range for Attention Problems (T = 70), and were in the at-risk range for Anxiety (T = 66), Depression (T = 63), Atypicality (T = 63), Withdrawal (T = 66), Social Skills (T = 40), Activities of Daily Living (T = 32), and Functional Communication (T = 34). Ms. Doe’s remaining responses fell in the average range for the following areas: Hyperactivity, Aggression, Conduct Problems, Adaptability, and Leadership. These scores suggest that Ms. Doe perceives that Juan has significant difficulties with inattention, as well as some difficulties with worry and/or fear, with being withdrawn or making pessimistic statements, with engaging in behaviors that are considered strange or odd, with disorganization, with appearing to be seemingly alone and/or being sometimes unwilling to join group activities, with using age-appropriate social skills, with performing simple daily tasks in a safe and efficient manner, and with communicating his wants or needs. In school, Juan may be easily distractable and have difficulty with assignments that require sustained effort. He may also appear to stress or worry, may sometimes make pessimistic statements (e.g., “I can never learn this”), may sometimes engage in behaviors or CONFIDENTIAL-Access to psychological records is restricted to those permitted by law who have legitimate educational interest in this record. PSYCHOLOGICAL EVALUATION JUAN DOE 4 make statements that are odd or strange (e.g., talking to himself during lessons), may appear shy or unwilling to join activities with other students, may inconsistently use social skills expected for his age/grade level (e.g., helping others, taking interest in others’ ideas), may have difficulty following routines or completing tasks independently, and may be reluctant to ask teachers for help if he does not comprehend an assignment or concept. Teacher Ms. Perez, Juan’s homeroom teacher, completed the BASC-3 Teacher. Ms. Perez’s responses were acceptable on all validity scales. Therefore, the scores can be taken as a valid evaluation of Juan’s behavior. Ms. Perez’s responses are in the clinically significant range for the School Problems Index (T = 77) and Adaptive Behavior Index (T = 29), are in the at-risk range for the Internalizing Problems Index (T = 60), and are in the average range for the Externalizing Problems Index (T = 42) and the Behavioral Symptoms Index (T = 56). For the Clinical and Adaptive scales, Ms. Perez’s responses were in the Clinically Significant range for Learning Problems (T = 81), Study Skills (T = 30), and Functional Communication (T = 28). Her responses were in the at-risk range for Anxiety (T = 62), Attention Problems (T = 68), Adaptability (T = 40), Social Skills (T = 31), and Leadership (T = 33). With the exception of Conduct Problems (T = 40), which fell in the low range, Ms. Perez’s remaining responses fell in the average range: Hyperactivity, Aggression, Depression, Somatization, Atypicality, and Withdrawal. These scores suggest that Ms. Perez perceives that Juan has significant difficulty comprehending and completing schoolwork in a variety of academic areas, that he often appears to be disorganized, that he has trouble using problem-solving to complete his classwork, and that he often has difficulty turning in assignments on time. The scores also suggest that Juan sometimes appears anxious or nervous, sometimes displays inattention in the classroom, struggles to adapt to change, has limited age-appropriate social skills, struggles with bringing others together to complete a project, and sometimes has difficulty communicating his wants or needs. At school, Juan may have difficulty with grade-level reading, writing, or math, may often fall behind in class, may sometimes appear to worry and be easily stressed by his schoolwork, may appear to be easily distracted and have difficulty attending to classwork, may inconsistently use social skills expected for his age/grade level (e.g., helping others, taking interest in others’ ideas), may have difficulty solving problems or working under pressure, and may have trouble asking his teacher for help when needed. Connors 3rd Edition (Connor’s 3) The Connors 3-Parent and Teacher forms evaluate parents’ and teachers’ observations about the behavior of students aged 12-21 years old, and are designed to assess ADHD and other disorders that commonly co-occur with ADHD. The Connors 3-Self-Report form is completed by a child or adolescent aged 8-21 years old. The Self-Report form is a set of behavior scales designed to evaluate different aspects of child or adolescent behavior, providing an index score of a child or adolescent’s tendency to engage in behaviors typically associated with ADHD or other commonly comorbid disorders. All 3 forms report scores as T scores with a mean (average) of 50 and a standard deviation of 10. Scores below 40 indicate that a child/adolescent has few problem behaviors/difficulties compared to others of his/her age and gender. Scores of 40-59 fall within the average range, meaning that the behaviors of the child/adolescent are typical given his/her age and gender. Scores of 60-69 fall in the elevated range, meaning that the child/adolescent has more problem behaviors compared to others of his/her age and gender. Finally, scores over 70 are in the very elevated range, indicating that a child/adolescent has many more problem behaviors and concerns than are typical of his/her age or gender. Typically, scores in the very elevated range are highly suggestive of ADHD or other comorbid disorders, although the individual conducting the evaluation should not base their conclusions solely upon a student’s scores on the Connors 3 forms. Rather, the evaluator will consider information gathered from interviews, observations, and other sources in conjunction with the Connors 3 scores, especially if the student’s scores are borderline (scores of 57-63). Parent Ms. Doe, Juan’s mother, completed the Connors 3-Parent form. The Connors 3-Parent consists of a Global Index and two scales: The Content Scales and the DSM-V Symptom Scales. Ms. Doe’s report of Juan’s scores on the Global Index indicated that Juan’s Total Global Index (T = 78), Restless-Impulsive index (T = 76), and the Emotional Lability index (T = 73) were in the very elevated range. None of her responses indicated an inconsistent response pattern or an overly positive or negative impression of Juan. Ms. Doe reported that Juan’s Content scales were very elevated in the areas of Inattention (T = 90), Hyperactivity/Impulsivity (T = 71), Learning Problems (T = 90), Executive Functioning (T = 89), Defiance/Aggression (T = 87), and Peer Relations (T = 86). For the DSM-5 symptoms scale, Doe reported that ADHD Predominantly Inattentive Presentation scale (T = 90), ADHD Predominantly HyperactiveImpulsive Presentation scale (T = 70), Conduct Disorder scale (T = 84), and Oppositional Defiant Disorder scale (T = 79) fell in the very elevated range. CONFIDENTIAL-Access to psychological records is restricted to those permitted by law who have legitimate educational interest in this record. PSYCHOLOGICAL EVALUATION JUAN DOE 5 Taken together, these scores are highly suggestive of symptoms of ADHD and suggest that Juan may be impulsive, fidgety/restless, disorganized and forgetful, inattentive, and easily distractible. In school, he may have trouble paying attention; may have trouble starting, completing, or turning in assignments; may have difficulty sitting still or being quiet during lessons; or may find it hard to keep his school materials organized. He may also struggle with or give up easily on tasks that require sustained mental effort, have difficulty synthesizing individual facts into concepts, be forgetful (e.g., lose his assignments) and make careless mistakes on assignments. Finally, Juan may engage in behavior due to his difficulties with inattention that may be unlikable to some people, such as disturbing classmates or teachers when they are trying to work on something else. Ms. Doe indicated that these areas of difficulty very frequently impact Juan’s academic performance, and she reported that these problems often appear to impact Juan at home or in social settings. Teacher Ms. Perez, Juan’s homeroom teacher, completed the Connors 3-Teacher form. The Connors 3-Teacher consists of a Global Index and two scales: The Content Scales and the DSM-V Symptom Scales. Ms. Perez’s report of Juan’s scores on the Global Index indicated that Juan’s Total Global Index (T = 55), Restless-Impulsive Index (T = 53), and Emotional Lability index (T = 54) were in the average range. None of Ms. Perez’s responses indicated an inconsistent response pattern or an overly positive or negative impression of Juan. Ms. Perez reported that Juan’s content scales were very elevated in the areas of Inattention (T = 74, Total Learning Problems/Executive Functioning (T = 79), and Learning Problems (T = 83), and her responses on the Executive Functioning scale (T = 67) fell in the Elevated range. The remaining Content Scales fell in the average range: Hyperactivity/Impulsivity (T = 43), Defiance/Aggression (T = 44), and Peer Relations (T = 50). For the DSM-V symptoms scale, Ms. Perez’s responses fell in the very elevated range for the ADHD Predominantly Inattentive Presentation scale (T = 82), but fell in the average for the Hyperactive-Impulsive Presentation scale (T = 73), the Oppositional Defiant Disorder scale (T = 48), and the Conduct Disorder scale (T = 45). Taken together, these scores are highly suggestive of symptoms of ADHD and suggest that Juan may be disorganized, inattentive, easily distractible, and forgetful. In school, he may have difficulty concentrating on class activities during independent or group work, may make careless mistakes on classwork, may struggle with starting and completing and/or turning in assignments, may struggle with or give up easily on tasks that require sustained mental effort, may forget assignments, may have trouble organizing his school materials, and may have difficulty following directions. He may also find reading, writing, and math to be significantly challenging. Ms. Perez indicated that these areas of difficulty very often have a serious impact on Juan’s academic performance, although she reported that these problems do not appear to impact his social functioning. Behavior Rating Inventory of Executive Function, 2 (BRIEF-2) The Behavior Rating Inventory of Executive Function, second edition (BRIEF-2) is a questionnaire that assesses executive function behaviors in the home and school environments. Executive functions are a collection of processes that are responsible for guiding, directing, and managing cognitive, emotional, and behavioral functions, particularly during active, novel problem-solving. The BRIEF-2 has 8 clinical scales that examine various domains of executive functioning and these scales combine to form three indexes (Behavior Regulation/BRI, Emotional Regulation/ERI, and Cognitive Regulation/CRI) and one composite summary score (Global Executive Composite/GEC). Scores are reported as T scores with a mean of 50 and a standard deviation of 10. T scores from 60 to 64 are considered mildly elevated, and T scores from 65 to 69 are considered potentially clinically elevated. T scores at or above 70 are considered clinically elevated. Ms. Doe, Juan’s mother, completed the parent form of the BRIEF-2. Her responses were in the acceptable range for the Inconsistency, Negativity, and Infrequency scales; therefore, her responses can be interpreted as a valid report of Juan’s behavior at home. Ms. Doe indicated that Juan's Behavior Regulation Index (T = 59) fell in the average range, but indicated that Juan’s Emotional Regulation Index (T = 73) and Cognitive Regulation Index (T = 71) were all in the clinically elevated range, suggesting that she perceives that Juan has significant difficulties regulating his emotional responses and adjusting to changes, controlling and managing cognitive processes, and using problem-solving skills effectively. Her responses also indicated that Juan’s Global Executive Composite/GEC (T = 75) was in the clinically elevated range; however, because there were two or more indexes that were substantially different, the GEC may not be an accurate representation of Juan’s executive functions problems. For the clinical scales, Ms. Doe’s responses were in the clinically elevated range for Shift (T = 79), Initiate (T = 71), Working Memory (T = 74), and Organization of Materials (T = 70). Her responses were in the potentially clinically elevated in the area of Task-Monitor (T = 69), and were in the mildly elevated range in the areas of Self-Monitor (T = 63), Emotional Control (T = 64), and Plan/Organize (T = 63). The only clinical scale that Ms. Doe rated as falling in the average range was Inhibit (T = 55). CONFIDENTIAL-Access to psychological records is restricted to those permitted by law who have legitimate educational interest in this record. PSYCHOLOGICAL EVALUATION JUAN DOE 6 Taken together, these scores suggest that Juan struggles to adapt to transitions or change, has difficulty beginning tasks and generating ideas or solutions, struggles to mentally store information needed to complete tasks or sequential steps, has trouble anticipating and planning for future events, and has difficulty organizing information into concepts when learning or communicating information. He also has difficulty assessing his own work or performance, has limited awareness of the consequences/outcomes of his behavior, has difficulty modulating his emotional responses to situations, and struggles to set goals and work toward his goal in an appropriate or timely manner. In school, Juan may have difficulty adjusting to new demands from his teacher or other school staff, may struggle to complete and turn in assignments that have been done correctly, may be overwhelmed when presented with large amounts of new information during a classroom lesson, may have difficulty following verbal directions from school staff or keeping track of what he is doing while working on an assignment, may often appear unaware of how his actions impact others in the classroom, may have difficulty controlling his emotional responses to events at school (e.g., directives from teachers, having difficulty with a task/assignment), and may struggle to plan for upcoming assignments (e.g., waiting until the last minute to finish homework). Student Questionnaires/Interview Conners Continuous Performance Test, Third Edition (Conners CPT-3) The Conners’ Continuous Performance Test, Third Edition (CPT-3) is a computerized, 14-minute, visual performance task in which the subject must respond repeatedly to non-target figures and then inhibit responding whenever the infrequently presented target figure appears. The CPT-3 requires the student to press the space bar when he or she sees any letter “other than an X” in the middle of the screen. The respondents react to target letters on the screen, allowing the CPT-3 program to measure response time, errors, and change in reaction time and consistency, signal detection theory statistics, and overall statistics. Students’ performance on the CPT-3 is reported as T-scores, but because the CPT-3 is not normed for Juan’s age group (the minimum normed age is 8 years, 0 months), Juan’s performance on the CPT-3 did not yield valid T-scores. Instead, the evaluator chose to use behavioral observations made during testing to evaluate Juan’s inattention. CPT-3 Behavioral Observations During testing, Juan had noticeably slow responding rates, often pressing the space bar several seconds after the target letter was presented. Consequently, if a target letter was presented quickly after the preceding target letter, Juan would often hit the space bar twice in rapid succession, making his response times highly variable. He also frequently pressed the space bar when presented with an X, even though he was given a reminder not to press the spacebar when X appeared after completing the practice round and before starting testing. Finally, he often failed to respond to some target letters, sometimes allowing as many as 2 or 3 target letters to be displayed before responding. Taken together, these behaviors displayed during the administration of the CPT-3 suggest that Juan had difficulty with inattentiveness, including difficulties sustaining attention and effort over long periods of time. Children’s Color Trails Test (CCTT) The Children’s Color Trails Test (CCTT) is a standardized, paper-and-pencil, orthographic neuropsychological instrument that is designed to provide an easily administered and objectively scored measure of alternating and sustained visual attention, sequencing, psychomotor speed, cognitive flexibility, and inhibition-disinhibition. Juan completed the CCTT K forms (CCTT-1 and CCTT-2). Because the CCTT is not normed for Juan’s age group, Juan’s performance on the CCTT did not yield valid Standard Scores. As a result, the evaluator chose to use observations made during testing to evaluate Juan’s cognition. CCTT Behavioral Observations Throughout the administration of the CCTT, Juan repeatedly lifted his pencil off the page (10 times for the CCTT-1, 12 times for the CCTT-2) despite prompts from the evaluator instructing him to keep his pencil on the page. Juan completed the first CCTT form (CCTT-1) in 1.06 minutes/63.6 seconds without number sequence errors, near misses, or prompting from the evaluator. For the second CCTT form (CCTT-2), his completion time increased to 3.29 minutes/197.4 seconds, and he made 2 color sequence errors and needed 3 prompts. While his performance on the CCTT did not yield Standard Scores because the CCTT is not normed for his age group (7 years, 8 months), it should be noted that his completion times for the CCTT-1 and CCTT-2 were in the 1st percentile for a child who is 4 months older than him (8 years, 0 months). Similarly, his number of prompts on the CCTT-2 were in the 2-5 percentile for a student who is 8 years and 0 months old, and his number of color sequence errors on the CCTT-2 fell in the 11-16 percentile range for a student aged 8 years and 0 months. This means that if Juan had performed similarly on the CONFIDENTIAL-Access to psychological records is restricted to those permitted by law who have legitimate educational interest in this record. PSYCHOLOGICAL EVALUATION JUAN DOE 7 CCTT after his 8th birthday, the results would have indicated that his performance on the CCTT was lower than the majority of students of the same age. Juan’s current performance on the CCTT can be attributed to his age (i.e., that he was 4 months younger than the age range recommended for the CCTT). However, the fact that his performance was significantly below what would be expected for a student 4 months older than him suggests that Juan may have difficulties in the areas measured by the CCTT, as it is unlikely that a student would typically increase their performance on the CCTT to a significant extent in the period of time between being 7 years and 8 months of age to 8 years and 0 months of age. Therefore, Juan’s behaviors during the CCTT suggested that Juan may have more difficulty with perceptual tracking, sequencing, graphomotor skills, sustained attention, and divided attention skills than same-age peers. In school, he may have difficulty tracking and moving between written words, may struggle to keep track of multi-step directions or multi-step procedures (e.g., math problems), may find it hard to keep track of word order or words he has written, may have difficulty forming letters and words, may hold writing utensils with an odd grip, may have difficulty keeping his writing within a specified area, may struggle with tasks that require continuous effort (e.g., reading, writing, math problems), and may appear to become “flustered” or to shut down when he is required to process multiple sources of information. Student Interview Juan reported that he lives with his mother and father, as well as a younger sister. His favorite teacher is Ms. Perez. His favorite subject is PE, where he enjoys playing soccer; his least favorite subjects are math, writing, and reading. He shared that reading and writing are both hard for him. SUMMARY FROM PSYCHOLOGICAL EVALUATION A psychological evaluation was requested to determine whether Juan qualified for Special Education services under the disability category of Other Health Impairment due to Attention Deficit Hyperactivity Disorder. Results of the parent interviews, classroom and testing observation, parent and teacher questionnaires, student evaluation, and other test data indicated that Juan does exhibit behaviors consistent with an Other Health Impairment due to a diagnosis of Attention Deficit Hyperactivity Disorder (though he will not meet TEA criteria for Other Health Impairment due to ADHD until a physician signs an Other Health Impairment form). Juan presented with significant inattention in the classroom, struggling the most with sustained attention (the ability to put forth continuous effort while completing a task) and divided attention (the ability to attend to one or more tasks at once). For Juan, his difficulties with sustained attention present as difficulty working on a task long enough for the task to be completed (taking frequent breaks while working on classwork), while his difficulties with divided attention present as him missing instruction from the teacher if he is attending to something else (e.g., if he is writing or is looking at his worksheet). The findings also suggest that Juan has difficulties with executive functions other than attention, as well as difficulties with sequencing skills, perceptual tracking, and graphomotor skills. According to his teacher and mother’s report of his behavior, his difficulties with executive functioning present as his difficulty starting and completing schoolwork, disorganization of his school materials, challenges with transitions or change, difficulty monitoring his performance when completing schoolwork (e.g., difficulty keeping track of errors), and struggling to complete tasks in a timely manner. These executive functioning difficulties may also present as Juan struggling to follow verbal directions, as well as difficulty modulating his emotional responses (e.g., becoming upset or crying when having difficulty with school assignments). Regarding perceptual tracking, his difficulty in this area manifests as difficulty tracking and moving between written words, while his challenges with sequencing skills present as struggling to keep track of multi-step directions or multi-step procedures (e.g., math problems), as well as keeping track of word order or words he has written. Finally, his difficulties with graphomotor skills present difficulty forming letters and words and difficulty keeping his writing contained within a specified area. The areas of difficulty described above all significantly impact Juan’s educational performance. These areas of difficulty impact Juan’s learning by directly affecting academic abilities such as reading, writing, and math, as well interfere with his ability to start and complete tasks, to maintain effort while working on class assignments, and to attend to teacher instructions and directives. As a result, Juan does appear to require specialized services that could only be provided through special education at this time. CONFIDENTIAL-Access to psychological records is restricted to those permitted by law who have legitimate educational interest in this record. PSYCHOLOGICAL EVALUATION JUAN DOE 8 STATEMENT OF DISABILITY CATEGORY Juan met the TEA criteria for the disability category of Other Health Impairment due to ADHD. This disability is contingent on Juan’s physician completing and signing the Other Health Impairment disability report to indicate that he did indeed exhibit behaviors consistent with ADHD and the severity to which these behaviors might impact him in the school environment. Classroom Recommendations 1. Create routines for tasks to help the task become familiar and automated. Use visuals and verbal cues for the routines to become internalized, be consistent in using them, and be patient (it will take time to learn and do independently). 2. For tasks with multiple steps (math problems, writing, etc.), provide a task checklist in sequential order with visuals. 3. Chunk assignments. 4. Provide Juan with notes to view while listening to classroom instruction. 5. It may be helpful to give Juan choices of assignments to complete or to choose the order he wants to complete these in. 6. Because of Juan’s difficulties with perceptual tracking and graphomotor skills, it may be helpful to provide a reading window and to provide aids to help Juan with organizing math problems and writing (e.g., draw columns on math assignments, draw colored line rows on writing assignments). 7. Model how to check for mistakes and make corrections. It may also be helpful to provide a checklist for checking for mistakes, especially for writing assignments (e.g., read his writing to himself, check spelling, etc.). 8. To help Juan’s organization, it may be helpful to use a check-in and check-out system with schoolwork that is brought home. It may also be helpful to incorporate a “clean-up time” for organizing into class. 9. When Juan has trouble solving a problem a certain way, provide him a visual (e.g. demonstration, etc.) of how to solve it differently. 10. Create a system for Juan to ask for help. __________________________ Hannah Hightower, Specialist in School Psychology Intern __________________________ Raina Walterscheid, M.S. Licensed Specialist in School Psychology #33901 CONFIDENTIAL-Access to psychological records is restricted to those permitted by law who have legitimate educational interest in this record.