College of Public Health and Health Professions
Department of Clinical & Health Psychology
Psychology Clinic
Health Science Center
PO Box 100165
Gainesville, FL 32610-0165
(352) 265-0294
Fax (352) 265-0096
December 16, 2003
RE:
MR#
Thomas, Colt Randal
DOB: 4/8/1965 (38 YOA)
Dates Seen: 10/12/98, 9/27/99, 5/24/00
Referral
Colt Randall Thomas is a 38-year-old Caucasian male seen for neuropsychological
evaluation at the request of public defender Herbert W. Ellis in the Third Judicial court to assist
in determining competency to stand trial. Mr. Thomas is currently held at XXXXX in XXXX. In
2000, Mr. Thomas was determined to be competent by a judge. He was then convicted at trial,
and sentenced to life imprisonment. On appeal, his conviction was reversed and he was
remanded back to trial court for re-trial. Mr. Thomas has been evaluated by numerous mental
health personnel in the past and underwent previous neuropsychological evaluation by this
examine on 10/12/98, 9/27/99, and 5/24/00. The current evaluation is performed to provide
updated information regarding Mr. Thomas’ neurocognitive status.
Background and History
Details of the medical and psychosocial history are contained in the report of our
previous evaluation (attached) and will not be fully recounted here. Mr. Thomas is currently
held under charges of capitol murder and grand theft in connection with an incident that occurred
on July 15, 1998. On this date, Mr. Thomas allegedly stole his brother’s gun from his home. He
then allegedly confronted his wife at the convenient store where she worked and fatally shot her.
Police discovered him lying on the floor of the back storage room of the convenience store,
having suffered an accidental gunshot wound to the head. The bullet appears to have primarily
injured his left frontal region.
Since Mr. Thomas’ last evaluation, he was determined competent to stand trial by a
judge, convicted of the charges against him, and sentenced to life imprisonment. [DISCUSS
WHERE HE SERVED TIME AND ANY REVIEW OF BEHAVIOR IN PRISON RE:
COGNITIVE ABILITIES] Mr. Thomas reported that since his last evaluation, he has been
concerned about increasing frequency of seizures (4 in the last year). No additional medical
records were reviewed in the context of this evaluation, so this report remains unverified. Mr.
Thomas continues to report no memory of the incident for which he is being charged, though he
can adequately recall details that were provided to him regarding the event (e.g. that he allegedly
stole a gun).
Equal Opportunity / Affirmative Action Institution
Re: THOMAS, Colt R.
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December 16, 2003 – Page 2
Behavioral Observations
Tests Administered
Wechsler Abbreviated Scale of Intelligence (WASI)
Boston Naming Test – Second Edition
Verbal Fluency (fas, animals)
Western Aphasia Battery (WAB) Kite Picture
Multilingual Aphasia Examination Token Test & Repetition
Trail Making Test
Wisconsin Card Sort Test (WCST)
Test Results
1) Intellectual Functioning:
A Wechsler Abbreviated Scale of Intelligence (WASI) was administered to measure current
intellectual functioning. On this test, Mr. Thomas obtained an estimated Full Scale IQ of 79,
which is in the below average range. This score was influenced by a significant discrepancy
between Verbal IQ (VIQ = 68, 1st percentile) and Performance IQ (PIQ = 97, 42nd percentile). In
his 1999 evaluation, he obtained the following WAIS-III Scores: VIQ = 80 (low average),; PIQ =
87 (low average); FSIQ = 81 (low average).
INTELLECTUAL FUNCTIONING
WASI FSIQ (4-scale estimate)
WASI Vocabulary
WASI Matrix Reasoning
WASI Similarities
WASI Block Design
Verbal Index
Performance Index
Raw Score
79
33
28
23
26
68
97
Ss
24
43
29
54
%ile
8
1
23
2
66
2
42
Descriptor
Below Average
Impaired
Low Average
Impaired
Average
Impaired
Average
Scores on both Verbal subtests (Vocabulary, Similarities) are more than 2 SD below the
corresponding subtest means. Mr. Thomas’ score on the Vocabulary subtest was influenced by
his tendency to be concrete in his attempt to define the words. He often listed features or
examples, rather than a cohesive definition (e.g. cart – thing you push around, like a golf cart, go
cart, you ride around). Similar difficulty with higher order conceptualization was evident on
Similarities. Though he was able to obtain full credit for concrete items, he characterized the
more difficult items, such as abstract concepts, as “not alike.” On performance subtests, Mr.
Thomas scored in the low average to average range. This discrepancy suggests that Mr. Thomas
has greater difficulty processing verbal as opposed to non-verbal information, especially as it
requires higher order conceptualization.
Re: THOMAS, Colt R.
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December 16, 2003 – Page 3
2) Language Functions:
Mr. Thomas’ spontaneous speech continues to be dysfluent. His sentences, while not
telegraphic, were short and effortful. Additionally, he was non-spontaneous in his speech and did
not initiate verbal behavior. Comprehension appeared to be basically intact, though instructions
and questions often had to be paraphrased to increase understanding. Long sentences were less
well-understood, though this appeared to be due to attentional deficits rather than language
deficits. He was very distractible, which led to difficulties tracking long questions or instructions.
Visual confrontation naming, assessed with the Boston Naming Test, was impaired (Raw
score = 46, 1st percentile). He had occasional phonemic paraphasias (e.g. stilks for stilts) and
scores was only modestly improved by phonemic cues (4/12 correct with cue). The lack of
benefit from cuing suggests that Mr. Thomas’ performance may have been impacted by lack of
word knowledge. On a measure of verbal fluency (timed word generation), Mr. Thomas
performed in the impaired range for bot letter and category fluency (FAS Raw = 16, 3rd
percentile, Animals Raw = 12, 1st percentile). This performance is consistent with his 1999
evaluation. On a measure of receptive grammar/verbal comprehension (Multilingual Aphasia
Exam Token Test), Mr. Thomas committed several errors involving complex sentences. For
example, he had difficulty with non-linear sentence structure (“Touch the white circle with the
green circle.) On a test of repetition (Multilingual Aphasia Exam Repetition), Mr. Thomas
performed in the impaired range (Raw Score = 8, 3rd percentile). On this test, Mr. Thomas was
asked to repeat sentences of increasing length and complexity. He committed 15 errors, all of
which occurred during longer sentences. These findings are consistent with performance on the
1999 evaluation. They suggest that Mr. Thomas continues to have difficulty with repetition,
which is aggravated by increased sentence length or complexity.
Mr. Thomas was asked to describe a scene in a picture (WAB Kite Picture) in writing. His
writing appeared marginally more fluent than his speech. His story is as follows: “Boy flying a
kite and the human fishing, and two people sail, and two people picniking and the dog is
watching the people picniking. There is a flagpole with a flag flying. There is a car parked under
the carport of a house with a oak tree in the front yard with a lake to the right of it as you face the
house.” This story represents consistent performance with his 1999 evaluation. It is notable for
reduced grammatical complexity and occasional grammatical errors. He was marginally more
fluent in written vs. oral output.
LANGUAGE
BNT
Kite Picture
Multilingual Aphasia ExamRepetition
Mutlilingual Aphasia ExamToken Test
COWA
FAS
Animals
Raw Score
46
%ile
1
Descriptor
Impaired
Effortful
8
3
Impaired
34
24
Low Average
3
1
Impaired
Impaired
16
12
T-Score
6/28
Z=-1.83
6/27
3) Executive Skills:
Mr. Thomas’ performance on the Trail Making Test A, a test of visual scanning with a
motor component, was in the below average range (6th percentile). His performance on a similar
task requiring speeded search and set-shifting (Trail Making Test B) was also in the below
Re: THOMAS, Colt R.
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December 16, 2003 – Page 4
average range, though marginally better (13th percentile). To assess problem solving skills, Mr.
Thomas was given the Wisconsin Card Sorting Test, which required him to use external
feedback in order to discover the proper rules for sorting cards. He performed within normal
limits on this task, achieving 6 category sorts. Number of perseverative responses, perseverative
errors, and total errors were within the average range. Mr. Thomas showed average performance
on a non-verbal problem-solving task and below average performance on tests requiring speeded
set shifting.
EXECUTIVE FUNCTIONING
Trail Making Test
Part A
Trail Making Test
Part B
WCST
# Categories
Perseverative Responses
Perseverative Errors
Total Errors
FMS
Raw
T
36” 0e
7/35
%ile
Descriptor
6
Below Average
84” 0e
8/39
13
Below Average
6
6
6
12
1
56
55
54
>16
73
70
66
>16
WNL
Average
Average
Average
WNL
Summary of Neuropsychological Findings
Colt Randall Thomas is a 38-year-old Caucasian male approximately 5 years s/p brain
injury to the left frontal lobe secondary to a gunshot wound to the head. He initially showed
symptoms of dysfluent aphasia and right hemiparesis. He was last seen for neuropsychological
evaluation in May 2000. Results during this exam revealed an expressive language disorder,
characterized by difficulty with word finding, repetition, and fluent output. He additionally
demonstrated moderate difficulty understanding complex grammar and higher order abstract
concepts. Current results are consistent with previous findings, suggesting a stable picture of
cognitive functioning. Mr. Thomas presented as largely dysfluent, with effortful, nonspontaneous verbal output. He accordingly performed poorly on tests requiring speeded verbal
output and higher order verbal conceptualizations/abstract thinking. While comprehension
appeared generally intact, with some need for paraphrasing or simplification of instructions, he
had more difficulty with long or grammatically complex sentences. Comprehension may have
been impacted by poor attentional abilities, though, as he was easily distractible throughout
testing. There was a significant discrepancy between verbal and non-verbal functioning on tests
of intellectual functioning and executive functions. This performance differential suggests that
Mr. Thomas has greater difficulty processing verbal (vs. non-verbal) information. These findings
are consistent with residual effects of left frontal brain injury.
Opinions Regarding Competency
Mr. Thomas’ condition appears to be stable since his evaluation in 2000. At that time,
several mental health professionals were of the opinion that he was incompetent to proceed.
However, questions remained about his competency to understand the complex nature of the
judicial process given his behavior in the detention facility (e.g. playing with puzzles). He was
ultimately deemed competent by the judge to stand trial.
Re: THOMAS, Colt R.
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December 16, 2003 – Page 5
In my opinion, Mr. Thomas suffers from residual effects of a left frontal brain injury that
impair his ability to engage in the role of defendant. I address my opinion regarding each facet of
competency as follows:
1) Appreciate charges or allegations:
Mr. Thomas expressed knowledge of the charges against him regarding capital murder
and grand theft. He explained that the burglary charge was “dropped,” as he had
permission to enter his brother’s house and could not break into an open public place. It
is my opinion that he was adequately aware of the charges against him and appreciated
the nature of these charges.
2) Appreciate range and nature of possible penalties:
Mr. Thomas provided appropriate possible penalties for each of the charges against him.
Notably, he listed the “electric chair” as a possible penalty, indicating that he appreciates
he is charged with capitol murder. However, he frequently referenced imprisonment as
the possible penalty throughout the interview. Given Mr. Thomas’ conviction,
sentencing, and time served, I am opinion that he has a greater appreciation for the nature
of the likely outcome of the trial than in previous evaluations.
3) Understand adversarial nature of the legal process:
In my opinion, Mr. Thomas has a cursory understanding of the adversarial nature of the
legal process. He made several comments regarding his distaste for the prosecutor and
judicial process (e.g. “During the trial, [prosecutors] run their mouths”), indicating that
recognizes the adversarial role of opposing counsel. However, given his difficulty
understanding abstract concepts and generally concrete descriptions of the role of
different legal entities, it is my opinion that he lacks a realistic understanding of the
implications of participating in an adversarial system.
4) Disclose to counsel facts pertinent to the proceedings at issue
Mr. Thomas appeared motivated to participate in self-defense. However, he indicated
distrust in his defense attorney, noting that he does not feel as though he can talk to Mr.
Ellis because he “goes back and tells the state.” Additionally, Mr. Thomas reported
persistent amnesia for events surrounding the incident on July 15, 1998. He demonstrated
good recall for facts relayed to him by others regarding the incident. However, he stated
that his first memory of the incident was August 5, 1998, when he was in rehabilitation
following his head injury. To the extent that the defense relied on Mr. Thomas’
recollection of emotional/physical states surrounding the event or a recounting of details
of the event, it is my opinion that Mr. Thomas’ ability to assist counsel would be
significantly impaired. Furthermore, Mr. Thomas demonstrated deficits consistent with
an expressive language impairment. His speech was effortful and dysfluent. In this way,
Mr. Thomas would have difficulty communicating with counsel regarding challenges to
opposing witnesses in situations requiring speeded verbal output. This ability is further
complicated by Mr. Thomas’ noted lack of self-initiated behavior. Finally, Mr. Thomas
demonstrated difficulty with comprehension of complex ideas and complex sentences,
which was aggravated by attentional deficits. Given this difficulty with abstract
understanding, it is my opinion that Mr. Thomas’ ability to communicate with and assist
counsel in formulating a defense is impaired.
Re: THOMAS, Colt R.
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December 16, 2003 – Page 6
5) Manifest appropriate courtroom behavior
Mr. Thomas demonstrated appropriate behavior during testing. He appeared motivated
and appeared to put forth good effort on cognitive test. Though he sometimes required
paraphrasing of instructions or became distracted by irrelevant stimuli, he was able to
appropriately request clarification and complete the task at hand. Therefore, it is my
opinion that Mr. Thomas can manifest appropriate courtroom behavior.
6) Testify relevantly
Mr. Thomas reported persistent amnesia for the events surrounding the incident on July
15, 1998. To the extent that testimony relied on Mr. Thomas’ ability to recount those
events or mitigating emotional/physical factors surrounding them, it is my opinion that
Mr. Thomas would not be able to testify relevantly. Additionally, as noted earlier, Mr.
Thomas demonstrated deficits consistent with an expressive language deficit. These
deficits severely impair fluent speech. While he is understandable, verbal output is
grammatically sparse and does not demonstrate evidence of higher-order
conceptualization. To the extent that testimony relied on fluent speech and understanding
of complex sentences or concepts, Mr. Thomas’ ability to testify relevantly is severely
impaired.
I appreciate the opportunity to conduct this evaluation of Mr. Thomas.
____________________________________
Amanda M. Garcia, M.S.
Graduate Student
Department of Clinical and Health Psychology
University of Florida