KENTUCKY COUNTY PUBLIC SCHOOLS
SCHOOL PSYCHOLOGICAL SERVICES
INTEGRATED ASSESSMENT REPORT
RIVERVIEW, KENTUCKY 40000-2212
Oc
January 31, 2012
NAME:
SCHOOL:
PARENT(S):
ADDRESS:
TELEPHONE:
Newstatt, Candace
Westside Elementary
Cindy Newstatt
2232 South 3rd Street #14, 40000
412-3232
Evaluation Procedures
Record Review
Child Developmental History
Parent Interview
Teacher Interview
Intelligence Test
Achievement Test
Behavioral Observations
Communication
Adaptive Behavior
STUDENT ID#:
RACE/GENDER:
DATE OF BIRTH:
C.A.:
GRADE:
YEARS IN SCHOOL:
Person Responsible
E. Maupin school psychologist
C. Newstatt, mother
E. Maupin, school psychologist
E. Maupin, school psychologist
E. Maupin, school psychologist
H. Sowell, consulting teacher
G. Dorchester, counselor
H. Sowell, consulting teacher
S. Jackson, speech/language pathologist
R. Powell, teacher
122033
W/F
07/15/2003
8-4
3
5
Date
12/1/2011
12/2/2011
12/5/2011
12/9/2011
1/9/2012
1/13/2012
1/6/2012
1/12/2012
1/20/2012
1/23/2012
REASON FOR REFERRAL
Candace was referred for a multidisciplinary assessment by her third-grade teacher, Ms. Rachel Powell.
The referral noted concerns about academic performance, cognitive functioning, communication
functioning, and study/work skills. Assessment data will be used to assist in determining if Candace
meets eligibility criteria as a student with a Mild Mental Disability (MMD). In addition, assessment
data will provide assistance and support to teaching personnel in their educational planning.
ENVIRONMENTAL FACTORS
The Child Developmental History form was completed by Ms. Cindy Newstatt, Candace’s mother, on
December 2, 2011. In addition, an interview was conducted by the school psychologist, Ms. Eleanor
Maupin, on December 5, 2011, to review the Child Developmental History and to gather some
additional information from Ms. Newstatt.
Candace is an 8-year-old child who resides with her mother, brothers (ages 10 and 20), sister-in-law (age
16), and niece (age 9 months). Candace’s sister-in-law assists her with homework.
Ms. Newstatt indicated that Candace was born at 39 weeks gestation and was delivered by cesarean
section because she was in the breech position. Candace was reportedly a healthy baby. Candace met
developmental milestones related to sitting, walking, and talking within developmentally appropriate
NEWSTATT, Candace
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time frames but was late to be toilet trained. A family history of mental health, behavioral, or learning
problems was not reported. Within the past 12 months, Candace’s family has experienced one stressful
event that included the addition of a family member, the birth of a niece.
At home, Candace plays outside, plays with toys or non-electronic games, and watches television.
In the community, she visits the library and zoos or parks. Candace is described as a sweet and timid
child. Ms. Newstatt is concerned about Candace’s lack of interest in socializing with other children and
her academic difficulties.
With regard to educational history, Candace did not attend preschool. Candace attended the majority of
kindergarten at Hilltop Elementary in Kentucky County. The family moved to Illinois, where Candace
repeated kindergarten due to a lack of mastery of pre-academic skills. Candace attended two different
schools in Illinois for Kindergarten, first and second grades. The family returned to Kentucky County
where Candace is enrolled at Westside Elementary as a third grader. Candace’s report card from second
and third grade indicated that she earned needs improvement or unsatisfactory marks in reading, writing,
and math.
Candace’s third-grade teacher, Ms. Rachel Powell, completed a Teacher Information Sheet that
indicated the following concerns: well below grade level performance in reading, math, and writing;
presently reading at a kindergarten level; difficulty working independently; difficulty answering
comprehension questions; rarely speaking; and difficulty comprehending whole group instruction.
Candace is able to copy from the board and complete basic/single-digit addition problems. Work
samples were provided and are available for review by the Admissions and Release Committee (ARC).
Prereferral interventions strategies (Response to Intervention Program) were implemented by school
personnel in an attempt to improve performance in reading, math, written language and
receptive/expressive language. Candace participated in Tier II and Tier III math interventions consisted
of direct instruction using manipulatives for counting, cardinality (number order), joining and separating
objects. Weaknesses in retention and generalization impacted Candace’s progress. Following a total of
ten weeks of intervention, Candace was able to count objects 1-20 (100%), recognize written numerals
1-20 (80%) and adding sets 1-10 using manipulatives or her fingers (no regrouping - 80%). She made
limited progress when subtracting sets (numbers 1-10) using manipulatives (no regrouping - 60%).
Further she demonstrated limited understanding of math concepts (attributes of less than, greater than,
equal to 0%).
In the area of reading, Candace participated in Earobics, a multi-sensory, multi-media, individualized
reading program consisting of computer based activities, manipulatives, read aloud and comprehension
instruction. The intervention addresses the following areas: phonological awareness, phonics,
vocabulary building, fluency and comprehension. Candace made progress in Tier II intervention,
however the gap between her performance and grade peers continued to widen. Thus the frequency of
the intervention was increased to daily 40-minute sessions. Following 10 weeks of Tier II and Tier III
intervention, Candace increased three levels within the Earobics program. Given the Developmental
Reading assessment on August 26, 2011 and again on November 10, 2011, Candace progressed from
Level A to Level 2 (Kindergarten range). Candace mastered letter recognition of upper and lower case
letters (90%). Emerging skills include letter/sound correspondence (65%) and recognition of
consonant/vowel/consonant words if presented in word family format (mat, cat, fat, sat - 62%) and
identification of high frequency sight word (Dolch words - 42% Level K). Following multiple
exposures to an instructional level passage, Candace reads 50 words with 18 miscues and answers
NEWSTATT, Candace
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comprehension questions (literal questions at 70% including main idea and key details, retell story), and
(inferential questions at 45% including making prediction, making connections between events,
characters, ideas). Following a read aloud of a grade level text (e.g., literature, science, social studies),
Candace does not volunteer during class discussion of the text. If called upon, she answers factual
questions (30% e.g., main character, setting ) and inferential questions (0% e.g., point of view, moral,
theme, cause/effect.
In the area of written language, for Tier II intervention, Candace received direct instruction in writing
production and conventions Standard English. The teacher use Handwriting Without Tears, a multi
sensory program for letter formation to understand the shape and construction of letters. She used visual
supports, highlighted text, and color coding to reinforce letter production. In four weeks of intervention,
Candace mastered the production of upper case (85%) and lower case letters (90%) when presented with
an alphabet strip at her desk. When the alphabet strip was removed from her desk, performance
decreased and then gradually improved (upper case 80%, lower case 80%). Candace copied single
syllable words (70%) and she progressed to copying a sentence using capital letter and end punctuation
(40%). Candace participated in six weeks of Tier III intervention in Fundamentals of the Sentence
Writing Strategy which is a direct instruction program using visuals, cue cards, teacher modeling and
mastery learning. Candace categorized familiar nouns with picture prompts (person, place, thing) in her
personal word bank at 80%, acted out familiar action verbs (e.g., jump, sit, stand 80%) and constructed
sentences using sentence strips with familiar vocabulary and picture prompts (75%). Candace was
unable to produce a simple sentence independently. During grade level writing prompts, Candace drew
simple pictures and wrote letter combinations (word attempts). With prompts, Candace described the
picture and with teacher assistance, Candace dictated simple sentences.
Candace participated in a Tier II and Tier III direct instruction language intervention entitled Language
for Learning. The intervention consisted of multi-sensory presentation of vocabulary, word forms,
sentence forms, word relationships to improve language skills. Given ten weeks of intervention,
Candace made limited progress in three skill areas: following oral teacher directions (20%), responding
to wh questions (who, where, when 40% - 60%, what, why 10-40%), and sorting objects by category
(40%). Retention of skills from week to week was poor.
ASSESSMENT RESULTS
A graphic representation of the data and specific test scores are found in the last section.
Physical Functioning
On the Child Developmental History form, Ms. Newstatt described Candace’s general health as fair. She
indicated that Candace has allergies to grass and pollen and has asthma. Candace is prescribed Albuterol
(an inhaler) for asthma. In addition, Candace is prescribed eyeglasses that she wears consistently. School
records indicated that Candace passed a hearing screening in December 2011.
Cognitive Functioning
Prior to the assessment, Candace transitioned easily from her classroom to the testing room. Candace
presented as a quiet but cooperative child. For example, she spoke minimally and in a very soft tone of
voice. At times, Candace’s speech was difficult to understand and the examiner often asked her to repeat
phrases. Candace willingly participated in the assessment process. She wore eyeglasses. At times, she
hesitated and tended to look for reassurance from the examiner. During the testing process, Candace
NEWSTATT, Candace
Page 4
demonstrated an appropriate level of attention and put forth good effort. The results of this testing are
believed to be a valid and reliable estimate of Candace’s current cognitive functioning.
Candace was administered the Kaufman Assessment Battery for Children, Second Edition (KABC-II).
The KABC-II is an individually administered, norm-referenced task that measures cognitive abilities for
children ages 3 to 18 using a variety of verbal and visual-motor problem-solving tasks.
Due to referral concerns related to suspected language deficits, Candace was given the Luria Model of
the KABC-II. The Mental Processing Index (MPI) summarized Candace’s overall performance on the
test battery. Candace obtained a well below average range MPI score of 65, which corresponded to a
percentile rank of 1. This means that Candace scored as well as or better than 1 out of 100 children her
age taking the test. When considering the band of error that naturally accompanies any standardized test
score, there is a 95 percent probability that the range of scores 60 to 72 will include Candace’s actual IQ
score.
The KABC-II is further divided into processing subscales, which can provide valuable information on
how a child processes different types of information. The Sequential Processing Scale measures a
student’s ability to solve problems, relying on successive processing, which emphasizes the sequential
order of stimuli. A child is presented with a set of stimuli and must reproduce the stimuli in the exact
order presented. Candace’s overall performance in this area was in the well below average range
(standard score = 66).
Candace’s performance on the Simultaneous Processing Scale was in the average range (standard
score = 87). The Simultaneous Processing Scale requires a student to spatially integrate stimuli, which
is needed to solve problems with maximum efficiency. The input has to be synthesized simultaneously,
such that the separate stimuli are integrated into a group or conceptualized as a whole. The child is
presented with a problem that includes visual stimuli (often complex) and requires some type of spatial
manipulation and nonverbal reasoning to solve correctly.
Candace demonstrated well below average range skills on the Learning Scale, with a standard score of
64. The Learning Scale of the KABC-II addresses an individual’s ability to store and retrieve newly or
previously learned information.
The Planning Scale involves having a student solve a novel nonverbal problem which is designed to be
reflective of the different types of problems taught in school, and must use verbally mediated reasoning
to figure out the answer. Planning ability requires hypothesis generation, revising one’s plan of action,
monitoring and evaluating the best hypothesis for a given problem (decision making), flexibility, and
impulse control. Candace’s performance on this scale was not interpretable due to a significant
difference among subtest scores.
Academic Performance
The Kaufman Test of Educational Achievement, Second Edition (KTEA-II), Comprehensive Form was
administered and scored by Ms. Hannah Sowell, consulting teacher. The KTEA-II is an individually
administered, norm-referenced test of academic achievement.
Letter-word recognition requires the student to identify letters and to pronounce words of gradually
increasing difficulty. Most words are irregular to ensure that the subtest measures word recognition
more than decoding ability. The Reading Comprehension subtest requires the student to read a word
NEWSTATT, Candace
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and point to its corresponding picture. The student reads a simple printed instruction and responds by
performing the action. With more difficult items, the student reads passages of increasing difficulty and
answers literal or inferential questions about them. Candace’s letter-word recognition skills were in the
well below average range (standard score = 66), and her reading comprehension skills were also in the
well below average range (standard score = 68).
A qualitative review of letter-word recognition items indicated that Candace was able to identify upper
and lower case letters. She had difficulty identifying sounds of letters and reading basic sight works (in,
did, have). A qualitative review of reading comprehension items indicated that Candace had significant
difficulty matching pictures to basic sight words and reading sentences.
The Math Computation subtest requires a student to write solutions to math problems printed in a
response booklet, including problems with addition, subtraction, and for older children, multiplication,
division, fractions, and decimals. The Math Concepts and Applications subtest requires a student to
respond orally to test items that focus on the application of mathematical principles to real-life
situations. Skill categories include number concepts, operation concepts, time and money, and
measurement. Candace’s math computation skills were in the well below average range (standard
score = 78), and her math concepts and application skills were also in the well below average range
(standard score = 77).
A qualitative review of math computation items indicated that Candace was able to complete one-digit
addition problems. She was unable to complete one-digit subtraction problems. She understood some
problems that included number concepts and basic graphs.
Within the Written Expression subtest, students Candace’s age are asked to complete writing tasks in the
context of an age-appropriate storybook format. Tasks at those levels include writing sentences from
dictation, adding punctuation and capitalization, filling in missing words, and writing a letter that
summarizes the story. Candace’s performance in this area was in the well below average range
(standard score = 40). Candace’s performance on the Spelling subtest was also in the well below
average range (standard score = 71).
A qualitative review of written expression items indicated that Candace was able to write her first name
appropriately and recognize upper and lowercase letters. She had difficulty writing simple words,
applying capitalization and punctuation rules, and writing sentences.
Behavioral Observations
On January 6, 2012, Candace was observed by Ms. Georgiana Dorchester, counselor, for 30 minutes in
her general education classroom. During the observation, students participated in a math lesson about
rounding place values to the nearest 10 and 100. Candace sat at her desk and quietly looked about the
room as the teacher showed examples on the Smartboard. When the teacher asked the class to round 799
to the nearest 10, Candace copied the question and then sat unsure as if waiting for the student next to
her to complete his answer. She did the same thing for the next question, 681 rounded to the nearest 10.
It appeared as if Candace did not know what to do despite the teacher showing a few examples on the
Smartboard. As the students worked on finding the answer to the second question, the teacher tried to
assist Candace. She pointed to 681 and asked Candace to say the number but she was unable to do so. In
trying to prompt her to say the number, the teacher held up eight fingers and told her to count by tens.
Candace replied 10, 11, instead of 10, 20. The teacher had to use many prompts to get Candace to say
the number 681. The teacher showed her 324 and asked the same question. She said three hundred but
again needed prompts to say the 24. The teacher again said that the 2 was in the tens spot but Candace
was still not able to say the number sentence. Candace was able to transfer the answers from the
NEWSTATT, Candace
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Smartboard once the teacher wrote the answers but seemed to not have any idea how to go about
answering the questions on her own.
On January 12, 2012, Candace was observed by Ms. Hannah Sowell, consulting teacher, for 30 minutes
during a guided reading lesson. During the observation, Candace sat at a table with four other students
as the teacher reviewed the unfamiliar words that were in the day’s story (Candace’s instructional level).
The teacher said each word and asked the students to repeat after her. Candace would move her lips to
give the appearance that she was actually saying the words but she was not. Next, the teacher went
around the table asking each student to say one of the words. When it was Candace’s turn to say ‘come’,
she needed prompts to sound out most of the letters. This happened again when Candace had to sound
out ‘flying’, this time the teacher had to help her sound out f/l/y/ and the ‘ing’ chunk. After sounding out
f/l/y and ing Candace still needed help putting it all together to say the word. The teacher then asked the
students to get their books to read the story Flying is Fun. She next told the students to turn to page 63
and Candace and another student needed help finding the page. Candace appeared to be following along
in the book by using a piece of paper to guide her as the students read. When it was her turn to read, she
needed help with several words in the sentence. When asked to read with the group, Candace moved her
lips and gave the appearance that she was reading.
Communication Functioning
Candace was referred for a language evaluation by her classroom teacher, Ms. Rachel Powell, due to
concerns regarding her auditory comprehension and oral expression in the classroom environment.
Results of standardized and non-standardized assessments indicate a severe language disorder.
Candace demonstrated a strength in identifying word relationships by pointing to pictures. Testing
revealed severe deficits in the following areas: following directions, sentence comprehension, use of
various grammatical structures, memory for language (recalling sentences subtest), sentence
formulation, and expressive vocabulary. Non-standardized testing revealed that Candace has challenges
with knowledge of basic concepts, answering “wh” questions, labeling categories, sequencing 3-step
picture events, formulating simple sentences, and using age-appropriate word structures in her
conversational speech.
Candace was cooperative during the testing situation and the results of the assessment are felt to be an
accurate estimate of her language abilities.
Teacher interviews confirm the presence of a severe language disorder that negatively affects Candace’s
ability to comprehend classroom instruction, follow directions, answer “wh” questions posed by the
teacher, and formulate sentences in her oral speech and written work.
Social and Emotional Competence
The Vineland-II Adaptive Behavior Scales: Teacher Rating Form was completed by Candace’s teacher,
Ms. Rachel Powell, in order to obtain her perceptions of Candace’s independent skills in the areas of
communication, daily living skills, and socialization skills. Ms. Powell rated Candace’s overall adaptive
behavior in the well below average range (Adaptive Behavior Composite = 61) when compared to sameage peers. Candace’s communication skills, which include receptive, expressive, and written skills,
were in the well below average range (Communication = 54). Candace appeared to be able to state her
correct age and copy her name. In contrast, she had difficulty telling about her experiences and asking
questions. For Candace’s personal, domestic, and community functioning, she appeared to be in the
well below average range (Daily Living Skills = 62). Candace appeared to be able to say numbers in a
NEWSTATT, Candace
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sequence and follow simple rules. In contrast, she had difficulty saying the days of the week, saying the
current month, telling time, and staying on task without seeking the teacher’s approval. Candace’s
socialization skills, which include personal, domestic, and community functioning, were in the well
below average range (Socialization = 72). Candace appeared to be able to play with others and share.
In contrast, Candace had difficulty expressing emotions and talking to others about shared interests.
Interviews were conducted with Candace’s mother and teacher to obtain additional information about
her adaptive behavior. In the home setting, Ms. Newstatt indicated that Candace speaks softly and
minimally. She often stays very close to her mother and is dependent on her mother for basic tasks such
as selecting her clothing and tying her shoes. Candace does not show an interest in playing with similarage peers. Candace tends to not want to complete chores. She has difficulty remembering information
such as telephone numbers and directions for homework. At school, Candace speaks minimally and is
hesitant to respond to questions. She has difficulty understanding directions. Even with assistance from
the teacher, Candace struggles to understand concepts and complete work. Most of the papers that
Candace turns in are blank.
ASSESSMENT SUMMARY
Candace is an eight-year-old-child who attends third grade at Westside Elementary. Candace was
referred for a multidisciplinary assessment due to concerns with academic performance, cognitive
functioning, communication functioning, and study/work skills. The purpose of the evaluation is to
determine if Candace meets eligibility criteria as a student with a Mild Mental Disability (MMD) and to
assist in planning for Candace’s educational needs.
Results of this evaluation indicated that Candace performed in the well below average range in general
cognitive ability, and the well below average range in adaptive behavior skills. Candace achieved at the
well below average range in letter word identification, reading comprehension, and written expression.
She achieved in the below average range in math concepts/applications and computation. Classroom
observations indicated that Candace had difficulty understanding reading and math tasks, even with
added explanation and support. A communication assessment indicated that Candace exhibited a severe
language disorder.
It is important to review all information collected for this assessment report. Candace scored in the well
below average range on cognitive, adaptive, and academic measures. Other factors reported may have
impacted Candace’s performance on standardized instruments and in the classroom. Factors include
Candace’s lack of participation in preschool, history of poor school attendance, and multiple school
placements. These factors in addition to standardized test scores should be discussed at the ARC
meeting.
The committee should consider that the information gathered in this report is one component of the total
material to be discussed by the Admissions and Release Committee (ARC). Members of the committee
must consider all relevant data presented at the meeting before making a final placement decision.
SUGGESTED EDUCATIONAL STRATEGIES
1.
Reinforce word attack and phonic skills with emphasis on medial sounds and word patterns.
Activities that require Candace to match initial consonants with ending sounds would be
beneficial. Increase sight word vocabulary and word meaning through use of word bingo and
other games, flashcards, and puzzles.
NEWSTATT, Candace
Page 8
2.
As basic sight words (such as those found on the Dolch Basic Sight Words Lists) make up such a
large percentage of words found in reading materials, these words should be presented and
reinforced heavily by the use of the language-experience approach, games, flashcards, wide
reading of easy but valuable literature, tactile approaches, writing strategies, and activity sheets.
3.
The single most important way to develop and improve reading ability is to have Candace read
interesting, self-selected good literature on her independent or low instructional reading level.
Encourage Candace to check out books from the library to read for pleasure.
4.
To improve reading comprehension, provide practice in using picture and context clues, recalling
factual details, identifying the main idea, sequencing events, drawing conclusions, making
inferences, and predicting outcomes. Develop reading vocabulary skills involving synonyms and
antonyms, and improve classification and generalization abilities.
5.
Continue to work on computation skills. The use of manipulatives may be especially helpful for
Candace as, when using her fingers, she does not know what to do when she deals with numbers
above five. For interest, consider varying the manipulative objects used (buttons, beans, checkers,
etc.). Gradually move into semi-concrete, varying the graphic representations (tallies, circles, etc.)
to provide more interest. Finally, with abstract activities, vary the format (presented verbally,
presented horizontally, presented vertically, etc.).
6.
Some strategies to try to improve memory are as follows:
a.
Try to make the material to be learned significant and relevant to Candace.
b.
Give meaning to rote data to enhance comprehension and learning.
c.
Regularly summarize information as it is being taught.
d.
Give multisensory presentations.
e.
Reinforce information presented with pictures or other visual images.
f.
Control the amount of information presented at one time.
g.
Use overlapping techniques, such as repetition and rehearsal.
h.
Have Candace overlearn material.
i.
Couple new information with previously learned information.
j.
Teach Candace to use one or more of the following techniques: visual imagery, “chunking”
techniques (organizing information into easily retrieved segments), association techniques,
and mnemonic devices, such as acronyms, repetition and rehearsal techniques.
NEWSTATT, Candace
Report prepared by:
Eleanor X. Maup
School Psychologist
Office: (502) 786-7777
E-mail address: eleanor.maupin@kentucky.kyschools.us
Page 9
NEWSTATT, Candace
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GRAPHIC REPRESENTATION
Well
Below
Average
Percentile Rank
Standard Score
0.1
55
Below
Average
2
70
16
85
CURRENT TESTING:
KABC-II
MPI ---------------------X
Sequential ---------------X
Simultaneous ---------------------------X
Learning ----------------X
KTEA-II
Ltr and Word Recog -------X
Reading Compr -------------X
Math C/A ------------------------X
Math Computation -----------------X
Written Express --<X
Spelling --------------------X
VINELAND-II (TEACHER)
Composite -------------X
Communication -----X
Daily Living Skills ---X
Socialization ----------------X
Average
50
100
Above
Average
84
115
98
130
Well
Above
Average
99.9
145
NEWSTATT, Candace
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CURRENT TEST SCORES
All summary scores are presented in standard scores or converted standard scores. The average is
85-115 unless otherwise noted. Most subtests within an instrument are reported in scaled scores where
the average is 7-13.
KAUFMAN ASSESSMENT BATTERY FOR CHILDREN, SECOND EDITION (KABC-II)
Model: Luria ages 7-18
A measure of cognitive abilities which assesses a student’s problem-solving processing styles and
acquired basic skills.
Global Scale
Mental Processing Index
Scale
Sequential
Simultaneous
Learning
Planning
Standard Score
65±3
66±5
87±5
64±4
*
Bold denotes core subtests.
Subtest
Sequential
Number Recall
Word Order
Simultaneous
Rover
Triangles
Learning
Atlantis
Rebus
Planning
Story Completion
Pattern Reasoning
Scaled Score
4
4
7
9
4
3
1
8
*not interpretable due to significant difference between subtest scores
NEWSTATT, Candace
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KAUFMAN TEST OF EDUCATIONAL ACHIEVEMENT, SECOND EDITION (KTEA-II)
COMPREHENSIVE FORM
A measure of basic academic skills
Reading Composite
Letter and Word Recognition
Reading Comprehension
Math Composite
Math Concepts and Applications
Math Computation
Written Language Composite
Written Expression
Spelling
Standard Score
66±3
66±3
68±4
74±3
77±4
78±4
56±4
40±6
71±4
VINELAND ADAPTIVE BEHAVIOR SCALES: SECOND EDITION,
TEACHER RATING FORM
A measure of an individual’s performance of personal and social sufficiency for student in a
structured school setting. Subdomain scores are reported as V-scores. V-scores between 12 and 17 are
in the average range.
Respondent: R. Powell, teacher
Adaptive Behavior Composite: 61±2
Domain
Communication
Receptive
Expressive
Written
Standard Score
54
V-Scale Score
7
7
8
Daily Living Skills
Personal
Academic
School Community
62
Socialization
Interpersonal Relationships
Play and Leisure Time
Coping Skills
72
12
6
8
8
13
9