Fill Test Data
Student Information
Student's First Name:
Gender:
Male
Female
Other
Introduction
First Sentence
Student was referred for a psychoeducational assessment as part of a three-year re-evaluation in order to update information about his cognitive profile, social/emotional functioning as a student and academic achievement to assist in planning his Individualized Educational Plan (IEP).
Student was referred for a psychoeducational assessment as part of a three re-evaluation in order to update information about his cognitive profile, general functioning as a student, and academic achievement to assist in planning his Individualized Educational Plan (IEP).
Student was referred for a psychoeducational assessment as part of an initial process to provide information about his cognitive functioning, general functioning as a student, and academic achievement and assist in determining if there is a need for an Individualized Educational Plan (IEP) to have success with the regular educational curriculum.
Second Sentence
Presently, Student learns as part of the Language Based Learning program (LBLC) which is designed for students who have previously been identified as requiring systematic instruction in an alternate method for reading skills acquisition such as Ortin-Gillingham or Wilson Reading Program.
Student presently learns within the Student Achievement and Individualized Learning (SAIL) program which provides direct, individualized and explicit instruction to students who face challenges in the general education setting due to their learning and cognitive styles and require a higher need of specialized instruction. Students in this program typically benefit from a multi-sensory approach with step-by-step instruction that is frequently retaught and customized to the students learning style. Small group instruction is provided for major academic subjects as well as reading, counseling, communication and academic support. {self.name} is offered extended school year services within the summer months to reduce the chance of skill regression.
Student receives services within the inclusion-based setting along with peers learning the regular educational curriculum for ##### and within the smaller group setting for ##### for greater levels of support.
Evaluation Procedures
Select All That Apply
Review of Records
WISC-V – Tests of Cognitive Abilities
WIAT-IV – Selected Subtests of Academic Achievement
Conners-4 – ADHD Rating Scales
CTOPP-2 – Tests of Phonological Processing
BASC-3 – Behavioral Rating Scales
BASC-3 BESS – Social/Emotional Screener
BYI-2 – Beck Youth Inventories
D-REFs – Executive Functioning Rating Scales
SRS – Social Responsiveness Scale
SSIS-SEL – Social Skills Rating Skills
NEPSY-2 – Theory of Mind
MASC-2 – Rating Scale of Anxiety
Teacher Surveys and Interviews
Observation and Student interview
WISC-V Test Scores
Full Scale IQ:
Verbal Comprehension Index (VCI)
Verbal Comprehension:
Similarities:
Vocabulary:
Visual Spatial Index (VSI)
Visual Spatial:
Block Design:
Visual Puzzles:
Fluid Reasoning Index (FRI)
Fluid Reasoning:
Matrix Reasoning:
Figure Weights:
Working Memory Index (WMI)
Working Memory:
Digit Span Forward:
Digit Span Backwards:
Include "Jotting information down when processing information may help support his working memory."
Digit Span Sequencing:
Picture Span:
Processing Speed Index (PSI)
Processing Speed:
Coding:
Symbol Search:
WIAT Test Scores
Optional Sections
Include listening comprehension section
Include oral expression section
Reading
Reading Comprehension:
Oral Reading Fluency:
Word Reading:
Pseudoword:
Writing
Essay Composition:
Sentence Building:
Sentence Combining (optional):
Math
Math Problem Solving:
Numerical Operations:
Math Fluency:
Listening Comprehension
Receptive Vocabulary:
Oral Discourse Comprehension:
Oral Expression
Oral Word Fluency:
Expressive Vocabulary:
Sentence Repetition:
CTOPP Assessment
Include CTOPP
Speech Sound:
Isolating Phonemes:
Combinations:
Automatic Naming:
Essay Evaluation
Essay Strengths
Adhering to the subject
Providing supporting information
Separating out thoughts effectively
Utilizing transitional elements
Elaborating on ideas
Separating out ideas into paragraphs
Providing an introductory sentence
Providing a concluding sentence
Utilizing punctuation effectively
Essay Areas for Improvement
Adhering to the subject
Providing supporting information
Separating out thoughts effectively
Utilizing transitional elements
Elaborating on ideas
Separating out ideas into paragraphs
Providing an introductory sentence
Providing a concluding sentence
Utilizing punctuation effectively
Essay Quality Assessment
_____ sentences utilized proper grammar and semantics
All
Many
Only some
The student tended to _____ with mechanical elements such as punctuation and capitalization.
have good success
have mixed success
struggle
The student was _____ with discerning what information was important...
good
fairly good
less successful
The student could organize and condense the information into successful sentences on _____ items.
all
most
several
some
Mathematics Assessment
Successful Calculations
Single digit adding
Single digit dividing
Single digit multiplying
Single digit subtracting
Multidigit adding
Multidigit subtracting
Multidigit multiplying
Multidigit dividing
Long division
Ordering operations
Adding fractions
Simplifying fractions
Basic algebra
Negative integers
Multiplying fractions
Dividing fractions
Calculating percentages
Recognizing money values
Basic probabilities
Recognizing prime numbers
Calculating patterns
Calculating averages
Successful Word Problems
Reading clocks
Reading calendars
One-step word problems involving subtraction
One step division problems
Understanding the physical values of fractions
Identifying ratios
Rotating shapes mentally
Calculating Perimeters
Angles
Longer word problems involving multiple steps
Executive Functioning
Include Executive Functioning
Executive Functioning Scores
Visual Scanning:
Number Sequencing:
Letter Sequencing:
L-N Switching:
Motor Speed:
Additional Assessments
Include paragraph about quick motor skills
Include paragraph about RCFT
DREF Assessment
Include DREF Assessment
DREFS Area
Rater
Within Normal Limits
Within Normal Limits / Borderline
Mild–Moderate Elevated
Severely Elevated
Clinical Areas
Attention/Working Memory
Self
Attention/Working Memory
Teacher
Activity Level/Impulse Control
Self
Activity Level/Impulse Control
Teacher
Compliance/Anger Management
Self
Compliance/Anger Management
Teacher
Abstract Thinking & Problem Solving
Self
Abstract Thinking & Problem Solving
Teacher
Core Areas
Behavioral Functioning
Self
Behavioral Functioning
Teacher
Emotional Functioning
Self
Emotional Functioning
Teacher
Executive Functioning
Self
Executive Functioning
Teacher
Social Emotional Assessment
Include Social Emotional
Self-Reported Traits
Anxiety (being nervous or worrisome)
Attention (being easily distracted and unable to concentrate)
Attitude toward school (reporting dissatisfaction regarding school)
Attitude toward teachers (holding belief that teachers are unfair, uncaring, or overly demanding)
Atypicality (thoughts and behaviors that may be different from other students)
Depression (presenting with feelings of unhappiness, and dejection)
Hyperactivity (being overly active, rushing)
Interpersonal relationships (the perception of having good social relationships with peers)
Locus of control (believing that rewards and punishments are controlled by external events or people rather than themselves)
Relations with parents (possessing a positive regard toward parents and a feeling of being esteemed by them)
Self-esteem (self-respect, and self-acceptance)
Self-reliance (having confidence in his ability to solve problems and be dependable)
Sensation seeking (tendency to take risks and to seek excitement)
Sense of inadequacy (perceiving himself to be unsuccessful in school and unable to achieve his goals)
Social stress (feelings of stress when interacting socially or feeling excluded)
Somatization (physical complaints which may be a result of stress)
Behavioral Traits
Anxiety (being nervous or worrisome)
Attention (being easily distracted and unable to concentrate)
Attitude toward school (reporting dissatisfaction regarding school)
Attitude toward teachers (holding belief that teachers are unfair, uncaring, or overly demanding)
Atypicality (thoughts and behaviors that may be different from other students)
Depression (presenting with feelings of unhappiness, and dejection)
Hyperactivity (being overly active, rushing)
Interpersonal relationships (the perception of having good social relationships with peers)
Locus of control (believing that rewards and punishments are controlled by external events or people rather than themselves)
Relations with parents (possessing a positive regard toward parents and a feeling of being esteemed by them)
Self-esteem (self-respect, and self-acceptance)
Self-reliance (having confidence in his ability to solve problems and be dependable)
Sensation seeking (tendency to take risks and to seek excitement)
Sense of inadequacy (perceiving himself to be unsuccessful in school and unable to achieve his goals)
Social stress (feelings of stress when interacting socially or feeling excluded)
Somatization (physical complaints which may be a result of stress)
Adult-Reported Problem Areas
Activities of daily living (performing everyday tasks)
Adaptability (adapting to changes easily)
Aggression (acting in a hostile manner either verbally or physically that can seem negative or threatening to others)
Anxiety (being nervous or worrisome)
Attention (being easily distracted and unable to concentrate)
Conduct problems (engaging in rule-breaking behavior)
Depression (presenting with feelings of unhappiness, and dejection)
Functional Communication (expressing ideas and communicating in a way others can understand)
Leadership (showing motivation toward academic, social, or community goals, including working with others)
Learning (having academic difficulties, particularly understanding or completing homework)
Social Skills (possessing the skills necessary for interacting successfully with peers and adults)
Study skills (being organized and able to follow through with work)
Somatization (physical complaints which may be a result of stress)
Withdrawal (tending to evade others to avoid social contact)
Teacher-Reported Problem Areas
Activities of daily living (performing everyday tasks)
Adaptability (adapting to changes easily)
Aggression (acting in a hostile manner either verbally or physically that can seem negative or threatening to others)
Anxiety (being nervous or worrisome)
Attention (being easily distracted and unable to concentrate)
Conduct problems (engaging in rule-breaking behavior)
Depression (presenting with feelings of unhappiness, and dejection)
Functional Communication (expressing ideas and communicating in a way others can understand)
Leadership (showing motivation toward academic, social, or community goals, including working with others)
Learning (having academic difficulties, particularly understanding or completing homework)
Social Skills (possessing the skills necessary for interacting successfully with peers and adults)
Study skills (being organized and able to follow through with work)
Somatization (physical complaints which may be a result of stress)
Withdrawal (tending to evade others to avoid social contact)
BASC-3 BESS Assessment
Include BASC-3 BESS
Area Rated
Rater
Normal
Elevated
Very Elevated
Internalizing Behaviors
Student
Teacher
Parent
Externalizing Behaviors
Student
Teacher
Parent
Adaptive Skills
Student
Teacher
Parent
Accommodations & Supports
Learning/Memory
Check-ins for comprehension
Copy of notes/skeletal notes
Pair visual with verbal information
Examples of finished product
Chunk lengthy assignments into parts with clear timelines
Sentence frames/starters
Limit visual clutter on page
Preview of pertinent vocabulary
Word banks
General
Extra time on in-class assignments (up to 50%)
Quality over quantity with assignments when possible
Break assignments into manageable portions with specific due dates
Reduced assignments that emphasize concepts
Provide visual examples
Verbal explanation of visual presentations
Parents may wish to share this report with healthcare providers to provide the best care for the student
Encourage engagement in positive social activities with alike peers (i.e. extracurricular activities, clubs, sports)
Reading
Extra time for reading comprehension
Preview less familiar words in text and instruction
Break down readings and assignments into manageable chunks
Audiobooks when appropriate to follow along for word recognition/decoding
Audiobooks when available
Word banks for word recognition and decoding
Do not penalize for spelling/allow spelling aids
Provide oral reading practice through activities like repeated reading, paired readers, and read along with audio tapes to improve fluency
Text to speech
Written/Verbal Expression
Allow alternate ways to express knowledge (i.e. verbal response vs written, projects)
Wait time for processing
Graphic organizers
Editing checklists
Support speech-to-text when necessary
When given open ended questions, provide choices of response
Word banks
Allow oral presentations within a small group environment
Sentence frames/starters
Math
Highlight key words for math word problems when appropriate
Step-by-step math instruction with frequent repetition and review
Scaffolding previous learned procedures when introducing new concepts
Attention/Organization
Structured Movement breaks/alternate seating options (ex. standing, wiggle seat)
Gain attention prior to instruction or directions
Preferential seating for optimal learning
Seated away from distraction
Repetition when attention is lost
Allow fidgets as appropriate
Small group for assessments
Assignment tracking system
Check-ins for organization
Checklists/visuals for organization
Breaks for movement
Social/Emotional
Reinforce positive choices, effort, and good behaviors
Continued counseling regarding areas identified by the BASC-3
Consideration for accessing an adjustment counselor during the student's school day
Pre-warn for changes in routine
Pre-warn before calling on the student
Access to counselor
Redirection to task
Extended time for assessments
Clear classroom expectations
Positive praise and incentives
Calm structured environment whenever possible
Short breaks
Praise for positive behaviors/work follow through
English Language Learning
Use visuals and real day-to-day items during presentations
Use gestures and body language
Clear, concise instruction with pauses and rephrasing
Write key words and ideas during lectures
Check-ins for comprehension
Keep presentations and assignments short