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time to solve problems. Even when the examiner told him she would be keeping track of how long it took him, Rob did not work quickly. He appeared more interested in focusing on accuracy than on speed. The exception was on a task in which he was told to work quickly and if the examiner asked him what his answer was, he was to tell her. On this task, he answered quickly, appearing to not want to run out of time to respond.

Even though Rob worked very slowly on many tasks, he did not appear to struggle, except on tasks that required handwriting or paper and pencil copying tasks. On these tasks, he frequently erased, made letters and numbers that were di cult to read, and had poor spacing on the line or page.

Rob did not show any obvious signs of inattention or di culties with sustaining his focus. In fact, he demonstrated good attention and concentration. No fidgety behaviors or extraneous motor movements were observed.

Given that Rob appeared motivated to do well and showed good attention and concentration, this evaluation is deemed a valid estimate of his current cognitive and academic abilities.

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ASSESSMENT PROCEDURES AND TESTS ADMINISTERED

Clinical interview with mother Review of records

Behavior Assessment System for Children–Second Edition Parent Rating Scales–Adolescent (BASC-2, PRS-A)

Behavior Rating Inventory of Executive Function, Parent Form (BRIEF) Kaufman Assessment Battery for Children–Second Edition (KABC-II) Kaufman Test of Educational Achievement–Third Edition (KTEA-III) Nelson Denny Reading Test

Wechsler Intelligence Scale for Children–Fifth Edition (WISC-V)—selected subtests (a summary of all test scores is provided in Tables 6.25–6.29)

Results

Cognitive Abilities

Rob was administered the KABC-II to obtain a comprehensive picture of his mental processing and cognitive abilities. The KABC-II o ers five scales:

1.Sequential/Gsm (short-term memory)

2.Simultaneous/Gv (visual processing)

3.Learning/Glr (long-term storage and retrieval)

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4.Planning/Gf (fluid reasoning)

5.Knowledge/Gc (crystallized ability)

These five scales can be interpreted from two di erent perspectives: (1) a neuropsychological theory that focuses on attention, coding and storing information, and planning behavior (while de-emphasizing acquired knowledge), or (2) from the perspective of a data-driven (CHC) theory that divides abilities into those specific cognitive abilities listed parenthetically above.

In Rob’s case, his cognitive abilities were interpreted from the perspective of the data-driven theory because his primary language is English, and the fact that his referral reason was to diagnose any processing or learning disability. Using this interpretive perspective, Rob’s global measure of general cognitive ability was assessed by a combination of all five of the scales.

Rob’s overall mental processing ability was in the Average range, as he earned a KABC-II Fluid Crystallized Index (FCI) of 107, ranking him at the 68th percentile. The chances are 90% that his true FCI is between 103 and 111. However, looking closely at Rob’s skills revealed that his overall ability was just an average of highly discrepant skills and not a meaningful measure of Rob’s global abilities. Specifically, Rob demonstrated a 41-point di erence between his lowest and highest index scores, which is variability of large magnitude. Therefore, it is more meaningful to examine his performance on the separate indexes to gain a better understanding of his cognitive

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on his performance on two scale indexes: He earned a standard score of 91 on the Sequential/Gsm Index (27th percentile), and a standard score of 94 on the Learning/Glr Index (30th percentile). Although Rob’s abilities are in the Average range, indicating that his short-term memory abilities and his associative memory abilities are all comparable to others his age, these skills are areas of relative weakness for him. Rob’s short-term memory skills were shown on two tasks: (1) a task in which Rob was to repeat numbers presented verbally; and (2) a task in which he touched a series of silhouettes of common objects in the same order as the examiner said the names of the objects. His long-term memory ability was tapped in a task (Atlantis) that required him to learn nonsense names assigned to pictures of fish, plants, and shells, and a subtest (Rebus) requiring him to learn a new language, namely to associate new visual symbols with familiar words and to read sentences composed of these symbols. Even though Rob performed in the average range, he had some di culty initially learning the material. However, the tasks provided repeated exposure. One task gave corrective feedback and the other

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enabled him to use context to help him. However, if he did not respond within 5 seconds, the examiner either told him to skip it or told him the answer. Thus, he was penalized for slower responding. Overall, Rob’s memory abilities were a personal weakness for him, even though they are still average compared to same-aged peers.

Rob demonstrated a personal strength in his knowledge based on what he has obtained through his environment. This personal strength was evident on his Above Average performance on the Knowledge/Gc Index, on which Rob earned a standard score of 115 (84th percentile). This index comprises tasks such as (a) a task of verbal knowledge in which the examiner said a word or asked a question and the was to point to the picture that showed what the word meant or showed the best answer (Verbal Knowledge), and (b) a task in which the examiner verbally provided several characteristics of a concrete or abstract verbal concept and Rob had to name it (Riddles). Rob worked slowly, spending ample time thinking about his responses (neither task was timed); however, he asked for very few questions to be repeated.

Rob’s nonverbal problem-solving skills were a significant normative strength for him, as evidenced by his standard score of111111111132 (98th percentile) on the Planning/Gf Index, which is in the Upper Extreme range. Tasks that comprise this index include a test in which he was shown a row of pictures that tell a story and he was to complete the story with pictures he was given (Story Completion), and a task in which he was shown a series of stimuli that form a logical, linear pattern with one stimulus missing; he was to complete the pattern by selecting from an array of 4 to 6 options (Pattern Reasoning). It should be noted that typically, these tasks are timed, with bonus points being awarded for quick performance. However, given Rob’s significant di - culty with timed tasks, his performance was scored without time restrictions. Without time constraints, Rob’s nonverbal reasoning skills are extremely high; however, when scored with the bonus points for quick responding, his performance would be in the average range (standard score of 99; 47th percentile). This clearly demonstrates one of the ways Rob’s slower speed of processing and responding interferes with his success if he is expected to work quickly.

Rob’s visual processing and problem-solving was in the Average range. Rob earned a standard score of 100 (50th percentile) on Simultaneous/Gv Index, indicating average visual processing and visual-motor skills. Both tasks are also timed, but there is not an option to score the task without timing (as can be done for the Planning/Gf Index). On one task in which Rob was shown a stack of blocks with some partially

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hidden and he was to count how many blocks he saw (Block Counting), he responded more quickly. On this task, the examiner told him that when time was up she would ask him to say his answer. This task was the only task on which he appeared to work more quickly, although he worked slowly before these directions were given. Furthermore, he made numerous errors when rushing. On the second task in which he was to move a toy dog on a grid to get its bone using the shortest path (Rover), Rob worked slowly and lost points for running out of time. Thus, it is likely that if Rob were not rushed and not penalized for slower responding, his overall visual processing abilities would be significantly higher than his Simultaneous/Gv Index reflects.

Because Rob has a history of di culties with handwriting and visual-motor integration, he was administered several supplemental paper-and-pencil tests, both timed and untimed. He was administered the Beery Buktenica Developmental Test of Visual Motor Integration (VMI), a paper-and-pencil design copying test (untimed). Rob earned a VMI standard score of 63 (1st percentile), which is in the Low range. Rob was also administered two tasks that make up the Processing Speed Index (PSI) from the Wechsler Intelligence Scale for Children–Fifth Edition (WISC-V). On the PSI, a measure of clerical speed and accuracy, Rob earned a standard score of 56, which is in 2nd percentile and in the Low range, indicating impairment in his ability to fluently and automatically perform relatively easy cognitive tasks, when under time pressure. Rob’s ability was assessed by two tasks—one required him to quickly copy symbols that were paired with numbers according111111111 to a key (Coding), and the other required him to identify the presence or absence of a target symbol in a row of symbols (Symbol Search). As mentioned previously, Rob appeared more concerned with accuracy than with working quickly. He did not make any errors, but he worked extremely slowly, referring to the key for each code rather than using his memory to aid him (Coding).

Academic Achievement

To assess Rob’s academic achievement in reading, math, oral language and written language, he was administered the KTEA-3, which is an individually administered test of academic achievement. Rob’s academic skills range from above average in some select areas to very low in other areas. Therefore, it is important to examine Rob’s performance within each area to fully understand his di culties and his areas of strength.

Rob’s reading skills were mostly consistent with the exception of one area, Silent Reading Fluency. He performed in the Average range when he was reading real words (61st percentile on Letter and Word Recognition; 39th on Word Recognition Fluency) and reading made-up words (68th percentile on Nonsense Word Decoding; 37th on Decoding Fluency), although his performance was markedly better on the untimed reading tests as compared to the timed tests. His reading comprehension skills were also estimated in the Average range (45th percentile on Reading Comprehension). He exhibited a skill strength in his literal reading comprehension.

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However, when quickly reading simple questions and indicating whether each is true or false, Rob performed in the Below Average range (13th percentile on Silent Reading Fluency), which is a personal weakness for him.

Rob was also administered the Listening Comprehension subtest, in which he listened to passages spoken aloud and then he answered questions read by the examiner. Rob earned a standard score of 90 on the Listening Comprehension subtest (25th percentile), which is in the low Average range. In comparing Rob’s understanding of what he reads to his understanding of what he hears via passages, there is no significant di erence. However, an analysis of Rob’s errors indicates a specific skill weakness in inferential listening comprehension (having to infer or predict the answer).

Rob was also administered a Written Expression subtest to assess his ability to complete sentences, use punctuation, and write his own sentences and a short essay. Rob earned a standard score of 110 (75th percentile). However, on the untimed portion, he spent a significant amount of time writing sentences. When asked to write a short

punctuation was identified as a specific skill weakness.

Rob’s performance on the Mathematics Composite reveals consistently Above Average to Superior skills both in his computation skills (93rd percentile) and in his ability to apply mathematical principles to solve word problems (87th percentile on Math Concepts & Application). Even though Rob performed quite well on both of the math tasks and he did not have any skill weaknesses, it should be noted that the errors he did make were primarily simple computational or careless errors (e.g., 7 × 0 = 7; transferring the wrong number/answer from his scratch paper).

To further examine Rob’s academic fluency skills, he was administered several timed tasks from the KTEA-3: Silent Reading Fluency, Decoding Fluency (both mentioned briefly earlier), Math Fluency, and Writing Fluency. These fluency tasks involve solving simple arithmetic problems (the four basic operations); reading a list of made-up words; creating simple sentences to describe a picture. On the Academic Fluency Composite, which combines decoding fluency, math fluency and writing fluency, Rob earned a standard score of 80 (9th percentile), which is in the Below Average range. His fluency di culties were most evident in the areas of