CONFIDENTIAL (THIS REPORT CONTAINS PERSONAL INFORMATION WHICH MAY NOT BE RELEASED TO UNAUTHORIZED PERSONS) PSYCHOEDUCATIONAL ASSESSMENT (all

names have been changed)

Name: Carl Smith Date of Birth: Age: 24 years, 3 months Phone Number: DATE OF REPORT: May 11th, 2012

Dates of Assessment: April 24th, 27th, 2012 REASON FOR REFERRAL

Carl was referred by his counsellor for a psycho-educational assessment in order to better understand his strengths and challenges, in hopes that such understanding would assist Carl as he looks for employment. BACKGROUND INFORMATION Background information was obtained during an interview with Carl and his brother, Luke, on April 19th, 2012. Carls parents were also contacted via email with Carls permission, and his mother responded with background information on Carls development. Carl grew up in another province with his parents and two brothers, and moved to BC in 20xx. He currently lives with his two brothers in BC. Carl noted that he gets along well with both of his brothers, and that they have a regular routine at their home which helps to keep him on task in regards to household chores. Carl enjoys video games and using the internet. Luke noted that Carl is very good at niche internet research. Carl did not describe any friends of his own, but said he did spend time with his brothers friends. Mrs. Smith confirmed his good attention to detail, his artistic talents and his strong memory for information that interests him. Carl has been trying to find work, but has found it difficult to keep a job. He has previously worked as a sales associate, in data entry and as a kitchen worker. He noted that he likes meeting people but does not enjoy physical labour. During a follow-up conversation, he mentioned that he believed he had lost at least two previous jobs due to his inability to meet the physical demands of the job. He feels he would have more success if he was able to find a job that he really enjoyed. Luke mentioned that Carl is interested in voice acting and agreed that it would be good for Carl to find work that interests him. He noted that in another province, Carl

worked as a volunteer doing video editing, a role he enjoyed. Luke also commented that Carl was good with his hands, but often took longer than average to complete a task, and sometimes completes tasks in unconventional, but effective, ways. He also noted that Carl has a good memory for things he enjoys (such as movie quotes), and has good attention to detail (puzzles, plasticine sculptures). Luke said that Carl was able to be very autonomous if he had a high interest level in the task. Mrs. Smith noted that Carl has difficulty gauging other peoples reactions and emotions, and that while he tries to be polite, he doesnt understand and follow certain social norms, like waiting his turn. Carl noted that he was a healthy child other than having asthma. His mother confirmed only minor childhood illnesses, including asthma, ear infections and bronchitis, as well as mild allergies which cleared up around age 7. Carls mother indicated that her pregnancy with Carl was normal. Luke noted that while Carl met motor milestones on time, he was delayed with speech, stating that Carl could write before he could talk. Mrs. Smith confirmed that Carls speech was delayed, noting that he did not speak much before age 5, and even at age 6, was still only using simple sentences. Carl received speech therapy both before he entered school, and on through elementary school. She also noted that he walked later than his brothers and that he was delayed with toilet training. Mrs. Smith noted that a female paternal relative is believed to be on the autism spectrum, although this relative has never been officially diagnosed (and is high functioning). Mrs. Smith also noted that she experienced significant bouts of depression during Carls childhood. Carl commented that school went well. He had some tutoring support in writing in high school, and found writing essays particularly difficult. He enjoyed art and math, and spending time with his friends. Mrs. Smith confirmed that help at school only began in Grade 10 and was focused on helping him to stay on track throughout the day, rather than specific tutoring. PREVIOUS ASSESSMENTS While Carl could not recall any previous assessments, Mrs. Smith noted that he had undergone a variety of assessments while he was growing up. Carl was seen by a child psychologist at age three, and was diagnosed (as per Mrs. Smiths description) with Aspergers Syndrome at age nine or ten. Due to the remote location in which the family lived, little resources were available in terms of support. Mrs. Smith also noted that Carl had other evaluations completed, such as a hearing test, but none resulted in further interventions. Copies of Carls previous assessments were unavailable at the time of this assessment. ASSESSMENT MATERIALS Wechsler Adult Intelligence Scale Fourth Edition: Canadian (WAIS-IV) Woodcock-Johnson: Tests of Achievement Third Edition (WJ-III Ach) Wide-Range Assessment of Memory and Learning Second Edition (WRAML2), selected sub-tests Behavior Assessment System for Children 2nd Edition (BASC-2) parent & self-report forms Vineland Adaptive Behavior Scales, Second Edition (Vineland-II)

BEHAVIOUR DURING ASSESSMENT During the assessment process, Carl was cooperative and hard working. He put forth good effort on all tasks, was polite, and maintained good focus. Carl did demonstrate some frustration with himself and his abilities on more difficult tasks, and at times expressed concern about whether or not he was doing well. He often apologized to the examiner for taking too long or his anxiety increased when he was unable to figure out a task, or if he felt he was working too slowly. While Carl answered all questions and participated in all tasks, his responses were terse, he spoke in a monotone voice and he did not initiate any discussion or conversation with the examiner. He did talk to himself at times, and on multiple occasions continued to ruminate out loud about a previous question or task. Carl did not sustain eye contact and repetitively twisted his beard hair throughout the assessment process. Carl displayed intense focus on tasks that he excelled at and was unwilling to give up on any task until he had at least attempted to figure out the answer. Overall, Carl put forth good effort on all tasks, and it is believed that the results of this assessment are an accurate reflection of his current level of cognitive and academic functioning. ASSESSMENT RESULTS AND INTERPRETATION Cognitive Functioning The Wechsler Adult Intelligence Scale (WAIS-IV) was administered to assess Carls current functioning in areas of verbal and non-verbal reasoning and cognition. The WAIS-IV attempts to measure the strategies that Carl uses when faced with a problem that he has not been taught to solve. These abilities are thought to reflect the individuals schooling as well as more general experiences outside of school. The WAIS-IV has four indices, the Verbal Comprehension Index, Perceptual Reasoning Index, Working Memory Index, and Processing Speed Index. Each of these indices is comprised of several subtests measuring a variety of abilities related to cognitive functioning. The Verbal Comprehension Index measures language expression, comprehension, and the ability to apply these skills to solving problems. The Perceptual Reasoning Index assesses nonverbal problem solving and perceptual organization. The Working Memory Index assesses attention skills and the ability to actively maintain information in conscious awareness while performing some operation or manipulation with the information. The Processing Speed Index measures the speed of information processing. It is important to recognize that the WAIS-IV measures only a portion of human intelligence and is best thought of as a predictor of school achievement. A summary of Carls scores on the WAIS-IV is presented below. The average subtest scaled score ranges from 7 - 13. For Index scores, standard scores between 85 and 115 are within the Average range or normal limits ( 1.0 standard deviation). The following are Carls scaled scores on the WAIS-IV subtests administered. Verbal Comprehension Subtests Scaled Score Percentile Perceptual Reasoning Subtests Scaled Score Percentile

Similarities Vocabulary Information (Comprehension) Working Memory Subtests

13 9 10 7 Scaled Score

84th 37th 50th 16th Percentile

Block Design Matrix Reasoning Visual Puzzles Processing Speed Subtests Symbol Search Coding

10 15 13 Scaled Score

50th 95th 84th Percentile

Digit Span 8 25th 12 th Arithmetic 6 9 5 th (Letter-Number Sequence) 9 37 ( ) supplementary subtest score not included in the computation of Index scores Index Verbal Comprehension Perceptual Reasoning Working Memory Processing Speed General Ability Index Standard Score 103 116 82 91 111 Percentile 58th 86th 12th 27th 77th Classification Average High Average Low Average Average High Average

75th 5th

Due to the significant discrepancies between Carls individual Index Scores, the General Ability Index (GAI) is the best representation of Carls overall cognitive abilities. Carls performance on the WAIS-IV showed a GAI at the 77th percentile (in the high average range). Carls Verbal Comprehension scores were at the 58th percentile (in the average range). Carls performance on the tasks in this domain showed significant variability. Carls ability to compare how objects were alike was at the 84th percentile (high average range). He was able to define words (37th percentile; average range) and to answer general knowledge questions (50 th percentile, average range). An additional, supplemental activity, in which Carl was asked to demonstrate his social reasoning skills, proved more difficult for Carl, as he scored at the 16th percentile (low average range). Overall, these scores demonstrate that Carls ability to express himself verbally is at the expected level for his age, but he has more difficulty when social understanding is needed. Carls Perceptual Reasoning scores were at the 86th percentile (in the high average range). These activities measured Carls ability to reason using non-verbal abilities, such as visual-spatial awareness and visual reasoning. Carl performed very well in all activities in this domain, in particular on a task that measured his ability to understand and complete a pattern or sequence, where he scored at the 95th percentile (in the superior range). Carl was also able to use his visual-spatial abilities to correctly choose 3 pieces that fit together to create a given shape (84th percentile; high average range) and to use blocks to recreate a given pattern (50 th percentile; average range). Carl demonstrated excellent perseverance and attention in all activities in this domain. Overall, these scores indicate that this is an area of strength for Carl. Carls Working Memory scores were at the 12th percentile (in the low average range). Carl was able to repeat a group of numbers forwards, backwards, and in numerical order (25 th percentile;

average range) and to remember and reorder groups of numbers and letters (37 th percentile; average range). Carl did better on these tasks when he needed to manipulate the information (such as reordering numbers), indicating that Carl may better remember information that he needs to think about and process, rather than simple recite. Carl had more difficulty on a task that required him to remember and solve a math problem (9th percentile, low average range), however his achievement on this task appeared to be affected more by his math abilities, than by his memory. Overall, Carls ability to retain and work with information in his short-term memory is lower than expected for his peer group, but may be affected by both the type of information he is asked to recall and the type of processing he is asked to do. Carls Processing Speed score was at the 27th percentile (in the average range). Carl was easily able to scan, discriminate and match symbols quickly (75 th percentile; average range). However, he struggled significantly when asked to quickly copy and transfer symbols associated with a given key (5th percentile, borderline range). Carls performance on the latter task was affected by his lack of focus, as throughout the timed activity, he continued to ruminate on the questions from the previous task. While he was able to be redirected, this distraction may have been the cause of the significant difference in scores in this domain. Overall, Carls ability to process information quickly during a pencil and paper task is at the expected level for his age. Academic Functioning The Woodcock-Johnson: Tests of Achievement Third Edition (WJ-III) is designed to measure current levels of academic achievement across reading, mathematics, and writing. Standard Scores have an average range of 85-115 (1 standard deviation) while percentiles indicate the percentage of students Carls age who would receive the same score or less. A number of subtests from the WJ-III were administered to obtain a current measure of Carls achievement skills relative to the performance of other students his age. Subtest Letter-word identification Passage Comprehension Reading Fluency BROAD READING Math Fluency Calculation Applied Problems BROAD MATH Spelling Writing Samples Writing Fluency BROAD WRITTEN LANGUAGE Standard Score 94 97 114 100 69 75 88 79 103 108 88 100 Percentile 34th 41st 82nd 49th 2nd 5th 22nd 8th 57th 71st 22nd 51st Classification Average Average High Average Average Very Low Low Low Average Low Average Average Low Average Average

Story Recall Story Recall Delayed Understanding Directions STANDARD ORAL LANGUAGE TOTAL ACHIEVEMENT

92 99 89 90 94

29th 48th 24th 25th 34th

Average Average Low Average Average Average

In Reading, Carl scored at the 49th percentile (in the average range). His ability to read a passage for speed and accuracy was at the 82nd percentile (in the high average range). Carl was also asked to read a random list of words (34 th percentile; average range) and to answer comprehension questions after reading a short passage (41st percentile; average range). Overall, Carl is able to read at a level typical for his age, and his ability to read quickly is a relative strength. In Mathematics, Carl scored at the 8th percentile (low range). When asked to solve a number of simply math equations within a set amount of time, Carl scored at the 2nd percentile (very low range). While he was able to accurately solve the equations, he did so very slowly. Carl also struggled when asked to solve numerical operations using pencil and paper, scoring at the 5 th percentile (low range). Carl did relatively better when asked to solve math problems using both visual and verbal information (22nd percentile; low average range). However, Carl took a significant amount of time to do so. Carl found these activities quite frustrating, and was disappointed that he was not able to remember more of his math knowledge. While Carl has a basic understanding of math facts, he struggles to use that information to solve more complicated problems, especially when time is a factor. Overall, these results indicate that Carls mathematical abilities are below the expected level for his age group. In Written Language, Carl scored at the 51st percentile, in the average range. Carl did tasks that required him to spell a list of words (57th percentile; average range) and to create unique sentences based on given parameters (71st percentile; average range). He had a bit of difficulty when asked to create simple sentences based on given information in a timely manner (22nd percentile; low average range). Carls work was very accurate, but his score was negatively affected by the speed at which he worked. While Carl may need additional time when asked to express himself in writing, his writing abilities are at the expected level for his age. In Oral Language, Carl scored at the 25th percentile (in the average range). Carl was able to remember and recall details from a story he heard both immediately (29th percentile; average range) and after a delay (48th percentile; average range). Carl was also asked to accurately follow sets of directions (24th percentile; average range). Carl did well in the early levels of this activity, but struggled as the directions became more complex (multiple parts and if/then statements). These results indicate that Carl may benefit from being given directions in smaller chunks and using direct language. Overall, Carls ability to understand language is at a typical level for his age. Memory

Selected subtests from the Wide Range Assessment of Memory and Learning (WRAML-2) were administered to further asses Carls auditory and visual memory skills. Standard Scores of 7-13 are considered to be in the average range. Subtest Verbal Memory Sentence Memory Verbal Learning Immediate Verbal Learning - Delayed Visual Memory Design Memory Standard Score 10 11 13 13 Classification Average Average Average Average

Carls performance on these activities indicate that both his verbal and visual memory abilities are at the expected level for his age, as he scored in the average range on all activities. When given a list of random words to recall, Carl showed that multiply repetitions helped him to recall more words both immediately and after a delay. Carl was also able to remember and repeat increasingly complex sentences back verbatim. Carl had good attention, concentration and effort throughout these tasks. When taken in conjunction with the memory tasks on the WAIS-IV, Carl appears able to encode and recall information, but his ability to do so may be affected by factors such as his interest in the material, his focus and what type of output is expected. Behaviour Rating Scales The Behavior Assessment System for Children 2nd Edition (BASC-2) was completed by Carl, and one of his brothers, with whom he lives. While Carl is slightly older than the age limit on the rating forms, they were used to determine if any areas of concern were present. Carls Self-Report ratings: At-Risk in the following areas: o Anxiety, Sense of Inadequacy, Test Anxiety, Mania Of note, Carl indicated that he finds it difficult to relax, he worries about the little things and that he worries most of the time. Carl also noted that he sometimes quits easily, sometimes fails at things and often wants to do better, but is unable to. Carls brothers ratings: At-Risk in the follow areas: o Anxiety, Atypicality, Developmental Social Disorders (social skills and communication) Of note, Carls brother indicated that Carl has difficulty making new friends, prefers to be alone and sometimes engages in repetitive activities. He also noted that Carl often worries about what others think, is afraid to and worries about making mistakes, and often believes he is not very good at certain tasks. Carls brother also completed the Vineland Adaptive Behavior Scales, Second Edition (VinelandII). The Vineland-II assesses an individuals personal and social sufficiency in a number of areas.

Carls brothers ratings: Carls overall Adaptive Behavioral Composite was in the Low Adaptive Level, below the 1st percentile. The following areas scored in the Low Adaptive or Moderately Low range and are areas for concern: o Communications: (<1st percentile, low range) Receptive, Expressive and Written Language: Low Specific concerns include listening to instructions, listening for an extended period of time, ability to stay on topic or move from topic to topic in a conversation, inability to describe short or long-term goals. o Daily Living Skills: (2nd percentile, low range) Community: Low Personal, Domestic: Moderately Low Specific concerns include budgeting for monthly expenses, using a bank account responsibly, and maintaining part or full-time work o Socialization: (<1st percentile, low range) Interpersonal Relationships: Low Play and Leisure Time, Coping Skills: Moderately Low Specific concerns include meeting regularly with friends, recognizing social cues and the emotions of others, understanding conversational cues and expressing interest in the interests of others.

SUMMARY AND RECOMMENDATIONS Carl was cooperative and hardworking throughout the assessment. He demonstrated good focus, although he was easily frustrated by tasks he found difficult but felt he should be able to do. Carl displayed some atypical social behaviors during the assessment, including a lack of eye contact, monotone speech, repetitive mannerisms (hair twisting), and minimal reciprocal conversation with the examiner. Carl put forth good effort throughout the assessment and did not give up on any of the tasks. Carls cognitive abilities show some variability, but his GAI is at the 77 th percentile (high average range). Carl performed very well on tasks that required attention to detail, understanding patterns and interpreting visual-spatial material (Perceptual Reasoning; 86 th percentile). His ability to express himself verbally was at a typical level (Verbal Comprehension; 58 th percentile), but he did struggle when he needed to consider social norms and expectations. Carls Working Memory was at the 12th percentile, but he showed significant variability on the tasks. On these tasks, and follow-up tasks from the WRAML-2, Carl demonstrated that he is able remember and recall information at a typical level, as long as the manipulations he is asked to do mentally are within his general ability set. For instance, he was able to remember and reorder numbers, but not to perform math calculations that were beyond his math ability level. Finally, Carls Processing Speed was at the 27th percentile. While this is in the average range, Carls performance on tasks throughout the assessment indicate that he does often require a longer than average amount of time to complete tasks.

Academically, Carls reading, writing and oral language skills are all in the average range for his age. He did have some difficulty when asked to follow complex directions, or to write quickly. A significant strength for Carl was his ability to read quickly and accurately. In Math, Carls scores were in the low range (8th percentile). He struggled on all tasks, including numerical calculations, fluency and using visual and verbal information to solve problems. Carls understanding of basic math facts was adequate, but he struggled with more complex problems, including problems that involved currency, fractions and decimals. Rating scales indicated that Carl shows many signs of anxiety, and that he struggles with understanding and using social skills effectively. A measure of independent functional skills (Adaptive Behaviour) indicated that Carls overall Adaptive Behavior Composite is in the low range (<1st percentile). His scores for Communication (<1st percentile), Daily Living Skills (2nd percentile) and Socialization (<1st percentile) were all in the low range. While these results will not prevent Carl from being successful at finding, and keeping a job, Carl will require supervision, repeated instruction, and monitoring to be successfully employed and keep a job.

Recommendations: 1. Carl should consider pursuing further assessment specifically related to his social communication and interaction difficulties. The benefits of and referrals for a formal diagnostic assessment was discussed at the time of feedback to Carl. As noted by Mrs. Smith, Carl has had a previous diagnosis of Aspergers Syndrome, but since there is no official report of the diagnosis, and current diagnosis requires additional assessment than Carl may have previously received, an up to date assessment is recommended. 2. Carls difficulty with mathematics means that jobs that involve numeracy skills, including complicated money transactions, or using fractions or decimals, may not be a good fit for him to pursue at this time. Carl may find it useful to upgrade his math skills with a trade-level math course in order to broaden his job search possibilities. Such course upgrades can be done through Adult Learning programs in many school districts. 3. Carl has several indicators of anxiety, as demonstrated on both the ratings scales and anxious behaviours noted during the assessment process. Carl would benefit from working with his counsellor to develop good coping strategies to use to combat his anxiety, as well as working to help Carl to develop realistic expectations for himself. 4. Carl will do best in an environment that allows him to complete tasks at his own (reasonable) pace and in his own manner. He also responds better to specific encouragement as to what he is doing well, as well as support and redirection (rather than criticism) when he is struggling. Carl will do better when given simple, rather than complex, directions and may find it easier to work on tasks independently, than with a team. He will most likely do better if left to work autonomously, with regular accountability, rather than with direct supervision, which he may find stressful. Carl may be more successful in roles where he does not need to deal directly with the general public. 5. Carl will need to learn to advocate for himself with employers. This includes both expressing what accommodations he may need (such as extra time to complete tasks, written checklists rather than verbal instructions, clear understanding of expectations and

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explicit instructions on how tasks should be done), as well as being able to confidently express what his strengths and assets are. It is recommended this be addressed, or continue to be addressed, as part of Carls individual counseling. It may be helpful for Carl to discuss and pinpoint the specific areas of concern that led to him losing jobs in the past, as these may indicate specific areas where explicit instruction and support may be helpful. This is another area that should continue to be addressed through Carls individual counselling sessions. Carl will most likely do better at a job that is of interest to him, and allows him to use his strengths. This will help Carl to stay focused and motivated to the task at hand. Carl would benefit from participating in a career or vocational assessment that helps him to narrow down or refine his interests. Some options include: www.careercruising.com One-Stop Career Shop Local community colleges and universities offer free career assessments to enrolled students. Carl may find that the jobs that are a best fit for him require additional schooling (such as a certificate program). Carls cognitive and academic profiles indicate that he has the abilities to be successful if he decided to pursue such schooling, especially if it was an area of high interest to him. Carl may find it helpful to participate in volunteer work in order to build up both his resume and his on the job social competencies. A volunteer environment may have less stressful time demands, and Carl would be able to explore, and develop, his interests. If Carl is interested in pursuing voice acting opportunities, it is recommended that he put his good internet research skills to use to find local workshops and seminars that will allow him to acquire some formal training.

It was a pleasure to meet and work with Carl. Please contact us if there are any questions about this assessment and report. We would be pleased to provide follow-up as required.

_____________________________ Jo Friesen, B.Comm., B.A. Psychology Practicum Student University of Calgary