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Greater Randolph Interlocal Cooperative

325 S. Oak St., Suite L 103
Winchester, IN 47394
Phone (765) 584-7602 FAX (765) 584-7544

REPORT FOR PSYCHOEDUCATIONAL EVALUATION

CONFIDENTIAL

Name: STUDENT Address: ADDRESS

Date of Birth: DOB ADDRESS
Age: AGE School: SCHOOL
Parent(s)/Guardian: PARENT Grade: GRADE
Phone Number: PHONE Evaluation Date(s): DATES
Prepared By: Haley Wilde

Reason for Referral:

Student was referred for a psychoeducational re-evaluation to consider special education
eligibility under the category of Emotional Disability.

Background Information:
Student is a 15-year, 11-month old female in tenth grade at ABC High School. Student currently
resides with her biological father, stepmother, grandmother, stepsister, and half-brother in
Muncie, Indiana. Students medical, academic, and social-emotional histories were obtained
from the information provided by Parent for the initial evaluation in November of 2016.

Medical History
Parent reported Students length of gestation and delivery as normal and without complications.
It is unknown whether or not forceps were used during delivery. Parent reported Students
mother denies all claims of using medications during pregnancy; however, he reported she did
use drugs and alcohol heavily until she became aware of the pregnancy. It is unknown if Student
experienced any oxygen loss during delivery. Parent reported Student was slow to crawl and
walk during her first few years. She was able to roll over at eight months, sit alone at nine
months, crawl at nine/ten months, and walk alone at fifteen months. Parent also reported Student
has had visual problems since age eleven. She was diagnosed with functional amblyopia and
monocular esotropia for the right eye. He reported she has had difficulty concentrating since the
age of five. He also reported Student has been diagnosed with Attention Deficit Hyper Activity
Disorder, Depression, and Anxiety since she was in the fourth grade. Student is currently taking
medication Lexapro (15 milligrams) at bedtime, as prescribed by Dr. Smith. He reported she has
been taking Lexapro since she was in fifth grade. Parent reported Students mother has a history
of depression, nervous/psychological problems, and alcohol/drug abuse. Students grandparents
have a history of cancer. Parent also reported he has a history of attention problems and her half
brother has a history of seizures/epilepsy.

Academic History
Parent reported Student has difficulty with reading, arithmetic, memory, science, and reading
comprehension. He also reported she does not like school. Parent reported Student attended
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preschool from ages three to five years old. Student attended ABC Elementary School, 123
Elementary School, and ABC Middle School before starting ninth grade at ABC High School.
Student was evaluated in March of 2011 for a Specific Learning Disability and Other Health
Impairment due to concerns about her math skills and ability to focus. She was given the
Woodcock-Johnson III and Kaufman Achievement (2nd edition) assessments and demonstrated
academic skills that were in the average and above average range. The case conference
committee found her not eligible for services. Students records indicated that she had a 504 plan
for ADHD. Records indicated she receives accommodations including extended time on
assignments, projects, tests, and quizzes, tests to be read in a small group setting upon request,
and use of a calculator. Parent reported Student received tutoring when she was in fifth grade.
Parent reported Student spends approximately thirty minutes on homework each night and has
not missed any school. He also reported Student has received detention three times for skipping
class and staying in the restroom.

Records from an evaluation by Dr. Jones in November 2012 indicated Student was diagnosed
with DSM Axis I Generalized Anxiety Disorder, Learning Disability NOS (spatial-relations
deficits), and Attention Deficit/Hyperactivity Disorder, Predominantly Inattentive Type.
Students cognitive abilities were found to be in the average range, as indicated by WISC-IV
scores. Records from an evaluation by Dr. Smith in March of 2016 indicate DSM diagnoses of
Attention Deficit/Hyperactivity Disorder, Autistic Disorder, Post Traumatic Stress Disorder
unspecified, Reactive Attachment Disorder of childhood, and Developmental Disorder of
scholastic skills unspecified. Records from the initial psychoeducational evaluation in November
of 2016 indicated Students academic skills fall within the Average to Below Average ranges.

Ms. John, Students English teacher, reported Student is easily distracted, that her academic
performance is inconsistent and varies from week to week. She also reported Student appears to
be inattentive and often daydreams, however, has improved on this issue since last year. Ms.
John reported Students oral performance sometimes exceeds her written work, and she seeks out
excessive attention/praise from teachers. She reported Student seems responsive to feedback and
is not afraid to ask questions if she does not understand. Ms. John also reported Student has good
attendance.

Ms. Note, Students Spanish and academic lab teacher, reported Student does well in her class
and tries hard. Although Ms. Note described her as meek she reported she also volunteers
often. Mr. Ratliff, Students geometry teacher, reported she demonstrates a laissez-faire
attitude toward her work and hurries through it with little regard for correctness. He also reported
Student once finished a 53 question evaluation test in fifteen minutes, which was a concern, as it
was suspected she may have guessed on the multiple choice questions.

A case conference committee meeting determined Student eligible for special education services
under the category of Other Health Impairment in November of 2016. Services included adding a
basic skills course to Students class schedule and dropping an earth and space class, as well as
additional accommodations for academic support.

Social-Emotional History
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As reported by Parent for the initial evaluation, Student has poor social skills, is shy or timid,
more interested in things than people, is rejected by others, has trouble making/keeping friends,
and prefers to be alone. Parent reported Student has excessive sadness/depression, poor social
skills, blank spells, trouble sleeping, a short attention span, difficulty establishing trust, a
tendency to worry, special fears, habits, and mannerisms, and low self-esteem. Parent also
reported Student is easily distracted, excessively nervous/anxious, shy or timid, slow to learn,
clumsy, and impulsive. Parent reported Student does not get along well with siblings, looks to
others to solve problems, tells lies, and gives up easily. Parent reported Student is, aware of a
difference in herself and her peers. He also reported Student has received counseling
sporadically over the last five years.

During the initial case conference, Parent reported Students challenges began in preschool and
that she loved to let the other kids do the work for her and lacked motivation. While difficulty
with paying attention was the observable challenge for Student, her parents reported they
suspected deeper issues even early on. Parent and Parent reported they see the attention problems
and impulsivity. They reported Student understands the difference between right and wrong, but
her ability to make choices in the moment is poor and if she does not have to think for herself
she wont. Parent reported this is the first year she has stepped away from helping Student every
night with schoolwork and that Students grades have suffered without the help, as she often has
missing/incomplete assignments. They reported trying schedules, incentives, and consequences
at home, but nothing seems to work. It was reported Student takes things literally and tends to
become very focused on one topic at a time. Students teachers reported that she has not
participated or engaged in class this year like she did the previous year, however, sometimes asks
questions that are off topic or redundant for the class discussion. Parent reported Student asks
similar redundant questions at home, but says that she just wants to be sure when asked why
she asks them. Mr. Winters, one of Students teachers, reported Student does not take the
opportunity to get help on assignments when it is offered. Mr. Winters reported Student always
has something else she has to do instead of coming to him during academic lab for help. Mr.
Rain, Students previous geometry teacher, reported Student rarely asked for help last semester.
Parent and Parent also reported that Student lies often. They reported they are able to tell when
she is lying, but school staff, who do not know her as well, do not.

Parent and Parent reported Student has found friends, but it is consuming now and all she
wants to talk about is peer interactions. Mr. Winters also reported socialization is Students focus
at the moment, however, only if it is someone she is comfortable with. Mr. Winters reported
Student can get snippy with people and her parents reported she has a tendency to tattle. Parent
and Parent reported they think Student does such things because she does not understand it, but
tries to. They reported Student does not understand sarcasm or tones, and no matter how much
you reason with her it often does not change her thinking.

Behavioral and emotional adjustment assessment results from the initial evaluation indicated
Student displays At-Risk levels of hyperactivity, conduct problems, adaptability, and activities of
daily living at home. Results also indicated Student displays Clinically Significant levels of
adaptive skills, attention problems, atypicality, withdrawal, social skills, leadership, and
functional communication at home. The school setting ratings did not indicate any At-Risk or
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Clinically Significant levels of behavior, however, the teachers at the case conference expressed
concerns about her lack of motivation, focus on socialization, and lack of engagement at school.

Students self-report ratings indicated she experiences difficulty with social stress and
establishing and maintaining relationships with others. Students ratings also indicated she has a
strong dislike for school and attention problems. Students self-report ratings indicated high
levels of atypicality and feeling like she has unusual thoughts and perceptions compared to her
peers. Students ratings regarding her self-esteem indicated she has a very negative self-image in
terms of physical and personal attributes. Students self-report included the endorsement of
critical items including hearing voices others cannot hear, trouble controlling her thoughts,
feeling sad, feeling like life is getting worse and worse, hating school, feeling other kids hate to
be with her, and feeling like life is not worth living. Parent and Parent reported they were aware
of these concerns and that they have been discussed with Student in the past. The case
conference committee discussed the intensity of Students internalized negative thoughts and
emotions. The case conference committee also discussed the likelihood that Students emotional
tendencies are interfering with her academic performance and behaviors at school.

Behavioral Observations for Functional Behavioral Analysis:

Student was observed on several occasions, the first being in her social studies class with Mr.
Stevenson. She was observed on the Tuesday of finals week in the early afternoon. It should be
noted that Student saw the observer, said hello, and appeared to be aware of the fact that she was
being observed; this may have had an effect on her behavior. The classroom consisted of
approximately twenty to twenty-five students, all of whom sat in desks, organized in rows.
Student was seated at a desk in the row furthest to the right of the room toward the door, two
desks back. Student was seated behind a female peer. Due to the nature of finals week, the class
was working on a packet and miscellaneous tasks while the teacher walked around the room to
assist students and called them up to his desk to discuss their current grades and missing
assignments.

During the first five minutes of the class period, Student sat quietly and was looking at her iPad
before conversing with the peer seated in front of her. Mr. Stevenson walked around the room to
check on students and their work. Mr. Stevenson approached Student and asked if she was done
with the packet, which she responded to with a yes. He picked up the packet, looked at it, and
then handed it back to Student. She took the packet back and did not make any further
comments. Once Mr. Stevenson walked away, Student and the female peer continued to chat.
The female peer turned around to show Student her iPad and they continued to talk quietly and
giggle. While still conversing on and off with the female peer, Student remained with her gaze
focused on the iPad and appeared to be scrolling through content on the screen.

During the next five minutes of the class period, Student continued to look down at her iPad. She
continued to have on and off conversation with the female peer, however, did not look up from
her iPad. The class was still supposed to be working on the current packet, and if they were done,
it appeared they were allowed to work freely. Many students socialized or worked on other
assignments during this time. Student appeared to be scrolling through content on her iPad, but it
was not known if she was working on academics or leisure. Student was then called up to Mr.
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Stevensons desk. He informed her that she was missing the weekly worksheet from the week
prior, told her she needed to hand it in, and she responded with ok. Student returned to her
desk and started looking at her iPad again. the female peer turned around and initiated
conversation with Student. The next five minutes Student and the female peer continued to
converse and Student continued to look at her iPad. The class was still working freely and many
students socialized during this time. Student and the female peer showed each other their iPad
screens during conversation.

When the female peer was called up to the teachers desk, Student sat quietly and remained
looking at her iPad. When the female peer was called up to the teachers desk, Student laughed
and smiled before looking down again at her iPad. It was not apparent what Student was working
on during this time, but she remained focused on her iPad. Mr. Stevenson walked up and down
each row of the classroom. Student did not look up and continued to look at her iPad when Mr.
Stevenson walked by her desk. For the next five minutes, Student continued to sit quietly and
work on her iPad. the female peer returned several minutes later and as soon as she sat down, she
started to talk to Student again. While the two conversed, Student appeared to be looking at the
female peer instead of the iPad. It was noted that the female peer talked more often than Student,
but Student appeared to listen and respond accordingly. Student then picked her iPad back up and
started looking at it again, however, Student and the female peer continued to talk incrementally.
Mr. Stevenson announced that he checked for Students weekly worksheet and that it appeared
she had not submitted it after he told her to turn it in earlier in the class period. Student told Mr.
Stevenson that she thought she had submitted it. She appeared to go about submitting the
assignment while Mr. Stevenson waited. He informed her that it was now submitted. She
continued to look at her iPad. For the remainder of the class period Student looked at her iPad
and incrementally talked with the female peer.

Prior to the start of another observation in Students first period Spanish class with Mrs. Note,
Mrs. Note reported Student seems to always need something. Mrs. Note gave an example of
Student needing tissues and saying she had been sick for so long. Mrs. Note also reported a
situation in which Student sought out help for something that should not have required help, but
Student could not make a decision on what to call a color of an item on a project.

It should be noted that Student appeared to be aware that she was being observed. Student was
seated in the front of the room in her Spanish class, one row over from the middle. Student had
her iPad out on her desk and appeared to be using it. A female peer sitting next to her made a
comment to Student, to which she looked up from the iPad and responded. Mrs. Note then
announced that they would be playing Spanish bingo as a class. She instructed them to get out
their bingo pages. Student did not look up while Mrs. Note talked to the class, she continued to
look at her iPad but did get out her materials promptly. During the bingo game, Mrs. Note read
words aloud while the rest of the class followed along on their worksheets and were to announce
if they had bingo. The bingo game lasted approximately ten to twelve minutes. Student did not
seem to be engaged in the game, however, she appeared to follow along with the words being
read and placed her chips on her paper occasionally. When there were pauses in the game due to
teacher and student comments and conversation, Student peered at her iPad until the game
resumed.
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After the bingo game, the class was instructed to work on their group projects. Someone from the
office walked into the room and delivered Student a note; it was not known what the note said.
Student looked at her iPad while the rest of the students got up to work or get in their groups.
Student stood up and walked over to the teachers desk and appeared to ask Mrs. Note a question
to which Mrs. Note responded with a yes to. Student then went back to her seat and went back
to doing something on her iPad. It was noted that the majority of students were working on the
project or socializing with their groups and peers at this time.

Mrs. Note returned Students groups project poster to them by handing it to Student, whos group
included the students sitting behind her in the same row. Student quickly passed the poster back
to the other students in her group behind her and returned to focusing on her iPad. Mrs. Note
verbally commented on the fact that only two people in Students group were actually working
on the project. While the rest of the group appeared to move closer to the poster and talk to each
other, Student turned around and looked at the peers in her group for a few seconds, but did not
move from her seat. Student appeared to continue focusing on the screen of her iPad.

While Student worked on her iPad during the group project time, Mrs. Note approached the
observer and reported that Student was texting on the iPad. She reported it was not out of the
ordinary for Student to be texting on the iPad during class, however, Mrs. Note does not know
who Student texts. Mrs. Note reported that she doesn't fight it anymore when it comes to
texting on the iPads. When Mrs. Note left the back of the room and walked by Students desk,
she put the iPad down, looked up, and oriented toward her group behind her. Mrs. Note then
collected Students groups poster and Student went back to looking at her iPad.

Student had her iPad tilted upward, making the screens content visible to the observer. Student
scrolled through what appeared to be a texting conversation on the screen, as indicated by grey,
blue, and green text bubbles. Student appeared to be scrolling up and down, looking at different
parts of a texting conversation. She then switched to a new texting conversation thread, as
indicated by a change in color of the text bubbles. Student scrolled up and down again.

The class was then told that they were to be doing a Spanish activity on their iPad if they were
done with their project. While many of her peers sat near one another and talked as they worked,
Student worked on her iPad alone at this time. She appeared to have the correct activity opened
on her iPad. Mrs. Note began to talk to the class and Student sat up and oriented towards the
teacher. Mrs. Note was discussing a certain musician. She announced the name of the musician
and then elaborated. Less than one minute after Mrs. Note said the name of the musician, Student
got up from her seat and walked over to the teachers desk. Student asked Mrs. Note what the
name of the musician was and Mrs. Note repeated the name she had previously announced.
Student walked back toward her seat. As she approached her desk, a peer in her row asked
sarcastically, Why, you gonna listen to some rap? and giggled. Student said, No, I was just
gonna, with a serious expression as she sat down in her chair. The class was then told to work
on a puzzle on their iPads during the last few minutes of class. Student appeared to be working
on her iPad when the observation concluded.

Summary:
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Student is a 15-year-old female in tenth grade, referred for a psychoeducational re-evaluation to

consider special education under the category of Emotional Disability. In correspondence to
behavioral and emotional adjustment assessment results revealing Students experience of
negative emotions, suicidal ideation, social stress, and strong dislike toward school, observations
were conducted to analyze the functions of Students behavior.

Student was observed in her social studies class and Spanish class. In her social studies class,
Student spent a lot of time conversing with a female peer seated in front of her. She appeared to
be off task more often than not throughout the class period, either talking to the female peer or
looking at her iPad. In her Spanish class, where she did not seem to socialize much at all, she
appeared to be off task more often than not by focusing on her iPad and texting. It should be
noted that Students iPad screen was not visible to the observer at all times, so it was not known
whether or not she was working on an academic activity whenever she was on her iPad.

Students reported difficulty with turning assignments in and being responsible for her own work
was evident in her social studies class when she needed to be reminded several times to turn in
an electronic assignment. Student stated to the teacher that she thought she submitted it, but the
teacher reported she had not. Students observed difficulty with submitting assignments and
ensuring they are turned in may be interfering with her ability to maintain good grades, as seen
during the fall semester. Students difficulty with doing her own work was also observed,
specifically in her Spanish class. Student did not participate in her group project with several
other peers, even after being redirected to do so several times. Student refrained from working
with her group and contributing to the project, which was consistent with reports that she lacks
motivation and allows others to do the work for her. Student spent a significant amount of time
looking at her iPad. While working on the iPad was required on several occasions per teacher
instruction, she was looking at the iPad when she was supposed to be working on something else.
It was reported Student spends a lot of time texting on her iPad, which was also observed.

While it should be noted that Student appeared to be aware that she was being observed, her
behaviors were consistent with teacher and parent reports regarding her lack of motivation, as
well as her self-reported dislike of school and social stress. Student did not converse or express
much emotion outside of her time spent talking to the female peer, even when she was required
to talk to peers for a group project. It is likely that Students clinically significant feelings of
atypicality and difficulty with relationships, as reported in the initial evaluation, are interfering
with her ability to work with others in class. Students clinically significant levels of negative
thoughts and low-self esteem are also likely to be interfering with her ability to do well, stay
focused, and engaged in the classroom. This appears to have resulted in increased levels of off-
task behaviors in Students classrooms. Overall, Students internalized negative emotions are
likely affecting her behaviors and performance at school.

Recommendations:

1. It is recommended that a case conference committee meeting be scheduled to discuss the

results of this evaluation.
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2. It is recommended that Student continue to receive accommodations including extended

time on assignments, projects, tests, and quizzes, tests to be read in a small group setting
upon request, and use of a calculator.

3. It is recommended that Student continue to have the Basic Skills course as a part of her
daily schedule.

4. Observations revealed that Student is often off-task. Behavioral interventions should

include increasing on-task behaviors and improving Students work ethic.

5. Based on the fact that Student spent much of the observed time off-task and on her iPad,
it is recommended that the iPad settings be configured to limit the amount of time she is
allowed to spend text messaging or using leisure applications.

6. Based on Students emotional difficulties, it may be beneficial for her to receive

additional emotional support at school.

7. It is suggested that this report be shared with Students pediatrician and psychiatrist.

8. Counseling through a community counseling agency or private practitioner may be

beneficial. Specific issues to be addressed include emotional adjustment, self-esteem, and
interpersonal relationships.