SAMPLE REPORT CONFIDENTIAL

PSYCHO-EDUCATIONAL EVALUATION

NAME: XXX SCHOOL: Central High School

DATE OF BIRTH: 07/26/1995 GRADE: 9th grade
DATE OF EVALUATION: 03/11/2011 PARENT(S):
CHRONOLOGICAL AGE: 15 years, 8 months
EXAMINER: Jessica F. Castine

REASON FOR REFERRAL:

XXX was assessed as part of a routine reevaluation as is mandated by the New York
State Department of Education.
BACKGROUND INFORMATION:
XXX is a 15-year, 8-month-old young lady, currently in the 9th grade at Central High
School. She has been previously evaluated and has been identified as having a Speech
Language Impairment.
XXX has an Individualized Education Plan (IEP) in place. She is able to participate in all
general education services that are available to her and will continue to work towards a regent’s
diploma. Within her IEP, XXX receives the following services: Resource Room support services
(5x week), Occupational Therapy (1x week), Speech Therapy (2x week), peer/guided notes for
science and social studies, foreign language exempt, and testing accommodations (i.e., separate
location, reduced number of items per page, extended time, and check for understanding of
directions).
XXX’s latest report card grades indicate that she is passing all of her classes except
Earth Science, which she is failing with a 59. However, current 5 week marking period grades
indicate that XXX has managed to bring up her Earth Science grade to passing (65); however,
her grades in Global History (73), English (64), and Algebra (70) have slipped. XXX’s teacher
indicate that XXX does try; however, she struggling particularly in science. XXX often does not
ask questions when she does not understand something and struggles on tests. XXX does best
when things are broken down for her.
EVALUATION PROCEDURES:
XXX presented as well-mannered young lady. Rapport was easily established and was
maintained throughout the evaluation process. XXX came willingly to the testing sessions.
Testing was completed in three sessions that together lasted two hours in total length. XXX had
good attention and appeared to put forth her best ability on all that was asked of her.
The evaluation is a valid and reliable estimate of XXX’s abilities, assessed in a
controlled, quiet setting free of distractions. The following evaluation tools were used:
 XXX (07/26/1995) pg 2

Kaufman Brief Intelligence Test – Second Edition (KBIT-II)

Wechsler Individual Achievement Test – Third Edition (WIAT-III)
Behavioral Observations
Record Review
EVALUATION RESULTS:
XXX was administered the KBIT-II, an individually administered standardized intelligence
test for assessing cognitive ability. XXX’s Full Scale IQ fell within the below average range
[Standard Score (SS)=76, Confidence Interval (CI)=70-84, Percentile Rank (PR)=5]. Meaning five
percent of children her age scored at or below the level obtained and due to the possibility of
error associated with the KBIT-II, there is a 90% chance that her FSIQ would fall in the range of
70-84, if the test were administered again. Furthermore, her Full Scale IQ is broken down into
verbal and nonverbal ability. Both XXX’s verbal ability (SS=80, CI=74-88, PR=9) and her
nonverbal ability (SS=79, CI=72-88, PR=8) fell in the below average range. These results are
slightly lower than past assessments of XXX’s ability.
XXX was also administered subtests from the WAIT-III to determine her achievement
levels within the areas of reading, writing, and math. Overall, XXX’s performance within these
subtests fell primarily within the average range.
XXX’s Written Expression performance fell within the average range (Written Expression:
SS=108, CI=101-115, PR=70). XXX’s ability to write an essay on a given topic (Essay
Composition: SS=112, CI=102-122, PR=79) fell in the average range. XXX immediately started
writing her essay and did not take time to plan/ organize; this lack of planning is a possible
explanation for XXX only writing one paragraph for her essay. However, XXX often took breaks
from writing to read over what she had already written. She was given 10 minutes to write; around
5 minutes XXX looked up and said she had finished. XXX was prompted to look over her writing
and try to write more which she did. XXX finished writing her essay after 9 minutes and 45
seconds. XXX’s ability to spell dictated words, which requires writing the correct spelling of words
presented orally (Spelling: SS=105, CI=99-111, PR=63) fell in the average range. Her ability to
formulate and write one simple sentence that either conveys the main idea of multiple sentences
that are given or that incorporates a single word that is given (Sentence Composition: SS=104,
CI=92-116, PR=61) fell in the average range. During this section of the test, XXX performed
better on sections where she was require to combine two given sentences (Sentence Combining:
SS=112, PR=79) compared to coming up with a sentence on her own (Sentence Building:
SS=96, PR=39).
XXX’s Basic Reading performance fell within the average range (Basic Reading: SS=110,
CI=106-114, PR=75). Her reading decoding skills, which requires pronouncing nonsense words
(Pseudoword Decoding: SS=117, CI=111-123, PR=87) fell in the above average range, while her
decoding skills for real words (Word Reading: SS=103, CI=97-109, PR=58) fell in the average
 XXX (07/26/1995) pg 3

range. XXX’s reading comprehension of contextual information, which requires reading a short
passage and answering questions about it (Reading Comprehension: SS=92, CI=81-103, PR=30)
also fell in the average range. XXX had access to the reading passages during this test, and she
often referred back to the passage when she was unsure of an answer. In addition, it is noted that
XXX had trouble answering inferential questions about the reading. However, XXX was able to
answer the majority of factual questions about the passages she read.
XXX’s performance within the Mathematics cluster fell in the average range
(Mathematics: SS=92, CI=86-98, PR=30). Throughout the math sections that she completed,
XXX would use strategies such as using her fingers to help her figure out the answer. XXX’s
mathematical reasoning, which requires analyzing and solving practical math problems (Math
Problem Solving: SS=94, CI=85-103, PR=34) fell in the average range. XXX’s ability to perform
mathematical computations, which requires calculation of simple to complex mathematical
problems and equations (Numerical Operations: SS=92, CI=86-98, PR=30) also fell in the
average range. Throughout this math section, XXX often used the paper and pencil that were
provided to solve the problem.
SUMMARY/RECOMMENDATIONS:
XXX, a 9th grade student at CCRS, was assessed at this time as part of a routine
reevaluation process. She is currently identified as a student with a Speech Language
Impairment. XXX receives the following services: Resource Room support services (5x week),
Occupational Therapy (1x week), Speech Therapy (2x week), peer/guided notes for science and
social studies, foreign language exempt, and testing accommodations (i.e., separate location,
reduced number of items per page, extended time, and check for understanding of directions)
through her IEP.
Current intellectual test results indicate that XXX is of overall Below Average Ability;
which is slightly lower than results from previous testing. Furthermore, in regards to her academic
achievement she fell primarily in the average range. XXX worked very diligently throughout
testing; in addition, XXX often used resources that were available to solve any problems she was
unsure of. XXX is able to answer factual questions about what she has read; however, she has
trouble with inferential questions. In regards to writing, XXX did not take time to plan what she
wanted to write which resulted in her only writing one paragraph for her essay. XXX’s performed
the poorest in mathematics; when supplied with paper and pencil to help her solve problems she
often used them, she also used other strategies such as using her fingers to solve problems.
Furthermore, XXX’s latest report card grades indicate that she is passing all of her
classes except Earth Science, which she is failing with a 59. However, 5 week marking period
grades indicate that XXX has managed to bring up her Earth Science grade to passing (65);
however, her grades in Global History (73), English (64), and Algebra (70) have slipped. It is also
 XXX (07/26/1995) pg 4

noted that teacher reports indicate that XXX is a pleasure to have in class as well as cooperative
and attentive.
In summary, it appears from current test results, behavioral observations, teacher input
and current grades that XXX still qualifies as a student with a learning disability and should
maintain her classification. It is believed that XXX would continue to benefit from Resource Room
support to help her with re-teaching of needed information as well as to gain help from the
Special Education teacher when completing assignments. Furthermore, XXX would also continue
to benefit from testing accommodations due to her difficulty with language. Pending the results of
her Speech Language Pathologist, the classification of Speech Language Impairment can be
considered to be the most appropriate.

Jessica F. Castine, B.A./B.S. Date

School Psychology Trainee
 XXX (07/26/1995) pg 5

Appendix A:

Summary of Scores: KBIT-II

Composite/ Subtest Composite/ Percentile Confidence Description
Scaled Rank Interval (90%)
Scores
FSIQ 76 70-84 5 Below Average
Nonverbal 79 72-88 8 Below Average
Verbal 80 74-88 9 Below Average

Summary of Scores: WAIT-III

Composite/ Subtest Composite/ Percentile Confidence Description
Scaled Rank Interval (95%)
Scores
Basic Reading 110 106-114 75 Average
Pseudoword Decoding 117 111-123 87 Above Average
Word Reading 103 97-109 58 Average
Reading 92 81-103 30 Average
Comprehension
Written Expression 108 101-115 70 Average
Essay Composition 112 102-122 79 Average
Spelling 105 99-111 63 Average
Sentence Composition 104 92-116 61 Average
Mathematics 92 86-98 30 Average
Math Problem Solving 94 85-103 34 Average
Numerical Operations 92 86-98 30 Average