Week 12 - Cognitive Assessment 2 Flashcards
Scaled Scores
Put the raw scores in the raw score column
We need to convert the Raw Scores to Scale Scores
Most range from 1-19
You find them in the back of the manual
Based on age – so make sure you get the RIGHT one!
Put the Scaled Score in each available box across the row
Use Table A.1 in the back of the administration manual
Sum of Scaled Scores
start adding to produce the: Verbal Comprehension Visual Spatial Fluid Reasoning Working Memory Processing Speed Full Scale (FS)
If secondary subtests are administered they SHOULD NOT be summed with the primary subtests
Sum of Scaled Scores to Composite Score Conversions
Transfer scores to this table
NOTE: the FSIQ is not the sum or average of the other index scores, it is derived from the Full Scale Score
Look at Tables A2-A7
Fill in the Composite Score, Percentile Rank and Confidence Interval (95%)
Plotting the Score Profiles
Subtest Scaled Score Profile
—Plot each of the scale scores
Composite Score Profile
—Plot each of the composite scores
Primary Analysis - Strengths and Weaknesses
Transfer VCI, VSI, FRI, WMI, PSI and FSIQ scores onto the ‘Primary Analysis’ page
Similarly transfer SI, VC, BD, VP, MR, FW, DS, PS, DO and SS
Decide which comparison score you will use (average of 5 index scores or the FSIQ)
Subtract each score from the comparison score, indicating whether it is positive or negative
Use Table B.1 to work out critical values
Child’s difference score must equal or exceed the critical value to be significant – record whether it is a strength or a weakness
Base Rate = percentage of children in the standardisation sample who obtained the same or greater discrepancy
Base rates – if it doesn’t match, then use a range e.g., 10-25%
Only do this for differences that are significant – Use Table B.2
Primary Analysis - Pairwise Difference Comparisons - Index Level
Transfer all index scores into the table
Subtract Score 1 from Score 2 indicating whether it is positive or negative
Look up critical values in Table B5
Work out whether or not there is a significant difference (Y/N)
Look up base rates in Table B6
Primary Analysis - Pairwise Difference Comparisons - Index Level (part 2)
Transfer individual subtests into table
Subtract score 2 from score 1, indicating the sign
Look up critical values in B7
Indicate a significance difference (Y/N)
Look up base rates in B8
WISC-V Qualitative Descriptors of Standard Scores
130 & above > extremely high 120-129 > very high 110-119 > High Average 90-109 > Average 80-89 > Low Average 70 - 79 > Very low 69 and Below > Extremely Low
Interpretation
Chapter 4 in Sattler & Dumont (2004)
read it i guess?
Profile Analysis
Subtest profiles
- -Extreme variability e.g., 1-19
- -Moderate variability e.g., 5-15
- -Minimal variability e.g., 8-12
Index profiles
- -Extreme variability e.g., 70-130
- -Moderate variability e.g., 80-120
- -Minimal variability e.g., 90-110
Profile analysis with the WISC-IV cannot be used to arrive at a diagnostic label!
Aim of the Profile Analaysis
The FSIQ does not inform us about the underlying abilities on which it is based
Profile Analysis attempts to describe the child’s unique ability pattern
Goal is to generate hypotheses about the child’s abilities
Remember that “…even variability outside of normal limits may not indicate the presence of psychopathology or exceptionality; rather, variability may simply reflect the child’s cognitive strengths and weaknesses” (Sattler & Dumont, 2004)
Interindividual Comparison
Easiest way is in reference to the norm group
Mean of 10 and SD of 3 on subtests
There is both a 3 and 5 category approach
Regardless of which one you use:
- –13-19 – always a strength
- –8-12 – always average
- –1-7 – always a weakness
“Remember, however, that the child may have cognitive strengths and weaknesses in areas not measured by the test” (Sattler & Dumont, 2004)
INTRA-individual comparison
ipsative approach
Relative to their own performance
Use the same as the 3-category approach
Careful not to say that 8 or higher is a weakness or that 7 or lower is a strength
E.g., a ’13’ in a profile that is generally 18 and 19, - ‘it is a strength, but it is a strength in the ability measured by the subtests, but that it is not as well developed as the child’s other abilities”
Helpful Phrases
“Relative to Caroline’s own level of ability” “Within Rachel’s average level of functioning” “Reflects a better developed ability” “Relatively more developed” “Relative strength” “Strength” “Reflects a less developed ability” “Relatively less developed” “Relative weakness” “Weakness”
Establishing Significant Differences
Significant differences approach – do 2 scores differ statistically from each other?
Can be between Indexes, scores, scores and their Composites etc….
Base Rates
Base rate approach or the probability-of-occurrence approach
Determine the frequency with which the differences between scores in the profile occurred in the standardisation sample
Comment
When there are significant differences between Index scores, the FSIQ may be only a forced average. Need to focus more on the Index scores in the report
When there is significant variability in subtest scores within an Index, the Index Score may not be an accurate reflection on what is going on. Need to focus more on the subtests within the report
When you need to provide ‘a number’, it HAS to be the FSIQ
Report Writing
Write with a focus on the individual child, not according to a template
Test data is important – child more important
Consideration of the child’s background, history, family and school are important for a well-rounded understanding of WHAT is going on for the child
Assess – understand - intervene
6 Purposes of Reports
1 Referal issues & 2. education
- Reports address referral issues
- -What are some possible referral issues?
- -Must tailor your evaluation and report for the referral issue - Reports educate
- -Can provide a better and new understanding of the child – for parents and teachers – WHY are they behaving, feeling, performing this way???
- -Many think the recommendations are most important – but don’t underestimate the power of understanding the child in new and better ways
- -Understanding increases the likelihood that parents and teachers will comply with recommendations
6 Purposes of Reports
3. Integration of info
- Reports integrate information
- You will have a wealth of information on prior records, interviews, observations, and testing
- You must try to organise, integrate, and synthesise information in light of referral issues
- Two children with a FSIQ of 100 are two completely different children –in terms of their test scatter, but also their background, history, emotional experience etc. – don’t make them out to be the same!
6 Purposes of Reports
4. legal docs
- Reports serve as legal documents
- Reports are one way to record your work for ethical and legal reasons
- –Who worked with whom?
- –Why?
- –When?
- –Where?
- –How?
6 Purposes of Reports
5. clear comms
- Reports Communicate Clearly
- You are usually conducting an assessment at the request of others (medical professional, parent, school etc.)
- How good a report is, is therefore at least partially determined by how well you can communicate the results of your assessment
Problems:
- -Use of unfamiliar terms and / or abbreviations
- -Vague and non-specific statements
- -Mixing data-based conclusions with hypotheses or guesses
- -Over-reliance on computerised reports
- -Using statements that aren’t descriptive of the child
Sometimes initial assessment (e.g., for ADHD) can lead to the necessity of further assessment (e.g., learning disorder) – you need to document this in your report!
6 Purposes of Reports
6. reports describe children
- Reports describe children
The child is the star here!
The numbers are only important in so far as they contribute to an understanding of the child
No point being very clever in your presentation of the data, if it doesn’t help somebody to understand what is going on for this child
Tips for a good report
Paragraphs begin with a strong declarative sentence – the rest explains and supports it
Select words that increase precision
- E.g. use the term ‘cognitive’ only when referring to both achievement and intelligence
- E.g., the term ‘environment’ is imprecise
The text should avoid ‘density’ – can make comprehension difficult
Avoid redundancies
Don’t include information that isn’t relevant to the assessment
Watch your tenses
Tips for a good report
part 2
It is not necessary to include every test score in the body of the report – OK in tables though. Include those that contribute importantly to the understanding of the child
Adverbs (e.g., very, greatly) should be avoided
Try to avoid psychobabble
Test titles are capitalised
Avoid abbrevs
Length and Thoroughness of Reports
Big differences here – from 1-20 pages
Length depends on:
- Complexity and importance of the evaluation
- Quantity of information to be reported
- Institutional policy
- Presumptions of professional preference
Sections of the Report
No optimal format
Keep these 2 questions in mind:
- -1. Who will be responding to the results or implementing the recommendations of the report?
- -2. What style of report will have the greatest chance of beneficially impacting the child?
Can have up to 13 sections…
Sections of the report
Section 1.
Demographic
Child’s name
DOB
Age
Sex
Race / ethnicity
Names and addresses of parents, teachers, and school
Dates of testing and completion of the report
Title of the report is centred across the top of the first pages
A privacy disclaimer should also be included
Sections of the report
Section 2. Documents reviewed
Section 3. Assessment
Section 4. Referral issues/Q’s
- Documents Reviewed
- List the documents reviewed (e.g., form school, medical profession, mental health agencies) by name and date in chronological order - Assessment Methods
- Lists the tests administered, interviews conducted, and observations made - Referral Issues or Questions
- Who made the referral and WHY
- All sections of the report should be written with the referral question in mind
Sections of the report
Section 5. Background info
Section 6. obs
- Background Information
- Summarises prior and current medical, social (including familial), educational, psychological, language, and / or motor qualities
-Only RELEVANT information is included
Include information that helps to clarify the interpretation of the scores – so yes, developmental stuff is important!!!
- Observations
- Home and school observations (either structured, unstructured or both)
- Reports from teachers, parents and others for this information
- Can be integrated into others sections of the report if necessary
sections of the report
section 7. test behaviours
Physical appearance Attitudes How engaged were they? Did they seem to enjoy it? Were they co-operative? What was their attention like What did they do behaviourally? Remember that results from a child who was inattentive, uncooperative etc. are less valid
Sections of the report
section 8. description of the results
Describes achievement, intelligence, language, social and emotional qualities, temperament and personality, and motor and sensory-motor skills
Need to define terms that readers may not understand
Use narrative descriptions and percentile scores
Try to put first the qualities that are highly developed or positive generally, followed by less highly developed or more negative in descending order
Make sure you INTEGRATE all the information so that you are building a picture of the child
Sections of the report
Section 9. Summary
- Summary
Integration of the important information that is central to the referral in a way that people can understand
Remember that many referral agents only read this section!
Relate the diagnostic impression
- –Describe data that support the diagnosis
- –Provide enough data to support the conclusion
- –Use diagnostic codes when appropriate
Sections of the Report
Section 10. Diagnoses
Section 11. Intervention Reommendations
- Diagnoses
- Intervention Recommendations
- –Might well be the most important section
- –Some referral agents only read the summary and recommendations sections!
- –Should be based on best practice
- –Should be tailored to the child’s needs
- –Should be specific and clear
- –The focus is on the CHILD
Sections of the report
section 12. signatures
section 13. data tables
- Signatures
Signatures of intern AND supervisor are needed - Data Tables
- -All standard and percentile scores are usually provided in tables at the end of the report
- -Should also try to present the data visually, perhaps using bell curves when needed
