PSYCHOLOGICAL ASSESSMENT REPORT

(CONFIDENTIAL)

Identifying Information

Name: xxxx
Birthdate: xxxx
Age: 14 years
Gender: Male
Address: xxxx
Date of Testing: May 7, 2018

Reason for referral:

xxxx was recommended to take an assessment as one of the requirement for the admission in Pasay North
High School.

Background Information

Family

xxxx was born at San Diego California USA and 5 years later, his parents decided to separate. xxxx has a
fragmented family. His parents were separated and living apart their new family. His father is a seaman
and his mother is a waitress in United States. According to his auntie, xxxx’s mother had a history of
aborting two of her child before and tried to abort xxxx but didn’t succeed. xxxx was brought up by his
paternal grandmother since he was 1-year-old. One of his happy experiences when he was a child was
going out with his grandmother. Now, he and his younger stepbrother are currently living with her auntie
for almost 2 years. He felt angry towards his mother whenever she gave the sole attention on his step
brother. At times, he and his mother have been argued over his decisions. Hence, he would stay at his
room and play games. He felt worthless and insignificant of his mother’s love. On the contrary, he has
good relationship towards his father. His father shows affection by calling him almost every day. He
included that he has also good relationship with his stepbrother. xxxx and his brother’s past time is playing
games and watching funny videos. At times, he was being scolded by his auntie whenever he did
something wrong. Yet, his auntie described him as his own son and she wants to give the love that he
needed.

Educational

The client went to Special Education last 2015 because of his behavior as decided by his auntie. After a
year, he left SPEd because his teacher told him that he’s okay already. The client admits that it’s hard for
him to make good grades. He often had difficulty in math subjects and thinks that he is stupid or dumb.
He frequently asked for extra help from his auntie because of his learning difficulties. Sometimes, he had
difficulty sustaining his attention because his mind was preoccupied with so many things about future. He
had some misunderstanding with his classmates in decisions of the group. Yet, he was not afraid to go to
school and can get along with most of the teachers.
 Strictly Confidential

Social/Personal

xxxx doesn’t initiate conversation with the kids on his own age and almost wanted to play alone. xxxx said
that other kids make fun of his ideas and often makes them angry because of his decisions. He had
sometimes having arguments with his cousins hence, he didn’t talk to them. He has best friend named
xxxxx who he can be told of his problems.

xxxx is tall, seemed to be overweight and appeared to be older than his chronological age. He went to the
clinic clean and wearing dull shirts. He looked sad, perplexed and bored. He seemed to be confused but
responsive. He was fleeting his eyes almost two times while answering the question. He walked slowly
and hand wringing has been observed. He talked slowly monotonous and relevantly responding only to
the questions being asked. He was oriented with time, place and person and able to come to appropriate
conclusions. xxxx loves playing games with his step brother and watching funny videos. He had few friends
and often wants to be alone. He also enjoys muai thai training with her auntie and seemingly worried of Commented [a1]:
his health. At the age of 11, xxxx underwent developmental evaluation at xxxx Doctors Hospital last 2015
because of school difficulties and some behavioral concerns. He had difficulty in conceptual skills like
reading, writing and understanding instructions. Now that he is 14 years old, he often felt sad and angry
at the same time in his mother. He mentioned that he wanted to kill himself since he heard that her
mother wouldn’t care about him. Yet, he was still thinking of his auntie and others that he might not see
them if he committed suicide.

Tests Administered:
Slosson Full Range Intelligence Test

The S-FRIT is a screening test that provides a balanced measure of Verbal Performance/Memory cognitive
assessment. It assesses Verbal Skills/Quantitative/Recall Memory/Abstract Performance Reasoning.

Intelligence Scale Raw Score Standard Score Percentile Stanine Cognitive Age

Verbal Index 46 64 7 2 10.07

Performance Index 66 82 13 3 12.00
Memory Index 20 74 4 1 9.10
Full Range 132 77 8 2 11.02
Confidence Level 73 to 81 Dull Normal

Adaptive Behavior Inventory

It is a comprehensive, norm-referenced measure, appropriate for students. The ABI is composed of 150 brief items
covering five scales: Self-Care Skills, Communication Skills, Social Skills, Academic Skills, and Occupational Skills.

Adaptive Areas Raw Score Standard Score Percentile Description

Self-care Skills 76 11 63 Average
Communication Skills 79 9 37 Average
Social Skills 87 10 50 Average
Academic Skills 66 7 16 Below Average
Occupational Skills 68 10 50 Average
 Strictly Confidential

ABI Composite Quotient 96 Average

Behavioral and Emotional Rating Scale- Parent Rating Scale

The Behavioral and Emotional Rating Scale is a standardized, norm referenced scale designed to assess the
behavioral and emotional strengths of children, instead of their deficit, problem and pathologies.

Behavioral & Raw Percentile Scaled Behavioral & BERS-2 Probability

Emotional Rating Score Score Emotional Strength
Scale (BERS) Strength Index
Interpersonal Strength 41 91 14 Above Average
Family Involvement 22 37 9 Average
Intrapersonal Strength 29 84 13 Above Average
115 Very Low
School Functioning 20 50 10 Average
Affective Strength 21 95 15 Superior
Career Strength 14 91 14 Above Average

Behavioral and Emotional Rating Scale- Youth Rating Scale

The Behavioral and Emotional Rating Scale is a standardized, norm referenced scale designed to assess the
behavioral and emotional strengths of children, instead of their deficit, problem and pathologies.

Behavioral & Behavioral & BERS-2

Raw Scaled
Emotional Rating Percentile Emotional Strength Probability
Score Score
Scale (BERS) Strength Index
Interpersonal Strength 42 98 16 Superior
Family Involvement 23 63 11 Average
Intrapersonal Strength 31 84 13 Above Average Extremely
120
School Functioning 21 63 11 Average Low
Affective Strength 19 91 14 Above Average
Career Strength 7 9 6 Below Average

Gilliam Autism Rating Scale –Third Edition

The Gilliam Autism Rating Scale –Third Edition is a standardized instrument designed for assessment of person who
have autism spectrum disorder (ASD) and other severe behavioral disorders.

Scaled Autism Probability of

Scale Raw Score Percentile
Score Index Autism
Restricted behaviors 5 3 5
Social Interaction 4 2 4
Social Communication 19 37 9 69 Probable
Emotional Response 11 25 8
Cognitive Style 0 3 5
 Strictly Confidential

Maladaptive Speech 5 25 8

Personality Inventory for Youth

This test provides a multidimensional, psychometrically sound measure of emotional and behavioral adjustment,
family interaction, and academic functioning.

Scales Raw Score T Score Description

Validity Scale 0 44 Normal
Inconsistency Scale 4 39 Normal
Dissimulation Scale 10 56 Normal
Defensiveness 13 56 Normal
Cognitive Impairment 11 63 Elevated
Poor Achievement & Memory 5 57 Normal
Inadequate Abilities 6 71 Elevated
Learning Problem 1 52 Normal
Impulsivity & Distractibility 5 49 Normal
Brashness 2 59 Normal
Distractibility & Overactivity 0 37 Normal
Impulsivity 3 57 Normal
Delinquency 9 45 Normal
Antisocial Behavior 2 47 Normal
Dyscontrol 3 44 Normal
Noncompliance 4 47 Normal
Family Dysfunction 14 62 Elevated
Parent- Child 5 60 Normal
Parent Maladjustment 3 52 Normal
Marital Discord 6 68 Elevated
Reality Distortion 9 58 Normal
Feelings of Alienation 6 56 Normal
Hallucinations & Delusions 3 58 Normal
Somatic Concern 10 56 Normal
Psychosomatic Syndrome 4 57 Normal
Muscular Tension & Anxiety 1 40 Normal
Preoccupation with Disease 5 73 Elevated
Psychological Discomfort 12 55 Normal
Fear & Worry 6 54 Normal
Depression 4 57 Normal
Sleep Disturbance 2 51 Normal
Social Withdrawal 8 59 Normal
Social Introversion 7 65 Elevated
Isolation 1 45 Normal
Social Skill Deficit 8 52 Normal
Limited Peer Status 5 50 Normal
Conflict with Peers 3 54 Normal
 Strictly Confidential

Summary of Findings:
Psychological and Cognitive Functioning

xxxx was subjected to a series of psychological tests to understand his psychological framework.
Presented on the following paragraphs are the summary of the findings on the different aspects of the
assessment.

Using the Slosson’s Full-Range Intelligence Test, the result shows that xxxx’s general intellectual quotient
is at 77. xxxx’s IQ range is on dull normal and this indicates that his cognitive function can be reach up to
81 IQ level. His full range IQ is estimated to be functioning at 11 years and 2 months. This shows that his
intellectual ability is much lower than of his current age in the general population. Also, this implies that
he is having difficulties in learning academic skills such as arithmetic, reading, short term memory that
requires substantial support. The deterioration of his cognitive function possibly happened while he was
in special education program. xxxx perhaps adapt the environment of SPED centers and thus, he has this
learning gaps. His verbal intelligence is estimated to be functioning at 10 years and 7 months. This shows
that xxxx has difficulty to comprehend and reason using concepts that expressed through words. His
logical intelligence is estimated to base functioning at 12 years old. This implies that Raphael has difficulty
He has also difficulty in analyzing information, detect patterns and relationships, and solve problems on a
complex, intangible level. More so, xxxx's ability to recall and retain information is estimated to be
functioning at 9 years and 10 months. Remembering some important dates or information is in need of
someone’s help.

xxxx’s general adaptive functioning is within normal range. This indicates that he is adequate on sustaining
their mental and emotional on changing environment. His self-care skill is on average. This means that he
can perform personal grooming, general information about self and performs household chores
effectively. Communication skill is also average. This reveals that xxxx can express personal feelings and
attitudes, comprehends information through media and understand and use spoken vocabulary
appropriate for age. His social skills are also average. This shows that he’s aware of other’s perception and
can organizes and leads group activities. xxxx occupational skill is within average. This indicates that he
can follow work schedule, performs work with little or no supervision and performs assigned work
accurately. On the other hand, his academic skills are within below average. He has difficulty in conceptual
skills such as measurement, intermediate writing task and uses reference materials. He may be unable to
cope successfully with academic tasks and the school environment but he can be able to compensate for
outside of school and to meet daily living challenges and sociocultural expectations adequately.

xxxx has also a very low probability of having emotional behavior disorder. This implies that the client has
sufficient behavioral and emotional strength. He can manage stresses of daily life more effectively and
recover easily from challenges and crises when they arise.

Based on Gilliam Autism Rating Scale, xxxx got probable score on having Autism Spectrum Disorder. This
indicates that he would be highly functioning individual but in need of instruction on social communication
skills.

In Personality Inventory for youth, all four validity scales are below 60, suggesting that the client had paid
appropriate attention to inventory item content. The results for the validity scales suggests consistency
of responses in regards to the inventory, does not represent severe pattern of maladjustment. Systematic
effort to either exaggerate or minimize problems is not suggested.
 Strictly Confidential

xxxx demonstrates two areas of concern through primary elevations of cognitive impairment (63T) and
family dysfunctions (62T). He has difficulty in achieving to age expectations at school and deficits in
cognitive functions that was reflected when he entered special education program last 2015. Also, there
is an elevation in family dysfunction that suggests the need to evaluate family interaction and adjustment
with his parents. This was supported by the experiences when his parents got separated and there is an
existing insufficient love and care of his mother to him. Likewise, his relationship with his mother were
occupied their time arguing with each other. Moreover, his sadness triggered whenever his mother
showing love and affection for his step brother. The client felt worthless and unhappy because of this
situation. Hence, he would rather avoid his mother because he felt angry and sad. Inadequate abilities
(71T) appears elevated and this indicates xxxx had academic concerns and negative self-evaluation of
intellectual ability such as he thinks he is stupid and difficult to make good grades. Marital Discord (68T)
is also elevated. This indicates that he has conflicts between parents because of separation. Preoccupation
with Disease (73T) are also elevated and an indicative that xxxx frequently talks about his sickness because
he wanted to be healthy. Social Withdrawal (65T) is also elevated and xxxx would likely feel uncomfortable
with strangers.

Diagnosis:

 Dull Normal IQ with adequate adaptive functioning

Recommendations:
 Enrolled him in inclusive educational program
 Provide intensive academic intervention to address learning gap

Prepared by:

xxxx
Psychologist