Psychological Report
(Confidential)
Name: Jennie Client Date of Birth: July 17, 1996
Age: 7‑4xxxxxxxxx Date of Exam.: Nov. 20, 2003
Grade: Secondxxxxx Date of Report: Nov. 21, 2003
Test Administered
Wechsler Intelligence Scale for Children ‑ Fourth Edition (WISC‑IV):
Verbal Comprehension Perceptual Reasoning Working Memory Processing Speed
Similarities 12 Block Design 14 Digit Span 11 Coding x8
Vocabulary 13 Picture Concepts 12 Letter-Number Seq. 10 Symbol Srch x9
Comprehension 12 Matrix Reasoning 11 Arithmetic 15 Cancellation 10
Information 14 Picture Completion 12
Word Reasoning 12
Verbal Comprehension Index 112
Perceptual Reasoning Index 115
Working Memory Index 102
Processing Speed Index x91
Full Scale IQ 109
Reason for Referral
Jennie, a 7‑year, 4‑month‑old girl, was referred to the clinic for evaluation because of encopresis, fecal smearing, and stealing.
Background
According to Jennie's aunt, Jennie was born out of wedlock and never knew her natural father. She was separated from her mother at 6 months of age when her mother developed leukemia from which she died a year later. Since that time Jennie has lived with a paternal aunt and her three children, who range in age from 8 to 18 years. The aunt has been divorced twice. Jennie calls her aunt "mother" and thinks of her aunt's first husband as her father. This man, who had been in the family as long as Jennie, has not been involved with the family since he divorced the aunt. Jennie was 22‑years‑old at the time of the divorce. Her aunt reported that Jennie made incomplete and ineffective attempts at toilet training during this period of turmoil. Last year Jennie's aunt remarried. During the six months that this marriage lasted, Jennie formed no attachment to her second step‑uncle.
Jennie's aunt reported that she has bowel movements in the bathtub; she smears feces on the walls or leaves them in trash cans around the house. She also soils herself frequently. she wanders around the house at night, and sometimes vanishes for hours while in the park or on her way home from school. Her aunt stated that she stole a stopwatch from the principal's office, and food and money from other places. The aunt also reported that she seems to make an effort to be discovered when she steals.
Her aunt also reported that Jennie is an excellent student in school, although she is difficult to handle because of her opposition and defiance. Her behavior in the past three months has been changing. There has been a decrease in encopresis and fecal smearing, and an increase in stealing and aggressive behavior.
Behavioral Observations
Jennie is a small, thinly built, energetic child. She was cooperative and friendly during the testing session. Her test behavior was characterized by competitiveness, tenacity, and anxiety. She seemed to want to answer all the questions correctly and was reluctant to give up on any question. On the Information subtest, for example, she responded to "What are the four seasons of the year?" with "Spring" and "Fall," but could not remember the other seasons. She had to be encouraged to go on to the next question, and three times later she spontaneously returned to the season question, adding "Winter" and "Summer." Jennie seemed to need continual assurance from the examiner that she was answering items correctly. She often asked, "Have I gotten them all right?"
Assessment Results and Clinical Impressions
With a chronological age of 7‑4, Jennie achieved a Verbal Comprehension Index score of 112, a Perceptual Reasoning Index score of 115, a Working Memory Index score of 102, a Perceptual Speed Index score of 85, and a Full Scale IQ of 108 on the WISC‑IV. Her overall performance is classified in the Average range and is ranked at the 73rd percentile. That is, her overall performance on the WISC-IV was better than about 73% of other children her age taking this test. The chances that the range of scores from 104 to 114 includes her true IQ are about 95 out of 100. Given her earnest effort, the present measure of her level of intellectual functioning appears valid.
Jennie’s verbal and nonverbal skills and her short‑term auditory sequential working memory are all adequately developed. However, her speed of mental operations, psychomotor speed, and visual-motor coordination are perhaps less well developed. Overall, with the exception of her processing speed skills, Jennie consistently demonstrated average skills as assessed by the WISC-IV.
Within the verbal area, her range of factual knowledge, language usage and development, and long term memory are good. Social comprehension, common sense, and concept formation ability are also adequate. Within the nonverbal area, her perceptual organization, abstract conceptualizing ability, ability to differentiate essential from nonessential details, and fluid reasoning ability are also adequately developed. Regarding short-term auditory sequential memory and attention and concentration, Jennie generally showed adequate skills. She also demonstrated excellent mental computational abilities. Relatively less developed are skills associated with visual‑motor coordination and psychomotor speed. She appeared to approach tasks that require good visual attention and motor speed with impulsivity and, to some extent, perseveration. Perhaps the scores reflect temporary inefficiency due to fatigue, or perhaps they simply indicate that her abilities in these areas are not as well developed.
Overall, she approaches problems by giving detailed answers that are descriptive and meaningful. A number of Jennie's responses are particularly interesting. In response to the question "What are you supposed to do if you find someone's wallet or purse in a store?" she said, "Well, you could keep it, but you probably should give it back." In reference to another question asking why it is important for cars to have license plates, she said, "Because the car might be stolen." Her mention of "keeping" and "stolen" are notable responses in view of her behavior pattern, which includes stealing. A preoccupation with stealing may be intruding into her outlook toward life. One response differed from her general pattern of rather clear cut, detailed, well‑oriented, and direct responses. When queried about how an apple and a banana are alike, she said that an apple and a banana are alike because they "feel the same." The above responses were the only ones that were idiosyncratic.
The test’s results suggest that Jennie's behavioral problems, for the most part, have not interfered with her intellectual functioning. Her psychomotor speed and visual‑motor coordination are slightly less‑adequately developed than her other abilities, but her overall functioning is better than average. There were suggestions of preoccupation with stealing, but it is difficult to determine the extensiveness of such a preoccupation.
Recommendations
On the basis of the present limited evaluation, it is recommended that a personality evaluation also be conducted. Furthermore, the seriousness of her behavioral disturbance suggests that therapy should be initiated for both Jennie and her aunt. Every attempt should be made to obtain further information about her home environment and to determine which factors in the home may be reinforcing her deviant behavior pattern. Her aunt should be actively engaged in the development of a treatment program.
Summary
Jennie, with a chronological age of 7‑4, achieved an IQ of 109 on the WISC‑IV. This IQ is at the 73rd percentile and in the Average range. The chances that the range of scores from 104 to 114 includes her true IQ are about 95 out of 100. The test results appear to give a valid indication of her present level of intellectual functioning. Jennie's verbal, nonverbal, and working memory skills are uniformly developed, but there was some relative decrement in her speed of mental processing due to apparent impulsivity. The findings suggest that her behavioral problems are not significantly interfering with her cognitive skills. A personality evaluation was recommended, along with a treatment program that would involve Jennie and her aunt.