CONFIDENTIAL PSYCHOLOGICAL EVALUATION

Name: Date of Birth: Age: Testing Dates: Tests Given:

Peter Sample X-XX-XXX 25 years, 9 months 2-18-00, 2-25-00, 3-1-00, 3-9-00, 3-16-00, 3-22-00

Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI) Bender-Gestalt Test of Visual-Motor Integration (BGVMT) Brown ADD Scales Nelson-Denny Reading Test, Form H Wechsler Adult Intelligence Scale- Third Edition (WAIS-III) Woodcock-Johnson Psychoeducational Battery - Revised: (WJ-R) Tests of Cognitive Abilities and Tests of Achievement: Standard and Supplemental Batteries

REASON FOR REFERRAL Peter Sample requested a comprehensive psychoeducational evaluation in order to document the history and the nature of his learning difficulties and the educational accommodations that he has been receiving since 1996. Peter is currently a third year law student and is seeking appropriate accommodations for the California State Bar Exam in July. BACKGROUND INFORMATION Peter is 25 years old and completing his third year of law school at XXXXX University. Educational history reflects that he has always done well in reading/language arts classes and poorly in math classes. An evaluation completed in 1996 at XXXX revealed a math disability and visual processing deficits that may have resulted from having meningitis as an infant. Based upon the results of that evaluation, he received the accommodation of extended time on the LSAT exam and for exams in law school.

Peter Sample Page 2 Currently, Peter is working as an intern at a law office and he is reading contracts all day long. He noted that it takes him longer to complete them than other interns and that he makes editing errors when he pushes himself to complete the work. While reading, he misses important information and leaves in language that conceptually he knows doesn't belong. When he takes his time, he is more accurate. Peter's goal is to do litigation, and he reported no difficulties in court, as oral expression and "thinking on his feet" are strengths for him. Peter described difficulty in maintaining his concentration. Although he is able to focus initially, he has trouble maintaining and sustaining his concentration. Unrelated thoughts distract him and interrupt his concentration and slow down his thinking process. Peter wants to understand why it takes him so long to comprehend a set of legal facts, to formulate and organize them, and "why does it take me so long to read everything?". Developmental/Family: Peter reported that he grew up in an intact but troubled family and that he took on the role of holding it together at an early age. He felt that his role in the family caused him to mature early and he developed strong abilities to cope and to keep moving ahead. His mother was the nurturer, while his father was ill-tempered and "macho". His father was born in the United States but grew up in XXXXX. Peter is the elder of two brothers and his younger brother has severe learning disabilities in the areas of fine motor skills, visual-motor perception, visual memory, and short-term auditory memory. His younger brother also had meningitis as a child and was hospitalized. His speech and language development were delayed and he has problems with stuttering and he did not learn to read until he was 10 years old. Peter's younger brother attended special education classes full time from the second grade until he was in high school. Currently he uses the learning disabilities program at XXXX, where he is a junior. Peter indicated that his mother completed her B.A. degree and his father completed a graduate program in architecture. Neither of them had any learning difficulties. Health/Medical: Peter Sample reported that he was a breech baby delivered through an emergency cesarean section procedure. He was full term and his mother received adequate prenatal care throughout her pregnancy. Peter reported that he had significant health problems as a baby, having seizures at 2 months and taking Phenobarbital. Parents consulted several specialists and, after misdiagnosis, he was diagnosed as having meningitis at 9 months. He had numerous bouts of pneumonia, bronchitis, and high fevers, and was always sick and crying. By age 4, symptoms had diminished.

Peter Sample Page 3 Peter also reported a history of severe migraines beginning at age 5 and continuing until he was approximately 13 years old. When he was 9-10 years old, he had double vision and the headaches were occurring daily. When he was in junior high, he recalled the headaches were so painful that he "felt like blacking out". He was treated by a neurologist at XXXX Medical Center and the medication Inderal was prescribed for this condition. The migraines recurred in 1997, when he entered law school, but symptoms were less severe and he did not experience double vision or blackouts. When they occur now, at the advice of his doctor, he rests and takes Advil. Peter experienced high blood pressure as a youngster and needed to control his food intake. He also has a history of weight problems, but feels that this is under control now. He caught chicken pox with a high fever at age 16. Educational: Peter has a history of panic attacks related to test anxiety during math exams. In the 6th grade, he was taking a group administered standardized test and it was here that he had his first panic attack. He needed to leave the room and parents were called in for a conference. His second panic attack occurred in the 8th grade, under similar circumstances, while taking a timed test in math. His third attack occurred during an accounting exam during his 3rd year of college and his fourth attack occurred during a criminal law exam his first semester of law school. Peter attended kindergarten and first grade in the XXXXX School District. In the first grade, he was reading above his grade level and went to a third grade class for reading and language arts but was beginning to have difficulties with learning basic math skills. Peter was identified as a gifted student and he transferred to the XXXXX Magnet School in 2nd grade. His struggles with math became more apparent in grades three to five, and parents were called in numerous times for conferences regarding his math performance. He remained at this magnet school until junior high, when he went to a gifted/magnet program at XXXXX Junior High School. As part of this GATE program, he enrolled in an advanced pre-algebra class, which he failed. This had social as well as academic consequences for him, as his friends continued in the advanced math track, but he took his math courses in a non-magnet track. He recalled that he "fell out of the social loop" with established friends because of math and was perceived differently as a student. Peter recalled that, after his panic attack in 8th grade math, his math teacher allowed him to bring math formulas into the exams so that he did not have to memorize them. This eased his anxiety, he did not have another anxiety attack, and he scored better on math exams. Peter transferred to XXXXX High School at the beginning of 10th grade, and received A's and B's in history and English courses and D's and F's in chemistry and algebra. He failed advanced algebra trigonometry his first semester and was placed in an intermediate class second semester. He also failed this class, as he was unable to

Peter Sample Page 4 do the homework and did not understand the math concepts at all. He took intermediate algebra again during the first semester of 11th grade and received a "D' grade. He recalled feeling frustrated because he received no help from the school; he recalled going to his counselor for help but none was forthcoming. He failed advanced algebra the second semester of 11th grade and again during the first semester of 12 grade. By 11th grade, it had became apparent that he could not go to the college of his choice and he became demoralized and stopped studying. He was very involved in athletics and put all of his energy and effort into football. His grade point average was 2.60. Upon graduation, he was recruited to play football for several colleges but would have had to make the team as a "walk-on" player. He did not pursue this and attended XXXXX Community College for one year where he did well and received "B" grades in his courses. He transferred to XXXXX for his second year to play football and majored in political science because it had no math requirement. For his third year, he transferred to XXXX and described his first quarter at as being "like a boxing match where I got knocked out the first minute". This quarter system moved too quickly for him, as both previously attended colleges had been on a semester system. He scaled back his course load from four to three classes and did better, again earning "B" grades. Peter reported that he was doing well until he took an accounting class, where he experienced another panic attack during an exam. During the exam, he realized that only 20 minutes remained and he was "nowhere close to finishing" and he "freaked out" over the sounds of students finishing and leaving the classroom. Directions suddenly made no sense to him, he began hyperventilating, and he needed to leave the room. At the urging of his mother and his best friend, who had learning disabilities, he sought help at the Learning Disabilities Center on campus and the director of that program screened him and recommended a full evaluation. When he returned to Los Angeles for the summer, he went to XXXX for testing. Based on the results of that evaluation, he was granted extended time for test-taking at college, and was granted time-and-a-half for the Analytical section of the LSAT exam. He earned his highest score on this section, which he attributed to having additional time as well as being in a separate room. Peter was accepted to law school at XXXXX University and did not initially seek out accommodations there. Wanting to do it on his own, he reflected that this was "really stupid" to do because he experienced another panic attack during his exam in Criminal Law. A review of Peter's law school transcript reflects the benefit of extended time for him. In the first year, he was in the bottom third of his class after the first semester and in the bottom quarter after the second semester. For the second year, he submitted his

Peter Sample Page 5 testing documentation and was granted time-and-a-half for all exams. Since then, he has ranked at the top 25-30% of the class, an impressive change from his first year. Peter noted that the normal length of time for exams is 3 hours; he was granted 4-1/2 hours which helped tremendously but he still does not fully complete exams within that extended time period.

BEHAVIORAL OBSERVATIONS Peter was fully oriented to his surroundings at all times. Testing was completed in six sessions and he arrived promptly each time. He was dressed casually but appropriately and engaged in conversation readily. He appeared to exert full effort on all tasks presented to him and maintained attention and concentration in this one-onone testing situation. Based on all circumstances, the environmental setting, Peter's motivation, and the testing conditions, the results of this evaluation appear to be valid and interpretively useful.

ASSESSMENT RESULTS AND IMPRESSIONS Cognitive Functioning: Based on the results of the WAIS-III, Peter possesses cognitive ability that falls within the superior range (FSIQ, 92nd PR; 95% confidence interval 117-125). This single score, however, does not accurately reflect his abilities because of the significant variability among his test scores. There is a statistically significant 23-point difference between Peter's very superior verbal abilities (98th PR) and his average nonverbal abilities (68th PR). A difference this size occurred in only 4.1% of the standardization sample, indicating that it is quite unusual. Verbal Abilities: Peter's verbal abilities are significantly more developed than his other cognitive abilities. When his abilities are analyzed at the index score level, there is a 15-point discrepancy between his verbal comprehension and his perceptual organization, and between his verbal comprehension and his processing speed abilities, which occurred in 23.1% and 32.4% of the national normative standardization sample, respectively. Cognitive research suggests that individuals with such disparate skill development often experience frustration and inefficiency in the learning process. Verbal comprehension is the ability to use language for thinking and for problem solving and Peter's subtest scores on the verbal comprehension index fall within the superior level. He demonstrated exceptional strength in his knowledge of social conventions and in his ability to formulate abstract verbal concepts (Comprehension, 99th PR and Similarities, 99th PR).

Peter Sample Page 6 In providing oral definition to words, Peter performed at the superior level (Vocabulary, 91st PR). In his knowledge of synonyms and antonyms, Peter performed better through oral expression than through reading (WJ-R, Oral Vocabulary, 73rd PR vs. Reading Vocabulary, 43rd PR). His ability to use words to maintain a verbal pattern was at the high average level (WJR, Verbal Analogies, 81st PR). He performed at a higher level on a contextually based language comprehension task (WJR, Listening C omprehension, 90th PR). Auditory processing skills are evenly and well developed, with superior skills in sound blending and in auditory closure (both at 93rd PR). Memory Skills: Working memory is a complex memory skill that requires holding information mentally while performing some active manipulation or calculation with it. All of the WAIS-III memory subtests present numerical data orally and on this index, Peter's scores ranged from average to high average range (Arithmetic, 75th PR; Letter-Number Sequencing, 91st PR; Digit Span, 84th PR). This is further supported by his performance on auditory memory tasks on the WJR: Tests of Cognitive Ability. While the WAIS-III subtests assess working memory of numerical data, the selected WJ-R subtests assess memory for language-based tasks. Peter was strong with the meaningful information (WJ-R, Memory for Sentences, 89th PR) and even stronger with the nonmeaningful information (WJ-R, Memory for Words, 95th PR). On visual/auditory learning tasks that required memory of novel information. Peter scored at the average level (WJ-R, Memory for Names, 47th PR and Visual-Auditory Learning, 61st PR). Memory of purely visual material wasat the average level (WJR, Picture Recognition, 69th PR). Attention: Peter appeared to exhibit developmentally appropriate levels of attention and concentration throughout the evaluation. He did, however, report difficulties in maintaining his concentration and becoming distracted by unrelated thoughts during the evaluation, while in class, and throughout a typical day. For example, while finding the matching numbers on a task (WJR, Visual Matching), the number 405 led him to think, "oh, the 405 freeway", which momentarily distracted him from the timed task at hand and slowed his pace. To assess these symptoms further, a self-report measure was administered and his self-ratings placed him into the "probable" range for having a diagnosable attention disorder. These ratings alone do not provide enough documentation for diagnostic purposes, but the symptoms reported by him reflect his functional level. With a history of anxiety attacks, these symptoms may stem more from anxiety than from a true neurological attention deficit disorder, but further investigation may be warranted.

Peter Sample Page 7 Nonverbal Abilities: Perceptual organization is the ability to organize visual information and to reason and problem solve with visual data. There is quite a bit of variability in this area, as his scores ranged from the average to the superior level. Spatial ability is very well-developed, whether he is mentally manipulating spatial images (WJR, Spatial Relations, 95th PR) or actively manipulating blocks to reconstruct designs from a model (Block Design, 84th PR). He demonstrated good fluid reasoning in solving problems using unfamiliar information, scoring at the high average level (Matrix Reasoning, 84th). He displayed average ability in identifying and applying logical rules to solve puzzles (WJR, Analysis-Synthesis, 71st PR). In identifying pictures with missing parts or with image distortion, he scored at the high average level (WJR, Visual Closure, 76th PR) and at the average level in his visual attention to detail (Picture Completion, 63rd PR). Visual sequencing skills were less developed, falling at the lowest point in the average level (Picture Arrangement 25th PR). Peter's visual strength appears to be his spatial skills, and his visual organizational skills are adequately developed to the average level overall. There is, however, significant weakness in his visual-motor integration skills which was apparent on two measures, the Bender-Gestalt and the VMI. Reproductions of designs on the VMI fell at the low average level (18th PR) and performance was similar on the Bender-Gestalt. Peter reported that he has always gotten "flack" from teachers about his poor handwriting, which is explained by this weak development in his visual-motor integration skills. Processing Speed: Processing speed is the ability to process concrete data in an automatic, fluent manner, and, when compared to his superior verbal ability, this is a relative weakness for Peter and comprises an intra-cognitive discrepancy. Research suggests that when mental operations are speedy, more information can be process ed without overloading the cognitive system. Individuals with deficient processing speed often experience frustration and failure and need high levels of motivation and persistence to compensate for pervasive deficits. Peter's performance on processing speed subtests across the WAIS-III and the WJR were consistent, with scores falling within the average range in coding abstract symbols (Digit Symbol-Coding, 75th PR) and in identifying two matching numbers (WJ-R, Visual Matching, 64th PR). He scored at the high average level in locating matching symbols (WJ-R Cross Out, 82nd PR) but barely scored average on a similar task in visually tracking and matching abstract symbols (Symbol Search, 25th PR).

Peter Sample Page 8 ACADEMIC ACHIEVEMENT: Development in academic skills was assessed in the areas of reading, math, and written language. Scores are age-normed. Reading: Reading skills were measured under untimed, timed, and extended time conditions. Under the untimed conditions of the Woodcock-Johnson, Peter scored at the very superior level in his reading skills, performing similarly in his identification of familiar and unfamiliar words and in his comprehension of short passages (Letter-Word ID, 98th PR and Passage Comprehension, 98th PR). Under the timed condition of the Nelson Denny test of Reading Comprehension, he scored at a much lower level in reading longer passages and answering multiple choice items (19th PR). The Nelson Denny also provides norms for an extended time condition, and the additional time aided Peter, as he improved his score to the 75th PR. His rate of reading on the Nelson Denny was measured at the 6th percentile, which is significantly below expected levels. With no time imposition, Peter was clearly able to demonstrate his knowledge and comprehension to a greater degree than even with an extended time condition. The reading material on the Nelson Denny is at an undergraduate level; Peter's legal reading is far more advanced and demands excessive amounts of his time for completion. Writing: On structured writing samples, Peter wrote sentences that maintained parallel format in sentence construction and scored at the superior level (WJ-R, Writing Samples 92nd PR). On a timed measure of writing very simple sentences Peter did well, scoring at the very superior level (WJ-R, Writing Fluency, 99th PR). His knowledge of spelling and basic language mechanics fell at the average range (WJ-R, Dictation, 41st PR). Math: Peter's weakest skills were in math, which has historically been his most difficult school subject. He performed at the average level in his ability to calculate math problems with paper and pencil, (WJR, Calculation, 30th PR) and in applied math problems (WJR, Applied Problems, 41st PR). These scores are lower than his score for mental math problems on the WAIS-III (Arithmetic, 75th percentile), which are calculations with money and other practical situations. Peter reported that he had difficulty remembering formulas and that impacted his performance on the WJR math tasks. SOCIAL/EMOTIONAL: No standardized assessment was completed in this area, but Peter reported a history of anxiety that manifests specifically around math and timed tests. Based upon interview and other background information, there are no other emotional conditions impacting him. Socially, he has maintained close friendships since kindergarten and he functions at a high level in his life.

Peter Sample Page 9 SUMMARY and RECOMMENDATIONS Peter Sample is a 25-year-old third year law student who exhibits significant variability in his cognitive abilities. Cognitive strengths are apparent in his verbal comprehension and fluid reasoning abilities, while significant weaknesses are evident in his processing speed and in his visual-motor integration development. These intra-cognitive processing deficits have impacted his academic skills in the are as of timed reading comprehension and math, which fall below levels predicted by his superior level of verbal comprehension. Peter has compensated well and has been successful in his academic pursuits, but it appears that he continues to be impacted by the learning difficulties that were noted in early elementary school years but not formally diagnosed until 1996. With a history of meningitis in infancy, this may provide some medical explanation for Peter's cognitive profile. His younger brother also had meningitis as an infant and has been diagnosed as having multiple cognitive processing deficits and began attending special education classes in the second grade. Culturally and educationally, Peter has enjoyed enriched exposure to new information and has not suffered from any disadvantage in these areas. Based upon the results of this evaluation, Peter is identified under Section 504 of the 1973 Rehabilitation Act as having a handicapping condition that substantially limits one of his major life activities, specifically, learning. Based upon this identification, he cannot perform at his ability level without the provision of appropriate educational accommodations that are provided by this law for handicapped individuals. For the upcoming California State Bar Examination, Peter would benefit from the educational accommodations that he has been receiving, including the following: 1. Double time for all sections of the exam. This is based upon his slow rate of reading (6th PR), the intra-cognitive discrepancy between his abilities in verbal comprehension and his processing speed, and his lower level of reading comprehension under timed conditions versus extended time versus untimed conditions (19th vs. 75th vs. 98th PR). Since there is no untimed condition offered for the State Bar exam, the maximum of double time is recommended. Separate examination room. Peter becomes distracted and anxious in an exam when people around him appear to be finishing before him. To prevent another panic attack, Peter would benefit from being in a separate exam room. Intervention for anxiety management. Although Peter is nearing the end of his academic life and of being tested under timed conditions, he would benefit from some specific interventions for anxiety management, such as learning relaxation and breathing techniques. Hypnosis can also be very helpful for test-related anxiety.

2.

3.

Peter Sample Page 10 DSM-IV Multiaxial Diagnosis Axis I: 315.1 Mathematics Disorder 309.24 Adjustment Disorder with Anxiety, chronic test anxiety Axis II: V71.09 No Diagnosis Axis III: Meningitis, migraine headaches in childhood Axis IV: Demands of law school and upcoming State Bar examination Axis V:GAF=73 (Current)

Test Giver, M.A.

Date

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CONFIDENTIAL TEST DATA WECHSLER ADULT INTELLIGENCE SCALE - THIRD EDITION (WAIS-III) Scaled Scales Score Scaled score of 100 is average. Verbal Scale Score Performance Scale Score Full Scale Score 130 107 121 95% Confidence Interval Percentile 124-134 100-113 117-125 98 68 92

Classification Very Superior Average Superior

Scaled Indexes Score Scaled score of 100 is average. Verbal Comprehension Perceptual Organization Working Memory Processing Speed 126 111 117 111

95% Confidence Interval Percentile 119-131 103-117 109-123 101-119 Percentile 91 99 75 84 84 99 91 96 77 87 77

Classification Superior High Average High Average High Average

Scaled Verbal Tests Score Scaled score of 10 is average. Vocabulary 14 Similarities 17 Arithmetic 12 Digit Span 13 Information 13 Comprehension 17 (Letter-Number Sequencing) 14

Classification Superior Very Superior Average High Average High Average Very Superior High Average

Performance Tests Scaled score of 10 is average. Picture Completion Digit Symbol-Coding Block Design Matrix Reasoning Picture Arrangement (Symbol Search)

Scaled Score 12 12 11 13 8 12

Percentile 75 75 63 84 25 75

Classification Average Average Average High Average Low Average Average

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WOODCOCK - JOHNSON PSYCHOEDUCATIONAL BATTERY - REVISED: TESTS OF ACHIEVEMENT Standard CLUSTERS Score Percentile Classification Broad Reading Letter- Word ID Passage Comprehension Basic Reading Skills Letter-Word ID Word Attack Reading Comprehension Reading Vocabulary Passage Comprehension Broad Mathematics Calculation Applied Problems Broad Written Language Dictation Writing Samples Broad Knowledge Science Social Sciences Humanities 134 130 132 131 130 133 113 97 132 95 92 96 106 96 121 104 100 116 99 99 98 98 98 98 99 80 43 98 37 30 41 66 41 92 62 50 86 47 Very Superior Very Superior Very Superior Very Superior Very Superior Very Superior High Average Average Very Superior Average Average Average Average Average Superior Average Average High Average Average

NELSON-DENNY READING TEST - Form H Raw Score Vocabulary Time limit norms 63 Extended time norms 70 Comprehension Time limit norms 27x2=54 Extended time norms 37x2=74 Reading Rate 181 Standard Score 230 233 212 243 Grade Equivalent 15.4 15.9 13.6 18.6 %ile 37 41 19 75 6 Stanine Classif. 4 5 3 6 2 Average Average Low Average Average Very Low

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WOODCOCK - JOHNSON PSYCHOEDUCATIONAL BATTERY - REVISED: TESTS OF COGNITIVE ABILITY Cognitive Factors Long-Term Retrieval Memory for Names Visual-Auditory Learning Short-Term Memory Memory for Sentences Memory for Words Processing Speed Visual Matching Cross Out Auditory Processing Incomplete Words Sound Blending Visual Processing Visual Closure Picture Recognition Comprehension/Knowledge Picture Vocabulary Oral Vocabulary Fluid Reasoning Analysis-Synthesis Concept Formation Spatial Relations Verbal Analogies Oral Language Memory for Sentences Picture Vocabulary Oral Vocabulary Listening Comprehension Verbal Analogies Standard Score 101 99 104 124 118 125 111 105 114 127 123 122 109 111 108 99 91 109 108 108 106 125 113 111 118 91 109 119 113 Percentile 54 47 61 95 88 95 77 64 82 96 93 93 73 76 69 48 27 73 71 71 65 95 81 76 88 27 73 90 81 Classification Average Average Average Superior High Average Superior High Average Average High Average Superior Superior Superior Average High Average Average Average Average Average Average Average Average Superior High Average High Average High Average Average Average High Average High Average

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WJR Cognitive Aptitudes Reading Aptitude Math Aptitude Written Language Aptitude Knowledge Aptitude Standard Score 119 111 115 121

Percentile 89 76 84 92

Classification High Average High Average High Average Superior

BEERY TEST OF VISUAL-MOTOR INTEGRATION (VMI) Mode Visual-Motor Standard Score 86 Scaled Score 7 PR 18 Classification Low Average

BENDER-GESTALT Angulation errors on designs A, 8,9

BROWN ATTENTION DEFICIT DISORDER SCALES T-Score > 60 is considered significant for ADD. Peter's scores are significantly elevated in all areas except Affect. Cluster Activation Attention Effort Affect Memory Total T-Score 72 92 97 50 76 86