NEW YORK STATE INSTITUTE ON DISABILITY, INC.

930 Willowbrook Road-Bldg. 41-A Staten Island, NY 10314 Phone/Fax (718) 494-6457

CONFIDENTIAL PSYCHOLOGICAL EVALUATION

Name: Amelia Suazo

DOB: 1/22/07 Age: 14-11 Gender: E

Phone:

Contact:

Date of Evaluation: 1/21/22 Address:

Type: Comprehensive – Home

REFERRAL

Amelia was referred for a comprehensive psychological evaluation in order to assess current levels of functioning and determine her eligibility for NYS OPWDD services. The following report was completed during the COVID-19 crisis. Consequently, modifications were made in order for services to be delivered, including the use of web-based technology and the omission of aspects of data collection which could only occur by way of in-person interaction. While some data could therefore not be obtained, services were provided using the best practice standards available at the time given the constraints of the pandemic emergency. The family was made aware of the necessary adjustments to our services and consented to proceed under these conditions.

PROCEDURES

Review of Records Clinical Interview Behavioral Observations

Stanford-Binet Intelligence Scale – 5"' Ed. (prorated) Vineland Adaptive Behavior Scales – 3n1 Ed.

BACKGROUND

Amelia is a verbal and ambulatory fourteen-year-old female of Hispanic descent with a history of developmental delays and learning difficulties in school. She has a complex medical history significant for a malignant brain tumor at the age of four, followed by invasive neurosurgery, several associated epileptic seizures, chemotherapy, and a stem cell transplant, along with a VP shunt. Amelia also has a mild high frequency hearing loss and central auditory processing disorder, which requires dual hearing aids and FM unit in the classroom. She is prescribed HGH and an estrogen patch to correct hormonal imbalances. Amelia receives periodic MR.I's and is

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Amelia Suazo / Psychological / 01.21.22

followed by a neurologist, oncologist, endocrinologist, and gastroenterologist to meet her health needs. She does not have a formal psychiatric history and no behavioral problems are noted in school records but the family reports self-esteem issues and social skills deficits. Amelia is classified as Other Health Impaired on her IEP and participates in a special education program at the Cooke School and Institute, where she receives speech, counseling, and occupational therapies. She resides with her mother in an apartment in the Bronx.

BEHAVIORAL OBSERVATIONS

The remote testing environment appeared free of distractions and adequate rapport was established with the examinee via the Zoom digital platform. The examinee was engaged in the task throughout the session with no problems noted during the administration.

Amelia is pretty and well-groomed fourteen-year-old girl who appears her stated age. She is slim and petite with long straight dark brown hair, dark brown eyes, and a light tan complex.ion with dental braces. Her gait, balance, and coordination appear grossly normal and observed fine­ motor functions are intact. Amelia presents with a shy demeanor but made good eye contact and has a fair capacity to relate with others, as rapport was easily established with the examiner. She typically speaks in grammatically-complete sentences, albeit simple with a limited functional vocabulary and mild articulation difficulties at times. No deficits in pragmatic communication or reciprocal social interaction were noted. Amelia was cooperative throughout the assessment and participated in all activities as requested. She denied visual/auditory hallucinations or suicidal ideations but demonstrated limited insight and social judgment for his chronological age, along with a visibly slow mental process when engaged in cognitive tasks, particularly on verbal subtests. Gross hearing and visual acuities were deemed adequate for assessment purposes.

TEST RESULTS

The Stanford-Binet Intelligence Scales- 51h Edition (SB-V) was administered to assess Amelia' current level of intellectual functioning. Please note that deviations from standard procedures were utilized in order to accommodate remote testing. Specifically, a proration of the nonverbal domain due to the exclusion of visual-spatial processing (form board) and working memory (block tapping). The results are as follows:

Scale

Standard ScorePercentile RankClassification

—————·————————-

Verbal80

Nonverbal92

Full Scale85

09Low Average

30Average (prorated)

16Low Average (prorated)

Amelia Suazo / Psychological / O1.21.22

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elia achi veda prorated Full-Scale I.Q. Score of 85 on the Stanford-Binet Intelligence Scale, which Usm the low average range and is ranked at the 16th percentile . There is a 90-percent probab1hty that her true I.Q. Score falls between 82 and 88. She enjoyed considerably more success with tasks that involved perceptual reasoning than those which required verbal comprehension. Deficits in the area of speech and language are contributory.

The Verbal Scale of the SB-V measures the ability to reason, solve problems, visualize, and recall important information presented in words and sentences (printed and spoken). It is based on the verbal subtests of five factor index scales, which assess the ability to express verbal responses clearly, present a basic rationale for response choices, create simple stories, and explain spatia l

relations. Amelia achieved a Verbal I.Q. Score of 80, which falls in the low average range and is ranked at the 9m percenti le.

The Nonverbal Scale of the SB-V measures the ability to reason, solve problems, visualize, and recall information presented in pictorial, figural, and symbolic form, as opposed to information presented in the form of words and sentences (printed or spoken). Amelia performed adequately on the Fluid Reasoning subtest, which required her to recognize and continue patterns. She fared similarly on the Knowledge subtest, during which she had to demonstrate nonverbally what items in pictures are used for, and had only mirlor difficulty on the Quantitative Reasoning subtest, which required her to demonstrate nonverbally how many items are being asked of her to selecL Amelia achieved a prorated Nonverbal I.Q. Score of 92, which falls in the average range and is ranked at the 30111 pe rce ntile.

ADAPTIVE FUNCTIONING

The Vineland Adaptive Behavior Scales, 3n1 Ed. (Vineland-3) is a standardized measure of adaptive behavior – the things that people do to function in their everyday lives. Whereas ability measures focus on what the examinee can do in a testing situation, the Vineland-3 focuses on what he or she actually does in daily life. Because it is a nonn-based instrument, the examinee's adaptive functioning is compared to that of others his or her age. The Vineland-3 provides overall scores for Communication, Daily Living Skills, Socialization, and Motor Skills (optional). It also provides a composite score that summarizes the individual's performance across all domains.

Amelia's adaptive behavior was measured using the Vineland-3 Domain-Level Parent/Caregiver Form utilizing her mother as the primary informant through the Zoom audio-video feed. The results are deemed reliable and summarized below:

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.

DomainStandard ScorePercentileAdaptive Level

.

Communication75

Daily Living Skills81

Socialization79

Composite76

05Moderately Low

10Moderately Low

08Moderately Low

05Moderately Low

Amelia's overall level of adaptive functioning is moderately low, corresponding with a standard score of 76 which is ranked at the 5th percentile.

In the area of Communication, Amelia's standard score of 75 is moderately low and ranked at the 5th percentile. The Communication domain measures how well Amelia listens and understands, expresses herself through speech, and her basic literacy. Amelia follows straightforward directives, expresses basic wants or needs adequately, speaks in complete sentences, and asks appropriate "wh" questions to obtain relevant information. However, she has difficulty following multi-step directives, relating detailed experiences , or saying something in a different way to clarify what she means. Her overall literacy skills are at a_3ni grade level.

In the area of Daily Living Skills, Amelia's standard score of 81 is moderately low and ranked at the 10th percentile. The Daily Living Skills domain assesses Amelia's performance of the practical, everyday tasks of living that are appropriate for her chronological age. Amelia is independent in basic AOL areas, including feeding, toileting, showering, and dressing. She can help herself to cold cereal in the morning or make sandwich for lunch. However, she does not read analog time, has poor money skills, and does not count change from minor purchases, nor does she complete household chores or use the stovetop for cooking. Amelia is minimally-aware of basic safety issues, is easily distracted outdoors, and may not look both ways before crossing the street or road.

In the area of Socialization, Amelia's standard score of79 is moderately low and ranked at the 8th percen tile. The Socialization domain measures how well Amelia functions in social situation s. Amelia can be affectionate with family members at times, shows some interest in other people, and will participate in games or structured activities with prompting and supervision in school. However, more often than not Amelia tends to self-isolate and avoids interaction with peers. She rarely talks with others about shared interests or show understanding that gentle teasing with family and friends can be a form of humor or affection. Amelia's interpersonal development and coping skills are immature for her chronological age and she has difficulty interacting appropriately with peers. She also has self-esteem issues.

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SUMMARY

Amelia is a verbal and ambulatory fourteen-year-old girl with a history of developmental delays and learning difficulties who was referred for a psychological evaluation to assess current levels of functioning and determine her eligibility for OPWDD services. She has a complex medical history significant for a malignant brain tumor at the age of four, followed by invasive neurosurgery, several associated epileptic seizures, chemotherapy, and a stern ceJl transplant, along with a VP shunt. Amelia also has a mild high .frequency hearing loss and central auditory processing disorder, which requires dual hearing aids and FM unit in the classroom. She does not have a formal psychiatric history and no behavioral problems are noted in school records but the family reports self-esteem issues and social skills deficits. The current evaluation was completed during the COVID-19 crisis and deviations from standard procedures were utiliz.ed in order to accommodate remote testing. On this date, Amelia achieved a prorated Full-Scale 1 Q. Score of 85 on the Stanford-Binet Intelligence Scale, which falls in the low average range of cognitive ability. Her overall level of adaptive functioning is moderately low, corresponding with

a standard score of 76 which is ranked at the 5th percentile.

Developmental Disability Diagnosis: Traumatic Brain Injury (S06.9)

RECOMMENDATIONS

1. Continued participation in special education programming with supportive therapies.

2. Psychological counseling to address low self-esteem and social skills deficits.

3. Community habilitation to improve self-sufficiency,travel skills, and safety awareness.

4. A need for after-school/recreational programming is also indicated.

5. Coordination of services through ca:re management.

Licensed Psychologist

NYS License No. 7876lfll/2022