SAMPLE. Developmental Milestones Parent Assessment Report. By C. Keith Conners, Ph.D.

Similar documents
ETR PR-06 Form. Annotations for the New. Contents. Using the ETR Form document. Evaluation Team Report

Conners' Adult ADHD Rating Scales Self-Report: Long Version (CAARS S:L)

ETR. Evaluation Team Report TYPE OF EVALUATION: CHILD'S INFORMATION: DATES PARENTS'/GUARDIAN INFORMATION ETR FORM STATUS CHILD'S NAME:

Description of Services

A GUIDEG EDUCATION FOR CHILDREN SPECIAL PRESCHOOL TRANSITIONING FROM EARLY INTERVENTION

Continuous Performance Test 3 rd Edition. C. Keith Conners, Ph.D.

Conners' Continuous Performance Test II (CPT II V.5)

A Guide to Preschool Special Education

Developmental Assessment. School of Child & Youth Care University of Victoria

A GUIDE TO PRESCHOOL SPECIAL EDUCATION

Conners' Continuous Performance Test II (CPT II V.5)

CHILD S NAME INSERT CHILD S PHOTO HERE

Age Birth to Four Months Four to Eight Months

Aligning Curriculum with the Pre-Kindergarten Standards. Pre-Kindergarten Standards and Indicators by Key Learning Area

Infant-Toddler Alignment. Preschool Alignment. HighScope Educational Research Foundation

Advocating for Services: How a Parent Can Access a Special Education Program, Special Education Teacher Support Services and/or Related Services

INDIVIDUAL FAMILY SERVICE PLAN (IFSP)

CHILD, HEALTH, WELFARE & DEVELOPMENT ASSESSMENT GUIDE

Register of Students with Severe Disabilities

Autism and Intellectual Disabilities

School-based Support Personnel

The test uses age norms (national) and grade norms (national) to calculate scores and compare students of the same age or grade.

EARLY CHILDHOOD TRANSITION GUIDEBOOK. What You Need to Know Before Your Child s Third Birthday

The Clinical Evaluation of Language Fundamentals, fourth edition (CELF-4;

A GUIDEG SPECIAL PRESCHOOL EDUCATION FOR CHILDREN TRANSITIONING FROM EARLY INTERVENTION DRAFT

EARLY CHILDHOOD TRANSITION PROCESS

Eligibility for DD Services and the SIB-R

Components of an Effective Evaluation for Autism Spectrum Disorder

An Introduction to Ages & Stages Questionnaires (ASQ-3)

Fact Sheet 10 DSM-5 and Autism Spectrum Disorder

Ages & Stages Questionnaires : A Screening Tool For Pennsylvania s Child Welfare Workers

ADULT ASPERGER ASSESSMENT (AAA)

ALBUQUERQUE PUBLIC SCHOOLS

Eastgate Early Childhood & Family Center

Early Intervention Services in New Jersey Frequently Asked Questions

Last name: State/ Province: Home telephone number:

Upcoming changes to autism spectrum disorder: evaluating DSM-5

Technical Report. Overview. Revisions in this Edition. Four-Level Assessment Process

Last name: State/ Province: Home telephone number:

Assessing Adaptive Behavior in Young Children. Gloria Maccow, Ph.D. Assessment Training Consultant

AUTISM SPECTRUM RATING SCALES (ASRS )

FAQ regarding IEP s. Does a Special Ed teacher (Service Coordinator) have to be present at IEP meeting? Yes. At least 1 must be present.

Collaborative Documentation on Daily Living Activities Regardless of Age

INDIVIDUALIZED FAMILY SERVICE PLAN

Incorporating Sensory Processing in Early Intervention Programs

Female Child s date of birth: Last name: State/ Province: Home telephone number:

Chapter 6: Assessment for Service Planning

Digging Deeper into Safety and Injury Prevention Data

Gifted & Talented Program Description

Starting School. Guidelines for Parents/Guardians of Children with Special Educational Needs

Traveling the Special Education Highway. A Parent s Guide to a Successful Journey. Arizona Department of Education Exceptional Student Services

Form: Filled in table. Method: Peer assessment. Tool: Checklist. Form: Completed table. Method: Peer assessment. Tool: Checklist

School Packet. Teacher Instructions Principal/Music Specialist Letter Parent Letter and Forms

Portage Guide Birth to Six Preschool Indicator 7 Child Outcomes Crosswalk. Outcome 2 Acquisition & Use of Knowledge & Skills

School Psychology Resources Catalog

Conners' Continuous Performance Test II (CPT II V.5)

Check List for identifying Special Needs Children among School age children. Cerebral Palsy

The Special Education Referral & Identification Process. Menlo Park City School District Source: US Department of Education and

Adaptive Physical Education

Early Childhood Through Young Adulthood / School Counseling. Component 1: Content Knowledge SAMPLE ITEMS AND SCORING RUBRICS

Policy for Documentation

Behavior Rating Inventory of Executive Function - Adult Version BRIEF-A. Interpretive Report. Developed by

Role of Occupational Therapy With Infants, Toddlers, and Families in Early Intervention. The American Occupational Therapy Association, Inc.

Alignment of the Hawaii Preschool Content Standards With HighScope s Preschool Child Observation Record (COR), 2nd edition

TEXAS RISING STAR WEBINAR SERIES: CURRICULUM AND EARLY LEARNING GUIDELINES RECORDED OCTOBER 29, 2015 NOTES

Inventory for Client and Agency Planning Instructor Training Program

FIRST 5 MARIN KINDERGARTEN SCHOOL READINESS: TEACHER S FINDINGS AND OBSERVATIONS OF THE CLASS OF 08-09

Behavioral and Developmental Referral Center

General Therapies for Individuals with Autism

WHODAS 2.0 World Health Organization Disability Assessment Schedule item version, self-administered

James is a five year old boy and spends his days at the. spends time with each individually. One of activities James loves is to sit down on the

On-entry Assessment Program. Accessing and interpreting online reports Handbook

SPECIFIC LEARNING DISABILITY

UTA Application for Reduced Fare Card

FIT Child Development Audio Conference Journal Date: March 10, 2010 Topic: months Participants: 6 New information:

ADEPT Glossary of Key Terms

Recommended Practices For Assessment, Diagnosis and Documentation of Learning Disabilities

Helping your child with Non-verbal Learning Disability

Comprehensive Reading Assessment Grades K-1

Child s Developmental Stages: A Challenge to Relevancy and Curriculum Development in Children s Church

Policy/Program Memorandum No. 8

Lecture 2. The Development Part of the. The Greenspan Floortime Approach D Part of Model Lecture 2

DR. PAT MOSSMAN Tutoring

Marcia E. Humpal, M.Ed., MT-BC Ronna S. Kaplan, M.A. MT-BC. Journal of Music Therapy

Overview. Benefits and Features

Education Adjustment Program (EAP) Handbook

Standards Based IEP s for Preschool Children. Special Education Services Alabama State Department of Education

Special Education For Preschoolers

MISSOURI S Early Learning Standards

Chapter 6: Individualized Education Programs (IEPs)

Understanding Types of Assessment Within an RTI Framework

INCREASE YOUR PRODUCTIVITY WITH CELF 4 SOFTWARE! SAMPLE REPORTS. To order, call , or visit our Web site at

MY MEMORY BOOK. My Story IMPACT PROGRAM

Is There a Difference Between Asperger's Syndrome and High Functioning Autism? Dr Tony Attwood

PLAY STIMULATION CASE STUDY

Adaptive Behavior Assessment System-Second Edition Interpretive Report

Transcription:

By C. Keith Conners, Ph.D. Developmental Milestones Parent Assessment Report This Assessment Report is intended for use by qualified assessors only, and is not to be shown or in any other way provided to the respondent or any other unqualified individuals. P.O. Box 950, North Tonawanda, NY 14120-0950 3770 Victoria Park Ave., Toronto, ON M2H 3M6

Summary of Results Overview of Scores The following graph provides T-scores for each of the Conners Early Childhood DM P scales. Summary of Elevated Scores The following section summarizes areas of concern for Sue J based on her parent s ratings. Note that areas that are not a concern are not reported in this summary. Developmental Milestone Scales The T-scores for the following Conners Early Childhood Developmental Milestone scales are very elevated (i.e., T-score 70), indicating many more concerns than are typically reported: Adaptive Skills (T = 85), Communication (T = 90), Play (T = 85) and Pre-Academic/Cognitive (T = 76). Impairment The parent reports that Sue J s problems occasionally (rating = 1) seriously affect her learning, interactions with other children, and home life. Conners Early Childhood DM P Results and IDEA Scores suggest possible consideration for IDEA 2004 eligibility in the following area(s): Autism, Developmental Delay-Adaptive, Developmental Delay-Cognitive, Developmental Delay-Communication, Mental Retardation/Intellectual Disability, Specific Learning Disability and Speech or Language Impairment. Cautionary Remarks This Summary of Results section provides information only about areas that are a concern. Please refer to the remainder of the Assessment Report for further information regarding areas that are not elevated or could not be scored due to too many omitted items. Page 2

Introduction The Conners Early Childhood Developmental Milestones Parent (Conners Early Childhood DM P) is an assessment tool used to obtain a parent s observations about his or her child s behavior. This instrument is designed to assess a wide range of developmental milestones in young children. When used in combination with other information, results from the Conners Early Childhood DM P can provide valuable information to aid in assessment and guide intervention decisions. This report provides information about the parent's assessment of the child, how he/she compares to other children, and which scales are elevated. See the Conners Early Childhood Manual (published by MHS) for more information. This computerized report is an interpretive aid and should not be given to parents or other unqualified users, or used as the sole criterion for clinical decision-making. Administrators are cautioned against drawing unsupported interpretations. Combining information from this report with information gathered from other psychometric measures, interviews, observations, and review of available records will give the assessor a more comprehensive view of the child than might be obtained from any one source. This report is based on an algorithm that produces the most common interpretations for the obtained scores. Administrators should review the parent s responses to specific items to ensure that these interpretations apply to the child being described. Developmental Milestone Scales: T-scores The following graph provides T-scores for each of the scales. High T-scores for the Developmental Milestone scales suggest that the parent has concerns about Sue J s development. The error bars on each bar represent Standard Error of Measurement (SEM) for each scale score. For information on SEM, see the Conners Early Childhood Manual. Page 3

Developmental Milestone Scales: Detailed Scores The following table summarizes the results of the parent s assessment of Sue J, and provides general information about how she compares to the normative group. Please refer to the Conners Early Childhood Manual for more interpretation information. Scale T-score ± Raw SEM Guideline Score (Percentile) Adaptive Skills 22 85 ± 4.1 (99) Very Elevated Score (Many more concerns than are typically reported) Communication 25 90 ± 2.8 Very Elevated Score (99) (Many more concerns than are typically reported) Motor Skills 12 55 ± 3.9 Average Score (Typical (74) levels of concern) Play 7 85 ± 4.2 Very Elevated Score (99) (Many more concerns than are typically reported) Pre-Academic/ 25 76 ± 3.2 Very Elevated Score Cognitive (97) (Many more concerns than are typically reported) Note: SEM = Standard Error of Measurement Impairment Common Characteristics of High Scorers Potential delay in the development of Adaptive functioning skills, including dressing, eating/drinking, toileting, personal hygiene, and helping. Expressive and receptive language, including verbal, facial, and gestural communication. Fine and gross motor skills. Imaginative and pretend play. Knowledge of pre-academic concepts (e.g., shapes, colors, letters, numbers, and body parts), pre-reading skills (e.g., rhyming, name recognition), and early memory/reasoning skills. The parent s report of Sue J s level of impairment in learning/pre-academic, peer interactions, and home settings is presented below. Content Guideline 0 1 2 3? IM 1 Learning/Pre-Academic Problems occasionally seriously affect learning. IM 2 Peer Interactions Problems occasionally seriously affect interactions with other children. IM 3 Home Life Problems occasionally seriously affect home life. Parent s rating: 0 = Not true at all (Never, Seldom); 1 = Just a little true (Occasionally); 2 = Pretty much true (Often, Quite a bit); 3 = Very much true (Very often, Very frequently);? = Omitted. Additional Questions The following section displays additional comments from the parent about Sue J. Number Content Response AQ 1 Additional concerns about your child This item was omitted. AQ 2 Child's strengths or skills This item was omitted. Page 4

Conners Early Childhood DM P Results and IDEA The Conners Early Childhood DM P provides information that may be useful to consider when determining whether a child is eligible for early intervention or special education and related services under current U.S. federal statutes, such as the Individuals with Disabilities Education Improvement Act of 2004 (IDEA 2004). The following table summarizes areas of IDEA 2004 categorization that are typically considered when a particular score is elevated. The At Risk; Followup Recommended column indicates which areas are elevated for Sue J, suggesting the need for follow-up to determine if she is eligible for services under IDEA 2004 in this particular area. The information in this table is based on IDEA 2004 and general interpretation/application of this federal law. Specific state and local education agencies may have specific requirements that supersede these recommendations. The assessor is reminded to review local policies that may impact decision making. An elevated score is not sufficient justification for IDEA 2004 eligibility. The IDEA 2004 indicates that categorization is not required for provision of services, particularly in the case of early intervention services. In most districts, a child qualifies for early intervention services if there is evidence that he/she is at risk for substantial delays if services are not provided (even if no developmental delays or diagnoses have been documented yet). Please see the Conners Early Childhood Manual for further discussion of IDEA 2004. Content Areas Developmental Milestone Scales Adaptive Skills Communication Motor Skills At Risk; Follow-up Recommended Possible IDEA Eligibility Category DD-Adaptive, MR/ID Autism, DD-Communication, S/L DD-Physical, OHI Play Autism, DD-Cognitive, MR/ID Pre-Academic/Cognitive DD-Cognitive, DD-Communication, MR/ID, LD, S/L DD = Developmental Delay; LD = Specific Learning Disability; MR/ID = Mental Retardation/Intellectual Disability; OHI = Other Health Impairment; S/L = Speech or Language Impairment. Page 5

Responses The parent marked the following responses for items on the Conners Early Childhood DM P. Developmental Milestone Scales DM1. 1 DM14. 2 DM27. 2 DM40. 1 DM53. 1 DM66. 0 DM2. 2 DM15. 0 DM28. 0 DM41. 1 DM54. 0 DM67. 2 DM3. 1 DM16. 1 DM29. 2 DM42. 1 DM55. 1 DM68. 0 DM4. 0 DM17. 0 DM30. 2 DM43. 1 DM56. 1 DM69. 0 DM5. 0 DM18. 1 DM31. 0 DM44. 0 DM57. 0 DM70. 0 DM6. 1 DM19. 1 DM32. 1 DM45. 2 DM58. 1 DM71. 2 DM7. 1 DM20. 1 DM33. 1 DM46. 1 DM59. 0 DM72. 1 DM8. 0 DM21. 1 DM34. 1 DM47. 2 DM60. 1 DM73. 2 DM9. 0 DM22. 1 DM35. 1 DM48. 0 DM61. 0 DM74. 0 DM10. 0 DM23. 0 DM36. 1 DM49. 1 DM62. 1 DM75. 0 DM11. 1 DM24. 2 DM37. 0 DM50. 1 DM63. 0 IM1. 1 DM12. 0 DM25. 0 DM38. 1 DM51. 2 DM64. 1 IM2. 1 DM13. 0 DM26. 1 DM39. 1 DM52. 0 DM65. 1 IM3. 1 Parent s rating (DM items): 0 = No (Never or rarely); 1 = Sometimes; 2 = Yes (Always or almost always);? = Omitted item. Parent s rating (IM items): 0 = Not true at all (Never, Seldom); 1 = Just a little true (Occasionally); 2 = Pretty much true (Often, Quite a bit); 3 = Very much true (Very often, Very frequently);? = Omitted item. Date printed: June 08, 2009 End of Report Page 6

Child's Name: Child's Age: Date of Assessment: Name: Assessor's Name: Conners Early Childhood Feedback Handout for Parent s Sue J 4 years and 4 months February 15, 2009 Mrs. J ES This feedback handout explains scores from parent ratings of this child s behaviors and feelings as assessed by the Conners Early Childhood Parent form (Conners Early Childhood P). This section of the report may be given to parents (caregivers) or to a third party if parental consent is granted. What is the Conners Early Childhood? The Conners Early Childhood is a set of rating scales used to gather information about young children. The Conners forms were developed by Dr. Conners, an expert in child behavior, and can be completed by parents and teachers (or childcare providers). Research has shown that the Conners scales are reliable and valid, which means that you can trust the scores that are produced by the parent s ratings. Why do parents complete the Conners Early Childhood? Information from parents (or guardians) about their child s behavior and feelings is extremely important, as parents generally know their child better than anyone else. Parents can describe their child s behaviors in a number of different situations, including the home and community. The Conners Early Childhood is typically used to better understand a child s difficulties and find a way to help. The Conners Early Childhood can also be used for a child receiving treatment to see if the child is improving. Sometimes the Conners Early Childhood is used as a routine check, even when the child does not appear to have a problem. If you are not sure why the parent was asked to complete the Conners Early Childhood, please ask the assessor listed at the top of this feedback form. How does the Conners Early Childhood work? The parent marked 75 developmental milestones to describe how often Sue J shows each skill without help. The parent s responses to these statements were combined into several groups of items. Each group of items describes a developmental area (for example, communication). The parent s responses were compared with what is expected for girls who are the same age as Sue J. The scores for each group of items tell how similar Sue J is to her peers. This information helps the assessor know if Sue J is having more difficulty in a certain area than other girls who are the same age. Results from the Conners Early Childhood Parent Form The assessor who asked the parent to complete the Conners Early Childhood will help explain these results and answer any questions you might have. Remember, these scores were calculated from how the parent described Sue J in the past month. The parent ratings are supposed to let the assessor know how Sue J acts at home and in the community. The results from parent ratings on the Conners Early Childhood should be combined with other important information, such as interviews with Sue J s parent, other test results, and observations of Sue J. All of the combined information is used to determine if Sue J needs help in a certain area and what kind of help is needed. As you go through the results, it is very helpful to share any additional insights that you might have, make notes, and freely discuss the results with the assessor. If the results do not make sense to you, you should let the assessor know so that you can discuss other possible explanations. Remember that the parent s responses to all of the items were combined into groups of possible problem areas. The following tables list the main topics covered by the Conners Early Childhood Parent form. These scores were compared with other girls who are the same age as Sue J. This gives you information about whether the parent described typical or levels of concern (that is, not an area of concern ) or if the parent described more concerns than for girls who are the same age as Sue J. Page 1

Developmental Milestones The tables below summarize the parent s observations of Sue J s developmental milestones. The tables also give you examples of the skills that are included in each developmental area. Sue J may not have delays in all aspects of an area; it is possible to have more concerns than even if only some of the skills are delayed. Also, it is possible that the parent may describe typical or levels of concern even if Sue J is showing some delays in an area. Self-Care Communication Physical Movement Play Thinking and Learning Dressing, eating & drinking, toileting, personal hygiene, and helping. Explaining and understanding with spoken language, facial expressions, and gestures. Using fingers and body to do things like drawing and jumping. Imaginative and pretend play. Learning important concepts like shapes, colors, letters, numbers, and body parts. Showing pre-reading skills. Using early memory and reasoning skills. It is important to discuss these results with the assessor listed at the top of this feedback handout. This feedback handout only describes results from the Conners Early Childhood Parent form. A checkmark in the more concerns than box does not necessarily mean that Sue J has a serious problem and is in need of treatment. Conners Early Childhood results must be combined with information from other sources and be confirmed by a qualified clinician before concluding that an actual problem exists. Impairment When asked to rate whether the problems described on the Conners Early Childhood Parent form affected the child s functioning, the parent responded: The parent indicated that Sue J s problems occasionally seriously affect her learning. The parent indicated that Sue J s problems occasionally seriously affect her interactions with other children. The parent indicated that Sue J s problems occasionally seriously affect her home life. Page 2