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In order to integrate assessment information into treatment…
In order to integrate assessment information into treatment planning, having reviewed the sample assessment reports titled “12 Year Old Assessment” and “5 Year Old Assessment,” students are to choose ONE of these clients and treatment plan for them based on the findings and recommendations of the psychologist. The treatment plan should consist of 3 long-term goals, with 2 objectives (short-term goals) each. Each objective should also include at least 2 interventions. The goals should be to follow the S.M.A.R.T. (Specific, Measurable, Achievable, Realistic, and anchored within a Time Fame) format. Then students should respond to at least and provide feedback on their treatment plan. The feedback should go beyond a simple “good job on the treatment plan” and should be substantive, with ideas for improvement, or specific examples of things done well.
Name: Sally M. Gender: Female Date of Birth:
Age: 12:10 Ethnicity: Caucasian
Reason for Referral:
CONFIDENTIAL ASSESSMENT REPORT
Place of Evaluation:
Referral Source: Outpatient therapist Evaluator:
Dates of Evaluation:
Date of Report:
Sally M. was referred for a neuropsychological assessment by her outpatient therapist, John H.
Current concerns include Sally’s emotional functioning (specifically feelings of anxiety and depression), declining grades in Math, and her social functioning with peers. Additionally, Sally’s mother reports problems with impulsivity, low self-esteem, and recent incidents of lying and stealing. Finally, Sally’s mom reports a desire to better understand Sally’s neurocognitive functioning.
Ther evaluation was designed to assess Sally’s neurocognitive strengths and weaknesses as well as her social and emotional development in an effort to establish a targeted and evidence-based treatment plan, which can be implemented by her parents, teachers, and treatment team.
Background Information:
Sally is a 12-year old Caucasian female who resides in City, State with her mother, Jill M., maternal grandparents, and 9-year old sister, Sam. The family’s primary language is English. Sally attends Middle School in City, and is in the 7th grade.
Developmental & Medical History:
Sally is the first child of Jill and Robert M. Mrs. M. was 36-years old at the time of her pregnancy with Sally and she reported a healthy pregnancy, denying drinking alcohol, taking medication, or smoking during their time. However, Mrs. M. stated that she experienced a placental abruption and was placed on bedrest for the last 2 weeks of pregnancy. Sally was delivered via caesarean section at full-term (39- weeks gestation). She weighed approximately 7-pounds 11-ounces and measured 19-inches in length. Mrs. M. and Sally were discharged from the hospital 4-days later without any medical concern.
Sally’s development was described as typical with several milestones having been reached early per mother’s report. Specifically, she took her first steps and spoke her first words by 10-months and was reported by Mrs. M. to have spoken in complex sentences by 12 months. She achieved daytime toileting at 2.5-years old and nighttime continence at approximately 4-years old, although she continued to have occasional episodes of nighttime bedwetting through 10-years of age. No childhood diseases were endorsed, however, Sally had a number of emergency room visit and hospitalizations related to allergic reactions to food, medication, and suicidal ideation (discussed later in the report).
At the time of the evaluation Sally’s health was described as good, with the exception of chronic asthma and seasonal and food-related allergies, which are controlled with medication. There is no history of significant head injury, loss of consciousness, or seizures. Sally’s appetite is reported to be good and Sally’s sleep is reported to be normal.
Mental Health History
Sally has been receiving outpatient psychotherapy services since the age of approximately 10-years, focusing on the impact of her parents’ divorce and her conflicts with her sister. She has had 6 psychotherapists in that time, with several of the changes being related to goodness of fit and Sally’s feelings of mutual rapport. Sally’s mental health history is also significant for two psychiatric hospitalizations at the age of 11-years as a result of suicidal ideation and attempt. The first hospitalization was over the course of 4 days, after which Mrs. M. requested her release and admitted her to the hospital at XXX due, per her report, to inattentive care. Sally spent an additional 2 days at XXX, was released and returned several hours later, after an aggressive incident toward her younger sister. She remained at XXX for 8 days, and has not had further need for hospitalizations. Sally denies current suicidal ideation and is under the care of a psychotherapist, John H., MFT, and a psychiatrist, Dr. Kelly T., M.D.
Educational History
Sally attended preschool in City, where she was described as “always a helper” and was well-liked by teachers and peers. She then transferred to Elementary School, also in City, for kindergarten through the 5th grade. Here, per Mrs. M.’s report, Sally’s teachers described her as “a pleasure to have in class” and she demonstrated a love for science. In 5th grade, noticing her potential, Sally’s teacher fostered her public speaking abilities. In 6th grade, Sally transferred to Middle School, and currently attends the 7th grade there. She typically and historically receives grades of As and Bs, but there has been a recent decline in her Math grade (she is currently earning a C+). Sally reports disliking the Math teacher due to her unengaging teaching style, which “doesn’t work for [her].” Overall, Sally enjoys positive relationships with most teachers, but does exhibit some school avoidance at times.
Outside of the classroom, Sally is reported to have difficulty completing her homework due to procrastination reported by both, Sally and her mother. Nevertheless, Sally reported often worrying about finishing her homework on time and is noted to be perfectionistic in its content and execution.
Family and Social Environment
Sally has lived with her mother and with her maternal grandparents since birth. Prior to her parents’ divorce when Sally was 4-years old, her father lived in the home as well. While she enjoys a very close relationship with her mother, describing her as “[her] best friend.” Sally reported negative feelings toward her father, with whom she has had no contact for 8 years.
Sally was described by her mother as kind, thoughtful, generous, caring and creative, as well as resilient in the face of difficult or traumatic experiences. However, she was also described as a needing to control situations, anxious, and as exhibiting some age-inappropriate behaviors (e.g. sucking thumb and bedwetting).
Interpersonally, Sally’s mother stated that she is a “people pleaser” and likes to help other and to make them feel good (e.g., give meaningful gifts, cook for others). She does, however, have a conflicting relationship with her sister, which Sally and her mother describe as a trigger for Sally’s anger and depression. Additionally, although she is able to identify several close friends (some of whom she has known since Kindergarten), Sally has a history of having been bullied at school from the 2nd to the 5th grade. Notably, Sally reports having chosen her current middle school based on the fact that her bully would be attending a different school.
Sally reports that she has many hobbies, such as baking, sports, art, and music. She is part of the orchestra at school and is on a basketball team outside of school. Additionally, Sally reports wanting to be an in the FBI as a career choice and is actively pursuing activities and opportunities to add to her resume for college.
Assessment Measures Administered:
Clinical Interviews with mother (Jill M.)
Clinical Interview with client (Sally M.)
Behavior Assessment System for Children- Third Edition – Adolescent (BASC-3), Self-Report, Parent Report (Mother and Grandmother)
Beck Anxiety Inventory (BAI)
Beck Depression Inventory- 2nd Edition (BDI-II)
Child and Adolescent Memory Profile
Conners 3rd Edition, Self-Report, Parent Report (Mother and Grandmother) Continuous Performance Test – Third Edition (CPT-3)
A Developmental Neuropsychological Assessment- 2nd Edition
Roberts Apperception Test for Children- 2nd Edition
Wechsler Intelligence Scale for Children- Fifth Edition (WISC-V) Wechsler Individual Achievement Test – Third Edition (WIAT-III)
Behavioral Observations
Sally’s evaluation was conducted over four sessions. She was accompanied by her mother and arrived 15 to 30 minutes late for each session, due to various reasons. Upon meeting the examiner, Sally was generally friendly and but somewhat reserved when engaging in conversation. She was oriented to person, place, time and situation. Sally was well groomed and dressed comfortably, but throughout testing, she complained of feeling cold, and wore several jackets. Sally’s eye contact was consistent. Sally’s hearing and vision were reported to be normal limits (when corrected with glasses) and she did not note any difficulty perceiving the testing stimuli. Gait and posture were unremarkable. Sally’s mood was euthymic. Her affect appeared appropriate during casual conversation with the examiner. Her thought process was generally linear, Sally’s language was clear with no speech errors. It is of note that Sally brought many snacks with her to testing and within the first several minutes of the intake session beginning, started to eat, even though she reported having had a satisfying breakfast.
Sally appeared reserved, but polite. As such, rapport was slow to develop, but was established by the last testing session. She was notably more reserved on the first three days of testing and presented with more spontaneous speech and reciprocal communication as rapport was established and commonalities were identified with examiner (e.g., knowledge of a video game). For example, Sally preferred to read during breaks between subtests rather than engaging in conversation with the examiner, something her outpatient therapist reported as having happened in their early sessions as well. However, per her mother’s report, Sally likes to “do nice things for others” and on the second day of testing Sally brought a cookie for the examiner which she had baked. Similarly, she brought a croissant from a bakery she went to on her lunch break on the last day of testing. This was interpreted as her attempts to engage and connect with the examiner, as supported by the report of the outpatient therapist who corroborated Sally’s need to establish a strong rapport prior to sharing/engaging openly.
Sally was somewhat resistant to the testing process, manifesting in providing minimal or humorous responses to open-ended stimuli, changing her handwriting part-way through writing tasks, and asking for
frequent breaks. Notably, and requesting that her mother sit in on the testing sessions. To elicit Sally’s best performance on the cognitive and executive functioning assessments, examiner allowed her mother to be present with the caveat that she could not interfere in the testing process. This appeared to provide the support Sally needed and she more readily engaged in the tasks. As stated, she presented with some resistance to the testing, and requested many breaks, on one occasion requesting a break between items (WISC-V, Matrix Reasoning). Additionally, she presented with anxiety about her performance frequently asking about how well she performed, what the correct answer was, and how other children perform on the test. At times, Sally also presented with some inattention and impulsiveness, beginning to respond before the instructions were given fully and frequently missing important details of the guidelines, requiring the examiner to repeat instructions or correct her efforts. Furthermore, she also exhibited fidgeting behaviors. Sally frequently played with the testing materials, drummed on the desk, and shifted in her seat. Notably, this occurred mainly when she appeared to have understood the instructions for the subtest and during “teaching” items prior to the administration of test items (e.g., NEPSY-II Auditory Attention and Response Set).
Of note is Sally’s tendency to become bored and inattentive during what she perceives as “easy” items.
This tendency led to Sally rushing through items, resulting in lost credit due to calculation and inattention errors. For example, during the initial items of an arithmetic task, she requested more difficult questions (WIAT-III, Numerical Operations) and she rushed to answer prior to the question having been given, answering incorrectly (WIAT-III Math Problem Solving). However, she also presented with a desire to be precise in her answers, providing more decimal places than required (WIAT-III, Problem Solving), as well as to complete all items on a page (e.g., “I had six more problems left! I want to do six more!” [WIAT-III, Math Fluency-Subtraction]).
Overall, Sally did not require additional time to complete tasks, but did require prompts and encouragement to engage in non-preferred/non-desired tasks, during which she exhibited delay aversion (i.e., a desire to get a task over with quickly, sacrificing accuracy for speed of completion). When she was engaged and interested, however, she wanted to put forth her best effort and demonstrate her full ability. This is consistent with her mother’s reports of perfectionism in her performance in school and on homework assignments. With frequent breaks, support, and accommodations of the testing schedule, Sally put forth sufficient effort and these results can be considered a valid estimate of her current neurocognitive functioning and learning style.
Test Results (See Appendix A for Scores):
An important consideration in the discussion of results is that all cognitive measures were conducted in an environment free from distractions, and that Sally was allowed to take breaks and structure the day as needed in order to elicit her best performance. Therefore, the results of the assessment battery discussed in this report represent Sally’s performance capacity and may not reflect her ability in a setting less conducive to her learning/working style.
Additionally, Sally’s true ability likely falls within a range, called a confidence interval, however these are not included in the present report, and the scores described can be considered the best estimate of Sally’s ability.
The scores will be discussed in terms of percentile rankings, which indicate Sally’s relative standing in a group of 100 adolescents in her age range. For example, a percentile ranking of 53 means that if 100 adolescents were given this test, Sally would likely perform better than 53 of them. The table below is also helpful in describing Sally’s performance relative to same-age peers.
Percentile Description
98th%ile+ Extremely High
91st-97th%ile Very High
75th-90th%ile High Average
25th-74th%ile Average
9th-24th%ile Low Average
3rd-8th%ile Very Low
2nd%ile and below Extremely Low
Intellectual Development:
The Wechsler Intelligence Scale for Children 5th Edition (WISC-V) was administered to in order to measure Sally’ intellectual abilities. It is comprised of five indices: The Verbal Comprehension Index (VCI), the Visual Spatial Index (VSI), the Fluid Reasoning Index (FRI), the Working Memory Index (WMI), and the Processing Speed Index (PSI). A Full-Scale IQ (FSIQ) is derived from a sum of the seven scaled scores of the subtests making up the indices. When the index scores are relatively consistent, the FSIQ is considered the most representative construct of general intellectual functioning. Sally’s performance on the WISC-V was generally consistent, with no significant discrepancies between indices. Thus, the FSIQ is thought to be the best estimate of Sally’s intellectual development and her FSIQ score falls within the high average range (FSIQ, 84th percentile).
Verbal Comprehension: The Verbal Comprehension Index (VCI) assesses basic language skills and reasoning measured via two subtests: vocabulary and similarities. Sally’s performance on these subtests ranged from low average to average, with her overall performance within the verbal comprehension domain fell within the average range (VCI, 58th percentile) and representing an area of relative weakness for her. Sally’s ability for abstract verbal reasoning and her ability to verbally display her word knowledge were within the average range (Similarities, 50th percentile and Vocabulary, 63rd percentile, respectively) and are similar when compared with same-aged peers.
Visual Spatial: Subtests within the VSI focus on the use of visual information to build a geometric design to match a model. This is a reasoning task which requires that the parts be seen as elements of a whole and that reasoning skills be used to mentally rotate and visualize the solution, rather than simply match parts within a design. Sally’s performance on the VSI was fell within the high average range (VSI, 87th percentile). However, within the domain, her performance varied between the high average and the very high range. Specifically, Sally’s ability to analyze and re-construct 2D visual-spatial designs using 3D blocks was fell within the very high range (Block Design, 91st percentile). Notably, she completed most of the items within a time significantly shorter than was allowed for each. Further, working within a specified time limit, Sally was asked to view a completed puzzle and utilize part-to-whole thinking and spatial reasoning to select three response options that, when combined, reconstructed a puzzle. Sally’s ability to mentally rotate and combine abstract visual information was within the high average range (Visual Puzzles, 75th percentile).
Fluid Reasoning: The Fluid Reasoning Index (FRI) measures the ability to utilize visual information in order to identify a common theme or concept. The visual information does not directly provide a solution to the problem, however once the underlying conceptual link is discovered, the visual information must be applied to it to arrive at the correct answer. Sally’s performance on subtests within the FRI ranged from average to high average falling within the average range (FRI, 73rd percentile). Sally was asked to use visual spatial information to identify and apply an underlying pattern to solving series of patterns missing one item in the sequence. Her performance on this task was within the high average range (Matrix Reasoning, 84th percentile). Sally was also asked to apply the concept of equality to identify the relationship between objects, applying concepts of matching, addition, and/or multiplication (fluid reasoning skills). While the task included time limitations, these did not impact Sally’s score and she
performed in the average range on this task (Figure Weights, 50th percentile). The difference between the two subtests, although not statistically significant, nevertheless may be representative of Sally’s varied level of energy and motivation to complete tasks throughout the testing day.
Working Memory: Subtests within the Working Memory Index (WMI) measure the ability to register, maintain, and mentally manipulate visual and auditory information. Registration requires attention, discrimination of information, and concentration. Maintenance is the process by which information is kept active in conscious awareness. Finally, manipulation is mental re-sequencing of information. Sally’ performance on subtests within the WMI fell within the average range (WMI 58th percentile). Her ability to listen to and recall numbers was within the very high range (Digit Span, 91st percentile), although a closer look reveals some variability between conditions within the subtest. When Sally was asked to listen to and repeat a string of numbers in the same order in which they were presented she scored in the average range (Digit Span Forward, 63rd percentile), yet when she had to repeat the numbers in reverse order or repeat the numbers after mentally sequencing them from smallest to largest, her score improved and fell within the very high range (Digit Span Backward and Digit Span Sequencing, 91st percentile). This suggests that Sally may become bored with easy tasks and may perform better when she feels more challenged.
Sally’s performance on a second task of visual working memory which required her to register and recall the correct order of visual objects after a 5-second presentation declined, falling within the low average range (Picture Span, 16th percentile). However, it should be noted that due to the examiner error the subtest was discontinued early and may not be indicative of Sally’s true visual working memory ability. Nevertheless, the results are interpreted to be relatively accurate as they are similar to findings from other visual working memory-related measures administered as part of Sally’s assessment battery.
Processing Speed: The Processing Speed Index (PSI), which consists of the coding and symbol search subtests, measures speed and accuracy of visually identifying target information, as well as decision making and execution using two subtests: Symbol Search and Coding. The tasks use visual scanning and discrimination skills, short-term visual memory, visual-motor coordination and require the ability to concentrate. Sally performed equally well on both, with her performance falling within the high average range (PSI, 77th percentile). Sally was first asked to visually scan a line of abstract symbols and quickly decide whether or not a target symbol was present. Then, she was given a measure of visual perception and motor speed, which required matching a number with its designated symbol. On both, Sally’ score was within the high average range (Symbol Search and Coding, 75th percentile).
Academic Achievement:
The Wechsler Individual Achievement Test, 3rd Edition (WIAT-III) was used to measure Sally’s academic achievement. Sally’s performance on academic achievement tests was varied, ranging from very low to average.
Reading: The primary skills involved in the reading process are letter-sound associations, as well as the ability to quickly generate and blend these together in order to produce a word. This task requires intensive instruction and rigorous practice, as well as the ability to rely on working memory when faced with unfamiliar words. The WIAT-III reading subtests measure how quickly and accurately words are recognized, fluency, tone and rhythm of oral reading, and reading comprehension. Overall, Sally’s demonstrated academic achievement was consistent with expectations relative to her intellectual development and similar to that of most same-age peers, with several areas of strength.
Word Reading, Fluency, and Phonological Awareness: Sally was asked to quickly and accurately read real words out of context. On this task, her performance was within the high average range (WIAT-III Word Reading, 75th percentile). She performed similarly when asked to quickly and
accurately read brief passages aloud, with her scores falling, again, in the high average range (WIAT- III Oral Reading Fluency, 77th percentile) with scores in accuracy and rate falling within the average range (WIAT-III: Oral Reading Accuracy 45th percentile, Oral Reading Rate 73rd percentile).
However, Sally performance declined to fall within the average range on a measure of phonological processing, which required her to blend sounds and read nonwords (e.g., “tummingly”) (WIAT-III Pseudoword Decoding, 42nd percentile). Sally’s approach to pronouncing the nonsense words was to rely on more familiar, units of language or syllables (e.g., “un-fro-ding” for [unfrodding]; “tummy-n- glee” for [tumingly]; “tuf-full” for [tufle]). Other errors Sally committed on this subtest were ones related to omission of letters/sounds (e.g, “aptu-ral” for [apturarial]; “ohsk” for [ostique]).
Reading Comprehension:
Sally was also given a measure which required her to answer questions about what she had read in order to assess her reading comprehension. On this measure, Sally read a passage to herself, and then answered questions while having the passage available for reference. Sally’s performance on this subtest was within the high average range (WIAT-III Reading Comprehension, 88th percentile), and consistent with her performance in school.
Writing: The WIAT-III writing domain includes a spelling test and two measures of grammar and syntax on which Sally had to combine simple sentences into one complex sentence, as well as generate sentences that incorporated a target word. She was also given 10 minutes to compose a short essay on a provided topic. Sally’s performance on these tasks were also varied, with individual performances falling between the low average and the high average range.
Sally’ ability to accurately spell different words was within the average range (WIAT-III Spelling, 73rd percentile). Sally’s ability to combine multiple sentences while maintaining their original meaning was within the high average range (WIAT-III Sentence Combining, 84th percentile), however, she displayed similar success in her ability to generate a syntactically correct sentence that incorporated a target word was notably less developed, falling within the average range (WIAT-III Sentence Building, 23rdpercentile). This discrepancy in performance on the two sentence-related tasks may be indicative of waning effort due to difficulty sustaining her attention and motivation. Many of Sally’s sentences contained errors with mechanics of writing, which resulted in reduced credit. The latter task places a higher demand on executive functioning skills, when compared with simple sentence combining. Sally had to generate her own sentence while keeping in mind syntax, grammar, and the appropriate use of the target word. Several sentences also lost credit due to errors related to grammar, and notably, one received no credit due to being a fragment. Overall, Sally’s performance suggests a relative level of difficulty managing all of these demands simultaneously, likely due to managing worries related to her performance and/or a desire to quickly complete the task. Nevertheless, Sally demonstrated a high average ability to compose a short essay about her favorite game (WIAT-III Essay Composition, 84th percentile). While her grammar and mechanics, score was similar to the latter sentence task and within the average range (WIAT-III Essay composition: grammar and mechanics, 34th percentile), her ability to develop the theme of the essay and organize her writing were in the superior range, Sophie having scored better than 99% of same-age peers (WIAT-III Essay composition: theme development and text organization, 99th percentile).
Mathematics: Sally was given three subtests measuring her achievement in math. Specifically, the tasks examined her abilities related to math problem solving skills (both, in an orally presented and written format), as well as speed and accuracy of math calculations. Sally’s overall math skills were above age- level, within the very high range (WIAT-III Mathematics, 93rd percentile). On subtests of untimed arithmetic and word-based math problems, Sally’s performance was within the very high range (WIAT- III Numerical Operations and Math Problem Solving, 91st percentile). When timed, Sally’s ability to calculate basic addition, subtraction, and multiplication problems with both accuracy and speed was
varied, was between the average and very high range (WIAT-III Math Fluency-Addition, 96th percentile; WIAT-III Math Fluency-Subtraction, 91st percentile; WIAT-III Math Fluency-Multiplication, 73rd percentile). A closer examination of Sally’s performance reveals, that she solved all items she attempted correctly, and the decline in her scores on the Subtraction and Multiplication conditions is due to the problems left unsolved at the end of the 60 second time allowance. Notably, after the Addition task, Sally stated that she would not rush through the subsequent tasks and thus took more time in responding, possibly leading to fewer total items attempted. It is also important to consider that multiplication is a task that places a greater demand on working memory and mental manipulation of information, which are impacted by performance anxiety.
Language: Sally was administered several measures of language competence. In general, assessments of language involve testing the ability to express thoughts and ideas orally, as well as to understand what others are saying. These skills are measured at the as single words and as multiple sentences. Tests address either expressive language (the ability to express ideas orally) or receptive language (the ability to understand what is being said). Sally’s performance on measures of receptive and expressive language was within the very high range (WIAT-III Oral Language, 95th percentile).
Measures of receptive language suggest that Sally possesses skills that are more developed when compared to those of same-age peers (WIAT-III Listening Comprehension, 90th percentile). When asked to listen to and extract meaning from orally presented dialogue or when asked to point to one of four pictures that matched an orally provided word, her performance was within the high average range (WIAT-III: Oral Discourse Comprehension, 81st percentile; Receptive Vocabulary, 88th percentile).
Further, measures of expressive language revealed skills generally above age expectation (WIAT Oral Expression, 92nd percentile), though individual subtest scores ranged from average to extremely high. On a measure of her ability to come up with the name of a picture while given an oral cue, Sally scored within the average range (WIAT-III Expressive Vocabulary, 79th percentile). Sally’s strongest performance was on a task of generating words belonging to a specific category (e.g., colors) within a 60- second period (WIAT-III Oral Word Fluency, 98th percentile) and her lowest performance was on a task that required her to listen to and repeat sentences of increasing length and complexity, on which Sally produced a score within the average range (WIAT-III Sentence Repetition, 66th percentile). This variability may be a result of differing levels of attentiveness and engagement with the tasks. Specifically, Sally appeared very engaged in producing as many words for each category as possible, while appearing distracted during the most challenging sentence she was being asked to repeat, admitting that she “blanked out.”
Overall, Sally’s language competence skills appear to be well above her verbal comprehension skills (WISC-V VCI, 58th percentile). Such a discrepancy may be accounted for by the fact that the latter assessment was one of the first given, and, having met with the examiner several times between the WISC-V and WIAT-III administrations, Sally felt more comfortable, lessening her anxiety and its impact on her performance. Additionally, consideration should be given to the nature of the various tasks that make up the WISC-V verbal comprehension indices and the WIAT-III oral language index, with the former requiring the Sally to generate her own definitions, and the latter relying on skills which are practiced more regularly in school (e.g., listening to a passage and answering questions). Finally, it should be noted that Sally’s performance indicates a relative difficulty in generating information/responses with little guidance (e.g, definitions of words [WISC-V Vocabulary]; constructing sentences using a target word [WIAT-III Sentence building]), thus her oral language ability, which is tested with less emphasis on generation of novel responses/definitions is consistent with her overall performance across similar tasks.
Attention, Organization, and Learning
Attention: In describing the reasons for the assessment referral, Sally’s mother indicated some concern about impulsivity. To that end, Sally’s ability to direct and sustain her attention was measured on relatively short tasks (2 to 3-minutes) and on longer tasks (14-minutes). Sally’s ability to direct and sustain her attention was measured using the Conners’ Continuous Performance Test (CPT-3). This is a 14-minute task of visual attention in which requires the manual response to visual stimuli. In general, Sally de
