Case Conceptualization #5

Now that you have the background and initial assessment results, now is the
time to determine what testing, if any, you want to follow-up with.
Following the system of Hypothesis testing, complete the following
1. Identifying information
tudent!s Name" #. $. %ge" &"1' (rad
e"
)
*eason for
*eferral"
*eferred by paediatrician due to the di+culties with attention,
concentration and impulsivity.
,. -reliminary Hypotheses" .ased on presenting problem/s0 and initial
assessment, the following cognitive strengths and weaknesses are
hypothesi1ed"
trengths -ossible 2eaknesses
3erbal $omprehension 2orking 4emory
3isual-spatial perception
*eading
%ttention5 67ecutive Function
imultaneous processing
8. Hypothesis testing" follow-up plan" 2hat tests would you follow-up to
test your hypothesis9
%rea of suspected weakness Follow-up test
%ttention567ecutive Function N6-:-II auditory attention;
<=6F trial making, sorting,
color5word interference
3isual-spatial perception N6-:-II arrows, geometric
pu11les, picture pu11les
*eading $>?--- phonological awareness
domain
2orking 4emory N6-:-II auditory attention or
2*%4@
imultaneous processing $% or =-%.$
-rovide a rationale for why you think he5she has the weaknesses you have
listed and why you chose the tests"
1. %ttention567ecutive function" #arred was referred due to the concerns
about his attention, focus, and impulsivity. Family reported di+culties with
attention; further teacher .%$ ratings were high for Inattention and
$ase study A#ared $hris -age ,
Hyperactivity. ?n the 2I$-I3, #ared scored low on subtests related to
attention /@N, 0. However, during class observation inattention /oB-
task behaviour0 was noted only on di+cult tasks which #arred didn!t know
how to approach; during testing poor focus was noted on perceptual
reasoning task, which were di+cult for #arred; further .%$ report from his
mom did not raise any concerns, so inattention was not evident across
environments. It is possible that inattentive behaviour could be coping
due to di+culties understanding at school C an7iety. N6-:-II auditory
attention subtest allows to separate selective vs sustained attention and it
does not include visual stimuli, which could be di+cult for #arred.
#arred could have di+culty with 6F because it was reported by teaches
that he struggles with multistep problems, lacks organi1ation and planning
skills, as well as has di+culty with impulsivity and proper peer relationship
/acts without thinking, interrupts0. His mother also reported that he
becomes overwhelmed with too much information and he performs better
when it presented step by step. <-=6F battery assesses various
components of 6F, including inhibition, planning, and organi1ation.
,. 3isual-patial -erception" on the 2I$-I3 #arred performance on -*I
tasks was signiDcantly lower than verbal skills, and was in .orderline
range. #arred behaviour during those tasks indicated frustration. He also
has di+culty with reading, making substitutions and relying of conte7t,
and di+culty with mathematics, especially computations and problem
solving, and those skills rely on visual-spatial perception. N6-:-II arrows,
geometric pu11les, picture pu11les subtests assess visual-spatial skills and
allow for segregation of more basic processes" scanning, spatial relations
etc.
8. *eading" #arred has a history of additional support for early literacy.
$urrently, according to teacher, #ared commits high number of miscues
when reading. ?n 2I%> test #ared had di+culty with word reading and
pseudo-words decoding. It was observed that he often substituted words
for the look-alike. *eading di+culty could be due to poor phonological
skills of di+culties in perceptual skills. $>?-- evaluates diBerent aspects
of phonological processing.
). 2orking 4emory" #ared scored low on 24I, and his performance was
lower on @N subtest, which has higher demand on working memory
compare to $< subtest. #ared also has di+culties with multi-step
problems. 2*%4@ could provide information about verbal versus visual
working memory, as well as delayed memory and learning.
E. imultaneous -rocessing" .oth teacher and mother reported that #arred
has di+culty with multi-step problems and coping with comple7
information; he performs better when information presented step by step.
$ase study A#ared $hris -age 8
?n 2I$ #arred had more di+culty with tasks that involve comple7 stimuli
/4*, -$, 0 compare to the task that allow for step by step manipulation
/.<, -$m, $<0. =-%.$ or $% are based on the theoretical framework
allowing for segregation of simultaneous and successive processing skills.