CASE CONCEPTUALIZATION SHEET

Now that you have the background and initial assessment results, it is 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
Students Name:
Reason for
Referral:

David Foster

Age:

9 yrs 0
Grad 3
mths
e:
-Difficulties with reading, writing and spelling
-Reduced confidence, increase anxiety and high frustration
with reading

2. Information about strengths and weaknesses based on initial

information (from background, observations, and test data)
Based on presenting problem(s) and initial assessment, the following cognitive
strengths and weaknesses are hypothesized:
Strengths

Supporting evidence

Perceptua
l
Reasoning

-WISC-IVPRI (Above Average)

BD (Above Average)
MR (Above Average)

Areas of
suspected
weakness
ReadingComprehensi
on

-Background - Parents
and teacher higher
level thinking skills
and David loves to
build and make things
with his hands

Analytical
Thinking

-WISC-IV PRI scores

Background Parents
and Teacher identify

Supporting evidence

WIAT-III- Reading Comprehension

and Fluency Composite (Far
Below Average) Reading
Comprehension (Far Below
Average)
Background (All reading tasks)
Attends resource classes 3 times
a week behind grade level in
reading grandfather difficulties
with reading Parents identify
reading as a problem

ReadingPhonemic
AwarenessDecoding

Behaviour Observations (All

reading tasks) Frustration was
observed and David seems aware
of his difficulties
WIAT-III-Basic Reading (Below
Average) Word Reading (Below
Average), Pseudoword Decoding
(Below Average), Earl Reading

higher level thinking

skills (analytical
thinking) as a strength
David loves building
and making things with
his hands

Reading
Fluency
(reading
aloud)

Skills (Below Average)

- Reading Comprehension and
Fluency Composite (Far Below
Average) Oral Reading Fluency
(Far Below Average)
Background Teacher says David
spells phonetically, struggles with
decoding and his reading is
choppy

Math

WIAT-III Average
scores on all math
measures (Numerical
Operations, Math
Problem Solving)

Spelling

Behaviour Observations Word

Recognition decoding was slow
WIAT-Spelling (Below Average)
Background Teacher says he
spells phonetically
Behaviour Observations
Reversal of b and d (could
impact spelling)

Understan
ding
Language

Oral
Language

Background Teacher
says he understands
verbal language
WIAT/WISC
Understood and follow
directions precisely
WIAT-III Oral
Expression (Average)
WISC-IV- Vocabulary
(Above Average)
Significant Difference
between Similarities
(Average) and
Vocabulary (Above
Average)
Background Teacher
reports she is not
concerned about
Davids oral language
he speaks fluently and

Written
Expression
General
Written
Output

Written
Expression
-Letter
formation
efficiency

WIAT-Essay started twice over

with new topics
-large letters, formed bottom up,
reverses b and d
WISC-Coding significant
difference between Symbol
Search Coding has higher
written output demands
Background Parents identify
written language output as a
moderate problem
-Teacher says printing is large,
fine motor skills are a moderate
problem

clearly and explains his

ideas in a sufficient
manner

Persistenc
e with
difficult
tasks
(other
than
reading)

Attention
to Tasks &
Organizati
on

Behaviour
Observations David
engaged in
conversation no
challenges to report
Behaviour
Observations David
persisted when tasks
became difficult and
took a methodical
approach to
assessment tasks

Background Teacher
identifies that attention
to tasks is good
Behaviour
Observations
-During formal testing
David was serious and
methodical
-Checked his work
when finished
teacher says he does
not do this.
Teacher says David has
no difficulty with
planning activities, the
organization of
materials he need for

Within
Reading:
Motivation
Confidence
Self-Esteem
Anxiety

Social Skills

Behaviour Observations-aware of
his difficulties high frustration
said he could have done better
than he did
Background Parents and
teacher David doesnt want his
friends to know he receives extra
assistance doesnt want to
seem different from his
classmates Davids confidence
and motivation have reduced as
the year has progressed, and he
is self-conscious about receiving
help parents report he doesnt
like to ask for help in class Grandmother depression
Background Parents report
difficulties making friends,
getting along with peers and
sharing and cooperating Parents report David likes things
to go his way when playing with
others and does not often get
invited to play by other children
-Teacher reports David can be
rejected by peers and has
difficulty making and keeping
friends

class or keeping track

of time does will with
planning and creating
projects
Task
completion
longer the is
typical

WISC-IV-Timed tests that required

complex written response (i.e.
Coding) - PSI still within Average
range

InitiationSwitching
Tasks

WIAT-III-Essay Started over

twice
Behaviour Observations testing
took longer than is typical
Background Info Teacher says
David is slow to complete tasks,
gets behind in his work or doesnt
finish assignments
-Teacher says David likes to do
things at his own pace in the
classroom often hands
assignments in late is slow to
switch activities

Primary Hypothesis (include rationale):

-David may have a reading and writing specific learning disability, based on
standardized assessment scores, background information (Parent and Teacher
report) and behavioral observations within testing.
-Further Investigation into confidence, frustration and anxiety is warranted, based
on Davids increased frustration, increased avoidance of tasks and increased
anxiety, within reading tasks
-Further investigation into peer relations, based on the difficulty David is having
making friends Is this due to anxiety, frustration and self-confidence? Or, are
there social skill deficits?
Alternative hypotheses (if any) (include rationale):

2. Follow-up plan: What tests would you administer to test your

hypothesis/hypotheses?
Follow-up test (s)
CTOPP-2 (Comprehensive Test of
Phonological Processing)
WIAT III Listening Comprehension
(Oral Discourse Comprehension) or
WJ-ACH Passage Comprehension
WIAT-III Essay Composition Test
Limits
WJ-ACH Handwriting Subtest or do
further informal analysis of Davids
writing samples from school
WJ-ACH - Editing

DKEFS Initiation, Switching and

Word Context Test subtests

Rationale
Further Investigate Reading Disability
Investigate Memory, Retrieval and
Phonological Processing
Orthographic Decoding
Investigate if he demonstrates better
comprehension with a reader (i.e. when the
passage is read to him)
Try a Word Processor or a scribe to investigate
improvement in Written Language Output (i.e.
reduce anxiety to investigate improvement)
Error analysis for handwriting gain more
information in addition to behavioral
observations
There was differential reporting for Davids
ability to notice errors (b/w teacher and
behavioral observations)
Trail Making Test - Switching Because David
can be slow to switch tasks, further
investigation into set shifting would provide
insight into this difficulty as it could just be
due to difficulties with reading and writing
within the task (i.e. takes him longer due to
his difficulties) Motor component of line
drawing should not impact his performance as
the writing demands are low
Sorting Initiation (Free Sorting) Further
investigate Davids ability to initiate tasks Is
it the nature of the task (i.e. reading or written
response) that causes anxiety and effect
initiation? Or, is It difficulty with initiation in
general, which would impact time it takes him
to finish all tasks
Word Context May provide insight into
significant differences found between
Similarities and Vocabulary subtests on the
WISC-IV David appears to do well with
concrete recall of information but struggles
with integration of that information confirm
this

WISC-IV Integrated Coding Recall

We didnt plan ahead to use this
should have needs to be
administered immediately after
WISC-IV Coding subtest
WISC-IV-Integrated Coding Copy
Social skill peer rejection

Attempt to rule out a processing speed

difficulty and confirm written task response in
Coding impacted Davids score and it is not a
deficit in processing speed
Can try Coding Copy to rule out graphimotor
problems
Teacher interview and parent interview to
determine if anxiety and self-confidence are a
factor