Case conceptualization:

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

Students Name:
Reason for
Referral:

Jared Chris

Age:

9.10

Grad 4
e:
Concerns with attention, impulsivity and focus
Investigate learning issues before diagnostic
conclusions are reached
Determine current level of cognitive and academic
functioning

2. Preliminary Hypotheses: Based on presenting problem(s) and initial

assessment, the following cognitive strengths and weaknesses are
hypothesized:
Strengths
VCI- average (relative strength)

Possible Weaknesses
Non-verbal LD?
Associated with deficits in nonverbal reasoning, weak visual
spatial and visual discrimination,
poorly developed organizational
skills, difficulty making
inferences and abstract
reasoning, problems with math
reasoning, limited social
competence.

Low PRI- measures visual

processing and fluid reasoning
Picture Concepts (PRI)- Poor
visual-perceptual reasoning, poor
conceptual thinking, poor ability
to select appropriate relationships
between two objects or concepts,
poor ability to use logical and
abstract thinking, poor ability to
discriminate fundamental from
superficial relationships, poor

vision, rigidity of thought process

Picture Completion (PRI)- poor
visual-perceptual reasoning, poor
perception and concentration,
poor alertness to details, poor
ability to differentiate b/w
essential and nonessential details,
poor vision, preoccupation with
irrelevant details, anxiety and
negativism
Matrix Reasoning (PRI)- poor
visual perceptual organization
reasoning ability, poor reasoning
ability, poor attention to detail,
poor concentration, poor vision,
poor motivation and persistence
Symbol Search (PSI)- poor
processing speed, poor visualperceptual discrimination, poor
attention and concentration, poor
visual short-term memory, poor
vision, poor motivation and
persistence, poor ability to work
under time pressure
Externalizing problems, school
problems-hyperactivity,
depression, atypicality,
withdrawal, learning problems,
sensory needs
Social skills challenges- appears to
be misinterpreting social cues to
adjust his behaviour
Adaptive functioning skills low
Needed encouragement to
persevere, gave up easily
Did not demonstrate planning or
strategizing
Overwhelmed with large amt of
stimuli
Task avoidance
Written output- lack of attn. to
detail and planning
Relied on context clues for
comprehension

Coding (relative strength)- may

indicate good processing speed, good
visual sequential processing, good
visual-motor dexterity, good vision,
good attention and concentration,
good ability to learn new material
associatively and reproduce it, good
scanning ability, good motivation and
persistence, good pencil control,
good ability to work under time
pressure.

Math- trouble with patterns and

multi-step probs
Perceptual Reasoning- found tasks
frustrating
Attention, concentration,
executive functions to provide
information to Dr. to support
existing ADHD hypothesis- but is
the lack of attention,
concentration etc a case of ADHD
or a case of undiagnosed
NonVerbal LD?

Low working Memory- temporarily

storing and manipulating
information (requires attn. to
ignore irrelevant information),
strong measure of verbal shortterm and working memory
Digit span (WMI)- may indicate
poor auditory sequential
processing, poor auditory short
term memory, poor rote memory,
poor immediate recall, poor
attention and concentration, poor
encoding, poor rehearsal
strategies, poor self regulation
Letter-number sequencing (WMI)poor auditory sequential
processing, poor auditory short
term memory, poor rote memory,
poor attention and concentration,
poor encoding ability, poor
rehearsal strategies, poor self
monitoring
Difficulties with areas of fluid
reasoning
Low WMI and PSI (speed of mental
and and graphomotor processing)
Challenges with math, word
reading, spelling and writing
which all require attention and
concentration
Distracted

Similarities (relative strength)- good

verbal comprehension, good
conceptual thinking, good ability to
see relationships, logical and abstract
thinking, good ability to
conceptualize and verbalize
relationships between concepts and
objects

Gave up easily, task avoidance,

written output- lack of attention to
detail and planning
Uneven oral reading (skipped
words, high level of word
substitutions)
Math- trouble with multi-step
problems
ACID profile? (arithmetic-yes,
coding-no, information- n/a, digit
span- yes)
SLD? Auditory Processing?

Digit span (WMI)- may indicate

poor auditory sequential
processing, poor auditory short
term memory, poor rote memory,
poor immediate recall, poor
attention and concentration, poor
encoding, poor rehearsal
strategies, poor self regulation
Letter-number sequencing (WMI)poor auditory sequential
processing, poor auditory short
term memory, poor rote memory,
poor attention and concentration,
poor encoding ability, poor
rehearsal strategies, poor self
monitoring
Challenges with math, word
reading, spelling and writing
which all reading abilities
Distracted
Gave up easily, task avoidance,
written output- lack of attention to
detail and planning
Uneven oral reading (skipped
words, high level of word
substitutions)
Problems with self regulation and
monitoring, retrieval fluency,
cognitive flexibility, problems with
organizing and prioritizing stimuli
Received support with early

Comprehension on WISC-IV (relative

strength)

literacy skills- focus on

phonics/phonemic awareness?
History of ear infections?
Memory? It would be helpful to
further probe memory skills with
Jared to assist with planning
interventions and support to
teachers

Low working memory

Problems with retrieval fluency
Digit span (WMI)- may indicate
poor auditory sequential
processing, poor auditory short
term memory, poor rote memory,
poor immediate recall, poor
attention and concentration, poor
encoding, poor rehearsal
strategies, poor self regulation
Letter-number sequencing (WMI)poor auditory sequential
processing, poor auditory short
term memory, poor rote memory,
poor attention and concentration,
poor encoding ability, poor
rehearsal strategies, poor self
monitoring
Academic challenges

Reading comprehension WIATT-III

(relative strength)- especially with
low working memory
Listening comprehension WIATT III
(relative strength)
3. Hypothesis testing: follow-up plan: What tests would you follow-up to test
your hypothesis?
Area of suspected weakness
Non- verbal LD----Memory
Non-verbal LD-----Visual Motor
SLD

Follow-up test
WRAML-2
NEPSY- II and DVMI
CTOPP

Provide a rationale for why you think he/she has the weaknesses you have listed
and why you chose the tests:
Non-Verbal Learning Disability
I would be interested in further exploring the possibility that Jared has a Nonverbal learning disability. Although his current test scores indicate that this may
be his area of challenge, I would want to assess his memory and visual motor
skills to help with me test my hypothesis.
Memory
I would want to further probe Jareds memory skills with the WRAML-2 to help
determine strengths and areas of challenge with visual and verbal memory skills.
This would be key information that would help add to my non-verbal learning
disability hypothesis as well as highly useful information for the school in terms
of intervention planning and instructional aids that would help support Jared.
Visual Motor
I would also want to assess Jareds visual motor integration skills with the Test of
Visual Motor Integration to help determine if written output challenges may be
compounding his challenges. This would also factor in with my nonverbal
learning disability hypothesis as children with NVLD often also have comorbid
challenges with visual motor processing.
Learning disability
Finally, I would be interested in administering the CTOPP to help assess Jareds
phonological
processing skills to help determine if this might be impacting
his reading skills.