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Psychoeducational Diagnostic & Intervention Clinic

Ball State University
Teachers College 037
Muncie, IN 47306 Renee Nevins, Ph.D., HSPP, Director
Phone: (765)285-8526

PSYCHOLOGICAL EVALUATION
CONFIDENTIAL
Client: FIRST LAST Parents: FATHER; MOTHER
Date of Birth: 12/04/2002 Address: 1234 STREET
Phone: NUMBER CITY, ZIP
Date of Intake: 5/31/16 Student Examiner: Haley E. Wilde
Date(s) of Testing: 6/07/16; 6/08/16 Student Supervisor: Gregory A. Satmare, M.A.
Age at Testing: 13 Supervisor: Renee Nevins, Ph.D., HSPP
Date of Report: 6/23/16

INFORMED CONSENT

Potential risks and benefits, limits of confidentiality, and test procedures were discussed
with CLIENTs parent at which point they provided written consent for the current
psychoeducational evaluation.

REASON FOR REFERRAL

CLIENT was referred to the Psychoeducational Diagnostic & Intervention Clinic (PDIC) by his
parents due to concerns of a recent drop in grades, decreased interest in once enjoyed activities,
such as school, withdrawal from socialization, and seemingly low self-esteem. CLIENTs parents
reported he is a gifted student, but has recently been neglecting homework and other school
related activities. They also noted concerns related to CLIENT not having many friends and
spending much of his time alone. Finally, Mr. and Mrs. LASTNAME reported they are interested
in better understanding why CLIENT is exhibiting the above concerns and what they can do to
help.

BACKGROUND INFORMATION

At the time of evaluation, CLIENT was a 13-year, 6-month old, right-handed male enrolled in 9th
grade at ABC HIGHSCHOOL. CLIENT lived with his biological parents and 17-year-old sister
in NOWHERE, IN. The primary language spoken at home was English. Mr. and Mrs.
LASTNAME described CLIENTs race as Asian. The family described themselves as Muslim
but stated CLIENT stopped praying approximately one year ago and no longer identifies himself
as a Muslim; according to his parents, this has not produced any tension within the family. Mr.
and Mrs. LASTNAME and SISTER, CLIENTs sister, provided the following information
regarding CLIENTs medical, developmental, and background history at the time of the initial
interview.
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Developmental and Medical History

Mr. and Mrs. LASTNAME reported CLIENT was the product of a full-term pregnancy without
complications and denied the use of any illicit substances, consumption of alcohol, or taking
medications while pregnant. They denied any feeding or sleeping concerns and reported CLIENT
met developmental milestones within normal limits. He has never received speech, occupational,
or physical therapy. Mr. and Mrs. LASTNAME reported CLIENT experiences seasonal allergies
and asthma but stated he is generally in good health. He is not currently prescribed any
medications. CLIENT wears glasses to correct his vision.

Mr. and Mrs. LASTNAME reported the family has moved about the Midwest several times and
lived in Pakistan for one year, due to fathers employment. Because of frequent moves, CLIENT
attended school in Michigan until 3rd grade, 4th grade in Indiana, 5th grade in Pakistan, and then
middle school and the first semester of his freshman year in Michigan. Approximately 6 months
ago, the family moved from Michigan to Indiana, where client completed the remainder of his
freshman year. On inquiry, Mr. and Mrs. LASTNAME indicated onset of CLIENTs neglecting
of homework and increased withdrawal from social activities seemed to coincide with this move
and through the course the second semester of his freshman year.

Educational History
CLIENTs parents reported he is a gifted student and has demonstrated above average abilities
since he was young. According to his parents, CLIENT took a college physics course at the age
of ten and aced it and, was a Davidson Institute young scholar, a program for gifted students,
when they lived in Michigan. Currently as a freshman at ABC HIGHSCHOOL, CLIENT is
almost done completing his high school credits, including three advanced placement courses. As
previously stated, CLIENT has attended several schools since elementary with the most recent
move to a new school in Indiana occurring about 6 months ago. It was around this time,
according to Mr. and Mrs. LASTNAME that he began to exhibit reluctance in doing his
homework causing his grades to drop significantly; it should be noted however, that despite his
reluctance to study or complete homework, CLIENT continues to earn above average grades on
exams.

Social-Emotional History
Mr. and Mrs. LASTNAME reported a positive relationship between CLIENT and his parents, as
well as his sister. They indicated he has always been an outlier when it comes to friends,
socialization, and confidence. Additionally, they indicated a history of him preferring to be alone,
often appearing more interested in things than in people, struggling to make and keep friends,
and not always getting along with his peers; however, they stated these seem to have become
more noticeable over the past six months. In addition, it was reported CLIENT used to be more
of a family person but has been more withdrawn over the last six months. Mr. and Mrs.
LASTNAME reported CLIENT is overall a kind boy who cares about others, but also can be
indifferent at times. CLIENTs recent hobbies have included watching television, reading, and
surfing the Internet; according to his parents, he used to enjoy more activities such as playing
instruments in the marching band and writing but now seems uninterested in these things.
According to his parents, CLIENT does not appear to exhibit overt signs of depression or anxiety
although he can be irritable at times. They denied he has expressed suicidal or homicidal
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ideation. His parents reported he occasionally becomes engrossed in something he is working on

and can lost track of time and can be fidgety but denied symptoms consistent with impulsivity or
hyperactivity.

Mr. and Mrs. LASTNAME reported they have tried to encourage and support CLIENT in hopes
of increasing social activity and engagement in schoolwork, but these have been unsuccessful.
They also reported utilizing positive and negative incentives for CLIENT that also has proven
ineffective since they seemed to create more pressure. Mr. and Mrs. LASTNAME expressed
concern that CLIENT no longer seemed to be as goal-oriented as he once was and does not open
up and talk about his thoughts or feelings with them.

TESTING OBSERVATIONS AND MENTAL STATUS REPORT

CLIENT was observed during two testing sessions in a quiet, well-lit room with minimal
distractions. He was casually dressed, well groomed, and oriented at an age-appropriate level. He
followed directions and was attentive during the sessions. Rapport was established and
maintained. CLIENT was polite and cooperative throughout the evaluation process. He did not
initiate conversation but replied when asked direct questions, typically replying with short
responses. CLIENT often avoided direct eye contact with the examiner, but otherwise
demonstrated age-appropriate behavior. As testing progressed, and particularly during the second
testing session, he seemed to become more comfortable as indicated by demonstrating more
relaxed body language and willingness to engage in conversation. While discussing the topic of
school and homework, CLIENT stated that he does not like his current school because it is
boring. He also stated he initially started procrastinating on his schoolwork before getting to
the point where he simply stopped doing it. In addition, he reported he does not have any friends
here in Indiana, but had friends at his school in Michigan. Finally, he expressed a general dislike
for living in Indiana, indicating a preference to return to where he lived in Michigan.

Throughout both testing sessions, CLIENT appeared to give his best effort on all items
presented. He was thoughtful and often took his time on subtests that did not include a time
component. He would occasionally sigh audibly when it took him longer to complete an item.
CLIENT occasionally expressed some frustration on items perceived as more difficult or
challenging, or those that took him longer than usual to provide an answer. Overall, results of the
evaluation and diagnostic impressions are considered a valid representation of CLIENTs current
abilities based upon data from a multi-informant, multi-method, multi-measure approach.

METHODS USED AND ASSESSMENTS ADMINISTERED

Clinical Intake Interview and Background History Questionnaire

Behavioral Observations
Behavior Assessment System for Children, Third Edition- Parent, Adolescent (BASC-III)
Behavior Assessment System for Children, Third Edition- Self-Report, Adolescent (BASC-III)
Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V)
Wechsler Individual Achievement Test, Third Edition (WIAT-III)

INTERPRETATION OF RESULTS AND CLINICAL IMPRESSIONS

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Cognitive Functioning

CLIENT was administered the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-
V), a valid and reliable measure of global cognitive functioning. Average standard scores fall
between 90 and 110 and average subtest scores fall between 8 and 12, according to Wechsler
scoring guidelines. Due to significant variability among composite scores, an overall score is
not considered the best reflection of CLIENTs abilities. Therefore, it is best to evaluate each
composite individually.

Wechsler Intelligence Scale for Children Fifth Edition (WISC-V)

(Mean = 100, Standard Deviation = 15)
Composite Scores/ Index Percentile 95% Descriptive
Subtests Standard/ Rank Confidence Classification
Scaled Score Interval
Verbal Comprehension 136 99 125-141 Extremely High
Similarities 16 Extremely High
Vocabulary 17 Extremely High
Visual Spatial 111 77 102-118 High Average
Block Design 12 Average
Visual Puzzles 12 Average
Fluid Reasoning 147 99.9 136-151 Extremely High
Matrix Reasoning 19 Extremely High
Figure Weights 17 Extremely High
Working Memory 135 99 125-140 Extremely High
Digit Span 15 Very High
Picture Span 18 Extremely High
Processing Speed 108 70 98-116 Average
Coding 12 Average
Symbol Search 11 Average

Verbal Comprehension
CLIENTs overall performance on measures evaluating his ability to use language to articulate
knowledge and comprehension fell within the Extremely High range (Verbal Comprehension
Index = 136). His ability to identify connections between words or concepts was Extremely
High (Similarities = 16) as was his ability to define words presented in isolation (Vocabulary =
17). Based on his performance on these subtests, it is anticipated CLIENT should be capable of
verbally expressing his thoughts at a higher level than his same-aged peers.

Visual Spatial
CLIENTs overall performance on measures requiring him to evaluate visual details and
understand visual spatial relationships fell in the High Average range (Visual Spatial = 111).
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CLIENTs visual-spatial skills and ability to mentally manipulate visual information was at the
high end of the Average range (Visual Puzzles = 12) as was his visual-motor integration and
ability to use fine motor skills to combine individual pieces into a whole picture (Block Design
= 12). Based on his performance on these subtests, CLIENT is likely capable of performing
visual spatial tasks with little to no difficulty.

Fluid Reasoning
CLIENTs non-verbal reasoning and problem solving and his ability to detect the underlying
conceptual relationships among visual objects was in the Extremely High range (Fluid
Reasoning Index = 147). His performance on tasks measuring his ability to use abstract
reasoning to solve visual problems was Extremely High (Matrix Reasoning = 19) as was his
ability to use inductive and quantitative reasoning (Figure Weights = 17). These scores indicate
CLIENT will perform at a much higher level compared to his same-aged peers on tasks that
require quantitative reasoning and pattern recognition.

Working Memory
CLIENTs overall performance on tasks measuring his ability to hold and manipulate
information in working memory fell within the Extremely High range (Working Memory =
135). CLIENTs basic attention, rote recall, and short-term auditory working memory was in
the Very High range (Digit Span = 15). His visual attention and visual short-term memory was
in the Extremely High range (Picture Span = 18). These scores suggest CLIENT should have
little to no difficulty on tasks that involve listening, attending to, recalling, and mentally
manipulating information.

Processing Speed
CLIENTs overall ability to quickly complete simple graphomotor (i.e., pencil and paper) tasks
under time constraints fell within the Average range (Processing Speed = 108) and, although
Average, was identified as an area of personal weakness. It should be noted however,
qualitative observations suggest a slow, somewhat methodical response style suggesting a
tendency towards accuracy over speed. His performance on a task measuring incidental
learning, visual attention, visual-motor integration, and speed of information processing was at
the high end of Average range (Coding = 12). His ability to quickly use visual perception to
scan rows of information and isolate target items (Symbol Search = 11) was Average.

Academic Achievement

CLIENT completed the Wechsler Individual Achievement Test, Third Edition (WIAT-III), which
is considered a valid and reliable estimate of academic skills in the areas of oral expression,
reading, written expression, and math. Average scores fall between 90 and 110 according to the
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Wechsler classification system. CLIENTs obtained scores were referenced to those of his same-
aged peers. CLIENTs overall performance on the WIAT-III fell within the Superior range (Total
Achievement = 138), although variability is present among the various skill areas.

Wechsler Individual Achievement Test Third Edition (WIAT-III)

(Mean = 100, Standard Deviation = 15)
Composite Standard Percentile 95% Descriptive
Score Rank Confidenc Classification
e Interval
Total Achievement 138 99 134-142 Superior
Oral Language 127 96 116-138 Above Average
Listening Comprehension 124 95 111-137 Above Average
Oral Expression 122 93 109-135 Above Average
Total Reading 130 98 125-135 Above Average
Basic Reading 126 96 122-130 Above Average
Reading Comp & Fluency 128 97 120-136 Above Average
Reading Comprehension 120 91 109-131 Above Average
Word Reading 123 94 117-129 Above Average
Pseudoword Decoding 122 93 117-127 Above Average
Oral Reading Fluency 127 96 120-134 Above Average
Written Expression 129 97 122-136 Above Average
Sentence Composition 119 90 109-129 Above Average
Spelling* 131 98 124-138 Superior
Essay Composition 116 86 106-126 Above Average
Mathematics 146 99.9 139-153 Very Superior
Math Problem Solving 128 97 120-136 Above Average
Numerical Operations 160 >99.9 151-169 Very Superior
Math Fluency 121 92 114-128 Above Average
Math Fluency-Addition* 126 96 115-137 Above Average
Math Fluency-Subtraction* 122 93 112-132 Above Average
Math Fluency-Multiplication* 108 70 98-118 Average
*Subtest not included in the Total Achievement score

Oral Language
CLIENTs overall ability to understand and use spoken language fell within the Above Average
range (Oral Language = 127). His basic receptive language skills were Above Average (Listening
Comprehension = 124) as were his expressive language skills (Oral Expression = 122). These
scores allow us to anticipate that CLIENT will perform at a higher level than his same-aged
peers on tasks related to understanding verbally presented information and expressing his
thoughts.

Reading
CLIENTs overall reading skills fell within the Above Average range (Total Reading = 130). His
skill in reading individual words presented in isolation, as well as his phonemic awareness, or
ability to apply phonetic rules to decode nonsense words, were in the Above Average range
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(Word Reading = 123; Pseudoword Decoding = 122 respectively). His ability to read passages
and answer corresponding comprehension questions (Reading Comprehension = 120) and his
ability to read short passages quickly and accurately (Oral Reading Fluency = 127) also were
Above Average. Overall, CLIENTs performance suggests well-developed reading skills and
indicates he should have little to no difficulty with reading tasks.

Written Expression
CLIENTs overall writing skills were in the Above Average range (Written Expression = 129),
although some variability was present. His skill in combining sentences and constructing novel
sentences was in the Above Average range (Sentence Composition = 119) as was his ability to
organize and express his thoughts in essay format (Essay Composition = 116). It should be noted
that, although above average, his score on the essay may not be a truly accurate representation of
CLIENTs writing skills due to the advanced nature of his essay that is not accounted for in the
basic scoring procedure. CLIENTs skill in spelling words presented in isolation fell within the
Superior range (Spelling = 131). Overall, his performance suggests well developed written
language skills and ability to express his thoughts in writing.

Mathematics
CLIENTs overall math skills fell in the Very Superior range (Mathematics = 146). His skill in
completing increasingly complex paper and pencil math computations (Numerical Operations =
160) was in the Very Superior range. His ability to apply his math concept knowledge to solve
every day problems was in the Above Average range (Math Problem Solving = 128). These
findings suggest CLIENT should have little to no difficulty with math related tasks.

Math Fluency
CLIENT's overall math fluency skills fell within the Above Average range (Math Fluency =
121). His skill in quickly solving simple, addition and subtraction problems within a specified
time frame were in the Above Average range (Math Fluency-Addition = 126; Math Fluency
Subtraction = 122 respectively). His skill in quickly solving multiplication problems within a
specified time frame was in the Average range (Math Fluency-Multiplication = 108). As with the
processing speed tasks discussed above, qualitative observations suggest CLIENTs performance
on tests of math fluency was likely impacted by a preference for accuracy over speed.

Behavioral and Emotional Functioning

The Behavior Assessment System for Children Third Edition (BASC-3) is an objective
personality measure assessing overall emotional adjustment and behavioral functioning. The
BASC-3 uses both At-Risk and Clinically Significant classifications to signify areas of concern.
Scores 40 and 60 are considered average, while scores that fall within the 61-70 range are At-
Risk and 71 and above are Clinically Significant. At-Risk scores indicate areas that have not
reached the clinical level but warrant monitoring. Clinically Significant scores indicate areas in
which problems have reached a level that may warrant intervention. Mrs. LASTNAME
completed the Parent Scales. CLIENT completed the self-report scales.

Parent Rating
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Mrs. LASTNAME completed the Behavioral Assessment System for Children-Third Edition
(BASC-3) as a measure of CLIENTs emotional and behavioral functioning at home. Mrs.
LASTNAMEs ratings put CLIENT in the At-Risk range regarding activities of daily living, such
as performing everyday tasks in a safe and efficient manner. Her ratings also put CLIENT in the
At-Risk range for withdrawal behaviors, indicating that he often seems alone, has difficulty
making friends, and/or is sometimes unwilling to join in on group activities; this is consistent
with parents concerns as reported during the clinical interview

Behavior Assessment System for Children

Third Edition (BASC-3)
(Mean = 50, Standard Deviation = 10)

Parent
Validity Index Mrs. LASTNAME
F Scale Acceptable
Response Pattern Acceptable
Consistency Acceptable
Composite T-Score
Externalizing Problems 46
Internalizing Problems 50
Behavior Symptoms Index 50
Adaptive Skills 46
Clinical Scale
Hyperactivity 46
Aggression 50
Conduct Problems 42
Anxiety 46
Depression 48
Somatization 55
Attention Problems 46
Atypicality 45
Withdrawal 65*
Adaptive Scale
Adaptability 52
Social Skills 49
Leadership 44
Activities of Daily Living 34*
Functional Communication 51
* At-Risk
** Clinically Significant

Self-Report
CLIENT completed the Behavioral Assessment System for Children-Third Edition (BASC-3)
self-report to further evaluate behavioral and social-emotional functioning. In reviewing the
validity indicators, there are several possibilities for the elevations in his scores. Overall, his
score profile should be interpreted with some caution due to possible over-reporting of symptoms
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however, a review of individual responses suggest to some extent, certain aspects of his profile
do seem to be reflective of his current level of distress. These are outlined below:

Behavior Assessment System for Children

Third Edition (BASC-3)
(Mean = 50, Standard Deviation = 10)

Validity Index
F Extreme Caution
Response Pattern Caution High
Consistency Acceptable
L Index Acceptable
V Index Acceptable
Composite/Scale T-Score
School Problems 68*
Attitude to School 71**
Attitude to Teachers 73**
Internalizing 90**
Problems
Atypicality 70**
Locus of Control 72**
Social Stress 87**
Anxiety 75**
Depression 90**
Sense of Inadequacy 81**
Somatization 98**
Inattention/hyperact 72**
ivity
Attention Problems 70**
Hyperactivity 71**
Emotional 92**
Symptoms
Personal Adjustment 10**
Relations with 17**
Parents
Interpersonal 10**
Relations
Self-Esteem 14**
Self-Reliance 25**
* At-Risk
** Clinically Significant

Based on CLIENTs responses, he is currently indicating an overall strong dislike for school, a
strained relationship with his parents, and a high level of social stress; these are consistent with
information obtained via conversation in which he reported a desire to return to Michigan and
feeling as though he has few to no friends in his current school. Additionally, CLIENT noted
significant concerns regarding poor locus of control, anxiety, and depressive related symptoms
indicating he potentially feels as though he has little control over events occurring in his life,
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frequently worries, is irritable, and feels a lot of stress. CLIENTs responses indicated he may
feel sad, misunderstood, and a sense of inadequacy in his abilities or dissatisfied with his ability
to perform certain tasks; this too is consistent with information obtained during the course of the
evaluation.

SUMMARY

CLIENT is a 13-year, 6-month old, right-handed male who is a student ABC SCHOOL. Mr. and
Mrs. LASTNAME requested the current evaluation due to concerns related to a recent drop in
grades and behavioral concerns. CLIENTs parents report he is a gifted student but has become
reluctant to do his homework since the family moved to Indiana and he started a new high school
six months ago. Mr. and Mrs. LASTNAME are also concerned about his lack of interest in
school and socializing and seemingly low self-esteem.

Based on the current evaluation, CLIENT demonstrates above average to superior verbal and
non-verbal abilities, novel problem solving, abstract reasoning, working memory, and academic
skills, including reading, writing, and math. While still average, he did demonstrate a personal
weakness in processing speed, or the ability to scan visual information and process it quickly and
efficiently although qualitative observations suggests this is secondary to a desire for accuracy
over speed. CLIENTs high ability as measured on this evaluation confirms that his current
academic performance at school is not due to any achievement deficits. This suggests an
alternative explanation such as social-emotional distress is warranted; specifically, CLIENT
expressed displeasure at moving to Indiana six months ago, coinciding with the onset of the
concerns that ultimately lead to the current evaluation. Based on parent reports during the intake
interview, conversations with CLIENT during testing, and responses on a self-report measure of
social-emotional functions, CLIENT presents as having difficulty adjusting to current life
circumstances and exhibiting reactions to those circumstances that are beyond what would be
anticipated. He may be expressing these feelings through mild depressed mood, irritability,
withdrawal, and disinterest in social activities. Additionally, he may feel a sense of loss of
control over his life and decision-making, all of which are affecting his social interactions and,
more importantly, his academic performance. CLIENT also reports feeling as though others have
high expectations of him that may be contributing to an overwhelming amount of stress and
pressure, further exacerbating his anger at leaving behind his previous home and friends at an
age where friends and stability are an important aspect of ones sense of self. It is clear that Mr.
and Mrs. LASTNAME recognize and are concerned about CLIENTs current academic and
social concerns and wish to do all they can to alleviate these concerns. At the same time, there
appears to be a lack of awareness or knowledge related to CLIENTs emotions due to limited
reciprocal communication regarding his current feelings and interests. CLIENTs dislike towards
the familys most recent move is impacting his ability to appropriately adjust, which is affecting
his academic performance, social-emotional functioning, and overall mood.

DIAGNOSTIC IMPRESSIONS
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The following diagnostic impressions are made based upon the extent of the information made
available through a multi-method, multi-informant approach. In the event information changes or
has been withheld, impressions may vary considerably from another professionals perspective
and/or clinical diagnosis of this individual.

309.0 (F43.21) Adjustment Disorder, With depressed mood

RECOMMENDATIONS

1. It is recommended this report be shared with CLIENTs school to help them better
understand his unique strengths, weaknesses, and emotional needs.
a. Based on CLIENTs cognitive assessment results, it is evident that his abilities are
above average compared to his same-aged peers. Speed of information processing, or
his ability/willingness to complete tasks quickly within specified time constraints,
however was identified as an area of personal weakness when compared to his
abilities likely due to a preference for accuracy over speed. If not already done so, it
may be beneficial for his teachers to be aware that although he is a highly intelligent
student with above average abilities, when required to complete tasks quickly he may
not always have the opportunity to demonstrate his knowledge.
b. Based on CLIENTs self-reported current negative attitude towards school, it may be
helpful for his teachers to be aware of these feelings if they are not already. A positive
student-teacher alliance could reduce CLIENTs negative feelings and help him feel
more accepted and understood in the classroom.

2. Based on the results of CLIENTs self-report assessment and endorsement of depressive

symptoms, he may benefit from counseling services aimed at identifying and implementing
effective ways of expressing his thoughts and emotions, improve his self-esteem and
confidence, and develop coping and adaptive skills during this period of transition and
adjustment. Additionally, incorporating a cognitive component may be helpful for CLIENT
in that it can focus on changing negative thought patterns into more positive and productive
ones. Finally, involving the family in the counseling process also may be beneficial to
facilitate and foster open communication

3. CLIENT may benefit from continued encouragement to consider involvement in activities

and hobbies he is good at and once enjoyed. Doing so may further assist in adjusting and
would be beneficial for building his self-efficacy and confidence.
a. It was reported CLIENT was previously involved in a scholarly program while living
in Michigan. It may be beneficial for him to become involved in a similar program, if
one exists in the area where he currently lives. Interacting with others his age that also
are high-ability may help CLIENT feel more accepted and build his self-confidence.
b. Due to CLIENTs report of enjoying advanced placement courses, it would be
beneficial for him and/or his family to seek out opportunities for CLIENT to continue
taking these types of courses.
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It was a pleasure working with CLIENT. If there are any questions regarding this report,
please do not hesitate to contact the Psychoeducational Diagnostic and Intervention Clinic.

_________________________________________ ________________
Haley E. Wilde Date
Student Clinician
Ball State University

__________________________________________ ________________
Gregory A. Satmare, M.A. Date
Student Supervisor
Ball State University

_________________________________________ ________________
Renee Nevins, Ph.D., HSPP Date
Licensed Psychologist # 20042460A
Licensed School Psychologist #1308304
Director, Psychoeducational, Diagnostic, and Intervention Clinic
Ball State University