Billy Case Conceptualization
Billy Case Conceptualization
Billy Case Conceptualization
DOB:
School:
1.
2.
What are Billys current cognitive and academic strengths and needs?
- particularly important because of concerns regarding his writing (i.e., spelling) and reading
abilities (i.e., fluency and comprehension difficulties)
- determine intervention strategies to address ongoing concerns regarding his writing and
reading abilities and to ascertain potential identification(s) of learning issues
RELEVANT DEVELOPMENTAL HISTORY
Home:
- lives with his parents, older sister, and his younger brother and sister
- his grandmother looks after him and his siblings at his home
- plays on a hockey team
- enjoys watching hockey on television, playing video games, and reading
School:
- attended ***Elementary School since Junior Kindergarten
- placed in a mainstream class, but receives daily support from the schools Special Education
Resource Teacher, as well as support from the use of assistive technologies, scribing, and
additional time to complete tasks
- works according to an Individual Education Plan (IEP)
WORKING HYPOTHESIS
Specific Learning Disability with Impairment in Reading (i.e., fluency and comprehension)
Possible Causes:
- poor visual-spatial skills, visual-motor coordination, and visual memory
- phonological processing difficulty
Specific Learning Disability with Impairment in Written Expression (i.e., spelling)
Possible Causes:
- poor visual-motor coordination
- phonological processing difficulty
G. Wilcox 2013
- poor visual acuity (this is not a concern for reading and writing because he wears
glasses/contacts to correct vision)
- oral expressive/receptive language deficits
ASSESSMENTS
Tests Administered
WISC-IV
WIAT-III
STRENGTHS
Cognitive
Neuropsychological
Verbal reasoning (i.e.,
Similarities 84th
percentile)
Reasoning
Academic
Understanding of oral
language and ability to
listen to detail (i.e.,
Listening Comprehension
77th percentile)
Behavioral
Observation
Expressive oral language
(i.e., appeared to have a
broad vocabulary, listened
to and followed
instructions well)
Friendly, polite, and
cooperative (i.e.,
participated in all
assessment tasks, followed
instructions)
Easily shifted attention
Persistent and
conscientious
Parent/Teacher Report
T: Oral expression
P: Expressive
T: Cooperation
P: Kind, defends others
T: Homework completion
P: Completes homework
and projects at home
T: Athleticism
INFORMATION
PERSONABLE AND COOPERATIVE DISPOSITION WILL FACILITATE SOCIAL INTERACTION
LIKELY ABLE TO FOLLOW ORAL INSTRUCTIONS
LIKELY ABLE TO SHIFT HIS ATTENTION FROM ONE TASK IN THE CLASSROOM TO THE NEXT
G. Wilcox 2013
Academic
Spelling (9th percentile)
Behavioral
Observation
- thumb wrap pencil grasp
(i.e., held his pencil in a
tripod grasp with his
thumb wrapped over his
index finger)
- he noted his palm hurt
after writing a few
sentences
Reading skills
- phonological awareness:
13th percentile
- fluency: 8th percentile
- decoding: 16th percentile
Mathematic skills (e.g.,
problem solving, addition,
subtraction, multiplication,
geometry, algebra; overall
16th percentile)
Parent/Teacher Report
T: Written expression
P: Organization of written
thoughts; does not edit
written work
T: Reading
comprehension, reading
fluency
P: Can get down on
himself
T: Maintaining attention
P & T: Organization skills
NEEDS REAL LIFE IMPLICATIONS:
- DIFFICULTY WITH WRITTEN EXPRESSION AND MATHEMATICS (WHICH MAY EXTEND TO OTHER SUBJECTS,
SUCH AS GEOGRAPHY AND SCIENCE)
- SLOWER PROCESSING OF VISUAL INFORMATION (WILL NEED MORE TIME TO COMPLETE TASKS THAT
INVOLVE VISUAL INFORMATION)
- LACK OF ORGANIZATION SKILLS CAN IMPACT ACADEMIC PERFORMANCE
- INABILITY TO MAINTAIN ATTENTION CAN IMPACT ACADEMIC PERFORMANCE (E.G., MAY RESULT IN
MISSING IMPORTANT INFORMATION)
- BECOMING DISCOURAGED MAY LEAD TO A DEFEATIST ATTITUDE, CAUSE BILLY TO GIVE UP EASILY,
AND/OR MAY LEAD TO DISLIKE OF SCHOOL/ACADEMICS
WORKING HYPOTHESIS ANALYSIS
Hypothesis
Supporting Data
SLD in Reading
(rooted in poor
visual-spatial skills,
visual-motor
coordination, and
visual memory)
WIAT-III:
Total Reading: 10th percentile
Word Reading: 13th percentile
Pseudoword Reading: 16th percentile
Reading Fluency: 8th percentile
Teacher Observation & IEP:
- difficulties with reading comprehension
and reading fluency
WISC-IV:
Processing Speed Index (includes
measures of visual-motor coordination
and visual memory): 21st percentile
Block Design Subtest (measure of visualspatial abilities): 16th percentile
Non-Supporting Data
G. Wilcox 2013
SLD in Reading
(due to
phonological
processing issue)
SLD in Written
Expression (rooted
in poor visualmotor
coordination)
* No working
hypothesis for
deficit in
mathematics skills
because it was not
suspected;
however, there is
data to support
SLD in
Mathematics
WIAT-III:
Total Reading: 10th percentile
Word Reading: 13th percentile
Pseudoword Reading: 16th percentile
Reading Fluency: 8th percentile
Teacher Observation & IEP:
- difficulties with reading comprehension
and reading fluency
Test Observation:
- substituting words with the same first
letter when reading
- only saying the root word (i.e., playful
instead of playfully) or from adding a
word ending (i.e., photography instead
of photograph) when reading words
- missing a letter sound (e.g., eliminating
the i sound in radiant)
WIAT-III:
Spelling: 9th percentile
WISC-IV:
Processing Speed Index (includes
measures of visual-motor coordination
and visual memory): 21st percentile
Parent Observation:
Difficulty organizing written thought and
does not edit written work
Teacher Observation & IEP:
Difficulty with written expression
Test Observation:
Phonetic spelling
He used his own verbal representation of
the words to spell them, which led to
errors (e.g., this caused him to omit letters
due to missing sounds in his verbal
representation of the word)
WIAT-III:
Mathematics: 16th percentile
Math Problem Solving: 23rd percentile
Numerical Operations: 14th percentile
WISC-IV:
Processing Speed Index: 21st percentile
Test Observation:
Numerical Operations: Billy answered
equations that involved one operation
with ease (e.g., only addition or only
subtraction); however he skipped
questions that involved two operations
(e.g., division and addition) and questions
that required him to complete several
steps in order to arrive at an answer.
Math Fluency: Billy provided the correct
answer for all basic mathematical
equations, yet his speed of completion
contributed to Low Average scores on
addition and multiplication questions
WIAT-III:
Sentence Composition: 61st
percentile
WIAT-III:
Math Fluency: 37th percentile
G. Wilcox 2013
Given the results of the current assessment, Billy meets criteria from the Diagnostic and
Statistical Manual of Mental Disorders Fifth Edition (DSM-V) for the following diagnostic
categories:
315.00 (F81.0) Specific Learning Disorder with Impairment in Reading:
Word reading accuracy
Reading rate or fluency
Reading comprehension
315.1 (F81.2) Specific Learning Disorder with Impairment in Mathematics:
Number sense
Memorization with arithmetic facts
Accurate or fluent calculation
Accurate math reasoning
STRENGTHS
NEEDS
Verbal reasoning
INTERVENTION PLAN
RECOMMENDATIONS
NEEDS
Reading
Mathematics
SPECIFIC RECOMMENDATIONS
- Provide Billy with extra time to complete reading tasks due to his weak processing speed.
- Provide one-to-one intervention through school education programs, such as Later Literacy
and Targeted Reading Intervention, for the development and remediation of Billys reading
skills.
- Provide opportunity for use of Assistive Technology (AT), such as Kurzweil 3000, which
scans printed documents and reads the text aloud. Offer Billy age and level-appropriate
reading materials that include topics of interest to him and enable him to listen to them and
follow along using Kurzweil 3000.
- Give Billy an oral summary (i.e., main ideas of the plot, and brief description of the setting
and context) of the material he is to read or which will be read to him, via computer software
or through videos or films, and where possible, connect it to an experience in his own life, to
provide him with a context for understanding the information presented in the material.
- Provide direct instruction on how to identify the main idea, specific details, cause and
effect, and elements of contrast and comparison while reading (e.g., effective highlighting of
material, including answers to the five Ws).
- Provide Billy with extra time to complete mathematical tasks due to his weak processing
speed.
- Use a word-problem mnemonic, such as RIDE (Read the problem, Identify the relevant
information, Determine the operation and unit for the answer, Enter the correct numbers and
calculate, then check the answer), to provide Billy with a framework for solving word
problems. The mnemonic will remind him to work step-by-step through a word problem.
Some word-problem mnemonics can be used for problem solving beyond basic word
G. Wilcox 2013
Writing
Pencil Grip
problems.
- Allow Billy to use a calculator for mathematical equations that involve several steps or
multiple operations to assist him in the speed and accuracy of his responses.
- Provide Billy with extra time to complete writing tasks due to his weak processing speed.
- Provide Billy with direct instruction on developing his ideas prior to beginning the writing
process. In this regard, graphic organizers, semantic webbing, flow charts, expanded lists and
story outlines in point form, as well as mapping and scaffolding techniques could help him
organize and expand his thoughts in written language.
- Use Assistive Technology to assist Billy in writing (e.g., Inspiration, WordQ).
- Consider pursuing a follow-up consultation with an occupational therapist to provide Billy
with additional suggestions for addressing his pencil grip.
G. Wilcox 2013