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CONFIDENTIAL NEUROPSYCHOLOGICAL & EDUCATIONAL EVALUATION SCHOOL REPORT

Child’s Name: Josemaria Stricagnolo Castaneda

Grade/School: G1, International School of Luxembourg
Date of Birth: June 9, 2015
Dates of Testing: July 21, 25, & 26, 2022

REASON FOR REFERRAL

Josemaria Stricagnolo Castaneda is a 7-year, 1-month-old boy who recently completed Grade 1 at
the International School of Luxembourg (ISL). He was referred for a comprehensive
neuropsychological and educational evaluation by his parents, Dora Castaneda and Pasquale
Stricagnolo, at the recommendation of Dr. Steven Kurtz. His parents sought this evaluation to assess
his current neuropsychological functioning, including his strengths and weaknesses, and to determine
appropriate educational and treatment recommendations. This evaluation and the following report
were based on multiple sources of information, derived through multimethod procedures, including
a clinical intake interview with Josemaria’s parents; behavioral observations during the evaluation;
standardized and norm-referenced cognitive, neuropsychological, and academic assessments
administered in-person within a 1:1 non-distracting setting; parent and teacher behavior rating
inventories; and lastly, a review of initial intake paperwork completed as part of this evaluation.

RELEVANT BACKGROUND INFORMATION

Josemaria was the product of a pregnancy at risk of placenta abruption, which required his mother
to be on bed rest for three months. There were no post-natal complications. Josemaria met his early
speech and motor milestones within normal limits. Josemaria has maintained good health and his
hearing and vision are within normal limits. According to parents, there is no history of head injuries,
seizures, central nervous system complication, hospitalization, or severe illness. Josemaria is not
currently taking any medications. He began exhibiting symptoms of selective mutism at school when
he was three years old.

Josemaria currently lives in Luxembourg with his mother, father, and younger brother (Emanuel).
He also has a nanny who assists with childcare. Italian, Spanish, and English are spoken in the home.
However, Josemaria’s predominant language is English. Josemaria enjoys afterschool activities,
including gym and soccer. He also enjoys indoor playgrounds, traveling, and playing with toys.

Josemaria attended Il Cucciolo for nursery school in Turin, Italy. Josemaria then transitioned to World
International School of Torino (WINS) for pre-kindergarten. Josemaria began attending ISL after his
family moved from Italy to Luxembourg. Josemaria recently completed Grade 1 at ISL. There were
no significant concerns raised in school progress reports during the year. Per the ISL progress report,
Josemaria was described as a principled, caring member of the class who was learning to express
his own needs and thoughts in large group situations. Academic goals included improving his letter-
sound knowledge; sight word vocabulary; word segmentation; and ability to solve more abstract
math problems. Josemaria’s teacher described Josemaria as a talented artist who demonstrated
strong handwriting, a large knowledge bank, and a concern for fairness. Josemaria’s teacher reported
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 2

that he has had difficulty communicating in school due to his selective mutism. Over the course of
this year, his parents observed that Josemaria exhibited high levels of frustration when he returned
home from school. They noticed that he has struggled with reading and writing. He began
experiencing sleep difficulties, nervous tics, and nervousness around going to school as the school
year progressed.

Josemaria has received treatment for selective mutism with Dr. Steven Kurtz at Kurtz Psychology in
New York City. Josemaria recently underwent a neuropsychiatric evaluation with Professor Renzo
Guerrini at the University of Florence in Italy.

BEHAVIORAL OBSERVATIONS AND VALIDITY STATEMENT

Josemaria was accompanied to all testing sessions by his parents. All testing took place at Dr. Kurtz’s
office, as this was a familiar setting for Josemaria where it was predicted he would feel more
comfortable to engage in the evaluation. At the outset of the first testing session, a “fade in”
procedure was implemented, during which time Dr. Kurtz introduced Josemaria to me through
participating in an interactive game while his parents sat nearby. Josemaria warmed up quickly to
me and could verbalize in response to both forced-choice and open-ended questions. Dr. Kurtz and
his parents then left the examination room for the remainder of the evaluation process and all testing
was conducted 1:1 in the office. Throughout the assessment, he presented as a positive, engaging,
and friendly child. Gait and balance was within normal limits. Posture was upright. Activity level was
typical, with moments of higher energy. Eye contact was inconsistent. Facial expressivity was full in
range. Sensorimotor functioning on observation was within normal limits. He is right-handed and
used his dominant hand for all graphomotor tasks. Speech was relatively complex with atypical
prosody. There were occasional word finding/retrieval difficulties observed. Reciprocal conversation
was reduced. Mild motor restlessness was noted. Otherwise, he was largely on task. Gamifying tasks
and a visual checklist resulted in enhanced engagement and task motivation. He responded well to
praise and encouragement as well. Frequent breaks were interspersed to facilitate attention. All
standalone performance validity measures were passed. Thus, the results presented below are valid.

EVALUATION RESULTS
Intellectual Functioning: Josemaria was administered the Wechsler Intelligence Scale for Children,
Fifth Edition (WISC-V), a multifaceted test of intellectual functioning. On the WISC-V, he
demonstrated average general intellectual functioning (FSIQ = 100, 50th percentile). Thus, his overall
cognitive functioning is within age-expectation. His visual-spatial processing was high average
(VSI=114, 82nd percentile), standing out as a relative and normative strength. Josemaria’s nonverbal
fluid reasoning was in the upper end of the average range (FRI=109, 73rd percentile). Thus, he has
strong visual/nonverbal cognitive abilities, which will serve him well for thinking with visual material
and understanding higher-level academic concepts. His verbal abilities (VCI=95, 37th percentile) and
working memory (WMI=91, 27th percentile) were average. Josemaria’s processing speed was very
low (PSI=77, 6th percentile). This area was a relative and normative weakness compared to his peers.
As such, Josemaria is prone to experiencing difficulties with quickly processing incoming information.
Given significant discrepancies between “core” intellectual abilities (e.g., verbal/nonverbal
intelligence) and more attentionally-mediated abilities (e.g., working memory, processing speed),
the General Ability Index (GAI) and Cognitive Proficiency Index (CPI) were calculated. He exhibited
average general intellectual ability (GAI = 104, 61st percentile), contrasted by low average processing
efficiency abilities (CPI = 81, 10th percentile). Subtest performances are discussed in sections below.
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 3

Academic Functioning: In contrast to typically developing intelligence, Josemaria’s academic skills

were considerably weaker. His academic functioning was measured through quantitative ratings
(Conners CBRS) and direct assessment of his achievement skills in reading, written expression, and
mathematics (WIAT-4 & KTEA-3). Parent and teacher ratings resulted in elevations on the language-
based learning subscale (Conners CBRS Language). Teacher ratings indicated overall academic
concerns (Conners CBRS Academic Difficulties) and math difficulties (Conners CBRS Math).

Josemaria’s sight word recognition was below average (WIAT-4 Word Reading = 6th percentile).
Letter recognition was largely intact; however, some difficulties were noted in letter-sound
correspondence. Single word reading was most challenging for Josemaria. He had trouble reading
CCVC and CVVC words in isolation. Reading comprehension for his grade level measured in the below
average range (KTEA-3 Reading Comprehension = 3rd percentile). Rebus symbol correspondence
was intact, and so was identification of words within common environmental contexts (i.e., stop sign,
recycling, restroom). In contrast, word to picture matching was weak, as single word reading is
challenging for Josemaria. His orthographic knowledge was average (WIAT-4 Orthographic Choice =
50th percentile), buoyed by his strong visual skills. Nonetheless, Josemaria’s spelling by dictation was
low average (WIAT-4 Spelling = 19th percentile). He could dictate single letters and CV, VC, and
CVC words, but struggled to spell CVCV and CVCC words, as they were lengthier and more complex
to translate from speech to print. His ability to quickly write letters of the alphabet was below average
(WIAT-4 Alphabet Writing Fluency = 8th percentile), consistent with visuomotor processing speed
difficulties as noted above. Lastly, language-based math problem solving was below average for his
age (WIAT-4 Math Problem Solving = 3rd percentile; KTEA-3 Math Concepts & Applications = 10th
percentile). These latter tasks have heftier language demands, which likely contributed to these lower
scores.

Language Functioning: Josemaria’s language skills were variable. First, in terms of strengths,
Josemaria showcased a strong ability to retrieve words belonging to designated semantic categories
(NEPSY-II Word Generation Semantic = 95th percentile). When asked to repeat back sentences of
increasing length and complexity, Josemaria performed in the average range (CELF-5 Recalling
Sentences = 50th percentile). He demonstrated average ability to analyze phonologically novel words
and articulate them (NEPSY-II Repetition of Nonsense Words = 50th percentile). On a task that
required him to define words of increasing difficulty, Josemaria performed in the average range
(WISC-V Vocabulary = 50th percentile). Despite these competencies, his phonological processing
measured in the low average range (NEPSY-II Phonological Processing = 16th percentile). Sound
deletion tasks were the most difficult for Josemaria. In addition, his receptive picture vocabulary
measured below average (PPVT-5 Form A = 8th percentile). Phonemic fluency (NEPSY-II Word
General Initial Letter = 2nd percentile) and confrontation naming (BNT-2 = <1st percentile) were also
below age-expectation, indicating that he can struggle with language tasks that have greater retrieval
and mental search demands.

Nonverbal and Visual-Motor Functioning: Josemaria’s nonverbal cognition and visuomotor skills
were a strength within his neuropsychological profile. More specifically, Josemaria demonstrated high
average ability on a task that required him to select three shapes or designs that, when combined,
would form a correctly completed puzzle (WISC-V Visual Puzzles = 84th percentile). He demonstrated
strong visual-construction ability to use blocks to assemble identical two-dimensional designs (WISC-
V Block Design = 75th percentile). In terms of his visual-motor skills, assessed by his ability to copy
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 4

increasingly complex geometric designs, Josemaria performed within the average range (Beery VMI
= 50th percentile). Similarly, he performed satisfactorily on a task of visual-spatial organization (RCFT
Copy = WNL). His drawing speed was below average on this task (RCFT Copy Time = <2nd percentile),
as he sacrificed speed for accuracy (i.e., he was highly meticulous in attempting to copy the figure
as neatly as possible. Nonetheless, fine motor speed and dexterity, when measured without a
graphomotor component, was within normal limits bilaterally (Grooved Pegboard = 50th – 92nd
percentile). Conversely, his fine motor coordination and sensorimotor differentiation, when tasked
with imitating hand positions was below average (NEPSY-II Imitating Hand Positions Total Score =
2nd percentile). Thus, while he can perform motor tasks speedily, his coordination is not nearly as
well developed.

Memory: Josemaria scored within normal limits when required to mentally manipulate digits to
repeat them in reverse order (WISC-V Digit Span Backwards = 75th percentile) and sequentially
(WISC-V Digit Span Sequencing = 50th percentile). He exhibited average brief auditory attention and
rote recall when repeating the digits verbatim (WISC-V Digit Span Forward = 25th percentile). On a
subtest that required him to identify images of a series of objects from memory that had been briefly
presented to him, Josemaria performed in the low average range (WISC-V Picture Span = 16th
percentile). His ability to learn and then recognize a series of children’s faces was below average
(NEPSY-II Memory for Faces = 5th percentile). Thus, despite adequate auditory working memory and
visual-spatial skills, Josemaria has greater difficulty with visual working memory (i.e., our mind’s
mental sketchpad), which can make it difficult for him to encode and retrieve certain forms of visually
laden material.

Processing Speed: In terms of his processing speed, on a task which required him to name pictured
objects as quickly as possible, Josemaria scored in the low average range (KTEA-3 Object Naming
Facility = 21st percentile). He performed in the low average range when tasked with copying symbols
corresponding to numbers (WISC-V Coding = 16th percentile). He scored in the below average range
on a measure of visual scanning and rapid decision-making (WISC-V Symbol Search = 5th percentile).
As such, Josemaria would benefit from repetition of new information and information broken down
into bits and pieces, so he can more effectively demonstrate his strong intellectual and cognitive
abilities.

Attention and Executive Function: Parent and teacher ratings on a comprehensive behavior rating
inventory were negative for elevated ADHD symptoms or behaviors. On a trail-making task assessing
selective attention, Josemaria performed in the average range (TMT Part A = 61st percentile). Part B
was attempted but discontinued as he had trouble understanding task instructions. On a measure of
verbal inhibition, Josemaria performed within normal limits as well (RIT Color/Object Interference =
34th – 84th percentile). In terms of higher-level reasoning ability, he demonstrated solid ability on a
quantitative deductive reasoning task (WISC-V Figure Weights = 75th percentile). Likewise,
Josemaria performed within age-expectation when required to solve problems and recognize patterns
amongst abstract visual stimuli (WISC-V Matrix Reasoning = 63rd percentile). His verbal reasoning,
assessed by his ability to categorize words by their shared commonality, was in the lower end of
average (WISC-V Similarities = 25th percentile). As such, Josemaria has strong nonverbal than verbal
reasoning capacity, consistent with his overall higher levels of nonverbal cognition.
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 5

Behavior Rating Indices: In addition to qualitative reports and behavioral observations discussed
above, Josemaria’s social, emotional, and behavioral functioning was assessed through parent and
teacher behavior rating inventories (Conners CBRS and BRIEF-2) and direct neuropsychological
testing. On the Conners CBRS, elevated parent and teacher scores were detected on subscales
related to anxiety, perfectionism, and social functioning. On the BRIEF-2, parent and teacher ratings
on this executive function questionnaire resulted in elevations on the flexibility subscale (Parent
T=76; Teacher T=85). The emotional regulation subscale per parent report was also elevated (Parent
T=69). Thus, on a day-to-day basis, concerns were raised around behavioral flexibility, anxiety,
emotional regulation, perfectionism, and social functioning. Lastly, on a task requiring him to identify
emotional expressions on children’s faces, Josemaria scored within the average range (NEPSY-II
Affect Recognition = 63rd percentile). As such, his nonverbal social cognition measured within normal
limits.

SUMMARY OF FINDINGS
Josemaria, a 7-year-old boy, was referred for an evaluation by his parents to assess his current
neuropsychological functioning, including his strengths and weaknesses, and to determine
appropriate educational and treatment recommendations. The evaluation results are valid. His
general intelligence measured within the average range overall, characterized by strong
nonverbal/visual cognitive abilities, typically developing verbal comprehension and working memory,
and low processing speed, the latter of which can constrain his ability to quickly take in and process
incoming information. In contrast to typically developing intelligence, Josemaria exhibits weaknesses
in reading, spelling, writing, and math. He requires greater intervention and support for decoding
and single word reading, as well as encoding (i.e., spelling). He has satisfactory orthographic
foundations, aided by his solid visual-spatial skills, but requires intervention that is focused on
building his developing phonological and phonics skills to bolster his ability to become a skilled reader.
Josemaria also requires langauge-based multisensory support for his math problem solving. At this
time, he has not received sufficient remediation to formally diagnose a learning disability. In the
interim, he requires the aforementioned intervention to ensure his progress in closing academic gaps
with his peers. Future re-evaluation should consider if criteria is met for a learning disability.

Neuropsychologically, Josemaria has a unique constellation of strengths and weaknesses within hi

profile. Josemaria’s language is characterized by intact verbal intelligence, superior word generation,
and intact auditory working memory. However, relative difficulties are seen in phonological
processing and more notable weaknesses are apparent in receptive picture vocabulary and
confrontation naming. Thus, in addition to the supports mentioned above, language-based
multisensory intervention should also target word retrieval and vocabulary development. Josemaria
has well developed visuospatial processing and nonverbal reasoning. Visuomotor ability and visual-
spatial organization is within normal limits as well. These competencies indicate he is a strong and
capable visual learner, which will serve him well to continue to make progress so long as he is
provided with the appropriate language-based supports. Despite solid psychomotor speed, his fine
motor coordination and sensorimotor differentiation is less developed, which can hinder the writing
process. Thus, remediation efforts should also be focused on these underlying sensorimotor
functions. As noted above, his auditory working memory is typically developing, but challenges are
seen in visual working memory, which can constrain his ability to encode and retrieve novel visual
material, even with strong nonverbal cognition. His trail making and Stroop performances are within
normal limits and behavior rating inventories were negative for ADHD. His processing speed:
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 6

however, is an area of weakness, which, should be strongly considered when designing appropriate
classroom-based supports.

In terms of personality and socioemotional functioning, Josemaria has numerous strengths to

recognize. A kind, respectful, intelligent, family oriented, caring, athletically inclined, and empathetic
child, he was friendly positive, and engaging during testing sessions. On neuropsychological testing,
he exhibits solid nonverbal social cognition. On a day-to-day basis, the behavior rating scale data
indicated elevations on measures of behavioral flexibility, anxiety, perfectionism, and social
functioning. With that said, disruptive behavior was not clinically elevated, indicating he is generally
well-behaved across home and school settings. It is important to note that areas of specific
neurocognitive vulnerability can make it increasingly challenging for Josemaria to participate
effectively when his anxiety is heightened. Specifically, the test data indicate that Josemaria has
difficulty when he must quickly and efficiently organize his language internally, which can interfere
with his ability to generate and facilitate fluent social dialogue. Furthermore, his difficulties with
encoding and retrieving the visual memory of children’s faces can make it more challenging to feel
comfortable in novel and/or sensorily heightened social situations. Thus, his difficulties
communicating in school are in part due to heightened anxiety that is inextricably linked to specific
aspects of his neurocognitive profile. Overall, ongoing psychosocial support and intervention is
recommended to support his selective mutism and anxiety in school and to ensure that Josemaria is
comfortable in the classroom, so that he can more readily demonstrate his remarkable strengths and
unique qualities. Overall, Josemaria is a capable and bright child, who is expected to make great
progress with appropriate supports.

RECOMMENDATIONS
1. The findings and recommendations from this evaluation were reviewed with Josemaria’s
parents. The results of the evaluation should also be shared with educators at his school. His
parents and educators should have a meeting together to discuss the current
recommendations and how they can be implemented into his educational program. The
evaluation results should also be shared with other professionals who are involved in
supporting Josemaria moving forward.

2. Josemaria requires a school that only accepts children with average or higher IQ and cognitive
functioning and no significant behavioral or emotional disabilities (e.g., conduct disorder,
oppositional defiant disorder). He needs a small, nurturing, positive learning environment
staffed by teachers with background and expertise in working with children with a diverse
array of learning needs. Josemaria requires placement in a classroom with a low student-to-
teacher ratio, meaning educators should have enough professional support to provide 1:1
individualized attention for each child's specific learning profile at various points during the
day. Integrated related services and supports, differentiated academic instruction, and
language-based learning support using multisensory interventions to support reading, writing,
mathematics, and oral language skills should be incorporated into each child’s school day.

3. In the classroom, Josemaria requires a nurturing, positive learning environment staffed by a

teacher with whom he can establish a strong relationship and who can provide clear and
predictable instructions and limit setting but also be warm, encouraging, and understanding
of his learning needs. He would benefit from highly structured teaching situations
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 7

incorporating appropriate activities and materials modified to his performance levels with the
goal of making sure that he can make progress, regain self-confidence and self-esteem, and
renew his interest in learning. Recognition of his unique talents in the classroom with frequent
acknowledgment of his strengths in front of other students and adults will be important. Visual
schedules should be linked to his or him interests. Adjusted work demands into short, rapid
cycles of work/break/work/break to build stamina for sustained work will also be important.

4. An intensive program of academic intervention must begin soon to reduce frustration

regarding his lack of learning, increase his self-esteem, and resolve any concerns regarding
self and school. For reading and spelling, Josemaria will do best with a multi-sensory
instructional program (i.e., Orton-Gillingham and/or Lindamood Bell) for basic reading and
spelling skills. Educators should integrate instruction in reading decoding with instruction in
spelling. For example, when teaching Josemaria how to read phonically regular, 3-letter,
closed-syllable words (e.g., tag, lip), teach him how to segment the sounds in the same types
of words, writing the letter corresponding to each sound in order. Teach any related phonics
generalizations (e.g., closed syllables contain only one vowel and end in a consonant; the
vowel in a closed syllable typically has its short sound). Provide ample practice in recognizing
the syllable pattern and applying the generalization to reading and spelling real words and
nonsense words. In math, Josemaria would benefit from a program that incorporates
“multisensory math” strategies from the Concrete Representational Abstract (CRA) approach.

5. In terms of language-based work, Josemaria would benefit from support with vocabulary
development in reading, writing, and oral discussions. Ensure that oral vocabulary continues
to develop, and that Josemaria pronounces and uses new words correctly. It will be important
to expose Josemaria to multiple repetitions of new words in many different contexts and
settings. As Josemaria's word-retrieval problem interferes with the fluency of his oral reading,
do not require him to read aloud in the classroom. When calling on Josemaria in class, provide
him with as much time as necessary to organize his thoughts and formulate a response. He
may know the answer but need extra time to find the words. Privately, let him know this plan
so that he does not feel pressured to come up with answers quickly. Make sure to call on
Josemaria if he volunteers.

6. Given his neuropsychological weaknesses in processing speed and certain aspects of memory,
the following recommendations are offered:

• Do not require Josemaria to work under time pressure. Place emphasis on accuracy
rather than speed.
• Replace timed tests with alternative assessment procedures.
• Ample time to complete work or shortened assignments
• Extra time to complete reading, math, or writing tasks. Make sure he is allowed this
time in a way that does not bring negative attention to him.
• Shorten drill and practice assignments that include visual information or require visual-
motor skills, such as the repeated writing of spelling words.
• Reduce the amount of information that he is required to memorize.
• Limit the length and complexity of all instructions to Josemaria.
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 8

• Ensure that you have Josemaria's attention before speaking to him. If you are giving
a series of oral directions, limit them to two or three steps, and ask Josemaria to repeat
them.
• When giving directions for a task or assignment, write the steps on the board so that
Josemaria can review directions as often as needed.
• Provide intensive repetition, practice, and review in learning activities.
• In each teaching session, before introducing new information to Josemaria, review
previous information from the last lesson and check for mastery.
• Whenever it is possible, use a game format for learning. Josemaria will find it easier
to attend to the information and hold it in mind long enough to process it more
effectively.

7. To support Josemaria’s social functioning in school, educators should create situations that
allow Josemaria to have successful social experiences. For example, select a peer who would
like to play a game with Josemaria on the playground during recess. Further, he would benefit
from highly structured cooperative learning groups to help Josemaria participate in positive
social interactions. Make sure that all students in the group know their responsibilities and
how to accomplish them. Lastly, use social scripts, comic strip conversations, video modeling,
and guided practice will be essential to support Josemaria's development of social skills with
peers.

8. Josemaria’s teachers and school providers would benefit from training in evidence-based
behavioral interventions for selective mutism. The recommended evidence-based program for
SM has been adapted from Parent-Child Interaction Therapy (PCIT) and is referred to as PCIT-
SM. The following are recommended strategies to support Josemaria’s selective mutism and
anxiety in school:

• Before Josemaria begins school for the following years, Josemaria, his parents, and his
teacher(s) should spend time in the classroom playing games and establishing rapport.
The “fade in” technique will be used if it is necessary. Teachers next year should refrain
from prompting Josemaria for speech until they have been “faded in” to avoid
contamination, i.e., the association of not talking with specific persons, places, and
activities. Once “faded in,” they should only begin prompting for speech once
Josemaria is behaviorally engaged and/or spontaneously verbal.
• Teachers should wait 5 seconds following every question to give Josemaria the
appropriate opportunity to respond verbally and provide reflections & praise following
him response; these are specific skills in the SM treatment paradigm that staff should
use.
• Josemaria’s participation in group lessons should be monitored by teachers, identifying
his readiness to verbalize within the group setting. Teachers should prompt him
individually or within a small group setting until he is able to verbalize successfully in
front of the entire class, keeping in mind the type of information that is requested of
him.
• When available, teachers should provide practice time for Josemaria to rehearse verbal
behaviors, only adding additional demands within the whole group setting when
Josemaria appears available to share within that context.
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 9

• Josemaria’s teachers should establish daily, targeted home/school communication

system for monitoring using a daily report card. Progressive goals should be identified
each week, with the guidance of outside clinician.

9. Josemaria and his family would benefit from continued clinical monitoring and support, as
needed. Regular and ongoing communication between treatment providers, parents, and
educators at school is strongly recommended to provide the most appropriate degree of care
to foster Josemaria’s ongoing development. In addition, the following resources are
recommended to help Josemaria’s family better understand his specific needs:

• Breaking Free of Child Anxiety and OCD by Eli Lebowitz, PhD

• Overcoming Selective Mutism: The Parent’s Field Guide by Aimee Kotrba, PhD and
Shari Saffer

10. Close monitoring of Josemaria’s progress with interventions is recommended over the
upcoming school year. Over the longer course of his development, neuropsychological and
academic re-evaluation is recommended every 2-3 years to track progress and to make
appropriate changes to Josemaria’s school and treatment plan. It is hoped the information
provided in this report and these recommendations are helpful to Josemaria and those who
work with him.

It was a pleasure working with Josemaria and his kind and supportive parents. It is hoped the
information in this report and these recommendations are helpful to Josemaria and those who work
with him. I am available for ongoing consultation as needed. Please do not hesitate to contact me
with questions at drmatt@growingmindsnyc.com

Matthew Pagirsky, PsyD

Co-Founder, Director of Neuropsychology and Training
Growing Minds Psychology, PLLC
New York Licensed Psychologist #022348
National Register Health Service Psychologist (HSP) #57342
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 10

The following section provides scores obtained from Josemaria’s evaluation. It is important to note
that conclusions made about Josemaria’s abilities and conditions were based on a combination of
test scores, developmental history, and qualitative aspects of test performances during the
evaluation process. This process allows a valid and clinically meaningful way to comprehensively
assess Josemaria’s cognitive, academic, neuropsychological, and social-emotional functioning. Thus,
the following scores should be interpreted within the context of all the information contained in the
report.

All standardized measures were developmentally appropriate. Standard scores have a mean of 100
with a standard deviation of 15. Scaled scores have a mean of 10 with a standard deviation of 3. T-
scores have a mean of 50, with a standard deviation of 10. Z-Scores have a mean of 0, with a
standard deviation of 1.

Performance Validity Testing

Pediatric Performance Validity Test Suite (PdPVTS)
Passed

Intellectual Functioning
Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V)
Index Standard Score Percentile
Full Scale IQ (FSIQ) 100 50
Verbal Comprehension Index (VCI) 95 37
Visual Spatial Index (VSI) 114 82
Fluid Reasoning Index (FRI) 109 73
Working Memory Index (WMI) 91 27
Processing Speed Index (PSI) 77 6
Verbal Comprehension Subtests Scaled Score Percentile
Similarities 8 25
Vocabulary 10 50
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 11

Visual Spatial Subtests

Block Design 12 75
Visual Puzzles 13 84
Fluid Reasoning Subtests
Matrix Reasoning 11 63
Figure Weights 12 75
Working Memory Subtests
Digit Span 10 50
Forward 8 25
Backward 12 75
Sequencing 10 50
Picture Span 7 16
Processing Speed Subtests
Coding 7 16
Symbol Search 5 5

Academic Functioning
Wechsler Individual Achievement Test, Fourth Edition (WIAT-4)
Reading Subtests Standard Score Percentile
Word Reading 77 6
Written Expression Subtests
Orthographic Choice 100 50
Spelling 87 19
Alphabet Writing Fluency 79 8
Mathematics Subtest
Math Problem Solving 71 3

Kaufman Test of Educational Achievement, Third Edition (KTEA-3)

Subtests Standard Score Percentile
Reading Comprehension 71 3
Math Concepts and Applications 81 10
Object Naming Facility 88 21

Neuropsychological Functioning
A Developmental Neuropsychological Assessment, Second Edition (NEPSY-II)
Word Generation Scaled Score Percentile
Semantic Total Score 15 95
Initial Total Score 4 2
Contrast Score 2 <1
Phonological Processing
Total Score 7 16
Repetition of Nonsense Words
Total Score 10 50
Memory for Faces Scaled Score Percentile
Total Score 5 5

Peabody Picture Vocabulary Test, Fifth Edition (PPVT-5), Form A

Measure Standard Score Percentile
Total 79 8
CONFIDENTIAL INFORMATION: STRICAGNOLO CASTANEDA, Josemaria 12

Boston Naming Test (BNT-2)

Measure Z- Score Percentile
Total Score -3.04 <1

Clinical Evaluation of Language Fundamentals, Fifth Edition (CELF5)

Subtests Scaled Score Percentile
Recalling Sentences 10 50

Beery-Buktenica Developmental Test of Visual-Motor Integration, 6th Edition (VMI)

Measures Standard Score Percentile
Beery VMI 100 50

Rey Complex Figure Test (RCFT) Percentile Description

Copy >16 WNL
Time to Copy <1 Exceptionally Low

Grooved Pegboard Test Z-Score Percentile

Dominant Hand 1.4 92
Nondominant Hand 0.06 52

Reynolds Interference Test (RIT)

Measures T-Score Percentile
Object Interference 46 34
Color Interference 60 84

Trail Making Test (TMT) Z-Score Percentile

Part A 0.27 61

Social, Emotional, and Behavioral Functioning

Discussed in report text
Conners Comprehensive Behavior Rating Scale (CBRS) Parent and Teacher Report
Behavior Rating Inventory of Executive Functioning, Second Edition (BRIEF-2)