Age: 4 years, 7 months
Reason for Referral: Kira is being evaluated as part of a full child study team assessment. Parental concerns over perceptual-motor development and immature social/play behavior have persisted since Kira was first brought to the attention of Project Child one year ago. Currently there are questions about Kira’s readiness for Kindergarten.
Background Information: Kira was seen for screening by Project Child last year. Results at that time indicated possible deficits in gross and fine motor development, while age appropriate speech/language and cognitive skills were apparent. Kira demonstrates shy behavior in unfamiliar situations. An occupational therapy evaluation noted gross motor abilities within normal limits. However, delays in fine motor ability, including both quality of production and skill achievement were evidenced. Recommendations were made by the occupational therapist which were relevant to home and nursery classroom setting.
Currently behavioral concerns centering around socially reticent behavior, lack of peer relationships and immaturity are being noted by mother and classroom teacher. Delays in the fine motor area also appear to be hampering Kira’s development.
Observations: Kira is a very pretty 4 year 7 month old girl of average height and build. She was unwilling to separate from her mother and therefore Kira’s mother accompanied her throughout this assessment. Initially Kira remained seated on her mother’s lap but spontaneously moved to a nearby chair after approximately five minutes in to the session.
Kira was very interested in the testing materials and was cooperative with all tasks. No spontaneous speech was apparent. Speech upon demand was sparse and not elaborate but effective in relaying information.
Kira’s attention was appropriate although she sometimes seemed to tune out. Kira interacted affectionately with her mother and was socially responsive with the examiners. Kira seemed quite interested in people but hesitance was noted in her interaction with them.
Results of Evaluation:
McCarthy’s Scales of Children’s abilities
Scale Scale Index Scale Age Equivalent Percentile
Verbal 60 5-6 85th
Perceptual Performance 45 4-0 30th
Quantitative 52 4-6 55th-60th
Memory 55 5-0 70th
General Cognitive Index 105 4-10 60th-65th
Results of this measure indicate overall cognitive development at the average level. Perceptual-Performance scores are an area of relative weakness, with scores at below average levels. Verbal and memory skills are at high average level.
Verbal: The verbal scale measures the child’s ability to express herself verbally and to measure the maturity of her verbal concepts. Age scores for subtests include: Pictorial Memory (4-6); Word Knowledge (4-6); Verbal Memory I: Words and sentences (5-6) Verbal Memory II: Story (5-0); Verbal Fluency (6-6); Opposite Analogies (5-6).
Kira recalled four out of six pictures. She identified or named nine out of nine pictures and defined the words “coat” and “tool”. She repeated a series of four unrelated words. Kira correctly completed five opposite analogies.
Perceptual Performance: Kira achieved these subtest age scores in the perceptual performance area: Block Building (3-0); Puzzle Solving (4-0); Tapping sequence (3-6); Draw-a-design (4-0); Draw-a–child (4-0); Conceptual grouping (5-6). This scale evaluates reasoning ability through manipulation of materials. The child demonstrates skills of imitation, logical classification and visual organization which are generally below age expectations.
Kira copied block structures such as a 6 block tower and a 3 block chair. She correctly put together a three piece puzzle. Kira copied a circle, vertical and horizontal line and a right angle intersection. Her drawing of a person consisted of six scorable parts but the quality of her drawing was immature. Kira used the right hand for drawing tasks and a pincer grasp was inconsistent.
Kira identified the concepts of big/little, square-round and named nine colors. She was able to sort by three attributes.
Quantitative: The quantitative scale is designed to measure Kira’s number aptitude rather than the upper limit of computational skills. Kira’s understanding of quantitative concepts is judged to be at these age equivalents: Number Questions (4-0); Numerical Memory I: Forward Series (8-6); Counting and Sorting (5-0).
Kira answered number questions such as “how many heads do you have?” to a 4-0 year old level. She repeated six digits, which is a notable strength for her age.
Kira was able to sort four and ten blocks by half. She correctly counted to five with one to one correspondence.
Memory: Visual and auditory memory are assessed by subtests on this scale. The following subtest age equivalents have been achieved: Pictorial Memory (4-6); Tapping Sequence (3-6); Verbal Memory I: Words and Sentences (5-6) ; Verbal Memory II: Story (5-0): Numerical Memory (8-6). Kira’s short and long term memories appear adequately developed. A strength was noted in short term auditory recall.
Summary of Evaluation: Kira, a pretty and reticent 4 year 7 month year old girl, was cooperative and curious during this evaluation. She was able to maintain attention in a consistent manner for about fifty minutes.
Results of the cognitive assessment indicate functioning at approximately the 4-10 year level, with scatter to the 6-6 level. Perceptual-fine motor skills appear developed to the 4-0 level, which would be considered an area of notable weakness for Kira. Receptive language and expressive language appear well developed and were exhibited to the 5-6 level. Kira’s memory skills were demonstrated to the 5-0 level while qualitative skills appeared average.
These results suggest cognitive development at the average level overall.