WILLIAM THOMPSON CASE STUDY

WILLIAMTHOMPSON CASE STUDY

IdentifyingInformation

Tocarry out the cognitive assessment of William Thompson,Stanford-Binet Intelligence Scales is used. It is the main cognitiveassessment instrument developed in the United States. It operates onBinet discovered in France (Sattler, 2008). It is usually usedindividually in the process of administering intelligence testmodified from the original Binet – Simon scale, advanced by Lewis M.Terman who worked as a psychologist at Stanford University. Thisscale is currently in its fifth edition it is used to test thecognitive ability and intelligence of an individual thus useful toascertain the developmental or any intellectual deficiencies(Sattler, 2008).

Thisscale measures five common factors that comprise both the nonverbaland verbal subtests. This identifying information tested includesquantitative reasoning, knowledge, working memory, fluid reasoningand visual-spatial processing (Sattler, 2008). The scale set thestage for the development of the modern field of testing intelligencemaking up the early examples of an adaptive test.

Theoperation of the Standford-Binet Intelligence Scale: Fifth Edition(SB5) is similar to the Binet initially used to develop the IQ test,and it is still grounded in the schooling process to testintelligence. It efficiently and continuously assesses all the levelsof ability in the Individuals with a broader range in age (Sattler,2008). Besides, it is endowed with the capacity to ascertain severaldimensions of abilities (Sattler, 2008). This scale is used withindividuals as young as two years of age. About ten subsets involvedin the revision that includes both the verbal and non-verbal domains.

Theidentifying information used for the Williamson assessment includedthe verbal comprehension, perceptual reasoning, working memory,processing speed and the full scale. Within each of the fivecategories, the following were assessed, the composite score,percentile rank, 95% confidence interval and qualitative description(Sattler, 2008). To obtain the best assessment, two trials wereconducted to access any prevailing discrepancy.

Underverbal comprehensions, subtest summary, similarities, vocabulary andinformation were assessed. The summary of the perceptual reasoningsubtest was categorized into block design, matrix reasoning andvisual puzzles (Sattler, 2008). Under working memory subtest summary,digit span and arithmetic were assessed. The summary for theprocessing speed subtests are categorized into symbol search andcoding. Peoplewith memory concerns or other intellectual protests, Non-memorytriggers incorporate identity change, wretchedness, crumbling ofincessant infection without clarification, and falls or adjust issues.Source reports of subjective hindrance, with or without patientsimultaneousness .Medicare recipients, as a feature of the YearlyHealth Visit

Reasonfor referral

Williamafter undergoing severe traumatizing experience as a veteran of theIraq war was unable to discharge his duties as expected. He was laidoff at a New York City law firm where he was specialized infinancial law within the firm, having received his J.D. from theBronx School of law and finance (Sattler, 2008). His sudden change ofbehavior after returning from war was noticed by the firm as well ashis wife. Having been an active member of the Catholic Church much ofhis life, William participation drastically waned after his returnfrom the war (Sattler, 2008). Also he reported that he was unable tohave sufficient sleep and reported to have developed signs of feelingfatigue, drained and unenthusiastic concerning his past interest.

Toavoid horrid memories and flashbacks he resorted to drinking alcoholusually 5-12 drinks a day. He had confessed that he feels he lost avital part of himself during the war and that prior to the war, hewas stable, enthusiastic andhappy about his life (Sattler, 2008).These factors led to his referral for an evaluation ofsocial/emotional difficulties.

Background

Heand his wife, 27-year-old Luli Kim (Korean/American), needed to movein with William`s 56-year-old step-sibling Henry (African American)and his 54-year-old sister-in-law, Rosita (Columbian/Mexican) wholive in Pasadena, CA. William and Luli made the move to California onthe grounds that they got to be destitute when William neglected tomake the home loan installments in the wake of being cut back fromhis law office upon his arrival from Iraq (Sattler, 2008). Regardlessof rehashed endeavors to re-fund his home to make the installmentsmore reasonable, William was not able to acquire any assistance.William and Luli`s past house was in Hackensack, NJ. Henry and Rositalive in Pasadena, CA.

Whilein Iraq, William began drinking alcohol making him abusive, as ameans to cope the overwhelming feelings brought about by thetraumatic stress of war that, in essence, had spiraled out of controland took to drinking as a means of relief (Sattler, 2008). Regularlyhe claims to experience flashbacks to life-and-death experiences fromthe war and as a way of relief he tries he levelled best to avoid anyconversation or situation that may remind him of the war. He claimsthat daily he has a problem both falling and staying asleep,profoundly sad and, what is more, is the fact that he is angry muchof the time (Sattler, 2008).

Willianas a family man is incredible, that is, he has no history of cases ofdomestic abuse between him and the wife. What is more is the factthat William has never abused any woman. Though he loves his wife,Willian understands that his wife Luli, do not know the reality andhorrors of war he experienced and continued to be a nightmare to him(Sattler, 2008). In essence, Willian wants to offer protection to hiswife against the horrific events he regularly experience, as such hetalks to her superficially to hide giving more details. Therefore,this level of communication is making their marriage increasinglyestranged. On the other hand, Luli loves her husband and wants thebest for him she committed to making Willian open up to her, an actthat serves to only distance him from her.

Willianeducational qualification is impressive as he received his J.D fromthe Bronx school of law and finance, where he specialized in financelaw (Sattler, 2008). At the west point, he received his undergraduateeducation, with generally above average grades. After successfullycompleting his undergraduate education Willian went to serve as anArmy Captain for six years of active duty in Iraq (Sattler, 2008).

Willianinterests have included soccer, marathon running, being a novicemodern art collector and listening to jazz music. Before going toserve in Iraq, Willian was an active member of the Catholic Churchfor much of his life but his participation declined significantlysince his return from the war (Sattler, 2008). Throughout his life,Willian has been strong, healthy and active for most of his life.Interestingly, he claimed that upon his return, he has been unable tosleep sufficiently and has experienced heightened fatigue, drainedfeeling and has become unenthusiastic concerning his past interests(Sattler, 2008).

Tocontain this horrific experiences, Willian resorted to heavy alcoholintake, often taking 5-12 drinks daily to drown reliving the horridwar flashbacks and memories (Sattler, 2008). An important observationby Willian is the claim that he lost a vital part of himself while inIraq and that currently he longs to recapture his initial ability tobelieve in goodness in the world and the people. Something positivehe has retained is continued ability to run each morning, but claimedthat he was not ready to participate in any marathon at this time,the daily morning run is his most peaceful and choice time of the day(Sattler, 2008). Despite suffering from psychological challenges,Willian had not experienced any known medical issues and as a matterof fact he has no prescribed medication. Never before in his life hashe been to a psychiatrist or counsellor because his was enthusiastic,stable, and happy about his life (Sattler, 2008).

Assessmentprocedures

Theassessment criteria used focuses on four main areas these are verbalcomprehension, perceptual reasoning, working memory and processingspeed. Using Wechsler scales the general assessment procedures ismainly conducted using two subtests that are verbal scales and theperformance scales (Sattler, 2008). In verbal scales the measuretargets general language, knowledge and memory skills while on theother hand, the performances scales measure the sequencing,problem-solving and spatial skills.

Willianis examined by a trained examiner using a complex set of testmaterials (Sattler, 2008). The process of assessment takes about nineminutes. Each of thetest scores which are raw are converted to astandard scores by the use of mean of 10 and then subjected to astandard deviation of 3. The verbal battery scale scores are addedtogether and converted to a verbal IQ scores this process is alsosubjected to the performance scale scores to bring about theperformance IQ score (Sattler, 2008).

Thereafter,both the performance and verbal IQ scores are summed and henceconverted to obtain the Full Scale IQ score (Sattler, 2008). Thethree scales, verbal, performance and Full scale IQs are termed asnormative IQS, calibrated to a mean of 100 and subjected to astandard deviation of 15 (Sattler, 2008) . Scores on the full scalegoing beyond 130 classifies an individual in the superior or giftedrange. The scores in the range of 120 -129 are categorized as “veryhigh”, the scores within the range of 110-119 are termed as“bright normal”, 90-109 range is termed “average”, 85-89range is termed as “ low average” and scores within the range of70-84 is termed “ borderline mental functioning”, 50-60 is “mildmental retardation”, 35-49 is “moderate retardation”, 20-34 is“severe retardation” and 20-25 is termed “profound retardation(Sattler, 2008) .

Thegeneral method used includes interviewing, interpretation of anindividual standardized test of intelligence and administration andgiving a detailed written report (Sattler, 2008). In the event ofinterpreting the performance on the WMS-IV, it is important for theexaminer or the physician in question to put into consideration thefactors which may influence the performance tests of the Client.These factors include such factors as difficulties with hearing,vision, motor functioning, and speech/language functioning andEnglish language proficiency (Sattler, 2008). Also personal factorsfor instance fatigue, physical illness, headache and other factorsspecific to the testing session which include distractions or lack ofmotivation may significantly influence the performance on any givenday (Sattler, 2008). Therefore, the following factors may haveaffected Willian performance these include his ability to expresshimself among other minimal factors (Sattler, 2008).

Observations

Duringthe assessment process, the examiner found a difficulty inestablishing rapport with Willian (Sattler, 2008). At most casesWillian was constantly fidgeting and expressed high level frustrationwith his perceived poor performance. However, the examiner understoodthat Willian experiences had little negative effect on the completionof the various activities to the best of his ability and consequentlyno impact on his overall performance on the assessment (Sattler,2008).

Thefollowing are the observation made by the examiner:

WAIS–IV Scale

Score

Verbal Comprehension

125

Perceptual Reasoning

117

Working Memory

97

Processing Speed

105

Full Scale

115

Scale

Composite

Score

Percentile

Rank

95%

Confidence Interval

Qualitative

Description

Verbal Comprehension

VCI

125

95

118-130

Superior

Perceptual Reasoning

PRI

117

87

87

High Average

Working Memory

WMI

97

42

90-104

Average

Processing Speed

PSI

105

63

96-113

Average

Index-LevelDiscrepancy Comparisons

Comparison

Score 1

Score 2

Difference

Critical Value

.05

Significant

Difference

Y / N

Base Rate

Overall Sample

VCI – PRI

125

117

8

8,81

N

VCI – WMI

117

97

10

8.81

Y

22.8

VCI – PSI

125

105

20

12.12

Y

11.0

PRI – WMI

117

97

20

9.29

Y

7.1

PRI – PSI

117

105

12

12.47

Y

21.8

Index-LevelDiscrepancy Comparisons

Comparison

Score 1

Score 2

Difference

Critical Value

.05

Significant

Difference

Y / N

Base Rate

Overall Sample

WMI – PSI

97

105

8

12,47

N

FSIQ – GAI

Baserate by overall sample.

Statisticalsignificance (critical value) at the .05 level.

VerbalComprehension Subtests Summary

Subtest

Scaled

Score

Similarities

15

Vocabulary

14

Information

14

PerceptualReasoning Subtests Summary

Subtest

Scaled

Score

Block Design

12

Matrix Reasoning

14

Visual Puzzles

13

WorkingMemory Subtests Summary

Subtest

Scaled

Score

Digit Span

9

Arithmetic

10

ProcessingSpeed Subtests Summary

Subtest

Scaled

Score

Symbol Search

11

Coding

11

Subtest-LevelDiscrepancy Comparisons

Subtest Comparison

Score 1

Score 2

Difference

Critical Value

.05

Significant

Difference

Y / N

Base

Rate

Digit Span – Arithmetic

9

10

1

2.57

N

Symbol Search – Coding

11

11

0

3.41

N

DeterminingStrengths and Weaknesses

Subtest

Scaled Score

Mean

Difference

Critical Value

.05

Strength or Weakness

S / W

Base

Rate

Block Design

12

12.3

.3

2.85

Similarities

15

12.3

2.7

2.82

Digit span

9

12.3

3.3

2.22

W

10%-15%

Matrix Reasoning

14

12.3

1.7

2.54

Vocabulary

14

12.3

1.7

2.03

Arithmetic

10

12.3

2.3

2.73

Symbol Search

11

12.3

1.3

3.42

Visual Puzzles

13

12.3

.7

2.71

Information

14

12.3

1.7

2.19

Coding

11

12.3

.7

2.97

Assessmentof results

Theabove table gives Willian Verbal, performance and full scale IQscores. The verbal comprehension score is 130 which is termed assuperior measured by the verbal comprehension Index (VCI) indicatesthat Willian verbal comprehension is normal (Sattler, 2008). The VCLis developed to assess the concept formation and verbal reasoning.Willian performance on the verbal subtest making up his VCL offers avaried set of verbal abilities and therefore it shows he performsbetter in some verbal task than others. He attained the highestperformance on the verbal reasoning tasks on the information subtest(Sattler, 2008). This shows Willian is a person of general knowledgeand it is so because of his quality of education.

Perceptionreasoning of Willian is 85 on the 95% confidence interval score whichis translated as high average. This indicates that he has remarkablygood nonverbal reasoning abilities measures according to thePerceptual Reasoning Index (PRI) (Sattler, 2008). This scale measuresWillian fluid reasoning in the perceptual domain with such taskswhich measures nonverbal concept formation, visual organization andperception, learning, visual-motor co-ordination, and the ability toseparate figure and ground in visual stimuli (Sattler, 2008). Hisperformance is somewhat variable, even though the degree ofdifferences exhibited by the individual of his age is often a commonphenomenon (Sattler, 2008).

Onthe part of working memory, Willian recorded a score of 90-104 thattranslate to an average score. This shows the client has an averageability to sustain attention, exert mental control and concentrate(Sattler, 2008). It is measured using Working Memory Index (WMI).

Willianprocessing speed recorded a range of 96-113 score which is an averagescore just the same as that for the working memory (Sattler, 2008).It indicates that Willian has an average ability to process simple orroutine visual material without encountering errors compared to anindividual in the higher category. He has an average ability to makeprocessing of any quick visual materials just the same as his workingmemory but below his nonverbal reasoning ability (Sattler, 2008). When an individual has poor ability to process information means thathe cannot be able to comprehend faster novel information and willtake considerable time (Sattler, 2008).

Summary

Willian,38 year old as examined by the physician completed the WAIS-IV. Hiscognitive ability as conducted in the assessment indicated that it iswithin the high average range (FSIQ=106-114). He has superior verbalcomprehension abilities as indicated in the VCL of 118-130 (Sattler,2008). Willian general perceptual reasoning abilities was 87 on thePRI scale which is high average score (PRI=87). Willian ability toprocess simple or routine visual material without making errors isaverage range (PCI=96-113). And his ability to sustain attention,concentrate and exert mental control is average (WMI=90-104)(Sattler, 2008).

Recommendation

Beforeundertaking any task, Willian should be reminded to think about whatwill be necessary in order to complete important tasks. The materialrequired must be provided for him and all the steps required for anytask completion. It is essential that more counselling be given toWillian to help adjust to normal life. All this endeavors should beprovided to Willian as an attempt to increase his involvement in thehome and sense of self-worth.In essence the goal is to make himfell more valuable and significant within his family unit and theentire society in general

References

Sattler,J. M. (2008). Assessment of children: Cognitive foundations (5thed.). La Mesa, CA: Jerome M. Sattler, Publisher, Inc. â—¦Chapter16, “Stanford-Binet Intelligence Scales–Fifth Edition(SB5)†(pp. 565–604)—¦Chapter 18, “Assessment ofIntelligence with Specialized Measures†(pp. 676– )