77), CONNERS ‘Comprehensive Behavior Rating Scales” By C. Keith Conners, Ph.D. Conners CBRS-Self-Report Assessment Report Name/ID: DP | Age: 11 years Gender: Male Birth Date: December 07, 2003 Grade: 5 Administration Date: March 03, 2015 Assessor Name: Kaitlin Bateman Data Entered By: Normative Option: Gender-specific norms Report Options: Standard report options are being used for this report (these options are designed for the typical user and are recommended for most applications). Optional Assessment report features are available: Standard Error of Measurement, Percentiles, and item Responses by Scale. This Assessment report is intended for use by qualified assessors only, and is not to be shown or presented to the respondent or any other unqualified individuals x Senna 92% utah sae At gs eens ZEMHS 3 eemMcnnown ss = Sota” Fe teComers CORS-SR Assessment Report or Summary of Results Response Style Analysis Scores on the Validity scales do not indicate positive, negative, or inconsistent response style Summary of Elevated Scores ‘Te folowing secton summarizes areas of concern fr ORIEN vases on his ratings onthe Conners GaRS SR Not tat areas hat are nota concem are notrepoteg i this summary Conners CBRS-SR Content Scales MMII 7 roving cue 086-38 comer sao wre vay aid 8, T score = 70), indicating many more concerns than are typically reported Emotional Distress (T= 90), Hyperactivity/impulsivity (T= 76), Separation Fears (T= 81) and Physical Symptoms ( T= 71). OOM ne ong Comers CORS Contr snl was laatad a se = 8 CMT ore Concems than ae typically reported: Defant/Aggressive Behaviors (T= 68) DSM-IV-TR Symptom Scales ‘Symptom Counts were probably met and the T-scores were elevated or very elevated (ie, Tscore 2 65) for the following DSM-IV-TR Symptom scales ADHD Predominaly Inattentive Type ( T= 69), ADHD Predominantly Hyperactive-Impuisive Type (T= 75). Major Depressive Episode (7 = 78), Manic Episode (T= 73), Generalized Anxiety Disorder (T = 79), Separation Anxiety Disorder ( T = 79), Social Phobia (7 =.83) and Obsessive:Compulsive Disorder (7 = 80). These diagnoses should be given strong consideration. Impairment OMI sets at rooms aun ates nctenig vey equating =) 8s SETS. and often (rating = 2) inthe Socll and home setings. Conners Clinical Index cose o OI aos a incl canteaton zat (9% robb, bu te cat rolcvart nfarmatonahentaiso Be caretully considered in the assessment process. Other Clinical Indicators Based on DANE ratings to the Conners CBRS-SR, further investigation is recommended for the following issue(s). Bullying Perpetration (rating = 1), Bullying Victimization (rating = 3), Panic Attack (‘atings: dizziness = 1, feels sick = 2, shortness of breath = 1), Tics (motor) (rating = 1) and Ties (vocal) (rating = 2) “Critical Items. Bese on OI aos te Sel Ha tal tems on te Comers CBRS-SR mediate attention is required for the following issue(s). self-harm (rating = 1), nobody cares (rating = 2). helplessness (rating = 2) and hopelessness (rating = 1) Copyright © 2008 Me Health Systems Ine All rights reserved. = MHS Page 2Conners CBRS-SR Assessment Repor ‘or 0 Admin Date: 0310372015 Conners CBRS-SR Results and IDEA ‘Scores on the Conners CBRS-SR suggest possible consideration for IDEA 2004 eligibility in the following area(s): Autism, Emotional Disturbance, Other Health Impairment and Specific Learning Disability Cautionary Remark This Summary of Results section only provides information about areas that are a concern. Pl the remainder of the Assessment Report for further nformation regarding areas that are not could not be scored due to omitted items, Copyright © 2008 Muit-Health Systems Inc.All rights reseed Page 3 aaConners CORS-SR Assessment Repor for Admin Oat: 039082015 Introduction Conners Comprehensive Behavior Rating Scales-Self-Report (Conners CBRS-SR) is an assessment too! that prompts the youth to provide valuable information about himself. This instrument is helpful when information regarding a number of childhood disorders and probiem behaviors is required. When used in ‘combination with other information, results from the Conners CBRS-SR can provide valuable information to guide assessment decisions. This ‘eport provides information about the youth's score, how ne compares to ther youth, and which scales are elevated. See the Conners CBRS Manual (published by MHS) for more: information ‘This computerized report is an interpretive aid and should not be provided to youths or used as the sole criterion for clinical diagnosis or intervention. Administrators are cautioned against drawing unsupported interpretations. Combining information from this report with information gathered from other psychometric measures, interviews, cbservations, review of available records, and discussions with the youth, will give the practitioner or service provider a more comprehensive view of the youth than might be obtained from any fone source. This report is based on an algorithm that produces the most common interpretations for the scores that have been obtained. Administrators shoudd review youth's responses to specific items to ensure that these interpretations apply Response Style Analysis ‘The folowing section provides CAI scores forthe Postive and Negative Impression scales and the inconsiateney Index Positive Impression “The Positive Impression score (raw score = 0) does not indicate an overly positive response style Negative Impression ‘The Negative Impression score (raw score ) does not indicate an overly negative response style Inconsistency Index The Inconsistency Index score (raw score = 6, number of differentials = inconsistent response style. ) does not indicate an Copyright © 2008 Mult-Health Systems Inc. Al rights reserve. "SMHS Page 4Conners CBRS-SR Assessment Repor for 0 Admin Date: 0310972015 Conners CBRS-SR Content Scales: T-scores The following graph provides T-scores for each of the Conners CBRS-SR Content scales and subscales Erotonal Detress DeiantiAggressive Behaviors Academe Dificutes Hyperactivty/impusivty Separation Fears Violence Potental nétator Physical Syrotoms wo 9 9% 0 0 Copyright © 2008 Mult:Health Systems Inc.All rights reserved =MHS Pages wetConners CBRS-SR Assessment Report for (A ‘Admin Date: 03/03/2015 Conners CBRS-SR Content Scales: Detailed Scores The folowng table summarizes the results of ONIN sit assessment and provides general Feeeaearn gor cw ne comparce'o the norane group Pease refer tone Connors CARS Manca or ‘hore formation on the nerprtation of hese results Raw |Fscore ie \Common Characteristics of High Scale Seore| ‘Guideline \Scorers Eno e ary Elevated Store any —|Wertes aa caeudng powsbe socal Disvess Imere concerns han are” [ansietes) may fee narvous, Low typealy repotec) feticonfdence, May show sgn of | Gepresson. May nave physical compiants (aches pain. feuly sleeping), may nave repetive thoughts or cons Deka 8 Elevated Scare ove GoncaTs May have poor consol o anger: may agressive | than are ypealy reported) break ules: maybe physialy andlor Benavs | Nerbaly agressive, may show violence, | | Suiying,destroctve tendenees, may ‘seem uncaring Reaaame [259 vege SCTE UVPATTEVER | Struggles wih acing wing. spat Dieuies efeoneern) andor artnet May have diet [Keeping up in schoot ryperaanra 11818 ay EevaTea SS Many —_|righ acy eves, RAVES TESTESS, ay Timpisty move concerns tan are” rave iffeuty boing que. May have ‘yorcaly reported) Problems nth impulse cont may fnterupt others or have cic wating formsmer turn aparaon Fears 2 —]BT ay Eavarod Sears ay [Fars boing separated TOM | more concerns ten are” [parentfcaegivers. pal reported) | tenes Prana 20 igh Aravage Seors Tah Nay SRP. oF ay be ATK “ndeater more concerns han are’ [aggrssive behav. typical repotes). ‘Pyaar re HF Nery Elevated Score Wary — Way camp about aches, pars oF Symptoms Imere concerns tan are” [eetng sek May have sleeping or eating ypealy reported). sues, Copyright© 2008 Mul-Healh Systems ie Allsghts reserved = MHS Page 6