WAIS-VINDIA Calculation of Examinee's Age

Record Form Year Month Day

Test Date

Examince Name: Birth Date

Examiner Name: Test Age

Total Raw Score to Scaled Score Conversion Subtest Scaled Score Profle
Ref. Group Verbal Perceptual WorkingProcessing
Raw Scaled Speed
Score.
Scaled Comprehension Reasoning Memory
Subtest Score Score DS AR SS CO
SI VC IN BD MR VP
Block Design
19
Similarities 18
17
Digit Span 16
15
Matrix Reasoning 14
13
Vocabulary 12
11
Arithmetic 10

Symbol Search 8

Visual Puzzles

Information
Coding

Sum of Scaled Scores

Verbal Perc. Work. Proc. Full Composite Score Profile

Comp. Rsng. Mem. Speed Scale VCI PRI WMI PSI FSIO

160
15
þududunduoouonp
150
145

140
135
Sum of Scaled Scores to Composite Score Conversion 130
Confidence
Sum of 125
Scaled Composite Percentile Interval
90% or 95% 120
Scores Score Rank
Scale 115

Verbal Comprehension VCI 110

105

Perceptual Reasoning PRI 100

95
Working Memory WMI
90.
85
Processing Speed PSI
80
FullScale FSIQ 75

70
For SEMs used to calculate conñdence intervals, refer to Table 4.3 of the 65
Technical and Interprerive Manual.
60

50
45

40

Pearson Reprlnt Copyright O 2019 by Pearson Clinlcal &Talent Assessments. All rights reserved. O PsychCorp
Analysis
Discrepancy Comparison!
Critical
Value
Comiparison Signticant
Score Score 2 Dierence 15 or 05 Diferenco Base Rate Basis for Comparison
VCI PRI VCI Tick one:
PRI Y or N

VCI WMI VCI WMI Y or N Overall Sample

VC| PSI VCI - PSI Y or N Ability Level
PRIWMI PRI - WMI Y or N

PRI- PSI PRI PSI Y or N

WMI PSI WMI - PSI Y or N

Digit Span - Arithmetic DS -

AR Y or N

Symbol Search -Coding SS CD Y or N

For discrepancy comparisons, refer to Tables B.1, B.2, B.3, and B.4.
Determining Strengths and Weaknesses Basis for Comparison
Subtest Mean Ditference Critical
Scaled Value Tick one:
Scaled From Strength or
Subtest Score Score Mean .15 or.05 FWeakness Base Rate OverallMean of 10 Core Subtests
Block Design S or W
Verbal Comprehension & Perceptual Reasoning Means
Similarities S or W

Digit Span S or W
3Verbal
10 Core 3Perceptual
Matrix Reasoning S or W Subtests ComprehenstonReasoning

Vocabulary S or W Sum of Scaled Scores

Arithmetic Sor W Number of Subtests +10 :3 3

Symbol Search S or W
Mean Score
S or W
Visual Puzzles
Information S or W

S or W
Coding
For strengths and weaknesses, refer to Table B.5.
Process Score Raw ScoreScaled Score Process Score Raw Score Scaled Score
Process Analysis
Total Raw Score to Scaled Score Conversion BIlock DesignNo Time Bonus Digit Span Backwards
Digit Span Forwards Digit Span Sequencing
For scaled scores, refer to Table C.1.

Scaled Score Discrepancy Comparison Critical Value

.15 or .05
Significant
Base Rate
Comparison
Score 1 Score 2 Difference! Difference
BD BDN
Block Design - Block Design No Time Bonus
Y or N

DSF DSB
Digit Span Forwards - Digit Span Backwards
Y or N

DSF - DSS Y or N
Digit Span Forwards - Digit Span Sequencing
DSB DSS
Digit Span Backwards - Digit Span Sequencing
Y or N
Tables C.2 and C.3.
For discrepancy comparisons, refer to
Raw Score Discrepancy Comparison
Raw Score to Base Rate Conversion Base Rate Comparison Score 1 Seore 2 Diterence
Base Rate
Process Score
Raw Score
LDSF- LDSB
Longest DS Forwards (LDSF)
LDSF-LDSS
Longest DS Backwards (LDSB)
LDSB- LDSS
Longest DS Sequence (LDSS)
For discrepancy conparisons, refer to Tables C.5, C.6, and C7.
to Table C.4.
For bave rate information, refer
1. Block Design (Time limit: See item)
Start Reverse
Ages 16-85: Sample Score of0 on either Item 5 or Item 6, Discontinue Score
Item, then Item 5 preceding items in administer After 2 consecutive scores Items 1-4: Score 0, 1, or 2 points.
perfect scores are obtein order until two consecutive of 0
Items 5-8: Score 0 or 4 points.
Items 9-14: Score 0,4,5,6, or 7 points.
BON
Items 1-4: Score 0,1, or 2 points.
Presentation Lime
Items 5-14: Score 0 or 4 points.
Completion Constructed
Design Method Limit ime
16-85 S. Examinee Trial1 Trial 2
Design Score
Model and Trial 1 Trial 2
30"
Examiner
Picture
1 Trial 1 Trial 2 Trial 1 Trial 2
Modcl and
30"
Picture
2
2. Trial 1 Trial 2 Trial 1 Trial 2
Model and
30"
Picture
1 2
3 Trial 1 Trial 2 Trial 1 Trial 2
Model and
30"
Picture
0 2
4. Trial1 Trial 2 Trial 1 Trial 2
Model and
30"
Picture
0 2
Examinee
16-855.
Picture 60"
Examiner

Picture 60"
4

7
Picture 60"
4

8
Picture 60"
0 4

9 31-60 21-30 11-20 1-10

Picture 60"
0 4 5 6 7

10. 31-60 21-30 11-20 1-10

Picture 60" 4 6
0 5

76-120 61-75 31-60 1-30

11.
Picture 120" 4 6
5 7

76-120 61-75 31-60 1-30

12.
Picture 120" 4 6 7
0

13. 76-120 61-75 31-60 1-30

Picture 120"
4 6 7

14. 76-120 61-75 31-60 1-30

Picture 120"
0 4 6 7

Block Design No Time Bonus (BDN) Block Design

Total Raw Scors Total Raw Score
(Maximum = 48) (Maximum = 66)

WAIS-IVINDA Record Form 3

 2. Similarities
Start
Ages 16-85: Reverse Discontinue Score
Score of 0 or 1on either Item 4 or Item 5, administer After 3 consecutive Score 0, 1, or 2 points.
Sample ltem, then Item 4 preceding items in reverse order untiltwo Scores of 0 See the
consecutive perfect scores are obtained. Administration
Manual for and
sample responses.Scorinn
Item
Response
16-85 S. Two - Seven Score.
1. Knife- Spoon
0 1 2
2. Yellow Green
0 1 2
3. Carrots - Cauliflower
01 2
16-85 t4. Horse - Tiger
0 1 2
t5. Piano Drum
0 1 2
6. Boat-Car

0I 2
7. Nose -Tongue
0 1 2
8. Food - Petrol
0 1 2
9. Badge - Crown
01 2
10. Bud- Baby
01 2
11. Music Tides
01 2
12. Poem- Statue
01 2
13. Anchor - Fence
0 1 2

14. Wish- Expect

01 2
15. Acceptance - Denial
0 1 2

16. Always - Never

01 2
17. Enemny Friend
0 1 2

18. Allow - Restrict

01 2
tif che examinee does not obrain a perfect score, provide corrective feedback as instructed in the Administration and Scoring Mannol
Similarities Total Raw Score
(Maximum = 36)
 3. Digit Span Discontinue
Start Score
Ages 1685: Forwards: After scores of 0on both trials Score 0 or 1 point for each trial.
Forwards: Item 1 of an item
DSE, DSB, and DSS
Backwards: Sample ltem, Backwards: After scores of0 on both trials Total raw score for Forwards, Backwards, and Sequencing, respectively
then Item 1 of an item
Sequencing: Sample ltem, LDSF. LDSB, and LDSS
Sequencing: After scores of 0on both trials Number of digits recalled on last trial scored 1 point on Forwards,
then Item 1 of an item
Backwards, and Sequencing, respectively
Forwards
Trial Item
Item Trial
Response Score Scoré

16-85 1
9-7 1
6-3 2
0 1
5-8-2
0 1
2. 0 1 2
6-9-4
7-2-8-6
1
3. 0 1 2
6-4-3-9 1

4
4 2-7-3-1 1
7-5-8-3 -6 0 1 2
0 1
3-9-2-4 8-7 0 1
5. 1 2
6-1-9 4 7-3 0 1
4-1-7-9-3-8 6 0 1
6. 0 1 2
6-9-1-7-4-2-8
3-8-2-9-6-1-7-4 1
7. 01 2
5-8-1-3-2-6-4 7 1
2-7-5-8-6-3 1-9-4
8 0 1 2
7-1-3-9-4-2-5-6-8 1
LDSF
(Max = 9)
Digit Span Forwards (DSF)
Total Raw Score
(Maximum = 16)
Backwards
Irial. Item
Item Trial Correct Response Response Score Score
7-1 1-7
16-85 S.
3-4 43
3-1 13
16-85 1. 1 2
2-4 42 0 1
46 6-4 1
2. 01 2
5-7 7-5 1
6-2-9 9-2-6 1
3. 0 1 2
4 7-5 5-7-4 0 1
8-2-7-9 9-7-2-8 1
4 1 2
4 9-6-8 8-6-9-4 1

6-5-8-4-3 3 4-8-5-6 1 2
5. 1
1-5-4-8 6 6-8 4-5-1
5-3-7-4-1-8 8-1 4-7-3-5 1 2
6.
7-2-4 8-5-6 6-5-8-4 2-7 1
8-1-4 9-3-6-2 2-6-3-9-4-1 -8 1
7. 01 2
4-7-3 -9-6-2-8 0
8-2-6-9-3-7-4

8.
9-4-3-7-6-2-1-8 8-1-2-6-7-3-4-9 0 1 2
0
7-2-8-1-5-6-4-3 3-4 6-5-1-8-2-7
LDSB
(Max =8)
Digit Span Backwards (DSB)
Total Raw Score
(Maximum = 16)
continue

WAIS-IVINOIA Record Form 5

3. Digit Span (conúinued)
Sequencing Discontinue after SCores of 0on
Trial
both trials of an

Item Irial Correct Response Response. Score Item

2-3-1 1-2-3
Score
16-85- S.
5-2-2 2-2-5
1-2 1-2 1
16-85 1. 1
0 1 2
4-2 2-4
3-1-6 1-3-6 0
2 | 2
0-9-4 0-4-9 0 1

8-7-9-2 2-7-8-9 0
3 1 2
4-8-7-1 1-4-7-8
2-6-9-1-7 1-2-6-7-9 0
4. 0 1 21
3-8-3-5 8 3 3-5-8-8
2-1-7-4 3-6 1-2-3-4-6-7 1
5 01 2
6-2-5-2-3-4 2-2-3 4-5 6 0 1
7-5-7-6 8-6-2 2-5-6-6-7-7-8
6. 0 1 2
4 8-2-5 -4-3-5 2-3 4-4-5-5-8

7.
5-8-7-2 -7-5-4-5 2-4-5-5-5-7-7-8 1
01 2
9 4-9 -7-3-0-8-4 0-3-4-4-7-8-9-9 0 1

5-0-1-1-3-2-1-0-5 0-0-1-1-1-2-3-5-5 1
8. 0 1 2
2-7-1-4-8-4-2-9-6 1-2-2-4-4 6-7-8-9 0 1
LDSS
(Max =9) Digit Span Sequencing (DSS)
Total Raw Score
(Maximum - 16)
Digit Span Total RawScore
(Maximum = 48)

4. Matrix Reasoning
Start Reverse Discontinue Score
Ages 16-85: Score of 0 on either Item 4 or Item 5, administer preceding items in After 3 consecutive Score 0 or 1 point.
reverse order until two consecutive perfect scores are obtained. SCores of 0
Sample Items A& B, Correct responses are in colour.
then Item 4
Item Response Score Item Responsë Score

SA. 1 2 3 4 13. 1 2 4 5
16-85
SB. 1 3 4 14. 1 2 4 5
1 1 2 4 1 15. 1 2 4 5 0

2. 1 2 3 4 16. 2 3 4 5 0 1

3 1 2 3 4 17. 1 2 3 4

16-85 4 2 4 0 1 18. 1 2 4 5

1 2 3 4 19. 2 3 0
5.
2 3 4 0 20. 1 3 4 5 0
6. 1
0 1 21. 1 2 3 |5
7. 1 2 3 5
1 22. 1 2 3 4 5 1
8. 1 2 3 4 5 0
23. 1 2 3 1
9 2 3 4 5 1
24. 2 3 4 0 1
10. 1 2 3 4 5
25. 1 2 3 4 0
2 3 0
11.
26. 2 3 4 5 0 1
12. 2 3 4 5 1
Matrix Reasoning Total Ravw Score
(Maximum - 26)

WAIS-IVIMDIA Record Form

 5. Vocabulary
Start Reverse
Ages 16-85: Score of 0 or 1 on either Item 5or ltem 6. Discontinue Score
Item 5 administer preceding items in reverse order After 3 Items 1-3: Score 0 or 1 point.
until two Consecutive perfect scores are obtained.
Consecutive Items 4-30: Score 0, 1, or 2 points.
SCores of 0
tem See the Administration and Scoring Manual for sample responses.
1. Book Responise Score

0 1
2. Aeroplane

0 1
3. Basket

01

4. Bed

0 1 2
16-85 t5. Apple
01 2

t6. Glove

01 2

7. Breakfast
0 1 2

8. Curious
01 2

9. Assemble
01 2

10. Consume
0 1 2

11, Terrminate
01 2

12. Tranquil
0 1 2

13. Ponder
0 1 2

14. Reluctant
01 2

15. Conhde
01 2

as instructcd in the Administration and Scoring Manual.

flf the cxamince does not obrain a perfect score, provide corrective feedback continue

WAIS-IyINOA Record Form 7

5. Vocabulary (continued) Discontinue after 3
tem
Response
consecutive sCores of 0
16. Remorse Score
0 12
17. Plagiarise
0 1 2

18. Acute

01 2
19. Generate

0 1 2

20. Compassion
0 1 2

21. Tangible
0 12

22. Evolve

0 1 2

23. Diverse

0 12
24. Fortitude

01 2
25. Ominous

0 1 2

26. Encumber

01 2
27. Audacious

0 1 2

28. Tirade

01 2

29. Pragmatic
01 2

30. Palliate

01 2

Vocabulary Total Raw Score

(Maximum = 57)
8 WAIS IVINDIA Record Form
6. Arithmetic (Time limit: 30 seconds)
Start Reverse
Ages 16-85: Score of0 on either Item 6 or Item 7, Discontinue Score
Sample Item, then Item 6 administer preceding items in
reverse order until two consecutive perfect scores are After 3 consecutive scores of 0 Score 0 or 1point.
obtained.
Completion Correct Completion Correct
Item Time.
Response Response. Score ltem Time Response Response Score

16-85 S. Footballs 3 12 Packs 200 0 1

Counts
t1. Flowers 0 1 13. Cards 38 0 1
to 3

Counts to
t2. Apples 10 14. Run 140 0 1

3.

4.
Bats

Birds
6

JOOO0OOO0 0 1

1
15.

16.
Line

Cakes
30

186
0 1

600 0 1
5. Leashes 2 1 17. Maps

1 18. Hours 47 0 1
16-85 6. Blankets

0 1 19. Biscuits 49½ 0 1

7. Pens 5

51 0 1
5 0 1 20. Laps
8 Toys

0 1 21. Machines 96 0 1
9. Older 17

0 1 22. Mail 23,100 0 1

10. Books 5

3 0 1
11. Tickets

the Administration and Scoring Manual.

response, provide corrective feedback as instructed in
tIf the examince does not give a correct Arithmetic Total Raw Score
(Maximum = 22)

(Time limit: 120 seconds)

7.Symbol Search Discontinue Score
Start After 120 seconds Use the Symbol Search Scoring Key to score the examinee's
Ages 16-85: responses.
Items
Demonstration Items, Sample Items, then Test Subtract Number Incorrect from Number Correct.
If the total raw score is <0, enter 0 as the total raw score.
Symbol Search
Number
Total Raw Score
Number
Completion Incorrect (Maximum = 60)
Correct
Time

WAIS-IVINDUA Record Form

8. Visual Puzzles (Time limit: Seo item)
Revorso Discontinue Scoro
Start
Ages 16-85: Score of0on either Item 5 or ltem 6, administer After 3 consecutive Score 0or 1point.
SCores of 0
Demonstration Item, Sample pre items in reverso order until two Correct responses are in colonr
Item, then Item 5 nsacutive berfect scores are obtained.
Time Completion Response Timo Completion Response
hChoces
Item Limit Time Choices Score. Item Limit Tme; Score
1 3 2 3
13. 30"
16-85 D. 4 5 6 4 6
1 2 3 2 3
16-85 S. 14. 30" 4 5 1
6 6
1 2 3 1 2
1. 20" 1 15. 30" 4 5
4 5
1 2 3 1 2
2. 20" 1 16. 30" 6 0
4 5 6
1 2 3 1 2 3
3. 20" 1 17. 30" 4 5 6 0
4 6
3 1 2 3
4. 20" 1 18 30" 4 5 1
4 5 6
1 3 1 2 3
16-85 5 20" 1 19. 30" 0 1
4 5 6 4 5 6
2 3
6. 20" 20. 30" 0
4 5 5
1 2 3 1 2 3
7. 20" 0 1 21. 30" 6
0 1
4 5 6 4 5
1 3 1 2 3
8 30" 1 22 30" 5
4 4
1 3 1 2 3
9. 30" 0 1 23. 30" 5
0 1
4 6
3 1 3
10. 30" 0 1 24. 30" 0 1
6
1 2 3 1 2 3
25. 30" 1
11. 30" 4 5 6 4 6
1 3 2 3
1 26. 30" 0 1
12. 30" 5 6 5 6
Visual Puzzles Total Raw Score
(Maximum = 26)

9. Information Discontinue Score

Start Reverse
Ages 16-85: Score of0 on eitherltem3 or Item 4, administer preceding After 3 consecutive Score 0 or 1 point.
Scoring
Item 3
items in reverse order until two consecutive perfect scores Scores of 0 See the Administration and
are obtained. Manual for sample responses.

Seore.
tem Response.
*1. Monday 0 1

*2. Shape

16-85 3. Thermometer 01

01
t4. Seconds

5. Gandhi

6. Water
COntinu
*Responses requiring specific query are identified in che Adminiscration and Scoring Manual.
tIf the examince does not give a correct response, provide corrective fecdback as instructed in the Administratlon and Scoring Manual.

10 WAIS-IVINDLA Record Form

 9. Information (continued)
Item
7. Line Discontinue after3 consecutive scores of 0.
Respönse Score
8. National Anthem 0 1

9. Sarojini Naidu 01

10. IPresident

11. Sahara 0 1

*12. Brazil

13. Italy 0 1

1
14. Boil

01
15. Relativity
1
16. MLK Jr

17. Marie Curie

0 1
18. Olympics

*19. Vessels
0

20. Alexander
0I

21. Shakuntala
0 1

22. Malgudi Days 0 1

23. Language
*24. Minutes 0

25. Organ 01

*26. Circumference

and Scoring Manual.

"Responses requiring specific query are identifed in the Administration Information Total Raw Score
(Maximum = 26)

(Time limit: 120 seconds)

10.Coding
Start Discontinue
Score
Use the Coding Scoring Tamplate
to Completion Time
Coding Total Raw Score
(Maximum = 135)
Ages 16-85: After 120 seconds score the examinea's responses.
rasponse.
Demonstration Items, Score 1 point for each correct
Sample tems, then
Test Items

WAIS-VNDIA Record Form 11

 WAIS-IVINDIA
WEOIKER ADULT INTELLUCENCE SCALE-FOURTH foITNON NOA
Examince Name: Age:
Sex: E OM Handedness: R DL ID:

Examiner Name:

Record Form Testing Site:

Behavioural Observations
Referral source/Reason for referral/Presenting complaint(s)

Language (e.g., first/native language, other language, English Auency, expressive and receptive language ability, articulation)

Physical appearance

Visual/Auitory/Motor problems (Were problems corrected [e.g., with glasses, assistive listening device]?)

Attention and concentration

Artitude toward testing (e.g., rapport, eager to speak, working habits, interest, motivation, reaction to success/failure)

Affecu/Mood

Unusual behaviours/Verbalisations (e.g., perseverations, stereotypic movements, bizarre and atypical verbalisations)

Other notes
Normal Curve

Percent of Cases 2.2% 6.7% 16.1% 50% 16.1% 6.7% 2.2%

Qualitative Descriptions Extremely Borderline Low Average High Superior Very
Low Average Average Superior
Composite Scores 70 80 85 90 100 110 115 120 130

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