PSYCHOLOGICAL ASSESSMENT REPORT

Name: Wania Ali

Fathers Name: Raheel Ali
Date of Birth: June 12th 2019
Date of Assessment: October 22nd, 24th, 26th, 27th & 28th 2022
Examiner: Mariyah Tabassum
Case No: 31025

Identifying Information:

Wania Ali is a 3 years 4 months old girl. She is last born among 2 siblings. Her Father has done
Intermediate and he is currently working as a production operator whereas her mother has done
BSc and she is a teacher. She belongs to a Muslim, Urdu speaking family with middle socio
economic status, residing in a nuclear family set up in FC area, Karachi.

Referral source and presenting complains:

Client was referred by Dr Shahdab, General Physician from Dhorajee Institute to the Institute of
Clinical Psychology, University of Karachi for the purpose of IQ assessment. Her presenting
complains are lack of responsiveness, lack of attention, absence of adequate emotional
expression and speech deficit.

Interviewed Information:

Client’s mother reported that she was born through C-section and she was a full term baby. She
was healthy at the time of birth and cry was present immediately after birth.
Client’s Mother reported that her milestones were on time except speech i.e. she started neck
holding in 4 to 5 months, crawling and sitting in 6-7 months, walking independently in 11
months and but her speech is still not developed and she only uses one or two words.
Client have adequate relationship with parents and siblings and likes and asks father to play with
her and swing her in a circular motion. She herself likes to run in circular motion.
It was reported by parents that she doesn’t respond to her name and doesn’t seem to understand
most of the commands. Mother also reported that she is able to communicate her needs non-
verbally by holding mother’s hand and pulling her towards things she needs. She can also
indicate if her diaper is full. Mother further reported that she didn’t maintain eye contact till 2
years of age but currently she occasionally maintains eye contact. Furthermore, client mostly
prefer to stay alone or with family members and doesn’t show affection to others. She also
doesn’t like to go to any crowded places such as marriage event and shows clingy behavior in
events.
Mother stated that she preferred lights and doesn’t want the lights to be closed at night.
Furthermore, she excessively used mobile phone since young age due to mother’s tough routine
and she prefers to listen to high volume. Mother also reported that she gets obsessed with
different items for 6-7 months. Mother reported that she is completely dependent for all her daily
living tasks on parents. She has not been to any academic institute or taken therapy prior to
coming here.

Moreover, it was reported that she shows self-harming behavior i.e to pinch her skin and hit
herself if something that she wants is not given to her.

Tests Administered:

 Slosson Intelligence Test……………………………(SIT)

 Vineland Adaptive Behavior Scales-II………………(VABS-II)
 The Childhood Autism Rating Scale……………….. (C.A.R.S)

Behavior during Assessment:

Wania showed non-compliant behavior during assessment session. She had low eye contact and
was not able to comprehend instructions but only showed interest in the pen of examiner. She did
not have sitting tolerance and was continuously roaming around the cubical while crying and
pulling her mother to leave.

Psychological Evaluation:

On the intelligence test, Slosson Intelligence Test (SIT), Wania’s Intelligence Quotient lies
within the “Moderate Deficit” range. Her mental age is found to be equivalent to 1 years and 5
months, which is less than her chronological age of 3 years and 4 months. Item scrutiny indicates
that she takes interest in the pictures in a book and can turn the pages one at a time but unable to
indicate her major body parts like eyes, nose, hands, mouth. She takes interest in pictures and
points towards food whenever she feels hungry. Moreover, she is unable to perform on items that
require speech.

Wania’s overall adaptive functioning level (which is comprised of skills in four areas (i.e.,
Communication, Daily Living Skills, Socialization and Motor Skills) as assessed by Vineland
Adaptive Behavior Scales-II falls in the “Mild Deficit” range. On Communication, Daily Living
Skills and Motor Skills, her functioning falls in the “Low” range. Her scores on Socialization
domain fall in ‘Moderately Low’ range.

Analysis of sub-domains of Communication domain indicates that her receptive and expressive
skills fall in the Low range. Her adaptive ages on receptive and expressive subdomain are 0:6
years and 0:8 years respectively. Whereas her written skills fall in Moderately Low range and her
adaptive age on written subdomain is 1:10 years. She is able to understand the meaning of word
no. but she does not respond to her name. She also points to objects she wants and shows
preference but she cannot say one-word request. She cannot recognize alphabets or her own
name in print.

Daily Living Skills sub domain analysis indicates that in personal and domestic sub domain her
functioning lies in the low range. Her adaptive age on personal and domestic subdomains are 1:4
years and 0.7 years respectively. Whereas in Community subdomains her functioning falls in the
moderately low range. Her adaptive age on community subdomain is 2:2 years. She can drink
from a cup. She can let someone know when her diaper is wet. Whereas, her feeding and
dressing skills are not well developed. She is not careful around hot objects. She understands the
function of telephone but cannot summon the person to the phone.

Moreover, in Socialization domain, her interpersonal relationships fall in the moderately low
range. Her adaptive age on interpersonal relationships subdomain is <0.1. whereas, in play and
leisure time and coping skills falls in low range. Her adaptive age on play and leisure time and
coping skills are 0:7 and 0:7 respectively. Qualitative analysis indicates that she shows two
emotions but she cannot show affection to familiar person. She plays near another child each
doing different thing. Whereas, she is unable to play cooperatively with another child for up to 5
minutes. She doesn’t say sorry and does not act appropriately with strangers.

Furthermore, Motor Skills sub domain analysis indicates that her functioning lies in the
moderately low in gross motor skills. Her adaptive age on motor skills subdomains is 2:4 years.
Whereas her functioning lies “Low” in fine motors skills. Her adaptive age on fine motor skills
is 1:3 years. She is able to go up and down the stairs and she can walk and run properly. But she
cannot jump with both feet and catches beach size ball. She can put objects in container. But she
cannot stack blocks and unwrap small objects.

Her scores on Maladaptive Behavior Index lies in the “Elevated range”. The subdomain analysis
indicates that her scores on Internalizing sub-domain lies in the “Elevated” range and “Average”
in externalizing sub-domain. Analysis of her internalizing sub-domain indicates that she is overly
dependent on her mother and avoids socialization; prefers to be alone. Further analysis also
indicates that she sometimes has a poor eye contact. Moreover, her externalizing subdomain
indicates that she throws temper tantrums and displays physical aggression.

Scores on Childhood Autism Rating Scales (CARS) indicate that Wania’s functioning lies in
“Severely Autistic” range. She has difficulty in relating to people and persistent efforts need to
be made to gain her attention. Her emotional responses are also poor and she shows
inappropriate emotions. She also has difficulty in imitating behaviors according to her age. Her
listening and visual responses are also poor as she does not use his sensory modalities according
to the situation. Her verbal communication is also in deficit and meaningful speech is not
present.

Tentative Diagnosis:
299.00 (F84.0) Autism Spectrum Disorder requiring very substantial support in social
communications and requiring substantial support for restricted, repetitive behaviors with
accompanying intellectual impairment and language impairment-no intelligible speech.
Conclusion and Recommendation:
Clinical interview and observation and psychological assessment indicate ‘Autism Spectrum
Disorder’ i.e. the child has deficits in social communication as she does not interact, doesn’t keep
a proper eye contact. Further she also has difficulty in relating to other people, difficulty maintain
eye contact and has high level of activity as compared to other children of her age. Moreover, she
doesn’t respond to her name and her speech development is delayed according to her age. All
these behaviours indicate autism. Moreover, her intellectual functioning and adaptive functioning
falls within the low range.
Following are the recommendations:
 Speech therapy is recommended to develop his speech and help her interact with
people.
 Behavioural management therapy is recommended to reduce client’s maladaptive
behaviour.
 Occupational therapy is recommended to help the child to improve her adaptive
functioning.
 Parental counselling and training is also recommended to help them deal with the
child’s problems effectively.

Supervisor Examiner
Ms. Maimoona Jahangir Ms. Mariyah Tabassum
Teaching Associate M-Phil-I Internee