List of Content For Reports

PED 674
Essential Components for a Psych Report

(100 points for each report)
Exemplary (full points) Effective (majority of points) Needs Development (few points) Insufficient (0 points)
Essential content for your Case Study Report

 Based upon Sattler’s 9 Sections of a Psychological Report (read pages 709-715 for details and
 examples)
For each Section, your report will need to address the following:
1. Demographic Information: Identifying information such as (use ALL that apply):
1) Child’s Name (first/last) 6) Home Address 10) Date of Report
2) Gender 7) Parent Name 11) Examiner’s Name (you)
3) Date of Birth 8) Teacher’s Name 12) agency/school sponsoring the report
4) correct Chronological Age 9) Grade 13) Date of Testing
(Year and month) 10)Teacher’s Name
2. Assessment Instruments Used: List all of the instruments you used:

1) formal instruments 4) names of informal tests 7) a systematic behavioral observation
2) informal instruments 5) other techniques 8) Spell out all test names completely
3) names of standardized tests 6) interviews (all) (bold or underline them)
9) followed by acronym in parentheses
3. Reason for Referral: Cite the following information:
1) The reason for the referral
2) Who made the referral (parent, teacher, school administrator, physician, attorney)
3) Type of evaluation requested, or
4) Area(s) of possible difficulty suspected
5) Specify specific questions the referral source has about the child
6) Brief summary of any behaviors contributing to referral
7) Any possible outcome that you anticipate from the assessment
8) How the assessment may be used
4. Background Information: Include as much of the following as you can (ALWAYS acknowledge the
source of the information, recognize and discuss any differences in information)
1) Material taken from Interviews with parent / teacher / child;
2) Educational History material
(attendance by grade level, tardies by grade level, attendance --good vs poor, reasons for retention, relevant scores &
diagnosis, previous assessments by age & grade, current & past service providers, results of all Interventions, specific
accommodations, programs & modifications),
3) Previous psychological / psychiatric evaluation (if any)
4) Health History material from medical records
(pregnancy, delivery, postpartum, genetic or congenital issues) & school health file (illnesses, accidents, conditions,
treatments), screenings—vision & hearing,
5) Environmental demographic information regarding socio-economic issues,
6) Family constellation: parents, siblings and family issues,
(include Parent educational levels, home languages, parent occupations, other adults in home, changes of family status,
changes of residence, parent work hours if relevant, include shared custody along with days/times of shared custody)
7) Description of Child’s current problem
8) Developmental history (achievement of developmental milestones, problems with development,
Karen Pivirotto PED 674
9) Level of cooperation and accuracy of all informants,

10) Comparison of information from different sources,
11) Discrepancies between informants/ different views,
12) Systematic organization and interpretation of all background information.
5. Observations During the Assessment: Careful descriptions of:

1) Child’s behavior during the assessment process, both during testing, and in other environments where the child may be
observed (classroom, home, hospital setting); (physical appearance, reactions to evaluation, reactions to examiner, general
behavior, activity level, language style, response style, mood, response to inquiries and/or encouragement, attitude toward
self, motor skills, unusual habits, mannerisms, or verbalizations, interactions.
2) Help reader understand which of child’s behaviors you consider important
3) What did child do to help you form impressions (lend objectivity to report)
4) What information did you get from behavioral observations to help develop intervention plan?
5) You need descriptive statements about behavior, and
6) You need interpretive statements about behavior
7) Focus on the presence rather than the absence of behavior; emphasize how a child actually performed
8) Comment on the presence or absence of any behavior referral source asked you about
9) Comment on the absence of a behavior you would have expected to occur.
6. Assessment Results and Clinical Impressions: include the following:

1) Validity and reliability statement: are test scores valid and reliable indicators of child’s ability & behavior?
2) Do not simply report test scores, integrate and interpret them
3) Factors that may have affected assessment results
4) Names of instruments administered
5) Tests scores (IQs, standard scores, major scale scores, index scores, subtest scaled scores, any/all test scores
6) Classification of IQ and major index scores or standard scores (qualitative designation)
7) Percentile ranks associated with scores, and confidence intervals (Sattler, p. 713)
8) Description of child’s strengths and weaknesses
9) Comparison of scores with other scores within the same test
10) Illustrative responses
11) Signs suggestive of significant problems
12) Signs suggestive of exceptionality (Creativity, giftedness, emotional maturity, learning disability, etc.)
13) Interrelationships among test findings and among all sources of assessment information.
14) Implications of assessment findings
15) Diagnostic impressions
16) Organize by: ***test by test, domain by domain, by areas of specific ability0 (***used by most students)
7. Recommendations: Focus on:

1) Interventions, class placement, treatment or rehabilitation should be tied to assessment results
2) Offer a flexible approach for interventions & appropriate placements considering resources of family & school
3) Before making a suggestion involving others, collaborate with them first
4) Make reasonable recommendations: is child eligible for special program? what type of intervention does child need?
What are goals of intervention? How can strengths be used? How could family members be involved? Who can carry out
recommendations?
5) Recommendations should involve the referral questions.
6) Involve children, parents, and teachers in the recommendations
7) Be cautious in making long-term predictions
Karen Pivirotto PED 674
8. Summary: Include summary of details, but do not include new material:

1) The reason for the referral,
2) Who made the referral (parent, teacher, school administrator, physician, attorney),
3) Background information related to results
4) Behavioral observations related to results
5) Assessment results, reliability and validity of results
6) Classifications of scores, strengths and weaknesses, verbal/nonverbal, qualitative and clinical impressions
7) Recommendations and qualification for programs
8) Any other possible outcomes
9. Signature: Include the following in ALL reports:

1) Your name printed
2) Your professional title printed (School Psychologist Student, School Psychologist Intern, etc., comply with state laws)
3) Your degree, after your printed name
4) Your signature on a line above your printed name
5) Co-signer (credentialed school psychologist MUST co-sign ALL reports produced by a student in training)
REMEMBER:
Description of Instruments: must be written in Parent-Comprehensible Terms, not in Technical jargon only
Report Summary: “Eligibility Statement Rule-outs” should be included in Summary only
Signatures: Multi-disciplinary Team can list all members (Psych & team list) plus School Psychologist Student or School
Psychologist Intern (whichever you are)
Grammar, Spelling & Style: diplomatic, professionally correct, few to no grammatical or spelling errors
Don’t just cut and paste templates

Make sure NAMES, gender, and test interpretation and scores are correct!
USE of incorrect name and gender anywhere in the report will result in a ten point deduction
Document designed by Karen Pivirotto, 2016 and edited/modified by Melanie Facundo, 2018

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PED 674

Essential Components for a Psych Report

Essential content for your Case Study Report

2. Assessment Instruments Used: List all of the instruments you used:

9) Level of cooperation and accuracy of all informants,

5. Observations During the Assessment: Careful descriptions of:

6. Assessment Results and Clinical Impressions: include the following:

7. Recommendations: Focus on:

8. Summary: Include summary of details, but do not include new material:

9. Signature: Include the following in ALL reports:

Don’t just cut and paste templates

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