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www.registeredpsychologist.com.au
PECS’ Example Comprehensive ADHD Report:
John Smith
This report was prepared for the purpose of the client's clinical and/or educational management.
The report is not intended for, and is unsuitable for, use in legal proceedings.
The information contained in this report is sensitive and confidential and must be treated accordingly.
The results should only be interpreted by an appropriately trained professional.
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This Example Comprehensive ADHD Psychological Report is provided to act as an example of the breadth and
thoroughness of an assessment performed by Psychological & Educational Consultancy Services (PECS).
The assessment components provide practitioners with assessment evidence to complement their clinical opinion when
addressing the Department of Health / Stimulant Committee requirements for ADHD.
This example report also reflects changes relating to the release of the DSM-5 (APA, 2013).
This example report involves an adult client. A child ADHD assessment is very similar, however, uses the age-
appropriate versions of each test.
CONTENTS
(1) Biographical Details
(2) Referral Information
(3) Informed Consent
(4) Brief Background Information
(5) Global Screening Assessment
(6) ADHD Behavioural Assessment
(7) ADHD DSM-5 Criteria Checklist Assessment
(8) GAD DSM-5 Criteria Checklist Assessment
(9) Anxiety Severity Assessment
(10) Depression Assessment
(11) Cognitive Assessment
(12) Conclusions and Statement of Diagnosis
(13) Recommendations
(14) Appendix 1: Frequently Asked Questions (FAQs)
(15) Appendix 2: Ramifications of Untreated ADHD
(16) Appendix 3: WAIS-IV Subtest Descriptions
(17) Appendix 4: Brief Biography of the Author
Please note, the Conclusions and Statement of Diagnosis are on page 14.
1. BIOGRAPHICAL DETAILS
Name: John Smith
Date of Birth: 30/01/1991
Age: 30
Gender: Male
2. REFERRAL INFORMATION
John was self-referred to Psychological and Educational Consultancy Services (PECS) for a Comprehensive
Psychological Assessment and an indication of whether the results are reflective of an individual with
Attention-Deficit/Hyperactivity Disorder (ADHD).
Additional screening for disorders commonly associated with ADHD (e.g., anxiety, depression) was also
conducted to identify any possible comorbidity and/or differential diagnosis implications that may be present.
3. INFORMED CONSENT
John was informed of the reason for the assessment, the assessment components, and that the results would
be used to compile a report which would be provided to them and the referrer (if applicable).
John indicated that he understood all that was conveyed to him and signed a Consent Form acknowledging
that he consented to the administration of the assessment; and for the report to be generated and disseminated
accordingly.
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4. RELEVANT BACKGROUND INFORMATION
1. Pregnancy, Birth, and Development:
John’s mother did not experience any significant illnesses during her pregnancy with him. John reported that
there were no concerns in relation to maternal consumption of alcohol and/or substances during his mother’s
pregnancy with him. John was born with no apparent complications and did not require assistance with
breathing nor time in the neonatal intensive care unit. John reached all the major developmental milestones
(e.g., walking, speaking, toileting) within the expected age ranges.
2. Speech and Language:
John has a history of speech sound problems and underwent speech therapy when aged 5. John reported that
he had a lisp when younger but this was resolved through the speech therapy he received.
3. Handedness and Coordination:
John is solely right-handed and right-footed. John is of the opinion that he does not have any fine or gross
motor movement problems, nor does he have any hypermobility.
4. Sight and Hearing:
Normal auditory and visual acuity were reported; however, the most recent testing was more than 3 years ago.
5. Sleep Quality:
John has difficulty falling asleep, staying asleep during the night, and finds it difficult to wake up in the
morning. As a result, John reports a continuous feeling of being tired.
6. Peer Relations:
John reported that he has no issues with forming and maintaining good friendships or getting along with work
colleagues.
7. Academic / Educational/Occupational:
John had difficulty with literacy when at school and this has continued into adult life. John’s handwriting is
often messy. His school reports often mentioned that he was intelligent, however, he did not put in enough
effort during school and needed to maintain more focus.
John completed the STAT when he was 21 and did extremely well in the problem-solving section but poorly
on the English section.
John has attempted to complete a degree at university three times but keeps failing due to issues with
concentration and difficulty absorbing what he has read.
John reported that he is not reaching his full potential at work and is struggling to keep up with his work
demands due to his poor attention, concentration, and disorganisation. John reported that he has really good
staff who assist him with the tasks that require organisational skills.
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8. Behaviour:
John reported that he has issues with attention, concentration, memory, hyperactivity, sitting still, following
instructions, and being able to relax.
John reported that he is easily distracted and he is unable to stay on task most of the time (e.g., often starting
one thing then moving onto another before finishing the first task). John also reported that he has random
outbursts of energy, cannot sit still, is very fidgety, and is disorganised.
9. Health/Mental Health/Medical/Medication:
John reported that he has no major medical or neurological conditions. John has been diagnosed with anxiety
and depression and is currently prescribed Lexapro which is proving effective. John first experienced anxiety
and depression when he was 16 years of age. John is not currently receiving counselling, however, he has in
the past and found it helpful.
John has no previous history of self-harm and reported that he is not currently at risk of engaging in any self-
harming behaviours.
10. Family History of Mental Health Conditions:
There is a family history of depression, anxiety, and Attention Deficit / Hyperactivity Disorder (ADHD) on
both sides of his family.
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5. GLOBAL SCREENING ASSESSMENT
Screening Tests Administered:
Test Date of Administration
adult psychprofiler (APP; Langsford, Houghton, & Douglas, 2014) 18/01/2022
APP Outline:
The APP is a reliable and valid instrument that utilises two separate global screening forms; the Self-report
Form (SRF: 177 items) and Observer-report Form (ORF: 177 items) for the simultaneous screening of the 17
most prevalent disorders in adults aged 18 years and above.
The APP comprises screening criteria that mirror the symptom counts and diagnostic criteria of the Diagnostic
and Statistical Manual of Mental Disorders–Fifth Edition (DSM-5: American Psychiatric Association, 2013).
For example, a positive screen for Attention-Deficit/Hyperactivity Disorder: Predominantly Inattentive
Presentation indicates that the symptom count was 5 or more of the 9 DSM-5 Inattentive items.
For more information about the PsychProfiler, please see www.psychprofiler.com
APP Results:
In order to provide more comprehensive information, both John and his work colleague (Jane) completed
separate APP Forms.
John self-reported positive screens for the following disorders:
Generalised Anxiety Disorder
Attention-Deficit/Hyperactivity Disorder: Combined Presentation
Language Disorder
Persistent Depressive Disorder
Specific Learning Disorder – with Impairment in Reading
Specific Learning Disorder – with Impairment in Written Expression
John’s work colleague reported positive screens on John’s behalf for the following disorders:
Generalised Anxiety Disorder
Attention-Deficit/Hyperactivity Disorder: Predominantly Inattentive Presentation
Persistent Depressive Disorder
Specific Learning Disorder – with Impairment in Reading
Specific Learning Disorder – with Impairment in Written Expression
Please note that any indication of a positive screen on the APP does not constitute a formal diagnosis.
A positive screen merely indicates that the individual has met sufficient criteria for a disorder to warrant further
investigation by an appropriate professional.
The full list of 17 disorders screened for is available at www.psychprofiler.com
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6. CONNERS ADHD BEHAVIOURAL ASSESSMENT
Checklists Administered:
Date of Administration
(1) Conners’ Adult ADHD Rating Scale –Self-report (CAARS-SR; Conners, D., 1999) 18/01/2022
(2) Conners’ Adult ADHD Rating Scale – Observer-report (CAARS-O Conners, D., 1999) 16/01/2022
CAARS Overview
The Conners’ Adult ADHD Rating Scale (CAARS) is a reliable and 66-item instrument designed to assess
symptoms and behaviours related to ADHD.
Checklist Results:
Conners’ Self-Report Subscales
T-Score*
Interpretive
Guideline Category
Inattention/Memory Problems
81
Very much above average
Hyperactivity/Restlessness
75
Very much above average
Impulsivity/Emotional Liability
68
Much
above average
Problems with Self
-
Concept
79
Very much above average
DSM
-
IV Symptoms: Inattentive
82
Very much above average
DSM
-
IV Hyperactive
-
Impulsive Symptoms
71
Very much above average
DSM
-
IV ADHD Symptoms: Total
79
Very much above average
ADHD INDEX 81 Very much above average
*T-scores above 65 are deemed by the checklist authors to be clinically significant
Conners’ Observer-Report Subscales
T-Score*
Interpretive
Guideline Category
Inattention/Memory Problems
71
Very much above
average
Hyperactivity/Restlessness
66
Much above average
Impulsivity/Emotional Liability
70
Much above average
Problems with Self
-
Concept
77
Very much above average
DSM
-
IV Symptoms: Inattentive
90
Very much above average
DSM
-
IV
Hyperactive
-
Impulsive Symptoms
64
Above average
DSM
-
IV ADHD Symptoms: Total
90
Very much above average
ADHD INDEX 68 Much above average
*T-scores above 65 are deemed by the checklist authors to be clinically significant
CONNERS ADHD BEHAVIOURAL ASSESSMENT SUMMARY:
The authors of the CAARS state that T-Scores above 65 are usually taken to indicate a clinically significant
problem.
Furthermore, the greater number of subscales that show clinically relevant elevation (i.e. T-Scores above 65),
the greater likelihood that the CAARS scores indicate a moderate to severe problem.
John’s self-report exceeded the cut-off for 7 of the subscales, whilst his work colleague’s observer report
exceeded the cut-off for 6 subscales.
High scores on the ADHD Index are useful for differentiating clinical ADHD individuals from non-clinical
individuals.
John and his work colleague’s score on the ADHD Index both fell above the T-Score clinical cut-off of 65.
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7. ADHD DSM-5 CRITERIA CHECKLIST ASSESSMENT
Checklists Administered:
Date of Administration
(1) ADHD DSM-5 Criteria – Self Completion (American Psychiatric Association, 2013) 18/01/2022
INATTENTION
(Only behaviours occurring for 6 months or more are ticked)
Yes
(
)
A1
Often fails to give close attention to details or makes careless mistakes
A2
Often has difficulty sustaining attention in tasks or play activities
A3
Often does not seem to listen when spoken to directly
A4
Often does not follow through on instructions and fails to finish schoolwork, chores, or
duties in the workplace
A5
Often has difficulty organizing tasks and activities
A6
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
A7
Often loses things necessary for tasks or activities
A8
Is often easily distracted by extraneous stimuli
A9
Is often forgetful in daily activities
YES TOTAL
8
HYPERACTIVITY AND IMPULSIVITY
(Only behaviours occurring for 6 months or more are ticked)
Yes
(
)
A10
Often fidgets with or taps hands or
feet or squirms in seat
A11
Often leaves seat in situations when remaining seated is expected
A12
Often runs about or climbs in situations where it is inappropriate, or feels restless
A13
Often unable to play or engage in leisure
activities quietly.
A14
Is often “on the go,” acting as if “driven by a motor
A15
Often talks excessively.
A16
Often blurts out an answer before a question has been completed
A17
Often has difficulty waiting their turn
A18
Often
interrupts or intrudes on others
YES TOTAL
5
Clinically significant symptoms Yes No
NA
B
Have the several inattentive or hyperactive-impulsive symptoms been present
prior to age 12 years?
C
Are the several inattentive or hyperactive-impulsive symptoms present in two or
more settings
D
Is there clear evidence that the inattentive or hyperactive-impulsive symptoms
interfere with, or reduce the quality of, social, academic, or occupational
functioning?
E
Do the symptoms occur exclusively during the course of schizophrenia or another
psychotic disorder; and/or are not better explained by another mental disorder
DSM-5 ADHD CHECKLIST CONCLUSION:
Total number of Inattention criterion met = 8
Total number of Hyperactive-Impulsive criterion met = 5
John meets the DSM-5 criteria for Attention-Deficit/Hyperactivity Disorder: Combined Presentation (ADHD-
CP) on this checklist.
Any comorbidity and/or differential diagnosis implications are to be considered by a Medical Specialist.
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8. GENERALISED ANXIETY DISORDER DSM-5 CRITERIA ASSESSMENT
Checklists Administered:
Date of Administration
(1) GAD DSM-5 Criteria Self-report Checklist (American Psychiatric Association, 2013) 18/01/2022
GAD DSM-5 Criteria Ratings:
Criteria A: Excessive anxiety and worry (apprehensive expectation), occurring more days than not
for at least 6 months, about a number of events or activities (such as work or school
performance).
This criterion is rated as having been Met.
Criteria B: The individual finds it difficult to control the worry.
This criterion is rated as having been Met.
Criteria C: The anxiety and worry are associated with three (or more) of the six symptoms (with at
least some symptoms having been present for more days than not for the past 6 months).
This criterion is rated as having been Met
Criteria D: The anxiety, worry, or physical symptoms cause clinically significant distress or
impairment in social, occupational, or other important areas of functioning.
This criterion is rated as having been Met.
Criteria E: The disturbance is not attributable to the physiological effects of a substance or another
medical condition.
This criterion is rated as having been Met.
Criteria F: The disturbance is not better explained by another mental disorder.
This criterion is rated as having been Met.
DSM-5 GENERALISED ANXIETY DISORDER CONCLUSION:
John meets the DSM-5 criteria for Generalised Anxiety Disorder on this checklist.
Please note that meeting the criteria on the GAD DSM-5 Criteria Checklist does not constitute a formal diagnosis.
It merely indicates that the individual has met sufficient anxiety criteria to warrant further investigation of this area by
an appropriate professional.
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9. ANXIETY SEVERITY ASSESSMENT
Checklist Administered:
Checklist Date of Administration
Beck Anxiety Inventory (Beck, Epstein, Brown & Steer, 1990) 18/01/2022
BAI Overview:
The BAI is a 21-item self-report scale that measures the severity of anxiety in adults or adolescents aged 13
years and older. Individuals are asked to indicate the response to each statement that best describes the way
they have been feeling during the past week, including today.
Each item is rated on a 4-point scale ranging from 0 (Not at all) -3 (Severely), therefore, the maximum total
score for an individual is 63.
BAI Qualitative Descriptions:
The authors provide the following category cut-offs as a measure of severity of anxiety:
Score Category
0
-
7
Minimal Anxiety
8
-
15
Mild Anxiety
16
-
25
Moderate Anxiety
26
-
63
Severe Anxiety
BAI Checklist Results:
John self-reported a score of 14 on the BAI, thereby placing him at the upper end of the Mild Anxiety
category.
Please note that scoring in the Mild Anxiety or above categories does not constitute a formal diagnosis.
It merely indicates that the individual has scored sufficiently high enough to warrant further investigation of this area
by an appropriate professional.
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10. DEPRESSION ASSESSMENT
Checklist Administered:
Checklist Date of Administration
Beck Depression Inventory –II (Beck, Steer, & Brown, 1996) 18/01/2022
BDI-II Overview:
The BDI-II is a 21-item self-report instrument for measuring the severity of depression in adults or adolescents
aged 13 years and older. Individuals are asked to indicate the response to each statement that best describes
the way they have been feeling during the past two weeks.
Each item is rated on a 4-point scale ranging from 0-3, therefore, the maximum total score for an individual
is 63.
BDI-II Qualitative Descriptions:
The authors provide the following category cut-offs as a measure of severity of depression:
Score
Category
0
-
13
Minimal Depression
14
-
19
Mild Depression
20
-
28
Moderate Depression
29
-
63
Severe Depression
BDI-II Checklist Results:
John self-reported a score of 17 on the BDI-II, thereby placing him at the upper end of the Mild Depression
category.
Please note that scoring in the Mild Depression or above categories does not constitute a formal diagnosis.
It merely indicates that the individual has scored sufficiently high enough to warrant further investigation of this area
by an appropriate professional.
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11. COGNITIVE ASSESSMENT
Cognitive Tests Administered:
Test Date of Administration
Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV, 2008) 21/02/2022
WAIS-IV Overview:
The Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) is a test designed to measure intelligence
in older adolescents and adults (aged 16 years and above). It is composed of 10 core subtests and five
supplemental subtests, with the 10 core subtests comprising the Full-Scale IQ. The WAIS-IV has been
language adapted for Australia and New Zealand. Please see Appendix for Index and Subtest descriptions.
Examiner’s Details:
TEST ADMINISTRATOR: Dr Shane Langsford
QUALIFICATIONS: Bachelor of Psychology (1994, UWA)
Bachelor of Education with First Class Honours (1996, UWA)
Doctor of Philosophy in Educational Psychology (1999, UWA)
REGISTRATION: AHPRA/PBA Fully Registered Psychologist (PSY0001578191)
Test Behaviour:
The examiner was able to establish good rapport with John. John was observed to have put in an appropriate
amount of effort throughout the assessment, and he displayed a normal affect which remained consistent
throughout the assessment. No behaviours that would affect the test results were observed during the testing.
Psychological Test Results:
Age at Testing: 30 years
Table 1: WAIS-IV Composite Score Summary
WAIS-IV Scale
Composite
Score
Percentile
Rank
95%
Confidence
Interval
Qualitative
Description
Verbal Comprehension Index (VCI)
114
82
108
-
119
High Average
Perceptual Reasoning Index (PRI)
131
98
123
-
136
Very Superior
Working Memory Index (WMI)
98
45
93
-
102
Average
Processing Speed Index (PSI)
95
37
90
-
100
Average
Full Scale IQ (FSIQ)
111
77
106
-
116
High Average
General Ability Index (GAI) 122 93 117-127 Superior
Index scores have a mean Composite Score of 100 (50
th
percentile) and a standard deviation of 15.
Percentile Rank refers to individual’s standing among 100 individuals of a similar age.
Therefore, a Percentile Rank of 50 indicates that they performed exactly at the average level for their age.
If there is a one standard deviation or more difference between any of the Index Composite Scores, often an Index rather than the
FSIQ (e.g., GAI, FRI, etc) is deemed to provide a better estimate of the individual’s true underlying natural cognitive ability.
Composite Scores are intentionally removed from client copies of the report as per APS policy
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Below is a set of characteristic difficulties relevant to lower ability in each Index. These are generic difficulties and are not provided
as an illustration of the individual’s difficulties.
Verbal Comprehension weaknesses can cause difficulty learning and performing to ability in
exams/performing in the workplace by:
Trouble understanding verbal directions and/or instructions. This will be more so with complex
language, or when multiple steps are included in an instruction.
Struggling in written exams, especially when also faced with added time pressures.
Being seen as a ‘poor listener’. These individuals can appear to be easily distracted and inattentive at
times, especially when faced with high verbal task demands.
Being more likely to be working in environments that are more practical, hands-on or require
knowledge of maths, science, artistic skills etc.
Improved learning and skill acquisition from charts, visual materials, diagrams, videos, or hands-on
on the job training.
Difficulty in terms of reading comprehension – they may need to re-read a given text in order to fully
understand the meaning (i.e. filling out forms or completing paperwork may be particularly time
consuming).
Difficulty in understanding abstract concepts, particularly when asked to perform tasks that rely
heavily on verbal abstract reasoning.
Difficulty in understanding social conventions (i.e. what should you do if you find a wallet in a store).
Working Memory weaknesses can cause difficulty learning and performing to ability in exams/performing in
the workplace by:
Difficulty absorbing instructions, particularly if they contain more than one step.
Wide ranging difficulties in both maths and reading, both of which are activities that place high
demand on working memory ability.
These individuals will be slower than their peers in being able to pick up new skills, or in developing
new concepts.
Difficulty performing mental maths calculations, being able to recall names or phone numbers without
prompts.
Frequent errors across tasks that involve the individual needing to recall small amounts of information,
while at the same time performing another task.
Difficulty performing tasks with a number of steps, they may miss out steps or make mistakes in terms
of not carefully paying attention to the details.
Appearing to have a relatively short attention span, they may appear inattentive or distractible.
Processing Speed weaknesses can cause difficulty learning and performing to ability in exams/performing in
the workplace by:
Difficulty processing large amounts of information, or being able to understand long, complex
instructions.
Poorer performances when given deadlines or are under time pressure. They simply need longer to
complete a given task.
Written work is very time consuming, it takes these individuals a long time to write. They are likely
to have a preference for using a computer to complete the majority of their work.
Easy to fatigue; these individuals need to use more cognitive resources to complete the same amount
of work as their peers.
Difficulty following conversations, or keeping track of the plot in books/movies
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Table 2: WAIS-IV Subtest Scaled Scores
Subtests
Scaled
Score
Percentile
Rank
Verbal Comprehension Index
Similarities
11
63
Vocabulary
13
84
Information
14
91
Perceptual Reasoning Index
Block Design
16
98
Matrix Reasoning
15
95
Visual Puzzles
15
95
Working Memory Index
Digit Span
10
50
Arithmetic
9
37
*
Letter
-
Number Sequencing
10
50
Processing Speed Index
Symbol Search
10
50
Coding
8
25
See Appendix for complete subtest descriptions *Non-core subtest
Table 3: Differences Between VCI Subtest Scores and Mean of VCI Subtest Scores
VCI Subtests
Scaled
Score
VCI
Mean
Difference
From Mean
.05
Critical Value
Strength or
Weakness
Similarities
11
12.67
-
1.67
1.91
Low
Vocabulary
13
12.67
0.33
1.58
Information
14
12.67
1.33
1.64
High
"High" or "Low" is indicated when the score falls close to the critical value required for reaching statistical significance
Statistical Significance (Critical Values) at the .05 level *Non-core subtest
Table 4: Differences Between PRI Subtest Scores and Mean of PRI Subtest Scores
PRI Subtests
Scaled
Score
PRI
Mean
Difference
From Mean
.05
Critical Value
Strength or
Weakness
Block Design
16
15.33
0.67
2.05
Matrix
Reasoning
15
15.33
-
0.33
1.92
Visual Puzzles
15
15.33
-
0.33
1.99
"High" or "Low" is indicated when the score falls close to the critical value required for reaching statistical significance
Statistical Significance (Critical Values) at the .05 level *Non-core subtest
Table 5: WMI and PSI Subtest Discrepancies From GAI Index Subtest Mean
Please note, the statistics provided in this table are not standard WAIS-IV analyses and are provided as a guide only
Subtest
Subtest
Scaled
Score
GAI Mean
Score
Difference
From GAI
Mean
Nominal
Critical
Cut-off
Strength
or
Weakness
Working Memory
Digit Span
10
14
-
4
2.50
Weakness
Arithmetic
9
14
-
5
2.50
Weakness
*
Letter
-
Number Sequencing
10
14
-
4
2.50
Weakness
Processing Speed
Symbol Search
10
14
-
4
2.50
Weakness
Coding
8
14
-
6
2.50
Weakness
Scores referred to as ‘High’ or ‘Low’ falls close to the critical value for statistical significance *Non-core subtest.
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12. CONCLUSIONS AND STATEMENT OF DIAGNOSIS
ADHD:
John’s background information, interview information, positive PsychProfiler screens for ADHD, high
Conners Rating Scale behavioural results, high ADHD DSM-5 Criteria checklist results, and cognitive profile
(i.e. depreciated Working Memory and Processing Speed) suggest ADHD is a possibility and warrants further
investigation/consideration by a Medical Specialist.
Please note, although suitably trained Psychologists are permitted to diagnose ADHD, traditionally it is formally
diagnosed by either a Paediatrician, Psychiatrist, or Clinical Neurologist. Therefore, if an individual’s cognitive and/or
behavioural results suggest that ADHD is a possibility, it is deemed appropriate of PECS to recommend that the
appropriate Medical Specialist be consulted for their expert opinion. PECS does not make the recommendation on the
basis that they believe the individual definitely has ADHD.
ANXIETY:
The existing diagnosis of anxiety is supported by the background information, interview information,
PsychProfiler results, GAD DSM-5 Criteria checklist results, and BAI checklist results.
DEPRESSION:
The existing diagnosis of depression is supported by the background information, interview information,
PsychProfiler results, and BDI-II checklist results.
Based on the past history reported by John, information gathered during the interview, and BDI-II response
indicating that he has no thoughts of killing himself (item 9), John is considered to be at low risk of self-harm.
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13. RECOMMENDATIONS
Please note, PECS does not provide micro-strategies (e.g., sit student at front of classroom, etc) as part of their recommendations.
PECS’s provides recommendations on what further assessment is required, what intervention is necessary, and who is the most
appropriate to provide the assessment/intervention recommended.
PSYCHIATRIC INVOLVEMENT:
(1) Due to the background information, PsychProfiler results, DSM-5 ADHD Criteria Checklist results,
Conners results, and WAIS-IV profile all suggesting possible ADHD, it is recommended that John be
seen by a Psychiatrist for the purpose of a formal decision on the presence of an ADHD.
Please note that a GP referral is required to see a Medical Specialist.
Please ensure that you notify PECS of which Medical Specialist you book in with so this report can be forwarded to them.
ADHD COACHING:
(1) John may wish to contact an ADHD Coach for assistance with ADHD management and behavioural
strategies.
ADHD Coaches Australasia
www.adhdcoachesaustralasia.online
Please note that strategies to assist with poor concentration, low attention and distractibility
are beneficial to people with these characteristics even if they are not formally diagnosed with ADHD
ADHD SELF-HELP ORGANISATIONS:
(1) John would benefit from accessing ADHD information/resources from the following organisations.
ADHD WA
Suite B, 11 Aberdare Rd (cnr) Hospital Ave, NEDLANDS WA 6009
(08) 6457 7544 hello@adhdwa.org www.adhdwa.org
Open 9.30am to 12.30pm, Monday to Friday
ADHD WA is a support, information and advocacy agency, founded in 1993 for people with ADHD and associated
conditions. They work with individuals, teenagers and adults living with learning differences their families and partners.
They also support those who treat, teach and work with people living with ADHD.
ADHD Australia
info@adhdaustralia.org.au www.adhdaustralia.org.au
ADHD Australia aims to be a voice for positive change for people living with ADHD and to help build a community that
fully supports, understands, and accommodates ADHD.
ADHD Foundation
support@adhdfoundation.org.au www.adhdfoundation.org.au National Support Helpline: 1300 39 39 19
ADHD Foundation in Australia is a not-for-profit registered charity aiming to make the lives of people with ADHD better,
easier and simpler. Whether it’s accessing much-needed support, speaking to a trusted and professional community which
can provide advice or simply being a safety network.
Please note, these resources available from the also assist individuals that display similar traits
to an individual with ADHD, and not just those that are formally diagnosed with ADHD.
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PSYCHOLOGICAL INVOLVEMENT:
(1) John would benefit from re-engaging in on-going psychological counselling given the levels of anxiety
and depression being self-reported.
For assistance with locating a suitable Psychologist in their local area, John may wish to utilise the
‘Find a Psychologist’ function available via the Australian Association of Psychologists’ and/or
Australian Psychological Society’s websites.
AAPi = https://www.aapi.org.au/FindaPsychologist
APS = https://psychology.org.au/find-a-psychologist
To get a Medicare rebate for counselling, a referral from a Paediatrician, Psychiatrist, or General Practitioner is required.
A GP must have generated a Mental Health Treatment Plan. https://www.healthdirect.gov.au/mental-health-treatment-plan
(2) John’s schooling history highlighting difficulties with literacy, PsychProfiler screens for a SLD in
reading and writing, and a relatively depreciated WAIS-IV VCI, indicate that an educational test
should be conducted to investigate the possibility of a Specific Learning Disorder with impairment in
Reading and/or Written Expression.
ANXIETY/DEPRESSION SELF-HELP ORGANISATIONS:
(1) John would benefit from accessing the following organisations for assistance with anxiety and/or
depression resources. If immediate assistance is required, please contact Lifeline.
Lifeline (24/7 crisis support)
www.lifeline.org.au
Chat online – www.lifeline.org.au/crisis-chat
Text – 0477 131 114 Call - 13 11 14
The Black Dog Institute
www.blackdoginstitute.org.au
(08) 9382 2991 clinic@blackdog.org.au
beyondblue
www.beyondblue.org.au
beyondblue National Information Line - 1300 22 4636
headspace
www.headspace.org.au
headspace Nation Support Line - 1800 650 890
Helping Minds
www.helpingminds.org.au
(08) 9427 7100
HEALTH & WELL-BEING:
(1) It is recommended that John continues his/implements regular exercise and maintains a healthy diet.
Please note, the above is a generic recommendation that should be followed by all and is not a recommendation specific
to John due to any of his results or reported behaviours.
Dr Shane Langsford
Date of Report
Managing Director
-
PECS
Registered Psychologist
APS College of Educational & Developmental Psychologists Academic Member
17
APPENDIX 1: FREQUENTLY ASKED QUESTIONS (FAQs)
WHAT IS A COMPREHENSIVE PSYCHOLOGICAL REPORT?
A Comprehensive Psychological Assessment (CPA) is the systematic collection and analysis of developmental,
behavioural, socioemotional, cognitive and/or educational information for the purpose of making inferences
about underlying brain function.
These inferences are achieved by investigating an individual’s strengths and weaknesses across the
aforementioned areas and identifying any patterns that may exist.
Ultimately, the investigation’s aim is to rule out the presence of any clinically significant conditions, or if
indeed present, to facilitate diagnosis of the core underlying problem, identify its aetiology and impact on the
individual, and identify any comorbid concerns that may also exist.
Most conditions are genetic, hereditary and familial in nature, with a significant minority being
environmental/experiential in origin.
A Comprehensive Psychological Report (CPR) contains the information garnered from the CPA and is
primarily compiled to convey the information to other medical, health, and educational professionals (often
the referrer) for the purpose of specialist diagnosis, and/or the implementation of intervention/treatment.
WHY SPECIFIC LEARNING DISORDER vs DYSLEXIA / DYSGRAPHIA / DYSCALCULIA?
PECS aligns its diagnostic approach with the DSM-5 as this is the classification system that the educational
organisations in Western Australia (e.g., School Curriculum Standards Authority, WA Department of
Education, Catholic Education Office, Association of Independent Schools, etc) align with.
The DSM-5 Neurodevelopmental Work Group, who were responsible for the decision to use the term Specific
Learning Disorder (SLD) in the DSM-5, “concluded that the many definitions of dyslexia and dyscalculia
meant those terms would not be useful as disorder names or in the diagnostic criteria”.
PECS therefore only uses the term Specific Learning Disorder (SLD) throughout this report.
In simplistic terms, Dyslexia=a SLD in Reading (and often Spelling); Dyscalculia=a SLD in Mathematics;
and Dysgraphia=a SLD in Written Expression.
IS IT CALLED ADD OR ADHD?
As mentioned above, PECS aligns with the DSM-5 which allows for one of the following three diagnoses.
1. Attention-Deficit/Hyperactivity Disorder: Predominantly Hyperactive/Impulsive Presentation
2. Attention-Deficit/Hyperactivity Disorder: Predominantly Inattentive Presentation
3. Attention-Deficit/Hyperactivity Disorder: Combined Presentation
Therefore, the correct acronym if aligning with the DSM-5 is ADHD, not ADD.
ADHD Combined Presentation refers to an individual who has both Hyperactive/Impulsive and Inattentive
traits.
18
APPENDIX 2: RAMIFICATIONS OF UNTREATED ADHD
ADULTS WITH UNTREATED ADHD EXPERIENCE:
Increased comorbidity of at least one psychiatric disorder
1
Higher self-reported rates of anxiety and depression
2
Higher risk of substance abuse
3 4
Lower frequency of regular jobs
5
Higher rates of unemployment
6
Significantly more externalizing behaviours, including abuse and criminality
5
Lower work performance and change jobs more frequently
7 8
Lower occupational functioning
9 10
Decreased overall educational achievement level
11
Decreased average household incomes, regardless of academic achievement
12
Report significantly poorer marital adjustment and family functioning
13
More divorces
14 15 16
Higher prevalence of oppositional, conduct, and substance abuse disorders
16
Higher rate of risky driving behaviour and suspension of driving license
16
Decreased social–emotional competence & reduced salience of emotion in interpersonal interaction
17
Difficulty engaging others in conversation
17
Decreased tactfulness or ability to adjust their behaviour to be appropriate for the situation
17
Heightened emotional reactivity, especially to contempt and disgust
17
Less awareness of emotional cues made by others
17
Lower self esteem
26
CHILDREN WITH UNTREATED ADHD EXPERIENCE:
Higher risk for lifetime and 1-year prevalence of antisocial, addictive, mood, and anxiety disorders
18
Higher rates of frequent school disciplinary action against them
16
Functional impairments persisting through to adulthood
19 20
Significantly lower academic achievements
7 21
Lower educational attainment, grade retention,
22
and suspension
25
Increased likelihood of dropping out of school
22
Inattentive symptoms at constant levels throughout their life
23
More impairment in social competence, behavioural and emotional adjustment
24
Lower quality of life, as measured by self-report
24
Early
pregnancy
25
Behavioural disturbance
26
Feeling of parental incompetence
26
Lower social esteem
26
Antisocial behaviour
26
1
Biederman et al., 2004
2
Halmoy, Fasmer, Gillberg, & Haavik 2009
3
Biederman et al., 1997;
4
Mannuzza et al., 1991
5
Rasmussen & Levander, 2009
6
Halmoy, Fasmer, Gillberg, & Haavik, 2009
7
Barkley et al., 2006
8
Weiss & Hechtman, 1993
9
Barkley, Murphy, & Fischer, 2007
10
Sobanski et al., 2007
11
Halmoy, Fasmer, Gillberg, & Haavik, 2009
12
Biederman & Faraone, 2006
13
Eakin L et al. 2004
14
Biederman et al., 1993
Copyright – Langsford 2019. Not to be copied
15
Biederman et al., 1994
16
Murphy & Barkley, 1996
17
Friedman et al. 2003
18
Biederman et al., 2006
19
Biederman, Mick, & Faraone, 2000
20
Rasmussen & Gillberg, 2000
21
Mannuzza, Klein, Bessler, Malloy, & LaPadula, 1993
22
Biederman & Faraone, 2006
23
Biederman, Mick, & Faraone, 2000
24
Barkley et al., 1991
25
Erskine et al., 2016
26
UKAAN Handbook Adult ADHD
APPENDIX 3: WAIS-IV SUBTEST DESCRIPTIONS
The General Ability Index (GAI) is an optional summary score that is less sensitive to the influence of working memory
and processing speed. As working memory and processing speed are vital to a comprehensive evaluation of cognitive
ability, it should be noted that the GAI does not have the breadth of coverage as the FSIQ. The GAI should be interpreted
with caution if there is a 15+ difference between the VCI and PRI.
The Full-Scale IQ (FSIQ) score is the overall score that estimates an individual’s general level of intellectual functioning.
It is usually considered to be the score that is most representative of global intellectual functioning. The FSIQ should be
interpreted with caution if there is a one or more standard deviation (15+) difference between the VCI, PRI, WMI. or PSI.
VERBAL
COMPREHENSION
INDEX
The Verbal Comprehension Index (VCI) is a measure of verbal acquired knowledge and verbal
reasoning incorporating the 3 core Verbal subtests of Information, Similarities, and Vocabulary
and one supplemental subtest Comprehension.
Vocabulary The Vocabulary subtest required the individual to explain the meaning of words presented in
isolation, both visually and orally. As a direct assessment of word knowledge, the subtest is one
indication of their overall verbal comprehension and fund of knowledge. Performance on this
subtest also requires abilities to verbalise meaningful concepts as well as to retrieve information
from long
-
term memory.
Similarities On the Similarities subtest, the individual was required to respond orally to a series of word pairs
by explaining the similarity of the common objects or concepts they represent. This subtest
examines their ability to abstract meaningful concepts and relationships from verbally presented
material. As well as involving crystallised intelligence, abstract reasoning, auditory comprehension,
memory, associative and categorical thinking, distinction between nonessential and essential
features and verbal expression.
Information The Information subtest required the individual to respond verbally to a series of orally presented
questions that assess knowledge about common events, objects, places, and people. The subtest is
primarily a measure of their fund of general knowledge. Performance on this subtest also may be
influenced by their cultural experience, as well as their ability to retrieve information from long-
term memory.
Comprehension
(supplementary
subtest)
The Comprehension subtest required the individual to provide oral solutions to everyday problems
and to explain the underlying reasons for certain social rules or concepts. This subtest provides a
general measure of verbal reasoning and conceptualisation, verbal comprehension and expression.
In particular, this subtest assesses comprehension of social situations and social judgment, as well
as knowledge of conventional standards of social behaviour.
PERCEPTUAL
REASONING
INDEX
The Perceptual Reasoning Index (PRI) is a measure of fluid reasoning, spatial processing,
attentiveness to detail, and visual-motor integration comprising the 3 core Performance subtests of
Visual Puzzles, Block Design, and Matrix Reasoning and two supplemental subtests; Figure
Weights and P
icture Completion.
Block Design The Block Design subtest required the individual to use two-colour cubes to construct replicas of
two-dimensional, geometric patterns. This subtest assesses ability to mentally organize visual
information. More specifically, this subtest assesses the ability to analyse part-whole relationships
when information is presented spatially. Performance on this task also may be influenced by visual-
spatial perception and visual perception
-
fine motor coordination, as well as planning ability.
Matrix Reasoning The Matrix Reasoning subtest involves a series of incomplete gridded patterns that the individual
completes by pointing to or saying the number of the correct response from 5 possible choices. This
subtest assesses fluid intelligence, broad visual intelligence, classification and spatial ability, as well
as
the individual’s
knowledge of part
-
whole relationships and perceptual organisation abilities.
Visual Puzzles The Visual Puzzles subtest requires the individual to view a completed puzzle and to then select
three response options, which when combined will form the completed puzzle. This is a measure of
an individual’s non-verbal reasoning ability and their ability to both analyse and synthesise abstract
visual st
imuli.
Picture Completion
*
(supplementary
subtest)
The Picture Completion subtest required the individual to identify the important missing part in
each of a series of pictures of common objects, events, or scenes. An indication of their ability in
visual discrimination, the Picture Completion subtest assesses the abilities to detect essential details
in visually presented material and to differentiate them from nonessential details. Performance on
this task also may be influenced by an individual's general level of alertness to the world around
them
and long
-
term visual memory.
Figure Weights
(supplementary
subtest)
The Figure Weights subtest involves viewing a scale, which is missing weight(s) and then selecting
the response option which balances that scale. This is a measure of quantitative and analogical
reasoning, which involves reasoning processes that can be expressed mathematically. The task
emphasises the use of deductive and inductive logic.
20
WORKING MEMORY
INDEX
The Working Memory Index (WMI) comprises the two core subtests of Arithmetic, Digit
Span, and one supplemental subtest; Letter-Number Sequencing. The subtests provide a
range of verbally presented tasks that require the individual to attend to information, to hold
briefly and process t
hat information in memory, and then to formulate a response.
Arithmetic The individual was required to mentally solve a series of orally presented arithmetic problems
on the Arithmetic subtest. A direct measure of their numerical reasoning abilities, the subtest
requires attention, concentration, short-term memory, and mental control. The Arithmetic
subtest also measures logical reasoning, quantitative knowledge and sequential processing.
Digit Span The Digit Span subtest is a series of orally presented number sequences that the individual
must repeat verbatim (Digit Span Forward), in reverse order (Digit Span Backwards) or recall
the numbers in ascending order (Digit Span Sequencing). A direct assessment of their short-
term auditory memory, the Digit Span subtest requires attention, concentration, and mental
control and can be influenced by their ability to correctly sequence information. The Digit
Span Sequencing task increases the working memory dem
ands of the task.
Letter-Number
Sequencing
(supplementary subtest)
The Letter-Number Sequencing subtest involves a series of orally presented sequences of
letters and numbers that the individual simultaneously tracks and orally completes, with the
numbers in ascending order and the letters in alphabetical order. This task is a measure of
sequential processing ability, short term auditory memory span, mental manipulation,
attention, and concentration. Letter-Number Sequencing also assesses an individual’s
underlying information processing abilities, cognitive flexibility an
d fluid intelligence.
PROCESSING SPEED
INDEX
The Processing Speed Index (PSI) is an indication of an individual's ability to process
simple or routine visual information quickly and efficiently and to quickly perform tasks
based on that information. Good speed of simple information processing may free cognitive
resources for the processing of more complex information and ease new learning. The PSI
comprises two core subtests; Coding and Symbol Search and one supplemental subtest;
Cancella
tion.
Symbol Search On the Symbol Search subtest, the individual was required to inspect several sets of symbols
and indicate if special target symbols appeared in each set. A direct test of speed and accuracy,
the subtest assesses scanning speed and sequential tracking of simple visual information.
Performance on this subtest also may be influenced by visual discrimination and visual-motor
coordination.
Coding The Coding subtest required the individual to use a key to associate a series of symbols with
a series of shapes and to use a pencil to draw the symbols next to the shapes. A direct test of
speed and accuracy, the Coding subtest assesses ability in quickly and correctly scanning and
sequencing simple visual information. Performance on this subtest also may be influenced by
short
-
term visual memory, attention, or visual
-
motor coordination.
Cancellation
(supplementary subtest)
The Cancellation subtest asks the individual to scan a structured arrangement of shapes, for a
specified target shape, which they will mark. The Cancellation subtest is a direct measure of
processing speed, as well as visual selective attention, vigilance, perceptual speed and visual
motor ability. The inclusion of a decision-making component (selection is based on both shape
and colour) places more complex demands upon
them
.
Please note:
Supplementary Subtests are only administered on an as needed basis when there is a significant discrepancy
between the scaled scores of the Primary Subtests within an Index.
21
APPENDIX 4: BRIEF BIOGRAPHY OF THE AUTHOR
Dr Shane Langsford is a highly qualified and very experienced psychologist who has conducted more
than 5000 child and adult assessments since establishing Psychological & Educational Consultancy
Services in 1999.
Dr Langsford’s qualifications include a Bachelor of Psychology, a Bachelor of Education with First
Class Honours, and a PhD in Educational Psychology.
Dr Langsford is fully registered with the Psychology Board of Australia (PBA) and the Australian Health
Practitioners Regulation Agency (AHPRA).
Dr Langsford is a full member of the Australian Psychological Society (APS), Australian Association
of Psychologists (AAPi), Australian ADHD Professionals Association (AADPA), and the School
Psychologist’s Association of Western Australia (SPAWA).
Dr Langsford is also an APS College of Educational & Developmental Psychologists Full Academic
Member. To be awarded Full Academic Member status, an individual must have completed a PhD in
psychology, have at least two years’ experience as a researcher or educator in psychology in the College
specific area of practice, and have published a notable body of relevant research in the College-specific
area of practice.
In 2015, Dr Langsford was personally selected from a shortlist by the then Federal Minister of Health
(the Hon Sussan Ley) to be part of the 13-member Mental Health Expert Reference Group (MHERG).
The group was formed to provide advice to the Commonwealth Department of Health in relation to the
government’s response to the National Review of Mental Health Programmes and Services. Dr
Langsford was the only practising psychologist in Australia appointed to the group, and the only member
in the group from Western Australia. (For more information, see https://www.pecs.net.au/pecs-profile)
With regards to ADHD, Dr Langsford has conducted over 3000 ADHD assessments for various
Psychiatrists and Paediatricians, was asked in 2014 to be on the National Shire ADHD Expert Panel for
the “A Snapshot of ADHD: A Consumer and Community Discussion”, and in April 2018 was the only
Psychologist from Australia participating in the ADHD Institute’s “Meeting of the Minds” forum in
Madrid – which is an invite-only meeting “providing a forum for ADHD scientists and clinicians to
discuss the latest scientific evidence and share best practice in the management of ADHD”. Dr Langsford
was for the second year running once again the only Psychologist from Australia invited to the 2019
Forum, which was held in Munich (Germany) in November 2019, and also again for the 2020 Forum in
Stockholm (Sweden).
Dr Langsford’s extensive knowledge of a wide range of disorders led to the creation of the PsychProfiler,
which is a reliable and valid instrument oriented to the DSM-5 and has been the most widely used
Australian global psychiatric/psychological/educational assessment tool since 2004.
(For more information, see https://www.psychprofiler.com)
