Case Study Report:
Intervention Category: Emotional
Level: Intermediate
Stan
11 years, 4 months
6th grade

What was the reason for referral?

Dr. Wheelock was contacted for testing and evaluation by Stan’s mother because she felt he has a problem with comprehension.

What background information did the parents report?

Stan lives with his parents, who are in their early thirties, in a large urban neighborhood in a Midwestern city. Stan’s father is an electrician who has an Associate’s Degree and his mother is a nail technician who has completed a G.E.D. She works part-time on weekends and evenings. English is the only language used in the home. Stan is the oldest of three children. His two brothers, age three, are twins who have had developmental health problems from premature births. The family has lived in the same home for 5 years.

The mother reports that Stan had a normal birth. The mother also states that Stan developed normally, and that he has worn glasses since he was five for nearsightedness. Stan is in the normal ranges of height and weight for his age.

Stan is a very nervous child, according to the mother. Although he has a good disposition, she reports that Stan has upset stomachs and bites his nails until they bleed. It is not unusual for him to cry. He has friends his own age and younger, but the mother is concerned that he may be too controlling and bossy in his play with others. While right-handed, Stan likes to use his left hand as well. Stan is athletic and is a good basketball player. He looks up to the D.A.R.E. officer who visits his school and Stan wants to be a police officer. Stan watches television or plays video games three to four hours a day. Stan’s mother reports that she and her husband do not enjoy reading themselves, but that they make an effort to provide interesting reading materials for Stan, who likes fantasy stories.

What background information did the classroom teacher report?

Stan’s classroom teacher reports that Stan does not perform at what she considers his capacity in reading comprehension and content-based subjects. He performs at grade level math computations, but usually fails to complete multi-step thought problems. He does not like new learning challenges and frequently bites his nails, pulls on his hair or puts his head in his arms when facing new instructional tasks. He has friends in class with whom he plays well on the playground.

What were diagnostic outcomes?

Dr. Wheelock administered a series of diagnostic tests and procedures with Stan. His observations were that Stan was a wellk-groomed youngster who appeared well cared for. He was friendly and rapport was easy to establish. Stan was verbal, articulate and well oriented to time and place. While Stan generally worked well and with sustained interest, there were indications of anxiety. Stan writes with his right hand and wears glasses.

For the purposes of this case study, Dr. Wheelock presents the following outcomes of the Classroom Reading Inventory and a synopsis of relative data from other measures.

Stan’s Case Study
Part I: Word Lists
Form A: Pretest Inventory Record
Classroom Reading Inventory, 11th edition

On the CRI word lists, Stan correctly read all the words through the third grade. He made the following word recognition errors on the 4th, 5th and 6th grade lists:

polite – “pilot”
internal – “in-ter-al”
hymn – “hum”
embarrass – “embrace”
scar – “scare”
salmon – “sal-mon”
psychology – “psy-ic-ology”
dazzle – “day-zle”
hearth – “herth”
widen – “widden”

Stan’s phonetic and structural analysis skills are quite firmly established. In addition, he seems well able to analyze and synthesize unfamiliar polysyllabic words and has attained the level of automaticity in decoding.

Stan’s Case Study
Part II: Graded Paragraphs
Form A: Pretest Inventory Record
Classroom Reading Inventory, 11th edition

Dr. Wheelock positioned Stan to begin reading the graded paragraphs at the third grade level in the Classroom Reading Inventory, 11th edition. The third grade level was chosen because it was the lowest level at which Stan could read 90 percent of the words on the word lists.

Stan’s oral reading in context at sight was characterized by a fairly fluent and expressive reading of the material. However, there were numerous repetitions and regressive type errors. Errors of this sort usually indicate the presence of anxiety connected with oral reading behavior. His comprehension, nevertheless, was very good throughout.

Summary of diagnostic data from other measures:

• On the Wechsler Intelligence Scale for Children – III®, Stan had a Full Scale IQ classified as average according to the Wechsler norms for his age group. His individual verbal and performance scales were both rated as average. There was general evenness of functioning throughout the subtests. The overall clinical impression is of an anxious youngster with at least average intellectual capacity.
• On the Bender Visual-Motor Gestalt Test, the protocol is suggestive of uneven perceptual development with indications of anxiety.
• On the Wepman Auditory Discrimination Test and the Betts Visual Discrimination Test, there were no indications of difficulty in these areas.
• The results of the Harris Test of Lateral Dominance indicate a right-side dominant pattern.
• On the Wheelock Informal Spelling Test, Stan achieved a score of 90% at the fifth grade level of difficulty. Stan seems well able to associate spoken sounds (phonemes) with the printed symbols (graphemes) that represent them.
• The results of the Draw-A-Person Test and post-drawing interrogation tend to indicate a youngster who experiences his environment as overwhelming and the self as inadequate. As such, Stan may frequently attempt to avoid or withdraw from environmental (school) stimulation. When environmental stimulation cannot be avoided, he may respond with overwhelmed submission and anxiety.

Conclusions:
Dr. Wheelock found that Stan was a youngster of at least average intellectual capacity who does not have a reading problem, per se. His basic phonetic and structural analysis skills, as well as his comprehension abilities, are firmly established.

However, Stan is an anxious youngster who feels overwhelmed by his school environment. His anxiety is evident in his reading by the number of repetitions and regressive type errors he makes; e.g., missing easy and familiar words only to go on to decode more difficult and unfamiliar words.

During the other testing, Stan’s anxiety was evident by temporary inefficiencies; e.g., missing easy questions only to go on and answer much more difficult ones.

When these feelings of anxiety arise in Stan, his ability to perform is restricted and he is unable to smoothly and efficiently apply those skills he does, in fact, possess.

The results of the measures used in this diagnosis do not clearly indicate the source of these feelings. In many cases like this, the child may have experienced difficulty with learning to read early on. Parents and teachers begin to show their concern about the lack of achievement. Because of this concern, the child comes to feel that if he doesn’t succeed in learning he may suffer the loss of parental/teacher approval; possibly rejection. This is when the anxiety and feelings of being overwhelmed begin to manifest themselves. The anxiety inhibits progress, so more concern is shown. A vicious cycle is set in motion.

Recommended Interventions:

1. Therapeutic approach: Stan should be referred for counseling therapy. Names and addresses of private and community resources will be furnished the parents upon request. Counseling should include an approach in which Stan can formulate, express and achieve goals in a supportive environment.
2. Mentor/tutor: Stan will profit from the assistance of a mentor/tutor, a trained and certified reading specialist who helps mentor Stan by structuring learning applications so that Stan can more effectively apply his skills. These applications include homework strategies, note-taking, reports, content area reading, and test-taking skills, for example.
3. Spot tutoring: The mentor/tutor also coaches and builds Stan’s skills as needed; e.g., improving higher order literacy and vocabulary development.
4. Independent reading: The major instructional emphasis, however, must be on the development of a regular, daily program of independent reading.
5. School focus: At school, Stan is likely to profit from continued instruction in reading/language arts at his present grade level. The major instructional emphasis should be on the continued development of comprehension skills and vocabulary.
6. Reduce pressure: Any pressure on Stan to achieve at a high level in school must be reduced. Stan will need the support, positive reinforcement. approval and acceptance from the adults in his environment.

Discussion with experts:

Drs. Wheelock and Campbell answer questions below about Allen’s case study. If you have a question, please Ask the CRI Experts or check the FAQ.

FAQ’s related to Stan’s case study:

1. How do you find a qualified tutor if your child needs one?
2. What is person-centered planning?
3. What is the best age for involving the young person in person-centered planning?
4. How does anxiety reduce a child’s ability to read?
5. What are ways to communicate with parents who feel their children are not meeting their expectations?