Name: Gender: Male Female ID: Date of Birth: / / Age:

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1 DAPPER-3 TM Dimensional Assessment for Patient Placement Engagement and Recovery Norman G. Hoffmann, Ph.D., David Mee-Lee, M.D., & Gerald D. Shulman, M.A., M.A.C., FACATA Name: Gender: Male Female ID: Date of Birth: / / Age: Evaluation Dates Date for A-1: / / Date for A-2: / / Date for B-1: / / Date for B-2: / / Date for C-1: / / Date for C-2: / / month day year month day year With which ethnic grouping does patient identify: (1) Hispanic/Latino white (2) Hispanic/Latino non-white (3) African-American (4) Native American (5) Native Hawaiian/Pacific Islander (6) Asian (7) Middle Eastern (8) Caucasian/White (9) Multiracial/Biracial/Other Current marital status at entry into treatment: (1) Never married (2) Divorced (3) Separated (4) Widowed (5) Living as married (6) Married Highest degree earned: (1) No high school diploma earned (2) High school diploma or GED (3) Vocational/technical/business school grad. (4) Associate degree (5) Bachelor s degree (6) Master s, doctoral, or other postgrad. degree Employment status upon entry into treatment: (1) Working full time for pay (30 hr./wk. or more) (2) Working part time for pay (< 30 hr./wk.) (3) Unemployed (4) Not working for pay by choice (5) Disabled (6) Retired Primary job type when working for pay: (1) Professional (2) Upper-level management/business owner (3) Mid-level management (4) Sales/marketing (5) Supervisory Substance Alcohol Marijuana (6) Craft/skilled trades/technical (7) Office/white collar/clerical (8) Transportation/equipment operator (9) Laborer/unskilled worker (10) Service worker (waiter/waitress) (11) Domestic worker (housekeeper, etc.) (12) Military service (13) Other (specify) Cocaine (powder or crack) Stimulants of any type Sedative/hypnotics/etc. Heroin Inhalants PCP Hallucinogens Other/unknown/mixed Diagnostic Impressions Not Determined No Diagnosis Mild Moderate Severe Norman G. Hoffmann Copyright, 2000, 2014 All Rights Reserved. Evince Clinical Assessments, 29 Peregrine Place, Waynesville, NC USA Distributed by The Change Companies, 5221 Sigstrom Drive, Carson City, NV 89706; Phone: ; Reproduction or adaptation in any form, in whole or in part, by any means, is a violation of copyright and constitutes unethical and unprofessional conduct.

2 DAPPER-3 TM PLACEMENT INDICATIONS Dimensional Assessment for Patient Placement Engagement and Recovery Name: ID #: Dimensional Specifications for Admission Level 0.5 Assessed as meeting at least one of the specifications in Dimensions 4, 5, or 6. Identifiable problems in Dimensions 1, 2, or 3 are stable or being addressed appropriately in outpatient medical or mental health services. (The ASAM Criteria (2013) pp ) Level 1.0 All six dimensions meet Level I criteria or present no problem (Analogous to Level 0.5. (The ASAM Criteria (2013) pp ) Level 2.1 Level 2.5 Direct admission to Level 2.1 advisable for patient who meets specifications in Dimension 2 (if biomedical conditions or problems exist) and Dimension 3 (if emotional, behavioral, or cognitive conditions or problems exist), as well as in at least one of Dimensions 4, 5, or 6. (The ASAM Criteria (2013) pp ) Direct admission to Level 2.5 advisable for patient who meets specifications in Dimension 2 (if biomedical conditions or problems exist) and in Dimension 3 (if emotional, behavioral, or cognitive conditions or problems exist), as well as in at least one of Dimensions 4, 5, or 6. (The ASAM Criteria (2013) pp ) Level 3.1 Assessed as meeting specifications in each of the six dimensions. (The ASAM Criteria (2013) pp ) Level 3.3 Assessed as meeting specifications in each of the six dimensions. (The ASAM Criteria (2013) pp ) Level 3.5 Assessed as meeting specifications in each of the six dimensions. (The ASAM Criteria (2013) pp ) Level 3.7 Assessed as meeting specifications in at least two of the six dimensions, at least one of which is in Dimension 1, 2, or 3. (The ASAM Criteria (2013) pp ) Level 4.0 Assessed as meeting specifications in at least one of Dimensions 1, 2, or 3. (The ASAM Criteria (2013) pp ) Level OTP Assessed as meeting the required opioid treatment program specifications in Dimensions 1 through 6. (The ASAM Criteria (2013) pp ) PLACEMENT PROFILE Indicate the level of care recommended on each dimension for each assessment. 1 st 2 nd 3 rd 4 th 5 th 6 th Asmt. Asmt. Asmt. Asmt. Asmt. Asmt. 1. Intoxication/Withdrawal 2. Biomedical Conditions/Complications 3. Emotional/Behavioral/Cognitive 4. Readiness to Change 5. Relapse/Cont. Use/Problem Potential 6. Recovery Environment Date of Assessment: / / / / / / / / / / / / Level of Care Indicated: Level of Care Received: Reason for Placement Difference, if any Reasons for Differences: Blank if no difference; 1. Service not available; 2. Provider judgment; 3. Patient preference; 4. On waiting list for appropriate level; 5. No payment resource; 6. Geographic accessibility; 7. Family responsibility; 8. Language; 9. Other not listed. Outcome If Indicated Level of Care Was Not Provided: circle only one number -(see The ASAM Criteria 2013, p 126) 1. Admitted to acute care setting; 2. Discharged to street; 3. Continued stay in acute care facility; 4. Incarcerated; 5. Client dropped out; 6. Other (Specify) Document specific areas of concern for the treatment plan on the last page of this booklet.

3 DAPPER-3 Dimension 1: Acute Intoxication / Withdrawal Potential USE SCALE 1.1. Last Use A B C No use in past month No use in past 3 days Use in past 3 days Use within past day Use within past 12 hours If rating on Item 1.1 is 0, go to next Dimension Quantity of Recent Use No use or far below intoxication e.g. 1-2 drinks Increased use with well-controlled social behavior Use of substance results in obvious intoxication Use of substance results in uncontrolled behavior Heavy quantities result in ongoing dysfunction Frequency of Recent Use No use or used once or twice Sporadic or less than weekly At least weekly use Daily use Multiple substances used on a daily basis Potentiating Substances Additive Effects No use of multiple potentiating substances Possible potentiating combinations ingested Ingested small amount of potentiating substances Ingested substantial quantity of substances Potentially lethal combination of substances INTOXICATION SCALE 1.5. Level of Current Intoxication None not indicated Sub intoxication level Mildly intoxicated Very intoxicated Stuporous Physical Signs and Symptoms of Intoxication Vital signs, gait, speech, coordination normal Mildly unstable vital signs, speech, gait, coordination Mod. unstable vital signs, speech, gait, coordination Severely unstable vital signs, gait, coordination Life-threatening changes in vital signs Disoriented, clouded consciousness, or psychotic WITHDRAWAL SCALE 1.8. Physical Signs and Symptoms of Withdrawal A B C No problems: vital signs, tremor, sweats, GI Mildly abnormal vital signs, tremor, sweats, etc Mod. unstable vital signs, CNS or GI problems Severe unstable vital signs, CNS or GI problems Life-threatening vital signs, seizures Mental Status Signs & Symptoms of Withdrawal Oriented, alert, full mental function Mild anxiety, agitation, depression, dysfunction Mod. Depression, anxiety, agitation, dysfunction Severe depression, agitation, anxiety, dysfunction Suicidal, psychotic, disoriented, hallucinating History of Withdrawal Problems No prior history of withdrawal problems Minor problems noted in prior withdrawal History of moderate withdrawal problems History of severe withdrawal problems History of life-threatening withdrawal problems MODIFICATION FACTORS SCALE Client s Coping Skills with Intoxication/Withdrawal Symptoms Fully able to cope with intoxication/withdrawal Mild difficulty tolerating symptoms/functioning Moderate difficulty tolerating symptoms/coping Severe difficulty tolerating symptoms/functioning Unable to tolerate or cope with symptoms Living Arrangement Regarding Withdrawal Management Persons can fully assist in withdrawal management Someone available to offer partial assistance Unreliable persons available No one available for withdrawal management Living in environment that encourages use Mental Signs & Symptoms of Intoxication Oriented, alert, normal mental function Mild disturbance of mood, cognition, function Mod. disturbance of mood, cognition, function Fluctuating orientation, severe disturb. in function

4 DAPPER-3 Dimension 2: Biomedical Conditions / Complications MEDICAL SEVERITY SCALE TREATMENT ISSUES SCALE 2.1. Acute Medical Condition A B C No acute medical condition Few medical problems, mild symptoms Acute, non life-threatening problems Serious, unstable medical condition Severe, acute, incapacitating medical condition(s) Pregnancy Not pregnant Pregnant and receiving prenatal care Pregnant, but no prenatal care; or having problems Near term pregnancy or moderate complications Severe, acute pregnancy complications Chronic Medical Condition/Disability No chronic medical problem Mild chronic medical condition Moderate condition poses treatment challenges Unstable condition interferes with treatment Severe, unstable condition If Items 2.1, 2.2, and 2.3 are all 0, go to next Dimension. MEDICAL MANAGEMENT SCALE 2.4. Need for Stabilization No stabilization required Stabilization does not require close supervision Stabilization requires daily supervision Stabilization requires 24 hour observation Life-threatening condition requires stabilization Adherence to Medication Requirements A B C No medication required History of good adherence Mostly adherent Mostly non-adherent Not at all adherent with medications Biomedical Impacts on Functioning No impact on functioning Mild impediment to functioning Moderate impediment to functioning Substantial impediment to functioning Serious impediment to functioning in treatment Ability to Tolerate and Cope with Symptoms Full ability to tolerate, cope with discomfort Adequate ability to tolerate, cope with discomfort Some difficulty to tolerate, cope with discomfort Poor ability to tolerate, cope with discomfort Unable to tolerate, cope with discomfort Impediments to Treatment and Recovery No impact on treatment and recovery Mild impediment and distraction Moderate impediment and distraction Substantial impediment and distraction Severe impediment to functioning in treatment Need for Medical/Nursing Observation No observation required for chronic condition At least weekly observation/tests required Nursing observation required several days/wk Daily observation required hour intensive observation required Frequency of Medication Management No medications Medication management 3-4 times/year Medication management monthly At least weekly medication management Close daily medication management essential

5 DAPPER-3 Dimension 3: Emotional/Behavioral/Cognitive Conditions and Complications VIOLENCE POTENTIAL SCALE 3.1. Violence Potential A B C No history or indication of violence Mild tendency toward violence History of occasional violence toward objects History of occasional violence toward people Chronic violent behavior; currently violent Emotional Volatility Not volatile Volatile only with substantial provocation Volatile with moderate provocation Prone to volatility with minimal provocation Very volatile and unpredictable Dangerousness to Self No indication of self-harm thoughts Occasional thoughts of self-harm Frequent suicidal thoughts but not current Currently suicidal without plan or means Currently suicidal with plan and means Dangerousness to Others No thoughts about harming others General thoughts of harming others Specific target but no plan Current desire to harm someone Has target and intent or plan to harm Dangerousness Due to Addictions or Mental Condition No indication of dangerousness Slight risk to self/others due to mental condition Moderate risk Significant risk Mental condition poses imminent danger FUNCTIONING SCALE 3.6. Cognitive/Intellectual Functioning Normal cognitive ability; no problem Slight deficit(s) Moderate deficit(s) Severe deficit(s) Profound deficit(s) Attention/Ability to Focus on Treatment No difficulty focusing on tasks Some distractibility Moderately distractible Short attention/very distractible Unable to stay focused on tasks Social Functioning A B C No impairments in social functioning Adequate functioning despite mild problems Moderate impairments in social relationships Significant functional impairments Serious and persistent impairments Medication Adherence No medications needed Highly adherent Inconsistent adherence Non-adherence poses potential problem Non-adherence poses serious problems Self-care Fully able to care for self Minimal self-care problems Moderate level of self-care problems Severe self-care problems Unable to care for self CO-OCCURRING SCALE Thought Disorder Indications No thought disorder or well controlled Eccentric behavior possible thought disorder Thought disorder affects functioning Thought disorder is pronounced Thought disorder severely affects functioning Mood Related Problems No mood related problems Mild mood problems or controlled condition Moderate mood symptoms Meets criteria for mood disorder Disorder severely affects functioning Anxiety No anxiety problems Mild anxiety or controlled condition Moderate anxiety symptoms Meets criteria for anxiety disorder Anxiety disorder seriously affects functioning PTSD or other trauma disorder No indication of traumatic experience Traumatic events recalled, not diagnostic Possible diagnosis, monitoring for other indications Meets criteria for PTSD Disorder is highly detrimental to treatment

6 Dimension 3 Emotional/Behavioral/Cognitive Conditions and Complications (Continued) Eating Disorder No indication of a problem Some concern about diet/eating behaviors Possible diagnosis, monitoring for other indications Meets criteria for an eating disorder Disorder is highly detrimental to treatment Gambling Disorder No indication of a problem Some concern about wagering Possible diagnosis, monitoring for other indications Meets criteria for a gambling disorder Disorder is highly detrimental to treatment Other Axis I Disorder Problems None indicated Mild symptoms or indications Moderate symptoms or indications Meets criteria for a disorder Disorder is detrimental to treatment PERSONALITY DISORDER SCALE Antisocial Personality Behaviors A B C No antisocial behaviors noted Few indications of antisocial behaviors Moderate level of antisocial behaviors Meets criteria for Antisocial Personality Disorder Disorder seriously affects functioning Other Personality Disorder Problems None indicated Mild symptoms or indications Moderate symptoms or indications Meets criteria for a disorder Disorder is detrimental to treatment Guilt Guilt feelings not severe/positive motivation Guilt is mild distraction for treatment Guilt is moderate distraction Guilt impairs treatment efforts Guilt paralyzes treatment efforts

7 DAPPER-3 Dimension 4: Readiness to Change UNDERSTANDING SCALE 4.1. Awareness of Condition A B C Aware of substance related problems Voices awareness of problems Acknowledges, but ambivalent about problems Lacks awareness of problems Actively rejects existence of problems Acceptance of Responsibility for Behavior Fully accepts responsibility for problems Mostly accepts responsibility for problems Some acceptance of responsibility for problems Little acceptance of responsibility for problems Blames others for virtually all problems Rationalization/Minimization No rationalization or minimization Little rationalization or minimization Some rationalization or minimization Frequently rationalizes and minimizes Very high level of rationalization/minimization Understands Mental Health Problems No problem identified or excellent understanding Mostly understands mental health issues Some understanding of mental health issues Little understanding of mental health issues No discernible ability to recognize issues Interest In Changing Active interest in making changes Willing to change but has mild reservations Marked ambivalence to making changes Little interest in change; many preconditions Sees no reason for change Testing Ability to Control Use No intent to try using again Mild interest in trying controlled use Ambivalent about testing ability to control use Considering attempt to try controlled use Plans to try controlled use COMMITMENT SCALE 4.7. Confidence in Ability to Change Realistic confidence in ability to change Mostly confident about ability to change Some confidence about ability to change Little confidence in ability to change Lacks confidence or is unrealistically optimistic Willing to Accept Help for Change A B C Fully accepts help Mostly accepts help Ambivalent about help Little acceptance of need for help Hostile unwillingness to accept help Personal Treatment Goals Can articulate clear personal treatment goals Significant sense of personal treatment goals Some sense of personal treatment goals Little sense of personal treatment goals No personal treatment goals INTERPERSONAL SCALE Openness to Involve Family/Others Completely open (family/others positive resource) Mostly open, but some questions Ambivalent, has reservations, or no one available Refuses permission to contact; may be persuaded Hostile refusal of any involvement in treatment Willingness to Cut Ties with Negative Influences No negative influences identified Willing to distance from negative influences Ambivalence Resistant to distancing from negative influences Unable/totally unwilling to cut ties Comfort with Self-help/Support Groups Actively engaged or willing to engage Mild reservations about utilizing self-help/support Ambivalent about self-help/support Resistant to attending self-help/support groups Refuses to use self-help/support groups FOLLOW-THROUGH SCALE Follow-through on Plan for Change Excellent indication of ability to follow-through Good indication of ability to follow-through Some indication of ability to follow-through Poor indication of ability to follow-through Refuses or is unable to follow-through Follow-through & Need for Action No problems associated with follow-through Failure to follow-through could result in some prob Follow-through failure could result in moderate prob Follow-through failure likely to result in serious prob Follow-through failure poses imminent dangers

8 DAPPER-3 Dimension 5: Relapse / Continued Use / Continued Problem Potential ENGAGEMENT SCALE 5.1. Engagement in Ongoing Recovery A B C Highly willing to do whatever is necessary Moderate willingness to do whatever is necessary Ambivalent about taking necessary steps Unwilling to engage in recovery efforts Actively opposed to recovery activities Self Help Recovery Involvement High level of willingness to participate Moderate willingness to participate Ambivalent about participation Generally unwilling to participate Actively opposed to participation Engagement in Recovery Maintenance Services High level of willingness to participate Moderate willingness to participate Ambivalent about participation Generally unwilling to participate Actively opposed to participation Expectancies about Treatment Realistic and positive expectancies Positive but somewhat unrealistic expectancies Mixed expectancies about change No expectancies for positive change Negative/grossly unrealistic expectancies RISK FACTORS SCALE 5.5. Demographic Risk Factors (under 25; never married, unemployed; no H.S. diploma or GED) No demographic risk factors One or two changeable demographic risk factors One or two durable demographic risk factors Three demographic risk factors Four or more significant demographic risks Alcohol Related Risk Factors No use Episodic use (less than weekly) Regular use (once or twice a week) Frequent use (3 or more times a week) Daily intoxication Drug Related Risk Factors No use of illicit drugs Sporadic use of drugs (<1X/week), not injected Moderate use of drugs (1-3X/week), not injected Frequent use (>3X/week) and/or smoking drugs Daily use of illicit drugs and/or IV drug use Mental Health Related Risk Factors A B C No co-occurring mental health problems Acute MH problems pose minimal risks Moderately stable MH problems pose moderate risk Serious/chronic MH problems pose ongoing risk Unstable MH problems pose high risk REACTIVITY SCALE 5.9. Pharmacological Responsivity (positive reinforcement from use and/or negative withdrawal reinforcement) Negligible reinforcement Mild reinforcement Moderate reinforcement Strong reinforcement Very strong reinforcement Reactivity to Chronic Stress Non-reactive Mildly reactive Moderately reactive Strongly reactive Intensely reactive Reactivity to Acute Cues (trigger objects / situations) Non-reactive Mildly reactive Moderately reactive Strongly reactive Intensely reactive CRAVING SCALE Level of Craving Experience No cravings Infrequent cravings Intermittent cravings Frequent cravings Constant cravings Ability to Resist Cravings/Impulses Able to resist cravings/impulses Able to resist cravings/impulses for long periods Able to resist cravings/impulses for brief periods Able to resist cravings briefly only with support Unable to resist cravings

9 RELAPSE FACTORS SCALE Recognizing Relapse Triggers/Risks A B C Excellent understanding and recognition Able to recognize/understand most risks Able to recognize some relapse risks Unable to recognize/understand highest risks No discernable ability to recognize relapse risks Ability to Cope with Events/Feelings Deals effectively with negative events/feelings Some difficulty in addressing Moderate difficulty Serious problems dealing with negative events Negative events/feelings typically trigger use Relapse Prevention Skills Excellent skills Moderate ability to apply skills Inconsistent application of skills Little ability to apply skills No ability to apply skills PSYCHOLOGICAL FACTORS SCALE Cognitive Impairments Affecting Relapse Cognitive functioning intact re: relapse Mild impairment Moderate impairment Significant cognitive impairments Cognitive impairment with lack of awareness Locus of Control/Susceptibility to External Influence Behavior is self-directed Marginally affected by external influences Moderately affected by external influences Substantially affected by external influences Totally outer-directed Impulsivity A B C Deliberate no impulsivity noted Mostly non-impulsive Neither impulsive nor deliberate Somewhat impulsive Very impulsive Risk-Taking/Thrill-Seeking Not risk-taking or thrill-seeking Low level of risk-taking or thrill-seeking Moderate level of risk-taking or thrill-seeking High level of risk-taking or thrill-seeking Dangerous level of risk-taking or thrill-seeking Active vs. Passive Coping Style Demonstrates active efforts Somewhat active Neither active nor passive Somewhat passive Consistently passive MEDICATION ISSUES SCALE Adherence to Medication Requirements No medication required History of good adherence Mostly adherent Mostly not adherent Not at all adherent to medication requirements Adherence & Risks No problems associated with adherence Adherence failure could result in some prob Adherence failure could result in moderate prob Adherence failure likely to result is serious prob Adherence failure poses imminent dangers Self-Efficacy Appropriately very confident & self-determined Mostly confident Uncertain Dubious Very pessimistic or inappropriately confident

10 DAPPER-3 Dimension 6: Recovery Environment SOCIAL SCALE 6.1. Partner/Spouse A B C Very supportive Moderately supportive with some ambivalence Marginally supportive/no partner or spouse No support Negative influence oppositional/sabotaging Family/Relatives Very supportive Moderately supportive with some ambivalence Marginally supportive/no immediate support No support Negative influence oppositional/sabotaging Close Friends Very supportive Moderately supportive with some ambivalence Marginally supportive/no close friends No support Negative influence oppositional/sabotaging Extended Social Network Very supportive Moderately supportive with some ambivalence Marginally supportive/no social network No support Negative influence oppositional/sabotaging Social Skills Excellent social skills/can make friends easily Good social skills can make new sober friends Limited social skills Social skills insufficient to make friends easily Impoverished social skills/socially phobic ENVIRONMENT SCALE 6.6. Living Situation Living in a dry, drug-free home Safe, supportive in non-dry home Living alone Someone in household with SUD Unstable residence/shelter/mission/homeless Neighborhood Few liquor outlets/no overt drug dealing Alcohol & drugs readily obtainable Liquor stores and bars/drug dealers near home Bars/dealers prevalent Extensive drug dealing/solicitation Subcultural Environment... A B C Subcultural norms strongly discourage addictive use Subcultural norms discourage addictive use Subcultural norms inconsistent re: addictive use Subcultural norms encourage addictive use Subcultural norms strongly encourage addictive use Work/School Environment Very supportive of recovery Some support for recovery Neutral environment Encouraged to drink/use with co-workers/peers Peers tend to be heavy drinkers/drug users Client s Ability to Deal With Environment Excellent ability to deal with environment Can deal with the environment in most instances Assistance in coping required Frequent assistance required Serious inability to deal with environment Leisure/Recreational Activities Positive activities not associated with use Activities conducive to recovery available Activities neutral for recovery Alcohol or drugs available at some activities Leisure/recreational activities pose severe risks VICTIMIZATION RISK SCALE Abuse Victimization No risk for emotional, physical, or sexual abuse Some risk for abuse Above average risk for victimization Substantial risk for abuse in current environment Currently being abused LOGISTIC ISSUES SCALE Logistical Barriers/Obstacles to Treatment No logistic impediments Impediments readily overcome Impediments serious but resolvable Substantial impediments Extreme impediments to treatment Logistical Barriers/Obstacles to Recovery No logistic impediments Impediments readily overcome Impediments serious but resolvable Substantial impediments Extreme impediments to recovery

11 SCORES FOR SECOND SET OF RATINGS (A-2, B-2, & C-2) Dimension 1 A-2 B-2 C-2 Items : Use... Items : Intoxication... Items : Withdrawal... Items : Modifying factors... Dimension 4 A-2 B-2 C-2 Items : Understanding... Items : Commitment... Items : Interpersonal... Items : Follow-through... Dimension 2 A-2 B-2 C-2 Items : Medical severity... Items : Medical management... Items : Treatment issues... Dimension 5 A-2 B-2 C-2 Items : Engagement... Items : Risk factors... Items : Reactivity... Items : Craving... Items : Relapse factors... Items : Psych factors... Item : Medication issues... Dimension 3 A-2 B-2 C-2 Items : Violence... Items : Functioning... Items : Axis I... Items : Axis II... Item 3.17: Guilt... Dimension 6 A-2 B-2 C-2 Items : Social... Items : Environment... Item 6.12: Victimization risk... Items : Logistic issues...

12 Treatment Planning Considerations Indicate areas requiring immediate attention and/or areas of concern to be addressed. High ratings (e.g., 3-4) may suggest priorities or areas requiring greater attention. List item numbers corresponding to the areas of concern. Initial Assessment Dimension 1: Fourth Assessment Dimension 1: Dimension 2: Dimension 3: Dimension 4: Dimension 5: Dimension 6: Dimension 2: Dimension 3: Dimension 4: Dimension 5: Dimension 6: Second Assessment Dimension 1: Dimension 2: Dimension 3: Dimension 4: Dimension 5: Dimension 6: Fifth Assessment Dimension 1: Dimension 2: Dimension 3: Dimension 4: Dimension 5: Dimension 6: Third Assessment Dimension 1: Dimension 2: Dimension 3: Dimension 4: Dimension 5: Dimension 6: Sixth Assessment Dimension 1: Dimension 2: Dimension 3: Dimension 4: Dimension 5: Dimension 6: Additional Notes