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By C. Keith Conners, Ph.D. Conners 3 Parent Short Form Assessment Report SAMPLE REPORT This Assessment report is intended for use by qualified assessors only, and is not to be shown or presented to the respondent or any other unqualified individuals. P.O. Box 950, North Tonawanda, NY 14120-0950 3770 Victoria Park Ave., Toronto, ON M2H 3M6

Summary of Results Response Style Analysis The Positive Impression score (raw score = 0) does not indicate an overly positive response style. The Negative Impression score (raw score = 6) indicates a possible negative response style. These scores need to be taken into consideration when interpreting results. Summary of Elevated Scores The following section summarizes areas of concern for ABC based on his parent s ratings on the Conners 3- P(S). Note that areas that are not a concern are not reported in this summary. Conners 3-P(S) Content Scales The T-scores for the following Conners 3-P(S) Content scales were very elevated (i.e., T-score 70 ), indicating many more concerns than are typically reported: Inattention (T = 88), Hyperactivity/Impulsivity (T = 90), Learning Problems (T = 75), Executive Functioning (T = 87) and Peer Relations (T = 90). The T-score for the following Conners 3-P(S) Content scale was elevated (i.e., T-score = 65 to 69), indicating more concerns than are typically reported: Defiance/Aggression (T = 65). Conners 3-P(S) Results and IDEA Scores on the Conners 3-P(S) suggest possible consideration for IDEA 2004 eligibility in the following area(s): Autism, Developmental Delay-Communication, Developmental Delay-Emotional, Developmental Delay-Social, Emotional Disturbance, Other Health Impairment and Specific Learning Disability. Cautionary Remark This Summary of Results section only provides information about areas that are a concern. Please refer to the remainder of the Assessment Report for further information regarding areas that are not elevated or could not be scored due to omitted items. Page 2

Introduction The Conners 3rd Edition Parent Short form [Conners 3 P(S)] is an assessment tool used to obtain a parent s observations about his or her child's behavior. This instrument is designed to assess Attention Deficit/Hyperactivity Disorder (ADHD) and its most common co-morbid problems in children and adolescents aged 6 to 18 years old. When used in combination with other information, results from the Conners 3 P(S) can provide valuable information to guide assessment decisions. This report provides information about the parent's assessment of the youth, how he compares to other youth, and which scales are elevated. See the Conners 3 Manual (published by MHS) for more information. This computerized report is an interpretive aid and should not be provided to parents or used as the sole criterion for clinical diagnosis or intervention. Administrators are cautioned against drawing unsupported interpretations. Combining information from this report with information gathered from other psychometric measures, interviews, observations, and review of available records will give the assessor or service provider a more comprehensive view of the youth than might be obtained from any one source. This report is based on an algorithm that produces the most common interpretations for the scores that have been obtained. Administrators should review the client s responses to specific items to ensure that these interpretations apply to the youth being described. Response Style Analysis The following section provides the parent s scores for the Positive and Negative Impression scales. Positive Impression The Positive Impression score (raw score = 0) does not indicate an overly positive response style. Negative Impression The Negative Impression score (raw score = 6) indicates a possible negative response style. Scores may present a less favorable impression than is warranted. You may wish to review the individual items used to calculate the Negative Impression score. Page 3

Conners 3 P(S) Content Scales: T-scores The following graph provides T-scores for each of the Conners 3 P(S) Content scales. Page 4

Conners 3 P(S) Content Scales: Detailed Scores The following table summarizes the results of the parent s assessment of ABC and provides general information about how he compares to the normative group. Please refer to the Conners 3 Manual for more information on the interpretation of these results. Scale Inattention Hyperactivity/ Impulsivity Learning Problems Executive Functioning Defiance/ Aggression Peer Relations Raw T-score Score 15 88 18 10 13 3 11 90 75 87 65 90 Common Characteristics of High Guideline Scorers Very Elevated Score (Many Poor concentration and attention, difficulty more concerns than are typically keeping his/her mind on work, makes reported) careless mistakes, easily distracted. Very Elevated Score (Many Moves around a lot, fidgets, restless, more concerns than are typically impulsive. reported) Very Elevated Score (Many Problems with learning and/or more concerns than are typically understanding academic material that reported) involves reading, spelling, or math skills; needs extra explanations. Very Elevated Score (Many Poor organization, loses things; difficulty more concerns than are typically getting started on projects. reported) Elevated Score (More concerns May have poor control of anger; may than are typically reported) display physically and/or verbally aggressive behaviors including bullying. Very Elevated Score (Many Difficulty with friendships, poor social more concerns than are typically connections; seems to be unaccepted by reported) group. Additional Questions The following section displays additional comments from the parent about ABC. Item Item Content Number 44 Additional concerns about your child 45 Child's strengths or skills Parent s Rating This item was omitted. This item was omitted. Page 5

Conners 3 P(S) Results and IDEA The Conners 3 P(S) provides information that may be useful to consider when determining whether a student is eligible for special education and related services under current U.S. federal statutes, such as the Individuals with Disabilities Education Improvement Act of 2004 (IDEA 2004). Elevated scores on the Conners 3 P(S) may indicate the need for special education and related services. The following table summarizes areas of IDEA 2004 eligibility that are typically listed for children and adolescents who have elevated scores on various portions of the Conners 3 P(S). Checkmarks indicate which areas of the Conners 3 P(S) were indicated or endorsed, suggesting possible consideration of IDEA 2004 eligibility in related areas. The information in this table is based on the IDEA 2004 and general interpretation/application of this federal law. Specific state and local education agencies may have specific requirements that supersede these recommendations. The assessor is encouraged to consult local policies that may impact decision making. Remember that elevated scores or even a diagnosis is not sufficient justification for IDEA 2004 eligibility. Finally, keep in mind that the IDEA 2004 clearly indicates that categorization is not required for provision of services. Please see the Conners 3 Manual for further discussion of the IDEA 2004 and its relation to the Conners 3 P(S) content. Content Areas Follow-up Possible IDEA Eligibility Category Recommended Inattention ED, LD, OHI Hyperactivity/Impulsivity DD-Emotional, ED, OHI Learning Problems LD Executive Functioning LD, OHI Defiance/Aggression DD-Emotional, ED Peer Relations Autism, DD-Communication, DD-Emotional, DD-Social, ED DD = Developmental Delay; ED = Emotional Disturbance; LD = Specific Learning Disability; OHI = Other Health Impairment. Page 6

Item Responses The parent entered the following response values for the items on the Conners 3 P(S). Response Key: 0 = In the past month, this was not true at all. It never (or seldom) happened. 1 = In the past month, this was just a little true. It happened occasionally. 2 = In the past month, this was pretty much true. It happened often (or quite a bit). 3 = In the past month, this was very much true. It happened very often (very frequently).? = Omitted Item Date printed: January 09, 2017 End of Report Page 7

Conners 3rd Edition Feedback Handout for Parent Short Form Ratings Child's Name: Child's Age: Date of Assessment: Parent's Name: Assessor's Name: ABC 7 January 09, 2017 CDE This feedback handout explains scores from parent ratings of this youth s behaviors and feelings as assessed by the Conners 3 Parent Short Form [Conners 3 P(S)]. This section of the report may be given to parents (caregivers) or to a third party upon parental consent. What is the Conners 3? The Conners 3 is a set of rating scales that are used to gather information about the behaviors and feelings of children and adolescents. These rating scales can be completed by parents, teachers, and youth. The Conners forms were developed by Dr. Conners, an expert in child and adolescent behavior, and are used all over the world to assess youth from many cultures. Research has shown that the Conners scales are reliable and valid, which means that the scores that are produced by the parent s ratings can be trusted. Why do parents complete the Conners 3? Information from parents (or guardians) about their child s behavior and feelings is extremely important, as parents generally know their child better than anyone else. Parents can describe their child s behavior in a number of different situations, including the home and community. The most common reason for using the Conners 3 scales is to better understand a youth who is having difficulty, and to determine how to help. The Conners 3 scales can also be used to make sure that treatment services are helping, or to see if the youth is improving. Sometimes the Conners 3 scales are used for a routine check, even if there is no reason to suspect the youth is struggling with a problem. If you are not sure why you were asked to complete the Conners 3, please ask the assessor listed at the top of this feedback form. How does the Conners 3 work? The parent read 43 items, and decided how well each statement described ABC, or how often ABC displayed each behavior in the past month ( Not at all/never, Seldom, Just a little true/occasionally, Pretty much true/often, Quite a bit, or Very much true/very often, Very frequently ). The parent s responses to these 43 statements were combined into several groups of items. Each group of items describes a certain type of behavior (for example, inattention, aggression). The parent s responses were compared with what is expected for 7-year-old boys. The scores for each group of items tell how similar ABC is to his peers. This information helps the assessor know if ABC is having more difficulty in a certain area than other 7-year-old boys. Results from the Conners 3 Parent Form The assessor who asked the parent to complete the Conners 3 will help explain these results and answer any questions you might have. Remember, these scores were calculated from how the parent described ABC in the past month. The parent ratings help the assessor know how ABC acts at home and in the community. The results from parent ratings on the Conners 3 should be combined with other important information, such as interviews with ABC and his parent, other test results, and observations of ABC. All of the combined information is used to determine if ABC needs help in a certain area and what kind of help is needed. As you go through the results, it is very helpful to share any additional insights that you might have, make notes, and freely discuss the results with the assessor. If the scores do not make sense to you, let the assessor know so that you can discuss other possible explanations. Page 1

The parent s responses to the 43 items were combined into groups of possible problem areas. The following table lists the main topic areas covered by the Conners 3 Parent form. These scores were compared with other 7-year-old boys. This gives you information about whether the parent described typical or levels of concern (that is, not an area of concern ) or if the parent described more concerns than for 7-year-old boys. The table also gives you a short description of the types of difficulties that are included in each possible problem area. ABC may not show all of the problems in an area; it is possible to have more concerns than even if only some of the problems are happening. Also, it is possible that a parent may describe typical or levels of concern, even when ABC is only showing some of the problems in an area. It is important to discuss these results with the assessor listed at the top of this feedback handout. This feedback handout only describes results from the Conners 3 Parent form. A checkmark in the more concerns than box does not necessarily mean that ABC has a serious problem and is in need of treatment. Conners 3 results must be combined with information from other sources and be confirmed by a qualified clinician before the conclusion is made that an actual problem exists. Inattention (good/ score) Hyperactivity/Impulsivity (good/ score) Learning Problems (good/ score) Executive Functioning (good/ score) Peer Relations (good/ score) Poor concentration and attention, difficulty keeping his/her mind on work, makes careless mistakes, easily distracted. Moves around a lot, restless, impulsive; difficulty being quiet, interrupts others. Problems with learning and/or understanding academic material that involves reading, writing, or math skills; forgets concepts. Poor organization, loses things; difficulty getting started on projects. Difficulty with friendships, poor social skills; seems to be unaccepted by group. Page 2

Defiance/Aggression (good/ score) Poor control of anger; physically and/or verbally aggressive; bullying; argumentative. Response Style Analysis Information about the rater s response style should be considered when the assessor reviews the results with you. Page 3