ID: Test Date: 06/06/2017 Name: John Sample Examiner Name: Tina Anderson

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California Verbal Learning Test, Third Edition (CVLT 3) CVLT 3 Standard Form Expanded Report Dean C. Delis, Joel H. Kramer, Edith Kaplan and Beth A. Ober Examinee Information Test Information Test Date: 06/06/2017 Name: Examiner Name: Tina Anderson Gender: Male Birth Date: 05/07/1986 Age at Testing: 31 years 0 months Years of Education: 16 Race/Ethnicity: American Indian/Alaska Native Handedness: Right Copyright 2017 NCS Pearson, Inc. All rights reserved. Pearson, PSI design, PsychCorp, California Verbal Learning Test, and CVLT are trademarks, in the US and/or other countries, of Pearson Education, Inc., or its affiliate(s). This report contains copyrighted material and trade secrets. The qualified licensee may excerpt portions of this output report, limited to the minimum text necessary to accurately describe their significant core conclusions, for incorporation into a written evaluation of the examinee, in accordance with their profession s citation standards, if any. No adaptations, translations, modifications, or special versions may be made of this report without prior written permission from Pearson.

06/06/2017, Page 2 Current Medications List here the medications the examinee is currently taking. This page will not print if no medications or comments are entered. Comments Comments can be used to provide information on the current course of treatment for a particular examinee and/or include notes about his or her condition.

06/06/2017, Page 3 Core Score Summary Immediate Recall Trial 1 Correct 15 19 99.9 Trial 2 Correct 11 12 75 Trial 3 Correct 13 12 75 Trial 4 Correct 10 8 25 Trial 5 Correct 11 8 25 List B Correct 14 19 99.9 Delayed Recall Short Delay Free Recall Correct 12 11 63 Short Delay Cued Recall Correct 16 16 98 Long Delay Free Recall Correct 14 12 75 Long Delay Cued Recall Correct 16 15 95 Yes/No Recognition Total Hits 15 9 37 Total False Positives 4 7 16 Recognition Discriminability (d') 2.7 8 25 Recognition Discriminability Nonparametric 90 8 25 Recall Errors Total Intrusions 57 1 0.1 Forced Choice Recognition Score Raw score Base rate Total Hits 13.0 <=2.0

06/06/2017, Page 4 Scaled Score Profile

06/06/2017, Page 5 Standard Score Summary Index Trials 1 5 Correct Sum of scaled scores Index score Percentile rank 59 110 75 Delayed Recall Correct 54 118 88 Total Recall Correct 132 120 91

06/06/2017, Page 6 Process Score Summary Immediate Recall Trial 5 Semantic Clustering (Chance Adjusted) 2 10 50 Trials 1 5 Semantic Clustering (Chance Adjusted) 1 11 63 Trials 1 5 Serial Clustering (Chance Adjusted) 0.3 10 50 Trials 1 5 % Recall Primacy 23 7 16 Trials 1 5 % Recall Middle 53 14 91 Trials 1 5 % Recall Recency 23 8 25 Trials 1 5 Recall Consistency 69 6 9 Trials 1 5 Learning Slope Analysis -0.9 1 0.1 Trials 1 2 Learning Slope Analysis -4 1 0.1 Trials 2 5 Learning Slope Analysis -0.3 5 5 Trials 1 5 Recall Discriminability 1.6 6 9 Delayed Recall Short Delay Free Recall Semantic Clustering (Chance Adjusted) 1.8 10 50 Short Delay Free Recall Discriminability 0.8 4 2 Short Delay Cued Recall Discriminability 1 5 5 Long Delay Free Recall Semantic Clustering (Chance Adjusted) 0.4 8 25 Long Delay Free Recall Discriminability 2 9 37 Long Delay Cued Recall Discriminability 1 6 9 Cued Recall Discriminability 1 6 9 Delayed Recall Discriminability 1.2 6 9 Total Recall Discriminability 1.3 5 5

06/06/2017, Page 7 Yes/No Recognition List A vs. List B Recognition Discriminability (d') 2.4 7 16 List A vs. Novel/Prototypical Recognition Discriminability (d') 3.4 11 63 List A vs. Novel/Unrelated Recognition Discriminability (d') 2.7 6 9 Response Bias -0.2 8 25 Response Bias Nonparametric 0.6 14 91 Score Raw score Base rate Total List B False Positives 3.0 18.0 List B/Shared False Positives 1.0 33.0 List B/Nonshared False Positives 2.0 10.0 Novel/Prototypical False Positives 0.0 100.0 Novel/Unrelated False Positives 1.0 6.0 Intrusion Errors Trials 1 5 15 1 0.1 Free Recall 31 1 0.1 Cued Recall 26 1 0.1 Delayed Recall 36 1 0.1 Total Novel 26 1 0.1 Total Across/Within Trial Repeated 31 1 0.1 Score Raw score Base rate Cued Recall Novel 11.0 <=2.0 Cued Recall Across/Within Trial 15.0 <=2.0 Novel Cued Recall Intrusions/Total Cued Recall Intrusions Ratio 0.4 60.8 Novel Intrusions/Total Intrusions Ratio 0.5 47.9 Note. Ratio scores are not calculated if no intrusions were made by the examinee. Use caution when interpreting ratio scores calculated with low numbers of intrusions. See the CVLT 3 Manual for guidance on interpreting ratio scores.

06/06/2017, Page 8 Repetition Errors Total Repetitions 28 3 1 Total Target Repetitions 22 4 2 Score Raw score Base rate Total Correct/Total Correct + Intrusions Ratio 0.7 <=2.0 Total Correct/Total Correct + Total Target Repetitions Ratio 0.9 47.0 Note. Ratio scores are not calculated if no intrusions or within trial repetitions were made by the examinee. Use caution when interpreting ratio scores calculated with low numbers of intrusions or within trial repetitions. See the CVLT 3 Manual for guidance on interpreting ratio scores. Other Errors Score Raw score Base rate Cued Recall Target Category Errors 3.0 <=2.0 Standard Score Score Sum of raw scores Standard score Percentile rank Total Recall Responses 211 160 >99.9 Contrast Scores Score Score 1 Score 2 Contrast scaled score List B Correct vs. Trial 1 Correct 19 19 19 Short Delay Free Recall Correct vs. Trial 5 Correct 11 8 13 Long Delay Free Recall Correct vs. Trial 5 Correct 12 8 15 Long Delay Free Recall Correct vs. Short Delay Free Recall Correct 12 11 13 Long Delay Free Recall Correct vs. Recognition Discriminability (d') Long Delay Free Recall Discriminability vs. Recognition Discriminability (d') 12 8 14 9 8 10

06/06/2017, Page 9 Forced Choice Recognition Score Raw score Base rate Number of Target Words Recalled on Immediate/Delay but Missed on Forced Choice Recognition 3.0 <=2.0 Number of Hits on Yes/No Recognition but Missed on Forced Choice Recognition 3.0 <=2.0 Intrusion Frequency Type Raw score Base rate Noncategory 4.0 <=2.0 Across-List 9.0 <=2.0 Synonym/Subordinate 11.0 <=2.0

06/06/2017, Page 10 Demographically Adjusted Core Scores Summary Immediate Recall Score Scaled score Demographically adjusted score Trial 1 Correct 19 79 Trial 2 Correct 12 57 Trial 3 Correct 12 56 Trial 4 Correct 8 43 Trial 5 Correct 8 42 List B Correct 19 77 Delayed Recall Score Scaled score Demographically adjusted score Short Delay Free Recall Correct 11 52 Short Delay Cued Recall Correct 16 68 Long Delay Free Recall Correct 12 56 Long Delay Cued Recall Correct 15 67 Yes/No Recognition Score Scaled score Demographically adjusted score Total Hits 9 46 Total False Positives 7 41 Recognition Discriminability (d') 8 43 Recall Errors Score Scaled score Demographically adjusted score Total Intrusions 1 21 Standard Score Score Standard score Demographically adjusted score Total Recall Responses 160 79

06/06/2017, Page 11 Demographically Adjusted Standard Score Summary Index Index score Demographically adjusted score Trials 1 5 Correct 110 56 Delayed Recall Correct 118 61 Total Recall Correct 120 63 End of Report