FOR CLINICIAN USE ONLY Teacher Checklist Score Report
Child¶s name Child¶s ID Child¶s age at testing
Paul Sample 0000001 15 years 9 months
Administration date Report date Clinician¶s name/ID
03/25/2020 09/25/2020 S. Jones
Teacher¶s name Length of time teacher has known the child
Mrs. Lam 4 years
Score Summary
Raw Standard Confidence Percentile Descriptive Age Growth
Scale score score interval (95%) rank range equivalent score
Physical 29 68 47 - 89 2 Delayed 5:0 to 5:5 590
Adaptive Behavior 29 68 49 - 87 2 Delayed 5:0 to 5:5 563
Social-Emotional 12 52 40 - 64 0.1 Delayed <2:0 468
Cognitive 41 98 80 - 116 45 Average 10:0 to 10:11 702
Communication 26 79 63 - 95 8 Below average 5:0 to 5:5 580
General Development Score 65 53 - 77 1 Delayed
Standard score Developmental Profile 4 Percentile
>99.9
99.9
99.6
98
91
75
50
25
2
0.4
0.1
<0.1
Physical Adaptive Social- Cognitive Communication General
Behavior Emotional Development
Score
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DP-4 Teacher Checklist Score Report Page 1 of 11
Interpretive Report
Current Functioning
Results are based upon the responses given in the DP-4 Teacher Checklist. The graph on the previous page
displays the current level of functioning in five areas of development as well as development as a whole. All
scores were obtained by comparing scores on each scale to those of peers of a similar age. When looking at
differences among scores on the five DP-4 scales, it is important to know that some variation among scores is
expected. It is normal for skills in different areas to develop at somewhat different rates. Oftentimes,
differences among scale scores represent normal development, rather than a reason for concern. The Scale
Comparisons section of this report describes any statistically significant differences between scales.
This report contains a scale-by-scale interpretation of score results, as well as comparisons of scale scores
and information regarding item analysis. Additionally, the report concludes with intervention activities for skills
measured by items that received a response of ³No,´but are below, near, or just above the expected ability
level.
General Development Score
The General Development Score represents an overall summary of development, which can be useful for
summary and eligibility purposes. The General Development Score revealed that, overall, development is
Delayed compared to other children of a similar age. Although this score presents an index of general
development, interpretation is more informatively conducted at the level of the content scales and items.
Scale Interpretation
Physical Scale
The Physical Scale includes items measuring gross- and fine-motor skills, coordination, strength, stamina, and
flexibility. Based on the information provided, the standard score on this scale fell into the Delayed range. A
score in this range indicates many difficulties in the domain of physical development. It is important to
intervene by doing further assessment and addressing the areas of greatest weakness. Seeking the
assistance of a pediatrician is also recommended. The intervention activities at the end of this report provide
starting points for working on these skills.
Adaptive Behavior Scale
The Adaptive Behavior Scale measures age-appropriate independent functioning, which includes the ability to
use current technology. On this scale, the standard score that was obtained is considered to be in the Delayed
range. This score range suggests significant difficulty in the realm of independent functioning. Additional
assessment in the area of adaptive behavior and addressing targeted areas of weakness are suggested.
Seeking the assistance of a child psychologist or psychiatrist is also recommended. The intervention activities
at the end of this report provide ways to work on skills measured by items that that received a response of
³No´
Social-Emotional Scale
The Social-Emotional Scale measures skills related to interpersonal behaviors and the demonstration of social
and emotional competence. The standard score that was obtained on this scale is in the Delayed range and
signifies skills well below the expected level of social-emotional development. There is likely a great deal of
difficulty in the expression of needs, interactions with others, and adherence to societal norms. Further
evaluation is often needed in this area, followed by remediation of weaknesses, which can begin with the
intervention activities at the end of this report. Seeking the assistance of a child psychologist or psychiatrist is
also recommended.
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DP-4 Teacher Checklist Score Report Page 2 of 11
Cognitive Scale
The Cognitive Scale measures perception, concept development, number relations, reasoning, memory,
classification, time concepts, and related mental acuity tasks. The standard score that was obtained on this
scale is in the Average range, which implies an expected level of cognitive skills.
Communication Scale
The Communication Scale score reflects the ability to understand spoken and written language as well as to
use both verbal and nonverbal skills to communicate. On the Communication Scale, the obtained standard
score is considered to be in the Below Average range, compared to peers of a similar age. This score range
on this scale denotes some difficulty with communication skills and some problems in this area of
development. Using the intervention activities at the end of this report will help address some of these
problems.
Scale Comparisons - Standard Scores
While not necessarily representing significant differences, a child¶s highest and lowest scale scores give some
indication of the areas of quickest and slowest development. The score on the Cognitive Scale was higher
than scores on the four other scales, and the lowest score was obtained on the Social-Emotional Scale.
Although a certain level of variation is expected among the scores on the five DP-4 scales, it is worth exploring
whether or not any of these differences are statistically significant.
The presence of a statistically significant score difference suggests that the higher scale is an area of relative
strength and the lower scale is one of relative weakness. Such relative abilities may provide useful information
related to the child¶s functioning. In particular, it is often helpful to build on a child¶s area of strength when
remediating an area of weakness. However, it is important to remember that although differences may be
statistically significant, the clinician must determine whether the difference has clinical relevance for referral,
diagnosis, and intervention. The following are statistically significant scale differences.
The Cognitive Scale is statistically significantly higher than the:
Physical Scale
Adaptive Behavior Scale
Social-Emotional Scale
Communication Scale
The Communication Scale is statistically significantly higher than the:
Social-Emotional Scale
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DP-4 Teacher Checklist Score Report Page 3 of 11
Item Analysis
The following items received a response of ³No´and were below the ability level for each scale. That is, based
upon overall functioning on each of the five developmental scales, the following items are those that should be
demonstrated at least some of the time. These items should be useful points of departure for remediation.
Please see the Intervention Activities section of this report for strategies designed to address specific items.
An examination of the content of the items listed below offers important insights into individual functioning.
Items that received a response of ³No´on the Physical Scale could be checked to see if they suggest a
specific physical condition, such as an orthopedic, strength, small- or large-muscle coordination, or stamina
problem. Likewise, Adaptive Behavior items can be examined to determine if parental overprotection, lack of
exposure, or limited opportunities may be playing a role. Item analysis on the Social-Emotional Scale items
can aid in understanding whether internal psychological or external situational factors seem to be problematic.
With the Cognitive Scale, it can be determined whether the items that received a response of ³No´represent
educational or intellectual problems. Finally, with the Communication Scale, an examination of items can help
to determine whether the problem areas are primarily receptive or expressive, and whether they are largely
visual or auditory in nature.
Physical
Fine Motor
P23. Does the child copy two intersecting lines to make a cross or ³X´"
P30. Does the child draw or copy a square? The square must have right-angled corners, and the sides of the
square should be of about equal length.
P31. Does the child cut out simple shapes like a circle or square, staying close to the lines (within 1/2 inch of
the lines)?
Adaptive Behavior
A27. Does the child use coping skills appropriately at least some of the time when mad or upset? For
example, taking deep breaths, walking away, or using other means to control himself or herself?
Social-Emotional
All items that were expected to receive a response of ³Yes´did so on this scale.
Cognitive
G33. Can the child relay accurate information learned about a historical figure or scientific principle (for
example, George Washington or the water cycle) at least several hours after learning it? The information must
contain at least two facts.
Communication
Expressive
M25. Can the child use negotiation and compromise to solve a conflict? For example, agreeing to trade for a
toy that another child wants.
M27. Can the child retell (in about 5 minutes) the plot of a story, play, video, or TV show? The child must be
able to tell the whole story.
End of Professional Report
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DP-4 Teacher Checklist Score Report Page 4 of 11
You may share the following recommendations with the parent(s), caregiver(s), and/or teacher(s) to help them
foster the developmental progress of the child. Intervention activities are provided for items that were expected
to receive a response of ³Yes´based upon the child¶s ability level, as well as for the first few items just above
their ability level.
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DP-4 Teacher Checklist Score Report Page 5 of 11
Intervention Activities
General Teaching Guidelines
The following suggestions are best utilized by choosing to remediate those items that the child failed
unexpectedly. That is, any skill that the child cannot do that is below his or her ability level, is an appropriate
skill to target for intervention. It is important to attempt remediation only on those items that are near the
child¶s ability; any skills far above the child¶s level may be frustrating or overwhelming for him or her to try to
learn. Furthermore, all skills should not be attempted at once²it is recommended that you work on one at
time, returning periodically to previously learned skills for the purpose of practice.
Children often learn best through play, whether it¶s pretend play for younger children or fun, game-like
environments for older ones. Adults can take advantage of this by working these activities into leisurely
activities. Demonstrating or modeling skills is often a great starting point, then having the child help you or do
the steps, can help in developing the child¶s independence with the skill. Most importantly, make sure to keep
these activities positive, fun, and supportive rather than punitive or frustrating. Providing praise and celebrating
even small accomplishments or improvements will keep the child motivated and willing to persevere, so start
with simple tasks or steps, and progress based on the child¶s readiness to keep from moving too quickly.
Physical Skills
P23. Help the child learn how to draw intersecting lines.
After spending time using crayons and markers, the child should become more skilled at controlling hand
movements and decrease ³scribbling.´Once they are successful at drawing lines, you can begin to encourage
the drawing of intersecting lines and shapes. This requires more muscle control and precision than just
drawing lines and may be frustrating for some children. You can help by drawing two parallel lines an inch or
more apart and encourage the child to draw a line between them. This technique instructs the child on the
concept of line control.
Find a time when the child is already drawing and demonstrate how to draw two intersecting lines. You can
then guide their hand in copying yours. Be aware that using fine-motor skills may be frustrating, and therefore
it may be necessary to end the teaching session and return to it later.
P30. Teach the child to draw or copy a square.
Encourage the child to imitate shapes you draw, starting with easy shapes like single lines or simple circles.
Then, very carefully, draw a square with four right-angle corners and equal sides. Describe each step: ³See, I
draw one line this way and one line that way«Now you try it.´Reward any effort so that this is a positive
experience.
P31. Teach the child how to cut out simple shapes, staying close to the lines.
Make sure the child knows how to properly hold and manipulate the scissors and paper for cutting while using
both hands (one for the scissors and one to hold the paper). It may help the child if you make the guide lines
for cutting thick, and gradually make them thinner as the child becomes more proficient. Also, begin with
straight lines and progress to shapes with straight lines (squares, rectangles) to learn how to turn while cutting.
Then move on to circles and curved lines as the child becomes better at turning the materials to follow along
the lines. Encourage the child to try to stay as close to the lines as possible (within ½ inch of the lines).
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DP-4 Teacher Checklist Score Report Page 6 of 11
P33. Help the child learn to catch a thrown tennis ball (or a ball of similar size and weight) with one
hand.
If the child is able to catch a bounced ball, encourage the child to catch the ball when thrown. Begin very close
(1 to 2 feet away), throw the ball softly, and encourage two-handed catching.
Slowly increase the distance from which you throw it, but never go so far away that the child cannot be
successful at least 50% of the time.
Once the child can catch the ball from about 6 feet away, encourage the use of just one hand to catch the ball,
again starting with very short distances.
P34. Encourage the child to type sentences or ideas on a computer.
To keep the child interested in typing, encourage them to write stories or type lyrics to familiar songs.
Thinking about what to type and typing it takes a lot of brain power, so if the child is having trouble deciding
what to type, give them something to copy initially. As the child¶s typing skills and comfort level improve, move
on to having the child type their own thoughts.
Keeping the amount of typing short and gradually increasing the length will also help. Have the child begin
with typing one or two words at a time, then add more until it becomes a sentence. Then put a few sentences
together to make a paragraph.
Adaptive Behavior Skills
A27. Teach the child how to use coping skills appropriately when mad or upset.
At a time when the child is not mad or upset, teach the child several different coping skills that can be used to
manage frustrations, such as taking deep breaths, counting to 10, walking away and taking a break, or getting
help from an adult. Practice these skills and talk about situations in which the different skills would be most
useful so the child can learn how and when to use the skills. Then when you see the child becoming mad or
upset, gently remind them of the coping skills you¶ve been practicing together and suggest a skill that might be
helpful at that time and model it (e.g., ³I see you are getting mad. Remember when we practiced taking deep
breaths to help calm ourselves? Here, take a few deep breaths with me.´Model taking deep breaths while
encouraging the child to imitate you).
It is also helpful for children to know that adults get mad or upset, too, and use coping skills. When you are
feeling this way in front of the child, tell them how you are feeling and what coping skill you are choosing to
use (e.g., ³I¶m getting frustrated with this and I am going to take a walk to help me calm down. I¶ll come back to
it when I¶m better able to think´ so the child can learn from your example.
A31. Teach the skills that will allow the child to clean up after a messy project.
These skills include cleaning up during the project, as well as afterward. Make sure the child puts away all
materials that they used, cleans the surface on which they were working, and cleans themselves.
If the child was working with a partner, encourage collaboration in their clean-up process. You can model this
by dividing up tasks, such as "I will put throw away the trash if you want to wipe down the table".
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DP-4 Teacher Checklist Score Report Page 7 of 11
A32. Teach the child how to interact with a cashier to buy something at a store.
Teach the child different scripts to use in common situations that may arise when making a purchase, such as
how to order food or how to ask about the price of something. Then practice the scripts by pretending to be a
cashier in a store or restaurant. Take turns so the child can practice the role of the cashier and the customer.
Teaching the child money skills is also helpful so that the child knows whether they have enough money to
pay for the purchase, how much money to give the cashier, and whether or not to wait for change or a receipt
when making a purchase. Practice these skills while pretending at home as well, to make the practice as close
to the real-life situation as possible. Then when you are in the real-life situation with the child, be patient and
let the child do as much of the interaction as they can independently, while gently guiding when they struggle.
For example, if the child isn¶t certain of how much money to give the cashier, remind them to round up to the
next dollar and then wait to see if the child remembers to wait for change. When the interaction is complete,
praise the child for man-aging the situation appropriately.
A33. Teach the child to recite a parent¶s phone number and their home address for use in case of an
emergency.
To help the child memorize important information like a phone number or address, create a little song with the
information and teach the child the song. For older children, you can make it a game and occasionally ³quiz´
the child to make sure they are still recalling the information correctly.
Social-Emotional Skills
S11. Encourage the child to express the desire to play with peers.
It is important for children to spend time with peers on a consistent basis. If a child does not express the desire
to play with others, you can ask who they want to play with to show that you expect the child to have that
desire. Arranging for one-on-one time with peers that the child has shown a positive response to provides a
major help for developing essential friendship skills.
You may need to help find other children the child¶s age. Teachers can often offer suggestions as to children
with whom the child is either compatible or potentially compatible.
S13. Encourage the child to seek out other children to play with.
When in situations with other children, encourage the child to approach another child who is playing with
something or on a piece of playground equipment that you know the child enjoys. You can also suggest that
the child take a preferred toy and ask another child to play together. Give the child specific language to use
and stay in close proximity to help support them. For example, if they like cars and trucks and there is another
child playing with cars and trucks, say to the child, ³Look, those cars and trucks look fun. Let¶s go ask that
child if we can play, too!´Then remind the child to say, ³Hi! Can I play with those too?´or ³I have some cars,
too. Do you want to play with me?´
S15. Encourage the child to recognize and express feelings, both their own and those of others.
Support awareness of how people feel with remarks like ³She is angry,´³I¶m afraid,´or ³You are cranky.´If
caretaking adults show that it is okay to have and talk about feelings, children will naturally imitate them and
learn this skill.
Drawing or guiding the child to circle pictures of faces that clearly display an emotion the child is currently
experiencing is a useful tool to help them identify and eventually declare current emotional states.
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DP-4 Teacher Checklist Score Report Page 8 of 11
Cognitive Skills
G33. Teach the child memory strategies to use when recalling information that was learned at an
earlier time.
Remembering information that has been taught and being able to use it later are hallmarks of learning. There
are numerous memory strategies that can help a child remember specific information, such as mnemonic
devices, poems, or songs (e.g., ROY G. BIV for the colors of the rainbow, songs that use the months of the
year). Another strategy is to relate the information the child is learning to something personal (e.g., ³Marie
Curie¶s birthday is in November, just like mine´ ³Hurricane Katrina happened the year my sister was born´
Communication Skills
M25. Teach the child how to use negotiation and compromise to solve a conflict.
As conflicts arise, teach the child words and strategies that can be used with peers to help manage the
difficulty. For example, if the child wants a toy that another child is playing with, teach the child to ask for a
turn, wait until the child is done with it, or ask if they can play with it together. This helps the child see that
there is more than one option and that it¶s possible to compromise so that both children can have a turn.
M27. Encourage the child to retell the plots of TV shows, movies, plays, and stories.
It is best to begin by asking about a performance or story that you also saw or read so that you can help. It can
make the retelling task fun if you start out telling a well-known story and leave out some essential part or detail
(like ³forgetting´to mention the baby bear in the Goldilocks story). When the child corrects you, you can ask
them to help with the storytelling. Children generally love this game of helping you tell the story ³right,´and it
warms them up for independent storytelling.
The child should be urged to recount all the major aspects of a story and not just certain exciting or interesting
details. The retelling of a half-hour TV show might be expected to take at least 5 minutes.
Help the child learn to stay organized and balanced: encourage more attention to the sequence of the plot if
they get overly involved in details; also encourage saying more about a setting or a character if they race
through a recap of only the major plot points. Storytelling improves a child¶s communication level and can be
very rewarding.
M29. Teach the child how to carry on a back-and-forth conversation about a current event or issue.
Teach the child the skills necessary for maintaining a conversation, such as turn-taking, asking questions to
keep the discussion going, and responding in open-ended ways so that the other person has something to
respond to. It is also important to explain to the child that others may have a different opinion or position with
regard to the current event, so it is important to listen to what the other person is saying and be respectful of
differences in opinion.
M30. Encourage the child to change communication style depending on the situation.
Begin by teaching the child about formal and informal communication styles and the situations in which these
styles are considered appropriate (e.g., how you talk and what you say to a teacher in school should be
different from how you talk and what you say to friends). Use examples that are concrete and easy for the
child to relate to, pulling from the child¶s personal experience as well as videos or other media that the child is
familiar with.
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DP-4 Teacher Checklist Score Report Page 9 of 11
M31. Teach the child how to give a short presentation.
Begin by teaching the child skills for organizing a presentation and creating talking notes. Help them choose a
topic and conduct the research needed to prepare the presentation. Once the information is prepared, teach
the child how to make notes to talk from so that they are not reading the presentation word for word. In
addition, teach them how to organize any visuals that will accompany the presentation, such as graphs,
PowerPoint slides, or pictures. Finally, encourage the child to practice the presentation, using a timer to make
sure the presentation fits within any time limits, if applicable.
End of Intervention Activities
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DP-4 Teacher Checklist Score Report Page 10 of 11
Summary of Responses
Child¶s name: Physical Adaptive Behavior Social-Emotional Cognitive Communication
Scale Scale Scale Scale Scale
Paul Sample
1. Y (1) 1. Y (1) 1. Y (1) 1. Y (1) 1. Y (1)
Child¶s ID: 2. Y (1) 2. Y (1) 2. Y (1) 2. Y (1) 2. Y (1)
0000001
3. Y (1) 3. Y (1) 3. Y (1) 3. Y (1) 3. Y (1)
Administration date: 4. Y (1) 4. Y (1) 4. Y (1) 4. Y (1) 4. Y (1)
03/25/2020 5. Y (1) 5. Y (1) 5. Y (1) 5. Y (1) 5. Y (1)
6. Y (1) 6. Y (1) 6. Y (1) 6. Y (1) 6. Y (1)
Child¶s age at testing:
15 years 9 months 7. Y (1) 7. Y (1) 7. Y (1) 7. Y (1) 7. Y (1)
8. Y (1) 8. Y (1) 8. Y (1) 8. Y (1) 8. Y (1)
Report date: 9. Y (1) 9. Y (1) 9. Y (1) 9. Y (1) 9. Y (1)
09/25/2020 10. Y (1) 10. Y (1) 10. Y (1) 10. Y (1) 10. Y (1)
Clinician¶s name/ID: 11. Y (1) 11. Y (1) 11. N (0) 11. Y (1) 11. Y (1)
S. Jones 12. Y (1) 12. Y (1) 12. Y (1) 12. Y (1) 12. Y (1)
13. Y (1) 13. Y (1) 13. N (0) 13. Y (1) 13. Y (1)
Teacher¶s name
14. Y (1) 14. Y (1) 14. Y (1) 14. Y (1) 14. Y (1)
Mrs. Lam
15. Y (1) 15. Y (1) 15. N (0) 15. Y (1) 15. Y (1)
Length of time teacher has 16. Y (1) 16. Y (1) 16. N (0) 16. Y (1) 16. Y (1)
known the child:
17. Y (1) 17. Y (1) 17. N (0) 17. Y (1) 17. Y (1)
4 years
18. Y (1) 18. Y (1) 18. N (0) 18. Y (1) 18. Y (1)
Form name: 19. Y (1) 19. Y (1) 19. N (0) 19. Y (1) 19. Y (1)
Teacher Checklist 20. Y (1) 20. Y (1) 20. N (0) 20. Y (1) 20. Y (1)
21. Y (1) 21. Y (1) 21. N (0) 21. Y (1) 21. Y (1)
22. Y (1) 22. Y (1) 22. N (0) 22. Y (1) 22. Y (1)
23. N (0) 23. Y (1) 23. N (0) 23. Y (1) 23. Y (1)
24. Y (1) 24. Y (1) 24. N (0) 24. Y (1) 24. Y (1)
25. Y (1) 25. Y (1) 25. N (0) 25. Y (1) 25. N (0)
26. Y (1) 26. Y (1) 26. N (0) 26. Y (1) 26. Y (1)
27. Y (1) 27. N (0) 27. N (0) 27. Y (1) 27. N (0)
28. Y (1) 28. Y (1) 28. N (0) 28. Y (1) 28. Y (1)
29. Y (1) 29. Y (1) 29. N (0) 29. Y (1) 29. N (0)
30. N (0) 30. Y (1) 30. N (0) 30. Y (1) 30. N (0)
Key:
Y = Yes 31. N (0) 31. N (0) 31. N (0) 31. Y (1) 31. N (0)
N = No 32. Y (1) 32. N (0) 32. N (0) 32. Y (1)
- = not answered 33. N (0) 33. N (0) 33. N (0) 33. N (0)
34. N (0) 34. N (0) 34. N (0) 34. Y (1)
35. N (0) 35. N (0) 35. Y (1)
36. N (0) 36. Y (1)
37. N (0) 37. Y (1)
38. N (0) 38. Y (1)
39. Y (1)
40. Y (1)
41. Y (1)
42. Y (1)
End of Report
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DP-4 Teacher Checklist Score Report Page 11 of 11 ReportID : 846743 - 9/25/2020 10:39:14 AM
