CBCL/1.5-5 - Syndrome Scale Scores for Boys
ID: S65432-001
Name: Kenny K. Randall
Gender: Male
Age: 30 months
Date Filled: 01/12/2000
Birth Date: 07/10/1997
Page 1 of 4
Clinician: Dr. Winter
Verified: Yes
Informant: Amy Randall
Relationship: Mother
Internalizing
100
Externalizing
C
L
I
N
I
C
A
L
95
90
85
T
80
S
C
O
R
E
75
70
65
N
O
R
M
A
L
60
55
< 50
Total Score
T Score
Emotionally
Reactive
8
Anxious/
Depressed
4
Somatic
Complaints
4
Withdrawn
Sleep Problems
10
69-B
56
62
97
73
89
Percentile
6
Attention
Problems
4
Aggressive
Behavior
9
82-C
62
57
51
>97
89
76
54
2
21.DistChange
0
10.Dependent
0
1.AchesPains
1
2.ActsYoung
0
22.NotSleepAlone
0
5.Concentrate
1
8.Can'tWait
1
46.Twitching
0
33.FeelingsHurt
1
7.ThingsOut
1
4.AvoidsEye
0
38.SleepProb
0
6.Can'tSitStill
0
15.Defiant
1
51.ShowsPanic
0
37.UpsetBySep
0
12.Constipated
2
23.NoAnswer
0
48.Nightmares
0
56.Clumsy
1
16.Demanding
0
18.DestroyOther
0
20.Disobedient
0
27.NoGuilt
2
29.Frustrated
0
35.Fights
0
40.HitsOthers
0
79.RapidShifts
1
43.LookUnhappy
0
19.Diarrhea
0
62.RefusesActive
1
64.ResistsBed
2
1
82.MoodChang
2
47.Nervous
2
24.NotEat
1
67.UnRespAffect
2
74.SleepLess
2
83.Sulks
0
68.SelfConsc
0
39.Headaches
2
70.LittleAffect
1
84.TalkInSleep
1
92.UpsetByNew
1
87.Fearful
0
45.Nausea
2
71.LittleIntrest
2
94.WakesOften
0
97.Whining
0
90.Sad
0
52.PainfulBM
1
98.Withdrawn
0
99.Worries
0
78.Stomachaches
2
42.HurtsAccident
1
86.TooNeat
0
44.AngryMoods
0
93.Vomiting
0
53.Attacks
0
58.Punishment
0
66.Screams
1
69.Selfish
1
81.Stubborn
1
85.Temper
0
88.Uncooperative
0
96.WantAttention
Copyright 2000 T. Achenbach & L. Rescorla
B = Borderline clinical range; C = Clinical range
2
59.ShiftsQuickly
95.Wanders
Broken lines = Borderline clinical range
CBCL/1.5-5 - Internalizing, Externalizing, Total Problems, & Other Problems for Boys
ID: S65432-001
Name: Kenny K. Randall
Gender: Male
Age: 30 months
Date Filled: 01/12/2000
Birth Date: 07/10/1997
Clinician: Dr. Winter
Agency: Fairview
Page 2 of 4
Informant: Amy Randall
Relationship: Mother
100
Other Problems
95
90
T
85
S
C
O
R
E
80
C
L
I
N
I
C
A
L
75
70
65
60
55
< 50
Total Score
3.AfraidOfNew
0
54.PicksSkin
1
9.ChewNonFood
0
55.SexParts
0
11.SeeksHelp
0
57.EyeProb
0
13.Cries
0
60.SkinProb
0
14.CruelAnimal
0
61.Won'tEat
0
17.DestroyOwn
1
63.RocksHead
2
25.NotGetAlong
0
65.ResistToilet
1
26.NoFun
0
72.LittleFear
1
28.OutOfHome
1
73.Shy
0
30.Jealous
0
75.SmearsBM
0
31.EatNonFood
1
76.SpeechProb
0
32.Fears
1
77.Stares
0
34.GetsHurt
1
80.StrangeBehav
0
36.GetIntoThings
0
89.Underactive
0
41.HoldsBreath
0
91.Loud
0
100.OtherProb
Internalizing Problems
Externalizing Problems
Total Problems
26
13
57
0
49.Overeating
0
50.Overtired
T Score
71-C
51
62-B
Percentile
>97
54
89
B = Borderline clinical range; C = Clinical range
Copyright 2000 T. Achenbach & L. Rescorla
ASEBA, University of Vermont
1 South Prospect St.
Burlington, VT 05401-3456
www.ASEBA.org
ADM Version 7
N
O
R
M
A
L
2
Broken lines = Borderline clinical range
Copyright 2000 T. Achenbach & L. Rescorla
CBCL/1.5-5 - DSM-Oriented Scales for Boys
ID: S65432-001
Name: Kenny K. Randall
100
Gender: Male
Age: 30 months
Date Filled: 01/12/2000
Birth Date: 07/10/1997
Page 3 of 4
Clinician: Dr. Winter
Agency: Fairview
Informant: Amy Randall
Relationship: Mother
C
L
I
N
I
C
A
L
95
90
T
S
C
O
R
E
85
80
75
70
65
N
O
R
M
A
L
60
55
< 50
Affective
Problems
7
Anxiety
Problems
5
Pervasive Developmental
Problems
18
Attention Deficit/
Hyperactivity Problems
4
Oppositional Defiant
Problems
2
T Score
70-C
57
86-C
51
50
Percentile
>97
76
>97
54
<=50
Total Score
0
13.Cries
0
10.Dependent
2
3.AfraidOfNew
0
5.Concentrate
0
15.Defiant
2
24.NotEat
0
22.NotSleepAlone
1
4.AvoidsEye
0
6.Can'tSitStill
0
20.Disobedient
0
38.SleepProb
1
28.OutOfHome
1
7.ThingsOut
1
8.Can'tWait
0
44.AngryMoods
1
43.LookUnhappy
0
32.Fears
2
21.DistChange
1
16.Demanding
1
81.Stubborn
0
49.Overeating
0
37.UpsetBySep
2
23.NoAnswer
0
36.GetIntoThings
1
85.Temper
0
50.Overtired
2
47.Nervous
2
25.NotGetAlong
2
59.ShiftsQuickly
0
88.Uncooperative
2
71.LittleIntrest
0
48.Nightmares
1
63.RocksHead
2
74.SleepLess
1
51.ShowsPanic
1
67.UnRespAffect
0
89.Underactive
1
87.Fearful
2
70.LittleAffect
0
90.Sad
0
99.Worries
1
76.SpeechProb
1
80.StrangeBehav
1
92.UpsetByNew
1
98.Withdrawn
Copyright 2000 T. Achenbach & L. Rescorla
B = Borderline clinical range; C = Clinical range
Broken lines = Borderline clinical range
CBCL/1.5-5 - Language Development Survey for Boys
ID: S65432-001
Name: Kenny K. Randall
Gender: Male
Age: 30 months
Date Filled: 01/12/2000
Birth Date: 07/10/1997
Page 4 of 4
Clinician: Dr. Winter
Agency: Fairview
Informant: Amy Randall
Relationship: Mother
I.
Born early
No
IV.
Non-English spoken
No
II.
Birth weight
7 lb 12 oz
V.
Delayed speech in family
No
3-5
VI.
Worried about development
Yes
VII.
Says words spontaneously
Yes
VIII.
Combines words
Yes
III. Ear infections
Average Length of Phrases
Vocabulary Score
3.80
260
Vocabulary Score
Vocabulary Score displayed only for ages 18-23
months, 24-29 months, and 30-35 months.
Average Length of Phrases
> 80
P
E
R
C
E
N
T
I
L
E
Average Length of Phrases displayed only
for ages 24-29 months and 30-35 months.
80
70
70
60
60
50
50
40
40
30
30
P
E
R
C
E
N
T
I
L
E
< 20
24-29 months
Percentile
> 80
80
< 20
Avg. Length
> 85
50
Scores <= 20th percentile suggest delayed phrase development.
> 85
85
80
75
70
65
60
75
70
65
60
55
50
55
50
45
45
40
35
30
25
40
35
30
25
20
20
< 15
30-35 months
3.80
85
80
< 15
18-23 months
24-29 months
30-35 months
Total Words
260
Percentile
55
Scores <= 15th percentile suggest delayed vocabulary development.
Copyright 2000 T. Achenbach & L. Rescorla