06152006 DIAL-3 Name Kayla Ottman Sex Female Address 10933

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					 06/15/2006                           DIAL-3

 Name: Kayla Ottman                             Sex: Female
 Address: 10933 Marietta Dr.
 Phone: 555-1717                                Primary Language: English
 Mother: Barbara                                Father: Galvin

 Screening date: 06/14/2006                     Coordinator: David Latham
 Birth date: 05/12/2002                         School: McCormick Day School
 Age: 4-1                                       Teacher/Class: Carlia Juarez


 Developmental Indicators for the Assessment of Learning-Third Edition (DIAL-3)
 is an individually administered developmental screening test designed to
 identify young children in need of further diagnostic assessment. DIAL-3 items
 assess developmental skills that are the foundation for academic learning in
 the areas of motor, concepts, language, self-help, and social.

                                     SCORE SUMMARY
                         Decisions based on 7% (1.5 SD) cutoff

                             Scaled/Raw          Percentile
       Area                    Score                Rank               Decision
 ---------------------       ----------          ----------        ---------------
 Motor                           13                  79                  OK
 Concepts                        12                  39                  OK
 Language                         5                   3            Potential Delay
                                 --
 DIAL-3 TOTAL                    30                  29                   OK

 Self-Help Development           15                   2            Potential Delay
 Social Development              23                  14                  OK


 OVERALL SCREENING DECISION:     ____ Potential Delay         ____ OK

              Screening Decision based on: ____ DIAL-3 TOTAL            ____ Language
                                           ____ Motor                   ____ Self-Help
                                           ____ Concepts                ____ Social


 Behavioral Observations Total: 11        (Score is within the OK range, 1.5 SD
cutoff)

 Intelligibility: OK

 Refer for further follow-up vision assessment? ___ Yes             ___ No
 Refer for further follow-up hearing assessment? ___ Yes             ___ No


       ___________________________               ___________________________
                Signature                                   Title
06/15/2006                         DIAL-3 ASSIST
Name: Kayla Ottman                                 Sex: Female
Screening Date: 06/14/2006                         Age: 4-1

                             SCREENING RESULTS

Developmental Indicators for the Assessment of Learning-Third Edition
(DIAL-3) is an individually administered developmental screening test
designed to identify young children in need of further diagnostic
assessment.

On June 14, 2006, Kayla Ottman was screened with the DIAL-3. Kayla was 4
years, 1 month at the time of screening. The Parent Questionnaire was
completed by: Barbara. Kayla was screened using the English version.

In the Motor area, Kayla had a scaled score of 13 and a percentile rank
of 79. According to the 7% (1.5 SD) cutoff, her score is in the OK
range.

The Concepts area scaled score was 12, which corresponds to a percentile
rank of 39. Using a 7% (1.5 SD) cutoff, her score is in the OK range.

Kayla had a scaled score of 5 and a percentile rank of 3 in the Language
area. Her score is in the Potential Delay range according to the 7% (1.5
SD) cutoff.

Kayla's DIAL-3 Total score was in the OK range, using the 7% (1.5 SD)
cutoff. She had a scaled score total of 30, which yields a percentile
rank of 29.

Based on the responses on the Parent Questionnaire, Kayla had a
Self-Help Development raw score of 15 and a percentile rank of 2.
According to the 7% (1.5 SD) cutoff, her score is in the Potential Delay
range.

Also based on the responses on the Parent Questionnaire, Kayla had a
Social Development raw score of 23 and a percentile rank of 14.
According to the 7% (1.5 SD) cutoff, her score falls in the OK range.

Kayla exhibited age-appropriate development in Motor, Concepts and
Social. She scored in the Potential Delay range on Language and
Self-Help.

The overall screening decision for Kayla Ottman is __________________.
This decision is based on:
       _____ DIAL-3 Total
       _____ One or more area scores (specify)
               _____ Motor
               _____ Concepts
               _____ Language
               _____ Self-Help Development
               _____ Social Development
06/15/2006                         DIAL-3 ASSIST

Kayla's Behavioral Observations score was 11, which falls within the OK
range based on the 1.5 SD cutoff.

Kayla's Intelligibility was rated OK, indicating that the tester had
some difficulty understanding what Kayla said.

Refer for follow-up vision assessment?     _____ Yes      _____ No
Refer for follow-up hearing assessment?     _____ Yes      _____ No

Signature ______________________________

Title __________________________________

				
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