PRESCHOOL EVALUATION SCALE
SCHOOL VERSION RATING FORM
Stephen B. McCarney, Ed.D.
PROFILE
SHEET
Name of student: Austin Williams
Gender: Male
Class: Tues/Thur a.m.
State: PA
Midvale
2002
Date of rating:
Date of birth:
6
28
(year)
(month)
(day)
1999
7
1
(year)
(month)
(day)
Large Muscle Skills
33
9
0.98
Small Muscle Skills
21
6
1.25
Cognitive Thinking
29
8
1.02
Expressive Language Skills
25
8
1.12
Social/Emotional
23
9
1.55
Self-Help Skills
21
8
1.07
E
R
CO N
S
K IO
C
I
U VER LE
Q
-2 OL AMP
S
PE HO E S
SC FIL
O
R
P
35
(months)
Age at rating in months:
Total Scale
Sum of
Subscale SS %ile
Rated by (observer's name): M Jackson
Dates during which observation of child occurred:
From: 09/01/2001 To: 06/28/2002
Standard
Scores
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
Large
Muscle
Skills
Small
Muscle
Skills
X
PES-2 SV 0-35
Raw Standard SS Score
Score Score
SEM
Subscales
School: Midvale Preschool
City:
SUMMARY OF SCORES
Copyright © 1992, 2010
Hawthorne Educational Services, Inc.
19
87
Quotient Confidence
SEM
Interval
3.07
68%
SUBSCALES
Cognitive
Thinking
X
X
48
Quotient
Expressive
Language
Skills
X
Social/
Emotional
X
Self-Help
Skills
X
Percentiles
>99
95
90
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
<1
Percentile
Rank
X
The Large Muscle Skills subscale assesses gross motor skills, which require movement of large
muscles (e.g., walking, throwing, crawling, climbing, etc.).
Austin scored within one standard deviation below the mean on the Large Muscle Skills subscale. The following are
primary behaviors of concern:
14.
Kicks a large ball while standing in place
15.
Independently jumps in place on toes with both feet off the ground
18.
Walks up stairs alternating feet
The Small Muscle Skills subscale assesses fine motor skills, which require use of small muscles (e.g.,
grasping, writing, cutting, stacking, etc.).
BE P
SC H ES
H AV -2
O I Q
O O U
L R IC
V S
ER O K S
SI F C CO
O O R
N N E
SA CE
M RN
PL
E
Austin scored more than one standard deviation below the mean on the Small Muscle Skills subscale. The following
are primary behaviors of concern:
28.
Can correctly complete a three-piece form board consisting of a circle, square, and triangle
29.
Imitates drawing a circular and vertical stroke after seeing a demonstration
30.
Can unscrew bottle lids approximately two inches in diameter
31.
Builds a tower of eight blocks
32.
Uses a thumb and forefinger grasp in holding a pencil, instead of using a fist
33.
Builds a tower of ten blocks
34.
Can cut a piece of paper from one side to the other with scissors
The Cognitive Thinking subscale assesses mental development including basic sensorimotor skills and
concept development.
Austin scored within one standard deviation below the mean on the Cognitive Thinking subscale. The following are
primary behaviors of concern:
46.
Points to pictures in a book when asked
48.
Points to four body parts when named
49.
Points to three pictures of common actions such as running, eating, sleeping, crying, etc.
50.
Can point to an object by its usage, such as what we eat with, sit on, ride in, etc.
51.
Points to ten pictures of common objects when asked
The Expressive Language Skills subscale assesses receptive and expressive communication skills.
Austin scored within one standard deviation below the mean on the Expressive Language Skills subscale. The
following are primary behaviors of concern:
62.
Has fifty words or more in spoken vocabulary
63.
Uses three-word sentences when communicating
64.
Can name five pictures when asked, "What is this?"
65.
Names a preferred object when asked, "Do you want the ball or the car?"
66.
Speaks intelligibly, can be understood by someone who is not familiar with him/her
The Social/Emotional subscale assesses skills related to social interactions.
Austin scored within one standard deviation below the mean on the Social/Emotional subscale. The following are
primary behaviors of concern:
77.
Is beginning associative play (e.g., actively plays with another child)
78.
Verbalizes displeasure rather than physically hurting peers
79.
Can share toys in a reciprocal fashion
The Self-Help Skills subscale assesses skills related to independent daily functioning.
Austin scored within one standard deviation below the mean on the Self-Help Skills subscale. The following are
primary behaviors of concern:
86.
Uses a spoon with minimal spilling
87.
Unzips zippers
88.
Indicates toileting needs by squatting, holding self, or verbalizing
90.
Puts on coat independently
92.
Unties and removes shoes
93.
Can independently put on shoes although they are often on incorrect feet
94.0-35 SV
Snaps
front snaps
PES
Copyright
(c) 1992 Hawthorne Educational Services, Inc.
Page 2 of 4
PRESCHOOL EVALUATION SCALE
HOME VERSION RATING FORM
Stephen B. McCarney, Ed.D.
PROFILE
SHEET
Name of student: Thomas Andrews
Gender: Male
Class:
State: PA
Midvale
Date of rating:
Date of birth:
1998
9
(year)
(month)
(day)
1996
2
13
(year)
(month)
(day)
15
Standard
Scores
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
PES-2 HV 0-35
0.75
Small Muscle Skills
21
8
0.94
Cognitive Thinking
34
12
0.92
Expressive Language Skills
28
0.98
Social/Emotional
25
11
12
Self-Help Skills
24
10
1.06
1.26
64
102
55
2.42
68%
SUBSCALES
Cognitive
Thinking
X
X
11
Sum of
Quotient Confidence
Subscale SS Percentile Quotient SEM
Interval
Dates during which observation of child occurred:
From: 02/13/1996 To: 09/15/1998
Small
Muscle
Skills
33
Total Scale
Rated by (observer's name): M. Jackson
Large
Muscle
Skills
Standard Standard
Score Score SEM
Large Muscle Skills
E
R
CO
S
K ON
C
I
U ERI LE
Q
P
V
-2
M
S
E
PE OM E SA
H FIL
O
R
P
31
(months)
Age at rating in months:
Raw
Score
Subscales
School:
City:
SUMMARY OF SCORES
X
Copyright © 2004, 2010
Hawthorne Educational Services, Inc.
Expressive
Language
Social/
Skills
Emotional
X
Self-Help
Skills
X
X
Quotients
150
145
140
135
130
125
120
115
110
105
100
95
90
85
80
75
70
65
60
55
50
Quotient
X
Percentiles
>99
95
90
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
<1
Percentile
Rank
X
The Large Muscle Skills subscale assesses gross motor skills, which require movement of large
muscles (e.g., walking, throwing, crawling, climbing, etc.).
Thomas scored within one standard deviation above the mean on the Large Muscle Skills subscale. The following are
primary behaviors of concern:
11.
Seldom falls when walking alone
15.
Independently jumps in place on toes with both feet off the ground
18.
Walks up stairs alternating feet
The Small Muscle Skills subscale assesses fine motor skills, which require use of small muscles (e.g.,
grasping, writing, cutting, stacking, etc.).
BE P
H H ESO AV 2
M I Q
E OR UI
V
ER S O CK
SI F SC
O CO O
N
R
N
SA C E
M ER
PL N
E
Thomas scored within one standard deviation below the mean on the Small Muscle Skills subscale. The following are
primary behaviors of concern:
20.
Enjoys watching his/her hands move and putting them in mouth
24.
Lines up a small object in one hand with an object in the other hand
26.
Can insert a circular block in a form board
28.
Can correctly complete a three-piece form board consisting of a circle, square, and triangle
29.
Imitates drawing a circular and vertical stroke after seeing a demonstration
30.
Can unscrew bottle lids approximately two inches in diameter
31.
Builds a tower of eight blocks
33.
Builds a tower of ten blocks
34.
Can cut a piece of paper from one side to the other with scissors
The Cognitive Thinking subscale assesses mental development including basic sensorimotor skills and
concept development.
Thomas scored within one standard deviation above the mean on the Cognitive Thinking subscale. The following are
primary behaviors of concern:
The Expressive Language Skills subscale assesses receptive and expressive communication skills.
Thomas scored within one standard deviation above the mean on the Expressive Language Skills subscale. The
following are primary behaviors of concern:
62.
Has fifty words or more in spoken vocabulary
63.
Uses three-word sentences when communicating
The Social/Emotional subscale assesses skills related to social interactions.
Thomas scored within one standard deviation above the mean on the Social/Emotional subscale. The following are
primary behaviors of concern:
74.
Predominately plays side-by-side with peers with very little interaction with them
The Self-Help Skills subscale assesses skills related to independent daily functioning.
Thomas scored at the mean on the Self-Help Skills subscale. The following are primary behaviors of concern:
84.
Independently pulls off socks
88.
Indicates toileting needs by squatting, holding self, or verbalizing
90.
Puts on coat independently
92.
Unties and removes shoes
93.
Can independently put on shoes although they are often on incorrect feet
94.
Snaps front snaps
PES 0-35 HV Copyright (c) 2004 Hawthorne Educational Services, Inc.
Page 2 of 4