We recommend using Internet Explorer because this interactive form may not be compatible with other web browsers. This interactive form will create standard "feedback" letters for the cognitive testing portion of a CKiD participant visit. First time users should review the Instructions and Guide to Completing Feedback Letters for more detailed directions on completing this interactive form and generating the feedback letters. The name of person and email address of person generating the letter will appear at the end of the letter.

You are visiter: 2503
Date of Evaluation: mm/dd/yy
First Name of Participant:
Last Name of Participant:
Date of Birth: mm/dd/yyyy
Name of person generating letter:
Email address of person generating letter:

Select all administered tests:
(*To uncheck, please double click the radio button)
Enter scaled scores (and grade equivalent where needed):  

Scaled, T or standard

Age Equivalent


Percentile Scores:

Gross motor (enter T score) :   Gross motor < 40:
  Visual reception (enter T score) :   Visual reception < 40:
  Fine-motor (enter T score) :   Fine-motor < 40:
  Receptive language (enter T score) :   Receptive language < 40:
  Expressive language (enter T score) :   Expressive language < 40:
  Early learning composite (enter standard score) :   Early learning composite < 85:
WPPSI-IV    *Scores for < 4 year old
Receptive vocabulary (enter scaled score) :  

Receptive vocabulary < 8:

  Block design (enter scaled score) :  

Block design < 8:

   *Scores for >= 4 year old
  Vocabulary (enter scaled score) :  

Vocabulary < 8:

  Matrix reasoning (enter scaled score) :  

Matrix reasoning < 8:


Vocabulary (enter T score) :


Vocabulary < 40:


Matrix reasoning (enter T score) :


Matrix reasoning < 40:


Full-scale IQ (enter standard score) :

Full-scale IQ < 85:

NIH Toolbo (Use Age-Corrected Standard Score on the Assessment Score Report)
  Picture Vocabulary   Above Average
Below Average

  Flanker Inhibitory Control and Attention   Above Average
Below Average

  Dimensional Change Card Sort   Above Average
Below Average

  Picture Sequence Memory   Above Average
Below Average

  List Sort Working Memory (7+)   Above Average
Below Average

  Pattern Comparison Processing Speed (7+)   Above Average
Below Average

  Oral Reading Recognition (7+)   Above Average
Below Average

Please write any comments that you would like appended to the letter: