(Updated Sept. 16, 2012)

Background Information:  Emma is the only child born of her parents.  Her father works as an over-the-road tractor-trailer driver for UPS and her mother is a stay-at-home mother and is also involved with an arts program and a hybrid school program.  A review of ther mother’s family history indicates that she is one of 3 daughters born of her parents and she has spent most of her life residing in the Northeast Georgia area.  The mother’s family history does not appear to indicate significant mental health problems.  Emma’s paternal grandfather was described as hiving an alcohol problem.  Family relationships are generally described as being either emotionally distant or tense.  Emma reports that she has not seen one of her aunts for many years.  Emma’s maternal grandmother is in a nursing home in Monroe, Ga.  Emma reports that she has met her maternal grandmother for the first time just last summer.  A review of Emma’s father’s family is negative for the presence of significant mental health problems.  There is some report of alcohol related problems.  Her father is one of two children in the family.  The relationship between Emma’s father and his brother is described as being rather tense and distant.  Emma’s paternal grandmother resides in New Jersey and Emma reports that she last saw paternal grandmother w\she she was 3 years old.  Emma describes her relationship with her mother as being “not good,” stating that her mother was harsh and angry.  Emma reported that she felt somewhat frightened of her mother for several years.  Emma describes her relationship with her father as “normal” but somewhat estranged due to the fact that he is gone so much at work.
NOTE:  What is interesting about Emma being “frightened” of her mother and our relationship being “not good” is that up until Phill had me thrown out of our home, Emma came in my bedroom almost every night to cuddle up and talk or watch tv.  It was my usual routine to read or watch a few minutes of television before I went to bed, and Emma frequently came in and wanted to talk or just sit with me.  Often, I would mute the televisoin or put down my book because Emma wanted my attention.  Emma would get under the covers and snuggle up to me or hold my hand.  If we were watching tv, she would usually lean up against me and want me to put my arm around her.  This wasn’t an occasional thing, it was almost every night.  Often, if it wasn’t a school night and Phill was at work, Emma wanted to sleep in my bed.  Emma would complain because I got up early, but usually she would get up and go to her room and go back to sleep when I got up in the morning. 

Emma Katherine Roey

Emma Kate Roey

Information regarding Emma’s health history was collected from Emma and her mother.  Her  mother reports that Emma enjoyed normal early childhood development but at age 6 began having problems with nausea and vomiting.  Initially this was thought to be due to various viruses or immune system problems but eventually was diagnosed as being cyclic vomiting syndrome when Emma was 12 years old.  Emma continues to undergo medication therapy to help manage this syndrome.  she continues to have episodes of sever vomiting.  She missed a couple of weeks of school during her 9th grade year as a result and subsequently finished her 10th grade at home using on-line educational resources.  Emma also reports having a history of migraine headaches that started when she was 12 years old.  she reports that these headaches occur approximately 3-4 times per year.

NOTE:  There are several mistakes in this paragraph, but they are relatively minor.  Emma missed a couple of months, not weeks in 9th grade, and we withdrew her from school to finish up 9th grade at home.  This just shows that Dr. Richard Born did not listen very well.

Emma denies any history of depression, anxiety or other psychiatric condition or treatment.  She denies any history of alcohol use with the exception of drinking wine during communion services.  She denies any history of drug abuse.  She denies any tobacco use.  She denies being sexually active.  She reports that she has never really dated.

Information regarding Emma’s educational history indicates that she attended First Methodist Preschool in Winder and then attended George Walton Academy from kindergarten through the 3rd grade.   Her family apparently was not happy with her academic progress at George Walton and a decision was made for her to be home-schooled beginning in grade 4.  She then was enrolled in Jefferson City Academy for her 9th grade year but then the decision was made for her to do her 10th grade academic work on-line at home due to the vomiting problem.  The available information indicates that Emma is a very strong student, obtaining mostly As in all of her work.

Note:  I’m not sure where Dr. Richard Born got the idea that we were “not happy with her academic progress” at George Walton Academy,  or if that was something Emma said, but we were fine with George Walton.  We decided to try home schooling because of the long drive to the school, the expense, and because we had friends that homeschooled and we had looked into it and thought it might work for Emma.  Because of the long drive to school, Emma wasn’t able to participate in other activities, and her school friends were such a long distance away, so we thought homeschooling would give her more time and would allow her to make some friends closer to home.

When interviewed regarding other interests and activities, Emma reports that she enjoys music and has been involved in some sort of music instruction since she was in preschool.  She has studied piano with 5 different piano teachers and at the present time she is interim pianist at St. Mary and St. Martha’s in Hoschton.  She reports that she also enjoys reading and making jewelry.  She is currenntly enrolled in honor’s physics, Spanish II, AP History, and art composition courses.  Emma reports that after graduating high school she hopes to go on to college and is considering programs at Penn State and the University of Evansville in Indianna.  She reports that she thinks about performing medical missionary work in Haiti.

Note:  Emma did not start taking piano until she was 6 and had 3 teachers, not 5.  We quit piano for several years, (I believe grades 5-9)  because it was very difficult to get Emma to practice.  Emma started taking lessons again, I believe around the summer before she started 10th grade.)   When interviewed by Dr. Richard Born, Emma was taking Physics for the second time after withdrawing because she was failing the class in 10th grade.  It is interesting to note that Emma told her first Physics teacher that she had such a low grade because she had been dealing with being molested.  (She told this teacher this story before she told her parents.)  I now believe part of the reason Emma came up with the molestation story was because she was failing Physics and with all the drama she created about being molested, we let her drop the class so she would not have a failing grade on her record.   Emma probably should have done  fine in Physics, but she spent too much time chatting and writing letters and  e-mails with her school friends, instead of doing her schoolwork.  Once she realized she wasn’t going to be able to pull her grade up, she had to come up with a reason to get out of the class.

Our neighbor was one of the founders of Eternal Hope in Haiti, and Emma went on a misson trip with this group in 9th grade.

Behavioral Observations:  The current evaluation took place over three different appointments.  During all of her appointments Emma presented as a slender, attractive young women [sic} appearing her stated age.  She was casually-appropriately dressed with good personal hygiene.  She was alert and oriented to time, place person and situation.  She appeared mildly anxious and she exhibited mood-congruent thought that was logical an goal oriented.  Emma was fully cooperative throughout the evaluation session and appeared to apply herself fully to all of the tasks.  She was pleasant and engaging.  During the course of the first interview she became noticeably emotional, tearful, and distressed episodically when being interviewed regarding the events that occurred with her mother.  Her reasoning and judgment were grossly intact and normal.  Based upon the observations made during the evaluation it it thought that the results of the current testing can be seen as being a reasonable estimate of her true abilities and characteristics.

NOTE: At this point, Emma had been seeing 3-4 therapists or social workers a week, so she had plenty of time to work on her performance.  It’s called “rehearsal.”Unbeknownst to me, she was telling these therapists that I abused her, but funny how these incidents only took place on Tues-Thurs. when her dad was out of town because he never saw them.

Also, on the testing results below, a lot of this will be gobbly-gook to the lay person, but I’m going to go ahead and post this because I intend on making this site public once I get more up here in case someone more qualified than Dr. Born reads it and wants to give me their input on Emma’s problems.
TESTING RESULTS

Interpretation of WAIS-III Results

Emma was administered 14 subtests of the Wechsler Adult Intelligence Scale- Third Edition (WAIS-III) from which her IQ and Index scores were derived.  The Full Scale IQ is the aggregate of the Verbal and Performance scores and is usually considered to be the most representative measure of g, or global intellectual functioning.  Emma obtained a Full Scale IQ of 143, which places her intellectual functioning in the Very Superior range 138-146.  However, Emma’s unique set of thinking and reasoning abilities make her overall intellectual functioning difficult to summarize by the full Scale IQ on the WAIS-III because there are large discrepancies between the scores that compose either the Verbal scale or the Performance scale.  As a result, Emma’s performance may be more appropriately described by the separate scores contributing to the Verbal scale or the Performance scale.

Verbal and Performance Abilities

NOTE:  I am going to skip typing up all this, except to say that Emma’s Verbal IQ was in the Very Superior Range, above 99.9% of her peers.  We’d already seen Emma SATs.  Smart is not a problem.  If anyone wants more information on this part of the test, e-mail me, and I will scan it and send it to you.  One interesting note from Dr. Richard Born:

In Emma’s case, her ability to infer cause and effect in social situations is less well developed than her other nonverbal reasoning skills.  Her verbal reasoning abilities are much better developed than her nonverbal reasoning abilities.  Making sense of complex verbal information and using verbal abilities to solve novel problems are strengths for Emma.  Processing complex visual information by forming spatial images of part whole relationships and by manipulating the parts to solve novel problems without using words is a less well developed area.

NOTE:  The whole time Emma was growing up, Phill and I alway said that she didn’t get cause and effect.  If we told her not to do something, and that she would be punished if she did do what we told her not to, Emma never seemed to care and did what she wanted anyway.  Or, if we asked Emma to do something, like “clean your room and you can have a friend spend the night” if Emma didn’t feel like cleaning her room, she wouldn’t and didn’t seem to care that she lost out on doing something fun.  Instead, she blamed us and often said the reason she couldn’t have a friend spend the night was because we “were mean” or we “hated her.”  Phill and I had many discussions about how we did not understand why Emma was like this, and we talked about how, as children, if our parents had offered us a privilege, if we did our chores, etc., we would jump on it and get done whatever it was we needed to do.  Nothing seemed to matter to Emma except what she wanted at the moment.

Working Memory Abilities

Again, I’m not going to type all this out except:  She performed better than 99.0% of her peers.

Processing Speed Abilities

(Edit) Her preformance on tasks measuring processing speed is better than 47% of her peers.

Interpretation of WIAT:II Results

Reading

(Edit) Her skills in this area exceed those of approximately 84% of individuals her age.

Mathematics

(Edit) Her skills exceed those of approximately 93% of individuals her age.

Written Language

(Edit) Her skills in this area exceed those of approximately 91% of individuals her age.

Ability-Achievement Discrepancy analysis Simple Method

Emma’s achievement on th eWIAT:II was compared to that of her general cognitive ability, as estimated by her Verbal IQ score of 153 on the WAIS-III.  Word Reading is a specific area of weakness for her relative to her overall ability.  there is a noteworthy difference (38 points) between Emma’s Word Reading, subtest score (115) and her general cognitive ability, indicating performance lower than anticipated on tasks requiring her to correctly read a series of printed words.  Although lower than anticipated, Emma’s performance in this area is still in the High Average range.

Numerical Operations is a specific area of weakness for her relative to her overall ability.  There is a noteworthy difference (31 points) between Emma’s Numerical Operations subtest score (122) and her general cognitive ability, indicating lower than expected performance on tasks requiring her to add, subtract, multiply an ddivide one- to three-digit numbers, fractions, and decimals; and solve simple linear equations.  Although lower than anticipated Emma’s performance in this area is still in the Superior range.

Spelling is a specific area of weakness for her relative to her overall ability.  There is a noteworthy difference (33 points) between Emma’s Spelling subtest score (120) and her general cognitive ability, indicating lower than expected performance on tasks requiring her to correctly spell verbally presented words.  although lower than anticipated, Emma’s performance in this area is still in the superior range.

IQ Scores Summary

NOTE: These are charts showing again, that Emma is smart except for in a few areas.  I will not type them in here, but if you are interested, e-mail me and I will scan them and send them to you.

(continued in Part 3)