Video instructions and help with filling out and completing Where Form 5495 Assessment

Instructions and Help about Where Form 5495 Assessment

Hi Jason thank you again for coming in today now I want to ask you a few questions about your thinking and about your memory is that okay that's great okay fantastic we're going to start by if you can tell me the year the month and the day of the week it is 2012 here's July mm-hmm and the day of the week is Wednesday okay in what state and city are we we're in Milford Delaware okay and in what situation or setting our way right now we're sitting at a table answering questions okay now I'm going to read a list of words when I finish repeat them after me and I'm going to ask you to recall those words later as well I'm not concerned with the order in which you say them banana justice Sarah bridge can you repeat those banana justice Sarah bridge okay now can you see these three pictures yes I can okay tell me the name of this object it's a comb and tell me the name of this object telephone and this object keys can I look at the pictures again try to memorize them because I will ask you to recall them later okay okay now I'm going to read some letters to you every time I say the letter C I want you to tap your finger on the table only tap your finger when you hear the letter C okay C F b t Oh L see C Q a Z C B R B q WD c s b l r b c B Z X C B okay I'm going to ask you now to do some counting backward start with the number 20 and count backward 2 1 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 great now I'm going to ask you to recite the days of the week in backward order start with Sunday and tell me the days of the week in backward order Sunday Saturday Friday Thursday Wednesday Tuesday Monday fantastic ok I'm going to say some numbers when I am finished repeat them in exactly the same order as I say them two five nine seven four two nine five seven four five one seven eight nine six five one seven eight nine six now I'm going to say some more numbers this time repeat them in backwards order for example if I say one five you would say five one okay six to seven seven two six four one eight nine nine eight one four okay now I'm going to say some pairs of words the words in each pair have something in common tell me how an apple and an orange are alike they're both fruits okay tell me how a train and a boat are alike they're both modes of transportation and tell me how a book and a newspaper are alike they're both things you read okay I'm going to read you a sentence now when I'm finished repeat it exactly as I Michael married Marie's mother Michael married Marie's mother okay now I'm going to ask you to tell me as many names as you can think of I will tell you when to begin and when to stop you will have one minute to complete this task okay tell me as many girl names as you can think of and begin now Amanda Andrea Betty Barbara Carole Christine Debbie Donna Elizabeth Erika Fanny Frederica Gloria Hannah Joanne Jessica Julie Kathleen Cara Sara Samantha Rhoda Diane Velma Paula Mia Lily Tamsin Maria Marie Monica Nancy Noelle Teresa Tracy Veronica Victoria okay nice job a lot of names nice job okay I'm gonna ask you to do some counting now please count from one to ten are you ready yes and begin one two three four five six seven eight nine ten okay now I want you to say your alphabet start with the letter A and continue until you say the letter J a b c d e f g h i j okay now I would like you to say numbers and letters I will ask you to switch between numbers and letters but keeping them in proper order you would say 1 a 2 B 3 C and fourth okay start with one a and keep going until I ask you to stop begin 1 a 2 B 3 C 4 D 5 e 6 f 7 g 8 h 9i 10 J fantastic now I'm going to ask you to work through a practical problem here it is you have 25 dollars to spend at the grocery store you buy milk for three dollars you buy two apples for $1 how much money do you have left twenty one dollars okay suppose you have a one p.m. appointment with your doctor it takes 45 minutes to get there what is the latest you can leave to get there at 1:00 p.m. 12:15 okay now I'd like you to copy this design as accurately as you can you can do it in that space right there okay now in this clock I'd like you to first put in the numbers and then set the time to ten after eleven it's ten after eleven okay now I read you some words a short time ago tell me as many of the words as you can recall banana justice Sarah bridge okay now I'm going to read you a short story when I'm finished tell me as much of the story in all detail that you can remember later I will ask you to recall the story details again Carol borrowed ten dollars from her brother Jack last week she couldn't pay him back because she bought a delicious ice cream cone at the circus instead how many details can you remember um Carol borrowed ten dollars from her brother Jack