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Cogmed Working Memory Training Assessment

(FOR AGES 4-17)


Please complete the assessment forms below. There are four sections to complete:

SECTION 1 - Background

SECTION 2 - School Information

SECTION 3 - Questions about Attention

SECTION 4 - Questions about other Problem Areas


SECTION 1: Background Questions

The following questions concern how your child is coping at home and at school. The point is not to make a diagnosis but rather for us to consider together whether Cogmed Working Memory Training might benefit your child.

Name of your child*

Can you start by describing your child (interests, strengths, characteristics)?

What is difficult for your child?

In what situations does your child experience difficulty?

How long have things been like this?

What is your child's view of his/her difficulties?

Has there been any previous assessment of your child?

Select an option

What tests/assessments were completed?

What conclusions were drawn from the testing?

Was intelligence (IQ or cognitive ability) tested?

Select an option

If so, what were the results?

If Working Memory was assessed, what were the results?

Does your child have a diagnosed disorder, medical condition, or developmental delay? If so, what?

Is your child taking any type of medication?

Select an option

If so, which?

Please press the submit button below, before moving on to Section 2

Click on the link below to commence SECTION 2:

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