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Psychological Evaluation Guidelines for MR/DD Services

A psychological evaluation completed by any professional who can make an independent DSM-IV-TR diagnosis is required as a part of the application process through Sedgwick County Developmental Disability Organization. Please submit a copy of your formal report, which includes the information listed below, to SCDDO. Please be sure to be as specific as possible when addressing the following questions. Your consideration of and attention to these questions is appreciated. 

1. What is this individual’s level of intellectual functioning? (Please include test(s) used, scores from each test, IQ score, etc.)

2. What is the diagnosis? (Please include Axis I, Axis II, and DSM-IV-TR codes). If the individual has a MR diagnosis, it must be listed on Axis II with the corresponding DSM-IV-TR code.

3. If the individual is age 22 or above, in your professional opinion, did a diagnosis of a developmental disorder other than MR exist prior to age 22? If so, what diagnosis?

4. Describe any functional limitations in the following areas:

   1. Self-Care

   2. Communication

   3. Learning and Adapting

   4. Mobility

   5. Self-Direction

   6. Living Independently

   7. Economic Self-Sufficiency

   8. Social Skills

   9. Health and Safety

   10. Leisure

   11. Work 

5. Does the individual have the ability to comprehend and follow directions of one, two or multiple steps?

6. In what manner does this individual best learn?

7. Would this person be susceptible to mood swings?

8. How would this person respond to criticism?

9. How effectively does this person deal with "changes?"

10. Does this person engage in any of the following behaviors:

    1. Self stimulatory/self injurious

    2. Gestural, verbal, physical aggression

    3. Non-compliant

    4. Other specific psychological concern

11. In your opinion, is this individual a threat to him/herself or others?

12. What is the long-term prognosis for this individual?

Please send report to:

Sedgwick County Developmental Disability Organization
Attn: Intake & Referral Coordinator
615 N. Main
Wichita, KS 67203

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