CONFIDENTIAL PSYCHOLOGICAL EVALUATION Name: Peter Sample

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CONFIDENTIAL PSYCHOLOGICAL EVALUATION Name: Peter Sample
CONFIDENTIAL
PSYCHOLOGICAL EVALUATION
Name:
Peter Sample
Date of Birth:
X-XX-XXX
Age:
25 years, 9 months
Testing Dates:
2-18-00, 2-25-00, 3-1-00, 3-9-00, 3-16-00, 3-22-00
Tests Given:
Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI)
Bender-Gestalt Test of Visual-Motor Integration (BGVMT)
Brown ADD Scales
Nelson-Denny Reading Test, Form H
Wechsler Adult Intelligence Scale- Third Edition (WAIS-III)
Woodcock-Johnson Psychoeducational Battery - Revised: (WJ-R)
Tests of Cognitive Abilities and Tests of Achievement:
Standard and Supplemental Batteries
REASON FOR REFERRAL
Peter Sample requested a comprehensive psychoeducational evaluation in order to
document the history and the nature of his learning difficulties and the educational
accommodations that he has been receiving since 1996. Peter is currently a third year
law student and is seeking appropriate accommodations for the California State Bar
Exam in July.
BACKGROUND INFORMATION
Peter is 25 years old and completing his third year of law school at XXXXX University.
Educational history reflects that he has always done well in reading/language arts
classes and poorly in math classes. An evaluation completed in 1996 at XXXX
revealed a math disability and visual processing deficits that may have resulted from
having meningitis as an infant. Based upon the results of that evaluation, he received
the accommodation of extended time on the LSAT exam and for exams in law school.
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Currently, Peter is working as an intern at a law office and he is reading contracts all
day long. He noted that it takes him longer to complete them than other interns and
that he makes editing errors when he pushes himself to complete the work. While
reading, he misses important information and leaves in language that conceptually
he knows doesn't belong. When he takes his time, he is more accurate. Peter's goal
is to do litigation, and he reported no difficulties in court, as oral expression and
"thinking on his feet" are strengths for him.
Peter described difficulty in maintaining his concentration. Although he is able to focus
initially, he has trouble maintaining and sustaining his concentration. Unrelated
thoughts distract him and interrupt his concentration and slow down his thinking
process. Peter wants to understand why it takes him so long to comprehend a set of
legal facts, to formulate and organize them, and "why does it take me so long to read
everything?".
Developmental/Family: Peter reported that he grew up in an intact but troubled family
and that he took on the role of holding it together at an early age. He felt that his role in
the family caused him to mature early and he developed strong abilities to cope and
to keep moving ahead. His mother was the nurturer, while his father was ill-tempered
and "macho". His father was born in the United States but grew up in XXXXX.
Peter is the elder of two brothers and his younger brother has severe learning
disabilities in the areas of fine motor skills, visual-motor perception, visual memory,
and short-term auditory memory. His younger brother also had meningitis as a child
and was hospitalized. His speech and language development were delayed and he
has problems with stuttering and he did not learn to read until he was 10 years old.
Peter's younger brother attended special education classes full time from the second
grade until he was in high school. Currently he uses the learning disabilities program
at XXXX, where he is a junior. Peter indicated that his mother completed her B.A.
degree and his father completed a graduate program in architecture. Neither of them
had any learning difficulties.
Health/Medical: Peter Sample reported that he was a breech baby delivered through
an emergency cesarean section procedure. He was full term and his mother received
adequate prenatal care throughout her pregnancy.
Peter reported that he had significant health problems as a baby, having seizures at 2
months and taking Phenobarbital. Parents consulted several specialists and, after
misdiagnosis, he was diagnosed as having meningitis at 9 months. He had
numerous bouts of pneumonia, bronchitis, and high fevers, and was always sick and
crying. By age 4, symptoms had diminished.
Peter Sample Page 3
Peter also reported a history of severe migraines beginning at age 5 and continuing
until he was approximately 13 years old. When he was 9-10 years old, he had double
vision and the headaches were occurring daily. When he was in junior high, he
recalled the headaches were so painful that he "felt like blacking out". He was treated
by a neurologist at XXXX Medical Center and the medication Inderal was prescribed
for this condition. The migraines recurred in 1997, when he entered law school, but
symptoms were less severe and he did not experience double vision or blackouts.
When they occur now, at the advice of his doctor, he rests and takes Advil.
Peter experienced high blood pressure as a youngster and needed to control his food
intake. He also has a history of weight problems, but feels that this is under control
now. He caught chicken pox with a high fever at age 16.
Educational: Peter has a history of panic attacks related to test anxiety during math
exams. In the 6th grade, he was taking a group administered standardized test and it
was here that he had his first panic attack. He needed to leave the room and parents
were called in for a conference. His second panic attack occurred in the 8th grade,
under similar circumstances, while taking a timed test in math. His third attack
occurred during an accounting exam during his 3rd year of college and his fourth
attack occurred during a criminal law exam his first semester of law school.
Peter attended kindergarten and first grade in the XXXXX School District. In the first
grade, he was reading above his grade level and went to a third grade class for
reading and language arts but was beginning to have difficulties with learning basic
math skills.
Peter was identified as a gifted student and he transferred to the XXXXX Magnet
School in 2nd grade. His struggles with math became more apparent in grades three
to five, and parents were called in numerous times for conferences regarding his
math performance. He remained at this magnet school until junior high, when he
went to a gifted/magnet program at XXXXX Junior High School. As part of this GATE
program, he enrolled in an advanced pre-algebra class, which he failed. This had
social as well as academic consequences for him, as his friends continued in the
advanced math track, but he took his math courses in a non-magnet track. He
recalled that he "fell out of the social loop" with established friends because of math
and was perceived differently as a student.
Peter recalled that, after his panic attack in 8th grade math, his math teacher allowed
him to bring math formulas into the exams so that he did not have to memorize them.
This eased his anxiety, he did not have another anxiety attack, and he scored better on
math exams.
Peter transferred to XXXXX High School at the beginning of 10th grade, and received
A's and B's in history and English courses and D's and F's in chemistry and algebra.
He failed advanced algebra trigonometry his first semester and was placed in an
intermediate class second semester. He also failed this class, as he was unable to
Peter Sample Page 4
do the homework and did not understand the math concepts at all. He took
intermediate algebra again during the first semester of 11th grade and received a "D'
grade. He recalled feeling frustrated because he received no help from the school; he
recalled going to his counselor for help but none was forthcoming.
He failed advanced algebra the second semester of 11th grade and again during the
first semester of 12 grade. By 11th grade, it had became apparent that he could not go
to the college of his choice and he became demoralized and stopped studying. He
was very involved in athletics and put all of his energy and effort into football. His
grade point average was 2.60.
Upon graduation, he was recruited to play football for several colleges but would have
had to make the team as a "walk-on" player. He did not pursue this and attended
XXXXX Community College for one year where he did well and received "B" grades in
his courses.
He transferred to XXXXX for his second year to play football and majored in political
science because it had no math requirement. For his third year, he transferred to
XXXX and described his first quarter at as being "like a boxing match where I got
knocked out the first minute". This quarter system moved too quickly for him, as both
previously attended colleges had been on a semester system. He scaled back his
course load from four to three classes and did better, again earning "B" grades.
Peter reported that he was doing well until he took an accounting class, where he
experienced another panic attack during an exam. During the exam, he realized that
only 20 minutes remained and he was "nowhere close to finishing" and he "freaked
out" over the sounds of students finishing and leaving the classroom. Directions
suddenly made no sense to him, he began hyperventilating, and he needed to leave
the room. At the urging of his mother and his best friend, who had learning
disabilities, he sought help at the Learning Disabilities Center on campus and the
director of that program screened him and recommended a full evaluation. When he
returned to Los Angeles for the summer, he went to XXXX for testing.
Based on the results of that evaluation, he was granted extended time for test-taking
at college, and was granted time-and-a-half for the Analytical section of the LSAT
exam. He earned his highest score on this section, which he attributed to having
additional time as well as being in a separate room.
Peter was accepted to law school at XXXXX University and did not initially seek out
accommodations there. Wanting to do it on his own, he reflected that this was "really
stupid" to do because he experienced another panic attack during his exam in
Criminal Law.
A review of Peter's law school transcript reflects the benefit of extended time for him. In
the first year, he was in the bottom third of his class after the first semester and in the
bottom quarter after the second semester. For the second year, he submitted his
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testing documentation and was granted time-and-a-half for all exams. Since then, he
has ranked at the top 25-30% of the class, an impressive change from his first year.
Peter noted that the normal length of time for exams is 3 hours; he was granted 4-1/2
hours which helped tremendously but he still does not fully complete exams within
that extended time period.
BEHAVIORAL OBSERVATIONS
Peter was fully oriented to his surroundings at all times. Testing was completed in six
sessions and he arrived promptly each time. He was dressed casually but
appropriately and engaged in conversation readily. He appeared to exert full effort on
all tasks presented to him and maintained attention and concentration in this one-onone testing situation. Based on all circumstances, the environmental setting, Peter's
motivation, and the testing conditions, the results of this evaluation appear to be valid
and interpretively useful.
ASSESSMENT RESULTS AND IMPRESSIONS
Cognitive Functioning: Based on the results of the WAIS-III, Peter possesses
cognitive ability that falls within the superior range (FSIQ, 92nd PR; 95% confidence
interval 117-125). This single score, however, does not accurately reflect his abilities
because of the significant variability among his test scores. There is a statistically
significant 23-point difference between Peter's very superior verbal abilities (98th PR)
and his average nonverbal abilities (68th PR). A difference this size occurred in only
4.1% of the standardization sample, indicating that it is quite unusual.
Verbal Abilities: Peter's verbal abilities are significantly more developed than his
other cognitive abilities. When his abilities are analyzed at the index score level, there
is a 15-point discrepancy between his verbal comprehension and his perceptual
organization, and between his verbal comprehension and his processing speed
abilities, which occurred in 23.1% and 32.4% of the national normative
standardization sample, respectively. Cognitive research suggests that individuals
with such disparate skill development often experience frustration and inefficiency in
the learning process.
Verbal comprehension is the ability to use language for thinking and for problem
solving and Peter's subtest scores on the verbal comprehension index fall within the
superior level. He demonstrated exceptional strength in his knowledge of social
conventions and in his ability to formulate abstract verbal concepts (Comprehension,
99th PR and Similarities, 99th PR).
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In providing oral definition to words, Peter performed at the superior level (Vocabulary,
91st PR). In his knowledge of synonyms and antonyms, Peter performed better
through oral expression than through reading (WJ-R, Oral Vocabulary, 73rd PR vs.
Reading Vocabulary, 43rd PR). His ability to use words to maintain a verbal pattern
was at the high average level (WJR, Verbal Analogies, 81st PR). He performed at a
higher level on a contextually based language comprehension task (WJR, Listening C
omprehension, 90th PR).
Auditory processing skills are evenly and well developed, with superior skills in sound
blending and in auditory closure (both at 93rd PR).
Memory Skills: Working memory is a complex memory skill that requires holding
information mentally while performing some active manipulation or calculation with it.
All of the WAIS-III memory subtests present numerical data orally and on this index,
Peter's scores ranged from average to high average range (Arithmetic, 75th PR;
Letter-Number Sequencing, 91st PR; Digit Span, 84th PR).
This is further supported by his performance on auditory memory tasks on the WJR:
Tests of Cognitive Ability. While the WAIS-III subtests assess working memory of
numerical data, the selected WJ-R subtests assess memory for language-based
tasks. Peter was strong with the meaningful information (WJ-R, Memory for
Sentences, 89th PR) and even stronger with the nonmeaningful information (WJ-R,
Memory for Words, 95th PR).
On visual/auditory learning tasks that required memory of novel information. Peter
scored at the average level (WJ-R, Memory for Names, 47th PR and Visual-Auditory
Learning, 61st PR). Memory of purely visual material wasat the average level (WJR,
Picture Recognition, 69th PR).
Attention: Peter appeared to exhibit developmentally appropriate levels of attention
and concentration throughout the evaluation. He did, however, report difficulties in
maintaining his concentration and becoming distracted by unrelated thoughts during
the evaluation, while in class, and throughout a typical day. For example, while finding
the matching numbers on a task (WJR, Visual Matching), the number 405 led him to
think, "oh, the 405 freeway", which momentarily distracted him from the timed task at
hand and slowed his pace.
To assess these symptoms further, a self-report measure was administered and his
self-ratings placed him into the "probable" range for having a diagnosable attention
disorder. These ratings alone do not provide enough documentation for diagnostic
purposes, but the symptoms reported by him reflect his functional level. With a history
of anxiety attacks, these symptoms may stem more from anxiety than from a true
neurological attention deficit disorder, but further investigation may be warranted.
Peter Sample Page 7
Nonverbal Abilities: Perceptual organization is the ability to organize visual
information and to reason and problem solve with visual data. There is quite a bit of
variability in this area, as his scores ranged from the average to the superior level.
Spatial ability is very well-developed, whether he is mentally manipulating spatial
images (WJR, Spatial Relations, 95th PR) or actively manipulating blocks to
reconstruct designs from a model (Block Design, 84th PR).
He demonstrated good fluid reasoning in solving problems using unfamiliar
information, scoring at the high average level (Matrix Reasoning, 84th). He displayed
average ability in identifying and applying logical rules to solve puzzles (WJR,
Analysis-Synthesis, 71st PR).
In identifying pictures with missing parts or with image distortion, he scored at the
high average level (WJR, Visual Closure, 76th PR) and at the average level in his
visual attention to detail (Picture Completion, 63rd PR). Visual sequencing skills were
less developed, falling at the lowest point in the average level (Picture Arrangement
25th PR).
Peter's visual strength appears to be his spatial skills, and his visual organizational
skills are adequately developed to the average level overall. There is, however,
significant weakness in his visual-motor integration skills which was apparent on two
measures, the Bender-Gestalt and the VMI. Reproductions of designs on the VMI fell
at the low average level (18th PR) and performance was similar on the
Bender-Gestalt. Peter reported that he has always gotten "flack" from teachers about
his poor handwriting, which is explained by this weak development in his visual-motor
integration skills.
Processing Speed: Processing speed is the ability to process concrete data in an
automatic, fluent manner, and, when compared to his superior verbal ability, this is a
relative weakness for Peter and comprises an intra-cognitive discrepancy. Research
suggests that when mental operations are speedy, more information can be process
ed without overloading the cognitive system. Individuals with deficient processing
speed often experience frustration and failure and need high levels of motivation and
persistence to compensate for pervasive deficits.
Peter's performance on processing speed subtests across the WAIS-III and the WJR
were consistent, with scores falling within the average range in coding abstract
symbols (Digit Symbol-Coding, 75th PR) and in identifying two matching numbers
(WJ-R, Visual Matching, 64th PR). He scored at the high average level in locating
matching symbols (WJ-R Cross Out, 82nd PR) but barely scored average on a
similar task in visually tracking and matching abstract symbols (Symbol Search,
25th PR).
Peter Sample Page 8
ACADEMIC ACHIEVEMENT: Development in academic skills was assessed in the
areas of reading, math, and written language. Scores are age-normed.
Reading: Reading skills were measured under untimed, timed, and extended time
conditions. Under the untimed conditions of the Woodcock-Johnson, Peter scored at
the very superior level in his reading skills, performing similarly in his identification of
familiar and unfamiliar words and in his comprehension of short passages
(Letter-Word ID, 98th PR and Passage Comprehension, 98th PR).
Under the timed condition of the Nelson Denny test of Reading Comprehension, he
scored at a much lower level in reading longer passages and answering multiple
choice items (19th PR). The Nelson Denny also provides norms for an extended time
condition, and the additional time aided Peter, as he improved his score to the 75th
PR. His rate of reading on the Nelson Denny was measured at the 6th percentile,
which is significantly below expected levels.
With no time imposition, Peter was clearly able to demonstrate his knowledge and
comprehension to a greater degree than even with an extended time condition. The
reading material on the Nelson Denny is at an undergraduate level; Peter's legal
reading is far more advanced and demands excessive amounts of his time for
completion.
Writing: On structured writing samples, Peter wrote sentences that maintained
parallel format in sentence construction and scored at the superior level (WJ-R,
Writing Samples 92nd PR). On a timed measure of writing very simple sentences
Peter did well, scoring at the very superior level (WJ-R, Writing Fluency, 99th PR). His
knowledge of spelling and basic language mechanics fell at the average range
(WJ-R, Dictation, 41st PR).
Math: Peter's weakest skills were in math, which has historically been his most
difficult school subject. He performed at the average level in his ability to calculate
math problems with paper and pencil, (WJR, Calculation, 30th PR) and in applied
math problems (WJR, Applied Problems, 41st PR). These scores are lower than his
score for mental math problems on the WAIS-III (Arithmetic, 75th percentile), which
are calculations with money and other practical situations. Peter reported that he had
difficulty remembering formulas and that impacted his performance on the WJR math
tasks.
SOCIAL/EMOTIONAL: No standardized assessment was completed in this area, but
Peter reported a history of anxiety that manifests specifically around math and timed
tests. Based upon interview and other background information, there are no other
emotional conditions impacting him. Socially, he has maintained close friendships
since kindergarten and he functions at a high level in his life.
Peter Sample Page 9
SUMMARY and RECOMMENDATIONS
Peter Sample is a 25-year-old third year law student who exhibits significant variability
in his cognitive abilities. Cognitive strengths are apparent in his verbal
comprehension and fluid reasoning abilities, while significant weaknesses are
evident in his processing speed and in his visual-motor integration development.
These intra-cognitive processing deficits have impacted his academic skills in the are
as of timed reading comprehension and math, which fall below levels predicted by his
superior level of verbal comprehension. Peter has compensated well and has been
successful in his academic pursuits, but it appears that he continues to be impacted
by the learning difficulties that were noted in early elementary school years but not
formally diagnosed until 1996.
With a history of meningitis in infancy, this may provide some medical explanation for
Peter's cognitive profile. His younger brother also had meningitis as an infant and has
been diagnosed as having multiple cognitive processing deficits and began attending
special education classes in the second grade. Culturally and educationally, Peter
has enjoyed enriched exposure to new information and has not suffered from any
disadvantage in these areas.
Based upon the results of this evaluation, Peter is identified under Section 504 of the
1973 Rehabilitation Act as having a handicapping condition that substantially limits
one of his major life activities, specifically, learning. Based upon this identification, he
cannot perform at his ability level without the provision of appropriate educational
accommodations that are provided by this law for handicapped individuals.
For the upcoming California State Bar Examination, Peter would benefit from the
educational accommodations that he has been receiving, including the following:
1.
Double time for all sections of the exam. This is based upon his slow rate of
reading (6th PR), the intra-cognitive discrepancy between his abilities in verbal
comprehension and his processing speed, and his lower level of reading
comprehension under timed conditions versus extended time versus untimed
conditions (19th vs. 75th vs. 98th PR). Since there is no untimed condition
offered for the State Bar exam, the maximum of double time is recommended.
2.
Separate examination room. Peter becomes distracted and anxious in an exam
when people around him appear to be finishing before him. To prevent another
panic attack, Peter would benefit from being in a separate exam room.
3.
Intervention for anxiety management. Although Peter is nearing the end of his
academic life and of being tested under timed conditions, he would benefit from
some specific interventions for anxiety management, such as learning relaxation
and breathing techniques. Hypnosis can also be very helpful for test-related
anxiety.
Peter Sample Page 10
DSM-IV Multiaxial Diagnosis
Axis I:
315.1 Mathematics Disorder
309.24 Adjustment Disorder with Anxiety, chronic test anxiety
Axis II:
V71.09 No Diagnosis
Axis III:
Meningitis, migraine headaches in childhood
Axis IV:
Demands of law school and upcoming State Bar examination
Axis V:GAF=73 (Current)
Test Giver, M.A.
Date
Peter Sample Page 11
CONFIDENTIAL TEST DATA
WECHSLER ADULT INTELLIGENCE SCALE - THIRD EDITION (WAIS-III)
Scaled
Scales
Score
Scaled score of 100 is average.
Verbal Scale Score
Performance Scale Score
Full Scale Score
130
107
121
95%
Confidence
Interval
Percentile
Classification
124-134
100-113
117-125
Very Superior
Average
Superior
98
68
92
95%
Confidence
Interval
Percentile
Classification
119-131
103-117
109-123
101-119
96
77
87
77
Superior
High Average
High Average
High Average
Scaled
Verbal Tests
Score
Scaled score of 10 is average.
Percentile
Classification
Vocabulary
14
Similarities
17
Arithmetic
12
Digit Span
13
Information
13
Comprehension
17
(Letter-Number Sequencing) 14
91
99
75
84
84
99
91
Superior
Very Superior
Average
High Average
High Average
Very Superior
High Average
Scaled
Indexes
Score
Scaled score of 100 is average.
Verbal Comprehension
Perceptual Organization
Working Memory
Processing Speed
126
111
117
111
Performance Tests
Scaled score of 10 is average.
Picture Completion
Digit Symbol-Coding
Block Design
Matrix Reasoning
Picture Arrangement
(Symbol Search)
Scaled
Score
Percentile
Classification
12
12
11
13
8
12
75
75
63
84
25
75
Average
Average
Average
High Average
Low Average
Average
Peter Sample Page 12
WOODCOCK - JOHNSON PSYCHOEDUCATIONAL BATTERY - REVISED:
TESTS OF ACHIEVEMENT
Standard
CLUSTERS
Score
Percentile Classification
Broad Reading
Letter- Word ID
Passage Comprehension
134
130
132
99
98
98
Very Superior
Very Superior
Very Superior
Basic Reading Skills
Letter-Word ID
Word Attack
131
130
133
98
98
99
Very Superior
Very Superior
Very Superior
Reading Comprehension
Reading Vocabulary
Passage Comprehension
113
97
132
80
43
98
High Average
Average
Very Superior
95
92
96
37
30
41
Average
Average
Average
Broad Written Language
Dictation
Writing Samples
106
96
121
66
41
92
Average
Average
Superior
Broad Knowledge
Science
Social Sciences
Humanities
104
100
116
99
62
50
86
47
Average
Average
High Average
Average
Standard
Score
Grade
Equivalent
%ile
Stanine Classif.
Vocabulary
Time limit norms
63
Extended time norms 70
230
233
15.4
15.9
37
41
4
5
Average
Average
Comprehension
Time limit norms
27x2=54
Extended time norms 37x2=74
212
243
13.6
18.6
19
75
3
6
Low Average
Average
6
2
Very Low
Broad Mathematics
Calculation
Applied Problems
NELSON-DENNY READING TEST - Form H
Raw
Score
Reading Rate
181
Peter Sample Page 13
WOODCOCK - JOHNSON PSYCHOEDUCATIONAL BATTERY - REVISED:
TESTS OF COGNITIVE ABILITY
Cognitive Factors
Standard
Score
Percentile
Classification
Long-Term Retrieval
Memory for Names
Visual-Auditory Learning
101
99
104
54
47
61
Average
Average
Average
Short-Term Memory
Memory for Sentences
Memory for Words
124
118
125
95
88
95
Superior
High Average
Superior
Processing Speed
Visual Matching
Cross Out
111
105
114
77
64
82
High Average
Average
High Average
Auditory Processing
Incomplete Words
Sound Blending
127
123
122
96
93
93
Superior
Superior
Superior
Visual Processing
Visual Closure
Picture Recognition
109
111
108
73
76
69
Average
High Average
Average
Comprehension/Knowledge
Picture Vocabulary
Oral Vocabulary
99
91
109
48
27
73
Average
Average
Average
Fluid Reasoning
Analysis-Synthesis
Concept Formation
108
108
106
71
71
65
Average
Average
Average
Spatial Relations
Verbal Analogies
125
113
95
81
Superior
High Average
Oral Language
Memory for Sentences
Picture Vocabulary
Oral Vocabulary
Listening Comprehension
Verbal Analogies
111
118
91
109
119
113
76
88
27
73
90
81
High Average
High Average
Average
Average
High Average
High Average
Peter Sample Page 14
WJR
Cognitive Aptitudes
Standard
Score
Percentile
Classification
Reading Aptitude
119
89
High Average
Math Aptitude
111
76
High Average
Written Language Aptitude
115
84
High Average
Knowledge Aptitude
121
92
Superior
BEERY TEST OF VISUAL-MOTOR INTEGRATION (VMI)
Mode
Standard
Score
Visual-Motor
86
Scaled
Score
7
PR
Classification
18
Low Average
BENDER-GESTALT
Angulation errors on designs A, 8,9
BROWN ATTENTION DEFICIT DISORDER SCALES
T-Score > 60 is considered significant for ADD. Peter's scores are significantly elevated in all
areas except Affect.
Cluster
T-Score
Activation
Attention
Effort
Affect
Memory
72
92
97
50
76
Total
86