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| Kwei Chang
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| | Questions answered: 37, Questions asked: 0 Easy / 37 PRO, PRO-level points: 18 | Sample translations submitted: 2English to Chinese: Identification and Authentication using Liquid Crystal Material Markings
General field: Tech/Engineering
Detailed field: Physics | Source text - English
Identification and Authentication using Liquid Crystal Material Markings
Field of the Invention
The present invention relates to a machine readable marking for the recognition, identification and authentication of individual items. The marking is made of liquid crystal material, which is applied to a substrate by known variable information printing techniques. The marking is detectable and/or identifiable by passive detecting means, e.g. optical filters under unpolarized (ambient) light, as well as by illumination with polarized light. The marking is applied in the form of indicia, such as a one- or two-dimensional bar code, a matrix code, or the like.
Background of the Invention
“Track and Trace” systems are currently used in different fields of industry. Many industries suffer from counterfeit or diverted products, in particular in the field of mass-produced items such as beverages, perfumes, pharmaceutical drugs, cigarettes, CDs/DVDs, as well as other kind of consumables.
Counterfeiting and market diversion are facilitated if the mass products are handled on a lot base, rather than on an individual item base. Counterfeit or diverted products are in such case easily introduced into the supply chain. Producers and retailers would like to be in a position to distinguish their original products from such counterfeit or diverted (parallel imported) products at the level of the individual unit which can be sold.
The underlying technical problem has been addressed in the art through an individual marking of each sellable item introduced into the supply chain. The markings of the prior art were chosen in such a way that they were not susceptible to photocopying, i.e. preferably covert markings were used, which are not visible to the unaided eye or the photocopying machine.
A “Covert” marking, in the context of the present invention, is any marking or security element, which cannot be authenticated by the unaided eye, but which, for authentication, depends on a detecting or reading device of any kind, such as an optical filter or an electronic authentication equipment.
An “Overt” marking, in the context of the present invention, is any marking or security element, which, for authentication, does not depend on a detecting or reading device; i.e. which can be authenticated by the unaided eye.
“Color” in the context of the present invention is used to designate any spectrally selective return of light (electromagnetic radiation) from an illuminated object, be it in the visible, the infrared or in the UV range of the electromagnetic spectrum (i.e. in the whole wavelength range from 200nm to 2500nm).
The term “visible” is used to indicate that a property can be revealed by the unaided eye; “detectable” is used for a property that can be revealed by an optical instrument, though not necessarily by the unaided eye, and “invisible” is used for a property that cannot be detected by the unaided eye. In particular, the term “visible color” means a spectrally selective return of light in the wavelength range from 400nm to 700nm, which is detectable by the unaided eye.
A first type of individual markings, useful to prevent counterfeit and diversion, is disclosed in US 5,569,317, US 5,502,304, US 5,542,971 and US 5,525,798. According to these documents, a bar code is applied onto the item, using an ink which is not detectable under light of the visible spectrum (400-700nm wavelength) but which becomes visible when illuminated with light of the UV spectrum (200-380nm wavelength).
A second type of individual markings is disclosed in US 5,611,958 and US 5,766,324. According to these documents, a marking is applied onto a commercial good, using an ink which is not detectable in the visible spectrum, but which can be detected through illumination with light of the infrared spectrum (800-1600nm wavelength).
Yet another type of individual markings, applied through an ink, is disclosed in US 5,360,628 and US 6,612,494. This marking needs to be illuminated jointly with UV- and IR-light to be revealed.
Still another type of individual marking relies on inks comprising up-converting phosphors such as described in US 5,698,397.
All of the markings mentioned in the cited prior art are covert markings, which are completely invisible to the unaided human eye. The reading of such covert markings depends on a corresponding detecting or reading device, able to detect or read the marking. This can be a disadvantage at the retail center or at the point-of-sale, where an appropriate reading device may not always be available.
Overt markings comprising “optically variable” features, e.g. exhibiting viewing-angle dependent color, have been proposed in the art as authentication means for the “person in the street”. Among these are the holograms (cf. Rudolf L. van Renesse, “Optical Document Security” 2nd ed., 1998, chapter 10), the optical thin film security devices (idem, chapter 13) and the liquid crystal security devices (idem, chapter 14).
Particularly useful as security devices are the cholesteric liquid crystals. When illuminated with white light, the cholesteric liquid crystal structure reflects light of a determined color, which depends on the material in question and generally varies with the angle of observation and the device temperature. The cholesteric material itself is colorless and the observed color is only due to a physical reflection effect at the cholesteric helical structure adopted at a given temperature by the liquid crystal material. (cf. J.L Fergason, Molecular Crystals, Vol. 1, pp. 293-307 (1966)). In particular liquid crystal materials, the cholesteric liquid crystal polymers (CLCPs), the cholesteric helical structure is “frozen” in a determined state through polymerization, and thus rendered temperature-independent.
If the cholesteric liquid crystal material is applied on a dark or black background, its reflection color is highly apparent to the unaided eye, because the light transmitted by the cholesteric material is largely absorbed by the background, so that the residual backscattering from the background does not disturb the perception of the cholesteric material’s own reflection. A careful choice of the background color can thus contribute to the visibility of such an overt marking.
On a clear or white background the reflection color of the cholesteric liquid crystal material is virtually invisible due to the superposition of the cholesteric material’s own reflection with the strong backscattering from the background. The cholesteric liquid crystal material can, however, always be identified with the help of a circular polarization filter because it selectively reflects only one of the two possible circular polarized light components, in accordance with its chiral helical structure.
EP-B1-1 381 520 and EP-A1-1 681 586 refer to a birefringent marking and a method of applying the same in the form of a liquid crystal layer having a non-uniform pattern of regions of different thickness. The applied liquid crystal coating or layer may provide for a hidden image on a reflective substrate, which is invisible when viewed under unpolarized light but rendered visible under polarized light or with the help of a polarization filter.
US 5,678,863 refers to means for the identification of documents of value which include a paper or polymer region, said region having a transparent and translucent characteristic. A liquid crystal material is applied to the region to produce an optical effect, which differs when viewed in transmitted and reflected light. The liquid crystal material is in liquid form at room temperature and must be enclosed in a containing means such as microcapsules, in order to be used in a printing process such as gravure, roller, spray or ink-jet printing. The printed liquid crystal region can be in the form of a pattern, for example a bar code. The pattern can be verified by visual or machine inspection of the polarization states of the areas having left-handed and right-handed liquid crystal forms.
US 5,798,147 refers to coating compositions of polymerizable liquid crystal monomers which can be applied by conventional printing processes, such as letterpress, rotogravure, flexographic, offset, screen, and ink-jet printing. The printing inks can be used to produce markings and security inscriptions which are invisible to the human eye. The markings can be detected by their circular polarization or their angle dependent reflection color.
US 6,899,824 refers to a process for printing or coating a substrate with a multilayer of a liquid-crystalline composition and at least one non-liquid-crystalline coating. The process and the printed substrate are useful for producing a counterfeit-proof marking of articles. Preferred methods for applying such printing or coating are screen printing, planographic printing, flexograhic, and letterpress printing.
None of the markings disclosed in the prior art does, however, provide a solution to the technical problem underlying “track | Translation - Chinese
用液晶材料標記來做確認和識別
發明領域
本發明涉及到一個可用機器來讀的標記，作為識別，確認和鑒定個別項目之用。這個標記是用液晶材料做的。它是將已知的可變資訊打印技術應用到底基（substrate）之上。 這個標記可以被偵測得到，和/或可以用被動偵測方法，例如在非偏振（周圍）光下，用光學過濾器來偵測，或者用偏振光來照明。這標記采用的是郵戳形式，例如一維或二維的條碼 ，矩陣碼，或其它類似的方法。
發明背景
“跟蹤和追搠“系統目前被用在工業界的各種不同領域。很多行業受損於仿造或改造產品,特別是量產項目的領域, 如飲料、香水、藥品、香水、光盤/數位多功能光碟（ＣＤ／ＤＶＤ）、以及其它種類的消耗品。 假如量產品是基於一堆式而不是基於個別項目來處理的話，仿造或改裝的產品就很容易侵入到供應鏈。 生產商和零售商都希望把他們自己放在一種位置，能夠在可售個別單元的層次上來區分他們的原產品和偽造或改裝(平行進口)的產品。
已被學藝（art）提到的根本的技術問題是如何將引到供應鏈的每個可售項目做個別標記。 以前的學藝選擇的標記是防止照相影印,即，將標記隱蔽， 使肉眼或影印機都看不見。
一個“隱蔽”的標記,在目前發明的內容,是任何無法被肉眼辨識的標記或安全元素。 它們的辨識是依靠任何一種偵查或閱讀的裝置,如光學過濾或電子辨識裝置來完成的。
在本發明的內容,一個“公開的” 標記是不必靠偵測或閱讀的裝置來辨認的任何標記或安全元素;即可以用肉眼來辨識的標記。
目前發明內容中的“顏色”是光線（電磁波）從照明物選擇性地返回的光譜。它可以是電磁波頻譜中的可見光，紅外線或紫外線(即，從200nm到2500nm的整個波長範圍)。
“可見“一詞是用來"表明可以肉眼來看出的一種性質；“可測”是指可以用光學儀器來顯示，雖不一定能用肉眼看到，而“不可見”則是用來表示不能被肉眼偵查到的特性。特別是,“可見顏色指的是選擇性返回的光譜中，波長的範圍是從400nm 到700nm的顏色， 它能被肉眼偵測到。對防止偽造和轉移有用的第一類的個別標記是被披露於US 5,569,317， US 5,502,304, US 5,542,971 和 US 5,525,798。 根據這些文件,一個條形碼被加在項目上，這個條形碼所使用的油墨是可見光譜(400-700nm波長)測不到的,但經紫外線光譜(200-380nm波長)照射後，就變成可見。
第二種個別標記是披露於US 5，611，958和US 5，766，324. 根據這些文件,一個標記被應用到一個商品上, 使用的油墨是可見光譜下實測不到的,但經紅外光譜(800-1600nm波長)照射就變成可見。
另有一種個別標記所用的油墨是披露於US 5，360，628和 US 6，612，494 。 這個標記需要同時用紫外線和紅外線來照明才能顯示。
此外，還有一種個別標記依靠的油墨是上轉換(up-converting)的磷，例如 US 5,698,397 所述。
所有以上提到的以前學藝都屬轉換標記(, 是肉眼完全看不見的。閱讀這種轉換標記要靠相應的偵測或閱讀的裝置來偵測或閱。這對於零售中心或者是在點銷售來說，是一項缺點, 因為適當的閱讀的裝置不一定能夠找到。
公開標記(具備“光學變數 ” 的特色, 例如，展現的顏色隨觀看的角度而變。這種標記，已在學藝中被建議過，作為辨識“過街人士（person in the street）“的一種方法。包括在這其中的是全息圖（Holograms） (比較 Rudolf L. 和van Renesse的“光學文件安全"第二版,1998年,第10章)、光學薄膜安全裝置(同上,第13章)和液晶安全裝置(同上,第14章)。
特別對安全裝置有用的是氯的液晶。當照以白色光時，氯液晶結構會反射人們決定要的顏色。該顏色決定於疑問中的物質，而且通常會隨不同的觀察角度和裝置的溫度而變。氯材料本身是無色的，而觀察到的顏色完全決定於液晶材料在某一溫度下所采用的氯的螺旋結構(helical structure)之物理反射效應。(比較 L Fergason、Molecular Crystals, 第一卷, 第293-307頁(1966))。有一種特別的液晶材料、是氯液晶聚合物(CLCPs), 它的氯螺旋結構通過聚合被“凍結“ 在決定的狀態, 因而擺脫了溫度的影響。
假如這個氯液晶材料是用在黑暗的或黑色背景的話,它反射的顏色對肉眼非常明顯。 這是由於氯材料傳遞的光線大部分被背景吸收了的緣故。 因此,背景的殘余漫射就不至於幹擾到氯材料本身反射的視感。 小心選擇背景的顏色，因而會左右這種公開標記的可視性。
在清楚或白色的背景下,氯液晶材料反射的顏色實質上是看不見的。這是由於氯材料本身的反射和強烈的背景漫射重疊的緣故。不過，氯液晶材料總是能藉園極過濾器來幫助辯釋, 這是因為它會依其螺旋結構的旋光性選擇性地只反射兩個可能園偏振光的成分之一的緣故。
EP-B1-1 381 520和EP-A1-1 681 586指的是雙折射標記，和以液晶層形式來施用於標記的方法。這個液晶層在不同的厚度有不同的圖案。 加上去的液晶塗膜或塗層能在反射性的底基上造成一個陰藏的圖像。這圖像用非偏振光來看，是看不見的，但用偏振光來照射，或藉偏振過濾器的幫助，它可以轉成可見光。
US 5，678，863指的是認別重要文件的方法。 這些文件包括紙張或聚合物區域。該區域有一個透明和半透明的特性。 將液晶材料塗在這區域會產生光學效應。用穿透光和反射光來看，效應是不同的。
液晶材料在室溫是液態。它必須用一種包裝方法，比方說，微膠囊 ，圍封起來，才能用於打印過程，諸如凹版, 滾筒、噴霧或噴墨打印等等。打印出來的的液晶區域可以是一種圖案的方式，例如，一個條碼之類的。印證這個圖案的方法是用視覺或機器去檢查左手微（left-handed）和右手微(right-handed)液晶形式區域的偏振化狀態。
US 5，798，147指的是能聚合的單體（monomers）液晶的塗膜作品，它可應用在傳統印刷過程,例如凸版印刷、照相輪轉凹版, 平版印刷，屏幕, 和噴墨打印等等。 印刷的油墨可以用來產生人眼看不見的標記和安全題字。這些標記能用它們的園偏振性（园亟性）或隨角度而變的反射顏色來偵查到。
US 6，899，824指的是用多層的液體結晶組成（composition），和至少一個的非液體結晶在底基上印刷或塗層的一個過程。這個過程和印出來的底基對產生物件的防偽造標記很有用處。應用這種印刷或塗膜的首選方法是屏幕印刷，平面印刷，柔性印刷、和鉛印凸版印刷等等。
不過，以前披露的標記學藝(ART)並沒有一個對“跟蹤和追搠”應用的技術疑難提供解決方案。在該應用中，除了要能用機器來閱讀個別項目抗偽造的安全編碼之外，還需要能容易地用肉眼來辨識這些記號。
“跟蹤與追搠”的應用在學藝中並不陌生。郵政服務就是一個例子，在郵政局，每一個郵件都被做了個別記號，以便人們在傳遞鏈中做跟蹤與追搠, 例如一維-條形碼,堆疊的一維-條形碼,二維-條形碼或矩陣碼,是最常使用的標記和識別的手段。
該郵政標記沒有在辨認這方面做特別的努力。這是由於在郵件在整個傳遞鏈中，是寄郵件公司的內部操縱服務-辨認（authentication)是沒有必要的。郵政的“跟蹤和追搠“應用是只集中在郵件的確認(identification)上。
然而，在零售的應用上，辨識是至關重要的。 零售的原貨品有被仿造品或改造品掉包的潛在風險。為了這個原故，在這個應用場所的“跟蹤和追搠“要與至少一種的安全元素結合，要能證實做了記號的貨品的辯識是原先的。
以下的“安全跟蹤和追搠“ 表示的是“跟蹤和追搠“與至少一種安全元素合並應用。跟蹤和追搠能對個別項目做確認，而安全元素則對該項目的原先性（genuine）做另加的辯識。
技術問題
就 “安全跟蹤和追搠” 應用而言, 公開流通的貨品必須要個別的做標記， 作為它的辨識與身份的確認，然後對它的整個生命周期或是在某一特定期間做徹底的追蹤。比方該，為可靠性的緣故，一個標記必須要 i)有獨一編碼，以利於確認， ii) 能用機器來閱讀， iii) 能防拷貝（仿造），iv) 能用使用者的眼睛來辨識，以及 v) 用機器來辨識。有些特別的應用還進一步要求部分的標記是人眼看不見的。
發明總結
現在所發明的標記,目的是為了對一個項目或物件做安全跟蹤與追搠。它包括一個有確定光學特性的聚合液晶材料,使標記能被辨識及用機器來閱讀,同時他也能用人類的眼睛來辨識。這個標記是在一個底基（substrate ）上做成的。用的是可變資訊郵戳式的打印程序。 印出來是代表一個獨立碼的郵戳形式，供人們做確認之用。這標記可進一步作適當的編排, 使其中的一部分肉眼不可見。
目前的發明可應用各種項目或物件上, 例如，有價值的文件、紙幣、護照、身份證、駕駛執照,官方權限, 獲得文件、郵票、稅票和飄帶、運輸車機票、門票、標簽、箔、包裝、零件,和消費品等, 從而標記或是直接加在項目或物件的表面，或是間接地加在項目或物件表面的標簽上。
這聚合液晶材料最好是氯(即 扭曲向列，twisted nematic) 形式; 為某些應用，也可以使用向列雙折射（birefringent）液晶材料。
標記所用的聚合液晶材料可以是底基（substrate ）表面的液晶材料聚合物 , 或者是它的取代。是將聚合液晶的色素薄片應用在底基上的塗膜結構來做成的。
該底基可以是任何型的底基,可以是編織的或非編織的,特別是它可以是紙張, 紙板、木料、玻璃、陶瓷、金屬、塑料、紡織、皮革等; 底基可以是經過塗膜或未經塗膜, 或含有一個密封或非密封的表面。
該聚合液晶材料的標記,最好進一步包括加上安全材料,安全材料的存在可以增加對偽造的抵抗力。這些安全材料是選自以下的聚集，包括有無機發光化合物，有機發光化合物，紅外線吸收器, 磁性材料, 法醫（forensic）標記, 及它們的組合。
該安全材料可以僅僅是以一種混合物存在, 或者是按安全材料的天然性質,也可以作為液晶色素的一個共-聚合物成分,液晶前導組成（precursor composition）,或墨夾（ink binder）。特別是，包括丙烯酸（acrylic）或乙烯基（vinylic）的有機安全材料， 它們的功能很容易共同聚合(co-polymerized)入一個相應的主要聚合物。同樣可行的是, 安全材料可以被移植（grafted）, 即化學鏈接，到一個現有的聚合物鏈上。
這個代表液晶材料使用的背景的底基,可以是任何顏色; 白色背景是實現不可見標記的較好選擇, 即，觀察不到可見的顏色。一個金屬反射背景是進一步可取的選擇,特別是在一個雙折射(birefringent)液晶材料的情況。底基通常可以從反射底基，顏色底基，和透明底基群中選出。為使一個人類用戶的辨識變得容易, 液晶材料所應用的背景最好至少有一部分是對比色,如紅、綠、藍、或黑, 這些，與液晶標記結合時，可以讓人用肉眼察覺到一個可見的顏色和隨角度而改變的顏色。
這個底基,因此最好是有圖案的底基,包括至少有兩個不同顏色的表面地區。每個顏色選自白色表面區域,黑色表面區域,透明表面領域, 和它們的組合。由此可見,對有這種學藝技術的內行人來該, 攜帶液晶材料的底基表面，液晶材料的底下可以有兩個或多種顏色區域。液晶材料所在的底基表面,還可以攜帶郵戳,該郵戳可以是任何形式或顏色, 例如一種圖案,一個圖像,一個商標,一個文本,一個一維或2維的條形碼或矩陣碼等等。 該郵戳可以用任何方法的印刷或塗層來應用。
這個底基可以進一步攜帶至少一個安全元素。 元素可以選自無機發光化合物,有機發光化合物,紅外線-吸收器、磁性材料，和法醫標記，或以上的組合。安全元素可以用郵戳的形式呈現在底基表面，或被納入(嵌入)在底基的本身。
聚合液晶材料最好是以郵戳的形式呈現, 例如一個文本或代碼。比較好的郵戳可以選自一個組群，包含有一維, 堆疊一維,和二-維條形碼等。目前條形碼的符號已被 Bob Williams,披露於“Understanding Barcoding”, Pira International Ltd., 2004 (ISBN 1 85802 917 1)
目前發明的液晶標記,最好的制作做法是將液晶前導組成（precursor composition）加在底基上，使這個組成在有次序的液晶狀態下硬化。這個前導組成含有至少一個向列（nematic）液晶復合物的被動單體（monomers）或多體（oligomers）。該被動單體或多體最好有紫外線可愈合性; 在這個情況，應用的組成就被紫外線愈合了,還包含一個技術人員所熟知的光啟動（photoinitiator）系統。
有次序的液晶狀態是依賴旋光性攙雜劑（chiral dopant）的存在。沒有旋光性攙雜劑的向列液晶是排列成分子的紋理，其特點是雙折射。向列前導的知識來自歐洲的EP-A-0 216,712，EP-B-0 847 432 和US-B-658-445。
為制造氯(即 扭曲向列)液晶聚合物、該前導組成也必須包含旋光性攙雜劑。該攙雜劑可以選自isosorbides和isomannides的衍生物和它們混合物； 這是從歐洲EP-B-0 847 432,大不列顛的GB-A-330 139,和美國的US-B-658，945那兒獲知的。吾人所知的是 ，isosorbides 據知會誘致右螺旋扭曲（right helical twist）,而isomannides則誘使左螺旋扭曲(left helical twist)。
該攙雜劑在向列液晶復合物中誘使一個螺旋狀結構,其特點是一個波長為可見光量級的螺旋音調(helical pitch),導致光線在所決定波長的反射，因此有幹涉色的出現,以及有依賴角度而變化的顏色的出現。從氯液晶相反射的光線是園偏振的(非左手微即右手微),其偏振是根據氯的螺旋扭曲的旋轉方向（rotation sense）來決定的。
目前發明的標記的制作方法是將液晶的前導組成加到底基上， 然後讓這個組成在底基上硬化。硬化最好的方法是將這個組成照以紫外線輻射（UV-light）.這個輻射會誘使一個被動單體或多體的聚合化形成液晶聚合物。液晶的分子次序因而被保留了。換言之，向列或氯的紋理 被固定在被照射的當時狀態。以氯液晶材料的情況、螺旋音調（helical pitch）和因而有的光學特性,如反射的顏色和隨角度而變的顏色轉換等特性都得以保持下來。
一個在項目或物件上做標記的方法因而包含的以下的步驟：提供一個要做標記的合適項目或物件,並用可變資訊打印程序將至少一個代表一個獨特編碼郵戳形式的聚合液晶材料加到該項目或物件上。特別是,郵戳所代表的獨特代碼可能是一個加密信息（encrypted information）， 加密的方法可能包含一個對該資料加密的步驟。
前面提到的前導組成液晶可以用任何種塗膜或打印的技術加在底基上。組成最好是采用變量信息打印程序，例如雷射（激光）打印程序，或者是連續式或按需求動作的噴墨打印程序。這個變量信息打印方法允許為每一個被打了印的項目之標記做獨特編碼。
為應用激光打印，液晶聚合物的色素薄片（polymer pigment flakes）可以被納入調色劑的組成。就這一目的,液晶高分子色素粒子加入到調色劑組合的重量添加比例是從1 至 50% (1wt% to 50wt%)。這組成含有連接器樹脂，也可以是諸如電荷控制劑(charge control)或蠟之類的添加劑。
以上所說以 45 wt% 至 95 wt%,出現的的連接器樹脂包含有熱塑性塑料， 比方說，polyamides, polyolefines, polyurethanes, vinyl resins, epoxides, styrene butadiene, styrene acrylate copolymers 或 polyester resins, 玻璃轉換溫度tansition
temperature Tg)的範圍是 40C to 120C, 最好是60C 到 70C之間，平均聚合物粒的尺寸範圍在2-30痠之間，視影象印刷所要求的解析度而定。液晶聚合物顏料片可以在該樹脂夾（binder resin）的膠囊中。
另一種方法是，納入調色劑的液晶高分子色素片組成可以依比例5wt%至60wt%,加入到液體載體(liquid carriers)中，因而形成了液體發展劑（developer）。 這是技術人員所熟知的。首選的液體載體有，aliphatic碳氫化合物,alicyclic碳氫化合物 或polysiloxanes。在它們之中，石蠟溶劑 (paraffic solvents)和烷烴溶劑((isoparaffin solvents)是首選。
應用噴墨打印時，其組成也包括一個有機溶劑，為的是調整組成的粘度值，使之與選好的印刷程序相符合。這是內行人熟知的。
為應用連續噴墨打印，其組成還包括一個導電劑(鹽), 導電劑在使用的組成中必須是能溶的。內這類導電劑，如行家所知，是這種印刷過程中的技術所需。
在另一個體現，目前發明的液晶標記的產生是在底基塗上一個組成，包含有一個在適當的夾器中的液晶高分子色素片。
該液晶高分子色素片最好是氯液晶聚合物。這個氯液晶聚合物能展示在決定波長（幹涉色)的反射,也能作依角度變化的顏色轉換。內行人能在以下文件查到這種顏料色素的訊息：WO 2008/000755 A1(和有關文件), EP 1 213 338 B1; EP 0 685 749 B1; DE 199 22 158 A1; EP 0 601 483 A1; DE 44 18 490 A1; EP 0 887 398 B1, WO2006/063926, US 5,211,877, US 5,362,315, 和 US 6,423,246.
適當的夾器可以選自vinylic樹脂、丙烯酸樹脂 (acrylic resins)、苯乙烯-順丁烯二酐共聚物樹脂 (styrene-maleic anhydride copolymer resins)、 polyacetal樹脂、聚酯樹脂(polyester resins)、脂肪酸改性聚酯樹脂和它們的混合物。 夾器可能進一步選自紫外線糾正的單體和多體,比方說acrylates, vinyl ethers, epoxides 和它們的組合。
標記最好采用噴墨打印。要有可靠打印和可被接受的打印品質,噴墨裝置必須有一個足夠大的孔(噴嘴 ) 直徑。該噴嘴直徑至少應是10 倍於液晶色素聚合物片的平均直徑。比方說，該薄片直徑為25 m時, 噴嘴直徑應至少是250m。提供該特點的系統是 閥-噴墨打印機(valve-jet printer)， 一種特別形式的根據需求滴墨的噴墨打印機。
一般來該，辨識一個項目或攜帶一個按目前發明的標記的物件，其方法包括的步驟是，a)按照目前發明，提供一個項目,或攜帶一個標記的物件、b) 從至少一個光源提供至少一個有品質的光，將之照射到該項目或物件的標記上,c)從測標記的反射光來感測該標記的光學性質, d)從感測到的該標記的光學性質，來決定該項目或物件的辨認.
目前發明的標記，根據第一個方法，只需在周圍光下做簡單的視覺檢查即可。就這一目的來說,液晶材料的應用的背景必須提供足夠的光對比,讓觀察的人能看到反射的顏色和液晶材料所造成的彩色轉換。 依背景而異,一部分的標記在實質上仍然是肉眼看不見的。
在第二個方法,標記是在周圍光下，由一個被動偵查方法,例如一個光學過濾器，的幫助下來辨釋的。首選的這種消極的偵查方法是一個左手或右手園偏振（left-handed or right-handed circular polarizing ）過濾器, 或兩者並列使用（jutaposition of both）。這使得我們能根據該材料反射的光線的偏振狀態來決定氯液晶材料的螺旋調(helical pitch)的旋轉方向。或者,園偏振過濾器可以與彩色過濾器結合,來將光譜帶寬減少到液晶材料的反射譜寬,從而減少背景的影響。 一個以上的光學過濾器可聯合使用。
在第三種方法,標記的辨認是靠至少有一個偏振光源的園偏振光之助。液晶材料對不同園偏振的光反射各有不同; 因此材料的左和右螺旋音調可以用它們各自對園偏振光的不同反應來區分。用偏振光源來照明標記 , 以及觀察標記的反射光的這個程序,也可 經由彩色濾光來做。可以聯合使用多於一個的偏振光源。
第四種方法、標記的辨認是經由光電 辨認 裝置的幫助下完成的 。在第一次體現，該裝置包括至少一個光電池和一個園偏振過濾器和/或一個園偏振光源的結合。在另一個體現，該裝置包括一個電子光學相機, 諸如一個線性CCD傳感器陣列,一個二維CCD 圖像傳感器陣列,一個線性CMOS圖像傳感器陣列,或
一個二維 CMOS圖像傳感器陣列, 結合上一個園偏振過濾器和/或一個園偏振光源。或者,上述體現的園偏振過濾器或園偏振光源可以與顏色過濾器並用來選擇一個特定光譜，以增強從液晶反射的光線，和來自周遭光反射光線的對比。
園偏振過濾器一般也可由電子光學 園偏振光開關來取代。 該裝置是已知的學藝, 例如DE 102 11 310 B4, 它根據施用的電壓來選擇一個或另一個園偏振狀態。
在所有氯液晶材料情況 ，目前發明的標記是靠查證一個或更多的特征來做辨認，換言之，靠查證園偏振狀態和/或 查證從標記的隨角度改變顏色的反射光來做辨識。園偏振光源或園偏振光探測設備或兩者都可選擇用可見光、紅外線、或紫外線地區的電磁頻譜,或這些的組合來操作,視標記的光學特性而異。
目前發明的標記的確認方法是，先閱讀標記代表的郵戳，然後將郵戳擷取的資料與數據庫中的資料做關聯來完成確認。在一個具體體現,標記的郵戳所代表的訊息是加密的,並包括進一步解密資料。最好的該郵戳的讀取是用一個電子光學相機,例如CCD-或CMOS圖像傳感器陣列。
按照目前發明，確認攜帶一個標記的項目或物件，一般來該，包括以下步驟： a ) 跟據目前發明，提供一個攜帶一個標記的項目或物件, b) 用至少一個光源及至少一個有品質的光，來照明該項目或物件的標記, c)讀代表這個標記的郵戳, 獲得相應的信息.d)將從這個標記的郵戳所獲取的信息與存儲在數據庫之內的信息做關聯e)獲得這個項目和物件的身份的證實或否認。
按照目前的發明，確認（identification）攜帶一個標記的項目或物件，可以用做辨識用的同樣的閱讀裝置的配置或集合來執行。
在第一種體現，該郵戳是用1維或二維的條碼來代表。它被電子光學相機擷取的數字化圖像被用來分析，使用相應的運算法則。載於條形碼中的訊息被擷取,如果有必要,加以解密,並與存儲在一個數據庫內的信息做比較, 據此確認該項目。 也可以做的是，用補充的資料來更新數據庫,例如有關於該項目的歷史等等。相機可能是擁有自己通信能力的閱讀 裝置的一部分,也可能是通信 裝置的一部分,如移動電話。用行動電話時，訊息的擷取是由電話的內部資源執行的。 數據庫可能設在通信裝置(內置或交換內存)內, 或在外部服務器的通信網絡內。
在第二個體現，該郵戳是由一個字母代碼來表示,從數字電子相機(讀的裝置)擷取的數字化圖像被拿來做分析（使用相應的光學字體辨認(OCR)運算法則）。 條碼所載資料被擷取，來與存儲在一個數據庫內的信息做比較,據此確認該項目。也可以去更新數據庫。正如在第一種體現,數據庫可能設在閱讀裝置(內置或交換內存),或在經由通信網絡所達到的外部服務器。字母代碼可以用標準字體或者是機器能識別的特別字體來打印。 取代的方式是，字母代碼可以用視覺來閱讀，然後或是透過一個通信系統(例如 互聯網或SMS)到一個數據中心做識別，或是與項目提供的數據核對，提供的數據可能是一個標簽，一個參考記號，或者是另一個字母代碼。
目前發明的標記（由有確定光學特性的聚合液晶材料做成的），可用來對項目，物件或貨品做安全跟蹤與追搠。 這些項目，物件或貨品有一個個體化的防仿造的編碼，用來確保安全跟蹤與追搠。
將個別代碼應用到貨物或項目，需要一個變量信息印刷過程。首選的變量信息印刷過程在本發明的內容中是選自一組連續噴墨打印和按需求滴墨的噴墨打印; 這些印刷程序能夠很快地、非接觸性地將該個別代碼應用到任何一種表面。該個別代碼容許對每一個項目的爾後階段的生命周期做確認。
為了防止仿冒品攜帶該個別代碼的拷貝來與原來項目掉包，該個別代碼必須能抗假冒。防假冒可以經由特別安全材料。該安全材料有特別的物理特性，最好是光學特性； 該材料能夠constitutive或者是納入在標記中。特別安全材料可以是一個有確定光學特性的聚合液晶材料,或者是個添加劑。該添加劑可以選自一個組群的無機發光化合物，有機發光復合物，紅外線-吸收器、磁性材料,法醫標記,及它們的組合的。
可以用到目前發明的標記的項目或物件包括有：重要文件、紙幣、護照、身份證、駕駛執照,官方權限,存取文件、郵票、稅郵票和限制規(特別是對煙草制品及含酒精飲料)、交通票、門票、標簽、箔、包裝(特別是醫藥產品),和一般的零部件和消費品的標記(特別是提到責任問題)。
目前發明的標記、應用在項目、貨物或物件時，是適合對做了標記的項目，貨物或物件做 安全跟蹤與追搠。這樣一個項目或物件的安全跟蹤與追搠包含了值得註意的第一個取代的步驟的a)根據本發明的方法來將標記放到想要跟蹤的項目或物件上；以及 b)將這做了標記的項目或物件的資訊放到資料庫；以及第二取代步驟的 c)根據此處揭漏的方法來對項目或物件辨釋；以及d)根據此處揭漏的確認方法，利用先前儲存在數據庫的資料來確認該項目或物件。另外可選擇做的是，根據該項目或物件有關的新的資訊元素來更新資料庫。
應用到項目或物件的代碼代表的是數字資訊。該資訊是存在數據庫中，以便在爾後的階段湧來辨識項目或物件。該代碼可能加了密,以保護它的在從數據庫進出時所含有的資訊。該數據庫可能是一個數據庫管理系統的一部分。所有類氯的加密運算法則都是適合的,例如RSA類氯的公共- 私人鑰匙。
該數據庫可能是一個納入辨識裝置的地方數據庫。 也可能的是,它是一個與 辨識裝置 通過有線或無線連接的遠程數據庫。 當地的數據庫也可被遠程服務器定期更新。
在另一方面, 本項發明還能經由一個變量信息印刷過程來提供個別標記的應用。最好是噴墨打印,或者使用連續噴墨,或按需要滴墨（DOD）的噴墨打印或者是閥噴墨(valve-jet)印刷過程。 一般常用於空調線（conditioning lines）上和壓力印刷(printing presses)的編號和編碼的工業噴墨打印機特別適合這裏的應用。
較好的噴墨打印機是單噴嘴持續噴墨打印機(也稱光柵或多級偏轉打印機)和按需求滴墨的噴墨打印機,特別是閥-噴墨 （valve-jet）, 打印機。
提供一個完全轉換和機器可讀式的標記，可使用向列液晶材料。提供一個公開或半公開的機器可讀式標記, 則使用氯或螺旋性-單體（chiral-nematic ）液晶材料。
繪圖描述
為對目前發明有更完全的了解。可參考發明的詳細描述和所附繪圖。
圖1 紙板包裝的大要描繪,如攜帶代表標記的藥品包裝a)、 b、c)根據目前發明,在該紙包裝不同位置印刷液晶材料:
a)顯示一個在特別暗色背景的數據矩陣碼,例如一個黑色背景;
b)顯示混合色背景的下的數據矩陣碼,例如在黑暗和淺色部分;
c)顯示在白色背景下的數據矩陣碼。
圖2. 從ECC 200數據矩陣碼仆捉到的圖像。 這圖像是用紫外線愈合液晶(lc)材料塗在鍍膜的紙板上生成的：
a)在右偏振白光照明下，以黑色為背景所擷取的LC 數據矩陣碼。在CMOS 相機的前面有右偏旋的過濾器。
b)在右偏振白光照明下以黑/白色為背景所擷取的LC 數據矩陣碼。在CMOS 相機的前面有右偏旋的過濾器。
c)在右偏振白光照明下以黑/白色為背景所擷取的LC 數據矩陣碼。在CMOS 相機的前面沒有過濾器。
d)在無偏振白光照明下以黑/白色為背景所擷取的LC 數據矩陣碼。在CMOS 相機的前面沒有過濾器。
發明的詳細描述
在第一次體現,目前發明的標記是一個液晶前導物質， 它是在液體狀態塗在底基的表面，接著用紫外線或者是電子束照耀下聚集成有次序的液晶狀態。 這是內行人所知的技術。
應用在這一個體現的液晶材料因而是單體或二前導的液晶聚合物。 該前導成員包含至少一個向列（nematic）單體液晶單體多體液晶,該單體或多體液晶有可聚的（polymerizable）群體。 適當的向列液晶單體或多體是來自bisacrylates組，比方說，苯甲酸（benzoic acid） 4-[4-[(1-oxo-2-propenyl)oxy] butoxy]-1,4-phenylene ester,
苯甲酸 4-[4-[(1-oxo-2-propenyl)oxy] butoxy]-, 2-methyl-1,4-phenylene ester,
苯甲酸 4-[4-[(1-oxo-2-propenyl)oxy] hexoxy]-, 2-methyl-1,4-phenylene ester,
苯甲酸 4-[4-[(1-oxo-2-propenyl)oxy] butoxycarboxy]-1,4-phenylene ester,
benzoic acid 4-[4-[(1-oxo-2-propenyl)oxy] butoxycarboxy]-, 2-methyl-1,4-phenylene ester, 以及從中的組合.
向列液晶單體或多體可以存在於前導物質的重量比例是從10%至100%。
在由紫外線輻射做療合的情況，前導物質包括至少一個光啟動（photoinitiator）系統, 包含一個光啟動以及一個可選的穩定器。適當的光啟動可以選自irgacure 組(例如 irgacure 369,651,907或1300),genomer(例如 BP/EPD)或其他的激進誘導物。
適當的穩定劑是由kromachem供應的Florstab UV-1 ，或者是Rahn供應的 Genorad 16 。
Photoinitiator在前導物質存在的按重量的比例範圍是0.5%至5%。為獲得氯(即 扭曲向列)項,該前導進一步包括至少一個旋光攙雜劑 (chiral dopant)（旋光誘導器）。 適當的旋光攙雜劑包括 isomannide和isosorbide的衍生物 ,例如
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxyethoxy)benzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)benzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)-2-methylbenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)-3-methoxybenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4’-(acryloyloxybutoxy)benzoyloxy)-3-methoxybenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-2-methylbenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-3-methylbenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(acryloyloxy)butoxy)benzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-3,5-dimethylbenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(acryloyloxy)benzoyloxy)benzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(4-(acryloyloxy)butoxy)benzoyloxy)benzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(4-(acryloyloxy)butoxy)benzoyloxy)-3-methoxybenzoate,
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxyethoxy)benzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)benzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)-2-methylbenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)-3-methoxybenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4’-(acryloyloxybutoxy)benzoyloxy)-3-methoxybenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-2-methylbenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-3-methylbenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(acryloyloxy)butoxy)benzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-3,5-dimethylbenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(acryloyloxy)benzoyloxy)benzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(4-(acryloyloxy)butoxy)benzoyloxy)benzoate) and
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(4-(acryloyloxy)butoxy)benzoyloxy)-3-methoxybenzoate), 和叢中的組合。
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxyethoxy)benzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)benzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)-2-methylbenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)-3-methoxybenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4’-(acryloyloxybutoxy)benzoyloxy)-3-methoxybenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-2-methylbenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-3-methylbenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(acryloyloxy)butoxy)benzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-3,5-dimethylbenzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(acryloyloxy)benzoyloxy)benzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(4-(acryloyloxy)butoxy)benzoyloxy)benzoate),
(3R,3aR,6R,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(4-(acryloyloxy)butoxy)benzoyloxy)-3-methoxybenzoate,
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxyethoxy)benzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)benzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)-2-methylbenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)-3-methoxybenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4’-(acryloyloxybutoxy)benzoyloxy)-3-methoxybenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-2-methylbenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-3-methylbenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(acryloyloxy)butoxy)benzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxy)-3,5-dimethylbenzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(acryloyloxy)benzoyloxy)benzoate),
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(4-(acryloyloxy)butoxy)benzoyloxy)benzoate) and
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(4-(4-(acryloyloxy)butoxy)benzoyloxy)-3-methoxybenzoate), 和叢中的組合。
旋光攙雜劑可能存在於前導物質的重量比例是0.1%至25%。
標記最好采用噴墨打印, 連續噴墨或按需求供墨的噴墨型,最好由單噴嘴/光柵或閥-噴墨 印刷。就噴墨打印的應用、組成必須進一步包含溶劑，以便調整其粘度，使其達到該印刷程序所要求的低粘度值。
噴墨打印的墨在攝氏25 度時的典型粘度值是在4至30mPa.s,可以使用的溶劑是選自低粘度,略帶偏振以及aprotic的有機溶劑, 例如甲基-乙基-酮(MEK) （methyl-ethyl-ketone ,MEK) 、丙酮(acetone) ethylacetate, 乙酯(ethyl 3-ethoxypropionate )或甲苯（toluene）。氯化溶劑諸如二氯甲烷（dichloromethane）、三或三氯乙烯（dichloromethane, or trichloroethylene）是技術上適合的, 但由於其毒性的緣故，不是印刷油墨所希望用的。
這個溶劑包含在噴墨前導物質的重量比例為10%至95%,典型的是55%至85%。
在連續噴墨打印的情況，前導材料包括溶解的導電劑，通常是鹽,諸如鋰硝酸鹽（lithium nitrate）、鋰銨（lithium perchlorate）、tetrabutylammonium chloride。或tetrabutylammonium tetrafluoroborate。鹽的濃度的重量比值是從0.1至5%。
前導物質最好可能進一步包括以低濃度至中度濃度存在的安全材料以便增加標記的抗偽造性。
這些安全材料是選自一群無機化合物發光物，有機發光化合物,紅外線吸收器、磁性材料,法醫標記,及其組合。 發光化合物的濃度是0.01%至5%，,IR-吸收器或磁性材料的濃度是0.1%至10%， ,法院標記材料的濃度是0.001% to 1% 。
要執行使用噴墨打印的本發明，其首選的氯液晶前導物質包含以下的混合：至少一個向列化合物，至少一個旋光誘導化合物，一個有機溶劑, 和一個光啟動器。
該向列化合物最好是 EP-A-0 216 712和EP-B-0 847 432, US-B-6589445,所披露的丙烯酸（acrylic-）或者是二綸(bis-acrylic type )類. 這些都包括在參考文件中。 首選的向列化合的數額 在氯液晶的前導混合是從大約10wt%,至60wt%, 更好的是從約10wt% 至45wt%。
首選的旋光感應(chiral inducers )是選自isomannide isosorbide的衍生，這是 透露於EP-B-0 739 403,GB-A-330 2 139,和US-B-6589445, 請參看參考文件。 旋光感應呈現在氯液晶前導混合物的重量比例是從0.1wt%至大約25wt%, 最好是從大約0.5wt%至大約15wt%。
產生標記的液晶前導物質,根據目前的發明, 更可以包括染料，色素，作色劑, 稀釋液，導電鹽, 活性表面復合物，表面粘著促進劑，濕潤劑、消泡劑 以及擴散劑等。
目前發明的標記,最好采用郵戳的形式,該郵戳代表一個獨一的一維的,堆積一維的，或二維的條碼或矩陣碼。所用的符號(symbologies)最好選自零售業所用的商品標記 。 這些符號是國際公認的標準, 而且它的讀解碼的運算法則是眾所周知, 他們的執行裝置可在商業品上找到。
適當的一維和堆積的一維條碼的符號是內行人都知道的, 它們可以在以下的符號名稱下找到,如Plessey, U.P.C., Codabar, Code 25 – 非交錯式（Non-interleaved） 2 of 5, Code 25 – 交錯式（Interleaved） 2 of 5, Code 39, Code 93, Code 128, Code 128A, Code 128B, Code 128C, Code 11, CPC 二進位（Binary）, DUN 14, EAN 2, EAN 5, EAN 8, EAN 13, GS1-128 (以前所知的 UCC/EAN-128), EAN 128, UCC 128, GS1 數據條， 以前所知的節省空間的符號 (RSS), ITF-14, 藥學碼（Pharmacode）, PLANET, POSTNET, OneCode, MSI, PostBar, RM4SCC / KIX, 或 Telepen.
適當的二維條碼的符號律是內行人所知的, 它們可以在以下的符號名稱下找到,如
3-DI, ArrayTag, Aztec Code, Small Aztec Code, bCODE, Bullseye, Codablock, Code 1, Code, 16K, Code 49, Color code, CP Code, DataGlyphs, Datamatrix, Datastrip Code, Dot Code A, EZcode, High Capacity Color Barcode, HueCode, INTACTA.CODE, InterCode, MaxiCode, mCode, MiniCode, PDF417, Micro PDF417, PDMark, PaperDisk, Optar, QR Code, Semacode, SmartCode, Snowflake Code, ShotCode, SuperCode, Trillcode, UltraCode, VeriCode, VSCode, WaterCode, 和 ECC200. 後者有一個內建的誤差糾正碼。它的定義是根據國際標準的ISO/CEI 16022:2006。
光學辨字（OCR）所用的適當字體型是內行人所熟知的。
圖1 所示是一個有氯液晶標記（目前發明）的一個產品包裝的示意圖。該包裝的表面的標記顯示的形式是ECC200數據矩陣碼.。 ECC200數據矩陣是一個公共領域符號。 該標記可放在包裝的任何想要的位置。 因此,它可以完全呈現在第一個背景顏色(a), 或與第一個背景顏色和顯示在包裝上的第二個設計顏色部分重疊(b),或完全顯現在包裝的白色或無色區域c)。
閱讀（目前發明的）標記的閱讀器可以建立在已有的商用條形碼閱讀器的基礎上,特別是手提CCD/CMOS相機閱讀設備以及用於零售業的閱讀站。至於標記與現有的(窄頻)照明的適當配合,該閱讀設備可以直接閱讀液晶碼。
在其它情況下，閱讀裝置可以進一步適應（啟動）去閱讀裝在標記上的特定安全元素的回應。也可以使用相當的適應式平板掃描器（flat-bed scanner）。 CCD相機的條形碼閱讀器是內行人熟知的, 有好幾家公司都生產這種裝置,如Accusort、Cognex, ＤVＴ、 Microscan, Omron, Sick, RVSI, Keyence等。
該適應性閱讀裝置可能包括一個或幾個光學過濾器，可以供選擇的有：線性偏振過濾器,右偏振過濾器,左偏振過濾器, 光電學偏振過濾器,波片（wave plates）,以及任何種類的頻譜式選擇顏色的過濾器等，以及從中的組合。
在一個特別的具體表現，至少要用兩個不同的光學過濾器。 該適應器還可能進一步包含建立一個或幾個特別光源，這些光源可以選自一群可選頻譜(即 色)的光源, 線性 偏振光源,左和右偏振光源,以及它們的組合。
不過，這些光源可以選自周圍環境光、白熾燈光、激光二極管，發光二極管,和所有類型的有顏色過濾器的光源。該光源的發射頻譜包括可見光(400-700nm波長)、近紅外光(700-1100nm波長), 遠紅外線(1100-2500nm波長), 或紫外線(200- 400nm波長)。
該閱讀裝置, 不僅是用來閱讀標記,而且還能去辨識它是用正確的安全材料制成的,即包括所需的安全要素。 該閱讀裝置傳送一個代表被讀的代碼的數字信息,並指引進入（攜帶該標記和編碼的項目的）有關數據庫。
該數字信息可以與存儲在閱讀 裝置內的訊息做比較，或者是被閱讀裝置和外部數據庫交換使用;交流可以在加密的形式來做,使用，比方說，RSA類公共/私人編碼。 該信息交流可以采取各種各樣的傳播途徑,例如傳輸線、無線電鏈接,紅外線鏈接、等等… 。
在前導物質不包含旋光性誘導的特別情況下, 就得到一個向列液晶聚合物。 這種聚合物的特點通常是雙折射,即，印刷層面的分子排列在一個主要方向, 沿分子軸方向分量的折射率和正交於分子軸方向分量的折射率是不同的。
這種向列液晶聚合體的雙折射特性可以用來作為一個安全元素。 在這種情況, 這個聚合體形同一個波片。 在適當的層厚度，它能把線性偏振光轉成為園偏振光, 反之亦然。在反射底基的狀況，液晶聚合體的存在與否能藉置於標記頂端適當方向的線性偏振過濾器之助來揭露。 在透射式底基情況, 一個反射或第二偏振過濾器需要放在底基的後邊來使標記成為可見。
在第二個體現， 目前發明的標記包括一個液晶聚合物的色素片;該色素片被包含在底基表面的鍍膜組成上。
首選的液晶聚合物色素是這裏參考資料WO 2008/000755 A1所描述的那一型。 根據目前發明， 含有這樣色素的標記會出現至少兩個反射帶，波長的範圍是200nm/2500nm。
對執行本發明有用的氯液晶聚合物(CLCP)顏料是被披露於, EP 1 213 338 B1; EP 0 685 749 B1; DE 199 22 158 A1; EP 0 601 483 A1; DE 44 18 490 A1; EP 0 887 398 B1, 和WO2006/063926。其他參考資料還有US 5211,877, 至 US 5,362,315 以及至 US 6，423，246。 這些粒子的厚度為1至10微米級， 色素片的大小為10至100微米級, 是從將一個相應液晶高分子薄膜研成粉末得到的。目前發明的 首選片的厚度範圍是在1至10微米的範圍,平均色片直徑的範圍為20 至50 微米。
該塗層組成包含至少一個茄套作為一個強制要求的分量; 另一種做法是采用更多的色素、染料、填充劑、添加劑、光啟動等, 正如應用過程和坐標記的底基所需要的。首選的粘合劑是選自vinylic 樹脂,丙烯酸（ acrylic） resins, 苯乙烯-順丁烯二酐共聚物(styrene-maleic anhydride copolymer) 樹脂, polyacetal resins, 聚酯(polyester)樹脂,脂肪酸改性 ( fatty acid modified) 聚酯樹脂 and 紫外線治療單體和多體, such as 丙烯酸鹽（acrylates）, 乙烯醚,（vinyl ethers）環（epoxides） 和它們的混合物。
該塗膜組成最好進一步含有以低濃度或中濃度存在的安全材料, 以便增加其抗拒偽造的能力。這些安全材料是選自一個組群,包括有 無機發光化合物，有機發光化合物, 紅外線-吸收器、磁性材料 ,法醫標記,以及從中的組合。發光化合物典型的濃度是0.01%至5%, 紅外線-吸收器或磁性材料的濃度是0.1%至10% , 法醫標記材料的濃度則為0.001%至1%。
為了滿足特定的條件,按照目前發明制作標記的塗層組成可進一步包括染料、色素，色彩劑,稀釋液， 導體鹽,表面活性化合物,表面黏和促進器、濕潤劑,消泡劑,分散劑,等如學藝所術。
按照目前發明，辨識和確認液晶標記需要一個光源以及必須按以下的方法:
I ) 用圓偏振或線性偏振光照明的標記來偵查的標記的反射;
ii ) 用非偏振光（如周遭光）來照明標記來偵查通過標記的反射從圓偏振或線性偏振光過濾器的反射。, iii )用圓偏振或線性偏振的混合光來照明，來偵查圓偏振或線性偏振光過濾器的反射。標記了的項目或物件的照明的光源因而是選自非偏振光源, 線性偏振光源, 左園偏振光源 ,以及右園偏振光源。
在所有情況下, 偵察可由眼或藉電子光學偵察設備之助來做,如光電池,或CCD或CMOS相機之類的。 光源和偵測可以使用特別的光發射體和/或顏色過濾器來做頻譜選擇。偵測最好是在電磁頻譜的可見光區域 (400-700nm波長)。
在一個特別體現，為辨識一個項目或物件，標記的照明須使用至少兩個不同的光源，它可選自（隨機偏振）光源，線性偏振光源, 左園偏振光源 ,和右 園偏振光源。
圖2顯示從ECC 200數據矩陣碼得到的圖像。 這個碼是將液晶材料印刷在鍍膜紙板上來得到的。 這些圖像清楚地展示了用液晶材料標記的偏振性質的優勢, 這液晶材料的記號在清晰或結構背景下都能閱讀。
最有利的組合是用偏振光來照明和在鏡頭前使用偏振過濾器 。 所有圖像也采取了同樣的光源和同樣的相機設置,所有的都是黑與白的模式,在光源和/或相機前有或沒有偏振過濾器。 圖像是經數據化處理，做最大的對比和最佳化的亮度。
在一個理想的選擇,目前發明的液晶標記是在非偏振（最好是周圍)光下轉成可見光。 用的是一個被動偵測方法，諸如線性或圓偏振過濾器。
不過，標記也可用可見光譜(400-700nm波長)的頻譜來辨識和確認，例如，在紅外線區域(700至2500nm波長),最好是電磁頻譜的近紅外線(700-1100nm波長)區域,遠紅外線(1100-2500nm波長)區域或在紫外線(200- 400nm波長)區域, 這是由於標記在這些區域有放射能帶的緣故。
氯液晶聚合物是,它的天然性質, 有光譜選擇性的反射，其反射帶能夠經由適當的螺旋音調的選擇來調整跨越部分的電磁頻譜。 該音調，值得注意的，是取決於向列的前導物質與液晶前導內之對 旋光誘導復合物的比值，也取決於聚合的溫度。 在聚合之後、螺旋音調, 因此材料反射的顏色的,得以維持不變。
內行人都知道，低的旋光誘導提供造成低螺旋扭曲,因而一個大的螺旋音調。 因此,低數值的 旋光誘導產生的聚合物的一個反射帶，其波長是在波長的長的一端，通常是在紅外或紅區域, 反之，較高數值的誘導物 在聚合物產生的反射帶是在頻譜的短的一端。通常是在藍色或紫外線區域。
還必須注意到的是公平性 旋光誘導的旋向性,也就是該，決定了的誘導會造成左還是右螺旋音調。這會個別造成反射光的相反的圓偏振。
isomannide衍生工具,已知會誘導左偏振的反射,而isosorbide衍生工具則已知會誘導右偏振的反射光。
以下給的是一個典型的氯液晶聚合物前導組合的例子。它能用在連續噴墨打印程序。:
MEK 55.7 wt%
苯甲酸（benzoic acid） 4-[4-[(1-oxo-2-propenyl)oxy] butoxycarboxy]-, 2-methyl-1,4-phenylene ester 40.1 wt%，(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)benzoate) 1.70 wt%， Irgacure 907 1.30 wt%
LiClO4 1.20 wt%
以下的例子是一個典型的氯液晶高分子色素組成,它可以用在閥-噴墨(按需求滴墨)的噴墨打印過程:
Pioloform® BL18 5.0 wt%
MEK 64.6wt%
Diethylene glycol 10.0wt%
Ethanol 8.0wt%
LC polymer pigment 10.0wt%
Byk®-430 1.5wt%
Byk®-410 0.9wt%
Pioloform® bl18是一個聚乙烯縮丁醛樹脂（polyvinyl butyral resin ）。它的CAS 號是 63148-65-2。 是Wacker提供的。 Byk漅-430是Byk供應的一個緩和尿素溶液， Byk漅-410是一個高分子緩和尿素極聚胺（Polar polyamide）， 也是Byk提供的。
以下是可以被 閥-噴墨印刷過程使用的氯液晶高分子前導組成的一個替代的例子：,
MEK 83.0 wt%
benzoic acid 4-[4-[(1-oxo-2-propenyl)oxy] butoxy]-, 2-methyl-1,4-phenylene ester 14.7 wt%
(3R,3aR,6S,6aR)-hexahydrofuro[3,2-b]furan-3,6-diyl bis(4-(acryloyloxybutoxy)benzoate) 1.50 wt%
Irgacure 907 0.8 wt%
、
根據上文所提供的指示和體現範例，具備技術的內行人應能導出目前發明的進一步體現。
聲明
1. 對一個項目或商品做標記,該標記包含了一種有確定光學特性的聚合液晶材料。該光學特性讓標記能夠被辨識以及用機器來閱讀，也可用肉眼來辨認。 標記的特點是,它能在底基用變量資訊印刷程序來制做, 並有一個郵戳的形式。 該郵戳代表一個獨特的代碼,允許其做身份的確認。
2． 標記， 根據聲明1 ，其中的特點是，至少有一部分的標識是肉眼看不見。
3. 標記，根據聲明1 和2 的其中之一, 在其中，聚合液晶材料是一個氯液晶材料,展示顏色以及依角度而不同的顏色改變。
4. 標記， 根據聲明3, 在其中的氯液晶材料有一個在紫外線頻的反射帶，相應的波長是在200至400nm的範圍。
5. 標記，根據聲明3, 其中氯液晶材料有一個在可見光頻的反射帶。相應的波長是在400至700nm的範圍。
6. 標記，根據聲明3, 其中氯液晶材料有一個在紅外線頻的反射帶。相應的波長是在700至2500nm的範圍。首選波長是在700至1100nm的範圍。
7． 標記，根據聲明4至6的其中一項，在其中，氯液晶材料有一個第二反射帶。該反射帶是在頻譜的200至2500nm的波長範圍。
8. 標記， 根據聲明1至2 的其中至1, 在其中，該聚合液晶材料是一個向列（nematic）液晶材料 , 該向列液晶材料展示光的雙折射。
9． 標記，根據聲明1至8的其中之一, 在其中，該聚合液晶材料進一步含有安全材料,該材料是選自一個組群。該組群包括有：無機發光化合物，有機發光化合物, 紅外線-吸收器、磁性材料,和法醫標記,以及其中的組合。
10． 標記，根據聲明1至9 的其中之一, 在其中，該底基選自一個組群，該組群包含反射底基，有色底基,和透明底基。
11． 標記， 根據聲明1至9 的其中之一, 在其中，該底基是一個有圖案的底基,包括至少有兩個不同的表面領域。每個區域都選自一個組群, 該組群包括有；白色表面領域,黑色表面區域 、彩色表面領域,反射表面領域,透明表面領域和從中的組合。
12． 標記， 根據聲明1至 9 的其中之一, 在其中，該底基攜帶郵戳。
13．標記， 根據聲明1至9的其中之一, 在其中，該底基至少攜帶一個安全元素,該安全元素是選自一個組群。 該組群包括無機發光化合物，有機發光化合物,紅外線- 吸收器、磁性材料,法醫標記和以上的組合。
、
14. 標記，根據聲明13, 在其中，該安全元素是以郵戳形式出現。
15． 標記， 根據聲明1 至14 的其中之一，在其中，該底基是選自一個組群。該組群包含有 編制的底基，無編制的底基，有鍍層的底基，紙質的底基，厚紙板的底基，木質的底基，玻璃的底基，陶瓷的底基，金屬的底基，塑料的底基，紡織品的底基，皮革的底基等等。
16． 標記，根據聲明1至15的其中之一，在其中，做標記的過程中是選自一個組群，該組群含有持續噴墨打印,按需求滴墨的噴墨打印, 和激光打印。
17． 標記，根據聲明的1至16的其中之一，在其中，該郵戳代表的是一個獨一的代碼,該代碼選自以下組群， 一維條碼，堆疊的一維條碼，二維條碼。
18． 標記， 根據聲明17, 在其中，該一維條碼是選自一個組群, 該組群含有 Plessey, U.P.C., Codabar, Code 25 – 非交錯式 5 之 2, Code 25 – 交錯式5之2, Code 39, Code 93, Code 128, Code 128A, Code 128B, Code 128C, Code 11, CPC Binary, DUN 14, EAN 2, EAN 5, EAN 8, EAN 13, GS1-128 (以前所知的UCC/EAN-128), EAN 128, UCC 128, GS1 DataBar 以前縮小空間的 符號（Symbology） (RSS), ITF-14, Pharmacode, PLANET, POSTNET, OneCode, MSI, PostBar, RM4SCC / KIX, 或 Telepen.
19．標記，根據 聲明17,在其中，該二維條形碼是選自一個組群。該組群包括 barcode 3-DI, ArrayTag, Aztec Code, Small Aztec Code, bCODE, Bullseye, Codablock, Code 1, Code, 16K, Code 49, Color code, CP Code, DataGlyphs, Datamatrix, Datastrip Code, Dot Code A, EZcode, High Capacity Color Barcode, HueCode, INTACTA.CODE, InterCode, MaxiCode, mCode, MiniCode, PDF417, Micro PDF417, PDMark, PaperDisk, Optar, QR Code, Semacode, SmartCode, Snowflake Code, ShotCode, SuperCode, Trillcode, UltraCode, VeriCode, VSCode, WaterCode, 以及 ECC200.
20．標記， 根據聲明1至19的其中之一，在其中，聚合液晶材料的形式是以色素片形式呈現。該色素片是包含在適當的夾器中。
21．標記，根據聲明 20, 在其中，該夾器是選自一個組群。該組群包含 乙烯基（ vinylic）樹脂, 丙烯酸（the acrylic ）樹脂, 苯乙烯樹脂（styrene-maleic anhydride copolymer resins）, the polyacetal resins, the polyester resins, the fatty acid modified polyester resins 以及從中的混合。
22．標記，根據聲明 20, 在其中， 夾器是選自一個組群，該族群包含 可紫外線愈合的acrylates的單體和多體, vinyl ethers, epoxides 的單體和多體以及從中的合并。.
23．項目或物件至少攜帶一個，根據聲明1 至22的其中之一的標記。
24． 項目或物件, 根據聲明23, 在其中，該項目或物件是選自一個組群。該組群包含： 有價值的文件， 紙幣、護照、身份證、 駕駛執照,官方權限, 存取文件、郵票、稅郵票和 飄帶（ banderoles）, 交通票、門票、標簽、箔、包裝,和一般的零部件和消費貨品。
25． 根據聲明1 至22的其中之一所做的標簽來對一個項目或物件做跟蹤或追搠
26． 使用， 根據聲明 25, 在其中，該項目或物件是選自一個組群。該組群含有： 有價值的文件， 紙幣、護照、身份證、 駕駛執照,官方權限, 存取文件、郵票、稅郵票和限制規 banderoles, 交通票、門票、標簽、箔、包裝,和一般的零部件和消費品的標記項目或物件。
27． 方法，根據聲明1 至22的其中之一制作的標記，該方法包含以下步驟；
a) 提供一個底基；
b) 以郵戳的形式，將液晶前列組合應用到該底基；
c) 將該組合在有次序的液晶狀態硬化；
28．方法：根據聲明27， 在其中，前列組合包含紫外線愈合的活性的單體或多體，而且，組合的硬化是用紫外線愈合。
29． 標記一個項目或物件的方法, 、該方法包括以下步驟
a)提供一個要做標記的項目或物件
b)根據聲明1 至22的其中之一，將至少一個標記應用在該項目或物件
30. 方法， 根據聲明27至29的其中之一, 在其中，郵戳代表的獨特碼是一個加密信息 ,該方法包括對該信息加密。
31． 辨認一個項目或物件的方法，該方法包括以下步驟
a)根據聲明1 至22的其中之一，提供一個攜帶標記的項目或物件；
b)用至少一個光源提供至少一個有品質的光， 將該光線照在攜帶標記的該項目或物件之上；c)經由辨認標記反射的光線來測得該標記的確定光學特性;
d) 經由測到的標記的光學特性來辨認該項目或物件.
32. 根據聲明31的方法，在其中,該標記包含有一個氯液晶材料, 該材料能展示頻譜選擇性，觀察依角度改變的反射光、該反色光具有圓偏振的一個特別的轉向。
33. 根據聲明31至32的方法的其中之一，在其中，該光源是一個有頻譜選擇性的光源。
34． 根據聲明33的方法,在其中，該光源是選自以下的組群，周圍光、白熾燈光、激光二極管，發光二極管,有彩色過濾器的光源。
、
35． 根據聲明31至34的方法之一, 在其中，光源是選自一個發射某一頻譜範圍的組群。其中包括
可見光(400-700nm波長)、近紅外光(700-1100nm波長),遠紅外線光(1100-2500nm波長)和紫外線(200- 400nm波長)地區的電磁頻譜。
36． 根據聲明31至35的方法之一,在其中，該照明是來自一個光源，該光源是選自一個組群，該組群包括非偏振光，線性偏振光,左偏振光，右偏振光等。
37． 根據聲明31至36之其中之一的方法的, 在其中，至少有兩個不同的該光源是共同使用的。
38． 根據聲明31至37其中之一的方法，在其中，該偵查工作使用最少一個光過濾器。該光過濾器選自一個組群。 該組群包括一個線性偏振，左偏振，右偏振, 以及光電偏振開關。
39．根據聲明 38 的方法，在其中，該光學過濾器是和一個顏色過濾器並用的。
40． 根據聲明 38至39其中之一的方法，在其中，至少有兩個不同的該光過濾器是聯合並用的。
41．根據聲明 31至40方法的其中之一，在其中，該偵測是用肉眼來執行的。
42．根據聲明 31至40 方法的其中之一，在其中，該偵測是用光電設備來執行的。
53．根據聲明 42 的方法，在其中，該光電偵測設備是選自一個組群。該組群包括有光電池，線性CCD圖像感測列陣，線性CMOS 圖像感測列陣，二維CMOS 圖像感測列陣。
44．確認一個項目或物件的方法，該方法包含以下步驟：
a)提供一個項目或物件。該項目或物件昔帶有根據聲明 1至22的其中一所提的標記， b)用來自至少一個光源的至少一個的有品質的光線照在該項目或物件的標記上；c)閱讀該標記所代表的郵戳，導出相應的訊息；d)將從郵戳擷取的資訊和存在於數據庫中的資訊互相關聯；e)獲得對該項目或該物件的確認的證實或否認。
45. 根據聲明 44 的方法，包含辨識該項目或物件的進一步的步驟，使用的是的聲明 31至43 所術的方法之一。
46．根據聲明 44至45 的方法的其中之一，在其中，郵戳的閱讀是藉光電的圖像感測陣列來做的。
47．根據聲明 46 的方法，在其中，光電的圖像感測陣列是選自一個組群， 該組群包含以下：
線性CCD圖像感測陣列, 二維CCD圖像感測陣列，線性CMOS圖像感測陣列以及二維CMOS 圖像感測陣列。
48．根據聲明 44至47 的其中方法之一，在其中有關項目或物件的資訊是存在於數據庫中。
49．根據聲明 44 至48 的其中方法之一，在其中，和數據庫交換的資訊是在加密的形式下做成的。
50．根據聲明 44 至49 的其中方法之一，在其中，標記的郵戳所代表的獨特編碼是一個加密資訊。該方法包含對該資訊的解密步驟。
51．對項目或物件做安全追蹤和追搠所采用的方法。 標記是使用聲明 1 至22 的其中的方法之一所得到的，在其中，該方法包含以下的第一個可取代的步驟：
a)根據聲明 27 至30 的方法之一將該標記加到項目或物件上；
b)將和做標記的項目或物件有關的資訊存進數據庫中；
以及以下的第二個可取代的步驟
ｃ）根據聲明 31 至43 的方法之一，對項目或物件做辨識；
ｄ）根據聲明 44 至50 的方法之一來對項目或物件做確認；
以及 以下的可取代的步驟
e)用有關項目或物件的新的資訊元素來更新資料庫；
52． 根據聲明 51 的方法，在其中，該項目或物件是選自一個組群。 該組群包括以下：有價值的文件、紙幣、護照、身份證、駕駛執照,官方權限, 獲得文件、郵票、稅票和飄帶、運輸車機票、門票、標簽、箔、包裝、藥學產品，零件,和消費品等。
圖. 2a 圖. 2b
圖. 2c 圖. 2d
擇要
目前的發明涉及到一個聚合液晶材料的標記。該液晶材料有確定的光學特性，讓標記能用機器來閱讀和辨識, 以及用肉眼來做辨識。 標記是用可變資訊印刷程序加諸在一個項目，貨物，或物件之上來做成的。該標記是一個代表編碼的郵戳形式。郵戳很易讓人眼辨認，也很容易讓人們對做標記的項目，貨物或物件的整個生命期做安全跟蹤和追搠。
| | English to Chinese: PSYCHOLOGICAL ASSESSMENT REPORT | Source text - English
PSYCHOLOGICAL ASSESSMENT REPORT
Name: Caroline Hoang
MR #: 75911500
Age: 7 years
Date of Birth: 8-16-2001
Dates of Evaluation: 6-23-2008, 7-14-2008,
7-21-2008, 8-4-2008,
8-25-2008
Examiner: Andrea Hindes, Ph.D.
Referred by: Robert Horst, M.D.
Cassandra Ariaz, M.F.T.
Evaluation Included:
Interviews:
Clinical Interview with Mother (Lynn Feng)
Collateral Information from Therapist (Cassandra Ariaz, M.F.T.) and Psychiatrists (Robert Horst, M.D., Hong Shen, M.D.) at Visions Unlimited Mental Health Center
Collateral Information from Teachers (Mrs. Diane Farley at Florin Elementary School, Ms. Jennifer Carlisle at Samuel Kennedy Elementary School)
Review of Records
Social Welfare Institution of Feixi County
Visions Unlimited Mental Health Center
Psychological Testing;
Behavior Assessment Scale for Children – Second Edition (BASC-2): teacher and parent forms
Conners’ Parent Rating Scale-Revised: Short Form (CPRS-R)
Conners’ Teacher Rating Scale-Revised: Short Form (CPRS-R)
Roberts Apperception Test for Children
Sentence Completion – for Children
Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV)
Identifying Information and Reason for Referral
Caroline is a 7-year-old Chinese female who was referred for a psychological assessment by her psychiatrist, Robert Horst, M.D., to address concerns regarding Caroline’s behavior. In particular, Caroline exhibits problems with understanding and following directions, attention, restlessness, and fidgeting. Concerns were also raised that Caroline makes statements that are odd, off-topic, or difficult to understand and that she talks and laughs to herself when she is alone. Finally, it was noted that she engages in oppositional and angry behavior when she does not get her way. Caroline’s mental health providers and mother would like a better understanding of Caroline’s diagnosis in order to implement appropriate interventions.
Background History
Currently Caroline lives with her adoptive mother, Lynn Feng, and adoptive maternal uncle, aunt, and three cousins. Ms. Feng is Chinese and was born in China. She moved to the United States approximately 10 years ago. Her first languages are Mandarin and Cantonese, which she and her family speak at home with Caroline. Ms. Feng speaks some English; however, she employs the use of a translator when attending Caroline’s meetings with mental health providers. For the purpose of the current evaluation, Mary Ninh, an interpreter from Asian Pacific Community Counseling who has worked with Ms. Feng in the past, translated the interview and specific questionnaires for Ms. Feng. According to Ms. Feng, Caroline’s relationships with her family are generally fine. However, Caroline has difficulty getting along with her cousins, who do not like to play with her because she argues and fights with them. Throughout the assessment, Caroline remarked that her 8-year-old male cousin oftentimes teases her, which makes her feel bad. Ms. Feng reportedly has little time to spend with Caroline because of her demanding work schedule and Caroline’s aunt often cares for her at home.
Caroline was adopted by Ms. Feng in China when she was two-and-a-half years old. Documentation from the Social Welfare Institution of Feixi County in China indicates that Caroline was abandoned when she was approximately six weeks old. After two months of unsuccessful attempts to locate her biological parents, Caroline was placed in an orphanage, where she lived until she was adopted by Ms. Feng. After adopting Caroline, Ms. Feng returned with her to Mississippi in the United States where she had been living with her husband. Documents indicate that Ms. Feng divorced her husband shortly thereafter and moved to Sacramento in 2006. Caroline is unaware that she is adopted. When discussing her life during an individual interview, Caroline stated that she was born in China and but does not remember her early childhood there. She stated that she has always lived with her mother and that she does not have a dad.
Developmental History
There is no information regarding Caroline’s prenatal, birth, or early infancy history. Ms. Feng was not provided with any details with respect to Caroline’s developmental milestones, attachment to caregivers, behavior, or physical health during the time that she lived in an orphanage. However, she speculated that Caroline was neglected and malnourished there. When Caroline was first adopted she often bit or hit others and threw things at them. Caroline already knew how to walk at the time of the adoption but she did not begin talking, even in single words or phrases, until she was three years old. Since that time, Caroline has learned to speak English, Cantonese, and Mandarin. Typically, Caroline speaks Cantonese and Mandarin at home, while speaking English, which she prefers, at school. Ms. Feng noted that Caroline’s speech in Cantonese or Mandarin does not “flow” and she must speak more slowly in order for Caroline to understand her. Caroline’s mother, teachers, and mental health providers stated that in either English or Chinese, Caroline oftentimes has difficulty understanding and following instructions, directions, and conversations and appears confused, oblivious, and inattentive. Moreover, it is oftentimes challenging to understand Caroline’s meaning when she speaks because she makes irrelevant, off-topic, or inappropriate statements.
Family History
There is no information regarding Caroline’s biological family history.
Medical History
Ms. Feng reported that Caroline has been healthy since her adoption with no major illnesses, injuries, surgeries, or hospitalizations. She has seasonal allergies for which she has taken medication in the past. She has no history of head injuries, loss of consciousness, or seizures. Ms. Feng did not report any problems with Caroline’s hearing or vision. Caroline reportedly has trouble falling asleep and oftentimes laughs and talks to herself while in bed. Ms. Feng denied that Caroline is afraid of the dark, needs to sleep with someone else, wets the bed, or has any nightmares. She also denied that Caroline has ever been witness to or experienced any physical, emotional, or sexual abuse.
Psychiatric History
Caroline was referred for mental health treatment in April 2007 because of her difficulty with sitting still, following directions, and talking excessively. She was referred to Visions Unlimited Mental Health Center and now works with a therapist and a psychiatrist. Currently, she has a diagnosis of Attention-Deficit/Hyperactivity Disorder, combined type and Disruptive Behavior Disorder NOS. In therapy, Caroline works with Cassandra Ariaz, M.F.T. to improve her inattention, hyperactivity, and emotional expression. Ms. Ariaz also works with Ms. Feng to learn and practice techniques for appropriate limit-setting and behavior management. According to Ms. Ariaz, Caroline and her mother attend therapy inconsistently approximately once or twice per month. Initially, it was difficult to engage in therapy because of the language barrier between Ms. Ariaz and Ms. Feng, who was hesitant to allow an interpreter into the session. However, Ms. Feng now allows Mary Ninh to attend the therapy sessions.
Caroline also began working with a psychiatrist, Robert Horst, M.D. at Visions, in July 2007 to address her problems with inattention and hyperactivity. Currently she is prescribed Adderall XR (10 mg), which she takes in the morning. According to Dr. Horst, Ms. Feng is very concerned that Caroline is disrespectful and misbehaves, especially in comparison to her cousins. After speaking with Caroline’s teachers, however, Dr. Horst speculated that Caroline misbehaves more often with her mother than with her teachers. During her therapy sessions and psychiatry appointments, Caroline reportedly is well mannered and responds well to limit-setting and structure. In September, Caroline transferred to a new psychiatrist, Hong Shen, M.D., because Dr. Horst transitioned out of Visions. Dr. Shen, who is a native speaker in Mandarin and Cantonese, reported that during an interview with Caroline, she had difficulty communicating and expressing herself in English, Mandarin, and Cantonese. He remarked that it was difficult for her to understand Dr. Shen and she often made statements and responses that were irrelevant or off-topic.
Educational History
Caroline is in second grade at Samuel Kennedy Elementary School. Both Caroline’s current teacher, Jennifer Carlisle, and her first grade teacher, Diane Farley, reported that Caroline has significant difficulty in understanding and following conversations and discussions. Oftentimes she makes statements or tells stories that are off-topic and irrelevant to the current situation. Her teachers also remarked that Caroline requires several repetitions of directions and explanations in order to understand classroom assignments and expectations. Despite her difficulty with oral communication, Ms. Farley noted that Caroline’s reading abilities, including fluency and comprehension, are adequate. Caroline also exhibits problems with attention, hyperactivity, and impulsivity at school. She has difficulty maintaining her focus and concentration. She fidgets, cannot sit still, wanders the classroom, interrupts others, talks excessively, and oftentimes bothers her peers. Finally, it was noted that Caroline has had difficulty making and keeping friends at school. Ms. Farley observed that during the beginning of first grade, Caroline often fought with her peers, especially on the playground, where she hit, bit, and pinched them. At times, she had to be removed from the classroom and isolated from everyone else. Over time, Caroline stopped engaging in these behaviors and no longer displays any oppositional or defiant behavior. However, she continues to struggle with friendships as many of her peers are bothered by her inattentive, restless, and hyperactive behavior.
Behavioral Observations
Caroline attended four sessions for testing (7-14-2008, 7-21-2008, 8-4-2008, and 8-25-2008) and was accompanied by Ms. Feng. On all occasions, Caroline was well-groomed and appropriately dressed in a t-shirt, pants, and sneakers. She was of small stature, but looked her stated age. She sat in her mother’s lap or hugged her while waiting for each session. She separated easily from her mother and engaged with this psychologist without any difficulty. She displayed warm and cheerful affect, moderate eye contact, and open and spontaneous conversation. Throughout the sessions, she expressed excitement at showing her mother the stickers she “earned” during each session. Overall, Caroline was polite, respectful, and cooperative. She responded well to redirection, praise, and rewards. At times, however, she complained that the tasks were “too hard” and bargained for more rewards to complete what was asked of her.
Caroline was fairly distractible, impulsive, and restless throughout the evaluation. She appeared more attentive during those tasks that did not require detailed understanding or expression of information presented orally. At times, it was difficult to determine whether she understood the directions and questions on specific measures. Further, her responses lacked appropriate details and elaboration and, at times, were unrelated and off-topic. She appeared to compensate for problems with oral expression by getting out of her seat to gesticulate and physically demonstrate her answers and ideas.
Psychological Testing Results and Interpretation
Cognitive and Intellectual Functioning
In order to assess Caroline’s intellectual ability, she was administered the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV). The WISC-IV provides an overall estimate of a child’s intellectual abilities. In addition, it provides estimates of a child’s intellectual abilities across four specific domains: verbal comprehension, perceptual organization, processing speed, and working memory. The scores on each of these domains are compared in order to measure the consistency of children’s abilities. Commensurate scores across each of the four domains suggest relatively even development in the areas of verbal and nonverbal reasoning, speed of processing, and working memory. Significant differences in scores may indicate significant strengths and/or weaknesses in children’s cognitive development. The scores for each domain are presented in standard scores with a mean score of 100 and a standard deviation of 15, while the scores of each individual subtest are presented in scaled scores with a mean of 10 and a standard deviation of 3.
Scale Standard Score 95% Confidence
Interval Percentile
Full Scale IQ 101 96-106 53
Verbal Comprehension Index 77 72-85 6
Perceptual Reasoning Index 117 108-123 87
Working Memory Index 102 94-109 55
Processing Speed Index 112 102-120 79
Verbal Comprehension Index Scaled Score Perceptual Reasoning
Index Scaled Score Working
Memory Index Scaled Score Processing
Speed Index
Scaled Score
Similarities
3 Block Design 12 Digit Span 14 Coding 12
Vocabulary 6 Picture Concepts 10 Letter-Number 7 Symbol Search 12
Comprehension 9 Matrix Reasoning 16 (Arithmetic) 10 (Cancellation) 14
(Information) 9 (Picture Completion) 12
(Word Reasoning) 6
Caroline obtained a Full Scale IQ of 101 on the Wechsler Intelligence Scale for Children (WISC-IV), placing her in the average range of overall ability (53rd %ile). However, there were significant discrepancies in her performances across those indices that comprise the Full Scale IQ. As such, Caroline’s Full Scale IQ is not the best estimate of her overall intellectual abilities and her performance across the four indices should be considered separately.
Caroline’s overall performance on measures of verbal concept formation, verbal reasoning, and the amount of general knowledge that she has acquired from her environment fell in the borderline range of functioning (Verbal Comprehension Index, Standard Score = 77, 6th %ile). Her performance varied somewhat across individual subtests comprising the VCI. Across these subtests, Caroline displayed difficulty understanding information presented verbally. In fact, it was difficult to determine whether she understood the directions to tasks. She required that directions be broken down into smaller, simpler sentences and repeated frequently. She also exhibited problems in expressing herself verbally as her responses tended to be vague, muddled, and off-topic. Caroline appeared to compensate for her difficulties in verbal expression by employing physical gestures and pantomimes to get her point across. On specific subtests, Caroline performed in the extremely low range on a measure of verbal abstract reasoning and verbal expression (Similarities, 1st %ile), which represented a significant weakness relative to her own abilities as well as those of same-age peers. During the administration of this measure, it was difficult to determine whether Caroline understood the directions. In particular, she tended to respond to items by saying, “they are not the same,” as though she were asked to determine whether or not the items were similar, rather than the actual task, which was to state why the items were similar. She also demonstrated a weakness relative to her own abilities as well as those of other same-age peers when she performed in the low average range on a subtest assessing her long-term memory and knowledge of words and their meanings (Vocabulary, 9th %ile). On this measure, she had difficulty providing even simple definitions to words. Instead, she attempted to use the item word in a sentence or acted-out the meaning. For example, when asked the definition of “bicycle,” Caroline replied, “you ride a bicycle,” and then got up out of her seat and pretended to peddle a bike around the room. Caroline exhibited low average ability to reason through verbal material and integrate different types of information about a particular concept (Word Reasoning, 9th %ile). Although Caroline has been observed to engage in off-topic or unrelated behavior and speech, she demonstrated average and age-appropriate knowledge of conventional standards of behavior, common sense, and social judgment (Comprehension, 37th %ile). She also performed in the average range on a subtest that measured her knowledge of general facts (Information, 37th %ile). Caroline demonstrates adequate and age-appropriate understanding of general principles, facts, and social judgment, but significant limitations in her ability to perceive, reason through, and express information verbally.
In stark contrast to her verbal reasoning abilities, Caroline displayed high average nonverbal reasoning abilities (Perceptual Reasoning Index, Standard Score = 117, 87th %ile). On a measure of nonverbal abstract reasoning and the ability to process information presented visually, Caroline performed in the very superior range (Matrix Reasoning, 98th %ile), which is a strength relative to her own abilities as well as those of other same-age peers. Her performance on this subtest strongly diverges from her extremely low range performance on the Similarities subtest, which, as mentioned above, also assesses abstract reasoning and processing, but requires a language component. On another measure of nonverbal abstract and categorical reasoning, Caroline performed in the average range (Picture Concepts, 50th %ile). She performed in the high end of the average range on measures of visual recognition and identification, nonverbal concept formation, and the ability to synthesize a whole into its component parts (Picture Completion, 75th %ile; Block Design, 75th %ile). Overall, Caroline exhibits well-developed abilities for perceptual and fluid reasoning, spatial processing, and visual-motor integration. When she is not required to perceive, comprehend, and express information orally, Caroline demonstrates well-developed and advanced intellectual abilities that are higher than 86 percent of other same-age children.
Caroline exhibited average-range ability to sustain attention, concentrate, and exert mental control (Working Memory Index, Standard Score = 102, 55th %ile). Nevertheless, her performance across individual subtests of the WMI was considerably variable. On a measure of short-term auditory memory, she performed in the high average range, which was a strength relative to her own abilities as well as those of her peers (Digit Span, 91st %ile). On a measure of freedom from distractibility, short-term memory, and computational skill she performed significantly lower and in the average range (Arithmetic, 50th %ile). Such a difference in her performance may have been related to this subtest’s verbal demands as it requires an individual to perceive, process, and remember information presented verbally. Caroline performed in the low average range on a measure of sequential processing and short-term memory (Letter-Number Sequencing, 37th %ile). Her performance on this measure was significantly lower than her performance on the other two subtests that comprise the WMI and is a weakness relative to her abilities. Although Caroline’s performance on subtests of the WMI was variable, she demonstrated adequate to advanced abilities to temporarily retain information in memory, process and manipulate this information, and produce a result.
Caroline demonstrated high average abilities to process simple or routine visual material without making errors (Processing Speed Index, Standard Score = 112, 79th %ile). Caroline’s performance was consistent across individual subtests that comprise the PSI. On a measure of visual selective attention and processing speed, she performed in the high average range of functioning (Cancellation, 91st %ile), which significantly higher than same-age children. On this subtest, Caroline’s performance was consistent when the task was structured (Cancellation Structured, Scaled Score = 13) or unstructured (Cancellation Random, Scaled Score = 14), suggesting that Caroline has the ability to structure and organize information without outside assistance in order to solve problems effectively. She performed in the high end of the average range on a measure that required the coordination of fine-motor skills, short-term memory, and learning ability (Coding, 75th %ile). She performed in the high end of the average range on a measure that also assesses visual memory and sequential processing but is more demanding of attention to detail and mental control without a psychomotor component (Symbol Search, 75th %ile). Caroline’s performance on the subtests that comprise the Processing Speed Index indicates that Caroline has well-developed ability to quickly and correctly scan, sequence, discriminate, and remember simple visual information.
In sum, Caroline demonstrated significant differences between her verbal abilities and nonverbal abilities, working memory, and processing speed. While she has developed at or above average ability to nonverbal abilities, processing speed, and working memory, her verbal abilities fall in the borderline range of functioning. She evidences a tremendous difference between her verbal and nonverbal abilities that is very rare and occurs in less than one percent of children. Because of such significant differences in her abilities, the Full Scale IQ is not the best estimate of her intellectual abilities. Rather, her verbal and nonverbal intellectual abilities should be considered separately as they represent extreme differences in her functioning.
Language and Communication Skills
¬¬¬¬¬¬¬¬¬¬
Caroline evidences significant limitations in her ability to understand and express verbal information. As noted earlier, multiple reports indicate that Caroline oftentimes appears not to listen to or understand directions, makes irrelevant and off-topic remarks, and requires that directives be broken-down and repeated frequently. In order to understand better adults’ perceptions of Caroline’s functioning across several domains, Caroline’s mother and two teachers were administered standardized questionnaires, including the Behavioral Assessment System for Children – 2nd Edition (BASC-2). The BASC-2 is a paper-and-pencil measure that assesses children’s behavior and mood as well as academic and adaptive skills. Ms. Feng completed the parent report form of the BASC-2. Her overall pattern of responding on the BASC-2 indicates that she answered attentively and consistently to each item and did not rate Caroline in an overly positive or negative light. Caroline’s schoolteacher from last year, Ms. Farley, and her current teacher, Ms. Carlisle completed the teacher report forms of the BASC-2. Overall, their responses on the BASC-2 indicate that they were attentive to the item content and did not attempt to portray Caroline in an overly positive or negative light. However, Ms. Farley’s answers to relatively similar items on the measure were inconsistent, suggesting that her responses should be interpreted with caution. On this measure, Ms. Feng and Ms. Carlisle reported that Caroline demonstrates significant difficulty with understanding and expressing information verbally (BASC-2 Parent Report form, Functional Communication, T = 32, 5th %ile; BASC-2 Teacher Report form, Functional Communication, T = 34, 8th %ile). Such problems with communication typically manifest as problems with communicating ideas, information, or experiences clearly, responding appropriately to questions, and tracking down necessary information.
To more clearly assess Caroline’s ability to understand information presented verbally, she was administered the Peabody Picture Vocabulary Test – Third Edition (PPVT-III). The PPVT-III assesses children’s receptive language abilities by showing an array of four pictures and presenting them with a vocabulary word. Children are asked to point to the picture that matches the vocabulary word. Caroline’s receptive language abilities fall within the moderately low range (SS = 84, 14th %ile) and at a 5 year 7 month age level. Her performance on this measure is significantly below her estimated high average range intellectual abilities as measured by the Perceptual Reasoning Index on the WISC-IV. However, her receptive language skills are commensurate with her borderline verbal reasoning abilities as measured by the Verbal Comprehension Index of the WISC-IV. When coupled with her performance on the VCI, Caroline’s performance on the PPVT-II indicates that she has significant problems in her ability to understand information presented orally. It is not surprising then, that multiple sources report that Caroline oftentimes appears not to listen to or understand directions, makes irrelevant and off-topic remarks, and requires that directives be broken-down and repeated frequently.
Caroline’s difficulty in understanding and responding to information presented verbally was evident throughout the evaluation. In addition, to her aforementioned performance on the WISC-IV as well as the PPVT-II, Caroline made several off-topic or irrelevant comments and responses during both the interview and administration of standardized assessment measures. On one measure, the Rotters’ Sentence Completion – Child Form, which was administered orally because she could not sit down to read the responses, Caroline completed sentence stems with odd or unclear responses that oftentimes required several repetitions and clarification. For example, when presented with the sentence stem, “It isn’t nice to,” she replied, “meet each other.” She completed the sentence stem, “My mother,” with “wish [sic] that she will be a Cinderella.”
Visuo-spatial Skills
In order to assess Caroline’s visual, perceptual, and motor skills, she was administered the Developmental Test of Visual-Motor Integration – Fifth Edition (VMI). The VMI is a paper-and-pencil test in which individuals are instructed to copy a set of increasingly difficult objects. On the VMI, Caroline obtained a standard score of 101 (51st %ile), which falls within the average range. Her performance on this measure suggests that Caroline is able to integrate adequately visual-perceptual abilities with finger and hand motor movement. Nevertheless, her performance is significantly below her estimated high average range intellectual abilities as measured by the Perceptual Reasoning Index on the WISC-IV. This may suggest that Caroline’s visual-perceptual abilities are better developed than are her motor abilities, or, that both are relatively evenly developed, but that Caroline has more difficulty when required to integrate the two.
Socio-emotional Functioning
The following section provides insight into Caroline’s mood and behavior as well as the ways in which she perceives and interacts with the world. It is important to note that given Caroline’s considerable limitations in her capacity to perceive, understand, and respond to information that is presented orally, it was not possible to administer a full battery of standardized assessment measures. In particular, most standardized, self-report measures of a child’s functioning rely heavily on the use of questions and techniques that involve a large language component. In this case, it is likely that these measures would not serve as accurate representations of Caroline’s internal functioning because she has such limitations in articulating her thoughts, ideas, and feelings verbally. As such, Caroline was only administered two assessment measures, which should be interpreted with caution.
There is limited evidence to suggest that Caroline struggles with problems related to her mood or anxiety. Adults who know Caroline well perceive that Caroline sometimes struggles with depressed mood. Specifically, during an interview, Ms. Feng reported that Caroline frequently appears sad and cries. On the BASC-2, she rated Caroline within the at-risk range for problems with depression (BASC-2 Depression, T = 63, 90th %ile). Ms. Farley’s pattern of responding on the BASC-2 indicates that Caroline oftentimes appears withdrawn, pessimistic, and/or sad to a considerably higher degree than other children do (BASC-2 Depression, T = 76, 97th %ile). With respect to anxious behavior, neither Ms. Feng nor Ms. Carlisle reported that Caroline displays anxiety-based behaviors, such as worry, fearfulness, nervousness, or self-deprecation, more often than other same-age children do (BASC-2 Parent Report form Anxiety, T = 41, 20th %ile; Teacher Report form T = 43, 26th %ile). However, Ms. Feng did report that Caroline tends to be overly sensitive and complain about relatively minor physical problems and ailments (BASC-2 Somatization, T = 67, 94th %ile). Such a tendency sometimes represents a physical manifestation of anxious or mood symptoms. Ms. Farley, Caroline’s teacher from last year, did endorse that Caroline exhibits behaviors related to anxiety at an at-risk level (BASC-2 Anxiety, T = 62, 88th %ile). She also commented that Caroline bites her fingernails “constantly,” but did not rate her within the at-risk or clinically significant range for somatic problems (BASC-2 Somatization, T = 57, 82nd %ile).
Caroline’s presentation throughout the evaluation does not suggest that she experiences significant problems related to mood or anxiety. Nevertheless, as noted above, Caroline was only administered one standardized psychological measure because of her problems with oral information. Her responses on this measure may not adequately reflect her functioning as it relies heavily on children’s ability to express themselves verbally. Specifically, Caroline was administered the Roberts Apperception Test – Second Edition (Roberts-2), which is a projective measure in which children and adolescents are presented with illustrations of individuals engaged in various interactions. The children are asked to tell a story about the illustration and describe what happened before, during, and after the situation depicted in the card. They are also asked to describe the individuals’ thoughts and feelings. In general, Caroline’s stories on the Roberts-2 did not contain themes of depression, anxiety, or anger at clinically significant levels. Further, during an interview, Caroline denied that she worries or feels nervous. When asked what she worries about, she replied that her mother will die and she will not see her again.
The results of the evaluation suggest that Caroline has significant problems with hyperactive and impulsive behavior, which are easily evident to Caroline’s mother and teachers. Specifically, reports from Caroline’s mother and teachers as well as observations during testing reveal that Caroline frequently leaves her seat, talks excessively, interrupts others, and fidgets. To capture Caroline’s mother’s and her teachers’ perceptions of her behavior as compared to other same-age children, Caroline’s mother and two teachers were administered the BASC-2 and the Conners’ Parent or Teacher Rating Scale – Revised Edition (Conners’). On both the BASC-2 as well as the Conners’, Ms. Feng perceived that, when compared to other same-age children, her daughter frequently engages in disruptive, impulsive, and uncontrolled behaviors at an extremely high and clinically significant level (BASC-2 Hyperactivity, T = 75, 98th %ile; Conners’ Hyperactivity, T = 84). These behaviors include being overly active, difficulty sitting still, rushing through work and activities, and acting without thinking. Similarly, Caroline’s teachers reported clinically significant elevations in Caroline’s hyperactive and impulsive behavior on both the BASC-2 (Hyperactivity, T = 79, 98th %ile; T = 73, 96th %ile) and the Conners’ (Hyperactivity, T ≥ 90; T = 83).
Caroline also exhibits difficulty with attention and concentration. According to reports from her mother and teachers, Caroline easily distractible, has difficulty maintaining concentration on tasks and homework, and requires repetition of directions and instructions at home and school. As noted above, observations during the current evaluation indicate that Caroline appeared more distractible on measures that required her to perceive, understand, and express verbal information. On the BASC-2 and the Conners’, Ms. Feng’s pattern of responding indicated that Caroline has a significant difficulty maintaining necessary levels of attention and concentration (BASC-2 Attention Problems, T = 70, 97th %ile; Conners’ Cognitive Problems, T ≥ 90). Such difficulty likely manifests as problems with organization, completing tasks and schoolwork, and sustaining concentration especially on tasks that require more mental effort. Caroline’s teachers perceive that she has some difficulty with distractibility and poor concentration but to a lesser degree than her mother does. In particular, on the BASC-2, they rated her within the at-risk range for problems with distractibility and concentration (BASC-2 Attention Problems, T = 69, 98th %ile; T = 64, 88th %ile) while on the Conners’ they did not (Conners’ T = 60; T = 55). Caroline’s teachers also answered questions regarding her academic performance at school. Ms. Farley and Ms. Carlisle did not indicate that Caroline has any problems with academic achievement in the areas of reading, writing, or mathematics (BASC-2 Learning Problems, T = 50, 61st %ile; T = 50, 61st %ile). Nevertheless, Ms. Farley observed that Caroline exhibits behaviors, such as problems with motivation, attention, learning, and/or cognition that interfere with her overall academic success (BASC-2 School Problems, T = 60, 86th %ile). Ms. Carlisle also indicated mild problems with study skills, such as problem solving, note taking, organization, motivation, and completing homework (BASC-2 Study Skills, T = 38, 15th %ile).
Caroline appears to exhibit some oppositional and, at times, aggressive behavior. At home, Caroline reportedly exhibits some oppositional behavior such as not following directives, throwing tantrums, and fighting with her cousins. On the Conners’ Ms. Feng rated her daughter within the clinically significant range for oppositional behaviors, such as breaking rules, problems with authority, and becoming easily irritated and angered (T = 89). However, on the BASC-2, her responses do not indicate that Caroline exhibits rule-breaking or aggressive behavior more often than other children her age (Conduct Problems, T = 56, 76th %ile; Aggression T = 55, 73rd %ile). According to Ms. Farley’s and Ms. Carlisle’s responses, Caroline exhibits at-risk to clinically significant levels of rule-breaking and oppositional behavior at school (BASC-2 Conduct Problems, T = 73, 97th %ile; T = 63, 90th %ile; Conners’ Oppositional, T = 64; T = 64). Ms. Farley also perceived that Caroline acted aggressively towards others last year at levels that place her in the at-risk range (BASC-2 Aggression, T = 67, 93rd %ile). During the current evaluation, Caroline required redirection to remain on task and, at times whined that she did not want to continue with testing because she found it too difficult. However, she responded well to praise and redirection and was able to complete all that was asked of her.
Concerns were raised that Caroline exhibits odd or inappropriate behavior. Ms. Feng is concerned that her daughter talks and laughs to herself, especially at night. Further, her teachers noticed that Caroline oftentimes makes off-topic and unrelated comments during classroom instruction. On the BASC-2 Ms. Feng reported that Caroline exhibits strange or odd behaviors much more often than other children do (Atypicality, T = 74, 96th %ile). Specifically, she endorsed that Caroline sometimes does and says strange things and appears “out of touch” with reality and that she often babbles to herself. Caroline’s teachers also rated her within the at-risk to clinically significant range for odd or strange behavior (BASC-2 Atypicality, T = 79, 97th %ile; T = 66, 92nd %ile). Like Ms. Feng, they also endorsed that Caroline sometimes does and says things that are odd or do not make sense. Neither Caroline’s mother nor her teachers endorsed that she ever sees or hears things that are not there. Throughout the evaluation, Caroline made comments that were off-topic or irrelevant. Nevertheless, these comments appeared more related to her difficulty in expressing herself verbally, rather than representative of disorganized thinking or responding to internal stimuli.
The following paragraphs refer to the manner in which Caroline interprets, understands, and responds to events and experiences in the world. It provides specific information regarding her problem-solving, coping, and interpersonal skills.
Caroline was administered the Roberts-2 to evaluate her problem-solving abilities. Again, the findings from this measure must be interpreted within the context of Caroline’s limited abilities to express herself through verbal language. In assessing problem-solving ability, the Roberts-2 focuses on children’s ability to reason through problems effectively as well as their perceptions of and access to internal and external sources of support. Effective reasoning, involves the ability to recognize, understand, and resolve problems effectively and positively. Caroline exhibited problems in her capacity to perceive and identify problems accurately. Specifically, many of her stories did not identify key elements depicted in the pictures (Popular Pull, T = 38). Further, her stories only contained immature and vague identification of each character’s feelings, behaviors, and problems (Problem Identification 1, T = 77). They lacked more elaborate detail and explanation of the causes of these feelings, behaviors, and problems (Problem Identification 2, T = 32). Such an approach to situations is below her age level and demonstrates that Caroline likely overlooks or misidentifies problems in her day-to-day routine and has significant trouble considering how these problems came about. This is more typical of children who are referred for mental health treatment. Taken as a whole, her performance on the Roberts-2 suggests that Caroline likely has problems picking up on, understanding, and responding to social cues in her environment and likely is unaware of when problems arise. She probably has difficulty figuring out the expectations for appropriate behavior that are required of her in specific situations. As such, she is vulnerable to behavior that is off-topic, irrelevant, or inappropriate. Nevertheless, when Caroline is able to identify and accurately perceive cues and problems, she demonstrates age-appropriate ability to generate solutions to problems. As do most children her age, Caroline resolved the problems in her stories with relatively simple solutions that provided little to no elaboration on the process behind achieving the solution (Resolution 1, T = 40; Resolution 2, T = 56). Two of Caroline’s stories described outcomes to the situations that were detrimental, which is uncommon for children her age (Maladaptive Outcome, T = 75). Specifically, after telling a story in which a little girl breaks a chair and then proudly fixes it on her own, Caroline ended the story by stating, “and then she messed up the chair.” In sum, Caroline’s performance on the Roberts-2 reveals that she lacks age-appropriate and adequate ability to perceive and understand effectively information in her environment regarding social interactions and problems. This predisposes her to off-topic and at times, inappropriate verbalizations and behavior. However, when she is able to perceive accurately information, she is able to respond appropriately and work-through problems effectively.
The Roberts-2 also evaluates children’s perceptions of their internal and external resources to cope with problems. Caroline’s responses on the Roberts-2 suggest that she experiences positive feelings about herself and has an appropriate level of self-esteem (Support Self – Feeling, T =67). She appears to possess adequate internal skills to handle her emotions and resolve problems on her own (Support Self – Advocacy, T = 66). She finds that others in her support system are positive, nurturing, and responsive to her needs and, as such, reaches out to them for support and assurance (Support Other – Feeling, T = 59; Support Other – Help, T = 43; Reliance on Other, T = 51).
Caroline displays limited social skills. According to her mother and teachers, despite her best efforts and desire for friends, Caroline has difficulty initiating and maintaining friendships. She oftentimes disrupts, bothers, and annoys other children to such an extent that they do not enjoy playing with her. On the BASC-2 Ms. Feng and Ms. Carlisle rated Caroline in the at-risk range for problems with social skills (BASC-2 Parent Report form Social Skills, T = 37, 10th %ile; Teacher Report form, Social Skills, T = 34, 5th %ile). Caroline probably has difficulty complementing or encouraging others, offering assistance, and making tactful and socially appropriate statements. Further, Caroline’s teachers perceive that she is in the at-risk range for withdrawn behavior (BASC-2 Withdrawal, T = 66, 92nd %ile; T = 66, 92nd %ile) and they view her as sometimes alone, lonely, and rejected. Caroline herself is aware of her problems in connecting with other children her age. During an individual interview, when asked what things make her mad or sad, she remarked when other children do not play with her.
Caroline’s relationship with her mother merits immediate intervention. In order to better assess how she perceives her interactions and relationship with her daughter, Ms. Feng was administered the Parenting Stress Index/Short Form (PSI/SF). Ms. Feng’s responses to items on the PSI/SF suggest that she answered openly and honestly (PSI/SF DR subscale, > 95th %ile). It appears that Ms. Feng experiences a clinically significant level of distress regarding her role as a mother to Caroline (PSI/SF PD subscale, 95th %ile). Such an elevation may indicate that Ms. Feng lacks confidence in her ability to parent Caroline and/or lacks social support. She also finds it difficult to manage Caroline’s behavior in terms of setting limits and gaining her cooperation (PSI/SF DC subscale, > 95th %ile). She perceives a clinically significant level of negativity in her interactions with Caroline (PSI/SF P-CDI subscale > 95th %ile), which may represent that there is not a strong bond between Ms. Feng and Caroline or that Ms. Feng feel rejected by or alienated from Caroline. Overall, Ms. Feng’s responses reflect that she struggles with a clinically significant level of overall stress as a parent to Caroline (PSI/SF TS > 99th %ile). Throughout the evaluation process, Caroline referred to her relationship with her mother often. Specifically, as noted above, she stated that during those times that she does worry, she worries that her mother will die. On the Rotters’ Caroline brought up her mother several times. For example, she completed the sentence stem, “I worry about,” with “my mom – she’s gonna be mad at me.” She completed the sentence stem, “It makes me sad to,” with “when my mother goes to Sacramento.” Finally, she responded to the sentence stem, “the worst thing that ever happened to me was,” by noting a time when her mother got angry with her.
Diagnostic Impressions
Caroline is a 7-year-old Chinese female who was referred for a psychological assessment by her psychiatrist, Robert Horst, M.D., to address concerns regarding her difficulty with inattentive, hyperactive, and oppositional behavior. Concerns that Caroline exhibits odd, irrelevant, or off-topic behavior were also raised. Caroline’s mother and mental health providers would like a better understanding of her presentation in order to implement appropriate interventions.
Caroline evidences considerable delays in her language development to such an extent that she meets criteria for a diagnosis of Mixed Receptive-Expressive Language Disorder. As demonstrated by her scores on the WISC-IV, PPVT-III, and VMI, Caroline’s performance on measures of expressive and receptive language and verbal intellectual abilities was significantly below her performance on measures of nonverbal intellectual ability. Specifically, on the WISC-IV she performed in the borderline range on subtests assessing verbal concept formation, verbal reasoning, and general fund of knowledge. Similarly, on the PPVT-III, she demonstrated extremely low receptive language skills. In contrast, Caroline displayed high average nonverbal reasoning ability and processing speed on the WISC-IV and average range visual, perceptual, and motor skills on the VMI. Because English is a second language for Caroline, it would be reasonable to wonder whether her delays in language are because she has not yet mastered the English language. It is beyond the scope of the current evaluation to assess Caroline’s language and communication skills in Chinese. However, her mother and current psychiatrist, both of whom are native speakers of Chinese, stated that Caroline exhibits problems in understanding and expressing herself with oral language. Although it is not possible to provide a definitive statement concerning her communication in Chinese, there is sufficient evidence to suggest that Caroline’s problems with communication are likely the result of a disorder of language and communication rather than learning English as a second language. It is also important to note that because Caroline evidences such high nonverbal abilities and processing speed as well as average range attention, others may not perceive that how taxing it is for her to understand and employ oral language. As a consequence, she is at risk for the misperception that she is an odd, oppositional, or intentionally disruptive girl.
Such problems with receptive and expressive language have far-reaching implications for Caroline’s functioning across a variety of domains including attention and behavior, problem-solving, and social skills.
Caroline has a long-standing history of problems with attention, concentration, hyperactivity, and impulsivity. Currently, she is diagnosed with Attention-Deficit/Hyperactivity Disorder, combined type and Disruptive Behavior NOS. Reports indicate that she is easily distracted, has difficulty maintaining concentration on tasks and homework, and requires repetition of directions and instructions at home and school. Moreover, Caroline reportedly frequently leaves her seat, talks excessively, interrupts others, fidgets, and is impulsive. Throughout the evaluation, Caroline exhibited mild distractibility and moderate hyperactivity and impulsivity, all of which varied with the demands of the task. On those tasks that did not require a verbal language component, Caroline exhibited mild, if any, inattention. Indeed, on the WISC-IV she displayed adequate to advanced abilities to sustain attention, concentrate, and retain and manipulate information in short-term memory. This is not typical for children who are diagnosed with Attention-Deficit/Hyperactivity Disorder. Caroline appeared more distractible, hyperactive, and restless on measures that required her to listen to, process, and respond to verbal information. Therefore, although Caroline demonstrates some problems with inattention, hyperactivity, and impulsivity, it is not possible to determine whether these problems represent a true diagnosis of ADHD. There is such a significant overlap between symptoms related to a diagnosis of Mixed Receptive-Expressive Language Disorder and Attention-Deficit/Hyperactivity Disorder that it is not possible to determine whether Caroline’s symptoms of ADHD may be subsumed under the diagnosis of Mixed Receptive-Expressive Language Disorder. For that reason, it will be important to continue to monitor Caroline’s symptoms to rule out a diagnosis of Attention-Deficit/Hyperactivity Disorder.
Although concerns were raised regarding Caroline’s tendency to make irrelevant or off-topic comments and to engage in inappropriate behavior, the findings from the current evaluation do not suggest that Caroline functions at a psychotic level. Specifically, multiple sources denied any evidence that Caroline responds to internal stimuli, such as auditory or visual hallucinations, or engages in any form of delusional thinking. Rather, it is likely that, as with her symptoms of ADHD, Caroline’s limited language and communication skills dramatically affect her speech, behavior, and interpersonal interactions to such an extent that others may perceive her as odd or strange. Caroline’s language disorder makes it extremely challenging for her to determine when, where, why, and with whom communication should occur. She has problems in understanding and following oral directions as well as with initiating, maintaining, or terminating a conversation. Consequently, she likely appears confused, inattentive, or oblivious. She has the potential to interrupt conversations, talk excessively, or confuse listeners by switching from one unrelated subject to another. Further, Caroline probably overlooks the subtleties of conversation, such as facial expressions, gestures, posture, tone of voice, and personal space. As such, she may not be able to interpret the tone of conversation and may miss the main point of social interactions. She may make comments that appear arbitrary or insensitive even though she does not intend to hurt anyone’s feelings. She may also miss important situational and environmental cues like day-to-day rules and routines, which can lead others to perceive her as oppositional or defiant. Taken as a whole, Caroline’s speech and behavior are likely a manifestation of her language disorder rather than a true psychotic process.
Recommendations
1. The following recommendations are made to address Caroline’s delays in language and communication:
a. Caroline should receive a thorough hearing evaluation to rule out the presence of any underlying problems with hearing that may affect her language and communication.
b. Caroline should receive an extensive speech and language evaluation by a qualified professional to determine the nature and extent of her language disorder.
c. It is critical that Caroline receive speech and language therapy with a qualified language pathologist.
d. Caroline should be re-evaluated in one year to assess her progress in speech and language.
e. Caroline’s teachers may find the following strategies helpful in supporting Caroline within the classroom:
• BE PATIENT: Allow Caroline at least 10 to 15 seconds to process what is said as well as additional time for her to formulate a response.
• Employ a multi-modal approach to encourage Caroline’s encoding and understanding of information.
o Pair visual cues (i.e. pictures, graphs, charts) and nonverbal gestures with verbal communication in the classroom.
o Supplement verbal instructions with visual guides whenever possible.
o Use picture dictionaries that illustrate the meaning of the words and ideas.
o Whenever possible, use mechanical aids such as videotapes, books on tape, and computer programs, to supplement verbal instruction and assignments.
o Use materials and objects (i.e. clay, drawings, pictures, models) whenever possible to make abstract learning more concrete.
• When giving verbal instructions:
o Break them down into smaller, simpler phrases and concepts.
o Repeat directions.
o Ask Caroline to repeat instructions in order to ensure that she understands.
• Limit the demands on Caroline to express herself orally:
o Allow her to read prepared work rather than speak from memory.
o Ask questions that do not require detailed elaboration. Instead, use questions that allow for yes or no answers, the use of demonstration, or visual/physical responses (i.e. pointing to a map or a picture, gesturing).
• Caroline will likely benefit from accommodations such as seating near the teacher, extended time on tests and assignments, and modified homework and class work.
f. Caroline’s mother may find the following strategies helpful in supporting Caroline at home:
• She may find the American Speech-Language Hearing Association to be helpful in providing her with additional information regarding Caroline’s diagnosis:
ASHS National Office
2200 Research Boulevard
Rockville, MD 20850-3289
Phone: 301-296-5700
Website: www.asha.org
• BE PATIENT: Allow Caroline at least 10 to 15 seconds to process what is said as well as additional time for her to respond.
• Use visual cues, such as pictures, graphs, charts, and nonverbal gestures to help explain things to Caroline (please refer to attached handouts for ideas).
• Ask questions that do not require detailed elaboration. Instead, use questions that allow for yes or no answers, the use of demonstration, or visual/physical responses (i.e. pointing to a map or a picture, gesturing, or enacting concepts).
• When giving verbal instructions:
o Break them down into smaller, simpler phrases and concepts.
o Repeat directions.
o Ask Caroline to repeat instructions in order to ensure that she understands.
2. Caroline and her mother are encouraged to remain in therapy. Through therapy, Caroline’s therapist can help Caroline and her mother learn, practice, and employ
a. Helpful strategies for better language and communication skills:
• Develop and employ scripts to set a structured format for Caroline to practice and follow. For example, to help Caroline initiate conversations with her peers, it may be helpful her to rehearse a script such as:
o “Hello, my name is Caroline. What is your name?”
o “My name is .”
o “Would you like to play with me?”
o “Sure.”
o “Do you want to draw a picture with me?”
o “No.”
o “How about we play with the ball?”
• Role play and model acceptable and appropriate responses in specific situations (i.e. in class, on the playground, during a serious conversation). It may be important for Caroline to:
o Take the perspective of someone else in the situation. For example, in discussing the illness of a peer’s grandmother, encourage Caroline to think about how she would feel if placed in a similar situation. What words, facial expressions, and gestures might she choose to relate her feelings?
o Discuss the words, facial expressions, and gestures that are appropriate in different contexts. For example, brainstorm the appropriate responses for situations, such as during classroom instruction (i.e. children are expected to sit in their seats, make eye contact, and remain quiet). Make sure when brainstorming to make a list that is both verbal as well as visual. Draw pictures or make models next to ideas on the list.
o Practice talking to different types of people such as authority figures (teachers, principals), strangers (clerks, waitresses), relatives, and peers.
o Build responsiveness to nonverbal cues.
Use charts or pictures with faces showing different feelings.
Use a mirror and have Caroline demonstrate different facial expressions related to feelings.
Ask Caroline to look at pictures from magazines and books to describe how the people are feeling.
Use videos of TV shows or movies and stop the program periodically and ask Caroline to identify the characters’ feelings and why the character is feeling that way.
Model and practice different postures that relay feelings (clenched fists for anger, head down for sadness).
Discuss and practice tones of voice for different feelings (i.e. loud and fast means angry).
b. Because of Caroline’s difficulty in effective communication, she is at risk for becoming easily frustrated and engaging in angry outbursts. Therapy can provide Caroline and her mother practice with employing nonverbal means of emotional expression.
• Caroline’s therapist may find it beneficial to first devote time to helping her develop concrete and simple strategies for acknowledging, processing, and communicating her internal experience. She may find the following strategies easier modes to figure out how she is feeling, rather than typical questions, such as, “how are you doing?” or “what are you feeling?”
o At first, Caroline may find it helpful to practice attending to and identifying physical perceptions (heart rate, shallow breathing, muscle tension, stomachaches, lump in throat, tight chest, etc.).
o Next, encouraging her to relate physical perceptions to psychological experiences will be important (i.e. “When my heart is racing, I feel anxious.”).
o Finally, once she has demonstrated the ability to identify physical perceptions and psychological experiences, Caroline can engage in tasks that foster recognition of how these perceptions and experiences relate to her behavior. For example, she can practice filling in the blanks to sentences such as, “When I feel anxious, I scream, yell, fight.”
• Caroline should be provided with practice aimed at increasing her emotional vocabulary. For example, she should be encouraged to learn several words that describe a particular feeling (i.e. mad: angry, irritable, irate, frustrated, etc.) as well as learn to differentiate the different degrees of intensity of each feeling (i.e. irritated is less intense than angry, which is less intense than enraged).
• Caroline will likely find it helpful to develop a variety of practical, specific, and concrete ways to express his emotions (i.e. stomping feet = anger). Please refer to attached sheets for specific ideas.
3. It is strongly recommended that Ms. Feng set aside at least 15 to 20 minutes each day to spend alone with Caroline to participate in a fun activity(ies) of Caroline’s choosing. This time should be dedicated to increasing both Caroline’s and her mother’s pleasure in interacting with each other as well as their bond to each other. Ms. Feng should continue to make efforts to reaffirm Caroline and provide her with affectionate and nurturing demonstrations of love.
4. It will be important that Caroline continue to be seen by a psychiatrist to monitor the need for psychotropic medication to address her difficulty with inattentive and hyperactive behaviors.
5. Because Caroline is an energetic and active girl, she may find enrollment in classes that focus physical energy into positive and healthy outlet, such as sports, enjoyable. She may also find art classes or activities like pottery, finger painting, or sculpture engaging and fun.
Caroline has several strengths that will continue to serve as assets to her overall development. She is a bright, charming, and warm child who demonstrates a strong interest in connecting with and pleasing others.
I appreciated the opportunity to meet with Caroline and hope that this information will be helpful in guiding your work with her. If you have any questions regarding the results of this evaluation or recommendations, please feel free to contact me at (916) 875-1183.
Andrea Hindes, Ph.D.
Licensed Clinical Psychologist (License #PSY 21725)
| Translation - Chinese
心理评估报告
姓名: Caroline Hoang
MR #: 75911500
年龄:7 岁
出生日期: 8-16-2001
评审日期: 6-23-2008, 7-14-2008,
7-21-2008, 8-4-2008,
8-25-2008
检验员:Andrea Hindes, Ph.D.
推荐人: Robert Horst 医生.
Cassandra Ariaz 治疗师.
评审包括:
采访:
对母亲做临床采访(林峰，Lynn Feng)
附属资料来源： 治疗师 (Cassandra Ariaz, M.F.T.) 和精神病医生(Robert Horst, M.D., Hong Shen, M.D.) 服务于 Visions Unlimited 精神健康中心
间接的资料来自教师(Florin 小学的Mrs. Diane Farley 和Samuel Kennedy 小学的Jennifer Carlisle )
审查记录
Feixi 县的社会福利机构
Vision精神健康中心
心理测试;
儿童行为评估尺度的第二版 ,Behavior Assessment Scale for Children –(BASC-2):老师和家长表格
Conners’ Parent Rating Scale-Revised ，Conners’ 父母评估级别-修订本:简表格（CPRS-R）
Conners’ 老师评估级别-修订本简表格（CPRS-R）
Roberts领悟力测试（儿童用）
造句的完整性 – 儿童用
Wechsler 智力等级 --儿童用 – 第四版 (WISC-IV)
识别资料和转介理由,
Caroline Caloline是一个7岁的中国女孩，由她的精神科医生Robert Horst转介来做心理评估。特别是,她对问题的理解和执行指示的能力、她的注意力，不安静和烦躁坐立不安等。还有人指出, 她会做出很古怪,离题的,或难以理解的表达, 而且，当她一个人的时候，她还会对自己谈笑。最后,有人注意到,当她的需求没有得到满足时， 她会愤怒及做出对抗的行为。 Caloline的精神健康服务提供者和她的母亲希望能对诊断有更好的了解,以便采取适当的因应措施。
过去背景
目前Caroline 和她养母、Lynn Feng、收养舅舅，叔叔，阿姨, 和三个堂兄弟住在一起。 Ms. Feng 是出生在中国的中国人。 她于大约10年前搬来美国。她的第一语言是中国普通话和粤语, 这是她和她的家庭在家里与Caroline说话时所用的语言。 Ms. Feng能说一些英语; 不过,当出席精神健康服务提供者的会议时，她需要雇用翻译。为了目前的评审目的, Asian Pacific Community （亚洲太平洋社会咨询）的口译员Mary Ninh（玛丽亚宁）为Ms. Feng翻译采访的内容和被问到的问题。Mary Ninh在过去和Ms. Feng同事过。据Ms. Feng说,Caloline和她的家庭成员的关系一般来说还算好。不过,Caroline很难与她的堂兄弟姐妹们相处。他们不想和她玩，因为她总是与他们争吵和打架。在整个评审中,Caloline说,她的8岁表弟经常取笑她，这使她感到非常不快。 据说Ms. Feng很少有时间和她在一起。这是因为她有严格的工作日程。而且，Caroline的阿姨在家通常也可以照顾她。
Caroline两岁半时，在中国被Ms. Feng 收养。中国肥西县社会福利机构的文件显示，Caroline在大约6个星期大的时候，被亲生父母所弃。经过两个月的尝试,人们没法找到Caroline的亲生父母,于是就将她送进一个孤儿院, Caroline留在那里一直到被Ms. Feng收养为止。领养Caroline后,Ms. Feng 带她回到自己和先生居住的美国密西西比州。文件显示,不久后，Ms Feng和丈夫离异,于2006年搬到萨克拉门托。 Caroline并不知道她是被领养的。在一次个人的采访中，Caroline说, 她出生在中国, 但对童年没有记忆。 她还说, 她一直和她的母亲住在一起, 她没有父亲。
发展历史
Caroline没有自己的出生之前、出生时、或早期婴儿阶段的记载。当她住在孤儿院时，孤儿院没有提供给 Ms. Feng 有关Caroline的任何重要成长细节，也没有她照顾者的纪录以及她的行为或身体健康方面的记录。不过,她推测,Caroline在孤儿院时遭到忽略，而且营养不良。 当Caroline刚被领养时，经常咬人或打人,并向他们丢东西。 在被领养时，Caroline已经会走路,但还没有开始说话 ,在她三岁前，即使连一个单字或词句都不会。从那时起, Caroline已学会了英语、粤语和普通话. 在家里，Caroline通常讲广东话和普通话。 在学校时,她比较喜欢讲英语。 Ms. Feng 注意到, Caroline的粤语或国语都不流利。她必须讲得很慢才能让Caroline听懂。Caroline的母亲,老师和心理保健服务提供者说, 不论是中文还是英文, Caroline往往都很难去听懂，以至于无法遵从指示和方向, 而且她的谈话显得思想混乱、健忘、和心不在焉。此外,当说话时，人们往往很难理解她的意思,因为她讲些毫不相干, 离题或不适当的句子。
家庭历史
我们没有关于Caroline的亲身家族史。
病历
Ms. Feng说,Caroline自被领养后，一直还算是相当健康，她从没有重大疾病、也没有受伤、手术、或住院治疗过。她有季节性过敏。为此，她过去一直服药。 她没有头部受伤,失去知觉,或羊颠疯抽筋的历史。
Ms. Feng没有报告任何的听或视觉方面的问题。据报,Caroline睡觉有困难。在床上时，经常发笑和对自己说话。Ms Feng否认Caroline怕黑和需要别人陪她睡, 也没说她尿床或会做噩梦。 Ms Feng还表示,Caroline从未被证明或经历过任何身体、情感、或性方面的虐待。
精神病历史
Caroline过去于2007 的4月因为坐不定,无法遵守指示，太多话而被交给做精神健康治疗。她被交到 Visions精神健康中心 (Vision Unlimited Mental Health Center）,现正接受物理治疗师和精神科医生的治疗。
目前,她被诊断为注意力不足/过动症、复合型破坏行为及思想混乱在治疗时，Caroline 和Cassandra Ariaz, 治疗师处在一起 来改善她的注意力，情绪表达能力和过动的毛病。 Ms. Aariaz还和Ms Feng一同工作并向对方学习和练习适当的限制制定和行为管理。 根据Ariaz说, Caroline和她的母亲出席治疗的时间不一定，大致是每月一次或两次。最初, 由于Ariaz和Ms Feng 有语言 隔阂的缘故, 治疗很难进行。Ms Feng 不愿意让翻译员介入。 不过,现在Ms Feng允许玛丽•宁（Mary Ninh） 出席治疗的会谈。
Caroline也开始与Vision 的精神科医生、Robert Horst合作, 于2007的7月 述说了自己的注意力不集中、多动症方面等问题。目前她每天上午服用医生开的药方Adderall XR(10毫克)。根据Horst 医生， Ms Feng十分关切的是,Caroline很不懂礼貌以及行为不端, 特别是与她的表兄弟妹们比较。经与Caroline的老师谈过后, Horst 医生推测, Caroline在她母亲面前的行为不当要比在老师面前多。据说 在Caroline接受治疗期间以及和精神病学家约谈的时候，显得很有礼貌，而且对举止限制和结构反应良好。 在9月份, 因为Horst 医生离开了Vision，Caroline被转到新的精神科 Shen 医生那儿。 Shen医生的母语是普通话和粤语。 他报告说,在一次采访时,Caroline显得很难沟通和表达自己的英语、中文、和粤语。
Shen医生表示, 很难听懂他的话 ,而且经常作出无关紧要或离题的发言和反应。
教育历史
在Samuel Kennedy 小学，Caroline是个二年级生。 Carolin目前的老师, Jennifer Carlisle,和她的一年级老师 ，Diane Farley都说, Caroline在理解和听懂谈话和讨论方面有很大的困难。她经常讲些离题和与现实脱节的言论和故事。Caroline的老师们也说, 对课堂作业和交代学生做的事，她需要好几次重复解释才能了解Caroline。尽管她口头交流有困难、Ms. Farley 注意到,Caroline的阅读能力，包括流利和理解,都是足够的。在学校，Caroline还显出有注意力不集中,多动和冲动的毛病。她很难维持焦点和集中于某件事。 她烦躁不安,不能坐定，在教室徘徊、中断其他人， 以及讲太多的话。而且经常去打扰她的同学。最后,有人指出,Caroline在学校很难交上和维持朋友。Ms. Farley 观察到,在一年级开始时,Caroline经常和她同学打架,特别是在操场。 她会去打、咬和捏对方。有时, 老师不得不让她离开教室，和其他同学隔离。随着时间的推移,Caroline不再有这些行为,也不再显出有任何对抗或挑战的行动。不过, 她还是无法获得友谊，因为她的许多同学对她的无心、不安静、和过动的行为感到很困扰。
行为观察
Caroline参加了4节测试(2008 年的7月14日，7月21日,8月4日和8月25日) ，每次都是在Ms Feng的陪同下。在所有场合,Caroline都是梳洗打扮的很整齐，适当地穿上T恤衫、长裤, 和运动鞋。她的个子不高, 但和她的年龄相配。在等待每节测试时，她或是坐在她母亲的腿上，或是拥抱她。将她和母亲分开，让她来心理学家这边倒并不难。 她表现出热情和愉快,有温和的眼神接触, 并能做坦率和自然的交谈。
在每一节评审间, 她都很兴奋地将每节会话“赚来的”标贴炫耀给母亲看 。总的来说, Caroline有礼貌、尊重别人、及肯合作。她对重新的指示，称赞和奖励反应良好。不过， 有时, 她抱怨任务“太难“ 。她会讨价还价，争取更多的奖励来完成人们要她做的事。
在整个评审中，Caroline是相当地分心、冲动和不安定。在不需要详细了解或口头表达资讯的任务中，她显得比较自在。 有时，很难确定她是否理解指示和某些具体评估的问题。此外, 她的反应缺乏适当的细节和详细阐述,有时是互不关联,离题。 看来是补偿口头表达的不足，她会走出自己的座位,用比画和肢体动作来诠释她的答案和想法。
心理测试结果和诠释
认知和知识运作
为了评估Caroline的智慧能力,医生用Wechsler 智慧级别 的儿童-第四版(WISC-IV) 这本书来整理所获得的讯息。 WISC-IV 对儿童的知识能力提供一个整体的估计。此外,它提供 的儿童知识能力的估计跨越了四个特定的领域：口头理解、感性组织、处理速度和动用记忆。每个领域的成绩会被比较来衡量儿童能力的一致性。 四个领域中的各个相应分数对口头和非口头的推理方面以及处理速度和动用记忆方面的均衡发展能够做出建议。分数的重大分歧,可以显示儿童认知发展的重大优势和/或弱点。每个领域的得分是以标准分数来表示的。平均分数为100；标准偏差为15, 每一个领域的次测试得分则以10为平均分数，标准偏差为3。
得分 标准分数 95%信心值
间隔 百分位
全面IQ（智商）尺度 101 96-106 53
口头理解指数 77 72-85 6
感性推理指数 117 108-123 87
动用记忆指数 102 94-109 55
处理速度指数 112 102-120 79
口头理解指数 扩大比分 感性推理
指数 扩大比分 动用
记忆指数 扩大比分 处理
速度指数
扩大比分
相类似
3 方块设计 12 数位跨度 14 编码 12
词汇 6 图形观念 10 字-数字 7 符号搜寻 12
全面理解 9 矩阵推理 16 （算术） 10 （取消） 14
（信息） 9 （图片完成） 12
（文字推理） 6
Caroline在WISC-IV全面尺度智商得分为101， 这将她的整体能力置于平均范围的(53%Ile)不过，就组成全面尺度智商的那些指数而言有重大差异。因此,Caroline的全面IQ不是她的全面知识能力的最佳估计。 她在4个指数的成绩应分别审议。
Caroline的整体表现的 口头概念形成，口头推理和从环境获得的一般知识落在运作范围的边界（口头理解指数、标准分数=77、第6次%Ile）在组成VCI的次测试之间，她的表现不尽相同。在这些次测试中，Caroline显示对口头信息的了解有困难。事实上,很难确定她是否理解任务的指示,她要求将指示分为较小、较简单的句子以及不断地重复。在口头表达自己方面，她颇有困难，因为她的反应往往是模糊,混乱和脱离-主题。看来Caroline用肢体动作来弥补口头表达的不足，以及用手势来帮助将她的观点传达出去。
在特定的次测试中, Caroline在衡量口头抽象推理和语言表达(相似题,第一次%ile)上的表现属于极低的范围,相对于她自己的能力以及同龄学生的能力，这是一重大的弱点。在这项测试中,很难确定是否理解指示。特别是,她倾向于与对两件事说,“他们不一样,” 好像她被问到的是这两件事是不是类似的,而实际的问题是,为什么这两件事是类似的。 对长期记忆和字的知识和它们的意义的次测试中，她的平均评价很低。 这个表现与她自己的能力和其他同龄学生的能力相比，也显示出相对的薄弱。(词汇,第9级%Ile)
在这一测度中,她甚至对简单的文字都很难提供定义。 相反地,她会试图去使用那个句子里的字或是用行动来诠释那个句子的意思。比方说,当被问及“bicycle的定义,”Caroline会回答说,“你骑自行车”，然后她就离开自己的座位和假装兜着自行车在房间里绕。Caroline对经由口头材料来做推理,以及整合某一特别关念的不同类信息这两方面所展示的平均能力很低(文字推理,9等%Ile)虽然Caroline被观察到做离题或是做不相干的行为和谈话,对于传统行为标准,普通常识,社会判断等等，她表现出有平均和配合她年龄的知识。(理解、37%Ile) 对衡量一般事实的知识所作的次测试来说，她的表现还算在平均范围(资料,37次%)对于一般原则,事实,和社会判断，Caroline表现出充分和适当年龄的了解 ,但在重要的感知，透彻的推理,以及口头表达信息的能力方面，她相当的欠缺。
与她口头推理能力成鲜明对比的是、Caroline 展示高于平均的非口头推理能力(感性推理指数、标准分数=117,第87次%Ile)。 On a measure of nonverbal abstract reasoning and the ability to process information presented visually, Caroline performed in the very superior range (Matrix Reasoning, 98th %ile), which is a strength relative to her own abilities as well as those of other same-age peers 在一个非口头抽象推理能力及视觉信息处理测验中,Caroline的表现属非常优异的范围(矩阵推理,98%Ile次),这是相对于她自己的能力以及其他同龄学生的能力。她在这个次测试的成绩与她的极为低水平的相似次测试表现形成了强烈的对比。相似次测试，上面提到过,也评估抽象推理和处理,但需要一个语言部分。在另一个非口头抽象及明确推理的测试中,Caroline的表现属平均范围(图片概念,50次%Ile) 在鉴定图像识别和确认时， 非口头概念的形成，和将整体分成组成部分的能力方面，她的表现属平均的高端(图片完成,75次%ile;模具方块设计、75次%Ile)总的来说,在感性和多向推理、空间处理和视觉机动整合方面 Caroline展示出发展得很好的能力。 当不被要求去察觉和用口头表示信息时,Caroline表现出发展得很好的和先进的智慧能力，高于86%的其他同龄儿童。
在保持注意力,集中,并运用精神控制方面，Caroline展示平均能力范围 (记忆动用指数、标准分数=102,55次%Ile)然而,在横越WMI 次测试中，她的表现有很大的幅度变化。在短期听力记忆的鉴定中,她的表现属高平均范围,这是指相对于她自己的能力以及她同学的能力而言(数字跨越、91次%Ile)。 在鉴定不致分心，短期记忆及计算技能方面，她的表现大幅降低， 是属于平均范围（算数, 50th %ile).） 她的这种差异表现可能是和口头次试的要求有关,因为它要求一个人能理解 ,处理及记得口头提出的资料。Caroline在顺序处理和短期记忆方面的表现是低于平均范围(数字编号顺序、37%Ile)。 她的这一项表现就大大低于她的其他 两个组成WMI的次测试的表现，这是她相对薄弱的部分。虽然Caroline在众WMI次测试的表现各有不同,她展示了足够的能力来暂时保存资料在记忆中、以便处理和操纵这些资料来产出结果。
Caroline表现有高于平均的能力来处理那些过程简单或例行的视觉材料而不致于出错(处理速度指数、标准分数=112,第79次%Ile)Caroline的表现 在组成PSI的各别次试中是一致的, 在视觉选择性注意和处理速度的评审中,她的表现属于高于平均的范围(取消,91次%勒),远高于同龄儿童。Caroline在表现一致。这显示在需要协调的精工技能,短期记忆,和学习能力方面， 她的表现属平均范围的高端(编码,75次%Ile)在也须用视觉记忆和顺序处理，但较严格要求在没有心理肌肉运动的成份下注意细节和精神控制方面的鉴定中,她表现在平均的高端,(符号搜索,75次%Ile)Caroline在处理速度的次试中的表现显示她有发展得很好的能力来很快地正确地做扫描，次序，辨别和记住简单的视觉资讯。
总之, 在口头和非口头能力、动用记忆和处理速度这些方面，Caroline表现出相当大的能力差异。
虽然 她在非口头能力，处理速度,和动用记忆方面发展出高于平均水平的能力，她的口头能力降至运作的边界线上。他所显示的口头和非口头能力的重大差异是罕见的，发生在少于百分之一的儿童身上。
由于她的能力有这样大差异的缘故，她的智商总分并不是智力的最好估计。照说，她的口头和非口头智力应该分开来考量，因为这是她智力运作的两个极端。
语言和沟通技能
有足够的证据显示，Caroline在口头资讯 的了解及表达方面有很大的能力限制。正如以前注意到的，很多个报告指出Caroline经常看来不听或者是了解指示，做出无关紧要及离题的说话。并且要求将指示分成小段以及不断地重复。为了以成人的角度去理解Caroline的几个方面的表现，她的母亲和两个老师被安排做了几个标准问卷调查， 其中的一个是儿童行为评估（Behavioral Assessment System for Children ）第二版本（BASC-2）BASC-2 是一个纸和笔的鉴定，用来获知儿童行为和心态，以及学习和适应的技能。Ms. Feng 完成了 BASC-2的父母报告表。在她的BASC-2 反应的总体图案显示，Ms. Feng 对每一个项目都回答得很认真而并没有以过于正面或负面的角度来鉴定Caroline。Caroline去年的学校老师Ms. Farley和她现在的老师Ms. Carlisle 完成了BASC-2的老师报告表。总体来说，他们对项目的内容也认真地看待，并没有企图用过于正面或过于负面的角度去描绘Caroline。不过，Ms. Farley’s 对评估中相当类似的项目的回答有些不一致，这表示，她的回答应被小心地诠释。在这次评估中，Ms. Feng 和 Ms. Carlisle 两人都报告说Caroline对了解和表达口头资讯显示有很大的困难（BASC-2 父母报告表，功能沟通T=32,5%ile; BASC-2 老师报告表，功能沟通， T=34 8%ile.）这样的沟通上的问题典型上表现在试图清楚地沟通想法，资讯或经验时遭遇到困难，以及在试图对问题做适当的反应或者是截取必要的资讯时遭遇到困难。
为了更清楚地评估儿童接受口头资讯的能力，Caroline被安排去做Peabody图画词汇测试，Peabody Picture Vocabulary Test – Third Edition (PPVT-III)。PPVT-III 评估儿童接受语言的能力。 它展示一系列4个图片附带一个提供的词汇字。儿童被要求指出那一个图片配该词汇字。Caroline的接受语言能力属于中等偏低范围(SS=84,14次%Ile)，是属5岁7个月年龄层。 就这项考验，她的表现是大大低于根据WISC-IV感性推理指数所估计的高平均知识能力。不过，接受语言的技能颇符合她WISC-IV口头理解指数所衡量的边缘线口头推理能力。当和她VCI的表现配合时,Caroline的PPVT-II 表现指出,她了解口头提出信息的能力有重大的问题。 难怪，多种来源都报告说，Caroline经常不听或不了解指示，做无关和离题的发言，并要求将指示分为小段，以及不断重复。
Caroline的理解和响应口头资料上的困难在所有评估中都再再显示。此外,在前面提到的WISC-IV 以及 PPVT-II表现，在采访和管理的规范评估审定中， 做了好几次离题或不相关的评论和反应。在一项称为Rotters’ Sentence Completion – Child Form（Rotters完成句子-儿童表）的测试中， Caroline的答案是用口头方式提供的，原因是她无法坐下来读反应。她完成的句子非常奇怪和亟不明确。经常需要好几次的重复和澄清才能弄清楚她的意思。例如,当题目给了一个梗句,“这样做不好“时，她的回答是,“互相见个面”， 她将梗句“我的母亲“ 联成 ”希望她是一个灰姑娘。”
视觉-空间技能
为了评估Caroline的视觉感性和机工技能，她被安排用Developmental Test of Visual-Motor Integration – Fifth Edition (VMI).（视觉移动整合发展测试第五版）来做评定。VMI是一个纸和笔的侧试,被试者被指示去复制一组越来越难的物件。在VMI，Caroline获得了一个标准分数的101(51%勒), 可归类为平均范围。她在这个测试中的表现显示出她有能力用手指和手的动作与接受视觉的能力作足够的整合。不过,她这里的表现是远低于Perceptual Reasoning Index on the WISC-IV给她估计的高平均范围知识能力。这表明,Caroline的视觉-感性能力比她的机动能力发展得较好。或是说两者是相当均衡地发展。但是,当需要结合的时候，卡洛琳有较多的困难。
社会情感运作
下面的一节洞察Caroline的情绪和行为以及她如何来看这个世界， 她如何和这个世界交流互动。
重要需注意的是，由于Caroline的口头提出的感知，理解，回应信息的能力有很大的限制、做一个全面的标准评估措施是不可能的。尤其特别的是，大多数标准化的儿童运作的自我报告鉴定，重重地仰赖使用有大量语文成分的问题和技术。在这一个情况，很有可能的是,这些措施不能当作Caroline的内部运作的准确表述。原因是, 她在口头阐述想法、关念和感受的能力上受到限制。因此, Caroline只有两个评价被执行, 它们应该被慎重地诠释。
有限的证据显示，Caroline遇到与她的心情或焦虑有关的问题时，颇有挣扎。知道Caroline的成人们认为 Caroline有时与抑郁情绪挣扎，特别是在接受采访时。Ms. Feng说,Caroline经常看来伤心及想哭。
在On the BASC-2, 的认定指出， Caroline在抑郁症的问题上属危险范围(BASC-2 抑郁, T = 63, 90th %ile).
Farley女士在BASC-2 的反应模式指出， Caroline经常出现退缩，悲观,和/或难过。其程度远超过其他儿童(BASC-2 抑郁症,T =76、97次%Ile)。就焦虑行为来说，Ms. Feng 和 Ms. Carlisle都没有报告说 Caroline显示有焦虑行为，比方说就担心,害怕、紧张、或自我抑郁等来说，Caroline并不比她同龄的儿童来得严重焦虑。不过,Ms. Feng确实报告说Caroline往往过于敏感和抱怨相当轻微的身体问题和疾病(BASC-2焦虑 T = 67, 94th %ile) 这种趋势有时是一种焦虑或情绪症状的身体表现。Caroline去年的老师Farley女士确是同意，Caroline表现的行为关联到危险层次的焦虑(BASC-2 焦虑, T = 62, 88th %ile). 她还表示Caroline“不断地”咬自己的手指，但并没有将Caroline评鉴为危险或躯体问题上有临床症状的范围(BASC-2 躯体, T = 57, 82nd %ile)..
Caroline在整个评价的表现，并不表明她经历过有关焦虑或情绪的重大问题。不过,正如上文所述,由于她口头资讯的问题，Caroline只被执行过一种标准化的心理鉴定。在这一措施的回应可能并没有充分反映她的运作, 因为它在很大程度上，依赖儿童的口头表达能力。具体来说，,Caroline是用Roberts明觉测试-第二版来观察的,这是一种潜力测试。在测试里，儿童和青少年可看到个人们所从事的各种互动。 儿童被要求就有关所看到的，说出一个故事，根据被发的卡片描述发生前，当时，和发生后的事。他们还被要求描述那个人的想法和感受。一般来说,Caroline在Roberts-2 的故事并不包含严重到临床重大水平的抑郁、焦虑、或愤怒的主题。此外,在接受采访时,Caroline否认她担心或感到紧张。当被问到她忧虑什么时,她回答说,她的母亲会死去,她将不再能看到她。
评定的结果表明，Caroline有严重的过动和冲动行为，这从Caroline的母亲和老师那边很容易得到证明。具体来说，Caroline的母亲，老师以及其他在测试中的观察者们的报告都指出，她经常离开座位，话讲得特别多，还打断别人的谈话。她也经常坐立不安。为了获得Caroline的母亲和老师们就她的行为和其他同学的行为做比较的看法，他们接受了BASC-2 和 the Conners’ 父母和老师评分 修订版 (Conners’)这个鉴定。 在BASC-2 以及Conners这两项结果上，Ms. Feng 的看法是 相比於其他同龄儿童，她的女儿经常从事破坏、冲动,和不受控制的行为，其程度达到极高和临床严重的级别(BASC-2 过动, T = 75, 98th %ile; Conners’ 过动, T = 84)。这些行为包括过于活跃,坐不定，工作和活动草率,行动不加思考等 。同样,在BASC-2 (过动, T = 79, 98th %ile; T = 73, 96th %ile) ，the Conners’ (过动, T ≥ 90; T = 83)两个测试中，Caroline的老师报告都认为她的过动和冲动行为达到临床问题相当的高峰。Caroline还展示出注意力和集中的困难。根据来自她的母亲和老师的报告,Caroline容易分心,很难维持集中一项任务和功课,在家和在学校都需要重复方向的指示。如上所述，目前的评价表明Caroline在感知，理解和表达口头讯息方面似乎较易分心。根据the BASC-2 和 the Conners’, 这两项结果，Ms. Feng’s 答复的模式表示Caroline在维持必要程度的集中上有相当程度的困难。(BASC-2 注意力问题, T = 70, 97th %ile; Conners’ 认知问题, T ≥ 90). 这种困难导致了组织，完成任务和功课，以及保持集中的问题，尤其是需要很多思考的做业。Caroline的老师认为,Caroline 有分心和无法集中的困难，但是其程度比她母亲要来得轻。特别是，在BASC-2，他们把她的分心和无法专心列入危险区(BASC-2 注意力问题, T = 69, 98th %ile; T = 64, 88th %ile) 。而在the Conners’ ，他们并没这样做(Conners’ T = 60; T = 55). Caroline的老师也就其在学校的学术表现回答问题。Ms. Farley 和 Ms. Carlisle 并没有指出她在学业上的读，写，和数学有任何问题。(BASC-2 学习问题, T = 50, 61st %ile; T = 50, 61st %ile). 虽然如此,Farley指出Caroline呈现的行为， 比方说，动机，注意力，学习和/或认知等方面，影响到她的总体学业表现（BASC-2 学校问题, T = 60, 86th %ile). Ms. Carlisle 也表示她在学习的技能，比方说，解答问题，写笔记，组织，动机和完成作业方面有轻度问题(BASC-2 学习技能, T = 38, 15th %ile)。
Caroline看来有一些对抗和,有时候，侵略的行为。在家里，据说她展现一些反对行为，如坏脾气，和与她表兄弟打架。在the Conners’， Ms. Feng 将她的女儿鉴定为有相当程度的对抗行为，比方说，破坏规则，不受管束，很易恼火和愤怒(T = 89).。不过，在 BASC-2上，她的反应并未显示 Caroline 所出现的破坏规则或侵略行为会比其他同龄孩子严重 行为问题, T = 56, 76th %ile; 侵略性 T = 55, 73rd %ile).。根据Ms. Farley’s 和 Ms. Carlisle’s 的反应，她在学校的违规行为达到临床危险的程度（BASC-2 行为问题, T = 73, 97th %ile; T = 63, 90th %ile; Conners’ 反抗性, T = 64; T = 64). Farley女士还认为，Caroline在去年对其他同学有侵略性，其程度达到了危险范围(BASC-2 侵略性, T = 67, 93rd %ile). 在目前的评审中，Caroline 要求换题目才肯留下来，有时他会大嚷不想继续了，因为题目太难了。不过,她对赞扬和换方向，反应良好， 她能完成所有要她做的事。有人担心,Caroline呈现奇怪或不当的行为。Ms. Feng关心的是她的女儿会和自己谈笑,特别是在夜里。此外,老师注意到,在课堂教学上，Caroline往往做离题和无关的评论。在BASC-2 上Ms. Feng 报告说Caroline展现奇怪和离奇的行为，其程度远超过其他同学。（具体地说，同意，Caroline有时说及做的一些事情，看来与现实完全脱轨， 她有时还对自己做孩语。
Caroline的老师也将她在怪异行为上评定为临床危险。BASC-2 不正常, T = 79, 97th %ile; T = 66, 92nd %ile).
Like Ms. Feng, they also endorsed that Caroline sometimes does and says things that are odd or do not make sense.
像Ms. Feng一样,他们也同意Caroline有时说些奇怪和没意义的话。Caroline的母亲和老师都不认为 Caroline曾看到或听到并不存在的东西。在整个评估中，Caroline 做一些离题或无关紧要的评论。虽让如 此， 这些评论似乎较多相关到她口头表达的困难，而不代表思想混乱或对内部刺激的反应。 以下的段 落指出的是 Caroline对这个世界上的事情和经验所做的解释，了解和反应。它对她的解题，应对和 人际关系等提供具体的讯息。
Caroline是被用Roberts-2 的操作来评估她解决问题的能力。还是一样，这个 操作的发现需要用她口 头表达的困难来解释。 在评估解决问题的能力时，Roberts-2 集中在儿童有效思考问题的能力，以及他们 对取得内在及外来次援的认知力。有效推理涉及的能力有认知,了解,并积极有效地解决问题。Caroline展 示，她在正确地看到和确定问题上存有困难。具体来说，她的很多故事并没有确认让她看到的图片的重要 成分 （Popular Pull, ，T=38）。况且，她的故事对每个角色的感觉，行为，和问题只包括一些不成熟及模 糊的认定（问题确认 1, T = 77).它们缺乏详细的细节和解释那些感觉，行为和问题 的成因(问题确认 2, T = 32). 这种对问题的的处理法是低于她的年龄层，而且显示她有可能忽略了或者是错认了她例行日常生活中 的问题。 她在考虑问题来自何处时，有很大的难度。在被送去精神保健治疗的儿童中，这种情况是比较 典型的。整体来说, Caroline在Roberts-2 的表现 暗示到她可能对环境社会的了解及回应存有问题。当问 题出现时，她可能根本没有觉察。她可能很难掌握在某些情况下，人们对她适当行为的期望。
还发现，管教及约束Caroline的行为及获得她的合作非常地困难(PSI/SF DC 次刻度, > 95th %ile).
她认为她与Caroline的互动在临床上有很大程度的负面性 (PSI/SF P-CDI 次刻度 > 95th %ile), 这表示Ms. Feng 和Caroline之间缺乏 紧密的联系，或者是Ms. Feng感到被Caroline拒绝或 疏离。总的来说, Ms. Feng 的答复反映出，做为一个家长， 她挣扎于临床上很大的压力之下 (PSI/SF TS > 99th %ile). 在整个评估过程中，Caroline经常提到她与她母亲的关系。特别 地，正如上文所述, 她说道,在这些时间里, 她确实担心, 她担心她的母亲会死去。
在 Rotters’ Caroline 好几次提到她的母亲。例如,她对造句”我担心”接的是 “我妈—她会对我生气“。 另一个造句“我很伤心，“她接的是“我知道我妈到Sacramento去了“。 最后,她回应梗句,“我所发生过的最严重的事是 " “有一次，我注意到, 我妈对我很生气“
诊断印象
Caroline是一个7岁的中国女性，被她的精神科医生，Robert Hors, M.D推荐来做心理评估、Robert Hors医生的关切是她的心不在焉,过动,和反抗行为。Caroline所展示的其它奇异，毫不相干，或离题的行为等，也是关注的项目。Caroline的母亲和精神保健提供机构要对她的表现有更好的了解,以便采取适当的措施。
有证据显示，Caroline的语言发展缓慢的程度已达到符合诊断Mixed Receptive-Expressive Language Disorder（混合接受-语言表达混乱）的标准 Caroline的 WISC-IV, PPVT-III, 和 VMI, 成绩显示，她 的 表达和 接受语言 以及 口头知识的能力远低于 她的非口头知识能力。 具体来说, 在 WISC-IV，在口头观念 形成, 口头推理, 和一般其本知识 次测试鉴定，她的表现在边界范围。同样地， 在 PPVT-III, 她展现出极低的接受语言的技能。相反地, 在WISC-IV， Caroline 展示高平均的非口头推理能力及处理速度。在 VMI. 她在视觉，感性和机工技能的表现属平均范围。 因为英文是Caroline的第二语言 , 我们很有理由去怀疑 她在语言上的缓慢该会不会是由于尚未掌握英文的缘故。评估Caroline语言和沟通的技巧是超越了目前的规范。不过,两个皆是说中国母语的她的母亲和目前的精神科医生都说,Caroline在口头理解及表达自己方面有困难。 虽然我们不可能她的中文沟通提供明确声明，有足够的证据显示，Caroline的沟通问题可能源自语言和沟通的混乱，而不是学习英语作为第二语言的缘故。值得注意的是，由于Caroline被证明有很高的非口头能力和处理速度以及平均水平的注意能力，其他人可能不解为什么她理解和运用口头语言会这么费力。她有可能被误认为是怪异，反抗和故意作破坏的女孩。
这种接受和表达语言的问题 对Caroline 跨越各种领域上的表现， 包括注意力，行为，解决问题和社交技巧等等有深远的影响。
Caroline有长期历史的注意力缺乏, 集中、多动症,和冲动等问题。目前,她被诊断患有注意缺陷/过动症失 调， 复合型和破坏行为NOS。报告显示,她很容易分散注意力，很难维持集中做一件事和功课，在家里和 在学校所接收到的指示都是需要不断的重复。还有的就是，据报,她经常离开自己的座位，话说得太多,中 断别人，坐立不安,、而且还很冲动。在整个鉴定中，Caroline表现出轻微的分心，中度的过动和冲动。所 有这些都随任务的要求而变。在那些并不需要口头语言成分的这任务中,Caroline展示轻微的，假如有的话, 缺乏注意力。事实上，在WISC-IV 她表现出足够先进的能力,以保持注意，集中,并能保留和操纵信息的短 期记忆。被诊断患有注意力缺乏-过动症的孩子来说，这不是很寻常的。Caroline对要求她听， 处理,并作 出反应的口头资讯似乎更是缺乏注意力及有过动的毛病,
因此,虽然Caroline表明一些记忆力不集中、多动症,和冲动的问题，我们不可能判定她是否有真的ADHD问题。因为 接受-表达混乱， 语言失序和注意力短缺/过动失序 有很多重叠症状， 不可能去断定Caroline的ADHD症状能够被纳入为接受-表达混乱 语言失序。.为了这个原因，继续观察Caroline的特征来排除注意力短缺/过动失序 是非常重要的。
虽然人们提出Caroline倾向作无关或离题评论,并进行不适当行为,目前调查评估的结果并不显示Caroline的表现达到精神病的程度。具体来说,多种来源否认有任何证据显示Caroline反应出内部刺激, 例如听觉或视觉幻觉或从事任何形式的妄想相反地，有可能的是，就她的ADHD症状，Caroline’的受限的语言交流能大大地影响她的说话，行为和人际互动，其严重性已达到让其他人误以为她是怪异的程度Caroline的语言失序让她有极端的困难去决定什么时候，在那里，为什么以及该去和什么人交流。她对了解和执行口头指示，以及启动，维持或结束谈话存有问题。因此，她有可能看似混乱,心不在焉,或置若罔闻。她有倾向去中断谈话，讲太多的话，从一个话题换到另一个话题以至于混淆听她说话的人。况且，Caroline很有可能忽略了谈话的细节，例如面部表情， 手势，姿势，腔调和两人的距离等等。因此她无法诠释谈话的语调，也可能错失社交互动的重点。她有可能做一些看来恣意的 或无意义的评论，虽然她并非有意去伤害任何人的感觉。她很可能忽略了周遭情况的日常规则，导致他人误以为她是叛逆或挑衅。总体来说Caroline’的说话和行为很可能是她语言失序的呈现，而不是真的精神出了状况。
建议
1. 以下建议是为了表述Caroline的迟缓的语言和交流
a. Caroline应做彻底的听觉评估，来排除任何存在的潜在的听的问题，因为听的障碍可以导致语言和沟通问题。
b. Caroline也应受到一个合格的专业人员来做广泛讲话和语言评估以确定她语言失序的性质和程度。
c. 非常关键是,Caroline应获得一个合格的语言病理学者来做讲话和语言的治疗。
d. Caroline在一年内应重新评估,来获知她在讲话和语言取得的进展。
e. Caroline的老师可能会发现以下的战略有助于维持Caroline在课堂内。
• 有耐心：允许Caroline至少10至15秒来处理听到的话以及较长的时间来拟订一个反应。
• 雇用多模式的方法,鼓励Caroline的编码和了解信息。
o 在教室内，将视觉启示 (i.e. 图片, 图画, 图表) 和 非口语姿势 与口头交流配对.
o 只要有可能时，用视觉引导来补助口语指示
o .
o 只要有可能，采用机械辅助例如录影带，影带上的书, 和电脑程式 , 来补助口头的知识及作业.
o 用材料和物件 (比方说. 泥土, 图画,模型等) pictures, models) 使抽象的学习变得较实在 .
• 当给她口头指示时：
o 将其分为较小、较简单的片语和概念
o 重复指示：
o 让Caroline重复所收到的指示,以确定她弄清楚了。
• 限制要Caroline口头表达自己的那种要求。
o 让她读准备好的稿子,而不是从记忆中发言。
o 问些比较不需细细琢磨的问题。问的问题容许是或不是的答案，使用示范,或视觉/生理反应(比如， 指向一个地图或图画或做手势)
• Caroline还可能受益于特别的安排，比方说坐得靠老师近些，加长的考试时间和调整过的家庭作业或习题。
f. Caroline的母亲可能会发现以下的战略有助于维持Caroline在家里。
• 她可能会发现美国说话语言听力协会有所帮助。它能提供给她更多的有关Caroline诊断的资讯
ASHS 的国内办公室
2200 Research Boulevard
Rockville, MD 20850-3289
电话： 301-296-5700
网址：www.asha.org
• 有耐心：给Caroline至少10到15秒的时间来处理听到的话，以及较多的时间来做回应。
• 使用视觉线索，诸如图画，图片、图表、和非口语手势来帮助对Caroline解释（请看附带的讲义来获得一些观念）。
• 问些比较不需细细琢磨的问题。问的问题只要求是或不是的答案，使用示范,或视觉/生理反应(比方， 指向一个地图或图画，或做手势，或扮演观念)。
• 当给她口头指示时：
o 将其分为较小、较简单的片语和概念
o 重复指示：
o 让Caroline重复所收到的指示,以确定她弄清楚了。
2. Caroline 和她的母亲应被鼓励继续接受治疗.经由治疗, Caroline 的治疗师可以协助 Caroline 和她母亲学习，练习即现用（现买现卖）
a. 以下是一些加强语言和沟通技巧的有用策略:
• 发展和使用现有剧本来定一个设计好的格式，让Caroline练习和实际采用。比方说, 帮助 Caroline 打开话腔，与同学谈话。 让她预读一些写好的剧本，例如:
o “喂，你好？我的名字是Caroline“。“请问你叫什么名字？“
o “我的名字是 .”
o 你愿意和我玩吗？
o “好的“
o “你要不要和我一同画画呢？“
o “不“
o “那么玩球怎样？“
• 舞台演练模拟特定场合的可被接受及适当的反应 (比方说，在教室内，在操场, 在一个正式会话场合等.可能重要的是,Caroline要：
o 站在另一个人的立场来看这个情况：比方说，在讨论一个同学的祖母的病情时,鼓励Caroline去想，如果放在一个类似的情况，她会如何做。让她选择，用什么字，什么面部表情来显示她的感觉？
o 讨论在不同状况，适当时候的用字，面部表情和手势。比方说，洗脑似地灌输 适当的反应，诸如在课堂上的指示（例如，小孩应该坐在座位上，做视力接触和保持安静等等）。 确定做洗脑时，列一个单子，包括口头的和视觉的。在列出观念的地方画个图或做个模型。
o 练习和不同的人讲话，诸如权威人物（老师，校长），陌生人（店员，侍者），亲寂，和同学。
o 对非口语的线索建立反应。
用图表或画来呈现不同感觉的脸部表情。
使用镜子让她表演这些感觉的不同面部表情。
让Caroline 从扎志或书本的图片去看人们是怎么表示感觉的。
用电视的影带或电影，不断停住节目来让认出角色的感觉和为什么角色会有哪个感觉。
建立和练习不同与感情有关的 姿势 (生气时握拳, 低头表示伤心。).
讨论和练习不同感觉的声调（比方说，大声和速度快，表示生气）
b. 由于 Caroline 有效交流的困难, 她很可能变成易于恼怒以至于爆发怒气。治疗能提供 Caroline 和她的母亲练习用非口头的方法来表达情绪。.
• Caroline 的治疗师会发现开始时投资一些时间与帮助她来发展实在的及简单的策略来获知处理机交流他的内在经验是很有用的。她可能发现以下的策略很容易拿来找出她的感觉。 这比问一些典型的问题，比方说“你在做什么，或者是”你感觉怎样？“ 要来的有用。
o 开始时, Caroline 可能发现去练习 和去体会身体知觉 (心跳速率，呼吸短促,肌肉紧张, 肚子痛, 喉咙生块，紧绷的胸口，等等) 是很有用的。
o 下一步，鼓励她将身体知觉 和心理经验做关联。 这一点是非常重要的 (比方说 “当我的心跳加速时，我感到愤怒。).
o 最后, 一旦她展现了能力将身体知觉 和心理经验做关联，她就能做一些努力来培养对这些感受的认知， 知道这些感受经验与她的行为有什么样的关系。例如, 她能练习句子填空，比如,“当我感到紧张时，我尖叫，大喊，我想打架”
• 应让Caroline 练习，目标是增加她的情绪字汇。比方说,她应该被鼓励去学几个字，用来 瞄术某一个特别的感觉（比方说，愤怒，生气，困扰，火大，泄气等等。）也要学习去区分每一个感觉的不同程度的强度（比方说，.困扰没有愤怒来得强烈, 而愤怒又没有暴怒来得强烈)。
• Caroline 将可能发现去发展各种实际，具体， 实在的方法来表达她的情绪，会是很有帮助的(比方说 朵脚 = 生气)。具体想法请参看附件。.
3. 我们强烈建议Ms. Feng 每天至少拨出 15 至 20 分钟时间来和Caroline 在一起来参与由Caroline所选出的有趣活动.这一次应该是致力于增加 Caroline 和她母亲互动之间的乐趣以及她们之间的紧密关系。 Ms. Feng 应该继续做出努力来再度肯定Caroline 以及提供给她亲情养育及展示出的爱。
4. 重要的是 Caroline 继续去看心理医生来 测知是否需要精神药物来解决她的不专心 及过动的毛病。
5. 由于Caroline 是一个有活力和积极的女孩, 她或许会发现，参加一些体能之类的课程，将体能放到积极健康的路上，会是非常有趣的。她也可能发现参与艺术课，如陶器，手指画或雕刻之类，会是一种乐趣,。
Caroline 有几个强处 将继续是她总地发展的资产 。她是一个聪敏，有魅力, 和温暖的小孩，对周照有热情.
我非常高兴及感积有机会与Caroline见面，也希望这一信息将有助于引导你对她所要做的工作。假如你有什么问题请和电话联络at (916) 875-1183.
Andrea Hindes, Ph.D.
持照临床心理学家(许可证#psy21725)
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More Less | | Years of translation experience: 8. Registered at ProZ.com: Sep 2003. Became a member: Sep 2003. | | N/A | | N/A | | N/A | | applied information research, applied information research | | Adobe Acrobat, Microsoft Excel, Microsoft Word, Adobe illustrator, CIBA 2000, MS EXCEL, NJ STAR, PDF, WORDS, Powerpoint, SDL TRADOS | | English (DOC) | | About me
Six years experience in translation and and 5 years experience in interpreting (English to traditional Chinese or simplified Chinese)
For English to simplified or traditional Chinese:
Translation: USD 0.10/English source word for common document
USD 0.12/source word for highly technical document
USD 0.20/English for legal document
Proofread: 40% of translation charges
Interpreting: $50.00/hour
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Has a Ph.D. in physics and BS in mechanical engineering
9 years experience in translation 5 years experience in interpreting, 5 years experience in telephone interpreting (medical, insurance, credit card dispute,utility etc)
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Rate can be reduced for documents with many repeating sentences
so that TRADOS can be efficiently used.
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