Hello,

I am a member returning after a three year absence. I was born in 1946, and
grew up totally different from my siblings and peers. I went through the
Saint Louis Public School System without being aware of why I was so
different.

In 2001 I found out about Asperger's, and the more I learned the more my
past made sense. I asked the Veterans medical Center for a Neuro -
Psychiatric Evaluatio to check for autis. The VA classes Asperger's as a
neuro - biological disoreder.

So here is the reporst of my evaluation. All the tests, and what they mean
(scores) I joined Mensa from the IQ test.

Best to all!

Terry Klasek

My Neuro - Psych Evaluation Report (Terry Klasek)
CONSULTATION SHEET Page I of 6

Consult Request Consult To. NEUROPSYCOMOGICAL TESTING JB-BH * PTSD MED GP
CORVALAN
Requested; 09-11 2002 4:13 PM
Requesting facility ST. LOUIS MO VAMC-JB D ATTENTION: GAIDNI,STEPHEN J
Current Primary Care Provider, BANKS,WILLIAM
Current Primary Care Team, JC-GRECC TEAM 5 HYPERTENSION

REASON FOR REIUEST:
(Complaints and findings) had neuro psych appt at another VA Prior to move
here. Evaluation for autism.

PROVISIONAL DIAG; PTSD

REIUESTED BY: CORVALAN, JUAN C
STAFF PSYCHIATRIST

CONSULTATION NOTE 11003395793

Title: NEUROPSYCHOLOGCICAL TESTING JBCONSULT STL
DATE OF NOTE APRIL 02 2003m12:13
ENTRY DATE: APR 02, 2003 12;13:52
AUTHOR, SHINE,KATINA L
STATUS. CONPIIETED

PRESENTING PROBLEMS:

KLASEK, Terry A (xxx-xx-xxxx) is a 56-year, old WHITE, NOT OF HISPANIC
ORIGIN, MALE veteran. He presented with no complaint of memory problems but
stated he wanted an evaluation to clarify his diagnosis. He stated he is
almost sure that he has Asperger's Disorder, and noted that when he was
young he did not get along with his peers, hated socializing, and always
loved to read. He reported always having unusual habits for example
constantly adjusting his glasses or picking his eyebrows, drumming fingers,
taping feet or chronically touching his face. He stated that he gets totally
focused on I or 2 subjects (i.e., baseball cards, history, and classical
music) and is presently focusing on escapist literature or pulp fiction from
the years l910 to 1954.

Veteran began testing in February and was to return for additional testing
it a later date, however, this was prevented by transportation and
scheduling difficulties. This report is therefore based on the data
initially Obtained. Veteran was provided with verbal feedback of findings in
the IQ results

KLASEX, TERRY A SC VETERAN xxx-xx-xxxx 11 -03-1946
7449 HAIELCIEST DR IVE
HAZELWOOD MISSOURI 63042 phone. 314-839-5743

MEDICAL RECORD I CONSULTATION SHEET Page 2 of 6

By telephone on 3-26-03 at his request and no additional testing was deemed
necessary, as the available results were sufficient to address his concerns.

MEDICAL HISTORY:

KLASEK, TERRY A's current problem list includes:
1) Lipona of other skin and subcutaneous tissue
2) Hypertension
3) Obesity
4) PTSD/Hx Depression
5) Hiatal Hernia
6) Stress Disorders, Post-Traumatic
7) CELLULITIS OF LEG
8) Hyperthyroidism
9) Arthritis, Severe Degenerative
10) Anemia, lron Deficiency
11) Asperger's Disorder (High Function Autism)

KLASEK, TERRY A denied history of head injury, seizure, stroke, tumor, or
aneurysm, but reported that he occasionally has vertigo especially on
bridges and high buildings. No imaging studies of the head were available.

KLASEK, TERRY A reported a history of regular alcohol use during and
following Vietnam. He stated he quit drinking (beer) in 1982, He denied post
or present use of any illicit drugs, History is negative for substance abuse
treatment.

KLASEK, TERRY A's psychiatric history includes diagnoses of PTSD and
depression. He is currently followed by Dr. Corvalan in the PTSD clinic for
medication management and reported that he is supposed to go to PTSD group
therapy weekly, but transportation is difficult. At the time of interview,
patient reported always feeling depressed and down, He stated he has trouble
sleeping, is often up at night, continues to have nightmares of combat, and
flashbacks of Vietnam during the holidays. He complained of getting anxious,
having racing thoughts, panic attacks, and being easily angered or upset.


MEDICAL RECORD I CONSULTATION SHEET Page 3 of 6

SOCIAL AND OCCUPATIONAL HISTORY:

KLASEK, TERRY A was born and raised in St. Louis. He was raised by both
parents and had 7 siblings. He has been married for 32 gears and has 3
children. He lives with his wife and 2 daughters. KLASEK, TERRY A reported
that he completed high school and has two Associate's Degrees in Journalism
and Literature. KLASEK, TERRY A entered the Navy in 1965 and was discharged
in 1967 with the rank of E-3. His major, duties in the service consisted of
cleaning, painting, and serving guard. The veteran is service connected and
stated he served in Vietnam.

KLASEK, TERRY A reported that after leaving the military, he had many jobs
(35 to 45) where he worked alone; including driving a cab, He reported
difficulty maintaining employment and stated his list job was as a custodian
in a school district for three years.

MENTAL STATUS EXAMINATION/BEHAVIORAL OBSERVATIONS:

The veteran arrived early for his appointment by himself. His dress was
casual, his grooming was adequate, and his hygiene was adequate. He appeared
his stated age. He walked unaided and had no tremor. His speech was normal
in volume, rhythm, and clarity. He displayed no difficulty with word finding
or his use of words, He was very talkative and articulate, and after
correctly responding to test items would frequently elaborate and provide
unsolicited additional information in great detail. Veteran appeared a bit
unusual in presentation and interaction. He set sideways during testing and
made NO eye contact with the examiner. His body posture appeared very stiff
and he had very limited facial expressions.

Thought processes were circumstantial. He shoved no evidence of delusions,
SI or H1. His affect was flat and stable. He was oriented to person, place
and time. His insight appeared to be good and his judgment good.

TESTS ADMINISTERED:

Bender Gestalt direct reproduction task
Wechsler Intelligence Scale III (WAIS-III)
Minnesota Multiphase Personality lnventory-2 (MMPI-2)
Mississippi Scale
Chart Review
Clinical Interview

TEST RESULTS:

Testing is considered to provide an accurate estimate of KLASEK, TERRY A's
current level of neurocognitive functioning, at least within this well-
structured environment.

Intellectual Functioning:

On the Wechler Adult Intelligence Scale III (WAIS-III), KLASEK, TERRY A
achieved a Verbal IQ score of 133, placing him in the Very Superior range
(130 and above), a performance score of 121, placing him in the

MEDICAL RECORD I CONSULTATION SHEET Page 4 of 6

Superior range (120 to 130) and a Full-Scale IQ score of 130, placing him in
the Very Superior range (130 and above). Score places veteran in the 98th
percentile nationally. The difference between his Verbal and Performance IQ
is not considered to be clinically significant although veteran's verbal
abilities appear much stronger than his performance related abilities. His
scores were higher than expected based on his educational and occupational
background.

KLASEX, TERRY A had a Verbal Comprehension Index of 136 on tasks related to
verbal acquired knowledge and verbal reasoning, placing him in the Very
Superior range (99th percentile). He had a Working Memory Index of 124 on
tasks involving the ability to attend to information and hold it briefly in
memory while manipulating it, placing him in the Superior range (95th
percentile). He had a Perceptual Organization Index of 123 on tasks
involving attention to visual detail, nonverbal fluid reasoning arid
visual-spatial problem solving, placing him in the Superior range (94th
percentile). He had a Processing Speed Index of 103 on tasks involving the
rapid processing of visual information, plating him in the Average range
(58th percentile).

Attention/Concentration:

The Working Memory tasks of the WAIS-III and WMS-III involve
attention/concentration. The veteran's Working Memory Index on the WAIS- III
was 124, suggesting Superior ability (95tb percentile).

Memory:

On the WAIS-III Information subtest, which reflects long-term memory for
knowledge gained from his education and environment, his scale score of 17
falls in the 99th percentile for individuals his age indicating Very
Superior ability.

Abstract Reasoning and Executive Functioning:

On the WAIS-III Similarities subtest, an indicator of verbal abstract
reasoning ability, the patient's stated score of 15 is in the Superior range
(95th percentile) for individuals his age. His scaled store of 13 on the
WAIS-III Matrix Reasoning subtest, which assesses nonverbal reasoning, falls
in the High Average range (84th percentile).

The Bender-Gestalt direct visual reproduction task is a brief screening
instrument for organicity, as well as difficulties with executive
functioning processes (e.g., planning, organization, judgment, and impulse
control). His score of 1 error was not suggestive of organicity (cut-off
score = 5 errors). The overall organization of his drawings was fair and not
suggestive of significant difficulty with planning / organization.

Psychological Functioning:
The veteran's MMPI-2 clinical profile is considered to be invalid due to an
over endorsement of symptoms and was therefore not interpretable.

Mississippi Scale;
Veteran's score of 123 on the Mississippi PTSD form falls significantly
above the cut-off of 107, which correctly classifies PTSD about 90% of the
time.

MEDICAL RECORD I CONSULTATION SHEET Page 5 of 6

SUMMARY AND REDONMENDATIONS:

Results of Neuropsychological assessment were not suggestive of organicity.
The veteran's performance was well above average on most tasks, based on the
limited available data, there appears to be no significant deficits in
memory, language, abstraction, visuoconstruction, or executive functioning.

In fact, the veteran showed particular strengths in most of these areas
compared to other individuals his age. Mr. Klasek appears to be functioning
in the Very Superior range of intelligence; he has a reported history of
PTSD and depression although his Current symptoms do not appear to
significantly impact his cognitive functioning.

Veteran expressed concern about a potential diagnosis of Asperger's
Disorder, and based on behavioral observations during testing and patient's
reported history; he does meet DSM-IV-TR diagnostic criteria for this
disorder! Veteran demonstrated marked impairment in nonverbal
behavior i.e., eye contact, facial expression, body postures, fidgeting) and
lack of social reciprocity (i.e., pursuing conversational topics regardless
of relevance or interest of others). He reported failure to develop
appropriate peer relationships, preoccupation with various patterns of
interest (i.e., currently pulp fiction from 1910 to 1954), stereotyped/
repetitive motor mannerisms, and seems to have long experienced impairment
in social and occupational functioning in spite of well above average
intelligence.

Patient maintains that this has been a pervasive, life long pattern of
functioning for, him. His reliability appeared to be good, nevertheless it
should be noted that present findings are based in part on patient's
subjective report and there were no independent means of verification.
Patient does not meet criteria for Autistic Disorder (Kanner's).

Testing completed by David Rocco, N.A., Psychology Technician, under the
supervision of Stephen J. Gaioni, Ph.D., Clinical Psychologist./es/ KATINA L
SHINE, PMD Psychology Resident

Signed: 04-02-2003 12:25
Receipt Acknowledged By: AWAITING SIGNATURE GAIDNI,STEPREN J
AWAITING SIGNATURE ADANS,DOROTHY


MEDICAL RECORD I CONSULTATION SHEET Page 6 of 6

(Added Comment) Entered by, ROCCO, DAVID S – 03-26-2003 4:27 pm
Responsible Person: ROCCD, DAVID S Dr. Shine contacted patient and gave some
IQ results of the testing.
We were hoping to do more memory testing but patient would have a very hard
time getting transportation. The full report will be written early next
week.