An Opportunity to Understand
Joe is an 8 year-old boy who was referred to me by his 2nd grade teacher because of concerns about his classroom functioning. His teacher reported that Joe often does not seem to be paying attention, is behind his peers academically and has difficulty keeping himself organized. In addition, she reported that Joe frequently goes to the school nurse complaining of stomachaches and sometimes seems sad.As a child psychologist, Joe’s situation is typical of the kinds of concerns I hear about on a regular basis. Parents often wonder what the best course of action is to help a child like Joe. The first stop for many parents is the pediatrician’s office in the hopes that medication will do the trick. Other parents assume that their child will “grow out” of their difficulties and fail to act at all. Still other parents go to the other extreme and secure multiple services at once, sometimes without a clear sense of what is going wrong. When a parent contacts RNBC with this type of scenario, what is most often recommended is a comprehensive psychological assessment. How will such an evaluation help a child like Joe? This article will help answer this common question by highlighting some of the major goals of psychological/neuropsychological testing.
1. Diagnostic Clarity
Does Joe have ADHD? A learning disability? Executive functioning problems? Anxiety? Depression? A combination of things? These are all potentially valid hypotheses. Children are complicated and a host of factors may account for a similar behavioral presentation. For instance, children who look like they are not paying attention often have undiagnosed learning disabilities. The reverse is also true in that children who have attention deficit disorders may appear to have learning difficulties because they cannot consistently produce academically. Similarly, children who are anxious or depressed may have difficulty concentrating or be unavailable for new learning. One major goal of a comprehensive evaluation is to determine which problem areas are primary and which are secondary, and ascertain whether the data are suggestive of a specific diagnosis. Often, there is a combination of factors which need to be understood.
2. Learning style
In addition to diagnostic clarification, another major purpose of a comprehensive evaluation is to understand how a child like Joe learns the best. One size does not fit all. Testing provides a profile of a child’s unique strengths and weaknesses across multiple areas of functioning and sheds light on how a child processes information. Such information is invaluable for teachers and other professionals who are working with children on a daily basis and may be unclear about how to most effectively intervene.
3. Road Map
A comprehensive evaluation should provide a road map for parents, teachers and other pertinent professionals about how to address their child’s needs. Such interventions may include tutorial support, medication, psychotherapy, speech/language therapy, occupational therapy, social skills groups or school-based learning resource support. Sometimes, a change in school placement is recommended. Regardless of the type of intervention, once a full evaluation has been completed, the best combination of supports and specific goals for each is more readily understood.
4. Monitoring Tool
Comprehensive evaluations provide concrete data about a child’s level of intellectual, academic, social/emotional and attentional functioning at a snap shot in time. Nonetheless, children are moving targets. As such, children like Joe need to be monitored over time to determine whether in fact they are progressing, hitting a plateau or falling behind. Periodic evaluations are a very helpful tool in this monitoring process. Interventions often need to be updated or changed to accommodate children’s continual development. As such, 2–3 year re-evaluation intervals are typically recommended for school-aged children, while annual re-evaluations are ideal for children under age 5.
If you have questions about psychological/neuropsychological evaluations at RNBC, please contact our office at (847) 933‑9339