What Every Parent Should Know
By Lori A. Wilson, Ph.D
What does your heart tell you? Does your child’s behavior or school success concern you? A psychoeducational evaluation may provide the next step toward services and strategies for your child to succeed in school and in his daily activities.
David is a vibrant, busy and happy six-year-old boy. Outside of school, he makes friends easily, has a contagious laugh and can show a kindness and generosity that would melt any mother’s heart. He is athletic, energetic and full of life. At school, however, his expression of these same qualities gets in his way. His teacher shares with his parents that he has difficulty following directions and sitting still and he interrupts others when they are talking. He needs reminders to stay on task when working independently. He rushes through his work. At times, he is impulsive in what he says and in how he acts with his friends. He can be too physical on the playground.
When parents attend parent-teacher conferences, they hope that their child’s teacher sees the same strengths and the same loving child known at home. They are eager to know that their child is making new friends, paying attention, following directions, enjoying school and is interested in learning. It is hard for parents to hear that their child is struggling, in any aspect of his life. It is even harder when parents don’t quite understand why or know what to do to help.
Sometimes the concerns are easily identifiable and the next steps to take are clear with a plan for suggestions to try at home and for accommodations or strategies a teacher might try in the classroom. Other times, it is unclear. David is displaying potential symptoms for an attention deficit disorder. The same symptoms also may occur when a child is anxious, sad or having difficulty adjusting to a new setting.
They are also observed when a child struggles with underlying difficulties in learning. Sometimes difficulties in processing both language and auditory information give an appearance of inattention. Children who struggle with sensory processing also may have more difficulty regulating their activity level and attention. However, these same behaviors can be seen in delightfully typical six year old boys. A thorough evaluation that assesses all of these potential underlying causes is often needed to determine how to address areas of concern.
What is a psycho-educational evaluation and what is its purpose?
The questions for any parent with a child struggling in school are: How much is he struggling with attention, learning and behavior? In how many settings? How often? Is it getting in his way? What is the underlying cause? What are the next steps in helping him learn to better regulate his attention, activity level and behavior? In this situation, parents and teachers might turn to a psycho-educational evaluation as a helpful tool and next step. The purpose of psycho-educational testing is to help identify a child’s personal strengths and weaknesses, to determine appropriate diagnosis (ONLY when clear and necessary), to provide parents suggestions regarding emotional and behavioral functioning and to provide recommendations to aid in academic planning and placement.
When is a comprehensive psycho-educational evaluation helpful?
A number of questions can lead toa parent seeking a psycho-educational evaluation for his/her child. These might include:
- How does my child learn best?
- Does my child have a learning disability?
- Can my child’s school meet his educational and socio-emotional needs?
- Why is my child struggling to make and maintain friendships?
- Does my child have an attention deficit disorder?
- What can I do to help my child experience more success when learning?
- Is my child a little shy and nervous or should I be concerned about my child worrying?
- My child doesn’t look at people when he talks and doesn’t have any friends. Could this be high functioning Autism or Asperger’s?
When should a parent seek evaluation for their child?
This is an easy question for parents to answer when their child is struggling significantly. The answer is often, “immediately!” It is a harder question to answer when parents and teachers are noting some struggles, but are not yet sure whether they will be resolved with extra attention and effort or whether they might be red flags for a learning disability which might require different methods or styles of teaching. It is important to communicate closely with your child’s teachers regarding his progress so that you are informed when concerns resolve and when they continue. It is also important to expect that during busier times of the year, it may take a few months from the time a parent makes a phone call for an appointment until he can be seen for a psycho-educational evaluation. When testing seems like a strong possibility, it is often helpful to go ahead and schedule an appointment in advance of the final decision to test, even if parents and teachers are still monitoring progress.
At other times, evaluations seem to be helpful when parents and teach ers teach ers question whether a child needs a different level of academic support or a different academic environment. Many parents find that evaluations are helpful when looking at what learning style, academic needs and possible accommodations a student might need as they enter middle school or high school.
What can be expected from a comprehensive psycho-educational evaluation?
A comprehensive psycho-educational evaluation usually takes place over multiple days of testing, most often two days. The large amount of material that needs to be covered is too much to complete in one day especially for younger children. Psychologists often benefit as well from seeing a child on more than one occasion. This allows the psychologist the opportunity to see how a child enters a new situation and interacts with a new adult, as well as how he approaches the same setting on a second day when it is more familiar.
What are the main areas tested in a comprehensive psychoeducational evaluation?
There are five main areas most psychologists use when administering a comprehensive psycho-educational evaluation: background information; cognitive functioning; process measuring; academic functioning; and social-emotional functioning.
1. Background information
It is important for a psychologist to understand and interpret the testing information acquired in the context of a child’s life. In working with children, the psychologist is meeting them at one point in their life for two days in a highly structured setting. It is crucial to understand what strengths and weaknesses emerge in different situations. Information is gained through direct testing on how children perform in one moment of their life, in one type of situation. It is important to understand how children came to this moment; what struggles and successes they had when they were younger, how they perceive school, etc. In this respect, it is important to gather information from people who know the child well and have seen him across time in different settings. Most often, this includes a thorough interview with parents and information gathered from teachers, as well as from tutors, occupational therapists and speech therapists.
While parents want, and should expect, an unbiased assessment, it is important to keep in mind that unbiased is not the same as uninformed. It is important for parents to allow communication between teachers and the psychologist. A psychologist cannot do an accurate and thorough assessment just from interpreting test scores. This is only a piece of the puzzle. A psychologist’s job is to integrate ALL of the information available from parents, teachers, professionals, testing results and even from a child’s own perspective. With this information, a more clear understanding can be achieved on how these strengths and weaknesses affect school performance.
2. Cognitive functioning
Cognitive testing, or intellectual testing, attempts to measure a child’s potential for learning and to understand how a child processes information. Through cognitive testing, psychologists learn a lot about a child’s strengths and weaknesses. This includes how he reasons verbally and visually. It may also include how he processes new information and how quickly he can process that information. For these and other assessment measures, scores are useful to assess how a child is functioning compared to his peers. More importantly, however, this information can help the psychologist learn about a child’s personal strengths and weaknesses relative to his own skills (such as verbal compared to visual reasoning skills). While scores are important on this measure, a psychologist learns a lot of other important information watching how a child completes tests. Whether a child gets an answer right or wrong is only one piece of information. HOW a child gets an answer right or wrong is also very important.
Psychologists can watch how a child attempts to solve a problem. Do they talk out loud to help them with visual tasks? Do they get an answer wrong, but approach it in the correct way? Do they get an answer correct, but need to take much longer than others to figure it out? Do they give up easily? Do they enjoy the challenge of the tasks? Or do they ask to go to the bathroom when the work becomes too hard? When an item is hard do they say ‘I can’t do this?’ or do they say ‘This is a hard problem?’ Psycholo gists observe how the student main tains and regulates his attention and how long he can sustain his attention before needing a break.
3. Processing measures
Most evaluations include some processing measures to supplement cognitive testing to determine how a child makes sense of information. The psychologist may assess different avenues of processing: auditory processing, visual processing, visual-motor skills, memory functioning and executive functioning. The goal here is to delve a little deeper into underlying areas of a child’s struggles that can affect his learning or behavior. For example, if it is hard to interpret auditory information, this may affect how a child can read and spell. It may also affect how he processes verbal directions in class.
4. Academic functioning
Academic testing helps measure a child’s current academic achievement; what a child has learned so far. Academic skills are visited in a number of different ways, in an attempt to tease out areas of difficulty. For example, reading can be broken into reading speed, reading accuracy, and reading comprehension and how a child can demonstrate comprehension on open ended questions versus multiple choice questions. How does a child write individual sentences? How does he attempt to plan and organize a lengthier story? Again, scores are important on these tasks, but are only part of the evaluation. For example, if we look at three children who may receive credit for correctly reading the word bat, one child might look at the word and read it with ease. Another child might correctly read it, but only after needing to decode each and every sound (b.b.b.a.a.t.t. bat!). The third child may initially read the word as ‘dat’ but quickly recognizes that ‘dat’ ís not a word and change it to ‘bat.’ While all three children would get the item correct, they are at different levels of reading and the quality of their response may suggest different things.
5. Social-emotional functioning
During an evaluation, it is important to understand the whole child, not just his academic strengths and weaknesses. Testing this social-emotional area creates an opportunity to identify social and personal strengths and weaknesses that might not come out in a large classroom setting including: How does the child interact with others? Is he able to make and maintain friendships? Can he access a wide range of emotions? Is he experiencing more worry, sadness, anger or fearfulness than expected? Is he able to regulate his attention, behavior and activity at a level that is typical for his age? How does he see his own strengths and weaknesses? How does he see himself as a learner, a friend, a family member? Are any of these areas interfering with his ability to attend or learn at school?
What can be expected when an evaluation is complete?
Most often, parents can expect to wait up to a few weeks after the testing is complete while all the tests are scored, interpreted and written up in a lengthy report. It is important for parents to receive both written and verbal feedback. They can expect a face-to-face meeting to hear the results and recommendations from the psychologist AND to have the opportunity to ask questions. When parents receive a written report, it is recommended that they read through the report thoroughly before sharing it with the school. It is important for parents to know what the report says and feel comfortable that the report accurately describes their child, as well as describing the child’s current needs. Sometimes parents may want to add comments or highlight certain recommendations on the copy they share with the school.
While parent feedback is a standard part of the evaluation process, a child feedback session is not typical. However, it does provide a wonderful opportunity for a child to understand, at an age appropriate level, why he was involved in this process and to highlight his many areas of strength. It also introduces discussion of any areas of weakness and strategy suggestions. It emphasizes the important role that the child plays in his own learning and outlines his potential for growth. Sometimes, older children are so overwhelmed by an area of weakness that they are not aware of their strengths. At other times, particularly in academically accelerated private schools, children get an inaccurate picture of their skill levels, as they are comparing themselves to a very select, high achieving group of peers. Children also benefit from learning about how they approach tasks. Comments like “You are the kind of kid that sticks with the hard stuff” or “You do your best work when you take your time” are helpful.
The importance of a collaborative effort by psychologist, parents, therapists, teachers, tutors and the child himself cannot be stressed enough in getting a clear picture of your child. Through the process of a psychoeducational evaluation, parents can receive a good snapshot of their child’s current strengths and weaknesses as well as a plan that will help their child experience more success and progress to reach his full potential.
5 SUGGESTIONS FOR A MORE
POSITIVE EVALUATION EXPERIENCE
Most children do better when they know what to expect from an unfamiliar setting. These suggestions will help your child come to testing with some understanding of what will be involved. Taking the time to familiarize your child with the testing process can help to maximize a child’s motivation and effort for testing and increase the likelihood of an enjoyable and positive experience.
1. PREPARE YOUR CHILD FOR TESTING.
Normalize the experience for your child. Let him know that many kids go for this type of learning evaluation at some point in their schooling to figure out how they learn best. Explain to him that everyone has a different way of learning. Help your child become an active part of the testing process. Encourage him to think about what is easier to learn and what is harder to learn. Help him think about whether it is sometimes harder to pay attention, or if their body is “wiggly” during the day. Ask him if there is anything he would like help with to make school easier.
With older children, it is helpful to identify questions they have had about their own learning and to encourage them to ask these questions directly to the psychologist.
For younger children, if the term “doctor” is used, explain that they are seeing a learning doctor or a feelings doctor, not one that helps them when they are sick (or gives shots). Some kids understand a psychologist’s role better when they learn it is like having your own teacher for a day.
2. AVOID TELLING YOUR CHILD THEY WILL BE PLAYING “GAMES.”
While most children find some of the tasks fun and enjoyable, they are differ ent than the types of games they envision. Children can expect that they will be asked to answer questions and complete tasks that are easy for them, as well as tasks that are beyond their grade level.
3. MAKE SURE THAT TESTING DATES DO NOT CONFLICT WITH OTHER IMPORTANT ACTIVITIES.
Check with your child’s school calendar to make sure that there are no field trips or special activities that they will be disappointed to miss when they are in the evaluation. Also, be aware of your child’s level of sensitivity to changes in family routines. For example, while hav ing a parent out of town does not typically affect performance, this feels more disruptive to some children’s routines.
4. MAKE SURE YOUR CHILD GETS A GOOD NIGHT’S SLEEP.
Sleep is important to help maximize your child’s attention and effort for the testing day and sets them up for success. Make sure that there is nothing hap pening the night before testing that would prevent them from getting a good night’s sleep. For example, if you know that your child will be out late for Hal loween or up late watching the Superbowl, testing the next day would not be warranted.
5. MAKE SURE YOUR CHILD EATS A GOOD BREAKFAST BEFORE THE EVALUATION.
Let your child know that this is something he can do to help get his brain and his body ready for work. Also, ask your psychologist if it is okay for your child to have something to drink or eat during the evaluation and if there will be a break for a snack or lunch. |
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