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Would My Child Benefit from a Psychological Assessment?

By Psychotherapist,

Many parents, educators and physicians are presented with children and teens experiencing a variety of problems including; learning at school, attending and focusing in the classroom, acting out or oppositional behaviour and pervasive sense of being down and/or worried, low self-esteem and/or difficulty making and maintaining friendships.

Psychological assessments and psychoeducational assessments are often recommended when parents report the following types of concerns:

  • “My son has had a hard time reading since he began school. At first we thought he’d grow out of it (‘that’s what everyone told us’), but he just does not seem to recognize many words. He struggles to sound out even the simplest words. Sometimes he will correctly read a word, but three lines later he does not recognize it. His teacher recently told us that his reading comprehension is very poor.”
  • “If I get one more call from the school about my son’s behaviour I just don’t know what I will do. I am told he is constantly disrupting the class by talking, clowning around, and just ‘getting up’ when there is no reason. His teacher tells me that he is very bright but not working up to his potential because he is never paying attention. He has always been such a fun loving child. What is happening?”
  • “My child appears to be bored in the classroom. She finishes her work quickly and does not find it challenging. I am afraid she’ll stop trying.”
  • “My teenager is struggling and I am worried he will fail. He never seems to know what his homework is. He leaves everything to the last minute and, even when he does complete work, he often forgets to hand it in. Does he just lack motivation?”
  • “My child just doesn’t seem to be able to complete written work quickly enough and he is still reversing bs and ds and even some of the letters in words, like writing ‘saw’ for ‘was’. I’ve been told that this is normal, but now he is in grade three and is really falling behind the other kids. He does not like going to school anymore and, yesterday, he told me that he thought he was stupid. My heart almost broke when I heard that.”
  • “My child really doesn’t seem to like to go to school anymore. Every day she mentions a sore stomach or headache. What should I do? She was always such a happy, easygoing child before. Her teacher is concerned that she is so shy and hesitant. She seldom answers questions at school.”

Helping your child succeed at school and with his or her peer group is not an easy job. A psychological assessment may help to shed some light on the precise nature of the problem and, most importantly, provide you, your child, and, when applicable, the teacher, with strategies to address the identified problems. However, most individuals are not aware of what they should look for in a “good assessment” and whether or not their child really needs one.

To decide whether an assessment is necessary, it is important to determine if the problem is recent (less than six months in duration), whether there has been a change in the child’s life which might account for the observed problems, if the child is exhibiting the problems in all areas of his or her life, and how severe the impact of the problem is on the child’s successful functioning on a daily basis. At this point, talking with your child’s teacher and family physician can be beneficial. You may also want to have a consultation with a psychologist specializing in child and adolescent development. During this interview, the psychologist can also offer an opinion as to whether a full assessment appears necessary or, alternatively, provide some suggestions us to how to intervene. Most assessments that explore why a child might be having difficulties in school will involve at least five to six hours of testing, a thorough clinical interview in which the child’s developmental and familial history is reviewed, consultation with the school when relevant, and discussion of the results after testing is completed. For most children, the testing sessions need to be broken into several shorter testing sessions (from one to three hours in length) to ensure that the child does not become fatigued.

Five to six hours of testing may sound like a long time period, but it is necessary to obtain a comprehensive picture of the child’s abilities so that accurate conclusions can be drawn about the child’s problem. Typically, testing includes the administration of a test of intellectual or cognitive ability. This provides an overall measure of the child’s learning potential.

Academic testing allows the psychologist to determine if the child is achieving as well as could be expected given his or her measured learning potential. Once problems are identified (e.g., a significant delay in reading), then specific tests exploring different skills (e.g., phonological processing and visual sequencing) involved in reading can be administered so that the precise nature of the learning disability can be identified. Typically, it is important to explore memory functioning (both for visual and verbal information) as well as attentional capacity. Examination of how the child is feeling about him / herself is important as, often, children with learning disabilities or attention problems have become so discouraged that they lack the motivation to try.

Often, children are referred for possible attention problems (i.e., attention-deficit / hyperactivity disorder). A thorough assessment is vital because what may present as inattentive behaviour in the classroom could be due a verbal memory problem, a language processing disorder, anxiety, emotional preoccupation (e.g., the child is focused on a recent death in the family), neurologically-based attention problems, or may mask a learning disability.

Without a comprehensive assessment, the wrong diagnosis could be made and the child’s needs not appropriately met. This same rationale is important in differentiating between many different childhood problems that have some similar symptoms. There are a variety of different types of learning disabilities and it is important to clearly identify the child’s needs. Often different types of learning problems co-occur. In ensuing newsletters, different types of childhood learning and behavioural disorders will be highlighted.

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