The Role of Psychological Assessment in Intervention

UWindsor Blog Post by: S. Scott, M.A.

When your child is having difficulties in school, whether in the area of academics, social relationships with others in the class, or one or more other areas, the first instinct as a parent or teacher is to intervene to help make the situation better and meet the child’s needs.

StudentsThis motivation to act is critical, as is gathering information about what exactly the child is having trouble with and why.  Such information is key in providing direction in deciding what supports would best help the child. The process of identifying the necessary supports can be achieved in several ways, one of which is by completing a psychoeducational or a neuropsychological assessment.  These types of assessments evaluate skills and abilities in areas relevant to school performance in a standardized way.  That is, the child’s performance is compared to other children who are the same age, and this provides information about areas of strength and weakness compared to their age-mates. This method can help to speed up the process through which a child is formally identified and accommodated at school.

Clinical psychologists who specialize in assessing children have a variety of tools in their toolbox to help pinpoint the difficulty and potentially determine the reasons why it exists.  The assessment process overall can take several weeks or more and requires a fair amount of information to be collected, including the child’s performance on standardized tests; a clinical interview with parents to gather background information; observations of the child’s behavior during testing; and other informal assessment procedures, such as reviewing samples of the child’s classroom work or direct observation of the child in the classroom (Sattler, 2008).  Teachers and parents may also fill out questionnaires to help the psychologist better understand some aspects of the child’s everyday behavior.

Although it is a time consuming process, at its conclusion, recommendations are given that are tailored to the child’s unique combination of strengths and needs to ensure the most appropriate interventions and learning strategies are put in place.  Additional resources often become available after a child has been diagnosed and formally identified, such as access to assistive technology (if warranted), and other accommodations in the classroom that will support the child’s learning, such as preferential seating in the front of the classroom or additional time to complete tests.

Another benefit of completing an assessment is ruling out diagnoses that do not fit with the difficulties that the child is experiencing.  That is, accurate diagnosis enables steps to be taken to initiate appropriate intervention, significantly reducing the chances of starting down a path that will not prove to be helpful and potentially losing valuable time treating the real problem.  It is well established that different developmental disorders often require different interventions.  For example, Nonverbal Learning Disorder is best managed with classroom accommodations that draw on a child’s strengths in language based academic and learning tasks (e.g., developing step-by-step written instructions that can be memorized to solve mathematical problems or to find a classroom when entering a new school), while minimizing reliance on weaker visual spatial skills.  In contrast, Autism Spectrum Disorders are treated most effectively with Intensive Behavioral Intervention (Perry et al., 2008) and techniques that incorporate Applied Behaviour Analysis (Dawson et al., 2010).  The methods used to reach an accurate diagnosis are continually refined by the findings of new research. Currently, additional research focusing on the way decisions are made by clinical psychologists and other health professionals to arrive at the correct diagnosis of an Autism Spectrum Disorder or Nonverbal Learning Disorder is needed to further reduce the chances of misdiagnosis.

If you have noticed that your child is struggling in school, an assessment from a clinical psychologist would almost certainly be helpful, and there are a number of options available.  If educators have identified your child as having difficulties in school based on their academic performance, then children may be assessed by clinical psychologists who are employed by the school board.  As a parent, it is within the scope of your rights to have discussions with your child’s teacher about concerns you have and to ask if your child would be eligible for an assessment through the school board.  Another option is to obtain an assessment privately.  There are a variety of clinical psychologists in Windsor and the surrounding area who specialize in assessing children.  Often, the child’s teacher or other parents who have been consumers of psychological services can make recommendations regarding who to contact.  A complete list of registered psychologists and their specializations can be obtained from the website of the College of Psychologists of Ontario.

House on Sunset - Psych ServicesIt is not uncommon for children and their families to face financial or other barriers to accessing diagnostic psychological assessments.  For those facing such barriers, several alternatives are available.  Psychological assessments are completed on the University of Windsor campus by licensed psychologists and clinical psychology graduate students based on a sliding fee scale for qualified individuals and families (for further information, please contact the Psychological Services and Research Centre directly at 519-973-7012 or access through their website.

Another option available from time to time is to involve your child in a research study that includes a comprehensive psychoeducational or neuropsychological assessment, usually free of charge.  Such research studies are often available through the Department of Psychology at the University of Windsor.  Each study has its own particular criteria that a child must meet in order to participate. Browsing the websites of Psychology Department faculty will give some idea of what is available.  For example, there is currently a study that is investigating the similarities and differences between Autism Spectrum Disorder and Nonverbal Learning Disorder in order to better understand the characteristics of each and to ensure that a correct diagnosis is reached. In this case, participants receive a neuropsychological assessment free of charge. To participate, however, children must be between the ages of 9 and 16 (inclusive), be able to speak in sentences, and have a diagnosis of Autism Spectrum Disorder or meet study criteria for Nonverbal Learning Disorder.To find out if your child is eligible to participate in this study, please call 519-551-8997 or email asd.nld.study@gmail.com.

CNRG: Child Neuropsychology Research Group

Regardless of the route you take to have your child assessed, it is a helpful process that offers numerous benefits to your child, and potentially to children who have yet to be diagnosed and are having difficulties in school.  Through research, there is an ongoing refinement of methods used to reach an appropriate diagnosis and to identify the most effective interventions.

References:

Dawson, G., Rogers, S., Munson, J., Milani, S., Winter, J., Greenson, J., . . . Varley, J. (2010). Randomized controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125, e17-e23. doi: 10.1542/peds.2009-0958

Perry, A., Cummings, A., Geier, J. D., Freeman, N. L., Hughes, S., LaRose, L., . . . Williams, J. (2008). Effectiveness of Intensive Behavioral Intervention in a large, community-based program. Research in Autism Spectrum Disorders, 2(4), 621-642. doi:10.1016/j.rasd.2008.01.002

Sattler, J. M. (2008). Assessment of children: Cognitive foundations (5th ed.). San Diego, CA: Jerome M. Sattler.

S. Scott, M.A.
Child Neuropsychology Research Group
University of Windsor

The $64,000 Question

Guest Blog Post by: Erin Plumb

 

Hello My Name Is…

So I am new to the blogging world. This will be my first ever post and as such I thought I would take the time to introduce myself to you.   My name is Erin. I am an assistive technology trainer who works in a variety of places, including LDAWE, with a variety of age groups and disabilities. I have been an advocate for persons with disabilities for over 20 years. LDAWE asked me to create and facilitate a course for Adults with LD several years ago as Bev, our phenomenal Executive Director, and I share a passion for this under-serviced group.

What do I mean when I say under-serviced? Well, let me explain. Children within the public and separate boards have reasonable access to assessment, accommodation and funding for both. Young adults in either college or university have similarly comprehensive access. Adults by and large do NOT. That is not to say that parents and educators don’t struggle implementing reasonable and equitable accommodation; but, simply that adults have a couple extra hurdles.

Sculpture by artist Su Blackwell featured on the National Art Society. Click on the link to hers and other fantastic art. http://nationalartsociety.com/?p=4165

Sculpture by artist Su Blackwell featured on the National Art Society. Click on the link to hers and other fantastic art.
http://nationalartsociety.com/?p=4165

An Unhappy Ending

Once upon a time, before EQAO testing, IPRC and IEP meetings; there was no standardized system that existed province wide. There was limited resources for exceptional children in terms of testing and accommodation. Special education existed as a separate program for only the most severely disabled children. Many learning disabilities (LD) had not even become widely know to educators and parents. Even today many LD’s are poorly understood and many difficulties persist due to the invisibility of the disability. Adults who attended schools during this time were most often referred to as poor students who were perhaps lazy, deviant, or intellectually stunted. Unfortunately this fairytale does not end with “they lived happily ever after” for those involved.

The Woes of the Many

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Many of the adults I have met over the years have expressed fear and loathing as the most prevalent feelings associated with their school years. Many didn’t read well, had poor writings skills and were singled out for it. For many it has led to lower literacy, poor self esteem, and less employment opportunities. Many are chronically under or unemployed. Many end up on Ontario Works and ODSP without even the knowledge that they have rights much less how to stand up for themselves. Many who were either not diagnosed or misdiagnosed. Many who become frustrated, disillusioned with society, angry and isolated. The many are a growing group representing as much as 2.5% of the Canadian population.

The Vicious Cycle

Vicious Cycle 2The biggest problem for this group of “many”is access to funding and support. If they missed out on meaningful diagnosis they run the risk of being trapped in a vicious cycle. A diagnosis is required for any formal accommodation; however, without an understanding of strengths and weaknesses many adults don’t know what they need to succeed and have difficulty asking even for informal accommodations. Assessment is a pricey undertaking especially if you have a fixed or limited income. School or training without accommodation is difficult or impossible. Many adults also have profoundly negative feelings of school based on their experiences and inherently mistrust education. With limited education this population has limited employment opportunities. A lack of accommodation coupled with all the problems associated with poverty leads to difficulties retaining permanent employment. Rinse, lather, repeat. At least until utter the frustration and perceived futility of the exercise causes complete disengagement from the goal of success within the society.

The $64,000 Question

Given the amount of barriers and the difficulties overcoming these barriers is there a functional solution? Can we as people of many different abilities devise an equation that is balanced? My writings on this blog will not likely solve all of these problems; however, I do have some ambitions and caveats.

Stuff that I will do:

  • create a positive space for adults with LD to talk openly about their experiences and ideas
  • try to shed some some light on the available community resources for this group
  • create awareness of  the needs of adults as distinct from those of children
  • discuss possible solutions both high and low tech
  • encourage society at large to embrace inclusivity and understanding

Stuff that I will NOT do:

  • give specific advice to individual cases
  • tolerate any hate speech or demeaning commentary towards any group of society regardless how angry/frustrated someone is with that group
  • engage in an “us vs. them” mentality

I will be writing 9 more blogs throughout the year. It is my sincere desire to generate some discussion so that we can use the collective wisdom of our experiences and ideas for change to make a difference.

Did I mention I am new to blogging? I managed to post this before I wanted to, not figure out how to add tags, AND delete the title while doing so. So here’s hoping the edit will address some of those issues.