Psychological and Neuropsychological Assessments

Psychological and neuropsychological assessment is the most comprehensive way to diagnose ADD/ADHD, Executive Functioning Difficulties, Autism, learning disabilities (LD), anxieties, obsessive compulsive disorder (OCD), depression, and other developmental, emotional, intellectual, or academic challenges.  Treatment flows naturally from an understanding of strengths and weaknesses that are uncovered in such an assessment.  In order to know what interventions to pursue, a formal assessment is the most important step one can take.  This type of assessment is often used for diagnostic determinations, qualifications for services, exceptional student education and to provide necessary documentation for accommodations in school and on standardized tests (e.g. SAT. ACT, GRE).   Dr. Aviv also conducts evaluations for IQ assessment/evaluation of gifted students. 

 

If you are not sure whether your child needs an assessment, consider whether you following questions apply to your child:  

  • Does life feel harder for your child than you think it should? 
  • Does your child struggle and get frustrated at school? 
  • Does your child have difficulty getting along with friends and family? 
  • Do you find yourself making too many excuses for your child’s behavior? 
  • Is your child as happy as you think he/she should be? 

What Does Assessment Involve?

A psychological evaluation is a process of gathering information using specific tests, interviews, review of records, consultation with other professionals (e.g., psychologists, psychiatrists, teachers), and direct observations (for example, a child may be observed in classroom settings).  All of this information is then integrated in order to answer questions about an individual’s skills, functioning, emotions, and behavior.

Psychological assessment can also clarify treatment strategies and interventions when complaints may not meet full diagnostic criteria but clearly lead to difficulties in functioning at full potential at school, work, or in interpersonal relationships and other social interactions.  Testing also provides a better understanding of a person's behavior and learning in school, at home, and in the community. When we know what a child can or cannot control in their behavior or achievement, we are then in a position to empathically intervene and avoid identifying the child as being willful, malicious and/or lazy, labels often applied to children with diagnosable conditions that when  accurately identified can be addressed with targeted interventions.  

 

What Questions can a Psychological Evaluation Answer?

Does this individual have a Learning Disability (LD)?

Does this person have Attention-Deficit/Hyperactivity Disorder (ADHD)?

Is this person gifted?

Is this person experiencing a psychological disorder, such as depression or anxiety?

What are this person’s cognitive and academic strengths and weaknesses?

What are this person’s interpersonal strengths and weaknesses?

How does this person process information and learn information best?

What are the specific characteristics of this person’s strengths and weaknesses and what individualized treatment plan will be most effective? 

How can a complex set of difficulties that may include cognitive concerns, academic problems, emotional symptoms, and/or medical issues be clarified such that appropriate recommendations can be made and then prioritized?

 

Why Should The Assessment Be Conducted By A Clinical Psychologist/Neuropsychologist?

Clinical psychologists are specifically trained to administer and interpret testing data, and to integrate this data with a thorough developmental history in order to arrive at a diagnostic conclusion.  Different childhood disorders result in specific patterns of strengths and weaknesses.  These profiles can help identify a child's disorder and the brain areas that may be involved.  For example, testing can help differentiate whether a language delay is due to a problem in producing speech, understanding or expressing language, social shyness, autism, or cognitive delay.

 

In most states, calling an assessment a psychological assessment or neuropsychological assessment is limited to licensed psychologists. Sometimes unlicensed providers or individuals who may not be specifically trained as rigorously as neuropsychologists may call their assessment reports by other names.

 

What is Pediatric Neuropsychology?

Pediatric neuropsychology is a specialty that focuses on the relationship between brain function and expressed behavior within the context of a child’s neurodevelopment.   A pediatric neuropsychologist is a licensed psychologist with specialized training and certification in how learning and behavior are associated with the development of brain structures and pathway systems.  The field shares a knowledge base with other professions. A child or pediatric neuropsychologist may work with other pediatric specialists in behavioral neurology, developmental pediatrics, pediatric neurology, child psychiatry, pediatricians, occupational therapists and speech and language therapists.

 

It is also important to note that pediatric neuropsychology is not a simple downward extension of adult neuropsychology, but involves an understanding of normal and abnormal child development and learning, developmental motor skills, and language disorders as well as diseases associated with children.  Since children’s skills go through periods of rapid change, and they are faced with increasing cognitive and academic demands with each passing year, there is often a need to conduct periodic re-assessments.  Some conditions may not reveal their full impact until later years, such as with the multi-tasking demands of middle school, or the increased volume of work and writing demands of high school.

 

Pediatric Neuropsychologists can also use testing to obtain a baseline against which to measure the outcome of treatment (e.g. TOVA testing to determine the efficacy of ADHD medication) or map a child's development over time.

 

What Should A Thorough Pediatric Neuropsychological Assessment Include?

  • Diagnostic interview with parents
  • Review of the child’s academic and medical records
  • Intellectual strengths and weaknesses
  • Academic skills
  • Executive Functions (i.e., organization, planning, inhibition, and mental flexibility)
  • Attention variables (Inhibition, Hyperactivity, Impulsivity)
  • Learning and memory
  • Language
  • Visual and spatial abilities
  • Motor and sensory abilities
  • Developmental from gestation to the child’s current age
  • Behavioral and emotional functioning
  • Social skills
  • Feedback session and comprehensive written report

Each child’s and problem solving behavior during assessment is very closely observed.  This ‘qualitative’ analysis helps to fully understand and explain the statistical ‘quantitative’ data obtained through standardized testing.  For example, it is often more important to understand how a child missed a testing item than only relying on the outcome score.  A child’s motivation, cooperation, effort, and behavior can positively or negatively affect testing outcomes. 

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