Psychological Testing and Assessments
The psychological assessment services offered at NBI are designed to facilitate understanding of how individuals function and learn by using reliable neuropsychological, educational, and psychodiagnostic tests. An evaluation is most helpful when a learning disability, developmental delay, intellectual disability, or other cognitive problem (e.g., difficulty with memory, attention, or executive functioning skills, such as organization or planning) is suspected. A comprehensive evaluation may also be helpful for individuals struggling with behavioral, social or emotional difficulties (e.g., anxiety, depression, etc.) that seem to be interfering with social, cognitive, or academic functioning. Such evaluations may offer diagnostic clarity and related treatment recommendations.
In general, a comprehensive evaluation is intended to offer increased awareness of why an individual may be struggling to meet developmental, academic, or social milestones. The process often helps to solidify appropriate clinical diagnoses, but more importantly, works to identify which interventional or support services are recommended in order for individuals to perform at their best in multiple settings. As such, upon written consent, our team will communicate as needed with physicians, psychiatrists, therapists, school professionals, and other psychologists to coordinate management of the individual’s treatment plan, educational programs, and/or other necessary referrals or placements.
What is the purpose of a comprehensive diagnostic evaluation?
Evaluations increase our understanding of cognitive, emotional, and behavioral functioning in relation to difficulties that an individual is experiencing, whether at home, school, or in the workplace. This information augments or goes beyond what can realistically be obtained via clinical observations, interview material, or medical findings. Through an interactive assessment combining standardized written tasks, hands-on activities, questionnaires, and computer “games,” a greater awareness about present functioning and future risk factors is gained.
Once an individual’s unique profile is understood, including areas of relative strengths and weaknesses, specifically tailored recommendations for direct interventions and accommodations are provided. These recommendations are often essential for the development of optimal treatment, educational, or placement plans, or for qualifying for necessary services.
Diagnostic evaluations are also instrumental in re-evaluating current or past clinical impressions or identifying the presence of previously unrecognized pervasive developmental delays (PDD) and autism spectrum disorders (ASDs), language or nonverbal processing deficits (NVLD), learning disorders (LDs), attentional difficulties (ADHD), and a variety of emotional and behavioral problems, e.g. depression, anxiety disorders, thought disorders. Lastly, these evaluations can be utilized to track clinical and/or educational progress over time.
Why are individuals referred for evaluations?
Evaluations can be particularly helpful when an emerging learning disability, attentional disorder, developmental delay, pervasive developmental disorder (PDD) or autistic spectrum disorder, behavioral problem, motor delay, memory problem, or language and communication delay is suspected or requires additional verification. They are also indicated when anxiety or social/emotional difficulties are interfering with an individual’s functioning or when it is important to understand the psychological and/or cognitive ramifications of medical conditions (e.g., epilepsy, cancer, or Alzheimer’s). Individuals often self-refer or are referred for assessment by a parent, doctor, teacher or other professional because of one or more of the following reasons:
- Difficulty in learning, attention, behavior, socialization, or emotional control.
- Teachers or work supervisors report persistent difficulties.
- Poor work performance despite adequate attendance and seemingly good attention and effort.
- Problems with retention of information and needs frequent redirection.
- Inadequate achievement in school or at work despite sufficient effort.
- History of neurological or developmental difficulties known to affect the brain and/or brain systems (e.g., epilepsy, toxic exposure, metabolic disorder, autism spectrum disorder, or ADHD).
- Suspected developmental delay (e.g., language, motor, etc.) which may or may not be accompanied by other areas of impairment.
- Traumatic brain injury or significant illness that impedes cognitive development.
- Specific medical disease or congenital developmental problem that affects brain functioning.
- Proper documentation of giftedness or other special educational need is required.
- Documentation is desired regarding an individual’s current level functioning (baseline) or an individual’s progress or change after treatment or previous evaluations (re-evaluation or follow-up evaluation).
At what age should an evaluation be considered?
It is best to conduct evaluations as soon as possible, especially for children. Nearly all professionals agree that early intervention plays a significant and vital role in the treatment of developmental needs and long-term progress. Further, diagnostic evaluations and the resulting reports serve as important tools for documenting the development and pattern of cognitive strengths and weaknesses over time.
Evaluations are appropriate for individuals over 2 years of age, although children under two years of age may be seen as well, depending on the specific circumstances and referral questions. Dr. Lyons is highly experienced in the assessment of infants and children with developmental delays, Autism Spectrum Disorders, and general medical conditions. She has the requisite training to monitor infants as young as 6 months of age, but standardized assessments can only begin later, in some cases after 12 months of age.
What does an evaluation typically consist of?
NBI’s team of psychologists and neuropsychologists personally conduct each component of the evaluation process. Most evaluations include the following:
Initial Intake: At the first appointment, the psychologist meets with the patient and his/her family in order to gain an understanding of the reason for referral and obtain a detailed developmental, medical, psychological, educational and, depending on age, occupational history.
Evaluation: If a comprehensive evaluation is determined to be in the individual’s best interests, testing will usually begin immediately after the initial interview. During testing, standardized measures are administered in a systematic manner in an appropriate environment. The same tests are not given to every patient, but rather our team devises an individualized battery. Tests generally include a series of interactive activities that assess language and perceptual processing abilities, attention and memory, school based learning, cognitive skills, emotional functioning and behavior. Emerging skills can also be assessed in very young children. Parents and/or family members are usually not in the room during testing, although they may be asked to be present with very young children or on a case-by-case basis. The time required of testing depends on the patient’s age and problem. An evaluation may take up to eight hours and may spread across several sessions, depending on the needs of the patient. The evaluation of infants or preschool children is usually shorter in duration. Informal feedback may be provided to family members at the end of each session, as appropriate and relevant to the process.
During the course of the evaluation, the following areas may be assessed:
- General Intelligence
- Academic Achievement
- Attention / Concentration
- Executive skills, such as organization, planning, inhibition and flexibility
- Learning and Memory
- Language and Communication Skills
- Visual-spatial Skills
- Motor coordination
- Social Interaction Skills
- Play Skills
- Adaptive Functional Skills
- Social-emotional Functioning
- Personality and other psychological factors
Some abilities may be measured in more detail than others, depending on individual needs.
Feedback Session: Approximately three weeks after the initial testing session, a feedback session will be scheduled. This timeline allows the psychologist time to obtain and score teacher report measures and integrate and interpret all of the results gathered in the interview, testing session(s), and self-report measures and/or parent and teacher checklists. During the feedback session, each test that was completed and the subsequent results will be discussed. Based on the individual’s performance, individualized recommendations will be offered that draw upon the individual’s strengths and needs. Skills and other areas requiring intervention will be identified, and specific strategies and referrals will be offered, as necessary.
Report: A comprehensive written report documenting the test results, corresponding diagnostic findings, and subsequent recommendations will be provided upon completion of the testing.
Families are also offered consultation services both before and after the evaluation process, as needed. Reports are disclosed to other persons, professionals, or agencies upon appropriate written authorization, unless specifically contra-indicated by legal or ethical concerns.