A lot of people call and tell me that the teacher told them their child needed a "psychoeducational assessment." They aren't sure what it is, or how much it will cost. So I'd like to answer some basic questions about psychoeducational assessments and how they relate to ADHD, learning disabilities, accommodations in school and other similar questions people often ask.
1. What is a Psychoeducational Assessment?
A psychoeducational assessment is a set of tests, observations and history taking about a child, adolescent or, even an adult in college that helps us understand how they learn and process information. Usually we are asked to complete a psychoeducational assessment when a school or teacher suspects a learning disability. For instance, a child or adolescent might have difficulty with one particular subject such as math or reading. Sometimes a child is performing below what would be expected for their grade level, and a teacher wants to know what might possibly be happening to prevent the child from learning like his or her peers. The psychoeducational assessment helps us understand the student's current level of functioning, as well as their potential level of functioning. It also helps us understand a student's strengths and weaknesses so we can develop a plan to help the child succeed in the classroom.
2. What kinds of tests are used in a psychoeducational assessment?
Usually there are two major sets of tests. One is for measuring cognitive ability - intelligence. This might include tests like the WISC or WAIS, common intelligence tests. Or two other tests commonly used are the RIAS (Reynolds Intellectual Assessment Scales) or the Woodcock Johnson. Sometimes another test is chosen because of language difficulties, however the purpose of this part of the assessment is to understand the various cognitive abilities that a student has. In a way you can think of this as a measurement of potential.
A second set of tests are the academic tests. This might include the WIAT (Weschler Individual Academic Test) , the WRAT-4 or some other specific test of reading, oral reading, math skills, writing and so on. This set of tests measures a student's current skill level. What academic skills the student is able to demonstrate.
We then do two kinds of comparisons. We look at general and specific cognitive skills, and see if there are strengths and weaknesses there that might point to a "processing disorder" or specific cognitive deficit, and then we compare the cognitive tests (abilities) to the academic tests (level of functioning) and try to understand if there are specific weaknesses in the student's ability to produce work. Here we might find a specific learning disability.
Other tests are then used as needed based upon these results (this is why you usually need to go back to the psychologist more than once, they need to score and analyze these results to see what needs further investigation before continuing). These tests might look at auditory processing, learning and memory functions, executive functions, social skills or specific academic skills. Some school psychologists give a single battery, always the same, to every student. They usually have a rational for that. Others use a more flexible battery and may put more emphasis on the latter part of the investigation.
3. Who administers a psychoeducational assessment?
Usually schools are able to administer a psychoeducational assessment. School psychologists are experts in looking for specific learning disabilities, and are usually familiar with the school districts procedures and expectations for students, which can differ from district to district. This service is free in Canada and the United States. In the United States, when a parent requests a psychoeducational assessment the school district needs to look at the request and investigate it. The parent get either a reply that the district doesn't feel an assessment is necessary, or a psychoeducational assessment, within 50 days. If the district feels one is not necessary, and the parents disagree, there is a structured appeal process utilizing outside experts to determine if it is necessary or not. In Canada, regretfully, schools have very limited resources and requests for assessments are often put off for several years. There is an appeal process to the Ministry of Education, but not all schools inform parents of this right. Children are placed on a "priority list" which is often redone at the end of every year, and I have seen some children wait three or more years before being considered for an assessment.
Parents also have the option of using outside Registered Psychologist to provide a psychoeducational assessment. One advantage of this is that a Registered Psychologist is able to diagnose mental disorders, and school psychologists (who usually only hold an MA degree) are not. Some school psychologists, especially in BC, are also Registered Psychologists. The fee, which is not covered by MSP, ranges from $2,200 - $3,200 depending upon the complexity and length of the assessment.
4. What happens after the psychoeducational assessment is complete?
Not all psychoeducational assessments lead to a diagnosis, and some are simply not valid due to a student's behaviour or efforts. So nothing can be guaranteed. If there is a learning disability evident, or a mental health disability, usually the school's committee on special education meets with the parent and a child is "coded" meaning they are given a category that enables them to be provided appropriate accommodations and interventions. This is written up in an agreement called the IEP or Individual Education Plan. Parents should be informed and involved with this process at every step, and if you use an external psychologist you should make sure they are either present or agree with the IEP.
Here I'd like to make a cautionary statement: Often psychoeducational assessment reports contain a long....sometimes very long...list of suggestions for the school to implement. It is critical to work with a psychologist who has experience with the schools and the classroom. Otherwise they are likely to suggest interventions that are not practical and demonstrate a lack of awareness of the classroom. When I started working in this field I wanted to become a school psychologist (I am both a licensed/Registered Psychologist and a Licensed/Registered School Psychologist), but couldn't because to be accepted into a school psychology program required that I be a certified teacher for 5 years first! I did become a teacher and have classroom experience, without which it would be difficult to understand what interventions and supportive techniques work in the classroom. Give this consideration when picking a psychologist to complete your ch need for a "full psychoeducational assessment" must mean they feel they have completed a "not full" psychoeducational assessment, and I would agree. Many schools, especially in British Columbia, allow and even encourage teachers with minimal training to administer some simple and basic tests, including a brief IQ tests such as a TONI (Test of Non-Verbal Intelligence) and a brief academic test such as the WRAT-4. While the publisher of these tests say that they can be administered by an experienced teacher, that doesn't mean a teacher should administer a handful of these brief tests and then feel they are qualified to rule out a learning disability or other deficit. Using these tests in this way is a misunderstanding of the purpose of screening with these tests. They are meant to rule in students who would need further, more in depth, diagnostic testing. They are not meant to rule out learning disabilities or other academic or cognitive problems- which is how they are being used! If your child is failing at school, or having significant struggles, and they are administered a brief IQ test - which comes out in the normal range, and then a brief academic test, again scoring in the normal range, but he or she cannot produce in class .....these tests do not mean there is nothing wrong. The mean the exact opposite - THERE IS SOMETHING WRONG! Further assessment/testing needs to be done by a qualified school psychologist or licensed/registered psychologist. These screening should not be used to ignore problems that are real and obvious from a teacher report to student behaviour or a report card. A screener isn't suppose to be used to stop inquiry.
5. Can the school diagnose ADHD, depression, anxiety or autism?
Generally, no. A particular school psychologist may also be a Registered Psychologist and qualified to do this, but that is usually not the case. School Psychologists are not qualified by their school psychology certificate to diagnose mental disorders such as ADHD, depression, anxiety or Asperger's Syndrome/autism spectrum disorder. A properly trained Registered Psychologist can help you with that.
6. How young can a child be and need testing or assessment?
While here in BC there is a reluctance on the part of school districts to complete comprehensive psychoeducational assessments on students until they are older, this is not the case elsewhere, and is not best practice. For almost every disorder the general rule is that the sooner we have a diagnosis and get treatment, the better off the student is. In some jurisdictions, such as California and New York, special teams assess children at ages 4 and 5, in order to make sure they receive appropriate services before the enter school. Some jurisdictions offer treatment to children with special needs before grade 1 or K to make sure they do the best they can and experience as little difficulty as possible. You might ask your medical doctor about a referral to Children's Hospital or another provincial provider here in BC. Some providers associated with the Ministry of Families and Children work with children down to 3 years old. The earlier a child gets help, the better the outcome. If your school disagrees it's usually because they simply don't have properly trained professionals. Talk to your medical doctor and get an appropriate referral if you have concerns,
I hope this brief overview of Psychoeducational Assessment is helpful. For parents with concerns about their child's academic progress I often suggest a book by Dr. Mel Levine called, "The Myth of Laziness." Another alternative book by Dr. Levine is "Minds of All Kinds." There is also an organizational website for Minds of All Kinds which can provide very helpful information. Click here to get to that site: http://www.allkindsofminds.org
You'll also find a great book there for teachers called "Schools for All Kinds of Minds." Take a look!
For more information on the psychoeducational assessment services I provide please visit my website at http://relatedminds.com
or click here: http://www.relatedminds.com/testing/
KEY WORDS: ADHD, Learning Disorder, Learning Disability, Testing, Psychoeducational Assessment, School Testing, Psychologist, ADHD Coaching, Vancouver, Burnaby, San Franscisco