Psychoeducational Testing

When Brian, a 10-year-old 4th grader, repeatedly stood up at his desk looking distracted, his teacher recommended that he be tested for an attention deficit disorder.

  • Allison, a 15-year-old high school junior, could never finish tests and quizzes; attributing this to a learning disability, her parents wanted her school to give her extra time for exams.
  • 14-year-old Kathryn always mystified her teachers by her lackluster performance and failure to turn in her assignments. Just before she started 9th grade, her parents decided to figure out why this was happening and how she could get off to a good start in her new high school.
  • Matthew, an 8-year-old 3rd grader, did the bare minimum to get by in his writing assignments, rarely followed instructions, and caused conflict with his peers. His teacher saw him as a trouble maker, making his parents wonder if the problem was him, the school, or both.

Parents of kids such as Brian, Kathryn, Allison, and Matthew seek out psycho-educational evaluations for two basic reasons. They want to know (a) what is causing their kids’ difficulties, and (b) what can be done to help them. Sometimes recommendations for testing come from school personnel, pediatricians, or family physicians who suspect that something may be amiss. Or, in other cases parents hear about the benefits of testing from concerned friends and relatives, some of whom may have gone through the process with their own kids.

But most often, in my experience, mothers and fathers have nagging concerns for years. Teachers may have reassured them that nothing was wrong, that they should just relax. Parents also hope that with maturity, things will “click.” Whatever problems and peculiarities kids have had will disappear, much like toddler diaper rashes, Cheerio diets, and biting. They imagine sons and daughters who love reading, take responsibility for their work, make friends easily, prepare well for tests, and follow school rules. During parent-teacher conferences, they anticipate finally hearing glowing reports.

But before these changes materialize, something prompts parents to seek testing. Maybe a school year ended disappointingly, difficulties became more pronounced over the summer, or a new school year started off badly. New grades, especially transitions to middle school and high school, often trigger testing requests. That’s because greater demands for organization, independence, and higher-level critical thinking cause many students to hit the proverbial wall. A new teacher might also raise concerns, confirming parents’ ongoing suspicions that something needs to be addressed. Whatever the impetus, once parents initiate testing they’re usually relieved; finally, they’ll get answers.

Invaluable Information

While reasons for testing are as varied as children themselves, the process should provide basic information such as: What is going on with kids? How do they compare to their peers? What are their personal strengths and weaknesses? Are kids underachieving and, if so, why? Is a developmental or learning disability holding them back? How are children’s personalities, emotional lives, and social adjustment affecting their functioning and well-being? In other words, what is making them tick? And, most important, what can be done to help them? Is there a need for remediation, further evaluation, therapy, support, and/or accommodations? Finally, what sort of school environment best suits students’ learning styles and educational needs?

It is not only parents who benefit from testing. Usually, kids also are relieved to learn why they’re struggling. By the time they’re tested, many already believe something must be wrong with them. They describe feeling inadequate, helpless, and stupid. Sometimes they believe the labels given to them by others, such as “lazy” or “unmotivated.” That’s why, for me, the most satisfying component of testing is often giving students feedback. When they hear they have a specific learning issue-and it has a name-they are less apt to blame themselves. When they hear about strategies they will help them to learn more easily, they feel empowered and hopeful-sometimes for the very first time.

If three decades of testing have taught me anything, it’s that test results are unpredictable-and often remarkable. The suspected problem can turn out to be something else entirely. This was certainly the case with Brian, Kathryn, Allison, and Matthew, as I’ll explain shortly. For these kids, testing was invaluable, as findings made clear what was-and, just as important, what wasn’t-causing their struggles. Without this crucial information, their parents couldn’t have gotten them the right help.

The L Word

Parenting struggling students is a challenge. It is hard to hear that our kids “hate” school and to see them not doing their best work. I often see mothers and fathers at their wit’s end, utterly exhausted by nightly homework battles. They’ve tried, usually without success, to boost kids’ ambition, either by nagging, paying for good grades, or rewarding them with coveted electronics. Yet their kids don’t seem to have the intrinsic motivation, intellectual curiosity, and love of learning that characterizes scholars. Many frustrated parents conclude that their underachieving kids are simply lazy.

The truth is, in 34 years of testing young people I have seldom found laziness to be the cause of kids’ difficulties. Children are naturally curious. Most enjoy the processing of learning and acquiring facts about the world. Students want to feel competent and to be seen as smart by others. They’re gratified by accomplishing goals. Deep down, though they may not admit it, even teens want to make their parents and teachers proud. So when kids disengage from learning, there is always a reason-or, most often, a combination of reasons-including learning challenges, emotional reactions, and life circumstances-that explain their struggles.

Most often, they stop trying in school not because they are addicted to online gaming or social networking, but because they think they can’t succeed. Escapist activities are usually methods of coping with academic struggles, not their cause. Students avoid reading when it’s hard to decode words, understand main ideas, read between lines, or grasp characters’ motivations and emotions. They shun writing when any component of this complex process is difficult-for example, translating what’s in their minds onto paper, remembering how to form letters, placing them correctly on the page, spelling out words, sequencing words so sentences make sense, or using capital letters and punctuation marks. Students with poor planning and organizational skills are stymied by projects; they don’t even know where to begin, much less how to visualize required steps, self-monitor their performance, and work within time constraints. But without testing, it is hard to pinpoint exactly where such difficulties lie.

The Testing Process

The initial step in an evaluation is usually a consultation, during which parents give the psychologist detailed information about the presenting problem; the child’s birth, development, academic, and social histories; behavioral and social adjustment; and family history. With this background, the psychologist can then propose an individually tailored assessment plan. This should consist of several testing sessions-the length of which should be determined by the child’s age, attention span, and behavioral needs-in which a variety of test instruments and procedures are utilized  to assess cognitive abilities, academic achievement, and social/emotional/personality functioning. In some cases, neuropsychological functions such as sensory processing, attention, memory, language, motor coordination, and executive functioning may be evaluated, as well.

Test scores are only a part of the picture. Often, what matters most is not whether specific answers are right or wrong, but rather the process by which students arrive at answers. In addition, observations of students’ behavior throughout the evaluation are often more meaningful. For example, how do they present themselves, relate to the evaluator, and communicate? What is the quality of their motor activity? How is their attitude, mood, approach to tasks, and persistence of effort? Are students attentive, focused, impulsive, or distractible? How do they cope with challenges and frustration?

Results of Testing

At the end of the testing process, both parents and students should hear results during face-to-face feedback sessions-in plain, non-jargon language. A thorough and competent evaluation should explain the referral problems, giving parents and students a clear understanding of the reasons for those difficulties as well as specific, effective strategies to address them. Parents should be given a comprehensive written report, as well, which summarizes all tests, findings, conclusions, and recommendations. They can, at their discretion, provide copies to anyone working with their child (e.g., tutors, psychotherapists, mentors, language clinicians, etc.).

While findings are not usually a complete surprise (on some level, parents often knowmore than they think they do), testing should connect the dots, providing a holistic sense of who children are and how they are functioning at a particular point in time. In doing so, testing can correct any misunderstandings in how children have been understood. Brian’s parents, for example, learned that had they treated him for an attention deficit, perhaps even given him medication, they would have missed the real problem. Brian had a fairly severe language disability. Whenever he became confused by what his teacher was saying, he became anxious and agitated, standing up at his desk and looking around uncertainly. What he needed was speech and language services and classroom support, which enabled him to feel more capable, calmer, and better able to focus.

While Allison did not in fact have a learning disorder, she panicked so much about getting good grades that her thinking deteriorated during tests. Allison’s average cognitive abilities could support neither her lofty ambitions nor her parents’ expectations. While extra time on tests eased her anxiety a bit, Allison couldn’t truly thrive until she and her family addressed the issue of academic pressure.

Learning issues were not to blame for Kathryn’s difficulties, either. Testing showed her to be a bright girl who found her inner life far more fascinating and compelling than anything she was taught in school. Beneath her outward contentment, Kathryn was rather depressed as a result of struggling with deeply disturbing questions about who she was. While she couldn’t muster energy to do her homework, she spent hours every night writing lengthy blogs about her thoughts and feelings. Psychotherapy sessions, which were recommended as a result of testing, provided a safe forum in which she could explore these issues, gradually enabling her to focus more on academics and friendships.

But Matthew, who was blamed for underachieving and misbehaving, had a bona fide attention deficit disorder. This explained why it was so hard for him to control himself in school. Moreover, Matthew’s reluctance to write was not a reflection of disobedience, but rather a result of a learning disability. He was diagnosed with dysgraphia, a disorder of written expression that requires support and accommodations in school. A variety of treatment modalities and strategies were recommended to help Matthew and his parents better manage his attention deficit, hyperactivity, and impulsivity.

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         If you’ve had nagging worries about your child, you might consider testing to get some clarity. Schedule a consultation with a psychologist who is well-trained and experienced in evaluating kids and teens. Get personal recommendations from medical professionals, therapists, family members, school personnel. During the conversation, ask plenty of questions so you can determine:

  • Are you comfortable with both the evaluator and the testing plan that’s proposed?
  • Will you get all the information you need?
  • Will test results be conveyed to you in a clear, comprehensive, and timely manner?
  • Is the testing professional likely to work well with your child?
  • Will the evaluator confer with educators, therapists, tutors, or other personnel?
  • If necessary, is the tester willing to attend educational meetings at the child’s school?

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