Psychological and Psychoeducational Assessments of Children, Adolescents, and Adults

BHA provides assessments of children and adolescents suspected of the following difficulties:

• Academic, Cognitive and Learning Difficulties
• Pervasive Developmental Disorders
• ADHD
• Behavioral Disorders
• Cognitive, Academic or Behavioral Sequelae of Childhood Illness and Disease

Academic, Cognitive and Learning Difficulties

Academic and cognitive testing has significant implications for the person evaluated.  Important life decisions (e.g., diagnostic, therapeutic, eligibility, placement) are frequently made based on the results of the evaluation.  As such, you should expect that professionals conducting the evaluation would use cognitive models that are evidence-based and make interpretations of the test data that are supported by contemporary theory and research.  This expectation is no different than the expectation we have when visiting a physician; we expect medical doctors to use the most current and research-based medical technology to diagnose and treat various physical ailments. 

Yet the evaluation of cognitive abilities remains a topic of heated debate among psychologists.  One of the most controversial topics among psychologists is the concept of IQ.  Most modern psychologists are somewhat skeptical concerning the usefulness of this concept.  What we refer to as IQ is actually a combination of scores derived from multiple cognitive abilities.  Asking about a person’s IQ is like looking at a forest made up of several types of trees and asking, “How high is the average tree?”  While this may tell us something about the forest, we would learn a great deal more by knowing the average height of each of the types of trees. 

In the evaluation of cognitive functioning, BHA utilizes the most comprehensive framework available for understanding the structure of human cognitive abilities based on contemporary psychometric theory and research.  Research indicates that this model is the most thorough and well researched of the cognitive ability models (Flanagan, Ortiz, & Alfonso, 2007).  Furthermore, and more importantly from a parent’s perspective, research indicates that using an evidence-based framework in the evaluation of cognitive abilities facilitates the understanding of a child’s academic achievement deficiencies. 

Pervasive Developmental Disorders

The Centers for Disease Control (CDC) estimates that approximately 1 in 150 individuals are diagnosed with a pervasive developmental disorder (PDD).  This makes PDD one of the fastest growing neurodevelopmental disabilities identified today.  Some professionals have speculated that Loudoun County,Virginia has an unusually high rate of PDD owing to the large number of engineering and IT jobs in the area.  This is certainly a possibility given that research supports the association between children with PDD and parents with engineering, mathematics or physics backgrounds.  On the other hand, PDD diagnoses have become the diagnoses du jour, and as such, require thoughtful evaluation to ensure accurate identification.  Accurate identification of PDD requires a comprehensive evaluation of an individual’s developmental history and progress in 1) the use and understanding of social language, 2) social relatedness and reciprocity, and 3) age-appropriate interests and activities.  Comprehensive, well-designed evaluations to rule out PDD include 1) standardized assessment of cognitive and adaptive functioning, 2) assessment of social development, social-imaginative play, and social language and use (e.g., understanding of subtle jokes, teasing or sarcasm), 3) assessment of interests and hobbies, and 4) assessment of associated features of PDD (e.g., sensory abnormalities, auditory processing difficulties, motor skill difficulties).

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is an unusual condition in that it is both under-diagnosed and over-diagnosed depending on the demographic characteristics of the population.  ADHD is a neurological condition that warrants a comprehensive evaluation of sustained attention/concentration, impulsivity, distractibility, and hyperactive behavior.  An evaluation of ADHD is incomplete in the absence of a multi-trait, multi-method approach thatincludes most, if not all, of the following components: 1) a medical evaluation and/or history to rule out medical causes of the symptoms, 2) rating scale data from multiple informants to evaluate the nature and severity of symptoms, 3) cognitive and psychological testing to rule out alternative explanations of the symptoms, 4) computerized tests of sustained attention/concentration and impulsivity, 5) assessment of executive functioning, and 6) behavioral observations of the individual in a naturalistic setting.  In addition, the clinician must rule out multiple factors that can mimic ADHD, such as undiagnosed sleep problems, young-for-grade status, child temperament, and parent/child or teacher/child goodness-of-fit problems (Neul, Applegate, & Drabman, 2003).

Although ADHD, Combined Type and ADHD, Predominantly Hyperactive-Impulsive Type are relatively straightforward to assess, ADHD, Predominantly Inattentive Type requires a careful evaluation of attentional skills and abilities, the symptoms of which frequently remain unidentified by parents and teachers.

References

Flanagan, D.P., Ortiz, S.O., & Alfonso, V.C. (2007). Essentials of cross-battery assessment (2nd Ed.). Hoboken, NJ: John Wiley & Sons.

Neul, S.K.T., Applegate, H., & Drabman, R.S. (2003). Assessment of ADHD. In Handbook of Psychological and Educational Assessment of Children. (2nd. Ed.) Cecil R. Reynolds & Randy Kamphaus (Eds). Guilford Publications. New York: NY.