By Glenda Thorne and Alice Thomas
“I know my child is smart, but he continues to struggle with some of his schoolwork, and it’s getting worse now that he’s in fourth grade. His teachers aren’t sure what the problem is – one said he’s not trying hard enough, and another one said he’s not motivated, but I know he is! We’re all getting frustrated. What should we do?”
“My daughter tries and tries, but she still reads so slowly and has trouble pronouncing new words. It’s gotten to the point that she dreads reading, and she’s starting to think she’s stupid. It seems like her teachers keep trying the same methods, thinking she needs more exposure to them. But I think she may need a different approach. How do I find the approach that will be best for her so she does not keep falling farther and farther behind her classmates?”
These responses reflect typical concerns expressed by parents of children who are struggling in school. When children struggle, parents often feel confused, frustrated, overwhelmed and unable to help. They are often misinformed about the nature of their children’s difficulties. For example, they may be told their child is unmotivated or lazy and just needs to put forth more effort or try harder. At other times, educators may fail to recognize the actual difficulties a child is having because his or her grades may be acceptable. In order to achieve these grades, however, parents may spend countless hours working with their child in the evenings. Homework that should take an hour to complete may take three hours. Further, because of the long, difficult hours spent completing schoolwork, the student is unable to participate in extracurricular activities or just enjoy family time in the evenings. The first step in helping students who struggle in school is a comprehensive evaluation. This evaluation should provide the roadmap for school success.
“A crucial component in our work with children who learn differently is the psychoeducational evaluation,” states Joan Mondor, an educational therapist at a pre-kindergarten – grade 12 school. “This testing provides information for mapping a student’s strengths and weaknesses, understanding how they affect learning, and developing strategies for effective intervention.”
Not all evaluations are equal, however. Parents and teachers have found that evaluations, both those provided by public school systems and private clinicians and hospitals, vary greatly in their comprehensiveness, usefulness of information and specificity of recommendations. Therefore, parents must become informed consumers when selecting who will evaluate their children as well as what kind of evaluation will best serve their child’s needs.
Providers of Evaluations
The different facilities that provide psychoeducational evaluations include school systems, for profit and nonprofit centers, psychiatric hospitals, other hospitals having developmental departments and private practitioners. Private practitioners include both psychologists and educational specialists. The laws that govern who is able to administer certain tests that are psychological in nature vary from state to state. In some states, intelligence testing may only be administered by licensed psychologists. In other states, educational consultants may be able to administer these kinds of tests. In general, psychologists have received more training in the background knowledge necessary to interpret the information gleaned from psychological tests, such as intelligence tests and tests of memory and language. Because this is not always the case, however, parents should ask potential examiners about their training and experience.
Evaluations conducted by professionals at different facilities vary with regard to their focus and goal(s). Evaluations conducted by school systems are primarily done to determine if a student qualifies for special education services according to guidelines set forth by federal and state laws (e.g., the Individual with Disabilities Educational Act). Eligibility criteria for special education services varies from state to state. For example, one state may use the discrepancy between scores on a test of intelligence and academic achievement tests to determine if a child has a specific learning disability, whereas another state may use the discrepancy between two areas of achievement, such as reading and mathematics to classify a student as learning disabled. There is also a federally mandated timeline for the completion of school system evaluations.
Because of the nature of psychiatric hospitals, evaluations conducted in these facilities usually focus on a student’s cognitive and emotional functioning. Generally, the primary purpose is to properly diagnose the child or adolescent according to a manual published by the American Psychiatric Association, the Diagnostic and Statistical Manual (DSM), and to develop and implement an appropriate treatment plan. This is also often the purpose of evaluations that are conducted by private practitioners, for profit and nonprofit centers, and in general hospitals with developmental centers. Developmental centers also usually provide evaluations for developmental disabilities, such as autism or chromosomal disorders that cause motor or cognitive delays, especially during the early years of life. The following guidelines are offered for parents or teachers who are in need of through psychoeducational or neurodevelopmental evaluations for children who struggle in school.
Evaluation Methods and Sources of Information
Psychoeducational and neurodevelopmental evaluations utilize a variety of methods such as standardized and informal tests and inventories, behavior rating scales, questionnaires, interviews, and observations of behavior. Information should also be obtained from multiple sources including students, parents, and teachers.
All of this information should be interpreted and integrated to develop a profile of the child’s strengths and weaknesses in several neurodevelopmental areas that are relevant to successful performance in the educational arena. These include attention, memory, oral receptive and expressive language (i.e., listening and speaking), handwriting or graphomotor skills, sequential and spatial organization, higher order thinking (e.g., reasoning and problem solving) and social, emotional and behavioral functioning. Additionally, academic skills in reading, written language and mathematics should be assessed. The information that is obtained during the evaluation process should consist of both test scores and information that is descriptive in nature.
Descriptive information identifies functional weaknesses that may or may not be evidenced by test scores. For example, a child’s scores on subtests of auditory short-term memory may be average compared to peers; however, parents, teachers and the student may report problems in this area. When functional problems are identified, practical strategies can be provided during the feedback session and in the written report that addresses these problems.
A Good Evaluation Delivers More Than Test Scores
Good evaluations go beyond providing test scores. The examiner seeks to determine the underlying cause of academic or other weaknesses. For example, if the student is struggling in reading, the examiner will assess potential causes of the reading problem such as a breakdown in phoneme awareness, failure to adequately acquire phonics, poor vocabulary, weak comprehension related to global language deficits, and/or problems with attention and working memory. If the student is not well liked by his or her peers, the examiner will seek to determine if the student has a social skill deficit or a performance deficit (i.e., knows the skill but does not use it at the appropriate time). If the problem is due to the fact that the child has not learned the skills necessary for successful interaction with peers, strategies for teaching these skills should be recommended. If the child has acquired appropriate social skills, but fails to use these skills because he is too impulsive, different kinds of strategies that address impulse control should be recommended. Children may also not be well liked by their peers because they have deficits in oral language. These deficits could lead to trouble keeping up in conversations with peers or maybe the child makes statements that don’t seem to make sense to his or her peers. In this latter case, strategies should address treatment of the underlying language deficits.
A critical component of all evaluations should be the identification of the student’s strengths. These strengths may often be used to compensate for weaknesses. For example, if children have difficulty performing sequential tasks, it is often hard for them to outline material in the traditional way. Many of these same students very often perform well with tasks that are spatial in nature. Thus, they may benefit from making graphic organizers for the material they need to learn. Graphic organizers provide a spatial arrangement of information on the page rather than a linear, sequential outline.
Another critical component of good evaluations should be the provision of multiple specific strategies for management of problems and weaknesses identified during the evaluation process. Just as children or adults with diabetes have to manage their diabetes with exercise, diet and/or medication, children with school problems and their parents and teachers need recommendations for management of the students’ weaknesses so that these weaknesses do not “spill over” into other areas of their lives, or do so minimally. Because the concept of management is very important, a good evaluation will deliver a written report of suggested strategies for the student, parents and teachers.
Feedback: A Critical – but often overlooked – Component of the Evaluation Process
Finally, the evaluation process should conclude with feedback sessions for both parents and the student. During the feedback session, parents should be shown the kinds of tasks their child was required to complete and how their child responded or performed during the tasks. This performance should be related to the performance of day-to-day activities such as understanding what is read or following directions. For example, if testing reveals that the student has a weakness in oral receptive language, he or she will likely have trouble understanding and following directions at home or at school and understanding what was said during conversations and class lectures and discussions. In this case, specific strategies for remediation of language deficits should be provided to parents. If the student receives a low score on a test of verbal reasoning, he or she is likely to have trouble understanding concepts in literature, science and social studies. In this latter case, the strategies given by the examiner should address how to teach verbal reasoning and understanding of concepts.
The feedback sessions serve to demystify, or take the mystery out of, the problem. Demystification enables the parents and student to begin understanding the “whys” of struggling school performance. Students learn that they do not struggle because they are “stupid” or “dumb”. Parents learn their child is not struggling because he or she is “unmotivated” or “lazy”. They both learn to name the problem as “trouble sounding out words” or “trouble focusing attention on what others are saying”. In this way, the evaluation process is very therapeutic. They also learn specific ways for performing more successfully in school, and these recommendations and strategies instill hope.
Questions Parents Should Ask
When parents are seeking an evaluation of their child or adolescent, they should first ask about the qualifications/credentials of the examiner(s). If they are going to a large facility, they should be sure to understand whether a psychologist will be conducting the testing, or if someone less qualified will be conducting the testing with the results only reviewed by a psychologist.
Additionally, parents should ask about the tests that will be used in the evaluation process and, most importantly, they should ask how the information gleaned during the process will be interpreted. For example, they might ask the examiner questions about why children have trouble with reading or written language or why they have trouble following directions. If the examiner cannot give them specific reasons, such as children may have trouble following directions because they have weaknesses in oral language, attention, memory and/or performing sequential tasks, they should interview another examiner.
Finally, parents should know in advance how the results and the feedback of evaluation findings will be given to them. Because of the volume of information that may need to be conveyed to a parent, evaluation results and findings should be provided in written format. The report of evaluation findings should also include the strategies provided during the feedback session.
By being informed consumers, parents will seek to find a professional who will help them understand the causes of their child’s struggling school performance, what their child’s strengths are, and specific strategies that will lead to successful performance in school. Anything less will likely result in lost time, lost money, and lost opportunity for the child’s progress toward the goal of increased school and life success.