The first step in my efforts to help any family is always to do some kind of assessment. Without an adequate assessment of your child’s and family’s situation, I cannot know what is likely to be most helpful for you. Psychological assessment can take many forms, from just talking to administering tests of cognitive skills, academic achievement or other abilities. The type of assessment I do will depend on the types of problems you want to solve, the developmental level of your child, and what I think research has shown will be most useful and most cost-effective for your concerns. The assessment process always begins with a diagnostic interview, and ends with a feedback session. It will nearly always involve some questionnaires or checklists about your child’s adjustment, behavior and emotions. In some cases, more formal psychological tests will be administered. The assessment phase generally takes 2 or 3 sessions, including time for feedback. When psychological tests are administered, the process can take significantly longer.
The first time I meet with you will primarily consist of a detailed discussion of what your concerns are, and your child’s developmental and behavioral history. This interview allows me to begin to understand why you have come to see me, and to see your concerns in the broad context of the life of your child and family. It also allows me to “drill down” to learn more about specific factors in a way that cannot be captured by the pre-appointment background form I have all families fill out. The first appointment also allows time for you to learn more about me and how I work. Often, especially with younger children, parents choose to do the initial interview without the child present. The older the child is, the more likely they will be able to contribute to the process. In any case, it is up to you if you would like to bring your child, or would prefer to leave them home the first time. Depending on a number of factors, including the time available, the nature of the problem, and your child’s comfort separating from you, I may spend some time talking (or in the case of younger children, playing and talking) with your child alone. Often, I delay this step until the second session for younger children. Teenagers are generally more involved in the first session.
In most cases I will ask parents, often teachers, and sometimes other adults who know a child well, such as grandparents or caregivers, to fill out some questionnaires. Behavioral questionnaires are designed to allow me to compare how you see your child to how parents and teachers see the “average” child, and provide one way to measure whether a child’s behavior is different or unusual compared to what is typically expected at their age. Some questionnaires provide a broad overview of a child’s adjustment, while some focus more on specific areas, such as symptoms of ADHD, depression, or anxiety. Occasionally, I might arrange to observe your child’s classroom, so that I can see a brief slice of their “real world”. None of these procedures are “tests”, and no responsible professional would ever use one of them in isolation to make a diagnosis of your child. They are just one more source of information to add to the overall picture that helps me decide how I can best be helpful.
Often, but far from always, I will recommend that we administer some formal psychological tests. Many psychologists who work with children will routinely administer intelligence tests or tests of academic achievement to nearly all children they see. I try to do so only when I believe there is scientific evidence that such tests will provide information that adds to the overall picture in a significant and useful way. Testing can rapidly become quite time consuming and expensive, so I try to be careful about how and when I choose to do it.
Testing can be useful in assessing a variety of areas, including:
Assessment always concludes with a feedback session. There is no point in doing an assessment if it does not lead to recommendations about what kinds of help your child may need. In the feedback session I explain what I did to assess your child, why I did that, and what the results were. I then interpret what I think those results mean, and why I think they mean that. Finally, I talk about what I think will be most helpful for your child, and what I think will be the best way to accomplish that, either in therapy with me, in working on your own or with another provider, or in terms of recommendations for interventions at school. If you like, I will provide a detailed written report that you can share with your child’s doctor, their school, or any other professional you work with.