Types of Diagnostic Testing
There are numerous tests to assess various aspects of a child’s capabilities and performance. The key is to be selective about what testing you put your child through. Do enough to get the services your child needs at school and to understand the broad areas of your child’s challenges.
For example, if your son has problems with his working memory (commonly associated with ADHD), there are specific exercises to improve working memory skills and ADHD medications often address working memory impairments.
But there are other diagnosis for which there are no clear interventions. For example, say your daughter is given the Geometric Puzzles sub-test, which assesses non-motor aspects of visuospatial perception, and she receives a scaled score of 8, placing her at the 25th percentile, a low average score. What can you do you do with this piece of information? While visuospatial processing is important, there are no clear interventions to specifically address the non-motor aspects.
Along with interviews, questionnaires and report reviews, a variety of testing can be done. There are a few broad types to accurately diagnose your child. Some are conducted by schools and others by educational specialists or psychologists.
The main types of testing are:
A psychoeducational evaluation answers the question “Does my child have a learning difference?” It includes assessments of cognitive ability and academic achievement. A standardized IQ test is given to assess intelligence, along with other tests of cognitive ability, depending on the areas of concern. These evaluations are conducted by licensed clinical psychologists or school psychologists
Educational testing (individual achievement tests) measures a child’s current level of academic skills such as reading, writing and math. The assessment also includes an evaluation of specific abilities needed to acquire academic skills such as perception, memory and discrimination. Educational evaluations are carried out by an educational specialist or a resource teacher using a variety of standardized tests, as well as, some informal diagnostic procedures.
Psychoeducational evaluations focus on the discrepancy between academic achievement and general cognitive (or intellectual) abilities of school-age children and college-age adults. When they are conducted within the school setting, the purpose is to determine whether or not a student qualifies for special education services and accommodations for a specific learning disability. School evaluations are not conducted to diagnose disorders or their underlying causes, but rather to determine the eligibility of a student for services provided through the public school system as mandated by federal law.
A psychological evaluation answers the questions : “Does my child have anxiety or depression?” A child’s educational problems are sometimes the result of psychological issues such as anxiety, depression or conduct. Evaluations focus on identifying and diagnosing these disorders. This involves obtaining a detailed history of the child’s developmental, medical, social, school, and psychological functioning, along with behavioral observations and a series of standardized parent, teacher, or self-report measures, personality tests, and sometimes tests of general cognitive functioning. Psychological evaluations are performed by licensed clinical psychologists, while certain components (e.g., assessing the emotional, behavioral, and social functioning of a child in the school setting) may also be conducted by school psychologists. Results are measured through rating scales.
A neuropsychological evaluation answers the question “Why does my child have a learning difference?” Neuropsychological evaluations are considered the most comprehensive type of evaluation and typically include psychological and psychoeducational testing components. The major differentiator is that neuropsychological testing goes a step further to understand the relationship between behavioral, cognitive and functional deficits and the underlying brain functions. A neuropsychological evaluation focuses on learning and behavior in relation to an individual’s brain. It involves the use of standardized, norm-referenced tests and behavioral observations. The results incorporate knowledge of brain development, organization, and functioning into the evaluation findings. In other words, it measures cognitive abilities and processes, such as, attention and executive functions, reasoning, language, memory and learning, and visual-spatial/visual-motor abilities.
For instance, a child may struggle to accurately answer questions about what he/she just read. If this is a reading comprehension problem (answers the question IF there is a problem) it will help to know if the lack of comprehension comes from visual processing difficulties, difficulties with memory, expressive language deficits or even performance anxiety (answers the question WHY there is a problem).
A clearer understanding of “why” problems exist is crucial in determining the most effective, individually-tailored intervention plan. Children with known neurological conditions (ex. seizures, neurofibromatosis, brain tumors, etc.) and injuries (ex. concussions), as well as, exposure to toxins (ex. lead poisoning, alcohol and substance exposure prior to birth) and medical conditions and factors which increase risks for brain injury (e.g., history of complicated pregnancy, delivery, and prematurity) may be referred for neuropsychological evaluations.