March 16, 2022
Cindy Lopez:
Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen. So today we’re talking about assessments. People also refer to them as evaluations. An assessment can be a valuable tool for understanding your child and their strengths and challenges. So when your children are struggling, I know that you as a parent want to do everything you can to help them. What looks like distraction or in attention or laziness, or even reluctance may be a sign of a mental health or learning challenge. So an evaluation done by a psychologist or a multidisciplinary team will provide the information you need to effectively support your child at home, at school and in other social settings. Listen in today to the conversation with Dr. Pardis Khosravi, clinical director and psychologist, and Ann Lyke educational therapist, both at CHC. You’ll learn everything you ever wanted to know about evaluations.
Welcome Ann and Pardis.
Pardis Khosravi, PsyD:
Thanks for having us Cindy. Assessment is truly my one love within the field of psychology so I’m really excited to be here and talk to you about it today.
Ann Lyke, MEd:
I’m also passionate about evaluations and figuring out what’s going on for kids and what’s making things hard for them and then figuring out how adults can help them.
Cindy Lopez: I think that’s the value right of evaluations or assessments, and to our listeners will pretty much use those words interchangeably, assessment, evaluation, And so let’s talk about that. If I’m a parent, why would I consider having my child evaluated?
Pardis Khosravi, PsyD:
That’s such a great question Cindy and one that I hear from parents often, you know, we get a lot of calls. Do we need an evaluation? Do we just start in treatment? Like where do I start, and I think the times to consider an evaluation, if teachers, therapists, other providers are expressing concern about your child’s development, their learning their social emotional functioning that’s persisting for a couple months or longer and it’s not really clear where the kind of area of concern is coming from or what is underlying sort of the behaviors or concerns that you’re seeing an evaluation can often be a really great tool to really understand what’s going on for your kiddo and then how to move forward, I always think that’s the most important part is the game plan of what comes next.
Other reasons for considering an evaluation, if your child’s academic achievement doesn’t seem to match their intellectual abilities. So we often hear, “My kid is really bright. They’re really smart, and they’re still struggling in school. What is going on?” Those two things don’t match. When their test performance doesn’t match their knowledge of the content. Sometimes kids will get the academic material and then they’re just not able to reproduce it on an exam where they have to show that they really get it, and so again where’s that disconnect. So often when we get assessment referrals parents are reporting some kind of discrepancy, something that’s just not adding up and they’re not sure why.And so an assessment is our process of getting to the bottom of the why and figuring out what’s going on and then another reason that I think we get eval referrals is sometimes interventions and supports that have been put in place seem to be ineffective. So we’ve put in some academic accommodations in place or we’ve tried to address a weakness in reading or something, we’ve tried to intervene or a kiddo who’s been in therapy and they’re motivated and yet we’re just not seeing a lot of progress, sometimes we might feel like, oh, maybe there’s something missing, maybe we don’t have the full picture and so assessment can help us figure out what’s going on.
Cindy Lopez:
Thank you for that information. As an educator, 30 plus years in education, I see it from the classroom school setting, but I do think as a parent, you might be seeing some things and if the teacher hasn’t said something to you check in with the teacher about it too. So it goes both ways, right? The teacher might suggest to you, like,” I’m not sure what’s going on, I’m seeing this,” but you as a parent can also go back and check in with the teacher and say we’re seeing this, are you seeing anything like this and kind of put those two pieces together. So you talked about you know all kinds of different reasons for considering an evaluation. What kinds of evaluations are we talking about? Are there different types? And if so, what does that look like?
Pardis Khosravi, PsyD:
So I want to preface my answer to this by saying there’s a lot of overlap among the various types of assessments, and I think that’s often what contributes to confusion around when parents are trying to figure out what evaluation is the best fit for their child and figuring out what’s going on. There’s a lot of confusion around well do I need a psychoeducational evaluation? Do I need a neuropsychological evaluation? Do I need a psychological evaluation? And the words also have a lot of overlap in them. So I’m going to try to clarify, but with the caveat that there is, there truly is a lot of overlap.
One of the main types of evaluations is a psychoeducational evaluation and these are evaluations where the focus is a standardized assessment of the child’s intellectual and academic abilities. So this is the right type of assessment if you have concerns about how your child is doing in school, whether that’s related to a particular subject, like they’re really struggling in math, for example, or just in general. Maybe they’re just struggling with inattention or they’re not doing well on tests or there’s kind of a more pervasive issue in the classroom. And so this evaluation will get you sort of a broad overall assessment of your child’s strengths and weaknesses, and it really seeks to understand your child’s learning style. We figure out sort of their learning style, their strengths, their weaknesses, and then we can provide a roadmap for you know what interventions or school accommodations or other supports we can put in place to help your child succeed in school and outside of school.
Ann Lyke, MEd:
One thing is as an education specialist, parents come and say, my child’s having a problem reading, so why do we still have to do the cognitive or the neuro-psychological portion of the evaluation too can’t we just look at reading, but what we need to do is we need to know how your child’s brain is learning and processing information at a more foundational level first, there may be underlying issues with memory or attention or language or something else that’s going on that’s making it more difficult to learn how to read. So reading is not just, we can look at reading and see, oh, well you’re at this level. We want to know why that difficulty is happening, and so that’s why we have that multi-disciplinary approach is because we need to understand all those foundational skills as well.
Pardis Khosravi, PsyD:
Yeah Ann that’s totally correct and so that’s why when we do these assessments, we’re often looking at domains like cognitive functioning, attention, executive functioning, memory, academic achievement, social emotional functioning and it’s important like you said to look at all of these things because they’re related, and they influence one another.
So psychoeducational evaluations are broad based, they look at your child’s strengths and weaknesses. They’re often administered by clinical psychologists, school psychologists, neuropsychologists, educational psychologists, lots of different folks, and often we will pull other disciplines onto teams to do psychoeducational evaluations like Ann mentioned.
Another term you might hear are psychological evaluations, and these include many of the same tests as a psychoeducational evaluation, but the focus for these is more on the psychological, emotional and behavioral functioning of the child. And really they’re intended to guide diagnosis and treatment from a medical or psychiatric perspective. So there is less focus on school and academic functioning. So, we might be doing a psychological evaluation if for example a teen is presenting with significant mood symptoms, anxiety, other difficulties, and maybe they’re stuck in therapy and the provider and the parents and the kid are wondering, well, is there something else going on? And so the focus is less on school and more on emotional and behavioral functioning.
And then we have neuropsychological evaluations and neuro-psych evals are really focused on understanding the brain behavior relationship. It really seeks to look at how a child’s brain functions and how that functioning impacts their behavior in their learning. So again, many of the same domains are assessed. We’re looking at intellectual and academic achievement, neuro-psych psychologists are looking at specific domains of cognitive functioning controlled by different regions of the brain. So they might be looking at executive functioning, information processing, sensory perception, visual perceptual abilities, language, fine motor skills. They’re looking at all of these things, and the idea is that they’re going deeper to look not just at the what, what is going on, but why. They’re trying to figure out the neuropsychological underpinnings of what might affect the practical output that we’re seeing. So they’re trying to help differentiate, you know is it difficulty with reasoning and academics, is there some sort of underlying neuro-psychological difference contributing. I think of it as psycho-ed as the what and neuro-psych as the Y and neuropsychological evaluations are administered by neuropsychologists. So many different terms for all of these evaluations, and they look at you know, slightly different things, but there is a whole lot of overlap amongst them.
Cindy Lopez:
Pardis I’m wondering, both you and Ann referenced multi-disciplinary or many different disciplines, what do you mean by that?
Pardis Khosravi, PsyD:
When we’re talking about multidisciplinary evaluations, we’re typically talking about you have a psychologist or a neuropsychologist doing the psychological portion of the evaluation, but if we pick up on concerns about speech and language things, we might pull in a speech and language pathologists to help us with the testing or if we notice motor concerns or sensory concerns, we might pull in an occupational therapist. If there’s really significant academic concerns, we might pull an educational specialist onto the team. And so the idea with a multidisciplinary evaluation is to try to get a really comprehensive picture of the whole child. Instead of zooming in on one domain, we’re trying to get a really broad view of the whole child and really understand what all of the components are and how they interact and interplay with one another.
Cindy Lopez:
That whole child view is so important. So what does the psych ed evaluation look like? What’s involved, who’s involved?
Pardis Khosravi, PsyD:
I think of assessments like a giant puzzle. My job is to gather all of the different puzzle pieces and put them together to try to figure out the big picture. So what are all the pieces, right? So we often are always are doing a parent interview and questionnaires, we want to get the parents input on what they’re seeing, what’s going on at home, out in the community. We’re going to interview teachers and send them questionnaires. We want to really understand what’s going on at school. Often sort of behaviors or things that are going on at school might look different than at home or outside of school, and so we really want to get the perspective of the kiddo in all settings. We are going to seek input from any other providers or adults that are really important in the child’s life. So if they have a therapist, a psychiatrist, sometimes like a sports coach or something, like if they go to an afterschool program. This is a collaborative conversation with parents to often say like who would you want us to get input from, who would you want us to talk to? We might potentially do a school observation, we did a lot more of those before COVID of course it’s a little harder now, but you know, sometimes we want to really see how the kiddos behaving in the classroom both in an unstructured time and structured.
So we try to always observe a class and recess, for example and then of course we have our testing sessions where we’re doing standardized testing. We also want to review records. So we want to look at if there have been any past evaluations, we definitely want to take a look at those, report cards, anything kind of relevant to the things that are going on. And then we take all of those puzzle pieces and we put them together to really look at the big picture, to really understand what’s going on for the child. And then after we do all of that of course we have a feedback session with parents to talk about the results. Depending on age of the child and sort of presenting concerns, we will likely also have a session with the kiddo to talk to them about the results and then, we write this all up in a comprehensive report,and parents get the full assessment report.
Cindy Lopez:
It makes me think, if I’m a listener right now, like, wow, this sounds great how do I do this. So you can find out more at chconline.org. You can reach out to our Care Team at chconline.org, email them. You can make an appointment, there’s a point a button right on our website. If you want to follow up, we’re here for you and we have those multidisciplinary teams that Pardis and Ann were referring to.
So, as a parent, I might be kind of reticent to do an evaluation. I might be thinking, I don’t really want my child labeled. I don’t think we need a diagnosis that isn’t what we need. We just need help. So does this type of assessment always include a diagnosis, and maybe talk about the value of a diagnosis.
Pardis Khosravi, PsyD:
Yeah you know the thing that I always emphasize to parents when we’re doing feedback sessions is that your child is no different now than they were at the start of this evaluation. I might be discussing some terms or diagnoses that label the behavior or the patterns that, you’re seeing that brought you in for this evaluation that doesn’t change your child. They’re exactly who they were before this assessment. I’m just putting some words to some things, right? And so I think that’s what I always want parents to keep in mind that the label or the diagnosis doesn’t change anything about your child and the many, many strengths that they often come in with, and assessments don’t always yield the diagnosis. Sometimes we do all the testing and we might find some areas of weakness. There’s something that brought you in for testing, but they don’t meet criteria for any disorder, and in that case, I think the assessment is still really useful and ruling out diagnoses that may be worth concern, maybe you were worried about ADHD or a learning difference or something. So it’s helpful to know that those aren’t present, and we still can give recommendations to address some of those areas of weakness that we all have. Often though assessments do result in a diagnosis, and I think it’s important to remember as a parent, you don’t have to share the report or the diagnosis with anybody that you don’t feel comfortable sharing it with.
The evaluation report is part of the child’s protected health information, and so it’s up to you to disclose. And so I think sometimes it’s helpful to get an assessment to really understand what’s going on as a parent to help you figure out the roadmap, interventions and supports that can be helpful to your child. You don’t necessarily have to share that results of that assessment with anybody that you don’t feel comfortable sharing it with, that being said, I think the biggest value of an assessment is that it helps identify a game plan for moving forward. I always say to parents in a feedback session, it’s not helpful for me to sit here and tell you what’s wrong for an hour if I don’t spend another hour telling you what to do next. And so I think identifying services and supports that might be helpful and that may include sharing some of the results with the school so they can help put in supports and accommodations for the child that will be helpful to them. We’re sharing the results with other providers, so they have a better sense of what’s going on with the child, and so they can figure out better ways to understand your child or identify ways to support them.
Ann Lyke, MEd:
You know depending on the circumstances, but I will often also encourage parents to share the results with the school. As someone who spends hours each day with their child it’s helpful to know what’s going on in the background. And then maybe the kid is always kicking up a fuss and trying to escape out of math class. Well, okay, is it a math problem or is there something else that’s going on or maybe it’s transitioning back from recess and maybe they need an extra activity to do that helps recenter and recalm their body or something like that. It’s always helpful to have that information so that there’s an understanding that, okay, this kid isn’t being quote unquote you know bad on purpose or they’re not being lazy, it’s because their having a hard time processing information one way or another. And so there’s more of an understanding and often, hopefully more of a balance of being able to, okay, we need to provide this much support, you know we can push this far, but we need to not push or we need to provide help in this way. There’s just a better understanding of how a child learns when we have all that background.
Mike:
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Cindy Lopez:
As an educator, I would love to know and have more information about my student and that child in my classroom because that’s going to give me clues into how I can teach them, right? So as a parent, I would encourage you to share that information, but again, as Pardis said, it’s completely your choice, and you also know the teacher and that relationship that the child has with the teacher and all that, so that’s an important piece of this puzzle. So, Ann you mentioned schools, and so as we think about evaluations parents might say, well, do I have to go to CHC to get an evaluation or another, like, private place to get an evaluation? Does my school do evaluations? So can you talk about that a little bit? What are some of the differences between what they see in a school or a private setting?
Ann Lyke, MEd:
Every parent has the right to request an evaluation from the school of the district. Whether or not the school will provide an evaluation, it varies. If the school is also seeing challenges they will probably say, yeah, let’s figure out what’s going on, but sometimes the school will say, you know what this child is performing. They are learning. Yeah, there’s some days that aren’t as good as others, but that’s what we all do. You know, we all have days that are off and so there’s different reasons why a district may say we don’t see the need to evaluate right now. It may be that they are only in first grade and they maybe the child didn’t attend preschool, or they just haven’t had as much educational exposure or maybe they’re still on the development track where they’re supposed to be, but they’re just a little bit behind, and they do honestly just need a little bit more time to catch up.
School evaluations we’ll look for whether or not a child qualifies for special education services. And for that they do need to be fairly behind. There’s kind of a range of kids in every classroom. You’ve got kids who are doing just fine, kids who are excelling at everything and some kids who need a lot of support with everything, but they’re still able to pick up on the teaching as it’s happening one way or another. So schools are looking for are they able to access the curriculum without a lot of additional support? A lot of good teaching is already providing that support and making those adjustments for the different kids as it’s needed, whether or not a child may need to sit closer to the teacher so that they can have a little bit extra help paying attention, or maybe a child needs to be able to take a test in a separate part of the room so they’re not distracted, that’s just good teaching practice, and so hopefully those things are already happening.
Primary differences between assessments at the school and the private assessments, there’s Children’s Health Council or other organizations, is that schools cannot give diagnosis, but they will be looking for whether or not a child qualifies for special education. They may do a more global assessment, while private assessments can dig a little bit deeper into certain areas to find out more of those underlying challenges that might be there.
Cindy Lopez:
That’s so interesting thinking about the differences and the nuances between getting an evaluation with the school or school district and a private evaluation. If I’m a parent who receives a private evaluation, can I give that to the school? How do they handle that?
Ann Lyke, MEd:
It would be great for the school to see it. They are not legally bound to accept our results and say, oh, someone else diagnosed you know, I’m just going to stick with reading disorder for this time, a reading disorder, we must provide services. Just because the child has a diagnosis they may not necessarily need special education services. There are some older kids with a reading disorder diagnosis who just need accommodations, who would just need some additional time to be able to read through everything. As a child, as a younger student maybe in early elementary school yeah they needed that additional time or that additional help to be able to learn how to decode, but now they’ve got it they just need a little lecture time to do it. So even though the diagnosis may still stand, the child may not necessarily need services.
Cindy Lopez:
So, thank you for that. Having been an educator in both public and private settings, school settings, and now being here at CHC, I know it can be tricky sometimes between public schools and private settings. So just, be prepared to work with your school, your district and whatever way they do it. So say we’ve gone through all of this, right? And my child’s been tested, and we have results and a diagnosis. Do I share those results with my child? What’s your recommendation to parents around that?
Ann Lyke, MEd:
I usually find that kids are relieved to know that there’s something going on that it’s not their fault and that they’re relieved to know that parents and teachers and adults working with them understand that they have been trying hard that they’re not just goofing around. So for some just that acknowledgement that, oh yeah, that’s right your brain learns differently, it’s a huge relief. Of course it’s gonna depend on your child’s maturity level, how old they are, what kind of services they’re going to need, but I think it’s also really important to consider as a parent what are your own beliefs and understandings and attitude about learning differences? I think it’s great that our society these days is accepting a lot more differences between people, whether it’s gender or neurodiversity, but I think we also need to work on the fact that we all learn differently too. And some kids may be really great at math, but not so good at reading or really great at reading, but not so good at math. If you think about it, elementary, middle, and high school are the only times in our life when we’re expected to be an expert at everything, get an A in every class, but guess what as adults, we don’t do that. We find what we like and then we find ways to get around the other.
So we need to be able to work with kids to help them take ownership of their strengths, and so I think it’s important that kids understand that the adults understand what’s going on, whether or not you’re using a term like a learning disorder or dyslexia or something like that, that’s up to you. Know that kids are going to hear things, you know, teachers will talk or other adults with talk. Kids will talk and they’ll hear these terms, and so it’s important to understand what they mean, and that they’re not bad terms at all, it’s just a way of describing how someone is learning. So I think it’s great for kids to know, but I know that some families they’re not ready for that yet, but I think it is important to know your own feelings as a parent and be able to stick with the facts and be honest with your child.
Cindy Lopez:
So important and as a parent you know your child best, so, you know kind of where they’re at and what they’re going to be able to hear and take in and use.
Ann Lyke, MEd:
And parents will often tell us, we’re just learning about this too. What do we say? How do we do this? That’s what the clinicians are also for. We can talk to the child, and we can explain everything. We want to go into all the nitty-gritty details like we do with the parents to make sure that the parents understand, but we talk to kids about their strengths and weaknesses. And what we’re suggesting they do to help figure it all out so we can talk to the kids about it.
Cindy Lopez:
Anne and Pardis I’m wondering what advice you have for parents on this topic or what you really hope parents hear from you today?
Pardis Khosravi, PsyD:
My takeaway for parents is there’s a lot of different types of evaluations out there. It can be confusing to even know when you need an evaluation and which kind, and if you’re thinking maybe an evaluation is necessary, reach out, reach out to us, consult with a professional, talk about what’s going on and let us guide you and help you figure out, do you need an evaluation and if so, which kind. I want parents to know that they’re not alone and they don’t have to navigate this by themselves.
Ann Lyke, MEd:
I agree completely with that. As I told a lot parents and a lot of people ask and ask again, if you’re not sure let’s get some information. If you’re not as comfortable talking with people, ask what are good websites and what are good books to read and to learn more. Know that Children’s Health Council and some other good places will recommend what’s right for your child. You’re not just going to throw everything at them simply to do everything. We’re going to make sure that we’re fine-tuning what’s needed to answer your questions and to be able to figure out what’s up for your child specifically.
Reach out. Ask. We’ll help. It may be that you don’t need one right now, but we’ll say the school started some outside help so let’s try that for six months and then call us back and we’ll check in again. And so just let us know how we can support you because parenting is hard and parenting at the hopeful end of a pandemic is even harder and the impact of the distance learning and everything else. There’s a lot going on so let us help and support you.
Cindy Lopez:
Thank you both Ann and Pardis for joining us today on this topic of assessments and evaluations to our listeners, please reach out, chconline.org. As Ann said, we’re happy to help. Reach out to the careteam at CHC, careteam@chconline.org. You can request a free parent consultation if you’re not quite sure about next steps. We’re here and we’d love to help. Thank you so much for listening today and joining us.
Cindy Lopez:
Visit us online at podcast.chconline.org. Make sure to subscribe to Voices of Compassion so you never miss an episode and we’d love it if you’d leave us a rating and review. Have a question? Send us an email or a voice memo at podcasts@chconline.org. We’re here for you when you need us.
