THE AsSEsSMENT PROCESS
THE FOUR MAIN COMPONENTS OF A PEDIATRIC NEUROPSYCHOLOGICAL ASSESSMENT:
1. CLINICAL INTERVIEW
2. DIRECT ASSESSMENT
3. DIAGNOSTIC PROCESS
4. FEEDBACK APPOINTMENT
Using this model, we have worked hard to establish what we believe to be the best process for assessing and diagnosing cognitive, emotional, behavioral, and genetic disorders and diagnosis’. Read below to learn more about each step in the assessment process.
STEP 1. MEET & GREET
We want you to feel comfortable here and trust us. We are extremely proud of our state of the art facility and we invite all prospective families to come take a look at the work we do here. The first step of the assessment process is a complimentary meet and greet and tour with Dr. Jacob Boney, clinic owner, and director. During this meeting, he will gather information on what you are seeking, a quick briefing of your child’s medical history, and help to determine whether your child will be a good candidate for the diagnostic assessment. While Dr. Jacob is meeting with you, one of our registered Behavior Technicians will administer a short, 20 minute, pre-assessment. This will be filmed and, along with the notes, Dr. Jacob collects, sent to Dr. Sarah Burger so that she can prepare for the formal clinical interview if it is decided to go down that route.
STEP 2. CLINICAL INTERVIEW
During the clinical interview, Dr. Burger will be looking to accomplish a few things:
While Dr. Burger meets with the parents to conduct the clinical interview, your child will participate in a pre-assessment custom designed to determine whether your child is ready to engage in the full diagnostic assessment. Sometimes there may be certain behaviors present which can collude the results and findings of the full neurocognitive assessment, and by determining beforehand whether they will excel in the real assessment or may not perform as well, we can ensure that they trust assessment is given. If Dr. Burger finds evidence of problematic behaviors based on the results of the pre-assessment, she will recommend behavior therapy treatment to modify those issues before administering the assessment. If Dr. Burger does not find evidence of problematic behaviors based on the results of the pre-assessment, the formal assessment can be scheduled to take place in as early as two weeks from that day. This portion of the process is estimated to take between 90-120 minutes.
STEP 3. DIRECT ASSESSMENT
During the direct assessment portion of the evaluation, Dr. Burger is looking not only to formally assess a child’s neurocognitive strengths and weaknesses, but also to make direct observations of their social skills and of their ability to detect and respond appropriately to nonverbal cues. A child is taken through a series of highly structured, one-on-one assessments designed to assess their neurocognitive strengths and weaknesses. The assessment provider does most of the writing/recording, with the child asked to respond orally to questions, to solve puzzles, to manipulate blocks, and to otherwise engage in tasks arranged by the administrator. The assessment tools vary depending on the child’s age and developmental level, but are designed to provide a broad assessment of brain functioning. Domains assessed generally include: intelligence, memory, higher-level thinking (executive functioning), language functioning, and motor functioning. Academic achievement can also be assessed as needed. A child’s performance on these assessments will be compared to that of other children around the same age, allowing us to build a profile of current strengths and weaknesses that will serve as a baseline for use in future comparisons. Total testing time can range from 3 to 7 hours, and can be spaced out across 1-2 assessment days. After the report is conducted, Dr. Sarah will begin scoring and writing the complete diagnostic report.
STEP 4. DIAGNOSTIC PROCESS
A data-driven differential diagnostic process ensues after data collection is complete. This is where neuropsychologists are the puzzle solvers, of sorts. We collect puzzle pieces from wherever we can - parental reports, observer reports, medical records, direct observation, test data...and review of all of those pieces culminates in a lengthy clinical report detailing the relevant history, assessment findings and associated diagnostic clinical impressions. Specific recommendations are made on the basis of this process, addressing any specific referral questions and making recommendations about how best to direct future neurological development. That is the neat thing about doing an assessment of a child. Their brain is still developing, and we can use data from a neuropsychological assessment to direct that development in a principled way. What are their current strengths? How can we use those to minimize the impact of clinical weaknesses and to help them learn best when it matters most? And where should we stretch them? What skill sets are lacking and in need of targeted practice? All of these questions will have answers in the final report. One month after Dr. Sarah receives all records and supplemental references and payment, the feedback appointment will be scheduled.
STEP 5. FEEDBACK APPOINTMENT
The feedback appointment is critically important. While I provide lengthy reports (8-10 pages minimum and often upwards of 15-20 pages) for all of the kiddos I assess, these can be overwhelming to digest on your own. In a feedback appointment I begin with a big picture general diagnostic overview, review data directly with parents, discuss my recommendations and answer any questions they have at the time. I also orient them to the report...where should they look for what? And how can they use this report to help solicit any services their child may be needing? They then take the report with them to review at their leisure, and are encouraged to contact this writer thereafter with any additional questions they have.