Psychological Testing

There are three main reasons testing is performed these days. First, courts request it for a variety of reasons (e.g. mitigating circumstance questions, custody battles). Second, it is used in cognitive rehabilitation (head injury, stroke victims, etc.). Third, parents or schools suspect learning or emotional problems. For most of you reading this page the last situation is more relevant, so we’ll focus on that.

Testing can be divided into two main categories: Intellectual/cognitive strengths and weaknesses, and personality assessment. The first is where your child is evaluated for possible learning disabilities, attention problems, or other blocks to academic and social success. This kind of evaluation may extend into "neuropsychological assessment". This is where the tester examines all the various functions that make up cognition to determine where there are weaknesses. A full neuropsychological assessment is usually expensive, but can be invaluable if you are in one of those situations where the school says one thing, your intuition and observations tell you something else, and a psychologist seeing your child has a third opinion. 

At least a rudimentary personality assessment is part of any psychological evaluation. If academic and intellectual problems do not seem to be the problem, however, then a full evaluation is in order. Like psychotherapy, it is a way of becoming un-stuck; it can give you a lot of new insight into your child and into the family that you can hopefully use to break the cycles. 

If you are considering testing, keep two things firmly in mind. First, you may not like what you hear. The resistance to testing results is often similar to that experienced by parents with child psychotherapy. Watch for jealousy and resentment of the tester, fury at any perceived implication of inadequate parenting, knee-jerk reaction to terms like "learning disability", "attention deficit", "low self-esteem", or whatever pushes your buttons, and in general a reaction of "not my kid; this guy’s a quack". Give the test results a fair hearing before you reject them. 

Second, testing is imperfect. Any test is no more or less than a sample of behavior, just as are a patient’s words during a therapy session. We have no way of peering into the brain or the heart and seeing the problem directly. This is one reason test batteries are expensive -- you need a lot of data before you can conclude something about a person. A single test is of limited value. 

Therefore, the critical element in any testing is the tester. A given result can often have many meanings. Not only could a low score on some particular test be the result of five or six different cognitive -- intellectual -- problems, but the tester must consider the subject’s mood, attitude, rebelliousness, anxiety level, attention, motivation, etc. A test battery is only as good as the psychologist who interprets it. And just as important, that psychologist is only as good as is his communication with you. As with psychotherapy, all the brilliant insight in the world is useless to you if you do not understand it or how to use it. 

In seeking a quality evaluation, it is often best to go to a place that specializes in this work. Children’s hospitals, clinics, and other such centers often will have an evaluation program, as do some private practitioners. Public schools in some states are required to provide this service, but the quality can be appalling and the process riddled with internal politics and hidden agendas. Meet with the team before you agree to let them do it, and trust your reaction. If they cannot communicate clearly to you in such a meeting, there is no reason to expect the evaluation to make sense either. (The pages on credentials, finding a therapist, and interviewing and selecting a therapist are relevant here.) On the other hand, if you are lucky enough to work with a functioning team, then you are getting the attention of perhaps 10 experts, all bent on understanding your child. 

One last point: Within our profession, people do not agree about the definition of terms like "learning disability" or "attention deficit". Across professions -- for example when you sit at a meeting of the education team at your child’s school, with psychologists, social workers, teachers, education specialists, and administrators -- there is even less. My advice is to avoid getting bogged down in these terms. Instead, try to keep the focus on the following:

A good exercise here is to try and write a short summary of what you’ve learned. You’ll be amazed at how much you have and haven’t understood.

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