Facts & Questions
Is my child really old enough to be tested? Shouldn't we just wait and see how things go over in the next couple of years?
This is a common question parents of younger children ask. For most behavioral, cognitive, or academic problems, early intervention is important for long-term outcome. Therefore, the earlier a problem is identified, the earlier interventions can be put into place. When children with cognitive and/or academic problems experience difficulties completing academic work for a longer amount of time, they are at risk for developing lower self-confidence and lower self-esteem, and may increasingly shut down as a way of protecting themselves (i.e., the child who persistently struggles eventually decides not to try anymore, as he is then consciously rejecting the task and no longer feels bad about himself). Similarly, children with social skills deficits or other behavioral problems are prone to increased social rejection as they progress
into higher grades, and early identification of their social strengths and weaknesses can result in interventions to improve social success, which ultimately improves self-confidence and self-esteem. Children can be tested as young as during infancy, but many formal tasks are intended to be given to children 3+ years old.
Psychologists are always diagnosing kids and I am concerned that a diagnosis could negatively impact my child. What is the purpose of giving a diagnosis, particularly if I just want to know about interventions to help my child?
It is true that in many cases, a diagnosis does not tell you a lot about what needs to be done. Competent psychologists go above and beyond the diagnosis and thoroughly assess the child’s strengths and weaknesses. For instance, even if a child’s symptoms meet diagnostic criterion for an autism-spectrum or attention-deficit disorder, these children may have dramatic strengths and weaknesses, and the diagnosis alone doesn’t tell you a lot about what to do. On the other hand, diagnoses can be useful in acquiring information about typical treatments and school accommodations that have been effective for children with similar diagnoses in the past.
What happens on the day of the evaluation? When will I receive feedback about the test results and recommendations?
Typically, the parent(s) or guardian(s) are seen with the child for a brief meeting at the beginning of the testing session to introduce the child to the testing process and develop rapport with him/her. At that point, a doctoral graduate student typically begins some of the testing with the child while Dr. Baker interviews the parent(s) or guardian(s). The interview typically lasts 1.5 to 2 hours and involves reviewing background information and questionnaires, as well as completing a diagnostic interview. At that point, parents typically wait in the waiting room until testing is completed. Children usually take a lunch break at 11:30 a.m. (or when they typically eat lunch at school). Children are also given various breaks throughout the day. Once the testing session is finished, a feedback session is scheduled, which involves meeting with the parent(s) or guardian(s) to review the findings and recommendations. Feedback sessions typically last 1.5 to 2 hours, depending on the complexity of the issues involved. Dr. Baker does not typically provide feedback about the findings or recommendations on the day of testing, as scoring and interpreting the test results and behavioral observations is a complex process that goes beyond the time designated for the testing session.
How long do evaluations typically last?
The length of the evaluation depends on factors such as the child’s age and ability to focus/sustained attention. Typically, evaluations begin at 8:30 a.m. and are finished by no later than 3:30 p.m. As previously noted, this includes various breaks throughout the day, as well as a lunch break. For younger children (3-5 years old), evaluations are typically shorter. Autism, ADHD, and psychoeducational evaluations typically last 3 to 3.5 hours and are usually completed in a morning session.
My child's father/mother and I are divorced and we have dual custody. Do I need to get consent from my ex-spouse before doing testing?
Ethically, psychologists are only able to test a child if both custodial parents have consented to the evaluation. Therefore, if parents have a dual custody, they both need to sign a consent form prior to testing.
How do children typically react to completing a neuropsychological evaluation?
Most children are comfortable with the process, particularly if they are prepared for the process ahead of time. Some children find the process to be fun and challenging, while other children may need regular prompting to put forth maximum effort. It is best to let children know ahead of time that they will be completing various tasks and games to look at their strengths and weaknesses. For younger children (3-5 years old), a simpler explanation that they will play some different games will usually suffice. It is best to let children know they may complete some tasks that are more challenging so they know what to expect. It is also important to let children know that there are no invasive or painful procedures, as some children become fearful when they are told they are seeing a doctor because of concerns about needles or other uncomfortable procedures.
Can I be present in the room while my child is being tested?
It is a consensus within the fields of psychology and neuropsychology that whenever possible, parents should not be in the room for most cognitive and academic tasks because the tests were not standardized in such a manner (and research has found that having a parent or guardian in the room can negatively impact the test results). However, there is a small window on the door of the testing room if parents would like to periodically check on their child to ensure he/she is safe. On rare occasions, if a child has a high level of separation anxiety or is highly oppositional, a parent may need to be present for at least parts of testing. It is not uncommon for parents to be present when testing younger children (2-3 years old).
Can I leave the office while my child is being tested?
For younger children (i.e., under 8 years old), it is best for a parent or guardian to be present in the office throughout the evaluation. In certain cases it is permissible for a parent to leave the office for a shorter period of time (e.g., to run an errand or go to the store) as long as we can reach the parent/guardian easily by cell phone.
How long does it take to schedule the feedback session and receive the report?
Dr. Baker typically sees parents for the feedback session the week after the testing session is completed, particularly if the teacher questionnaires have been received. The written report is typically sent out the day after the feedback session.
I do not want to medicate my child unless it is absolutely necessary! Is Dr. Baker going to recommend my child be medicated, or even prescribe medications himself?
Dr. Baker is a neuropsychologist and is not a physician or nurse practitioner, so he does not prescribe medication. At very most, for some children Dr. Baker may recommend the parents consider discussing their child’s symptoms with a pediatrician or child psychiatrist to determine whether a low dose of a medication could be helpful for providing initial treatment for the child (especially children with more severe symptoms). However, Dr. Baker is unable to determine whether a particular child needs or doesn’t need medication, and that decision needs to be made by a physician or nurse practitioner (and agreed upon by the parents).