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Psychological Assessment

An Overview of Psychological Assessment

At The Calming Suite Psychology, Dr Alissa Knight provides a range of assessments to
explore a child’s developmental profile and determine whether they meet diagnostic
criteria for a range of developmental disorders, such as Attention-Deficit Hyperactivity
Disorder (ADHD), Autism Spectrum Disorder (ASD), Oppositional Defiant Disorder
(ODD), and a Specific Learning Disorder (e.g., Dyslexia). An assessment provides insight
into the child’s behaviour, as well as guided information about what types of support
and services could significantly improve their everyday functioning and
developmental trajectory. The assessment may also identify, and be used for, eligibility
to access funded early intervention services and other supports (e.g., NDIS).

Dr Alissa Knight is very experienced in conducting psychological assessment, and has received great recognition among fellow psychologists and clients for her level of dedication, attention-to-detail, accuracy, and commitment to parents/guardians, schools, and other healthcare professionals in assuring all concerns and questions over a child’s psychological functioning are answered beyond a level of doubt. 

 

Does my Child Need an Assessment?

A School Teacher, GP, or other Healthcare Professional has made a Recommendation

If a teacher, or someone else has suggested to you that your child might benefit from a psychological assessment, you may feel a little overwhelmed and perhaps confused about the need for one. This is understandable given how much you love your child. Children are often referred for a psychological assessment for a variety of reasons. Among other things, they may be showing signs of depression or anxiety (separation anxiety among younger children is common), have attention or behavioural problems at home or in school, be subjected to bullying, or have an intellectual disability or specific learning disorder (e.g., Dyslexia). Often when kids are struggling in school or seem to be behind their peers developmentally, a teacher will recommend the child undergo a psychological assessment.

How to Make an Informed Decision

To decide whether an assessment is necessary, it is important to determine if the problem is recent (less than six months in duration), whether there has been a change in the child’s life (which might account for the observed problems), if the child is exhibiting the problems in all areas of his or her life, and how severe the impact of the problem is on the child’s successful functioning on a daily basis.  

If your child is exhibiting any of the above, a comprehensive psychological assessment with a psychologist who specialises in child and adolescent development may be beneficial.  Cognitive assessment allows the psychologist to determine if the child is achieving as well as he or she could be. If any problems are identified (e.g., a significant delay in reading), then standardised psychological tests are used to explore in more depth those areas and skills (e.g., phonological processing and visual sequencing), which are the processes involved in reading. This provides insight into the precise nature of the learning disability for that particular child. 

 

How to Recognise When a Child may be Struggling due to a Developmental Disorder as opposed to just 'acting out' Defiantly

Often, children with learning disabilities, behavioural or attention problems become so discouraged at home or at school by their difficulties that they lack the motivation to try. They often feel targeted, isolated, alienated, and become frustrated with themselves and other people. This often leads to eventually ‘acting out’ behaviourally at home or in class at school, as this is their way of expressing that frustration. A thorough assessment is vital because what may present as defiant behaviour at home, or inattentive behaviour in the classroom could be due a verbal memory problem, a language processing disorder, anxiety, emotional preoccupation (e.g., the child is focused on a recent death in the family), neurologically-based attention problems, or may mask a learning disability.

Without a comprehensive assessment, an inaccurate diagnosis could be made and the child’s needs not appropriately met. This same rationale is important in differentiating between many different childhood problems that have some similar symptoms. For example, a very common diagnostic mistake in children is distinguishing true defiant/disobedient types of behaviour as seen in children with Oppositional Defiant Disorder (ODD), to that of children with Social Anxiety Disorder. They can appear very similar in terms of symptomatology, but have vastly different implications. 

 

How will my Child Benefit from a Psychological Assessment?

How it will Benefit the Child

Psychological assessment is a great way for your child to understand how they learn best.  When your child understands how their brain works best, they then have the power to advocate for themselves as they go through their life in school. Most importantly, above and beyond all, when a child learns that the struggles they have been battling with are common, other children are going through the same thing, they are not “bad children”, just frustrated and impacted by their issues, this gives them back hope. They learn they are not alone, not weird, or strange, but a beautifully unique child who has been trying their best with the difficulties they have.

“Every day, he sits and watches all his peers flying high in the beautiful blue sky. He wonders “why me”, with a frown and sense of not belonging. And then one day, his whole world changes and he is given his wings, and my gosh you watch that child transform into a beautiful butterfly and fly high!”

How it will Benefit the Parent

One of the most positive outcomes to come out of psychological assessment with children is clarity. Often, parents bring their child to see a psychologist due to several issues they have been experiencing, but have no idea why. For example, “he just can’t sit still”, “she can’t seem to control her outbursts, and she gets so angry at the smallest of things”, “he doesn’t get along with his siblings, and can be quite manipulative at times”. Children come to our practice with all these knotted up issues that parents and teachers aren’t sure how to help. With insightful and in-depth psychological testing, we can help “untie the knots” and provide clear practical ways of understanding. 

Some parents will feel a lot of self-blame for their child’s struggles, whether that be a blaming for genetics, parenting, the environment, siblings, the list can go on. It is very important that parents understand this blame is often very unnecessarily misdirected. In most cases, the child’s problems are multifactorial (a combination of several differing factors), and this complexity is what leads to the presenting problems they are having. We want you to know that at The Calming Suite Psychology, there is never any kind of judgment that goes on here. We know that due to the complexity just mentioned, you are simply trying your best, and doing everything you can to help your child despite the challenges you have faced.  

How it will Benefit the School

If your child is struggling at school, it is in his or her best interest to inform the school so that they find supports to help them thrive. With the right guidance, a teacher will be able to recognise the struggles a child may be having, as opposed to thinking it is just defiant behaviour in the classroom. They will also have strategies for how to best help your child.  While schools may be limited in their ability to diagnose your child, once there is clarity, most schools are able to provide straightforward, practical, appropriate help to your child.

How it will Benefit the Siblings

Often when a child in the family is battling with mental health difficulties, it can become very confusing and burdening for their siblings in the house, who often have to listen to, and deal with behavioural confrontation that occurs. This can be incredibly difficult and impacting upon siblings. Psychological assessment may identify strategies that can help improve the culture within the family home, and help to repair relationships between siblings.  

Psychological Assessment Packages

Cognitive/Psycho-Educational Assessment Package

A cognitive or psycho-educational assessment is performed by a psychologist extensively trained in psychological assessment, and provides information regarding a child’s intellectual cognitive functioning (IQ), and their academic ability (achievement). A child’s current academic performance score is compared to their overall cognitive functioning (IQ) score and then any discrepancy indicates whether or not a Specific Learning Disorder (SLD) or Academic Giftedness may be present. It can also identify whether an Intellectual Disability is present or not. This can provide very useful information and strategies for families, schools and particularly for the class and specialist teachers and health service providers to use to improve the child’s academic performance.

Assessments used for a Psycho-Educational Assessment Package

For children aged 4 – 7 years old;

Wechsler Preschool and Primary Scale of Intelligence – Fourth Edition (WPPSI-IV). 

The WPPSI–IV A&NZ is an innovative measure of cognitive development for pre-schoolers and young children that’s rooted in contemporary theory and research. This edition also places a strong emphasis on child-friendly, developmentally appropriate features, and includes new processing speed tasks, the addition of working memory subtests and an expanded factor structure. These extensive enhancements are targeted to benefit both children and examiners.

For children aged 6 – 16 years;

Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V). 

The WISC-V is the gold standard assessment tool designed to measure a child’s cognitive/intellectual ability for children aged 6 years 0 months through to 16 years 11 months.  The WISC-V provides subtest and composite scores that represent intellectual functioning in specific cognitive domains, as well as a composite score that represents the general intellectual ability. The WISC-V is composed of 16 subtests; Subtests can be grouped into two general categories: primary or secondary.

For children aged 4* – 16 years old;

Wechsler Individual Achievement Test – Third Edition (WIAT-III)

The WIAT-III A&NZ is recognised as the gold-standard, standardised academic achievement test suitable for use in a variety of clinical, educational, and research settings, including schools, clinics and private practices. The WIAT-III aims to Identify the academic strengths and weaknesses of a student for the ability to Inform decisions regarding eligibility for educational services, educational placement, or diagnosis of a specific learning disability. It is also useful for designing instructional objectives and plan interventions.

Screen for Child Anxiety Related Disorders (SCARED)

The SCARED is a s a 41-item self-report (child and parent) measure designed to assess anxiety disorders in children and young people. Anxiety is very common for children with learning difficulties. Often, due to the stress that comes with learning difficulties at school, it is common to find higher levels of anxiety in these children. As such, it is important to identify if a child with learning difficulties is also experiencing clinical levels of anxiety.

Suitability

Psycho-educational assessment is suitable for children aged 6 to 16 years old and will identify strengths and weaknesses in the following areas:

  • Verbal comprehension
  • Visual/non-verbal intellectual ability
  • Memory and learning
  • Attention and information processing.
  • Higher-level/ executive functioning (such as problem-solving, planning, reasoning, impulse control and organisation).
  • Academic ability (in areas such as reading, comprehension, writing, mathematics, and oral expression)

 

Autism Spectrum Disorder – Diagnostic Assessment Package

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterised by deficits in social communication and interaction, as well as restricted or repetitive patterns of behaviour, interests and activities. There is often also significant sensory processing difficulties present. The behaviours and difficulties associated with ASD are often quite evident very early on in an individual’s development, with parents identifying things being “not quite right, or different”. All children with ASD vary, and are unique in their attributes and symptomatology. The behaviours associated with ASD can vary within individuals as they grow and develop, and many with milder forms of severity can respond quite favourably to intervention if identified early enough.  This can greatly improve the quality of life for the child as they grow into an adult. 

The aim of conducting an ASD Assessment

The aim of an ASD assessment with a psychologist is to explore a child’s developmental profile and determine whether or not they meet diagnostic criteria for Autism Spectrum Disorder as defined within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013).

Will the Assessment provide Diagnostic Clarity?

In South Australia, to obtain a formal diagnosis of ASD there are currently to accepted methods.

  1. A single assessment from an AHPRA accredited Clinical Psychologist.
  2. A dual assessment from two accredited AHPRA clinicians from differing disciplines (e.g., a registered psychologist, speech pathologist, psychiatrist or a paediatrician) who must both provide an assessment and comprehensive report. 

 

Dr Alissa Knight is a Clinical Psychologist. As such, she is able to provide a comprehensive psychological assessment for parents and guardians that will fulfill SA diagnostic requirements, and the requirements of funding agencies such as NDIS.  This may reduce the costs for families who may struggle to financially afford an assessment with two clinicians (e.g., a psychologist and speech pathologist). However, if parents/guardians are wanting a dual diagnosis, Dr Alissa Knight is very happy to collaborate with other healthcare professionals. 

Assessments used in the Autism Spectrum Disorder Diagnostic Package

The tests used in the Autism Spectrum Disorder Assessment Package  includes:

A comprehensive parent interview using the Autism Diagnostic Interview – Revised (ADI-R)

The Autism Diagnostic Interview-Revised (ADI-R) is a comprehensive, standardised and structured interview used for assessing children and adolescents suspected of having an Autism Spectrum Disorder (ASD). The Autism Diagnostic Interview-Revised (ADI-R) is a comprehensive, standardised and structured interview used for assessing children and adolescents suspected of having an Autism Spectrum Disorder (ASD). The ADI-R (along with the ADOS-2) is considered the gold standard in the assessment and diagnosis of children with ASD. The instruments appear to have a complementary effect in aiding diagnosis and confirm the importance of a multidisciplinary assessment process with access to information from different sources and settings.

Childhood Autism Rating Scale, 2nd Edition (CARS-2)  

The Childhood Autism Rating Scale, 2nd Edition (CARS-2) is designed as a clinical rating scale for the trained psychologist to rate items indicative of Autism Spectrum Disorder (ASD) after direct observation of the child. Covering the entire Autism Spectrum, the (CARS-2) helps to identify children with ASD and determine symptom severity through quantifiable ratings based on direct observation. Widely used and empirically validated, the CARS-2 has proven to be especially effective in: Discriminating between children with autism and those with severe cognitive deficits and distinguishing mild-to-moderate from severe ASD.

For children aged 4* – 7 years old;

Wechsler Preschool and Primary Scale of Intelligence – Fourth Edition (WPPSI-IV)

*Please find description above for the WPPSI-IV under Psycho-Educational package

For children aged 6 – 16 years old;

Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V). 

*Please find description above for the WISC-V under Psycho-Educational package

For children aged 4* – 16 years old;

Wechsler Individual Achievement Test – Third Edition (WIAT-III) 

*Please find description above for the WIAT-III under Psycho-Educational package

The Adaptive Behaviour Assessment System–Third Edition (ABAS–3) (Parent and Teacher version)

The ABAS-3 is a rating scale useful for assessing skills of daily living in individuals with developmental delays, autism spectrum disorder, intellectual disability, learning disabilities, neuropsychological disorders, and sensory or physical impairments. Rating forms are filled out by the parent and a teacher. The ABAS-3 covers three broad domains: conceptual, social, and practical, using 11 skill areas within these domains. Tasks focus on everyday activities required to function, meet environmental demands, care for oneself, and interact with others effectively and independently. On a 4-point response scale, raters indicate whether, and how frequently, the individual performs each activity.

 

Attention Deficit Hyperactivity Disorder (ADHD) Behavioural Diagnostic Assessment Package

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder usually first diagnosed in childhood, and often lasting into adulthood. Some children with ADHD may have trouble paying attention, controlling impulsive behaviours (such as acting out without thinking about what the result will be), or be overly active.

Signs and Symptoms

It is quite age-appropriate for young children to have trouble focusing and behaving at one time or another. However, children with ADHD this ability to remain attentive, focus, and behave accordingly to a set of rules or instructions, can be much more difficult, and tends to occur much more frequently and intensely than what would be expected as part of normal, age-appropriate functioning. Often, children with ADHD will exhibit difficulties in more than one social context (e.g., at home, at school, at sport, dance, at the playground, beach, supermarket).

Various behaviours a child with ADHD might exhibit include, but not limited to:

  • Daydreaming (seeming zoned out)
  • Forget or lose things frequently
  • Squirm or fidget frequently when spoken to
  • Excessively talk, with often a fast rate
  • Can make careless mistakes or take unnecessary risks
  • Can have a hard time resisting temptation to do certain things
  • Has trouble taking turns, or waiting for their turn
  • Can have difficulty getting along with others
  • Can appear to not listen, or take in information
  • Has difficulty finishing school work, or within time limits
  • May have explosive “temper tantrums” or anger outbursts
  • Restlessness
  • Impulsivity (e.g., interrupts others when they are talking, speaks at inappropriate times

Will the Assessment provide Diagnostic Clarity?

When properly diagnosed and treated, ADHD can be well managed, leading to increased satisfaction in life and significant improvements in daily functioning. Many individuals with ADHD lead highly successful and happy lives. An accurate diagnosis is the first step in learning to effectively manage ADHD.

Assessments used in the Attention Deficit Hyperactivity Disorder Diagnostic Package

The tests used in the Attention Deficit Hyperactivity Disorder Assessment Package  includes:

A comprehensive parent interview

A comprehensive, standardised and structured interview will be used for assessing children and adolescents suspected of having an Attention Deficit Hyperactivity Disorder.

The Conners 3rd Edition (Conners 3)  

The Conners-3 assessment is designed to thoroughly assess for symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents aged between 6 and 18 years (Conners, 2012). There are three versions of the assessment: 1) parent version; 2) teacher version; and 3) self-report version. The parent and teacher version obtain observations of child behaviour conducted by parents and teachers. Used in combination, the two versions provide a more complete picture of the child’s behaviour: behaviour at home and behaviour at school. The Conner’s has been demonstrated to be a valid measure of ADHD, as it assesses for symptoms of inattentiveness and hyperactive/impulsiveness as well as common comorbid disorders such as oppositional defiant disorder, conduct disorder, depression, and anxiety (Conners, 2012). Scores within the clinical range (T scores of 65 and above) indicate that a child is experiencing significant problems within the domain represented by that score when compared with similarly aged peers who completed the assessment during standardisation

For children aged 4* – 7 years old;

Wechsler Preschool and Primary Scale of Intelligence – Fourth Edition (WPPSI-IV)

*Please find description above for the WPPSI-IV under Psycho-Educational package

For children aged 6 – 16 years old;

Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V). 

*Please find description above for the WISC-V under Psycho-Educational package

For children aged 4* – 16 years old;

Wechsler Individual Achievement Test – Third Edition (WIAT-III) 

*Please find description above for the WIAT-III under Psycho-Educational package

The Behaviour Assessment System for Children – Third Edition (BASC-3) (Parent and Teacher version)

The BASC–3 is a multimethod, multidimensional system used to evaluate the behaviour and self-perceptions of children and young adults ages 2 through 25. It was designed for use in school and clinical setting for assessing behavioural and emotional problems in children and adolescents. Used individually, the BASC–3 components provide a view of behaviour in a particular setting and/or from a particular view or context. Used together, they provide a comprehensive picture of behavioural and emotional functioning that informs clinical diagnosis (e.g., using the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. [DSM-5™; American Psychiatric Association (APA), 2013]) or the need for additional educational supports and services (e.g., those addressed by the Individuals with Disabilities Education Act [IDEA, 2004]). Together, the BASC–3 components offer a comprehensive system for identifying, evaluating, monitoring, and remediating behavioural and emotional problems in children and adolescents.

The Woodcock Interpretation and Instructional Interventions Program – School Observation

Clients are observed in their classroom at school for 30 minutes. During this time, a structured Time Sampling of their behaviour is recorded using 30 second intervals. In each 30 second interval, the child’s behaviour is rated as being either on task (+) or off task (–) and contrasted against another student’s behaviour, chosen at random. If a behaviour is observed as being off task it is then categorised further into various problem behaviours (i.e., inattentive, overactive, impulsive, uncooperative, anxious, withdrawn, aggressive, other inappropriate). A further categorisation of the child’s strengths and weaknesses are indicated.

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