Types of Assessment
Assessment doesn’t always mean testing. For example, interviewing a child and family, taking a developmental history and reviewing the results of checklists filled out by parents may be enough to understand the underlying causes of a problem and what to do about it. This type of assessment does not involve testing.
When testing is part of the process of understanding a child, it can consist of several types:
Intellectual testing provides more than just an IQ score. These tests show levels of cognitive skills in several areas. Most IQ tests are divided into Factors that measure some aspect of functioning. For example, the Wechsler IQ tests measure verbal ability, nonverbal reasoning ability, working memory and processing/copying speed. The Stanford-Binet IQ test measures verbal and nonverbal ability in fluid reasoning, knowledge, quantitative reasoning, visual spatial reasoning and working memory. Most IQ tests measure some variation of these factors especially verbal and nonverbal reasoning ability.
Intellectual potential can be assessed for children from age 4 1/2 and older using the Stanford-Binet-5 or Wechsler tests. For children under age 6, the WPPSI-III is a test frequently used to assess IQ. For children ages 6 to 16, the WISC-IV is a good choice. The WISC-IV now has Extended Norms that allow assessment of IQ scores above 160. Over age 16, the WAIS-IV is the instrument used. The Stanford-Binet-5 can be used with children from age 2 through adulthood. However, the best ages to assess children on this test are 4 through 12. The SB-5 has Supplementary norms that allow for calculation of a ratio IQ as well as Extended Norms for children above IQ 160. None of these tests allow for the range of scores that the older Stanford-Binet Form L-M allowed for verbal IQ. The older Stanford-Binet L-M is still available to be used when it is indicated that verbal reasoning is not fully assessed by other tests.
Most IQ testing takes about a morning to administer. Results are given as IQ scores and Standard Scores (SS). The average score is 90-109. High average is 110-119, superior range 120-129 and very superior, 130 and above. Generally scores from 120 on are considered to be in the gifted range. Scores above 120 also can be subdivided into gifted (120-144), highly gifted (145-160), exceptionally gifted (161-180), profoundly gifted (above 180). Scores at or above 145 are at the 99.99%.
IQ testing can also provide a picture of the child’s cognitive strengths and weaknesses. Knowing these can be helpful in planning interventions for the child at home and at school. However, having a score that is lower does not tell us why it is lower. Thus, scores that are very discrepant from other scores often require further assessment.
Achievement testing measures how well a child can demonstrate learning in academic subjects.
The achievement tests used in assessing academic levels are broad-spectrum tests. They test more than level of competency in a specific subject. Depending on the test used, measures of basic skills, fluency in the subject and ability to apply the skills are tested. For example in reading, tests might measure ability to decode words, knowledge of phonics, fluency in reading quickly and accurately and reading comprehension. The tests used in an academic assessment also can give clues to how the child approaches academics. By watching the child do the tasks, it is possible to see areas of strength and difficulty.
There are different types of achievement tests. Broad- spectrum tests include the Woodcock-Johnson Achievement Tests; Wechsler Individual Achievement Tests, Wide Range Achievement Tests among others. There are also specific subject tests such as the Gray reading tests, Test of Reading Comprehension, Test of Written Language, among others. Depending on which tests are chosen specific subjects can be evaluated in more depth.
Achievement testing shows a child’s levels of academic performance compared to a standard peer group. Children can be compared to age or grade peers or to children of lower or higher ages. This can allow a picture of strengths and weaknesses relative to others of the same age and grade. Also, if a grade skip is a possibility, comparison to peers a year ahead can be made to assess how the child would perform with this level. Most achievement testing consists of tasks of reading, spelling, math, writing, and general knowledge.
Comparison with IQ scores also provides a bigger picture. If a child’s performance is similar to what would be expected for their IQ level, then recommendations about how best to build on current performance are needed. If a child’s performance is discrepant from expectancy, then it may be necessary to determine why.
Achievement tests don’t show actual grade levels, except for young children. Usually tests can tell how advanced the child is compared to age or grade peers. They also don’t show what aspects of the level attained are discrepant from what should be known for that grade level. That is, a 3rd grade child reading Grade Equivalent 8.2 will not comprehend the same way as will someone who is actually in the 8th grade.
Achievement tests sores don’t show WHY a problem occurs, for example, lower fluency scores can mean slower processing speed, slower work speed, handwriting problems or attention problems, but could also mean weaker skills in automatic functioning (The more well learned the task, the less performing it requires small steps to accomplish it. For example, automatic reading does not require actually decoding each word).
If achievement scores are lower than expected further evaluation will be needed. Lower scores could be the result of poor scholarship, low motivation, learning disability, emotional problem, or due to lower level educational attainment overall in the school.
Neuropsychological assessment is used to evaluate dysfunction in various cognitive processes. This can be necessary to discover the underlying cause of an academic, social/emotional problem, or overall problems in many areas of daily living. Neuropsychological testing can evaluate if a child suffers from particular problems with executive functioning or right brain functioning for example.
Neuropsychological assessment also can evaluate cognitive strengths and weaknesses in a variety of areas including memory, visual-perceptual and visual-motor skills, language skills, processing speed, and executive function skills (organization and planning for example).
Finally, neuropsychological testing can help, along with other testing, to determine a differential diagnosis among several possible disorders. For example, Tara, age nine, had been diagnosed with several different diagnoses over the years by different mental health professionals. A gifted child with an IQ in the 130 range, she showed many symptoms that met criteria for several different diagnoses, but which was the primary problem? Was she a gifted child with ADHD? Did she have Asperger Syndrome? Was she really suffering from a mood disorder? A neuropsychological evaluation showed that Tara had underlying right brain dysfunction and executive function disorder that was part of Asperger Syndrome. In addition she had symptoms of ADHD, but these were more based on the Asperger Syndrome and an anxiety disorder than on ADHD. Thus, neuropsychological evaluation helped to differentiate what was Tara’s underlying problem so that the correct interventions could be planned.
Neuropsychological testing does not show what specific emotional problems a child might have. It does not show how the child constructs the emotional or social world, but it can give indications why problems may be occurring as with Tara.
Neuropsychological testing also does not show specific disorders. There is no specific profile for ADHD or Asperger Syndrome for example. It is the sum of the test scores compared to the child’s potential, the test observations and an analysis of all the strengths and weaknesses together, along with a family, developmental and school history that helps to make a determination of a diagnosis.
Neuropsychological evaluation can also be helpful in delineating areas of cognitive strengths and weaknesses when a child has ADHD, Asperger Syndrome or a specific learning disability. It can provide direction on how best to accommodate and remediate areas of specific weakness while capitalizing on strengths.
Social/Emotional Testing or Psychological/Projective Testing
Psychological testing involves describing the child’s social and emotional functioning with regard to activities of daily living. Psychological tests can involve paper and pencil checklists or inventories filled out by the child, parents and teacher. It can also involve projective instruments that give an underlying picture of how the child constructs the social and emotional world. These projective instruments can include drawings, stories, descriptions, and reactions to various types of material. The material is considered projective because there are no obvious right answers and the child projects him or herself onto the material in ways that give clues to how he or she sees the world.
Psychological testing gives measures of anxiety, depression, emotional control, resiliency, anger control, empathy, ability to access feelings, closeness to people, ability to problem solve, and creativity. It also can help assess reality testing and judgment when these might be issues. Thus, projective testing in particular can help with differentiating among diagnoses. With the use of other tests it can help differentiate emotional problems from cognitive based problems.
Psychological testing takes several hours and is time consuming to score and interpret. While it is helpful in assessing underlying problems, it has limitations. For example, a child does need to cooperate. If the child does not wish to reveal problems, paper and pencil tests may not show any issues. Sometimes projective testing can if the child does give adequate responses.
Psychological testing also will not show if a particular person will commit suicide or homicide. It generally can’t tell if someone is using drugs or alcohol especially if they are not doing so right then. Psychological testing also generally can’t tell how successful a person will ultimately be in life or what a long-term prognosis will be for a mental health problem.
Some testing also will examine different aspects of social and emotional areas such as pragmatic language, emotional control, levels of anxiety and depression, and concepts about social functioning. How the child perceives the world, how their social and emotional world is constructed and what inner resources they have also can be assessed.