“We’d like to refer your child for further testing,” is a scary phrase to hear as a parent. “Neuropsychological testing” can add a layer of confusion to the fear. My wife and I went through this ourselves when our child’s medical team referred us to a developmental psychologist. This was a standard referral for a kid with his medical history, but still nerve-wracking!
Recently, I spoke with Dr. Sarah Christman, a licensed psychologist specializing in psychological and neuropsychological assessment in Portland, to demystify this process.
Step One: Find a Provider
First, identify a provider with appropriate training. While master’s level clinicians like LPCs or LCSWs can use screeners and make formal diagnoses for things like anxiety, only providers with a PhD or PsyD (and assessment-specific training) can complete the full battery of tests included in a comprehensive neuropsychological evaluation and diagnose things like autism spectrum disorder. Be clear on the age range and testing a provider specializes in. Dr. Christman also recommended asking questions about what the evaluation results will show — such as, “How will this testing provide insight into my child’s attentional issues and emotional regulation?”
Finding a provider may be the most challenging step, as most in the area have long wait lists! Know that this is part of the process, for now, and that providers are doing their best to get through their backlogs and treat all patients.
Step Two: Prepare for Your Appointment
If you receive parent-/teacher-report forms ahead of time, Dr. Christman emphasized the importance of returning these completed on the day of testing. Additional items to bring may include: “report cards, teacher notes, previous evaluation reports, [and/or] medical records.” If your child has an IEP or a Section 504 plan, bring the full documentation (not just the summary), as well any school records that inform services your child receives. “All of this information is not always necessary,” says Dr. Christman, “but it can be, and it is always helpful!”
Prepare your child by sharing the expected length of the appointment — 3-6 hours over 1-2 days — and that you will be nearby but not in the room. Evaluations are the most thorough and helpful when your child tries their best, and Dr. Christman has seen success with parents offering an agreed-upon incentive for completing testing.
Step Three: Complete the Evaluation
On the day of your appointment, Dr. Christman suggests bringing “snacks, a drink, and a comfort item such as a stuffed animal or fidget toy.” Although the actual tests can vary, your child will likely be asked questions, given puzzles, and assigned numerous pencil/paper-based tasks. These tests measure things like attention, problem-solving, memory, language, executive function, visual-spatial skills, academic skills, and social-emotional functioning.
You may worry that your child’s behavior, attention, or communication difficulties will interfere with the evaluation. Dr. Christman assures that, in these cases, “observational data is used as part of the evidence” to supplement the results from the standardized testing, and that providers can also learn from parent/teacher input and symptom history.
Step Four: Review Results
What happens next? Dr. Christman says, “Parents will come back for a feedback session where the psychologist will review the results and recommendations with them, [including] any diagnoses.” Be aware that reports can take anywhere from 1-4 weeks to complete, and that you may receive yours either before or after the feedback session. Tell the provider ahead of time if you are seeking, “guidance on treatment approaches, school accommodations, or therapy referrals,” so they can include these in the report.
Hopefully the next time you hear the phrase, “further testing,” you’ll know exactly where to begin and that you’re doing the best you can to support your child to learn, grow, and be their best self.
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