Personal history (developmental, educational, social)
Review of previous interventions and evaluations and their results (if any)
Final written report:
Other components are added to the evaluation depending upon the referral question. These may include but are not limited to assessments for other disorders such as:
It is important to have a thorough developmental history to see if the child has a history of delays in various areas. There are many factors than can influence a child's success in school. Some focal points for the personal history include the mother's pregnancy, childhood illnesses, and the age when developmental milestones were reached.
The child's educational history is also important. Questions such as how many schools a child has attended, academic performance, and when problems were first noted help to complete a profile.
Information about the social development of the child may aid with a diagnosis. Learning how the child interacts with others and adapts to new situations is often helpful in building the profile.
If the child has been evaluated or interventions have been tried, it is important to have a complete accounting in the current report. It is necessary to compare testing results of the past to the present to determine key areas of change, both progression and digression. Also, previous interventions should be noted so that positive elements can be retained and negative elements avoided.
The psychological assessment test for intelligence quotient (IQ) is usually one of the Wechsler tests (WPPSI-III, WISC-IV, or WAIS-IV), but others can be used if required. These tests are made up of verbal and visual perceptual components and consider processing speed, working memory, and the ability to attend to information. These tests are designed to be bias free and examine innate intelligence. They do not require reading and therefore even a child who is unable to read can take these tests.
The educational battery consists of several tests and examines different areas of school learning. Which tests are given is dependent upon the age of the child, her educational level in school, and the perceived problem. Grade equivalent scores are usually reported along with standard scores and/or percentiles. Some of the educational tests are timed. It is important to compare how a client performs with and without time pressure.
Neuropsychology is the science of brain-behavior and understanding how brain processes affect one's ability to function at home, work, and school.
Neuropsychological evaluations can pinpoint specific weaknesses that interfere with an individual's ability to function, so that an effective remedial program can be initiated. One of the most important benefits of such examinations is to document cognitive strengths that can be used to compensate for areas of weakness.
In order for a person to be diagnosed with a learning disability, there has to be a discrepancy between his/her cognitive ability and his/her academic achievement. Sometimes children who go to very demanding schools are on grade level (when compared to national standards); however they still struggle academically due to very rigorous educational demands. This is often teased out through a thorough neuropsychological evaluation.
The final report synthesizes the personal history, previous interventions, and current test results. This builds a composite of where the child is currently functioning and what needs to be done to bring her forward to her appropriate level. Individual recommendations are based upon findings. The final report also includes standard scores and percentiles. The school as well as testing agencies may need these if accommodations and/or extended testing time are required.
After completing the final report, I hold two conferences. The first meeting is for the parents only. In that meeting I go over the results and my recommendations. During this conference, I review the results and address any questions and concerns that you might have. I thoroughly go over the recommended remediations and course of action. The second conference is optional and for the child specifically. In this conference I go over the general results and recommendations. I do not reveal IQ scores or any specific numbers to the child. I think it is important to explain their strengths and weaknesses to them without the context of numbers.
When evaluating a preschooler, it is important to know the underlying neuropsychological components of reading and to have a good battery with which to assess these skills. What makes me unique is that I have this knowledge, and I have the right battery (SEARCH, by Rosa Hagin, Ph.D. and Archie Silver M.D.) with which to evaluate these skills. Furthermore, I use an intervention program (TEACH by Rosa Hagin, Ph.D. and Archie Silver M.D.) and the knowledge as to how to work with a child to develop any weaknesses that may show up during the evaluation. By having a child who might be struggling evaluated at a very early age, an intervention program can be put into place that can prevent reading failure.It is important to know what skills are required in order to successfully learn how to read; to know how to evaluate these skills, and to know how to remediate these skills. This particular program called SEARCH and TEACH, was developed by Rosa Hagin Ph.D. and Archie Silver M.D. It utilizes a child's strengths to develop her weaknesses. The TEACH component is quite user friendly and does not have to be done by me. I can work with any learning specialist and sometimes a parent, to show them ways to help a child. The program develops skills that eventually lead to the knowledge of sound-symbol associations, blending, and decoding. It utilizes a multi-sensory approach and can precede an Orton Gillingham program.
Adults often present with unique problems. Young adults may perform at the college level on standardized tests but that does not mean that they do not have a learning disability. It may mean that they worked very hard in school and learned well to compensate for their difficulties but they still might require accommodations when attending college or graduate school. A neuropsychological component is very important at any age but crucial for adults. As mentioned above, for adults who have higher education, a neuropsychological evaluation can pinpoint areas of weakness when an educational evaluation might miss certain limitations because of compensatory skills or higher educational achievements.
DR. LISA RAPPAPORT
DR. LISA RAPPAPORT