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Assessment o Childrenognitive Foundations

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Jerome M. SattlerSan iego State University

Jerome M. Sattler Publisher ·Inc.San iego


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CHALLENGES IN ASSESSING CHILDREN. .THE PROCESS

Tests not accompanied by detailed data on their construc-tion validation uses nd limitations should be suspect.

O s c a r K Buros, founder o f the Instituteof Mental Measurements 1905-1978)

' Ypes o Assessment

Four Pillars o Assessment

Multimethod Assessment

Guidelines for Conducting Assessments

Steps in the Assessment Process

Thinking Through the Issues

Summary

Key Terms, Concepts, and Names

. Study Questions

1

oals nd ObjectivesThis chapter is designed to enable you to do the following:

• Identify the purposes o assessment• Delineate principles guiding the use o tests• Describe the skills needed to become a competent clini-

cal assessor• Describe the basic techniques used in the assessment

process• List the steps in the assessment process


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4 CHAPTER 1 CHALLENGES N ASSESSING CHILDREN: THE PROCESS

typical and gifted children, in order to develop skills with different populations. T h i r ~although this text covers the majorpsychological instruments used to assess children, it does notcover all of them, nor does it cover more than a small fraction of the thousands of informal assessment procedures usedby clinicians and researchers. New editions of assessment in

struments and new procedures will be published throughoutyour career. You will need to study these materials carefullyin order to use them effectively. The principles you willieamin this text will help you evaluate many kinds of assessmenttools with a more discerning eye.

The text summarizes the reliability and validity information presented in test manuals; however, it does not provide acomprehensive review of all the published research on eachmeasure. You will need to keep abreast of current research·on assessment and intervention throughout your training andcareer. You will want to pay close attention to research onthe reliability and Validity of the tests, interview procedures,observational techniques, behavioral checklists, and o i l i e ~ /

relevant assessment techniques. You may also want to conduct your own informal (and formal) research on intelligencetests, tests of special abilities, interviewing, observation, andother assessment procedures.

You will want to pay close attention to new findings aboutchildren with special needs. In order to work with childrenwith special needs, you will have to become familiar with stateand federal regulations concerning the practice of clinical andschool psychology. t is especially important that those conducting assessments understand state and federal regulationsthat address nonbiased assessment, classification of disabling

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conditions, eligibility criteria for special education programs,designing individualized educational programs, and confidentiality and safekeeping of records. Those who work inschool settings will need to know about and follow preciselysuch federal regulations as the Individuals with DisabilitiesEducation Improvement Act of 2004 (public Law 108-446,

or IDEIA; also referred to as IDEA 2004), Section 504 of theRehabilitation ct of 1973, the Americans with Disabilities

ct (ADA), and the Fa,mily Educational Rights to Privacy Act(FERPA). These laws are discussed in Chapter 3.

TYPES OF SSESSMENT

Assessment is a way of understanding a child in order to makeinformed decisions about the child. There are several types ofassessment, including screening assessments, focused assessments, diagnostif: assessments, counseling and rehabilitationassessments, progress evaluation assessments, and problemsolving assessments.

• A screening assessment is a relatively brief evaluation intended to identify children who are at risk for developingcertain disorders or disabilities, who are eligible for certain programs, who have a disorder or disability in needof remediation, or who need a more comprehensive assessment. Screening may involve, for example, evaluatingthe readiness of children to enter kindergarten programs orprograms for the gifted and talented. Decisions based ona screening assessment should not be viewed as definitiveand should be revised, if necessary, as new informationbecomes available.

• focused assessment is a detailed evaluati6n of-a specificarea of functioning. The assessment may address a diagnostic question (e.g., Does the child have attention deficithyperactivity disorder?), a skill question (e.g., Does thechild exhibit a verbal memory deficit?), or an etiologicalquestion (e.g., Why is the child failing mathematics?). Theexaminer may also examine, at his or her discretion andon the basis of clinical judgment, additional areas suchas reading ability. Settings in which time and financialpressures are severe (such as private medical facilities,schools, and health maintenance organizations) often use afocused or problem-solving assessment instead of a longerand more expensive diagnostic assessment.

• A diagnostic assessment is a detailed evaluation of a child'sstrengths and weaknesses in several areas, such as cognitive, academic, language, behavioral, emotional, and socialfunctioning. t may be conducted for a variety of reasons,including establishing a diagnosis (determining the classification that best reflects the child's level and type offunctioning and/or assisting in the determination of mentaldisorder or educational disabilities) and suggesting educational or clinical placements, programs, and interventions.

• A counseling and rehabilitation assessment focuses on achild's abilities to adjust to and successfully fulfill daily


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responsibilities. Possible responses to treatment and potential for J:ecovery (e.g., in cases of traumatic brain injury)also are considered.

• A progress evaluation assessment focuses on a child sprogress over time, such as day to day, week to week,month to month, or year to year. t is used to evaluate

changes in the chi ld s development, skills, or abilities andin the effectiveness of intervention procedures.

• A problem solving assessment focuses on specific types ofproblems (e.g., dyslexia) in a series of steps from problemidentification to problem analysis, intervention, and outcome evaluation.

Let s compare and contrast psychological assessment andpsychological testing. Both involve identifying critical questions and areas of concern and planning data collection. Theyalso differ. Psychological testing involves administering andscoring tests; the focus is on collecting data., Psychologicalassessment encompasses several clinical tools, such as formal

and informal tests, observations, and interviews. The focus ofpsychological assessment is not only on collecting data, butalso on integrating the findings, interpreting the data, and synthesizing the results. Testing produces findings; assessmentgives meaning to the findings within. the context of the child slife. For example, information from children and parents canbe skewed by their personal agendas or desire to please youor by a negative attitude toward mental illness or medications.You might need to consider such factors when you interpret theresults of the evaluation and formulate intervention strategies.With each type of evaluation, you will usually share the findings and recommendations with the referral source, the child,his or her parents, thf school, or other relevant parties.

FOUR PILLARS OF ASSESSMENT

The" four pillars of assessment-norm-referenced measures,interviews, behavioral observations, and informal assessmentprocedures---provide information about a chi ld s knowledge,skill, behavior, or personality (see Figure 1-1). The four pillars complement onedanother and provide a basis for makingdecisions about children. Each procedure must be interpretedill its own right, and the information obtained from all four

. must be woven together so that the final tapestry is integrated,. understandable, meaningful, and consistent. Let s look at

. each assessment procedure more closely.

Norm Referenced Measures

We have based this text on the premise that norm-referencedmeasures are indispensable for clinical and psychoeducational assessment. Norm-referenced measures are measuresthat are standardized on a clearly defined group, termed the

o group. A norm group is a group of individuals, representative with respect to characteristics such as age, gender,ethnicity, socioeconomic status (SES), or geographic region,who have taken the test. The test items are selected to rep-

FOUR PILLARS OF ASSESSMENT 5

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Figure 1-1. Four pill ars of assessment.

resent the domain of interest addressed by the test. The testinstructions, wording of items, probing questions, recordingof responses, time limits, and scoring criteria (with objectiveguidelines and examples) are specified in detail in the testmanuals so that they can be used by:hll examiners in the sameway. Test authors design standard procedures to reduce theeffect of personal biases of examiners and to reduce extraneous sources of influence on the child s performance (seeChapter 2). The intent of a norm-referenced test is to providea fair and equitable comparison of children by providing objective, quantitative scores.

Norm-referenced measures are scaled so that each scorereflects a rank within the norm group (see Chapter 4 for a discussion of psychometric issues). Norm-referenced measureshave been designed to assess, for example, individual differences in intelligence, reading, mathematics, problem solving,

organizational skills, writing, attention, visual-motor skills,gross- and fine-motor skills, and behavior. Although we arefortunate to have a choice of well-standardized and psychometrically sound tests with which to evaluate children, sometests do not meet psychometric standards. When you havecompleted your study of this text, you will be able to evaluatewhich tests have adequate psychometric standards.

Norm-referenced measures are an economical and efficientmeans of sampling behavior within a few hours and quantifying a child s functioning. Quantification (Le., assigningnumbers to responses) serves several purposes. First, it givesa picture of the child s cognitive, motor, and behavioral defi-


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6 CHAPTER 1 CHALLENGES IN ASSESSING CHILDREN:THE PROCESS

cits and strengths. (Note that norm-referenced rating scalesare particularly valuable in evaluating behavioral deficits andstrengths; see Sattler and Hoge, 2006). Second, it describesthe child's present functioning in reference to his or her peergroup. Third, it provides a baseline against which to measureprogress during and after interventions. Finally, it promotescommunication between the psychologist and parents, teachers, or others who requested the evaluation.

Norm-referenced measures allow us to evaluate changesin several aspects o a child's physical and social world.They inform us about developmental changes, changes in thechild's cognitive and neurological condition, and the effectso educational or behavioral interventions and other forms oremediation. For example, the effects o a medication regimencan be periodically evaluated through ongoing evaluation ofine-motor control and integration, processing speed, atten-tion and concentration, cognitive flexibility, and short-termmemory. Repeated evaluations are particularly needed whf lllmedications may have potentially detrimental side effects.

Interviews

You will gain valuable assessment information by interviewing a child and his or her parents, teachers, and other individuals familiar with the child. (Note that the term parentsrefers to the child's parents or to other caregivers, such asfoster parents, grandparents, or other relatives who are raisingthe child.) Results o an assessment may be meaningless orinconclusive i you examine the child without interviewingthose who play an important role in his or her life.

Unstructured or semistructured interviews are less rigidthan formal tests. They allow interviewees to convey information in their own words and interviewers to ask questions intheir own words--opportunities that neither may have whiletaking or administering standardized tests. Unstructured in-terviews are usually open-ended, without a set agenda. Semi-structured intervitnvs provide a list o questions, but the focuso the interview can change as needed. Structured interviewsprovide a rigid, but comprehensive, list o questions usuallydesigned to arrive at a psychiatric diagnosis. In addition, allthree inter:view formats allow direct observation o a child'ssocial interaction skills, language skills, and communicationskills. Chapters 5, 6, and 7 in Sattler and Hoge (2006) discuss

interviewing techniques, and Appendix B in that text includes15 semistructured interviews for obtaining information fromparents and teachers about normal development and severalchildhood developmental disorders. Clinical and ForensicInterviewing o Children and Families (SattIer, 1998) alsodiscusses interviewing techniques, including those neededfor child maltreatment investigations. Another valuable resource for interviewing children is the text by McConaughy(2005a).

Following are some examples o the types o informationthat you can obtain from unstructured and semistructured interviews with a child, a parent, and a teacher.

HILD

• Child' s view o the referral• Child's concerns about being evaluated• Child's view o which school subjects are easy and difficult• Child' s self-perceptions o strengths, weaknesses, inter

ests, and goals, including thoughts about why he or she ishaving problems

• Child's conversational language abilities, cooperativeness,interaction skills, and personal hygiene

• Child's interests and hobbies; Child' s view o his or her family, teachers, and peer group• Stressors in the child's life

P RENT

• Parent's view o the child' s presenting problems• P a r ~ n t sknowledge about the child's presenting problems• Child's developmental history• Child's medical, social, and academic history

• Child'sb e ~ v i o r

temperament, personality, interpersonalstyle (including relationship with parents, siblings, andteachers), interests, and hobbies

• Family situation, including sociocultural variables (e.g., socioeconomic status [SES), parental occupations, and levelo acculturation), langnage used in the home, individualsliving in the home, and factors that may be contributingto the child's problems (such as marital discord, financialstrain, alcoholism, or drug abuse)

• Prior intervention attempts• Parenting styles• Parental disciplinary techniques

able 1 1

Examples of Information Obtained fromBehavioral Observations

:if

• When and where the child shows the target behaviors• Frequency, duration, and rate of the target behaviors• How the child s behavior compares with that of a

nonreferred child in the same setting• How the child functions in situations that require planning,

decision making, memory, attention, and related skills• Child s reaction to social and interpersonal stressors• Child s reaction to environmental stressors

• How the child s behavior changes during the day• How others respond to the child s behavior• How the child behaves in multiple settings. with different

caretakers. and at different times during the day• Factors that contribute to and sustain the problem behavior,

including those that increase or decrease the frequency ofthe behavior

• How the child responds to various instructional methods,materials, and settings

• How the child responds to current interventions (ifappropriate)

• Clues helpful in formulating changes in interventions ornew interventions


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8 CHAPTER 1 CHALLENGES N ASSESSING CHILDREN: THE PROCESS

mal assessment procedures have been developed for differentpurposes. You might use one or more of these informal assessment procedures, or you might want to develop your own.However, informal assessment procedures that have unknownor questionable technical adequacy (e.g., unknown reliabilityand validity) must be used cautiously. Informal assessments

are particularly helpful for developing interventions. This tex tdescribes some informal assessment procedures that can beused in cognitive evaluations, such as testing-of-limits (seeChapter 6), but does not devote a chapter exclusively to informal tests and procedures. Appendix D in Sattler and Hoge(2006) provides several informal measures to help assesslearnillg disabilities in particular.

MULTIMETHOD SSESSMENT

This text advocates a multimethod ssessment (see Figure 1-2).First, a multimethod assessment involves obtaining i n f o r m a ~

tion from several sources (including the referral source, thechild, parents, teachers, and other relevant parties) and re-

viewing i f available) the child s educational records, medicalreports, social work reports, and previous evaluations. Second,a multimethod approach uses several assessment techniques,including norm-referenced measures, interviews, observations, and informal assessment procedures. Third, it assessesmultiple areas (e.g., intelligence, attention and memory, pro

cessing speed, planning and organization, achievement, visualskills, auditory skills, motor skills, oral language, adaptivebehavior, and social-emotional-personality functioning). Finally, it involves recommending interventions. Table 1-3 liststhe main factors to consider in a multimethod assessment.

A multimethod assessment allows you to do the following:

• Obtain information about the child s medical, developmental, academic, familial, and social history

• Obtain information about the child s current cognitive, acadefnic, behavioral, social, and interpersonal functioning

• Determine the ch ild s cognitive, academic, and socialstrengths and weaknesses

• Understand the nature presence, and degree of any disabling conditions that the child might have

Assessment Methods·

·Teachers •• ·••·•·• OWer a m i l y ~ e m b e r s

. Other nformants• Child s records and·previous evaluation:3

··.Interviews-Behavioral observations-Informal assessment. procedures

Figure 1-2. Multimethod assessment approach.

-Motor skills .O r ~ l l a f l g u a g e.

-Adaptivebeh,avior• o c i a l - e m o t i o h a f ~

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ITable 1-3Factors to Consider in Multimethod ssessment

Referral Information• Referral source• Reason for referral• Behaviors of concern to referral source

Demographic .and Background Information• Child s date of birth and age• Child s gender• Child s residence• Child s grade level• Child s ethnicity• Child s prenatal, birth, and postnatal developmental histories

and developmental milestones• Child s languages, such as language spoken t home, t

school, and with friends, and competency in each _ .• Child s educational history, such as grades, behavior ;n

school, grade placements, retentions, and special classplacements

• Child s social and interpersonal history, including involvementin court and family services

• Child s medical history, such as serious diseases, disabilities,and medications

• Family s history and socioeconomic status, such as numberof children, birth orde r of children, and resources

• Interventions attempted by parents and teachers and theirresults

• Recent changes in child s life (e.g., parents divorce orremarriage, loss of a close family member or fri.end, movechange in teacher)

• Child s school environment (e.g., violence, teacher-child ratio,overcrowding)

• Resources available to child (e.g., computer in home,parental support, tutoring, proximity to communi ty resourcessuch s library)

ssessment Findings• Description of problem behavior, such as (a) its origin,

(b) age of child when it began, (c) its frequency, duration,intenSity, and severity, and (d) its antecedents andconsequences

• Overall level of inteiligence, level of verbal ability, level ofnonverbal abilitY, and cognitive strengths and weaknesses

~ Reading ability, such as decoding, phonemic awareness,reading comprehension, and reading fluency

• Written language ability, such as spelling, writing mechanics,and written expression

• Cross-validate impressions provided by multiple infonnants• Determine the conditions that inhibit or support the acqui

sition o appropriate skills• Obtain baseline infonnat ion prior to the implementation

o an intervention program• Develop useful instructional programs

MULTIMETHOD SSESSMENT

• Mathemat ics ability, such as math computations, fluency, andmath applications

• Abilities in other academic areas• Attention and concentration, such as ability to filter out

extraneous stimuli and focus on a ta sk over a period of time• Executive functions, such as planning, organization, setting

priorities, creating and applying effective strategies, attendingto the mos t salient aspects of a task, and applying the correctamount of effort and attention to a task

• Adaptive skills, such as self-help skills and ability to functionin the environment

• Work and study skills, such as (a) study habits, includinglength of time spent studying, frequency of studying,when and where studying takes place, (b) note-takingstrategies, (c) study strategies such as writing and answeringstudy questions, (d) text-reading strategies, (e) use ofsupplementary materials, f) use of computer software, and(g) use of the Web and online resources

• AUditory perception, such as ability to identify, discriminate,interpret, and organize elements of acoustical stimuli

• Fine-motor coordination, such as ability to integrate smallmuscles,-usually in conjunction with visual perception

• Gross-motor activity, such as degree of coordination andability to organize movements of the large muscle groups

• Memory, such as ability to store and retrieve information• Visual perception, such as ability to identify, discriminate,

interpret, and organize physical elements of visual stimuli• Personal and emotional functioning, such as ability to

relate to others, ability to express and modulate emotions,ability to show a range of emotions, coping strategies, andtemperament

• Activity level in various situations• Effect of problems on ordinary acllvities• Compensatory strategies used by child

Interventions• Child s, family s, and school s expectations for changes in the

child s behavior• Most feasible interventions, including educational programs

and settings, given family, school, and community resources• Realistic goals• Prognosis• (For reevaluations) Changes in functioning

• Guide students in selecting educational and vocationalprograms

• Monitor cognitive, academic, or social cbanges in the childand in the family, scbool, and community as needed)

• Measure the effectiveness o interventions


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Table 1 4Guidelines That Form a Foundation for the Assessment Process

Background• Assessment should be used for the benefit of the child.• Assessme nt should be a systematic process of arriving at an

understanding of a child.

Selection of Assessment Measures• Assessme nt measures should have adequate reliability and

validity for the situations in which they are being used.• Assessme nt measures should have representative

standardization groups.• Assessme nt measures should provide information

needed to answer the referral question and make usefulrecommendations.

Administration of Assessment Measures• Assessmen t measures should be administered under

standard conditions (e.g., using the exact wording in the

manuals and following administrative instructions and timelimits precisely).

• Assessmen t measures should be scored according towell-defined rules.

Interpretation of Assessment Measures• Scores may be adversely affected by the child s (a) poor

comprehension of English, b) tempora ry fatigue, anxiety,or stress, (c) uncooperative behavior, (d) limited motivation,(e) disturbances in temperament or personality, an d/or (f)physical illnesses or disorders.

• Assessmen t strategies include comparing a child sperformance with that of other children (Le., normativecomparisons and evaluating the child s unique profile ofscorr::s or individual pattern s (Le., idiographic comparisons .

GUIDELINES FORCONDUCTING ASSESSMENTS

A clinical assessor should never focus exclusively on a child stest scores; instead, he or she -should interpret them y askingwhat the scores suggest about the child s competencies andl i m i t a t i o n ~Each child has a range of competencies and limitations that can be evaluated quantitatively and qualitatively.

Note that the aim is to assess both limitations and competencies, not just limitations. Table 1-4 provides guidelines thatform a foundation for the assessment process.

Tests and other assessment procedures are powerful tools,but their effectiveness depends on the examiner s knowledge,skill, and experience. Clinical and psychoeducational evaluations lead to decisions and actions that affect the lives ofchildren and their families. When used wisely and cautiously,assessment procedures can assist you in helping children,parents, teachers, and other professionals. When used inappropriately, assessment procedures can e misleading andhannful. The case of Daniel Hoffman in Exhibit 1 1 shows

• Interpretations are developed by use of inductive methods(i.e., gathering information abou t a child and then drawingconclusions) and deductive method s (i.e., proposing a

hypothesis about the child s behavior and then collectinginformation that relates to the hypothesis).• Results from psychological measures should be interpreted

in relation to other behavioral data and case historyinformation (including a child s cultural background andprimar y language), never in isolation.

• Assessment measures assess a child s performance basedon her or his answers to a set of items administered at aparticular time and place. The answers represent samplesof behavior; they do not directly reveal traits or capacities,but they allow yoti to make inferences about thesecharacteristi.cs.

• Divergent assessmen t findings need to be carefullyconsidered and reported, not minimized or ignored.

• Assessment. conclusions and recommendations should bebased on all sources of information obtained about a child,not on any single piece of information.

• Reevaluations may e needed periodically (e.g., 1 yearafter an intervention begins a nd/or every 3 years for specialeducation classification). However, reevaluations shou ld beconducted only when there is a good reason to do so, unlessrequired by state or federal statute (see Cha pter 3 for therequirements for reevaluation under IDEA 2004).

• Assessment measures intended to assess the same areamay yield different scores (e.g., two different intelligencetests purporting to measure similar constructs may yieldscores that differ). In such cases, you should discuss theimplications of these findings.

~ : :

how assessment results directly affect children and their parents. You must be careful about the words you choose whenwriting reports and when communicating with children, theirfamilies, and other professionals. Your work is a major professional contribution to children and tbeir families, to theirschools, and to society.

STEPS IN TH ASSESSMENT PROCESSThe assessment process comprises 11 steps (see Figure 1-3).These steps represent a multistage process for planning,collecting data, evaluating results, formulating hypotheses,developing recommendations, communicating results andrecommendations, conducting reevaluations, and followingup on a child s performance. The original assessment planmay need to be modified as questions develop from the assessment findings. Sometimes you will want to change assess- .ment procedures as a result of information obtained early on,so that you can gain more information about specific areas of


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Step 1

Step 2 I

Step 3

Step 4

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Step 6

Step 7

Step 8

Step 9

Step 10

Step 11

Review referral information

Decide whether t accept the referral

Obtain relevant background information

Consider the influence of relevant others

Observe the child in several settings

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Select and administer an assessmeDt test battery

I nterpret the assessment results

Develop intervention strategies andrecommendations

Write a report

Meet with parents the child if appropriate),and other concerned individuals

Follow up on recommendations andconduct a reevaluation

Figure 1-3. Steps in the assessment process.

functioning. For example, suppose your original plan does notcall for an in-depth developmental history interview with themother. However, the interview with the child reveals a periodof hospitalization last summer. Consequently, you decide thatyou need to interview the mother to obtain more detailed de

< velopmental information and, if necessary, ask for written permission to obtain a copy of the medical report. Finally, as youreview your findings, you may decide that the child needs aspecialized assessment, such as a n e u r o p s y h o l o g i ~evaluation or a speech and language evaluation. n this case, youwould refer the child to an appropriate specialist.

The steps in the assessment process are not necessarilyfixed in the order presented here. For example, you may wantto observe the child after you administer the assessment battery. The referral question, as well as case history information, will guide your selection of assessment tools. As youconduct the examination and review the results, your initial

< STEPS IN THE ASSESSMENT PROCESS

hypotheses may be modified and new ones may emerge. Insome cases, it may not be practical to conduct observationsor home visits, especially in clinics or hospitals with limitedstaff. Also, in school settings, the intervention strategies andrecommendations usually will be made by the multidisciplinary team rather than by one person.

Step : Review Referral Information

When you receive a referral, read it carefully and, if necessary, consult with the referral source to clarify any ambiguousor vague information. For example, if a teacher asks you tofind out why a child is having difficulty in class, you will wantto know the teacher s specific concerns (e.g., reading deficit,inattention, social skills deficit). You may find it necessary toredefine the referral question to focus on a particular concern.You: will want to know what the referral source expects youto accomplish and to identify the areas of most concern to ther e f e ~ lsource. f you can t identify these areas, it will be difficult to formulate an appropriate assessment strategy. f youcan identify these areas and identify the referral source s expectations, you will begin the assessment on a firm footing.

Remember that you and the referral source are workingtogether to help the child. You want to establish rapport and agood working relationship with the referral source. Communication and decision making will be easier if you and the referral source share a common vocabulary and agree about thereferral question. Rapport with the referral source also mayhelp you with the assessment process, as that person may beable to provide timely access to school records, conduct classroom observations, and contact other individuals with insights

about the child. Finally, a referral s »)lfce who has confidencein the process and results of an assessment will be more likelyto implement appropriate interventions.

Describe the assessment procedures to the referral source,and discuss potential benefits and limitations (e.g., placementin a special education program, effect of the testing processon the child). n some cases, based only on the informationprovided by the referral source, you may be able to suggestinterventions that can be implemented in the classroom priorto a formal assessment. f he child s problem behavior is alleviated, a formal assessment may not be needed. Some schooldistricts have prereferral committees or teacher support tearnsto work with teachers who have concerns about students

academic performance or behavior. Prereferral committeesmay recommend interventions. Their advice may reduce thenumber of children unnecessarily referred for assessment,making it easier to provide prompt and intensive services tothose most in need of individual assessment.

Step 2: Decide Whether to Acceptthe Referral

You are not obligated to accept all referrals, nor do you needto give all children who are referred to you a complete assess-


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WowamtBebcWwpwvtwbb 2 CHAPTER CHALLENGES N ASSESSING CHILDREN:THE PROCESS

ment battery. t is also important to know your competencies.Ask yoursel f questions such as these:

• Do I need to confer with the referral source about whatquestions an .assessment can and cannot answer? Identifying differences among the expectations of the referralsource, the parents, and other parties involved at the outsetof the evaluation may prevent misunderstandings after theevaluation is complete.

• Are there other professionals who are more competentto handle the referral because of its highly specializednature? For example, a ch ild who has recently sustained ahead injury would be best served by a neuropsychologicaland neurological assessment rather than by a psychoeducational assessment.

• Is formal testing needed? Can I answer the concerns ofthe referral source with assessment procedUres other thanformal testing (e.g., by examining work samples, classroom assessments, or report cards)?

• Do I need to refer the child for a medical evaluation because the referral indicates (or I have discovered in thecourse of my evaluation) that the child has physical concerns that may affect the assessment or has had a suddenchange in cognitive ability, physical condition, behavior, or personality? For example, has the child displayedchanges in any of these areas?

• Changes n cognitive ability-


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Step 5: Observe the Childin Several SettingsInfonnation obtained from observations will help you individualize the clinical evaluation and will supplement themore objective test infonnation. You will want to observe the

child in several school settings and a t home,i f

possible. Forexample, after visiting the classroom, you should be able toanswer questions such as these: What is the classroom environment like? Is the curriculum appropriate for the child?What instructional strategies and rewards are being used andhow effective are they? Row does the child s behavior compare to that of other children? Careful observation will helpyou to develop hypotheses about the child s coping behaviors. Ask the teacher to tell the students that you are there toobserve the class so that they do not wonder about why youare there. f you (or a social worker) visit the child s home,ask a parent to tell the family that you are there. to observethe family.

Classroom and home visits provide added benefits, including the opportunity to establish rapport with the child, teachers, and parents and to observe such aspects of the child senvironment as the layout and structure of the classroom andthe home (see Chapters 8 and 9 on behavioral observations inSattler and Roge, 2006). Developing a collaborative relationship with the child s teachers and parents will be importantboth during assessment and during any subsequent interventions. When you observe in these settings, avoid interferingwith classroom or home routines, and remind the adults thatyou don t want the clilld to know that you are there to observehim or her. Ask the teachers or parents to follow their usualroutines when you are present.

Also, ask the teacher, parent, or other adult whether thebehavior the child exhibited is typical and, i f atypical, how itdiffered from tJis or her usual behavior. Although you shouldmake every effort to reduce the parents or teachers anxiety about your visit, they must understand that their behaviormay be part of the problem and that changes in their behavior may be part of the solution. You should therefore observehow the behaviors of the ,parents and teachers affect the child.The behaviors of a cIilld and his or her parents or teachersare usually so .interdependent that i t is almost impossible toexamine the child s behavior without evaluating that of theparents or teachers.

Step 6: Select and Administeran Assessment Test BatteryConsider the following questions about test selection andadministration:

ow do I select an assessment test battery? Aneffective assessment strategy requires that you choose assessment procedures that will help you reach your goals. Thetests you select should be related to the referral question. For

STEPS IN THE ASSESSMENT PROCESS 13

OWS RVING

ITIJ 8CflOOlPSY HOLOGISi

Courtesy of Herman Zielinski and Jerome M. Sattler.

example, a reading fluency test with brief items will not address a referral question about the child s inability to comprehend textbook chapters; likewise, a short-tenn memory testwill not answer questions about long-tenn recall difficulties.The questions in Table 1-5 will help Y U evaluate assessmentinstruments and determine whether a test is appropriate for aparticular child. You should consider these questions for eachassessment instrument you use, to ensure that it is appropriatefor the child and for the specific purpose for which it will beused. Carefully study the infonnation contained in each testmanual, such as the reliability and validity of the test and thenorm group. Use tests only for the purposes recommendedby the test publisher, unless there is evidence to support otheruses for a test.

For infonnation on a vast number of tests, consult the latestedition of the Mental Measurements Yearbook. Consult Standards or Educational and Psychological Testing (American

Educational Research Association, American PsychologicalAssociation, National Council on Measurement in Education, 1999) for infonnation about technical and professionalstandards for test construction and use. Journals that reviewtests and present research on assessment include Psychological Assessment Journal o Psychoeducational AssessmentPsychology in the Schools School Psychology Review Journal o Clinical Psychology Journal o School PsychologyEducational and Psychological Measurement IntelligenceApplied Psychological Measurement Journal o EducationalPsychology Journal o Educational Measurement SchoolPsychology QlIaJ1erly and Journal o Personality Assess-


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ever, an efficient way of gathering relevant information is tohave a parent, a teacher, and the child if possible) completea questionnaire a d a rating scale before the formal assessment begins.

Should I use a group testr

an individually admin-istered test? In order to decide whether to use group orindividually administered tests, you will again need to consider the referral question. How important is it that tests beadministered individually? Would group tests be as effectiveas individual tests in answering the referral question? Arethere any motivational, personality, linguistic, or physicaldisability factors that may impair the chi ld's performance ongroup tests?

Individually administered tests are more expensive and timeconsuming than group tests, but they are essential as supplements to--or sometimes replacements for-group tests. Individually administered tests can also provide a second opinion

when results of group tests are questionable or when you needto observe the child's performance. Finally, individually administered tests are usually reqnired when children are evaluated for special education services or when testing is courtordered.

Group tests are valuable when a large number of nonreferred children need to be evaluated in a short period of time.Group tests, however, are not frequently used in the assessmentof children with special needs for four reasons (NewcomerBryant, 1993). First, group tests usually require some degreeof reading proficiency (e.g., to read the directions), and manychildren with special needs have reading difficulties. Individually administered tests, in contrast, usually rely on examinersto read the test directions and interact verbally with children.(Obviously, individually administered tests designed to measure reading ability require children to read.)

Second, because chi ldren taking group tests typically complete them by filling in bubbles, circling letters, or underlininganswers instead of giving their answers orally, it is difficultto determine whether they know the answers or are merelyguessing. (This is t u ~ef any multiple-choice test, whethera group test or an individually administered one.) Studentswith visual perceptual problems or attention problems mayhave difficulty using answer sheets correctly. They may, forexample, follow instructions to skip difficult items but forgetto skip corresponding items on the answer sheet. Also, grouptests do not allow you to observe the child's behavior as he orshe solves problems.

Third, group tests tend to use recognition rather than recall,requiring children to select one out of several answers. Although some individually administered tests require the childto select an answer from four or five choices (e.g., WISC-NMatrix Reasoning subtest, Peabody Picture Vocabulary Test-3,Peabody Individual Achievement Test-Revised NormativeUpdate, and Comprehensive Test of Nonverbal Intelligence),most have children answer questions directly rather thanchoosing the correct answer from among several.


Fourth, the examiner may not even notice when childrentaking a group test become lost, bored, fatigued, or indifferent. With an individual test, the examiner can monitor thechild and take steps to reduce any problems by providing enconragement, helping the child focus, taking short breaks, ormaintaining motivation.

What do I need to know about administering an as-sessment test battery? You need to know how to present the test materials, how to interact with children, how toscore their responses, and how to complete the record booklets (or test protocols or test forms). To score responses accurately, you need to understand the scoring principles andscoring criteria discussed in the test manuals and guardagainst allowing halo effects that might bias scoring. (Haloeffects occur when a judgment about one characteristic ofa person is influenced by another characteristic or generalimpression of that person. For example, i you think a childis bright; you may give him or her credit for borderline or

ambiguous responses.) You may also want to know how thechild functions with additional cues, a process called testingof-limits (see Chapter 6). The material in this text is intendedto complement-the material contained in test manuals and tohelp you administer an assessment battery.

Step 7: Interpret the Assessment Results

After you have gathered the background and observationalinformation, conducted the interviews, and administeredand scored the tests, you need to interpret the findings.

1 9 9 8 by ohn P ood

I marked them all True.I just can t believe that

you'd ever lie to us.

Copyright © 1998, John P Wood. Reprinted with permission.


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will need to consider factors in the school that may interfere with the child's ability to learn. Consider, for example,whether modifications are needed in the child's courses, theteaching methods used in the classroom, course schedules, orthe physical layout of the building. Also consider whether thechild needs a specific type of assistance, can tolerate a fullday or only a half day, needs special equipment to help withcommunication, or needs to be reassigned to another teacheror to a new school. Note that some schools are reluctant toreassign a student to another teacher within the same school.In such cases, the multidisciplinary team will need to be tactful, persuasive, and persistent to arrange for a reassignment.Evaluate how flexible, accepting, and patient the child'steacher is and whether he or she is willing to take suggestionsand work with other professionals.

Third, you will need to be guided by the services availablein a particular school district. Some schools offer speech andlanguage training; remedial classes in basic academic subjects;adaptive physical education; computer-assisted instruction;

tutoring for mainstream classes; social skills retraining; mobility and transportation assistance; academic, vocational, andpersonal counseling; and career development and employmentassistance. Recommendations for these services should bepractical and should take into account the realities of classroomand home life. However, do not let a school district's limitations prevent you from recommending a needed intervention.I f a school district cannot provide legally mandated services, itis required to find some way to provide them, including contracting with outside agencies. Also consider family and community resources and determine the parents' preferences andreactions to the proposed interventions.

Finally, you will need to apply the relevant information

you hav.e learned from the fields of school psychology, abnormal psychology, clinical psychology, developmental psychology, educational psychology, special education, and, ofcourse, your own experience.

Be cautious in naming a specific intervention program. Ify o u ~ k n o wthat a type of program would be significantly superior to all others for a child, you should; of course, give anexample of the program •However, if you are merely citing aprogram with which Y01 1happen to be familiar as an exampleofa class of acceptable interventions, be clear that this is onlyan example and that there are equally appropriate alternatives.UJ;lwarranted specificity in recommendations (e.g., "only theXYZ Miracle Phonics Program" or a class size of no morethan six children") can cause unnecessary difficulties, delaysin implementing programs, and needless conflict between theparents and the school.

Traditional psychometric assessments usually do not provide information about the conditions that best facilitate thechild's learning-Ior example, how the type of material, rateand modality of presentation, cues, and reinforcements differentially affect learning. Information about these and related factors can help us design more effective interventionprograms that might improve children's cognitive abilitiesand skills. An integration of experimental, clinical, and psychoeducational approaches, which has been in the making


for many years, has yet to occur. Until this union occurs, wemust use what we can learn from assessments to determinethe conditions that will best facilitate a child's ability to learnand succeed in school.

I t s a complex and difficult task to design interventions toameliorate a child's problems and to foster behavioral change,

learning, social adjustment, and successful participation inthe community. Still, we need to use our present knowledgeto design interventions, apply them carefully and thoughtfully, and then evaluate their effectiveness. Some problemsmay better be bypassed than remediated. For example, a childwith intractable graphomotor weaknesses might be betterserved by being taught word-processing skills than by hoursof penmanship training. Currently developing interventionsis as much an a 1 as it is a science.

This text provides general information on how to formu-" late recommendations. However, it is not designed to cover

remediation or intervention procedures. You will obtain thisknowledge from other texts and sources that cover behav

ioral interVentions, educational interventions, psychotherapy,counseling techniques, and rehabilitation counseling. Valuable knowledge can also be obtained from supervision andclinical experience and from skilled teachers and therapistswith whom you work.

Step 9: Write a Report

Shortly after completing the evaluation, write a report thatclearly communicates your findings, interpretations, and recommendations. It is important that you communicate the assessment results and recommendations r o m p t l ~ \because the .

referral source is no doubt anxious t9 receive Yfur report.The value of your assessment results and recommendations

\will depend, in part, on your communicative ability. Your

\report may be read by parents, teachers, counselors,\speechand language therapists, psychiatrists, probation officers, pediatricians, neurologists, social workers, attorneys, p r ~ e

tors, judges, other professionals, and the child. Therefore:'fhereport should be understandable to any relevant parties. Al-

\though your report may be used for purposes other than t o s ~you originally intended, it is important to specify in the report \ •its original intent; doing so can help prevent misuse.

One of the best ways to learn how to write a report is to \study reports written by competent clinicians. Use these re-

ports as general guides; ideally, you should develop your ownstyle and approach to report writing. Because the psychologi-cal report is a crucial part of the assessment process, it de-serves your care and attention (see Chapter 19).

Step 10: Meet with Parents, th ChildIf Appropriate), and Other Concerned

Individuals

After writing the report, discuss the results with the child(when appropriate), the child's parents, and the referral


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2 CHAPTER CHALLENGES N ASSESSING CHILDREN: THE PROCESS

2. The four pillars of assessment-norm-referenced measures,interviews, behavioral observations, and informal assessmentprocedures-provide different kinds of assessment information. How do the various assessment procedures overlap? Whyis it useful to integrate the information from the four differentmethods-that is, what do you gain by using the four methods rather than using one or two methods only? What kindsof problems do you foresee in integrating the information obtained from the four major types of assessment procedures?What are the strengths and limitations of each type?

3. The assessment process consists of several interrelated steps.What problems can occur at each step that might interfere withyour ability to complete the assessment? What might you doto prevent such problems? f problems occur, what can you doto recover and continue the assessment? What negative effectsmight result from interruptions in the assessment process?

SUMM RY

1The assessment procedures covered in this text are rooted intraditions of psychological, clinical, and educational measurement that are a century old.

2 This text is designed to help you conduct psychological andpsychoeducational evaluations in order to make effective decisions about children with special needs.

3. Effective decision making is the hallmark of sound clinical andpsychoeducational assessment.

4. To become a skilled clinical assessor, you should have somebackground in testing and measurement, statistics, child development, personality theory, child psychopathology, and clinicaland educational interventions.

5 This text summarizes the reliability and validity information presented in test manuals; however, it does not provide a compre

hensive review of all the published research on each measure.6 You will want to pay close attention to new findings about chil

dren with special needs.

Types of Assessment

7. Assessment is a way of understanding a child in order to makeinformed decisions about the child.

8 A screening assessment is a relatively brief evaluation intendedto identify children at risk for, developing certain disorders ordisabilities, who are eligible .for certain programs, who havea disorder or disability in need of remediation, or who need amore comprehensive assessment.

9. A focused assessment is a detailed evaluation of a specific areaof functioning.

10. A diagnostic assessment is a detailed evaluation of a chi ld sstrengths and weaknesses in several areas, such as cognitive,academic, language, behavioral, and social functioning.

11 A counseling and rehabilitation assessment focuses on a child sabilities to adjust to and successfully fulfill daily responsibilities.

12. A progress evaluation assessment focuses on a child s progressover time, such as day to day, week to week, month to month,or year to year.

13 A problem-solving assessment focuses on specific types ofproblems (e.g., dyslexia) in a series of steps from problemidentification to problem analysis, intervention, and outcomeevaluation.

14. Psychological testing involves administering and scoring tests;the focus is on collecting data.

15. Psychological assessment encompasses several clinical tools,such as formal and informal tests, observations, and interviews.The focus of psychological assessment is not only on collectingdata, but also on integrating the findings, interpreting the data,and synthesizing the results.

onr Pillars of Assessment16. The four pillars of assessment-norm-referenced measures,

interviews, behavioral observations, and informal assessmentprocedures-provide information about a child s knowledge,skill, behavior, or personality.

17. The four pillars complement one another and provide a basisfor making decisions about children.

18. We have based this text on the premise that norm-referenced, measures ,are indispensable for clinical and psychoeducationalassessment.

19. Norm-referenced measures are measures that are standardized

on a clearly defined group, termed the norm group.20. Norm-referenced measures are scaled so that each score reflects a rank within the norm group.

21. Norm-referenced measures are an economical and efficientmeans of sampling behavior within a few hours and quantifying a child s functioning.

22. Norm-referenced measures allow us to evaluate changes in several aspects of a child s physical and social world. They informus about developmental changes, changes in the child s cognitive and neurological condition, and the effects of educationalor behavioral interventions and other forms of remediation.

23. You will gain valuable assessment information by interviewinga child and his or her parents, teachers, and other individualsfamiliar with the child.

24. Unstructured or semistructured interviews at e lells rigid thanformal tests. They allow interviewees to convey informationin their own words and interviewers to ask questions in theirown words--opportunities that neither may have while takingor administering standardized tests.

25. Unstructured interviews are usually open-ended, without a setagenda.

26. Semistructured interviews provide a list of questions, but thefocus of the interview can change as needed.

27. Structured interviews provide a rigid, but comprehensive, list ofquestions usually designed to arrive at a psychiatric diagnosis.

28. You will obtain valuable information by observing the childduring the formal assessment, as well as in his or her naturalsurroundings, such as the classroom, playground, or home.

29. You may need to supplement norm-referenced measures withinformal assessment procedures.

ultimethod Assessment

30. This text advocates a multimethod assessment. A multimethodassessment involves obtaining information from several sources(including the referral source, the child, parents, teachers, andother relevant parties) and reviewing if avaiJable) the child seducational records, medical reports, social work reports, andprevious evaluations; using severru assessment techniques; assessing multiple areas; and recommending interventions.


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Guidelines for Conducting ssessments

31. A clinical ~ s e s s o rshould never focus exclusively on a child'stest scores; instead, he or she should interpret them by askingwhat the scores suggest about the child's competencies andlimitations.

32. Each child has a range of competencies and limitations that can

be evaluated quantitatively and qualitatively.33. Note that the aim is to assess both limitations and competencies, not just limitations.

34. Tests and other assessment procedures are powerful tools, buttheir effectiveness depends on the examiner's knowledge, skill,and experience.

35. Clinical and psychoeducational evaluations lead to decisionsand actions that affect the lives of children and their families.

36. You must be careful about the words you choose when writingreports and when communicating wit h children, their families,and o ther professionals.

37. Your work is a major professional contribution tochilpcen and.their families, to their schools, and to society.

Steps in the ssessment Process38. The assessment process comprises 11 steps.39. These steps represent a multistage process for planning, col

lecting data, evaluating results, formulating hypotheses,developing recommendations, communicating results and recommendations, conducting reevaluations, and following up ona child's performance.

40. The 11 steps are as follows: review referral information; decidewhether to accept the referral; obtain relevant background information; consider the influence of relevant others; observethe child in several settings; select and administer an assessment test battery; interpret the assessment results; develop intervention strategies and recommendations; write a report; meet

. with parents, the child if appropriate), and other concernedindividuals; and follow up on recommendations and conduct areevaluation.

KEY TERMS CONCEPTS AND NAMES

Daniel Hoffman v the oard o Educatioll o he City o New Yorkp.2)

Technical and c l i n i c ~sKills (p. 3)Types of assessment (p. 4)Screening assessment (p. 4)

. Focused assessment (p. 4)Diagnostic assessment (p. 4)

Counseling and rehabilitation assessment (p. 4)

STUDY QUESTIONS 2

'Progress evaluation assessment (p. 5)Problem-solving assessment (p. 5)Psychological testing (p. 5)Psychological assessment (p. 5)Four pillars of assessment (p. 5)Norm-referenced measures (p. 5)Norm group (p. 5)Interviews (p. 6)Unstmctured interviews (p. 6)Sernistmctured interviews (p. 6)Stmctured interviews (p. 6)Behavioral observations (p. 7)Informal assessment procedures (p. 7)Multimethod assessment (p. 8)Guidelines for conducting assessments (p. 10)Steps in the assessment process (p. 10)Step 1: Review referral information (p. 11)Step 2: DeCide whether to accept the referral (p. 11)Step 3: Obtain relevant background information (p. 12)Step 4: Consider the influence of relevant others (p. 12)Step 5: Observe the child in several settings (p. 13)Step 6; Select and administer an s s ~ s s m e n ttest battery (p. 13)Step 7: Interpret the as sessment results (p. 15)Step 8: Develop intervention strategies and recommendations

p.16)Step 9: Write a report (p. 17)Step 10: Meet with parents, the child if appropriate), and other

concerned individuals (p. 17)Step 11: Follow up on recommendations and conduct a

reevaluation (p. 18)

STUDY QUESTIONS

1 What relevance does the case of Daniel Hoffman have to hpractice of school and clinical psychology?

2. Discuss the technical and clinical skills needed to be a competent clinical assessor.

3. Discuss the purposes of assessment. Include i n your discussionfive different purposes of assessment, questions to consider inan assessment, and how psychological assessment differs frompsychological testing.

4. What are the four pillars of assessment, and how do they com-plement one another?

5. Describe some informal assessment procedures.6. What are some important guidelines for assessment?7. Describe the main steps in the assessment process.

assessment of children

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