What measures for comprehensive child assessment (ages 6 to 16)?

[Datadriven]

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What measures are folks using for comprehensive emotional, behavioral, neuropsych, academic, etc full battery testing for children ages 6 to 16? Also, does anyone know of a good replacement for the CHIPS structured interview?

 

[psychlife19]

Wouldn’t this depend on the referral question? And then you can do a full battery or a few tests centered around the issue or the referral question.

 

[Datadriven]

Yes, in general. Where I practice, there is a trend for parents to want a full battery. I was thinking of administering the WISC, Woodcock-Johnson, ASEBA, RCADS, possibly the BASC (instead of ASEBA) or CPT-II, but not sure what I may also want to include. The CHIPS was coded for the DSM-IV, and am looking for another structured interview, besides the KSADS...any thoughts?

 

[BuckeyeLove]

When I was doing juvenile forensic evals on the regs, I was a HUGE Basc guy. Love that test.

 

[WisNeuro]

When I was doing juvenile forensic evals on the regs, I was a HUGE Basc guy. Love that test.

I'm more of a Basque guy, love me some kokotxas

 

[Datadriven]

When I was doing juvenile forensic evals on the regs, I was a HUGE Basc guy. Love that test.

Thank you!

 

[Datadriven]

I'm more of a Basque guy, love me some kokotxas

I will have to try it!

 

[psychlife19]

Yes, in general. Where I practice, there is a trend for parents to want a full battery. I was thinking of administering the WISC, Woodcock-Johnson, ASEBA, RCADS, possibly the BASC (instead of ASEBA) or CPT-II, but not sure what I may also want to include. The CHIPS was coded for the DSM-IV, and am looking for another structured interview, besides the KSADS...any thoughts?

I hope this is okay to say as I only have experience doing a practicum at testing with kids/teens, but that seems like a lot (doing both the WISC and WJ)

I guess it depends on the referral question because some of the parents wanted to rule out autism/ADHD, some just said “my kid is having these problems at school and theres some behavioral stuff too”.

So we did a BASC, GARS, vineland, SRS-2, and wisc.

And then depending on the results of the WISC, pick subtests of the NEPSY, and we might do the stroop, trail making test, rey figure, Test of everyday attention for children, etc.

Based on the list you posted, I think the Vineland might be a good addition...but again, maybe I am totally off because of my limited child testing experience!

I am looking forward to reading others contributions to this thread

 

[ClinicalABA]

Its NECCESSARY to know the referral question before choosing tests. For example, achievement testing not really indicated if it's a 6 year with concerns for anxiety. If it's a question of adhd, then none of the tests are really indicated. If it's a question of ASD or not, then SRS may be more efficient than BASC, plus you'll want a direvtbmeadure of social communication skills, such as ADOS. In other words, there is no standard "full battery" for all kids 6-16. You should be testing to answer a specific question.

 

[erg923]

This "Full battery" thing is graduate school stuff/terminology. This is not a meaningful term in the real world. Give yourself (and your patient's) a break. Do what you need to to answer the question.

Achievement testing is already paid for by your tax dollars to the school system, and by federal law.

Keep in mind, more testing/tests equals more chance for type II error if you aren't really, really careful (and psychometrically mindful). The ROI (for the patient) of doing 6 tests/instruments vs 8, 10-12 is probably negligible in most cases.

 

[WisNeuro]

"Full battery" is graduate school stuff/terminology. This is not a meaningful term in the real world. Do what you need to to answer the question.

Achievement testing is already paid for by your tax dollars to the school system, and by federal law.

Keep in mind, more testing/tests equals more chance for type II error if you aren't really, really careful (and psychometrically mindful). The ROI (for the patient) of doing 6 tests/instruments vs 10-12 is probably negligible in most cases.

"Fixed-battery" people still exist. They're just like 65+ and live in Florida.

 

[ClinicalABA]

...Keep in mind, more testing/tests equals more chance for type II error if you aren't real careful.

Even if you ARE real careful. Just looking at the BASC, Vineland, and WPPSI (standard use) there are 44 subtests/domains on which you'll report scores (16 on BASC, min. 12 on Vineland, and 16 on WPPSI). If you're just throwing tests at some score is likely to fall within at least a below average/borderline range. Interpreting any of those outside the context of an operationalize referral question is going to be problematic. Even with a good referral question it can be questionable to put a lot of weight on a handful of lower scores. When you have dozens of scores that that come from non-disinterested third party reports its even more muddled.

My referral question tends to be very focused (e.g. are this child's difficulties best explained by a diagnosis of autism). I answer that question by choosing instruments and techniques (e.g. structured interviews) that establish:
1. The reported symptoms are real
2. The symptoms are of sufficient quality and quantity to meet DSM 5 criteria for ASD
3. The symptoms actually interfere with functioning
4. The symptoms are not better accounted for by other conditions or histories that commonly occur in this population with similar presentations

I choose the LEAST AMOUNT OF TESTS I need to to address these points. If one test addresses multiple points, great! If a test doesn't address any of them, I don't do it.

 

[Datadriven]

Its NECCESSARY to know the referral question before choosing tests. For example, achievement testing not really indicated if it's a 6 year with concerns for anxiety. If it's a question of adhd, then none of the tests are really indicated. If it's a question of ASD or not, then SRS may be more efficient than BASC, plus you'll want a direvtbmeadure of social communication skills, such as ADOS. In other words, there is no standard "full battery" for all kids 6-16. You should be testing to answer a specific question.

What tests do you feel are particularly indicative for ADHD?

 

[WisNeuro]

What tests do you feel are particularly indicative for ADHD?

Clinical history, parent/teacher report.

 

[Datadriven]

Its NECCESSARY to know the referral question before choosing tests. For example, achievement testing not really indicated if it's a 6 year with concerns for anxiety. If it's a question of adhd, then none of the tests are really indicated. If it's a question of ASD or not, then SRS may be more efficient than BASC, plus you'll want a direvtbmeadure of social communication skills, such as ADOS. In other words, there is no standard "full battery" for all kids 6-16. You should be testing to answer a specific question.

Also, yes I understand that a referral question is always behind any request for a comprehensive psychological assessment. Maybe I should rephrase, what are the full range of tests that should be available to use for child assessment.

 

[Datadriven]

Clinical history, parent/teacher report.

Right so that can be covered by the BASC and parent/child interviewing (or also ASEBA in addition) and child observation to a baseline child in the classroom. And review of records.

 

[erg923]

What tests do you feel are particularly indicative for ADHD?

This doesn't exist.

If you are already confident (in either direction) about whether ADHD is the correct diagnosis, there are no cognitive test results in the world that should undermine your confidence. Attention tests might be extremely useful for other purposes, mostly academic. But there is no literature to indicate that these would be diagnostically useful. And there is scant evidence that any attention tests you do give (whatever the result) would meaningfully change the treatment plan or standard of care treatment that would be rendered to a child with ADHD.

 

[Datadriven]

This doesn't exist.

If you are already confident (in either direction) about whether ADHD is the correct diagnosis, there are no cognitive test results in the world that should undermine your confidence. Attention tests might be extremely useful for other purposes, mostly academic. But there is no literature that these would be diagnostically useful. And there is scant evidence that any attention tests you do give (whatever the result) would meaningfully change the treatment plan or standard of care treatment that would be rendered for a child with ADHD.

Great, thank you that is my understanding as well, but wanted to ask the open-ended question to see if others were proposing alternatives check to see if there has been any recent research on psychometric changes in best practices for ADHD.

 

[erg923]

I'm not sure what the difference is between "comprehensive assessment" and "full battery"....but suffice to say it is cost prohibitive to give 6 and 8 hours or more of testing services to every kid who may have attention and/or behavior problems.

If there is significant neurological risk factors or overlay, I would be looking more for a neuropsych eval..in which ADHD proper would not really be a prominent or likely variable.

 

[WisNeuro]

I'm not sure what the difference is between "comprehensive assessment" and "full battery"....but suffice to say it is cost prohibitive to give 6 and 8 hours or more of testing services to every kid who may have attention and/or behavior problems.

If there is significant neurological risk factors or overlay, I would be looking more for a neuropsych eval..in which ADHD proper would not really be a prominent or likely variable.

If you had concern about LD with or without ADHD comorbidity in a kid, that eval would be important. Early interventions definitely helps educational outcomes.

 

[erg923]

If you had concern about LD with or without ADHD comorbidity in a kid, that eval would be important. Early interventions definitely helps educational outcomes.

School psychologists do this all day, every day, no? I mean, its got to be like the number 1 referral question?

Are they good at it? That's another question. Seems like they should be? IEP? Recs for said IEP? ADHD vs LD? MH tx triage/referral? Seems this would be highlighted in the job description?

 

[WisNeuro]

School psychs do this all day, every day, no? I mean, its got to be like the number 1 referral question?

Are they good at it That's another question. Seems like they should be?

I don't interact with school psychs pretty much at all. But, as a parent with means, if my kid needs an eval, they're going to a child neuropsych. I want someone who not only knows ADHD/LD, but also has a buttload of knowledge about neuroanatomy and neuropathology.

 

[ClinicalABA]

...Maybe I should rephrase, what are the full range of tests that should be available to use for child assessment.

We see kids birth through 17, with a specialty in ASD and developmental concerns. This what I have in my office (I'm leaving off edition numbers- assume most up to date version):

Cognitive-
Bayley
WPPSI
WISC
Kaufman ABC
Leiter
Stanford Binet

Language-
Bayley
PLS
REEL
CELF

Executive Functioning/Neuro/Visual-Spatial-
NEPPSY
Beery VMI

Social Communication-
ADOS

Behavioral/other-
VBMAPP
ABBLS

Motor Skills-
Bayley

Rating Scales (in versions for all age ranges, with teacher versions where appropriate). Spanish versions where available-
Vineland (interview and parent/caregiver forms)
BASC
SRS
BRIEF

There may be some niche questionnaires I'm forgetting. Other offices in my company see more older kiddos (I focus on under 5), and may have some more neuropsychological things, as well as achievement tests.

 

[R. Matey]

School psychologists do this all day, every day, no? I mean, its got to be like the number 1 referral question?

School psychs refer out for dyslexia testing in my current state, just fyi. It's not covered by the educational system.

 

[Datadriven]

We see kids birth through 17, with a specialty in ASD and developmental concerns. This what I have in my office (I'm leaving off edition numbers- assume most up to date version):

Cognitive-
Bayley
WPPSI
WISC
Kaufman ABC
Leiter
Stanford Binet

Language-
Bayley
PLS
REEL
CELF

Executive Functioning/Neuro/Visual-Spatial-
NEPPSY
Beery VMI

Social Communication-
ADOS

Behavioral/other-
VBMAPP
ABBLS

Motor Skills-
Bayley

Rating Scales (in versions for all age ranges, with teacher versions where appropriate). Spanish versions where available-
Vineland (interview and parent/caregiver forms)
BASC
SRS
BRIEF

There may be some niche questionnaires I'm forgetting. Other offices in my company see more older kiddos (I focus on under 5), and may have some more neuropsychological things, as well as achievement tests.

Thank you!

 

[ExecutiveDysfunction]

School psychs refer out for dyslexia testing in my current state, just fyi. It's not covered by the educational system.

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[borne_before]

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I know it's easy to pick on the dirty school psychologists, but they're just following the law. When working in a school, and therefore for the local education agency, and they are not licensed, they cannot DIAGNOSE.

What they can do, however, is CLASSIFY a student for special education services based on one of the thirteen disability categories outlined in the Individuals with Education Improvement Act (IDEA). One of those areas is Specific Learning Disability (SLD) and the language of the law does not state use the term dyslexia. Rather, it outlines 8 acheivement areas. The ones most closely related to dyslexia would be basic reading skills (i.e., dysphonetic dyslexia), reading fluency skills (dysfluent dyslexia), or reading comprehension.

You would be surprised how much a school psych does. They're not lazy.

 

[erg923]

I know it's easy to pick on the dirty school psychologists, but they're just following the law. When working in a school, and therefore for the local education agency, and they are not licensed, they cannot DIAGNOSE.

What they can do, however, is CLASSIFY a student for special education services based on one of the thirteen disability categories outlined in the Individuals with Education Improvement Act (IDEA). One of those areas is Specific Learning Disability (SLD) and the language of the law does not state use the term dyslexia. Rather, it outlines 8 acheivement areas. The ones most closely related to dyslexia would be basic reading skills (i.e., dysphonetic dyslexia), reading fluency skills (dysfluent dyslexia), or reading comprehension.

You would be surprised how much a school psych does. They're not lazy.

Lets play semantics with our usefulness. This will be very helpful to our profession???

For goodness sake son, do they have a learning disorder or not? What would you say you do here, Milton?

 

[borne_before]

Lets play semantics with our usefulness. This will be very helpful to our profession???

For goodness sake son, do they have a learning disorder or not? What would you say you do here, Milton?

It's not, at all, just semantics.

It varies largely by the local education agency they work for. They identify learning disorders, but they can't diagnose them or even use DSM-5 terminology. It's not that hard to grasp. APA has worked tireless to make sure it stays that way.

Here i've provided a link to help you learn a little more about school psychologists. You might want to leave your silo.

Who Are School Psychologists

School psychologists are uniquely qualified members of school teams that support students’ ability to learn and teachers’ ability to teach. They apply expertise in mental health, learning, and behavio...

www.nasponline.org

 

[futureapppsy2]

Also, it’s important to note that a student can have a diagnosis of something (like ASD) and still not qualify for special education services under that category of the IDEA. Thus one reason why diagnosis and classification are different and why private psychoeducational/psychodiagnostic evals are sometimes not accepted for special education classification purposes.