FAQs of Psychological Testing
Who provides evaluations?
Typically psychologists provide psychological evaluations/ testing, though they may have graduate students who help to administer some of the tests.
What's the process like?
Most of the providers I've worked with have a similar process. They do an intake appointment with parent(s) to get more information about what's going on, then they schedule another day for their initial meeting with the child. After they introduce themselves to the child and help the child get comfortable, they'll start with some assessment games and activities. It could be anything from a counting game to putting together a 3D puzzle to listening to a story and answering questions about their comprehension. Providers who are good with kids schedule movement activities in between sedentary activities for variety, and allow kids to stop or take breaks when they need to. For kids who need frequent breaks they may schedule another day of testing so that the child isn't getting burnt out or overtired. Usually parents do not stay with the child during the testing process because we might accidentally say or do things that cause our kids to respond in a different way than they would on their own and skew the results.
What exactly are they testing?
It can depend on what your concerns are. If you suspect your child has autism, they are going to do tests that specifically look at symptoms common in autism spectrum disorder. If you think your child may have a learning difference they will be looking a lot at how your child's brain processes written and spoken information. Sometimes we don't know exactly what we're looking for, but we just want to make sure we aren't missing anything, and they can do general tests that look at common areas of development to rule out the need for additional testing. Areas of testing might include intelligence, listening comprehension, visual-motor coordination, impulsivity, language skills, processing speed, nonverbal reasoning skills, memory, attention, executive functioning, flexibility, and motor speed. All the tests are standardized and have been shown to be reliable, valid, objective, normative, and predictable. Some tests are normed for certain age groups (16 and up, or 2 and up) or certain populations (those who might be struggling with social skills) so the evaluator chooses what battery of tests to use with each client.
Is it expensive?
It can be. Expect to pay anywhere from a few hundred dollars to a few thousand dollars for a complete evaluation. This price differs based on who you are working with, whether it's at a teaching clinic or private practice, the experience of the evaluator, and the time it takes them to complete the testing. Testing fees cover the evaluator's time and expenses during the testing with your child, but also their extensive time analyzing data and writing the report. It takes a lot of training to have a child do a jumping activity and then translate that into statistical information about their capacity to understand verbal directions.
Will insurance cover it?
I won't subject you to my soapbox about the increasing costs and decreasing value of health insurance (oops, maybe I just did). The answer, as with all things insurance, is complicated and may require investigation. Some plans will cover testing, depending on what tests are completed, some will not. Some will cover testing based on what the diagnosis is at the conclusion of testing. Meaning if you get your child tested and the test results indicate that your child has autism, it would be covered; if the results indicate your child has ADHD it would not be covered. So you'd need the testing results to know if the testing would be covered. Imagine insurance companies not covering the cost of a blood draw because the results showed you aren't diabetic.
Is there a waiting list?
Likely, yes. In my area those wait times may be anywhere from 3 to 12 months. I tell parents to get on a waiting list while you're deciding if you want to do testing. There is no obligation to move forward if you decide you don't need it, but I'd hate for parents to take 6 months thinking about it only to get on a waiting list for another 6 months.
What should I do to prepare my child?
You can let your child know that you met with (professional's name) and their job is to help you and your child understand more about how their brain works. They'll do that by playing some games and activities that measure all the cool things about their brain, and there is no right or wrong answer and no grade. Let your child know that any way they answer questions is good, and it's okay if they don't know some of the answers. They can also ask questions if they don't understand the directions or if they need something repeated.
When do we get the results?
The psychologist will schedule another separate appointment (usually with just parent(s)) to go over the results. They will explain their findings including any relevant diagnoses, areas that may require more attention or follow up, strengths, areas for growth, percentiles showing how your child performed in various areas compared to peers of the same age, and recommendations of things to do at home or school to best support them.
How much emphasis should we put on the testing process or results?
It's important to remember that you know your child better than anyone, and likely know them better than any test can. If the results are concerning to you in any way, talk to the evaluator about your concerns. Yes, the tests are standardized and shown to be reliable, but we also know that standardized testing at school does not always show a child's full capabilities. There are a hundred factors that can influence test scores, including how well your child slept, if they've eaten, and if they woke up on the wrong side of the bed for no reason at all. Though testing can be helpful for lots of reasons, a single evaluation will never define a whole child.
