psychotherapist tyler ong

helping you help yourself

Psychological testing for kids: What to watch out for

on February 15, 2013

When your child is being referred for psychological testing, there are some things you –  as a parent or guardian –  need to know. For starters, what is “psychological testing”?

Psychological testing is a process of objectively identifying and rating certain psychological factors (for example, intelligence and personality) about a person. Psychological testing requires the administration of test materials/instruments, which are commonly questionnaires and answer sheets. Some psychological tests are in the form of tasks. For example, as part of an IQ test, the child may be presented with blocks and told to form the figure on a given picture. Lastly, psychological testing is part of a bigger process called Psychological Assessment. Not all assessments require the use of tests, but all types of testing fall under assessment.

PRE-ASSESSMENT PHASE

This is the first phase of all assessment and testing. Majority of mental health professionals fail to consider this most important part of the testing process. Basically, this phase asks the following questions:

1. Who is the client or the TESTEE? – this question identifies who exactly is going to take the test. This question must be asked despite its seemingly simplistic nature because each type of population has unique testing needs. For example, children cannot tolerate lengthy periods of test-taking. They easily get bored and tired. Therefore, tests that stretch beyond one to two hours would slowly lose accuracy in measuring the psychological factors needed. Some IQ tests and personality tests are extremely long, so as time passes and the child loses interest, how sure are you that the test still measures the intelligence or personality of the child? Children are also extremely sensitive to new environments.

2. Why is testing needed? – this is the referral question. The answer to this question must be extremely specific. There is no psychological test in existence that covers all psychological factors. For instance, it is NOT appropriate just to say “to know the IQ of my child”. An IQ test will give you numbers. The interpreter of the results must know why you need to know the IQ results in order to provide you with a specific explanation that is also accurate. Is the IQ for admission to a school? Is the IQ test used to check for Mental Retardation or other special needs? Is the IQ requested by a professional? An example of a specific referral question is: “to determine the presence of a suspected Reading Disorder in the child.” Thus, the administrator would know which test to use, and the interpreter of the result would know how to form the report afterwards.

3. For whom are the results intended for? – is there a professional (for example, a pediatrician) who requested the test results? Ideally, results are immediately sent to the requesting professional without passing through your hands. All psychological test results are numerical in nature. They don’t have inherent meaning until read by a trained professional who understands what that number represents. Be careful! Many claim to understand how to interpret tests but all they do is read the test manual and just copy it! A competent provider of psychological tests must have undergone specific training by the publishers of psychological tests. Many so-called mental health “professionals” here in the Philippines often misuse tests. For example, there are many self-claimed “psychologists” who use personality tests to diagnose personality disorders in their clients. This is a misuse of personality tests since personality tests were never created to be diagnostic of personality disorders. Personality tests merely provide you with a personality profile, without judgment. If a test is misused, the results are invalid. Remember to take note of who specifically is requesting the psychological testing of your child. Only mental health professionals and specially-trained physicians can understand the value and purpose of psychological tests. Also remember: psychological test results are CONFIDENTIAL. That means they must not be revealed to any non-professional. If you suspect that your child’s psychological test result has been leaked to other people not involved in the treatment of your child’s issues, you must immediately file a complaint of unethical conduct of that “professional’s” supervisor/boss/employing institution.

Notices:

The pre-assessment phase also includes informing you as the parent regarding what tests to use. The mental health professional assigned to your child’s case MUST explain what each test is for and why they chose that specific test. There are hundreds of psychological tests. It is a sign of good training if the mental health professional can specifically describe why a particular test will be used as opposed to other tests of the same type. It would also be good if you as a parent can do your own research into what tests are normally used for the types of conditions your child is being tested for.

Many psychological testing companies will try to convince you that they have a cheap “package” of tests that they commonly give to all their clients. DO NOT ACCEPT! No professional will give the same types of tests to all clients! Some of the tests in that “package” are outmoded, others are irrelevant to the referral question. You end up paying between 5 thousand to 10 thousand pesos. Do not be shy or scared in questioning the employees of test companies. If you find that they are losing their patience, that merely indicates that they are not well-trained and you would be better off finding other companies. It’s your money, and more importantly, it’s your child’s mental health at stake. You deserve professionals who have kept themselves updated and abreast of all the recent happenings in the field of psychological assessment.

When you go to a neurodevelopmental pediatrician, most often he or she will tell you to have your child psychologically tested. Many of these doctors already have a “deal” with one or two testing companies. They refer to each other. For example, a parent was told by a neurodevelopmental pediatrician to go to Company A for testing. Company A charged the parent 10 thousand pesos for tests which were irrelevant to the referral question. The referral question itself was not explicated, and the doctor did not explain the need for testing or what tests to expect (as a rule, physicians do not explain in detail or to the patient’s satisfaction regarding assessment, diagnosis, and treatment. It is your right as a patient to ask for a fuller explanation from medical professionals). After researching the tests that were proposed, she found out NONE of them were important and useful in answering the main issue. But the parent had no choice. The doctor would not accept results from any other company or professional providing psychological tests. In cases like these, I strongly recommend you go to more reputable hospitals and seek out more reputable doctors in bigger cities like Manila or even abroad. It’s not worth the savings if your child has been misdiagnosed and you realized it too late.

The rules for testing kids are: interview with parent/s, interview with the child, ONLY two tests maximum are to be given at any one time, the kids must be given breaks in between testing, kids cannot sustain a whole day of testing. Be aware also that questionnaire-answer sheet types of tests have been found to be relatively ineffective with younger kids. Also, many art-related tests such as Draw-A-Person or House-Tree-Person lack validity (does the test actually measure what it is supposed to measure?) and reliability (does the test produce consistent results over time instead of changing drastically?). Some tests are not indicated for children, but unscrupulous “professionals” continue to use them. Other tests have child-versions which are shorter and easier to understand. Ask the company if there are child versions of the tests they are proposing to give to your child or do your own research. If you don’t understand some terms or concepts, ask your mental health professionals. Most physicians are poor in psychological testing, and lack the ability to explain them properly.

ASSESSMENT PROPER

During the assessment, try to stay in the waiting room while your child is taking the test. The child would be nervous and need reassurance you are there waiting. You will not be allowed to peek at your child. The room where your child will be taking the test must be clean and organized, without toys lying around as distractions. If there is a one-way mirror in the room, make sure to ask what it is for. As a rule, one-way mirrors can only be used to train future professionals in how to perform procedures. They are not to be used for parents looking in and checking up on their children, nor are they to be used for curiosity. Be prepared with water and other snacks for your child after the testing. Most importantly, do not forget to ask when you can obtain the psychometric report. The psychometric report is the output of the testing process. It is a formal report addressed to the one who requested for the psychological testing (see Pre-assessment phase questions). If a professional has requested it, you may request your own copy but don’t be surprised if the language is something you can’t understand. You may ask your mental health professional to explain the report to you if you don’t understand it. A psychometric report is usually accomplished after 3 to 5 days depending on the complexity of the tests provided. Some tests have very complicated scoring systems. If you do not get the report after a week, it’s time to be suspicious. Is the interpreter and report-maker (usually a guidance counselor or a psychometrician) too busy with too much caseload? If that is the case, how sure are you that your report will be accurately and carefully written, and not just haphazardly done? It is part of the training of mental health professionals to estimate the number of reports they can provide without affecting the quality of their outputs. Ask around regarding the reputation of the outputs from testing companies.

There have been recent revivals of the belief that children are best tested in familiar environments. Some fluctuations in test scores have been seen when children were tested in familiar versus controlled (such as those found in sound-proofed rooms in testing companies) environments. This is something best discussed with the professional providing the test and your treating therapist.

POST-ASSESSMENT PHASE

After the assessment, you should be given a formal report called the psychometric or psychological report. The following must be found in the report:

– demongraphic information of the testee (name, birthdate, age, etc.)

– assessment logistics (time and date of test-taking, were there breaks and for how long, how long it took testee to finish each test, place of testing, any unique environmental factors such as the airconditioner breaking down in the middle of the second test)

– test information (the referral question, and around two to three sentences describing the tests provided and how they answered the referral question, the professional who requested the test)

– observational data (behaviors, verbal statements, and overall psychological state of the testee during the entire process of testing. For example, the testee kept on sighing after five minutes into every test provided, consistently distracted and looked around the room for awhile before continuing, kept on swinging legs and humming a tune, verbalized being hungry often)

– test results (numerical data/results of each test taken. In here, the interview findings must be included)

– interpretation (what the numerical results mean, and there must be specific application to the referral question at hand. There must be separate interpretations for each test given)

– summary/conclusion (must directly answer the referral question, and must integrate all the interpretations of the tests provided including the observational data gleaned during the assessment proper)

– recommendations (based on the test result, what are the next steps? If results are unclear or inconsistent, recommendations may point to re-testing after a couple of months or re-testing in a more advanced facility/company. There may be recommendations to seek mental health help. Recommendations must be specific. A bad example is: “check-up and monitoring by Dr. So-and-so, Neurodevelopmental Pediatrician”. Lastly, taking psychological tests CANNOT provide you with a diagnosis. A psychological test may provide benchmarks for the need to diagnose and what diagnosis may be relevant. Unless the mental health professional performing the assessment or test is also the treating therapist for your child, no diagnosis can definitively be given).

You may keep a copy for yourself but be sure that you understand this is confidential information. Your mental health professional/therapist will always be happy to assist you in answering whatever questions you have regarding testing for your child. If you have need of psychological testing, please go to the page entitled “Miscellaneous Resources for Self-Help” on the upper right-hand corner of my website and find the entry on psychological testing. (Note: I do not provide psychological testing services)

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