CAAP 613: Assessment in Counselling -...

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Community Education Service

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Anatomy of a Psychoeducational

Assessment Report

Dr. Brent Macdonald, R. Psych.

Alberta Health Services

Community Education Services

Workshop, September 2017

11:00-12:30

Dr. Brent Macdonald complexlearners.com

No Smart Phones! In what way are space and time alike?

Who was the first Prime Minister of Canada in it’s current configuration (10 provinces, 3 territories)?

Name ALL seven of the Dwarfs.

No peeking - What was the exact title and information on the title slide (in proper colours and in order)

What does otiose mean? What does bloviate mean?

You have 30 seconds – write down the lyrics to the “Fresh Prince” theme song (OR “O Canada,” whichever)


Overview Assessment Primer (who gets referred for assessment

and why – what are we hoping to learn?)

Assessment Process (what the kids go through in a

typical assessment)

Assessment Reports (reading to understand)

Interventions/ Practical Applications


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Key Points Everyone is always being assessed!

“Assessment” is not synonymous with “testing”

Assessment is informed by – and informs – teaching and parenting practices

The is no magic bullet

Assessment – for our purposes – generally incorporates cognitive abilities, academic achievement, and social-emotional/ behavioural functioning

Assessment is a collaborative process

Our belief is that assessment should be strength-based!


Purpose of Psychoeducational

Assessment

Identify strengths

Identify areas of specific challenge

Develop norm/ criterion-referenced basis for better

understanding specificity of psychological processes

Psychological processes can include cognitive, academic,

social-emotional behavioural functioning, among others

Diagnosis (if warranted)

Interventions/ Recommendations/ Strategies


What to Expect: Parents Intake Interview (participants?)

What brings you in?

How can we help?

Current functioning

Developmental/ familial/ medical/ educational history

Questionnaires

Self-reports (standardized)

Clinician-developed measures

Timing of sessions

Timing of sessions (all at once v. spread out)

Feedback Interview


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Background Information Current Life Situation

Relationship status

Living arrangements

Developmental history Pregnancy, delivery, and developmental milestones

Childhood trauma

Other significant childhood/developmental issues

Educational/Occupational background Highest education

School functioning - academic, social, behaviour

Employment history (as necessary)


Background Information

Family Background Parents, siblings

Medical & Psychiatric History Physical problems

Psychiatric history

Medications

Hospitalizations

Other Relevant Background Additional information relevant to the assessment

Legal issues, avocational pursuits, interpersonal issues


Referral Question Who referred

Why

Be as specific as possible


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Responding to a Referral Question

Prior to the assessment, the clinician should formulate

a hypothesis/ referral question (i.e. What is the

presenting concern of the client and how will the

assessment process be beneficial in helping the client

in dealing with the possible/ presenting issue?)

The goal of assessment should be guided by the

question


Observations (note relative

relevance of each section) Arrival - on time,

accompanied?

How Dressed

Personal Hygiene

Motivation

Approach to Tasks

Problems with vision or hearing

Rapport

Unusual Behaviours

Motor Coordination

Affect


What to Expect:

Children/ Youth Active role in the process

Participation in intake and feedback meetings

Testing – standardized, duration, breaks, anxiety, etc.

What do YOU want to get from the process?


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Questions to Ask Before the Assessment

Qualifications and background

Goals

Cost/ insurance

“Product”


Questions to Ask During the Assessment

How is my child doing (in general)

What should I bring in?

Working hypothesis?


Questions to Ask After the Assessment

Ask for a clear understanding of assessment results

When you don’t understand, let the psychologist know

(avoiding the whole “head-nod” thing)

Ask for paper/ pencil to jot down questions and ideas as

they come up

Profile of strengths and areas of need

Deliverables (report, school meeting, follow-up with child

if necessary)

Follow-up – is the assessment over once you receive the

report?


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Types of Feedback Ongoing/ Formative

Individual/ Family

Case Conference

Summative

Oral

Written


Feedback Guidelines Focus, where possible, on the

positive

Strength-based assessment

should incorporate strength-

based interventions/ strategies

Check in with the psychologist

Good assessments lead to

interventions based on data/

observations/ background/

correlation with research/ best

practices

Use good judgement in planning

interventions

Develop a follow-up plan/ evaluation

of interventions

Avoid labelling (which is different

from “diagnosing”)

For psychologists, evaluate the

developmental appropriateness of

sharing results and feedback


Four Pillars of Assessment

Norm-referenced measures

Interviews

Behavioral observations

Informal assessment procedures


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An inverse normal curve…


Factors of a Multimethod

Assessment Referral information

Demographic and

background information

Assessment findings

Standardized

Informal

Pattern analysis

Positive interpretation

(comparing subtest/ index

scores to subtest/ index

scores)

Interventions attempted

(successes/ challenges)

Diagnosis

Recommendations

Accommodations

Strategies


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Measures Used Cognitive (intellectual)

WISC-V, WAIS-IV, SB-5, WJ-IV Cog, etc.

Academic Achievement

WIAT-3, WJ-IV Ach, KTEA-4, etc.

Social-emotional/ behavioural

BASC, CBRS, numerous others

Adaptive Functioning

ABAS, Vineland, etc.

Executive Functioning

CEFI, BRIEF, etc.


Sources of Variability Degree of rapport established

Quality of interaction between the examiner and the student

Number and kinds of tests administered

Length of the assessment process

Number of follow up questions asked

Number of trials needed to administer items

Number of breaks taken


Testing-of-Limits Procedures

Proving additional cues or aids

Changing stimulus modality

Eliminating time limits


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The Written Report Demographic Information

Reason for Referral

Tests/ Methods Used

Background Information

Developmental

Family

Medical

Academic

Employment

Test Session Observations

Test Results

Summary

Diagnosis (if relevant)

Recommendations

Appendices of Score Tables


The Written Report Should be succinct

Question jargon

Understand that the written report may have multiple audiences (client, other practitioners, employers, administrators, teachers, physicians, etc.)

The written report typically becomes the client’s property and may be shared with a wide range of individuals

Reports are generally kept on file for a minimum of 7 years (jurisdictions vary – psychologists keep records for 10 years or 2 years after the client turns 18, whichever is longer)


The Written Report Person Centered

Model of assess -> understand -> intervene

Describes how strengths and weaknesses manifest in real life

Test data is only meaningful if they contribute to the understanding of the person

Person-specific recommendations

Must effectively communicate an understanding of the client that addresses the referral issues


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Statement of Confidentiality

All psychological assessments are confidential in

nature as they contain private information, which may

be used inappropriately by others. To protect the

privacy and ensure the confidentiality of the persons

involved, please ensure that this report is only

circulated to those who are considered essential to

related judgments and decision-making. The intent of

this report is to provide opinions and recommendations

in a particular context, and any use of this report

outside that purpose should only be done with the

informed consent of the parties concerned and in

consultation with the writer.

U-CAPES (2007, p. 1)Dr. Brent Macdonald complexlearners.com

Summary Major points under previous sections that are most

salient to the referral question

No new information should be presented in the

summary

Diagnosis and Prognosis


Recommendations For complex assessment, many recommendations are

often grouped under areas of concern

Priorities (not all recommendations will be followed)

Immediate needs

Viable options for addressing needs

Integrate how strengths may contribute to positive

outcomes

Total number of recommendations?


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“Diagnosing” 2e: The ABCs GAI, FSIQ, and other acronyms of note…

Age/ Grade of diagnosis

Validity (WPPSI-IV; WISC-V; SB5; WJ-IV Cog)

DSM-5 and LD – intellectual measure not strictly necessary; what does this mean for Gifted LD?

Evolution from IQ/ Ability Discrepancy to RtI

RtI (historically deficit-based) not proven to be effective in identifying gifted individuals –need to focus on strengths as opposed to deficits

LD as 2e in itself (i.e. varying profiles)

Because the numbers are smaller, there is a need to focus on individual differences more so than in the typical population (true at both ends of the curve)


Accommodation/ Adapting/

Enabling Accommodation are largely environmental in nature and

simply allow the student to perform absent the preventative factors of their disability; enhances self-control

Enabling is the active interference of allowing a student to do what they, under most circumstances, would be capable of doing; reduces self-control

Difference lies in the ability to perform- a lifejacket it essential to someone who can’t swim; it inhibits the ability to learn to swim; if the individual is capable of learning to swim, a lifejacket may be beneficial in the short term, but inhibits performance if used too long


Community Education Service

For more information or to register for an upcoming education session, visit our website:

http://community.hmhc.ca/

Evaluation forms and Telehealth/Audioline Sign-In sheets can be sent to:

[email protected] or Fax: 403-955-8184 or

Interoffice Mail: CES, RRDTC

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