What Are We Testing? Making Child and Adolescent Evaluations Effective Federation for Children with Special Needs November 2017

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Neil Goodwin
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1 What Are We Testing? Making Child and Adolescent Evaluations Effective Federation for Children with Special Needs November 2017 Joseph Moldover, Psy.D., ABPP/cn Trauma and Learning Policy Initiative Mass Advocates for Children and Harvard Law School massadvocates.org/tlpi traumasensitiveschools.org 1

2 What do we know about trauma and the brain? Simple versus Complex trauma Simple trauma A discrete shocking, overwhelming event within the context of otherwise normal development leading to post-traumatic symptoms such as avoidance, hypervigilance, and intrusive re-experiencing Complex trauma Ongoing trauma forcing a fundamental adaptation in terms of defense mechanism and personality Particularly toxic in the case of children who cannot experience a sense of security and consistency with caregivers Interpersonal victimization in the home is the most common type of trauma among children Post-Traumatic Stress Disorder Hypervigilance/Hyperarousal Constant monitoring and preparing for threat Re-experiencing Nightmares Repetitive thoughts Flashbacks Avoidance Cognitive Behavioral Emotional (numbing) 2

3 Complex Trauma Children who experience complex trauma may experience severe problems with psychological functioning yet not meet criteria for PTSD. Psychiatrist Bessel van der Kolk calls this Developmental Trauma Disorder Chronic stress and trauma may lead to fundamental changes in the structure of the brain. One brain structure which may be particularly sensitive to overexposure to stress hormones is the hippocampus, which is critical for new learning. Possible Manifestations of Complex Childhood Trauma Language Disorder Expressive and receptive Particular deficits in narrative comprehension and construction Vulnerability to social and emotional misinterpretation Deficits in attention and self-regulation Trauma disorder and ADHD may co-exist, but the ADHD symptoms may mask the trauma reaction Dissociation may resemble simple inattention 3

Possible Manifestations of Complex Childhood Trauma Deficits in executive functioning Lack of planning associated with a foreshortened view of the future Challenging/oppositional behavior Social

4 Possible Manifestations of Complex Childhood Trauma Deficits in executive functioning Lack of planning associated with a foreshortened view of the future Challenging/oppositional behavior Social misinterpretation Need for control as a defense against anxiety Identification with the aggressor as a defense mechanism What do these all have in common? Language Attention Executive functioning Emotional self-regulation Social competence 4

5 How is testing supposed to work? Components of an Evaluation Language Clinical Evaluation of Language Fundamentals Comprehensive Test of Phonological Processing Visual-Spatial Skills Rey Osterreith Complex Figure Test Fine Motor Skills Pegboard tests Test of Visual-Motor Integration Learning and Memory Children s Memory Scales Wide Range Assessment of Memory and Learning Attention and Executive Functioning Dellis-Kaplan Executive Functioning System Test of Variables of Attention Social Cognition Theory of Mind Tests 5

6 IQ Testing What it is, what it isn t Types of IQ Tests Wechsler Scales (WPPSI, WISC, WAIS) Stanford-Binet Differential Ability Scales Leiter International Performance Scales Is a Full Scale IQ score valid? The Flynn Effect and editions of IQ tests Academic Testing Reading, writing, written expression Variables to consider: Timed vs untimed Open-ended versus closed format Creative versus expository writing Incorporation of writing mechanics Language demands embedded in math testing 6

Emotional and Personality Testing Objective tests of personality and psychopathology Personality Assessment Inventory (PAI) Minnesota Multiphasic Personality Inventory (MMPI) Projective Testing

7 Emotional and Personality Testing Objective tests of personality and psychopathology Personality Assessment Inventory (PAI) Minnesota Multiphasic Personality Inventory (MMPI) Projective Testing Rorschach Inkblot Test Thematic Apperception Test Projective Drawing and Sentence Completion Assessments of normal personality functioning Five Factor Personality Scales How can anything possibly go wrong? Test selection deciding what tools to use Test administration obtaining the data Test scoring data management Score interpretation pulling out the patterns Communication of Interpretation 7

8 A few things to think about before you begin Define your question IS there a problem? WHAT is the problem? What do we DO about the problem? Is the problem GETTING BETTER? Know your evaluator Do they have experience in the area you are looking at? How long does it take to get the report? Do they offer long-term management? Do they come out of the office? QUESTIONS??? 8

Chapter Three BRIDGE TO THE PSYCHOPATHOLOGIES

Chapter Three BRIDGE TO THE PSYCHOPATHOLOGIES Developmental Psychopathology: From Infancy through Adolescence, 5 th edition By Charles Wenar and Patricia Kerig When do behaviors or issues become pathologies?