Psychoeducational Evaluations – Assessment of ADHD/Learning Differences
When I work with a child, adolescent or adult, I conduct a thorough evaluation that will be accepted by all institutions says (educational, professional, and testing institutions). After an initial intake interview, I spend approximately eight hours of face-to-face time with individuals. I then spend about that much time, or more, scoring tests, interpreting test data, making collateral contacts, and writing up a very detailed report. Whether or not an individual meets the criteria for a learning difference or ADHD as outlined by the American with Disabilities Act, I prepare several pages of recommendations regarding how each individual may utilize their strengths to compensate for their weaknesses.
The intake/clinical interview typically lasts for 75 to 80 minutes. We will also schedule 8 hours of testing broken down into at least two 4-hour testing sessions. Shorter sessions are recommended for individuals who have difficulty maintaining attention and motivation over longer periods of time. Once all of the testing is complete and information is obtained from collateral contacts, I typically have about a three-week turn around time for the report. A draft version of the report is provided at the feedback session.
There is a wide range of areas that can be assessed and different providers in the Bay Area produce varied types of assessments in terms of how thorough the assessment is (adding in neuropsychological testing and screening of emotional functioning as I do), detail of report writing, connecting with teachers, tutors and other providers, and detail of recommendations made. Cost is also based on experience of examiners and demand. Some individuals do not require a complex or thorough evaluation, in which case a more basic screen/evaluation is sufficient.
I am able to provide you with an invoice at the conclusion of the testing with the appropriate CPT codes and diagnostic codes so that you may submit this to your insurance company. Payment is made directly to me at the onset of the assessment and it is the individual’s responsibility to submit the invoice for reimbursement. Half of the fee is due upon scheduling as a retainer and the other half is due at the final testing session. Additional hours and fees will be added to supplement the standard psycho-educational evaluation with assessment of emotional functioning as warranted.
If you are seeking reimbursement from you insurance company for the assessment, you will want to contact your insurance company and inquire about the reimbursement rate for out of network providers. CPT billing codes may be provided upon request.
About Psychoeducational Assessment
Learning disabilities and ADHD are neurobiological disorders that affect one's ability to read, write, speak, or compute math. These disorders can also impair social skills and contribute to emotional struggles. Learning differences and attention problems can be lifelong conditions that, in some cases, affect many parts of a person's life: early development, school, work, daily routines, family life, and sometimes even friendships and play. In some people, children or adults, many overlapping learning differences may be apparent. Other people may have a single, isolated learning problem that has little impact on other areas of their lives.
There are three basic types of learning disabilities:
Reading Disorders affect accuracy, speed or comprehension of reading material. In order for a reading disorder to be diagnosed, an individual's reading achievement (as measured by individually administered standardized tests) must be substantially below what would be expected given the individual's age, intelligence, and education.
Mathematics Disorders often affect academic achievement and daily functioning involving tasks that require mathematical abilities. People with this type of disorder may have difficulty recognizing or reading numbers, copying numbers correctly or counting objects. Similar to reading disorders, a mathematics disorder can only be diagnosed if an individual's mathematical abilities are significantly below what would be expected given the individual's age, intelligence, and education.
Written Expression Disorders
Written Expression Disorders interfere with academic achievement and with daily activities that require writing skills. Individuals with this disorder may have extremely poor handwriting, excessive spelling errors, and/or poor grammar and punctuation. Like other types of learning disabilities, these difficulties must be beyond what would be expected given other factors in a person's life. The disorder is not due to a simple lack of education but to the brain's impaired ability to process certain kinds of information.
For either the child or the adult, intervention as early as possible is extremely important when a learning disability is suspected. Appropriate interventions help to avoid a lifetime of difficulties that may include low self-esteem as well as academic and social problems. Early intervention in the case of a child can significantly enhance the child's school experience. Proper assessment can provide adequate clarification of a student’s strengths and weaknesses.
Below are some common characteristics of individuals at risk of having a learning differences or ADHD:
- Poor coordination and depth-perception
- Short attention-span
- Perseveration (doing the same thing over in the same way)
- Delayed speech
- Developmental delays
- Limited vocabulary/ poor verbal expression/ Inappropriate use of words
- Difficulty remembering what is heard
- Very low or very high pain-threshold
- Overreaction to noise
- Difficulty following or understanding simple directions
- Problems with organization
- Becoming easily overwhelmed
- Becoming easily bored
- Inconsistent performance or behaviors
- Difficulty adequately expressing knowledge on quizzes, test, or on other assignments
Psycho-educational assessment can determine whether a child or an adult has a learning disability, ADHD, a processing deficit, a developmental disorder of scholastic skills, a social (pragmatic) communication disorder, a language development disorder and rule out possibilities of other factors that may be negatively impacting academic performance. In conjunction with assessment, specific recommendations can be made to assist the individual in overcoming the challenges presented by his or her specific learning differences.
A psychoeducational evaluation may be warranted when a student or adult experiences academic or professional difficulties after various interventions have been attempted (e.g., parent/teacher conferences, tutoring, coaching, implementation of accommodations, behavior modification, etc.) Another situation that would precipitate a referral would be when individuals, parents and/or teachers observe major discrepancies in academic performance (e.g., from day to day or between subject areas). A more thorough evaluation is also sometimes sought following an evaluation performed by the school, which may not be thorough enough to clarify the relevant issues.
A psycho-educational evaluation includes obtaining a thorough clinical history, behavioral observations, review of relevant records, collaboration with loved ones, educators and/or other providers, and testing in the following areas:
- Overall Cognitive Abilities
- Visual-spatial functions
- Sensory-perceptual functions
- Academic skills
- Planning and organization
- Attention and Concentration
- Working Memory
- Processing speed/efficiency
- Auditory Processing
- Expressive abilities
- Problem solving and conceptualization
- Language functions
- Motor functioning
- Memory and learning
- Emotions, behavior, and personality
- Executive Functioning
- Verbal Fluency
What can be gained from having a psychoeducational evaluation?
The product or outcome of an evaluation provides information about the individual’s functioning including strengths and weaknesses. It includes specific recommendations to guide treatment and to enhance the individual’s functioning. There are several ways that test results are used including:
- The test results can be used to confirm or clarify a diagnosis
- Provide a profile of strengths or weaknesses to guide rehabilitation, educational, vocational, or other services
- Document changes in functioning since prior examinations, including effects of treatment
- Result in referrals to other specialists, such as educational therapists, neurologists, psychiatrists, vocational counselors, speech and language therapists, special education teachers, or counseling therapists
- Provide academic interventions and accommodations
- Provide guidelines for various types of other therapies and/or tutoring
- Contribute to a Student’s SST, IEP or 504 plan – I often attend these meetings as needed
- Recommendations for classroom, workplace, and other environmental supports and accommodations
- List suggested strategies to enhance learning and performance in school and at work
Regardless of whether or not an individual meets the criteria for a diagnosis, I always provide numerous recommendations regarding interventions and strategies in order to improve one’s daily functioning.