PSYCHOLOGICAL TESTS DEVELOPED FOR CHILDREN

PSYCHOLOGICAL TESTS DEVELOPED FOR CHILDREN The test instruments developed for children are the products of psychological research during the past 100 years. The specific procedures and tests that can be used to develop a meaningful description of the child in all significant domains vary according to many factors, including the following: (1) The child’s age (2) The child’s cultural background (3) The quality and appropriateness of available test and procedures (4) The child’s level of expressive and receptive language (5) The child’s capacity to participate in an examination (6) The availability of the child, and the cooperativeness of the parental environment Choosing the appropriate test to include in a complete psychological evaluation of a child requires a high level of professional skill. Although certain standardized tests are so useful that they maybe given during almost every evaluation, the properly trained and experienced psychological clinician must always be prepared to vary the choice of tests for a child’s evaluation in response to his/her situational requirements. Thus although Stanford-Binet or Wechsler Intelligence Scale for Children – Revised may be almost universally chosen to evaluate an 8-year-old’s intellectual function, should the child be a product of a bilingual environment, a test such as the Peabody Picture Vocabulary Test- Revised (Dunn & Dunn, 1981) or the Non verbal test of Cognitive Skills (Johnson & Boyd, 1981) may be substituted or given in addition to the more frequently chosen instruments. When evaluating children on their psychological faculties, in general, the completed psychological test battery should include instruments that cover the following areas: (a) The child’s intellectual capacity and learning styles (b) The child’s neuropsychological development and status (c) The child’s achievement level in all significant areas of academic activity (d) The child’s personality and character The child’s intellectual capacity and learning styles INTELLIGENCE TESTS A number of major instruments can be used for testing children between birth and 18 years. The most frequently used instrument is the Wechsler Intelligence Scale for Children-Revised (WISC-R). For children younger than six and half years, the Wechsler Preschool and Primary Scale of Intelligence have long been available. The recent revised edition (Wechsler, 1989) appears to have to have addressed problems with the parent instrument, and has become the instrument of choice in the recent times for children from age 3 to age 7. Other scales, which might be utilized for evaluating the intellect of very young children, include the Stanford-Benet and Bayley Scale for Infant Development (Bayley, 1969). It should be clearly understood that the purpose of intelligence testing is not to develop an intelligent quotient (IQ). Although the IQ has been a traditional way of describing children’s intellect, this oversimplification of the cognitive responses of children has fallen into professional and scientific disrepute (American Psychological Association, 1985). Clinicians today are interested in child’s ranking in respect to cohorts. Neuropsychological Test for Children The basic aim of the neuropsychological tests of children is to reproduce a reliable and valid demonstration of the relationship between the brain and the behavior. When there’s reason to believe that the child has some disruption of the normal fluctuation of the development in the functional system of the brain, a full neuropsychological assessment is recommended by the clinicians. The purpose of such an assessment is to develop a treatment orientation to help the child develop in the most complete way possible. The neuropsychological assessment is essentially a screening evaluation. The purpose of the screening evaluation is to determine whether further assessment is necessary. Because of the period of cognitive development in children is lengthy and is not completed until something during adolescence, the issue is not whether neuropsychological deficit exists, but rather whether there is reduced rate of cognitive development or constant degree of deficit during the developmental period. Should the screening assessment indicate some deficit, which is later confirmed by full neuropsychological battery, a series of neuropsychological assessment over a period of time every 06-months, is necessary to determine whether such deficit is constant and whether intervening measures have been effective. Serial examinations are vital for tracking the nature of a deficit and its impact on the child. When a history of brain trauma or severe disease is found, a full neuropsychological battery is necessary. However, younger the child more difficult it is to evaluate the neuropsychological status, either through screening device or full batteries. Major neuropsychological test instruments develop stable, normative data beginning at approximately age 08. Screening before this age tends to be questionable validity and reliability. The first level of screening for neuropsychological deficits takes place during the history taking. Information from the parents, the school, or other sources that indicate that the child has problems in communication, motor behavior, cognition, memory, vision and learning serves as clues that a neuropsychological test may exist. If such information has been revealed, the screening battery is the first step in determining whether neuropsychological deficit exists. The actual screening tests for young children may consist of nothing more than the intelligence tests. Observations of the child’s motility, language, and drawing behavior in addition to the clinical interview maybe sufficient to determine whether full scale neuropsychological evaluation is necessary. For older children, such instruments as the Florida Kindergarten Screening Battery (Satz & Fletcher, 1980) or the children’s screening tests for the Luria-Nebraska Neuropsychological Battery can be used. Examples for Neuropsychological Tests THE LURIA-NEBRASKA NEUROPSYCHOLOGICAL BATTERY: CHILDREN’S SCREENING FORM The Luria-Nebraska Neuropsychological Battery: Children’s Screening From was devised by Golden (1987) who selected 15 items from Luria-Nebraska Neuropsychological Battery: Form II and the Luria-Nebraska Neuropsychological Battery Children’s revision (Golden, 1987). The tasks include number reading, paragraph reading, word reading, writing, number writing, sounding of letters, counting aloud, correctly identifying the direction of arm touches, and other tasks are utilized. Items are scores from 0 to 2, with the poorest performance receiving the highest score. Thus a youngster may receive a score ranging from 0 to 45 on this test. The cutoff point recommended for children under the age of 12 would be 3 or less, which would predict a “normal” profile should the child be given the complete Luria-Nebraska Neuropsychological Battery. For older children and adults, a cutoff score of 7 (or below) predict a “normal” profile on the complete Luria-Nebraska Neuropsychological Battery. No effort is made to identify location or degree of impairment, although the implication is that the higher the score, the greater the impairment. THE TORQUE TEST The Torque test has been available for about two decades, and over 30 individual research studies have been done using the instrument. It is essentially a test lateral dominance. Blau developed this test in 1974. It can be given to children as well as adults. Youngsters 3 years of age and older can do most of the test. The Torque test is a simple exercise that requires each child to do three tasks (a) Copy a simple design (b) Write hi or her name (c) Draw a circle around three X’s given in the response sheet. Each task is to be performed by the child first with preferred hand and then with the nondominant hand. ACHIEVEMENT TESTS The task of education actually begins before the grade 1 for those children who enter kindergarten and prekindergarten. Children who are not keeping up academically are often referred for psychological evaluation. Assessment of both academic achievement and preparation for academic achievement are useful measurements in the complete psychological examination. Except in the most unusual situations, every child who is examined, regardless of the reason for referral, should be evaluated as to preparation for academic work, levels of achievement in fundamentals, and in particular reading skills. The choice of academic achievement instruments depends on the child’s age, grade, placement, and history and the currency of the instruments available at the time the choice is made. For children who are not in a school setting and who are too young for preschool reading and arithmetic readiness, instruments are available to evaluate developmental achievement. Such instruments include the Birth to Three Developmental Scale (Bangs and Dodson, 1979), the Minnesota Infant Developmental Inventory (Ireton & Thwing, 1980), and the classic a traditional Vinland Adaptive Behavior Scales (Sparrow, Balla, & Cicchetti, 1985). The more recently developed Child Behavior Checklist (Achenbach, 1985) provides rating scales for a full range of ages and normative data on children from infancy through adolescence and from normal development through serious pathology. These instruments are extremely valuable, but must be applied with caution. PERSONALITY TESTS Objective tests and projective tests are available that can be helpful in demonstrating a wide range of the child’s over affective responses social-interact ional capabilities, and interpersonal and intrapersonal potentials. These measurements of widely varying reliability and validity can provide rich and helpful insight into child. Examples for personality tests of children are House-Tree-Person Test (Buck), Child Behavior Checklist (Achenbach & Edelbrock, 1983), and Children’s Apperception Test (CAT). SCHDULING THE ASSESSMENT The clinician must estimate the amount of time necessary to complete the assessment by calculating how much time is necessary for each procedure, which he plans to administer on the concerned child. The total number of hours should be divided into components that are appropriate for the child’s age. Children from 2to 3 years should not be tested for more than an hour at a time. Children between 4and 6 can tolerate about 2 hours in the test room. Children older than 6 seem to do well with a 3-hr test sequence, assuming that they have opportunities to move about and break from the test situation. This scheduling of time must be flexible. Some children who suffer attention deficit disorders may have to be tested in 30-minute sequences. Again this is a matter of individual judgment, which must remain flexible throughout the assessment. Before the initiation of the evaluation process, it is the duty of the psychologist to structure the parents for the process. The idea is to make an effort to involve them in the process. The psychologist should say something similar to the following: “I want to schedule some appointments to conduct various tests and examinations with your youngster. I am estimating that it would take X hours to complete the assessment. I would like to split this into three separate sessions of X hours each During that time I will be talking to your youngster, having your child do a number of psychological tests, and observing those things that are important to understand about your child in order to help you and your child”. I would also like to schedule an interpretation time. This is a 2-hr block of time in which I will tell you what we have done, what I believe it means, and what I recommend for you to do with your child. I will at the same time explain all the tests that we have given, what they mean, and how they will help you and your child. I would also like to schedule an appointment time for you about 2-weeks after the first interpretation session. During the first interpretation session I will be giving you so much information that it will be difficult for you to absorb all of it ask questions. To help you with this, I’m going to make a cassette tape of all we talk about at that time. You can take this with you, play it as often as you like, develop questions that you might want to ask me, and identify things that are not totally clear to you. In the second session interpretation session we can answer your questions and help you to implement those recommendations that you believe you can carry out. Between now and the time we give you the interpretation, you may have questions. Please feel free to contact me I will do my best to answer your queries. The purpose of this structuring is to let the parent know what would take place and that it would come together in a meaningful interpretation in the end. It is also important at this juncture to suggest ways in which the parents structure the child for the evaluation. To some extent this depends on the age of the child as well as the child’s condition as estimated by the psychologist from the information already received.