ADD: The Psychological Evaluation
A psychological evaluation should be undertaken by a doctoral level, licensed psychologist, who is either a clinical psychologist or a school psychologist. The psychologist will administer an individual intelligence test, most often referred to as an I.Q. An individually administered test is very different from standardized, group-administered tests. The group-administered tests usually require that children write their responses on an answer sheet. An individually administered test is given to one child, and most questions require verbal responses or ask that the child do something; there is little or no writing or reading. There are a number of intelligence tests available to the psychologist, and a good psychologist selects the most appropriate test based upon the needs of the student. For example, if a child has speech and language problems, a test would be selected that does not require the child to talk. If English is not the child's native language, another type of test may be selected. Generally, however, the two most popular individually administered intelligence tests are the Stanford-Binet Intelligence Scale and the Wechsler Scales.
The Stanford-Binet Intelligence Scale, for use with ages two through adulthood, provides a mental age that can be converted to an Intelligence Quotient (I.Q.) score. Although it presents items that require either verbal or nonverbal performance, it tends to have many more verbal items; thus, the Wechsler Scales tend to be used more often.
- The Wechsler Pre-School and Primary Scale of Intelligence (WPPSI). This is used with children who are 4 to 6-1/2 years old. This test measures a child's verbal skills, nonverbal reasoning abilities, and perceptual motor skills.
- The Wechsler Intelligence Scales for Children-III (WISC-III). This is used for students ages 6 through 16. You may notice that some psychologists use the Wechsler Intelligence Scales for Children-Revised (WISC-R). However, the most recent test (WISC-III) has parts that are helpful in the diagnosis of ADD. Also, the standardized procedures are more up-to-date. It measures verbal and nonverbal performance skills (five parts for each).
- The Wechsler Adult Intelligence Scales (WAIS). If you are the parent of an adolescent, this test would be used because it applies to people from 16 years through adulthood. This test also measures verbal and nonverbal performance abilities.
If your child is school-age, the WISC III will probably be the test she is given. For many parents, the concept of I.Q. is mysterious. To give you a sense of what these tests measure, we will discuss the WISC III because it is used so often. It is divided into ten parts: five verbal and five performance. When evaluating the results of this test, the psychologist is looking for overall potential to learn. The WISC III will yield three scores: Verbal I.Q., Performance I.Q., and Full-Scale I.Q. The average I.Q. score will fall between 90 and 110. But the score is not enough. You need to look at individual sub-test scores and think about how ADD might interfere with how well a child does. A child who is hyperactive will find it difficult to stay seated throughout the entire test (approximately one hour). Impulsive children may yell out the first thing on their mind and feel pressured to respond rapidly. And a child who is distracted may be too interested in the blocks or the puzzle parts or the questions to think about the right answer. Add to this the fact that most of the Performance Scales are timed, which can really throw some children with ADD. Only in consultation with other members of the team can the results make sense.
The Verbal Scale of the WISC III includes the following areas:
Information. This measures how much general information a child has learned from home and school.
Comprehension. This measures how well your child can think abstractly and understand concepts.
Similarities. This also measures a child's ability to think abstractly. Children are asked to tell how things are alike or different.
Arithmetic. This is not a paper-and-pencil arithmetic task. Rather, it measures mathematical reasoning skills. It does this by giving children problems to solve.
Vocabulary. Children are required to tell what a word means. A dictionary definition is not necessary; they can explain it.
Digit Span. This measures a child's ability to remember a sequence of numbers (forward and backward). This test is optional; it does not have to be given.
The Performance Scale of the WISC III includes the following areas:
Picture Completion. Children have to look at pictures and tell the examiner what part is missing.
Picture Arrangement. This requires a child to put pictures in order so that the story makes sense. It measures a child's ability to provide the whole when only parts are given.
Block Design. Unlike Picture Arrangement, where children are given parts and make up the whole, this test measures a child's ability to look at the whole first, then break it into parts, then reconstruct the whole. It provides blocks and pictures, and the child must put the blocks together to make the picture of the blocks.
Object Assembly. The child is given puzzle parts and must complete the puzzle. It measures a child's ability to make a whole out of its parts.
Coding. This section measures a child's ability to decipher a code and copy the correct symbols in a specific period of time.
Mazes. The child has to find the way out of a maze by using a pencil. Performance is also based on time.
In addition to measuring intelligence, the psychologist will look at behavioral and social-emotional functioning. She may use specific tests, interviewing techniques, and/or rating scales. This enables her to rule out other psychological or psychiatric disorders that may be present, either with or without the attention deficit.
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From Keys to Parenting a Child with Attention Deficit Disorders by Barry E. McNamara, Ed.D. & Francine J. McNamara, M.S.W., C.S.W. Copyright © 2000 by Barron's Educational Series, Inc. All rights reserved. Used by arrangement with Barrons Educational Series, Inc.
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