In general, the more information we have about a child, the better we can understand and do our job in treating and improving their overall functioning.
Every child who comes to Dakota Boys and Girls Ranch goes through psychological testing to help our medication providers and therapists develop treatment plans specific to each child’s unique traits, strengths, weaknesses, and needs.
What are Psychological Tests?
“Test” is kind of a misnomer, as they are not the type of tests typically administered in academic settings. Psychology testing consists of a diagnostic assessment interview with the psychologist, one-to-one interaction with a psychometrist and/or psychologist, and observation forms and/or questionnaires. The tests are ordered by the psychologist after they have completed the initial diagnostic assessment interview.
When I explain psychological testing to parents, I explain how the tests are a way of taking an in-depth look at their child, such as cognitive ability, executive functioning, mood, perceptions, behavior, and attitudes.
We are thoughtful and intentional in the tests we order because it is important to take a comprehensive approach in order to arrive at the primary diagnosis(es). Identifying the primary problem(s), which is more difficult than you’d think because mental health disorders have many overlapping symptoms, is vital for the child to make significant and long-term progress in treatment.
For example, a therapist might be treating a child for anxiety before understanding the anxiety is a secondary symptom of ADHD or trauma. Teaching coping skills and working on symptoms of anxiety is important, but therapy must also address the underlying issue to make a true and lasting difference.
How are Psychological Tests Administered?
Most psychological assessments are administered by a psychometrist through one-to-one interaction and questionnaires. Others include observation forms completed by parents, teachers, and others who spend time with the child. While the number and type of tests per child vary, it’s not uncommon for Ranch residents to take 8-10 tests, plus observation forms from parents, teachers, and/or other people who spend time with them.
Once we gather all of the information, one of our Ranch psychologists completes a comprehensive report that includes information from the child’s initial psychiatric intake, diagnostic assessment, interpretation of the assessment results, diagnoses, conclusions, and recommendations.
How is Psychological Testing Helpful?
How psychological testing can be helpful is best explained through examples. The first example I’ll share is about a child’s processing speed.
A parent might say their child just seems to give them a blank look for a few moments versus immediately reacting when they ask them to do something or ask a question. If the assessments identify a processing speed weakness, I can explain to parents that their child is not necessarily being defiant or ignoring them, but their brain needs a little more time to process what they are saying. This is a very practical piece of information that helps parents give their child more understanding and space, rather than jumping in with, “Why aren’t you listening to me?” Giving them time to hear, process, and respond can eliminate relationship conflict.
A second example, related to what’s called “reality testing,” helps determine a child’s perceptions of situations and people. Let’s say a parent is sitting at the kitchen table with their child and they are working on homework. The parent makes what they believe to be a neutral and helpful statement, such as, “If you do it this way, or start right here, it’ll be much easier.” But if their child has a cognitive mediation or reality testing problem, they may hear, “You’re an idiot. I don’t believe you can do anything right.”
Parents will say to me, “I was trying to help, and they completely shut down and refused to finish their homework. What happened?”
How Can I Help my Child?
If we know a child struggles to perceive accurately, we can teach parents and caregivers how to help through what I call “the processing game.” I explain it to parents like this, “If you’re at home and this occurs, take a deep breath (or if they’ve stormed out of the room, give them a minute or two to calm- down before you approach them) and say, ‘Whoa! What do you think I said?’ or ‘What do you think I meant?’”
“When your child says, ‘You think I’m an idiot. I can never do anything right,’ respond with something like, ‘Oh my gosh. No. I’m so sorry you felt that way. I meant to be helpful and show you a way that might be easier or better to understand.’”
In addition to being helpful for parents, the psychological evaluation is helpful for Ranch staff when children are in treatment. By using this strategy and many others consistently and over time, we can reorient a child’s reality/perception to a more accurate and true perception.
In a nutshell, psychological testing helps us paint a comprehensive picture of how a child thinks, feels, behaves, and reacts so we can arrive at a diagnosis; modify or continue medication, inform therapy, and address their environment. This can help children and their families understand the nature of their struggles and empower them with the tools and strategies they need to be successful.