Evaluations Outline Cognitive Strengths and Weaknesses

•Outline Chapter 16
Understanding and Using Neurocognitive Assessments

•Evaluations outline cognitive strengths and weaknesses

•Provide specific recommendations regarding classroom placement, accommodations, and special education and therapy needs

•Assessments help to determine a child’s functional capacities and needs in real-world settings, such as home and school. Models for Developmental Neuropsychological Assessment

•Assessments integrate:

test performance,

behavioral observations,

contextual information,

principles of development

knowledge of brain function

•Bernstein’s model of assessment has three key variables

1.Development (understanding typical development and that of specific child being assessed)

2.Brain (understanding brain structure/function, expected in the specific disorder and observed in child being assessed)

3.Context in which the child is developing
Domains of Functioning Assessed in Neuropsychological Evaluations

•General intelligence

▫Considered the benchmark against which other cognitive abilities are measured

▫IQ tests capture only some of the abilities that govern a person’s performance in society: multiple intelligences exist

•Attention

▫Closely associated with executive functioning

▫Subdomains (orienting, focusing, shifting, and sustaining attention)

▫Affected by such factors as anxiety, arousal, difficulty of the task, motivation, and the novelty and type of situation

•Executive function

▫Cognitive abilities that govern behavior regulation and goal-oriented activity

▫Working memory, inhibition, flexibility, monitoring, planning, and generativity

•Language

▫Ability to understand language, express needs and wants, establish social relationships, make the sounds of speech

▫Motor speech capacities and pragmatic nonverbal communications such as gestures

•Visual processing

▫Perception and spatial location; visual processing closely associated with visual construction skills and visual pattern recognition

•Learning and memory

▫Learning can be impaired for visual or verbal information in the context of core deficits in language or verbal processing

▫A neuropsychological evaluation should provide specific insight into how a child learns best and in which learning conditions the child will require extra support

•Social cognition

▫Assessing this area relies on parent and teacher report, observation, and responses in structured interviews

▫To plan successful intervention, must have understanding of whether child can accurately perceive and express social clues, have a theory of mind, and reason with social information

•Motor/sensory

▫Includes range of gross and fine motor abilities as well as sensory perception

▫A complex or pervasive motor difficulty often merits a physical and/or occupational therapy evaluation

•Emotional adjustment

▫Mood, anxiety, and any other emotional difficulties interfering with the child’s functioning and ability to regulate mood and behavior

▫Parent, teacher, child report on standardized measures; qualitative report of symptoms/concerns; child interview

•Adaptive/academic

▫Outcomes of the patterns of strengths and weaknesses in a child’s core cognitive domains combined with the full range of contextual factors

▫Reflects how child copes with demands of daily living and accumulation of academic knowledge and skills

•Assessments driven by appropriate referral questions provide:

▫Diagnostic clarification, child’s level of developmental or cognitive functioning, patterns of strengths and weaknesses, school placement or program eligibility determinations, progress or deterioration over time, ideas for treatment

▫Standardized tests can provide normative benchmarks

•What does it mean for a test to be standardized?

•What does it mean for a test to be reliable?

•What does it mean for a test to be valid?

•What is a standardized score (how to interpret a score)?

▫Results should be prioritized including recommendations identifying targets for intervention

▫School-based recommendations include:

•Informal supports and accommodations provided by child’s teacher and/or student support team

•504 plan to provide formalized accommodations

•Individualized Education Program (IEP) to formulate specific and measurable goals

•Monitor child’s progress

•Provide advocacy resources for parents

•Annual revaluation or sooner if needed