Children may be referred for psychological testing for many reasons, as discussed in my prior blog post, My child was referred for psychological testing – what does that mean? Typically, the first decision to be made when your child is referred for an evaluation is choosing whether to have the assessment done by the school psychologist or by a psychologist in private practice. One common motive for requesting an evaluation is that it is a required part of obtaining an Individualized Education Program (IEP). Many parents are unaware that they have the RIGHT to request an independent evaluation if they receive a school evaluation for an IEP and disagree with the findings. Parents can even request that the district pay the cost of the subsequent private evaluation (see this link from the US Department of Education for details: http://www2.ed.gov/parents/needs/speced/iepguide/index.html#process). Given this mandate, one logical conclusion would seem to be to start with a school evaluation, and wait to see if you are satisfied with the results before scheduling a private evaluation. However, certain crucial measures (e.g. IQ tests) are prohibited from being re-administered for a period of one year due to practice effects, and therefore the private practitioner would be forced to use the scores gathered in the school’s evaluation, utilize different measures, or wait the long period before re-administration. In addition, the child would then have to miss additional class time to participate in a second testing. Thus, the decision of whether to use a school psychologist or a private practitioner is best made prior to the start of the testing.
Benefits of having your child evaluated by the school psychologist are that there is no charge for this testing, and it is completed at school. However, school psychologists may be restricted by their workload and the resources of their school. Thus, the evaluations done by school psychologists often include only an IQ test, an achievement test, and self-report questionnaires related to cognitive and psychological functioning. Typically, they do not include measures that assess the cognitive abilities that underlie the IQ scores, such as attention or executive functions. This is not to say that all testing done within the school setting is limited, but often the school psychologists are constrained by circumstances beyond their control. Notwithstanding any limitations, these evaluations can be useful when a child is being considered for a particular program or certain accommodations for which there are specific, objective criteria (e.g. a cut-off score).
Having your child evaluated by an independent psychologist who specializes in assessment affords many benefits. Whereas school psychologists are constrained by the resources of their school, a psychologist in private practice who specializes in assessment will most likely have a larger inventory of tests to choose from and will likely involve parents at each step of the evaluation. A qualified practitioner should assess not only IQ and achievement, but also many underlying cognitive abilities, such as attentional functioning, information processing abilities, executive functions, memory, and language skills. Being aware of a child’s strengths and weaknesses in these areas can help with understanding discrepancies between Index and Subtest scores on an IQ test, which is important when determining the roots of a child’s learning difficulties. In addition, knowing more about how a child thinks can be crucial for accurate diagnosis, as well as developing appropriate recommendations for treatment. Finally, an independent practitioner focusing on assessment will likely include a more comprehensive psychological evaluation in addition to assessing cognitive skills. This should not only include symptoms of Axis I disorders, but also a personality evaluation which can shed light onto a child’s coping and decision-making skills, their relationships with others, and their feelings about themselves.
One clear downside to having an assessment done by a psychologist in private practice is the cost, as the expanded focus of the report requires many hours to meet with the family, conduct the assessment, score the tests, interpret the findings and write the report. Unfortunately these evaluations are also not always covered in full by insurance, and many good practitioners work on a fee-for-service basis, and are not on any insurance panels. However, although a private evaluation can be costly, it can help parents save money in the long run as it will provide concrete recommendations for the most appropriate interventions. Thus, parents can avoid wasting time and money trying various treatments which may not be appropriate for their child.
Parents often want to know which type of evaluation is more likely to result in their child getting certain accommodations from the school. However, these decisions are based on the findings of the assessment, and neither a school psychologist nor a private practitioner can guarantee or even accurately predict the results. However, a private evaluation will likely have more data to draw from when making recommendations and requesting services. An outside psychologist can also serve as an additional advocate for a child at a meeting with the Committee on Special Education (IEP Team), if the parent desires. This may be helpful when determining a child’s eligibility for an IEP.
The decision about who should evaluate your child is a difficult one to make, but being informed about your choices is the first step towards a good decision. My next post which will address the assessment process when seeing a psychologist in private practice, and what you should, and should not, expect.
Third part of the series: I’ve decided to pay for a private evaluation for my child – what should I expect?
Melissa B. Singer, Ph.D. is a clinical psychologist in Westchester County, New York. She specializes in comprehensive psychological, cognitive, educational and neuropsychological assessment for children and adolescents. You can learn more about her practice at these websites: