Why Does Testing for a Learning Disability Take So Long?

Why Does Testing for a Learning Disability Take So Long?

It is the beginning of the school year, which for those of us who do psychological testing, means it is time for psychoeducational evaluations.  Whenever I get a call about a psychoeducational evaluation to identify learning disabilities, I always have to brace the person I am talking to for how long the evaluation could take.  “Six to eight hours!!  Why so long?!” 

Yes, these evaluations are something of a marathon. The psychologist feels almost as tired as the child. Scratch that - by the end of it all, we're MORE tired than the child. That is because after the evaluation, we have to spend another 10+hours scoring the tests and writing the report! Ah, but I digress. Suffice it to say, there are many reasons why these evaluations are so painstakingly comprehensive.

First, there are many types of learning disabilities: phonological, writing, mathematics, oral expression, and comprehension. Within each of these categories, there are subtypes. Take dyslexia for instance. Within the one category of a reading disorder, there is auditory, visual, attentional, surface, deep, developmental, acquired, directional, and math dyslexia. This isn't just academic - each one of those subtypes has entirely different interventions in order to help the child.

Second reason these evaluations are so long, is frequently an individual has more than one learning disability or subtype. Therefore, an evaluation has to rule out the presence of other disabilities.

Third and related reason, is that learning disorders are comorbid with many other psychiatric disorders. For example, many children with learning disorders naturally develop anxiety and behavior difficulties because they become so frustrated by their challenges. School avoidance, work refusal, social phobia, and selective mutism are just several behaviors that can often accompany a learning disorder. Identifying these issues can be just as important for effective intervention.

Fourth reason for the length of evaluations has to do with the definition of a learning disorder. A learning disorder is diagnosed when an individual's performance, called academic achievement, is significantly below a person's intellectual capacity, called intelligence. So, if someone has a Verbal IQ score of 110, his/her reading score should also be around 110 - the reading should match capacity. However, if the reading score is 70, that is far below what the person's capacity is - something is off. So this means we need to do an entire IQ test and an academic achievement test.

Final reason for evaluation length is that for a learning disability evaluation to be useful, we need to know your child's strengths AND weaknesses. Without an awareness of strengths, it is going to be awful difficult to address weaknesses. I had a client recently that had a horrible neurological event that damaged her ability to form new memories from auditory information. You could tell her a list of groceries to remember 100 times and she could only remember one or two items. To make matters worse, her reading comprehension was also seriously impaired, so a written list was also ineffective. Sounds pretty hopeless, doesn't it? Well, it would have been if we didn't find that her visual memory and reasoning were perfectly intact! Therefore, we recommended that she text herself some reminder photos of what to pick up at the grocery store - and this and other problems went away by finding alternatives through her strengths.

So what does this mean in terms of the length of assessments? It means that we have to give many different tests - intelligence, achievement, learning, memory, motor skills, sensory, executive functioning behavioral measures, etc. We don't want to miss anything or make any mistakes with your precious children. We want to be as accurate and helpful as possible, which means going beyond the minimal batteries that educational psychologists are permitted to do in the school system.



Jason B Miller, Ph.D., M.P.A is a psychologist that practices in Santa Paula, California. Dr. Jason Miller provides a wide range of psychological assessments, evaluations, and cognitive-behavioral therapies that integrate the Catholic faith with sound clinical practice. View his Profile for more information about his psychological services.

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