What is psychological testing?
Psychological Testing uses paper and pencil tests to assess a student's cognitive, emotional, social and psychological development. These tests have been widely used for many years and are very reliable. Some of the test questions and items will feel like school work, while other parts will feel more like games. There are pictures to look at, things to draw and puzzles to complete. In addition to tests that use paper and pencil, a student will answer questions orally and discuss how they think about or feel about certain topics.

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Are there different types of testing?
Yes. Testing can look specifically at learning and academic issues. Cognitive (IQ) and academic tests are administered to rule out verbal or non-verbal learning disabilities, attention-deficit disorders and processing deficits. The associates at PlusFour Solutions work closely with teachers and staff members at public and private schools throughout the Bay Area, and we routinely attend IEP and Student Study Team meetings.

Testing can be targeted to evaluate social, emotional and behavioral functioning. This type of testing is often requested to rule out or verify a particular diagnosis. Students are assessed for mood or anxiety disorders, sleep or behavior problems, defiance, substance abuse, tic disorders and pervasive development disorders, among other disorders included in the DSM IV.

Testing can also be used with any child to assess development. Just as a parent uses a pediatrician to monitor physical growth and a dentist to monitor oral hygiene, a PlusFour associate can use the Developmental Survey program to assess cognitive, emotional and psychological development. These surveys are gentle and quick, about half the cost of a full psychological battery, and provide the information parents need to determine that their child is on track in these critical areas of growth.

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What will the test sessions be like?
Your child will meet in a quiet office and be across a table from the testing associate. They sit in a comfortable chair and take breaks whenever needed. Some students bring a drink, snack, or even lunch if we are working through noontime. Most of what we do will be within a child’s ability, but there will always be some parts of the testing that stretch their capability. It is important to know where a student’s "ceiling" is, that is, the point where items become too hard to complete. Most every student reports that testing was "fun" or "not as bad as I imagined."

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How many times will we meet?
Most assessments involve two to three meetings with a student, usually ninety minutes to two hours in length. A meeting with parents to discuss findings and treatment implications will follow. Meetings can occur within in one or two weeks if there is an urgency to obtain results. Some assessments, due to situational factors or necessity, occur within one day. Finally, some assessments, often those involving the entire family and done for legal reasons such as custody evaluations, may take several months to complete.

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Can a pediatrician or psychiatrist administer these tests?
Neither a pediatrician nor a psychiatrist has sufficient training in the administration or interpretation of psychological tests. A pediatrician specializes in the physical health and well being of children, while a psychiatrist specializes in treating mental health problems with medicine. A psychologist is the individual best equipped to help with diagnosis because they are trained to administer and interpret psychological tests.

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What about time and costs?
The amount of time required to complete an evaluation depends on the questions being asked. Typically, an evaluation runs between three and six hours of face-to-face time. The clinician then needs additional time to score and interpret test data and review other documents provided by the family or other professionals. Finally, a report must be written. In this way, the costs for the psychological assessment process may appear excessive for a student who only spends three hours in the office. However, an additional four or five hours is spent "behind the scenes" to appropriately complete the process. Finally, there are costs for test booklets and scoring services that are part of the total charges a family is asked to assume.

The cost of a full psychological battery can be more than two thousand dollars, a considerable expense. However, compared to a MRI or PET Scan, which image the brain but do not provide information about functional ability, the cost is modest. Also, the commitment to a course of treatment without first establishing a clear diagnosis that informs treatment decisions, is very costly and may be counter-productive. Treatment without diagnosis is like archery without a target. Professionals understand the need to begin with a functional assessment, a clear diagnosis and then can more effectively make informed decisions about treatment.

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What about insurance coverage?
A few insurance companies will pay for psychological testing; many will not. Insurance companies often utilize managed care companies to help control costs. Most managed care companies decline coverage for psychological testing.

The associates at PlusFour Solutions cannot negotiate with insurance or managed care companies. A client will be provided with a statement, including CPT codes and a medical diagnosis for the student, at the conclusion of the assessment and when the bill is paid in full. This statement has all of the data an insurance company requires and may be submitted for reimbursement. No promise of reimbursement is implied.

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What will be included in a report?
A psychological report includes background information regarding school, prior treatment, family and health. It will include tables and charts that list and describe data from tests of intelligence and academic performance. If social and emotional questions have been raised, data regarding these areas will be presented and discussed. A diagnosis will be made and treatment implications and recommendations will be listed. A report is almost never released without first having a meeting where a PlusFour associate presents the information orally and answers questions.

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How do I know if my student should be tested?
This is a very important question and should be discussed on the phone or in person. Not every child or adolescent should be tested. At PlusFour Solutions we refer families to neuropsychologists, therapists, school psychologists or psychiatrists when appropriate.

An associate would be happy to discuss your child's needs with you at no charge. At PlusFour Solutions we specialize in the assessment of school-aged children. Because we have worked with so many older children who had problems that were identified too late in adolescence, we offer the Developmental Survey. It is an assessment designed to assess a student prior to the emergence of problem behaviors, emotional symptoms or academic difficulty.

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What are the ages of the people you test?
PlusFour Solutions specializes in the assessment of school-aged children, ages six to eighteen. We have worked with children as young as age four and we do not hesitate to assess adults when asked, or as part of a family evaluation.

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What about ADD and ADHD?
Disorders of attention, concentration and working memory are big business. You may have wondered if your student has an attention-deficit disorder. Many people have opinions about medicating children and over or under diagnosing this disorder. Many pediatricians and professionals will diagnose a child with an attention-deficit disorder based on one brief meeting or a single checklist completed by a parent. Others make the diagnosis based on brain scans. These procedures omit an analysis of function – how does the child perform compared to his or her peers?

The diagnosis of an attention-deficit disorder involves a review of past and current behavior as rated by several individuals on well-normed behavior rating scales. The student must be assessed with cognitive and achievement tests to rule out processing deficits and learning disabilities. Next, the child is tested with instruments sensitive to working memory and concentration. Finally, the student must be assessed for evidence of anxiety, depression or other disorders, whose symptoms mimic those of a child with an attention-deficit disorder.

The term "attention-deficit" is misleading. Children with problems focusing, organizing and completing work most often have deficits relative to executive functioning (a set of skills performed in the frontal cortex of the brain and best evaluated by psychological tests). These tests are administered in an office, by a psychologist, and evaluated along with the other essential data discussed above. Then, and only then, can a professional make accurate statements about a student's memory and attention.

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What types of problems are serious enough to warrant testing?
At PlusFour Solutions we commonly test children for depression, anxiety, distractibility, anger and school failure. We assess learning styles and disabilities and students who are withdrawn socially or don't seem to make friends or fit in. We often assess students who are experimenting with alcohol, marijuana or other substances, or who may be model citizens at school but create terror at home. While we can diagnosis rare and unusual disorders, so often the students who come through our doors are depressed or anxious, and are struggling at school and / or at home.

Children behave in only a few ways for a multitude of reasons. Identifying behaviors is descriptive, identifying causes is diagnostic. It is through testing that we go beyond describing a child's behavior and identify the root cause. Only when we do this will a course of treatment become apparent.

Finally, too many families wait until a child is in trouble to pursue testing. In most cases, an individual trained to look and understand what they see easily reads early warning signs. The PlusFour Developmental Survey allows for the screening of cognitive, academic, emotional, social and psychological factors before they result in problem behaviors.

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