PlusFour Solutions: Guidance through Assessment

• What is psychological testing?
• Are there different types of testing?
• What will the test sessions be like?
• How many times will we meet?
• Can a pediatrician or psychiatrist administer these tests?
• What about time and costs?
• How do I make payments?
• What about insurance coverage?
• What will be included in a report?
• How do I know if testing is necessary?
• What are the ages of the people you test?
• What about ADD and ADHD?
• What types of problems are serious enough to warrant testing?
• How do you protect my privacy when sending information electronically?

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.

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. Dr. Newton works closely with teachers and staff members at public and private schools throughout the Bay Area, and upon request will attend IEP and Student Study Team (SST) meetings.

Testing will often assess academic achievement in the areas of reading, writing and mathematics. Academic testing looks at comprehension, skill level and fluency, how quickly a student can complete work.

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-TR.

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, Dr. Newton can use the developmental methods to assess cognitive, emotional and psychological development.

What will the test sessions be like?
Your child will meet with Dr. Newton in a quiet office and will be seated in a comfortable chair across a table from him. The student may take breaks whenever needed. Some students bring a drink, snack, or even lunch if working through noontime. Most of what is done will be within a child’s ability, but there will always be some parts of the testing that stretch their capability. This is because it is important to know where a student’s “ceiling” is; that is, the point where items become too hard to complete. Most students report that testing was “fun” or, “not as bad as I imagined.”

How many times will we meet?
Most assessments involve three to five 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.

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.

What about time and costs?
The amount of time required to complete an evaluation depends on the test batteries being administered. Typically, an evaluation lasts between five and seven 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 six hours in the office. However, an additional five or six hours is spent “behind the scenes” to appropriately complete the process. Finally, the costs for test booklets and scoring services are part of the total charges that a family is asked to assume.

Most families should budget $3,000.00 for a full battery of tests. Dr. Newton will discuss with you those assessments that may be less or significantly more than this estimate. However, compared to an 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 which 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.

How do I make payments?
You may pay by check or cash or you may use PayPal to make a debit or use a credit card. You do not need to have a PayPal account to pay by credit card. When making a payment by credit card, you decide the amount to be charged; there are no pre-set amounts. PayPal accepts Visa, MasterCard, Discover and American Express.

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.

Dr. Newton does not 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.

What will be included in a report?
A psychological report includes background information regarding school, prior treatment, family and health. It will include meaningful 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 discussing the results with Dr. Newton.

How do I know if testing is necessary?
Dr. Newton is happy to discuss your questions about testing at no charge. This is a very important question and should be discussed on the phone or in person. Not everyone should be tested. We refer families to neuropsychologists, therapists, school psychologists or psychiatrists when appropriate.

What are the ages of the people you test?
Dr. Newton specializes in the assessment of school-aged children, adolescents and adults. While children as young as four years old have been seen for assessment, most have typically started school.

Adults are frequently seen for assessment, although clients with aging disorders such as dementia or alzheimers are referred to professionals who specialize in the assessment of these specialized disorders related to advanced age.

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; yet 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 by a psychologist, in an office 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.

What types of problems are serious enough to warrant testing?
Too many individuals or families wait until someone is in trouble to pursue testing. People behave in only a few ways for a multitude of reasons. Identifying behaviors is descriptive; identifying causes is diagnostic. In most cases, an individual who is trained to look and understand what they see easily reads early warning signs. It is through testing that PlusFour Solutions goes beyond describing an individual’s behavior to identify the root cause. Only when this is done will a course of treatment become apparent.

A comprehensive assessment is the single best disgnostic process available to people. At PlusFour Solutions we commonly test individuals for depression, anxiety, distractibility, anger and school failure. We assess learning styles, learning disabilities and students who are withdrawn socially or don’t seem to make friends or fit in. We often evaluate students who are experimenting with alcohol, marijuana or other substances, or who may be model citizens at school but create terror at home. We test adults who are not functioning successfully in college, at work or in relationships. It is why so many medical doctors, neurologists, teachers, counselors and health professionals refer clients to Dr. Newton and PlusFour Solutions.

How do you protect my privacy when sending information electronically?
All confidential information from PlusFour Solutions will be sent by a secure link that encrypts the message and any attachments. The encryption process allows only you to download and read the material that is sent (such as a report). PlusFour Solutions uses a second encryption service that allows you to send confidential data directly to Dr. Newton. You may access this service through the PlusFour Solutions web site and send totally secure messages and documents to Dr. Newton.

While these encryption services require a few extra steps to use, they are not cumbersome and do not require you to register to use the service. These services provide a very high level of security that guarantees no one else can access your data over the internet.