Disorders We Treat

All Evaluations Are Not Equal by Lynn Ayres, M. Ed

Eight-year-old Jessica had a Comprehensive Individual Evaluation at her school. Even though Jessica's reading, spelling, and written expression were below level, her parents were told that she did not have a learning disability.

For an additional two years, Jessica continued to struggle, her self-esteem plummeted, and she was beginning to dread going to school. Recently, Jessica had a Comprehensive Learning Style Evaluation at our Center, which determined that she had significant weaknesses in auditory processing, language skills, and phonological awareness. The proper treatment plan was initiated, and for the first time since Jessica entered school, she is encouraged and is making progress.

John, a ninth-grader in the gifted/talented program, had grades consistently declining during middle school. When his parents requested an evaluation in seventh grade, they were told there was no "educational need" and the school did not test "gifted students." During his first semester in high school, John was failing several courses. At the Tarnow Center, a Comprehensive Learning Evaluation determined that he had ADHD. Following medical treatment, educational therapy, and modifications/accommodations at school, John is back on track and doing well.

Fourth-grader Colby has had significant difficulties since he entered school. In second grade he had two private evaluations and in fourth grade the school completed testing. Each evaluation identified some difficulties; however, the problems causing the struggles were not identified and/or an effective plan to enhance his performance. After a Comprehensive Evaluation at the Center, which pulled all the pieces together, Colby is receiving special services at school, medical treatment for anxiety, and language therapy.

Jessica, John, and Colby all suffered tremendously as the result of inadequate, incomplete, or incorrect judgment of professionals. The evaluations or lack of evaluations (public school and private) lead to unanswered questions, missed diagnoses, and a lack of treatment. Such practices are often unfair and even damaging to the child. The foundations of learning are essential for future performance. Unidentified processing disorders early in a child's life may be more difficult to treat in the future. However, early intervention leads to potential long-term gain.

Evaluations as an Integral Part

At the Tarnow Center, evaluations are an integral aspect in the diagnosis and the treatment plan. When to evaluate, objectives of evaluations, and the components of comprehensive evaluations will be discussed.

There are a variety of times or situations that prompt a comprehensive evaluation. Preschool students who have difficulties with behavior, language, or motor skills may benefit from an evaluation that can prescribe early treatment. School age students who are struggling with reading, spelling, writing, math, attention, behavior, and/or organization skills may profit from a comprehensive evaluation that can determine skill levels, learning style, and the appropriate treatment. Middle school, high school, and/or college students who begin to struggle or continue to have difficulties may benefit from an evaluation or re-evaluation.

Evaluations can also determine progress, and appropriateness and effectiveness of current programs (medical treatment, special programs, and therapy). Monitoring the effectiveness or lack of effectiveness of school interventions are key to insure that the child doesn't fall behind and to determine if the IEP is appropriate and effective. Parents often request evaluations to determine learning styles that would be helpful in determining specific curriculum or school placements.

High school and college students have evaluations to help them establish modifications and accommodations such as extended time on standardized tests (SAT) and classroom tests, early registrations, note-taking assistance, etc. They also investigate learning strengths and preferences to help determine vocational interests. We like to teach this age group how they learn so they have methods to teach themselves. The result is a more self-confident student who is more competent and has the ability to advocate for themselves. These students are viewed as active learners, rather than as students with destructive personalities.

The objectives of evaluations at the Tarnow Center include a multi-dimensional, inter-disciplinary approach that is thorough, sensitive, pragmatic, and insightful.

Comphrehensive and "Custom-Designed"

Our evaluations are broad, comprehensive, and "custom-designed" to formulate a description of the child, which will be the basis for optimal self-management. They identify the child's learning style, strengths, and weaknesses, which can be utilized to enhance performance to choose appropriate curriculum, therapy and schools, and to build self-esteem.

Many times, especially in public schools, there is a very rigid diagnostic system. They administer two or three tests and then proceed to a diagnosis. They define learning disabilities as a statistical discrepancy between intellectual scores and achievement tests. Schools have criteria defined by the state legislature and the TEA. In addition, public schools are limited by the amount of services they can provide. Public schools are not evaluating the subtleties of a child's problems, nor evaluating the child's learning style, strengths, and weaknesses, and means of compensation. This limited testing leads to mistaken notions, which excludes many significant learning problems, productivity problems, higher-order cognitive weaknesses, language and auditory processing problems, working memory disorders, and poor executive and control problems. Many problems go undiagnosed and the child suffers.

Another objective of our evaluations would be to enhance the insight and answer specific questions or concerns of parents, teachers, therapists, and the child. They can also provide a baseline for monitoring the progress and judging the effectiveness of services, therapy, self-management, and medication. At the Tarnow Center, the psychiatrists often request updated evaluations to determine the effectiveness of medications.

Evaluations can help determine eligibility for school-based services (504 Eligibility, Special Education Services, modifications, and/or accommodations), in which specific service needs can be addressed. An evaluation can detect and describe complicating factors, which require educational, therapeutic, and medical attention.

Parents should be aware of numerous components that a comprehensive evaluation should include. The evaluation should be a descriptive assessment that establishes a functional profile of the child. It should be a systematic search for evidence based on consistencies in historical data, previous test information, test results, and direct observations. It should search for recurrent themes so that it results in numerous interlocking data. In other words, an evaluation should put all the "pieces of the puzzle" together to describe the child as a learner, determine therapy needs, and establish appropriate schools and programs.

The Tarnow Center has an interdisciplinary component that is unique. Cases are reviewed and the contributions of individuals from varied relevant professional backgrounds are offered, which enhances in the eclectic breadth of the evaluations. A broad range of neuro-developmental functions, which evaluate auditory/visual processing, cognitive skills, problem-solving, self-monitoring, memory abilities, self-management skills, and achievement, should be addressed. Practical suggestions for treatment at home and school should be included, and specific questions raised by teachers, therapists, and/or parents should be answered.

At the Tarnow Center, we feel that
"a good description leads to a good prescription."

Another unique component at the Center is that we evaluate self-management development and competencies and make suggestions to improve these skills.

The evaluation should include a description of the child's behaviors and approaches to tasks, how they react to the stress of academic tasks, and their cognitive style, rather than simply listing test scores and labels. Evaluation should be process-oriented with rich and numerous observations so that the child's learning can be understood in all settings.

In summary, compiling the results of a comprehensive evaluation is similar to a detective solving his case. Without the right tests, thoroughness, and insight the case may not be appropriately solved. Our evaluations are customized to answer diagnostic questions, ascertain the child's learning style, and establish a diagnosis and/or treatment plan if needed. At the Tarnow Center, we feel that "a good description leads to a good prescription."