CAAP 613: Assessment in Counselling -...
Transcript of CAAP 613: Assessment in Counselling -...
9/5/2017
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Anatomy of a Psychoeducational
Assessment Report
Dr. Brent Macdonald, R. Psych.
Alberta Health Services
Community Education Services
Workshop, September 2017
11:00-12:30
Dr. Brent Macdonald complexlearners.com
No Smart Phones! In what way are space and time alike?
Who was the first Prime Minister of Canada in it’s current configuration (10 provinces, 3 territories)?
Name ALL seven of the Dwarfs.
No peeking - What was the exact title and information on the title slide (in proper colours and in order)
What does otiose mean? What does bloviate mean?
You have 30 seconds – write down the lyrics to the “Fresh Prince” theme song (OR “O Canada,” whichever)
Dr. Brent Macdonald complexlearners.com
Overview Assessment Primer (who gets referred for assessment
and why – what are we hoping to learn?)
Assessment Process (what the kids go through in a
typical assessment)
Assessment Reports (reading to understand)
Interventions/ Practical Applications
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Key Points Everyone is always being assessed!
“Assessment” is not synonymous with “testing”
Assessment is informed by – and informs – teaching and parenting practices
The is no magic bullet
Assessment – for our purposes – generally incorporates cognitive abilities, academic achievement, and social-emotional/ behavioural functioning
Assessment is a collaborative process
Our belief is that assessment should be strength-based!
Dr. Brent Macdonald complexlearners.com
Purpose of Psychoeducational
Assessment
Identify strengths
Identify areas of specific challenge
Develop norm/ criterion-referenced basis for better
understanding specificity of psychological processes
Psychological processes can include cognitive, academic,
social-emotional behavioural functioning, among others
Diagnosis (if warranted)
Interventions/ Recommendations/ Strategies
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What to Expect: Parents Intake Interview (participants?)
What brings you in?
How can we help?
Current functioning
Developmental/ familial/ medical/ educational history
Questionnaires
Self-reports (standardized)
Clinician-developed measures
Timing of sessions
Timing of sessions (all at once v. spread out)
Feedback Interview
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Background Information Current Life Situation
Relationship status
Living arrangements
Developmental history Pregnancy, delivery, and developmental milestones
Childhood trauma
Other significant childhood/developmental issues
Educational/Occupational background Highest education
School functioning - academic, social, behaviour
Employment history (as necessary)
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Background Information
Family Background Parents, siblings
Medical & Psychiatric History Physical problems
Psychiatric history
Medications
Hospitalizations
Other Relevant Background Additional information relevant to the assessment
Legal issues, avocational pursuits, interpersonal issues
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Referral Question Who referred
Why
Be as specific as possible
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Responding to a Referral Question
Prior to the assessment, the clinician should formulate
a hypothesis/ referral question (i.e. What is the
presenting concern of the client and how will the
assessment process be beneficial in helping the client
in dealing with the possible/ presenting issue?)
The goal of assessment should be guided by the
question
Dr. Brent Macdonald complexlearners.com
Observations (note relative
relevance of each section) Arrival - on time,
accompanied?
How Dressed
Personal Hygiene
Motivation
Approach to Tasks
Problems with vision or hearing
Rapport
Unusual Behaviours
Motor Coordination
Affect
Dr. Brent Macdonald complexlearners.com
What to Expect:
Children/ Youth Active role in the process
Participation in intake and feedback meetings
Testing – standardized, duration, breaks, anxiety, etc.
What do YOU want to get from the process?
Dr. Brent Macdonald complexlearners.com
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Questions to Ask Before the Assessment
Qualifications and background
Goals
Cost/ insurance
“Product”
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Questions to Ask During the Assessment
How is my child doing (in general)
What should I bring in?
Working hypothesis?
Dr. Brent Macdonald complexlearners.com
Questions to Ask After the Assessment
Ask for a clear understanding of assessment results
When you don’t understand, let the psychologist know
(avoiding the whole “head-nod” thing)
Ask for paper/ pencil to jot down questions and ideas as
they come up
Profile of strengths and areas of need
Deliverables (report, school meeting, follow-up with child
if necessary)
Follow-up – is the assessment over once you receive the
report?
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Types of Feedback Ongoing/ Formative
Individual/ Family
Case Conference
Summative
Oral
Written
Dr. Brent Macdonald complexlearners.com
Feedback Guidelines Focus, where possible, on the
positive
Strength-based assessment
should incorporate strength-
based interventions/ strategies
Check in with the psychologist
Good assessments lead to
interventions based on data/
observations/ background/
correlation with research/ best
practices
Use good judgement in planning
interventions
Develop a follow-up plan/ evaluation
of interventions
Avoid labelling (which is different
from “diagnosing”)
For psychologists, evaluate the
developmental appropriateness of
sharing results and feedback
Dr. Brent Macdonald complexlearners.com
Four Pillars of Assessment
Norm-referenced measures
Interviews
Behavioral observations
Informal assessment procedures
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Dr. Brent Macdonald complexlearners.com
An inverse normal curve…
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Factors of a Multimethod
Assessment Referral information
Demographic and
background information
Assessment findings
Standardized
Informal
Pattern analysis
Positive interpretation
(comparing subtest/ index
scores to subtest/ index
scores)
Interventions attempted
(successes/ challenges)
Diagnosis
Recommendations
Accommodations
Strategies
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Measures Used Cognitive (intellectual)
WISC-V, WAIS-IV, SB-5, WJ-IV Cog, etc.
Academic Achievement
WIAT-3, WJ-IV Ach, KTEA-4, etc.
Social-emotional/ behavioural
BASC, CBRS, numerous others
Adaptive Functioning
ABAS, Vineland, etc.
Executive Functioning
CEFI, BRIEF, etc.
Dr. Brent Macdonald complexlearners.com
Sources of Variability Degree of rapport established
Quality of interaction between the examiner and the student
Number and kinds of tests administered
Length of the assessment process
Number of follow up questions asked
Number of trials needed to administer items
Number of breaks taken
Dr. Brent Macdonald complexlearners.com
Testing-of-Limits Procedures
Proving additional cues or aids
Changing stimulus modality
Eliminating time limits
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The Written Report Demographic Information
Reason for Referral
Tests/ Methods Used
Background Information
Developmental
Family
Medical
Academic
Employment
Test Session Observations
Test Results
Summary
Diagnosis (if relevant)
Recommendations
Appendices of Score Tables
Dr. Brent Macdonald complexlearners.com
The Written Report Should be succinct
Question jargon
Understand that the written report may have multiple audiences (client, other practitioners, employers, administrators, teachers, physicians, etc.)
The written report typically becomes the client’s property and may be shared with a wide range of individuals
Reports are generally kept on file for a minimum of 7 years (jurisdictions vary – psychologists keep records for 10 years or 2 years after the client turns 18, whichever is longer)
Dr. Brent Macdonald complexlearners.com
The Written Report Person Centered
Model of assess -> understand -> intervene
Describes how strengths and weaknesses manifest in real life
Test data is only meaningful if they contribute to the understanding of the person
Person-specific recommendations
Must effectively communicate an understanding of the client that addresses the referral issues
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Statement of Confidentiality
All psychological assessments are confidential in
nature as they contain private information, which may
be used inappropriately by others. To protect the
privacy and ensure the confidentiality of the persons
involved, please ensure that this report is only
circulated to those who are considered essential to
related judgments and decision-making. The intent of
this report is to provide opinions and recommendations
in a particular context, and any use of this report
outside that purpose should only be done with the
informed consent of the parties concerned and in
consultation with the writer.
U-CAPES (2007, p. 1)Dr. Brent Macdonald complexlearners.com
Summary Major points under previous sections that are most
salient to the referral question
No new information should be presented in the
summary
Diagnosis and Prognosis
Dr. Brent Macdonald complexlearners.com
Recommendations For complex assessment, many recommendations are
often grouped under areas of concern
Priorities (not all recommendations will be followed)
Immediate needs
Viable options for addressing needs
Integrate how strengths may contribute to positive
outcomes
Total number of recommendations?
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“Diagnosing” 2e: The ABCs GAI, FSIQ, and other acronyms of note…
Age/ Grade of diagnosis
Validity (WPPSI-IV; WISC-V; SB5; WJ-IV Cog)
DSM-5 and LD – intellectual measure not strictly necessary; what does this mean for Gifted LD?
Evolution from IQ/ Ability Discrepancy to RtI
RtI (historically deficit-based) not proven to be effective in identifying gifted individuals –need to focus on strengths as opposed to deficits
LD as 2e in itself (i.e. varying profiles)
Because the numbers are smaller, there is a need to focus on individual differences more so than in the typical population (true at both ends of the curve)
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Accommodation/ Adapting/
Enabling Accommodation are largely environmental in nature and
simply allow the student to perform absent the preventative factors of their disability; enhances self-control
Enabling is the active interference of allowing a student to do what they, under most circumstances, would be capable of doing; reduces self-control
Difference lies in the ability to perform- a lifejacket it essential to someone who can’t swim; it inhibits the ability to learn to swim; if the individual is capable of learning to swim, a lifejacket may be beneficial in the short term, but inhibits performance if used too long
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