Do You Need a Psychological Evaluation? By Jessica Myszak, PhD

For many people, the idea of a psychological evaluation begins when a teacher, physician, or friend brings up the possibility of some diagnosis. A teacher might note that your child has great difficulty staying on task and completing assignments, or your friend, whose brother has autism, mentions that many of your challenges are similar to the ones that he faces. You might have concerns about dyslexia, ADHD, autism, or another condition. Once this pops up in your head, it often leads to frantic google-searching of both related symptoms and how one goes about getting assessed for these conditions. 

At this point, some individuals wait to see what will happen and decide that they will act if things get worse. Others decide to proceed, but end up on long waiting lists. Others may ask friends or other providers for their recommendations regarding psychological testing or seek testing through the school system.

What makes someone a good psychologist for one person might make them the wrong choice for another person. Psychologists have different backgrounds and specializations. You should seek a provider who specializes in the type of difficulty you are seeking help for. If you are looking for someone to do an autism evaluation, you should choose someone who is experienced with autism. If you are looking for someone to assess a Traumatic Brain Injury (TBI), you should find someone with experience working with TBIs. Providers who specialize in a particular area are more likely to be up to date in the research and evidence-based strategies to help you.  

I understand that psychological testing can be a confusing process for many clients if they are unfamiliar with what it involves, so I want to share some information about how things work along with what you can do to make things go smoothly, regardless of whether you are an adult getting testing for yourself or a parent seeking assessment for your child. 

Psychological evaluations begin with a referral question. Without knowing the reason why testing is being requested, a psychologist would have difficulty understanding the scope and direction of the testing process. There are many types of assessments that evaluate all types of abilities: cognitive functioning, developmental delays, academic skills, daily living skills, behavior problems, emotional symptoms, personality, attention, speech, comprehension, executive functioning, social skills, and more nuanced versions of many of these areas. Once a psychologist understands the reason for testing, relevant assessments are chosen to evaluate the client and provide information about the client’s strengths and weaknesses. For this reason, it is important to understand exactly what you are looking for with regard to a psychological evaluation. If you have concerns or questions, share these from the beginning so the psychologist can make sure to address these issues.

Assessments can vary significantly. Some involve puzzle-like tasks and multiple-choice questions to evaluate the client’s ability; others include checklists, school-like tasks, or other measures which provide information about how the individual performed compared to other individuals in the same age range. Psychological evaluations typically involve a diagnostic interview, where the individual (or the individuals’ parents) provides background information and details about the client’s current symptoms, relevant assessment measures, and a record review, where previous reports, school records, or other relevant information is examined. Some questions may go back to the pregnancy and early developmental milestones, so it may be helpful to track down this information beforehand so you can respond confidently to this information. Teachers may be asked to complete rating scales about a child’s behavior and performance in school; for adults, interviews with their parents may provide information about their early development and childhood. Frequently, school observations of children or interviews with other providers can give additional helpful information about the individual’s current or historical difficulties. 

At times, the information requested may seem irrelevant or may be embarrassing to share; however, the psychologist likely has a good reason to ask these things, so be as honest and open as possible. Additionally, many assessments have internal validity measures, meaning if the scores are overly negative, overly positive, or really inconsistent, it flags the scores as potentially invalid. If you are asked to complete rating scales, get these completed and turned in as soon as you can—If the psychologist is waiting on them, it will delay your results. Also, if you are asked to complete a multiple-choice assessment, selecting more than one response or writing your answers in the margins as opposed to choosing items as requested makes it much more difficult for a psychologist to interpret your results, so try to follow the directions as written.

Once all of the relevant information is collected, a psychologist scores and compares the various sources of information and puts things together to determine whether the individual meets the criteria for a diagnosis, and then provides recommendations for the client. For children, this frequently includes sharing the report with the school system to obtain adaptations or accommodations with an IEP or 504 plan, but may also include additional therapies or services and book or strategy suggestions based on the difficulties reported by the client and client’s family. 

After receiving an evaluation that documents a diagnosis, school systems frequently complete their own evaluation to assess the child’s difficulties. Though this can seem somewhat repetitive, school testing is focused on the child’s educational needs and does not provide a medical diagnosis, so it is important and necessary to do both to enable the child to benefit from both school and additional resources. 

Ultimately, psychological evaluations can be incredibly helpful to identify strengths, weaknesses, and mental health conditions that can benefit from particular therapies, strategies, or accommodations. It can help a child get extra support in school or other supportive therapies, it can help individuals access supports or accommodations in high-stakes testing and work environments, and most importantly, it can help an individual and the people they spend time with understanding their needs. 

Dr. Jessica Myszak is a licensed psychologist and director of The Help and Healing Center. She conducts psychological evaluations for a variety of conditions for children and adults on the North Shore. You can reach her for questions or to schedule appointments at drmyszak@helpandhealingcenter.com.