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      Learning Objectives

      After reading this chapter, you should be able to do the following:

      4.1 Psychological Assessment

      What Is Psychological Assessment?

      Definition and Purpose

      Psychological assessment refers to the process of gathering data about children and families in order to reach valid conclusions about their current functioning and future well-being. The assessment of children and adolescents can have several purposes (Sattler, 2014). First, assessment can be conducted to screen children for possible behavior problems or developmental delays. For example, a pediatrician might ask a psychologist to screen a toddler who is showing delays in language acquisition and social skills despite normal sensory and motor functioning. The psychologist might conduct a brief evaluation to determine whether the child has a significant delay that needs attention. Early screening can prevent more severe problems later in development (Briggs-Gowan, Godoy, Heberle, & Carter, 2016).

      Second, assessment can be used to reach a diagnosis. For example, parents might refer their child to a psychologist because the child is showing a range of behavior problems. The psychologist would likely conduct a detailed evaluation of the child’s strengths and weaknesses to identify the nature of these problems. The clinician might assign one or more diagnostic labels to describe the child’s main problem areas. Diagnosis can help parents understand their child’s functioning, allow the clinician to estimate the child’s prognosis, and help the clinician identify treatment options (Achenbach & Rescorla, 2016).

      Third, some assessments are conducted to plan treatment. For example, a third-grade teacher might ask a school psychologist to assess a student who repeatedly bullies younger children during recess. In this case, the purpose of assessment is to identify potential causes of bullying and to plan an intervention. After careful observation of the bully’s behavior, the school psychologist might notice that the boy initiates fights only with certain peers. She might recommend that the bully be separated from these peers during recess in order to avoid the problem in the future.

      A fourth purpose of assessment is to monitor progress in treatment. For example, a pediatrician might prescribe methylphenidate (Ritalin) to a boy with ADHD. She might ask the child’s teachers to rate the boy’s ADHD symptoms for 3 weeks. During the first week, the boy might not take any medication. During the second and third weeks, he might take varying doses of the medication. The pediatrician could use teachers’ ratings over the 3 weeks to determine whether the medication reduced the boy’s symptoms and which dose was more effective.

      Psychological assessment involves much more than administering a test or assigning a diagnosis. Instead, assessment involves appreciating children’s strengths and weaknesses within the context of their surroundings and drawing valid conclusions regarding how to help them improve their lives. Consider the following case of Sara, a girl experiencing considerable distress. Her parents need help determining the best way to treat Sara’s problem.

      Psychological assessment is a process. From a scientific perspective, each assessment is analogous to a research study with a sample size of one. The clinician listens to the family’s most immediate concerns and begins to formulate hypotheses about the child’s functioning. For example, if a child refuses to attend school, like Sara, possible hypotheses might be (1) she has a cognitive or learning problem that causes her academic difficulties at school; (2) she is experiencing bullying, peer rejection, or other social problems at school that she wants to avoid; or (3) she is experiencing anxiety about school or worry about leaving home.

      The clinician systematically tests each of these hypotheses by gathering data from parents, teachers, and the child. Hypotheses that are supported by the data are retained; hypotheses not supported