Assessment & treatment of cognitive problems, learning disabilities and ADHD
At the SCDC we see a large variety of children with developmental, cognitive, learning, social, emotional and behavioural issues. We offer a very flexible assessment system: we do not believe in a fixed battery system as every child is highly unique with different core issues underlying their functional weaknesses and differing patterns of strengths and weaknesses. To administer all available cognitive tests to children would take over 7-8 hours and be highly inefficient and stressful for the child. We therefore base the initial assessment on parental ratings/ interview as well as teacher ratings, and then continue the assessment according to patterns of performance noted on the testing.
Our point of difference
An IQ test and academic tests are starting points, but we do not recommend these tests in isolation as they tell you little about the core issues underlying performance. We also do not recommend that questionnaires alone are used to measure attention skills as numerous processing issues (other than true attention problems) can create low ratings. It is vital that when you are looking to get your child assessed you ask what sort of assessment the health professional conducts and whether they can give all the specialist tests noted below. Otherwise you may find yourself shuffled to numerous professionals before a diagnosis can be made, or a misdiagnosis may be made if certain issues are not ruled out. Up to 50% of patients we see who come to us with a diagnosis of ADHD are misdiagnosed and actually have a non-attention based processing disorder such as a visual processing, auditory processing, or speed of information processing disorder. All of our assessments are aimed at understanding your child holistically in regards to not only their cognitive skills but the impact upon them psychologically, emotionally, socially and behaviourally. We recognise that accurate diagnosis and assessment is vital to be able to treat the child as holistically as possible in order to help them maximise their potential.
A complete solution
All our assessments are aimed at providing the parents with (1) a full description of their child’s strengths and weaknesses, (2) short-term recommendations on how to manage their weaknesses at school and at home, and then (3) a long-term program of how to manage and improve the areas of weakness through various types of therapy and cognitive training. Whilst there are certain specialists who do provide an excellent standard of assessment outlined above, it is vital that the person doing the assessment is also able to offer a comprehensive therapy and treatment program. At the Sydney Cognitive Development Centre we have a team of neuropsychologists, clinical psychologists, speech therapist, orthopist/visual trainer, cognitive trainers, and educational specialists who can treat every aspect of your child’s issues. We have a philosophy to address issues from all angles to be able to achieve maximum benefits. For example, many children with cognitive issues develop anxiety and low self-esteem and even though we can improve core cognitive skills, without improving the psychological factors, children won’t believe they can succeed and therefore still won’t try. For children with multiple issues we combine therapies so that the child can reach their highest levels of potential. We aim to provide families with a complete solution to helping their child maximise their potential and create the best quality of life for them in the long-term.
What types of specialist testing we conduct
- Intellectual functioning: verbal reasoning, nonverbal reasoning, working memory, processing speed
- Reading accuracy, reading speed & reading comprehension
- Spelling & writing
- Phonological Awareness: blending, segmentation, rapid naming, phonological memory, non-word reading
- Mathematical operations and reasoning
- Memory: visual & verbal memory, immediate and delayed memory, recognition memory
- Attention: visual sustained attention, auditory sustained attention, switching attention, divided attention, selective attention
- Attention/ memory span: auditory & visual
- Impulsivity & stimulation (boredom) levels- to both auditory and visual information
- Executive functioning: planning, organisation, abstract reasoning, self-monitoring, utilising feedback
- Processing speed: visual and auditory
- Cognitive flexibility
- Visual processing: discriminiation, figure-ground, spatial skills, closure, form constancy
- Auditory processing: discrimination, figure-ground, filtered hearing, ear dominance
- Psychological issues: depression, anxiety, anger/frustration, aggression, self-esteem
- Social skills
Note: Many parents take their children for cognitive testing and are surprised that even though they told the psychologist their child seems to have memory and attention problems they just do an IQ test and don’t actually do formal memory or attention testing. Make sure that the psychologist can assess all your concerns and don’t think that just because someone says they can do a cognitive assessment they actually have complete tools. You must know the correct questions to ask to see if they are properly qualified, so you don’t waste your time and money. The following questions are helpful:
(1) Do you have a full neuropsychological test library and can you administer tests of attention, memory & executive functioning? Not just one attention or memory test- but all the types mentioned above. Many clinicians, including doctors, can run one open source attention test (called a CPT eg. TOVA or Conners), however this is only a test of visual sustained attention. If your child has an auditory attention weakness the issues will be missed and thus this narrow type of attention testing is highly misleading and can lead to misdiagnosis and incorrect treatment.
(2) Are you a registered psychologist? You would be amazed how many people there are passing themselves off as psychologists (and even specialists) and they aren’t even registered. If you are unsure check the APRHA register. This register will also tell you whether the person has specialist registration as a neuropsychologist. Neuropsychological training is a two year degree with an additional 2 years of supervision, and neuropsychological tests are best done and interpreted by someone with this training.
(3) Have you had a minimum of master’s level training in the administration of interpretation of neuropsychological testing? One easy way to figure out if someone has skills in the most basic of IQ tests is to ask them what two skills the working memory index from the IQ test measures. If a psychologist can’t answer this then they do not understand the most basic levels of interpretation of an IQ test . Beware of having even a basic IQ test done with someone who cannot interpret it, as it is not recommended to repeat it within two years.