Parents and pediatricians often have concerns related to one or more aspects of a toddler or young child’s developmental trajectory.  Sometimes, the concern is specific, such as a question of an autism spectrum disorder or neuromotor delay. Other times, concerns arise pertaining to specific areas of development such as cognitive skills, language functioning, social interaction skills, emotional regulation or adaptive functioning.  Parents may wonder, “Why isn’t my child talking yet?” or “Why can’t my child follow directions?” A neurodevelopmental evaluation is a specialized assessment of infants and preschool aged children to provide a profile of the child’s relative strengths and weaknesses, and also determine if there is a specific disorder or delay in functioning.  The evaluation includes standardized assessment with the child, as well as a clinical interview with parents, behavioral observations of the child and use of norm referenced rating scales. Results of neurodevelopmental testing are used to develop early intervention strategies and make recommendations for various therapeutic services. The earlier the diagnosis is made, the more effective therapeutic interventions will be.

As children approach school age and begin formal educational programming, concerns often arise pertaining to children’s learning and ability to use knowledge and skills.  Often these concerns first surface when a child is struggling in school; there may appear to be a discrepancy between their effort and academic performance. Other times, concerns in functioning arise after a child has sustained a neurological injury, endured an illness, or suffered exposure to toxic substances.  Regardless of the impetus, a neuropsychological evaluation is a comprehensive assessment of basic and higher level cognitive functioning. This assessment entails measuring overall intelligence in addition to constructs such as attention, memory, language, motor skill, perceptual skills, critical thinking, problem solving and executive functioning.  Standardized testing is used in conjunction with observational data, questionnaires and rating scales. The neuropsychological evaluation serves as a roadmap or blueprint to the child’s learning. The data gleaned from this evaluation yields a cause of a child’s difficulties. The results of neuropsychological testing help to determine if a child qualifies for special education services.  Specific recommendations are made to help provide accommodations for areas of weakness and identification of compensatory mechanisms for the child to employ to maximize success. Recommendations may also be made for ancillary services as needed.

All children experience some challenging behaviors or changes in mood as they grow and mature.  While some “bumps” in the road are to be expected, there are also instances in which behavior supersedes what is to be expected.  Parents commonly voice concern when their children present with internalized sentiments such as excessive worry or anxiety, inadequate peer relationships, low self-esteem or irrational fears.  Parents may also notice more external manifestation of behavior such as frequent crying, lack of energy, isolation, tics or difficulty sleeping. A psychological evaluation may be warranted in these instances in order to decipher if a clinical disorder exists.  Obtaining a proper diagnosis is imperative so that appropriate treatment can commence. With implementation of treatment, symptomology often dissipates and overall functioning improves. A psychological assessment utilizes standardized testing as well and clinical interviews and interactions with a clinician.  

Identification of a child’s exceptional thinking skills is important for many reasons.  Knowing that a child is gifted helps in educational planning in order to ensure that he/she is exposed to curriculum that is stimulating and aligned with their learning style.  For many children who are gifted, school may be frustrating and isolating. Determining gifted and talented status will help to alleviate some of these negative sentiments by helping to identify a learning environment that will stimulate growth in the child’s areas of strength, provide enrichment and capitalize on their unique cognitive profile.

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by Michele Mannering, PhD