Pediatric Mental Health Evaluations

August 24th, 2022

Have you ever wondered why your child may struggle in school? Or why do they have difficulties completing tasks at home? Or maybe worry about how they are getting along with peers? While some of these issues may be a part of typical age development, you may wonder why it is particularly challenging for your child and what to do about it.

Psychological testing is an option. It is a specialized, in-depth process conducted by a licensed clinical psychologist to evaluate the person’s intellectual skills, academic skills, cognitive abilities, personality features, socioemotional well-being, and coping styles. You may decide that getting an assessment for your child or adolescent will be important for their future, help you better understand them, and get them the support and resources they need.

However, how would you communicate this to them? How do we help them get excited, engaged, and invested in the process?

Assessment

First, we have to understand what is involved in an assessment. Every assessment is individualized and unique to the person’s presenting concerns. But generally, an assessment would involve:

Interviews – We want to learn about your child and you as much as possible. This will include interviews with family, caregivers, and key people in their life (such as teachers or coaches) and formal questionnaires.
Review of records – The more information we can gather, the clearer we can answer those questions. If it is possible to obtain copies of school records, previous testing, or medical records, we will review them as part of the process.
Individual testing – This may span over several hours, which can be broken into shorter sessions over 2-3 days, depending on the child or adolescent’s tolerance and willingness to engage. During this time, the child or adolescent will be asked to complete various activities to assess areas of cognitive abilities, learning, problem-solving, memory, social skills, emotional processing, and behaviors. This may look like puzzles and games. Test selection is based on the specific question we are trying to answer. We will also do something fun, like play Uno, Jenga, draw, or other games, from time to time to take a break. The psychologist will utilize this time for direct observations of the child or adolescent’s behaviors.
Written report – After completing the testing, the psychologist will schedule a feedback session in about 2-3 weeks. During those 2-3 weeks, the psychologist will score and review all the information and data gathered to determine the answers to the questions and treatment recommendations. This is all happening in the background; you and your child do not need to be present. The psychologist may contact you or other key people to clarify information.
Feedback Session - During the feedback session, we will review the report in detail and help you identify your next steps, including discussing tips and tricks for home and school and collaborating with the school and other providers if needed.

Conversations

It is not a quick process, and for children and adolescents, this sounds like a big ask. What if they resist? What if they don’t want to participate? Here are some ideas or tips that may help make this a smoother process:

You may want to schedule a consultation with the testing psychologist without your child or adolescent present to address your concerns and work on a plan to approach having this conversation with your child or adolescent.
Explain that they are going to a “different kind of doctor.” Depending on the age of the child, you may say that they will be going to see a doctor who will help them learn about their brain and how it works. They may have their own ideas of what going to the doctor would be like, but you can assure them that there would not be any shots or be poked or prodded.
You may want to explain the purpose of the assessment to help you both learn how they understand and learn information, help teachers learn how to teach them, and help those who care about them know the best ways to support them.

An example conversation starter may be:

“I’ve noticed it has been a bit tough for you recently. What do you think? (pause for response). You know, you do really well at ________, but I agree and have noticed ____________________ (use their words). I’ve been thinking that if we knew more about how you think, learn, and understand things, I could do a better job of helping you and maybe show [teachers, grandparents, coaches, etc.] the best way to teach and work with you. I recently met with someone who can help us answer some of the questions you and I have. Their job is to help kids learn and understand their brain and figure out what you’re really good at as well as what ideas we can do to help you on things that are hard for you.”

Using Their Words

Use your child’s words to help them understand. Be thoughtful about using age-appropriate language. They notice they struggle too but are likely to use different words than adults to describe what is difficult. For example, “I hate school,” “I’m always in trouble because my teacher doesn’t like me,” or “I don’t have any friends.”

Examples of using their words:
- “It sounds like you think you’ve been getting into trouble a lot at school. I noticed that too. Maybe there is a way for us to figure that out together.”
- “I heard you say that you think you don’t have any friends or your classmates don’t like you. It doesn’t seem to make sense because you’re so kind and fun! I wonder if we can see what is going on there.”

Take pauses and check in with your child to see if they understand. Pay attention to their facial expression and body language. If they seem disconnected or like they are not paying attention, ask to see if they have any questions or if they understood what a particular word means. I found that when my child looks at me blankly, it was because I used a word that she didn’t know the definition of.

Permission

Ultimately, we want to get your child’s or adolescent’s buy-in. We don’t want to test them without their permission because it would be difficult to get an accurate assessment if they are not putting in a good effort. We may take extra care and time here to build the relationship and answer any questions or concerns that they may have. You may want to tell them:

“I understand you may not want to do testing, and it is a decision I respect. However, I would like you to have all the information and your questions answered before you decide. Would you please come to meet the doctor and see what it would be like, and then we can talk about it afterward and decide?”

We want to avoid pressuring them because that may create stress and anxiety as well as increase resistance and avoidance.

Choose the time and place to have this conversation. A place with little distraction but not intimidating would be helpful. I sometimes have the best conversations with my child in the car. I’m looking at the road, not directly at them, reducing intimidation. Make sure they are also not distracted by the TV, tablet, or other things that are going on in the environment. During a walk is a great example as well.

You’re taking a big step, and it can be an intimidating process. Utilize your psychologist as a source of support. We are here to support you and your family on this journey!

Written by Dr. Kailyn Bobb, PsyD.

Clarity Clinic

At Clarity Clinic, we have highly trained staff who specialize in therapy and psychiatry services. To learn more about how we can support your mental health, call Clarity Clinic at (312) 815-9660 or schedule an appointment today.

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Pediatric Mental Health Evaluations

Assessment

Conversations

Using Their Words

Permission

Clarity Clinic

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