Author: Dr. Norman Brodie
Source: Adapted from an article in LDA Yukon News, June 1998, reprinted with permission of the author.

Background information

A good diagnostic assessment for learning disabilities needs to address several important areas. A primary need at the onset of the diagnostic process is the taking of a good history. While the diagnostic testing can provide excellent evaluations of the current levels of functioning in the various areas assessed, it is also important to have:· a detailed history of the development of the problems (including a developmental history with attention to issues such as delayed speech and motoric milestones)

• any family history of similar conditions amongst blood relatives (many learning disabilities “run in families” and are clearly related to genetic predispositions),
• and personal history for relevant events such as head injuries or other neurological insults and emotional stressors (such as family break – ups, exposure to domestic violence or child abuse, reactions to changes tn the family structure from additions or losses to the family, etc.)
• This background information is crucial to a thorough assessment, as the professional not only has to determine if there are true educational deficits or impairments, but also to attempt to identify the cause of them in order to determine the correct line of intervention.

The next stage of the assessment process is to obtain some current information regarding the child’s functioning in the day – to – day life situations such as at school and at home. Depending upon the age and expressive verbal skills of the child, a considerable amount of information may be obtained from a direct interview and asking specific questions about their experiences and feelings in different situations. This helps to identify how the child sees him or herself, as well as providing some insight into their self-esteem and approach to challenging situations. I also interview the parents whenever possible and generally attempt to get some additional information from both parents and the teacher through behavioural rating scales that help to quantify and make more specific the descriptions of the behavioural and emotional responses in different environments. This is especially critical when assessing for the possible presence of an Attention Deficit Hyperactivity Disorder (ADHD) and/or a Conduct Disorder, as many of the defining symptoms or problems associated with these conditions are not likely to be displayed or observed in the one – on – one testing session in the office setting.

INTELLECTUAL FUNCTIONING

In the formal testing session, it is vital to obtain reliable measures of the child’s current intellectual functioning and academic achievement as a basic prerequisite for making a diagnosis of learning disability. Intellectual testing is most commonly done using the Wechsler Intelligence Scale for Children – 3rd Edition (WlSC – Ill). This is the most widely used intellectual battery for children in North America, and it also now provides (since 1996) Canadian norms based on a very large sample of children from across Canada. The Canadian norms should generally be used as there are significant differences in performance level seen between the norms for the USA and Canada, largely indicating that the American norms tend to over – estimate the child’s performance by a slight extent compared to standards in Canada.

The WISC – III is also a very useful test because it not only provides a general estimate of learning aptitude, it also provides a breakdown into the areas of Verbal, Performance (nonverbal) and Full Scale I.Q. It is also possible to identify patterns of strength and weakness across the profile that can help with determining more specific diagnoses of subtypes of learning disability (such as the identification of global language disorders or nonverbal learning disability subtypes) by consideration of discrepancies between the Verbal and Performance I.Q. scores and patterns of strength and weakness on the subtests.

ACADEMIC ACHIEVEMENT

In combination with the intellectual test results, it is also important to obtain concurrent measures of academic achievement using standardized tests that provide reliable estimates of performance relative to age or grade population norms. This allows for a comparison of performance using national standards rather than subjective ratings based on a comparison to the rest of the child’s class (with uncertainty as to how he/she would compare to a different class of students). It also provides an objective basis for comparing performance to potential by contrasting standard scores from the achievement test (which are generally expressed in I.Q. like units) with the I.Q. scores to determine if the achievement level is significantly below the intellectual expectancy range. This is important in that all standard definitions of learning disability emphasize that the individual has a deficit in learning that is not attributable to general intellectual handicap or deficiency.

It is also important to consider the possibility that a very bright child who functions in the well above average range on the intellectual battery may still have a significant learning disability condition that results in a relative deficit on academic achievement as reflected by low to even mid – average performances on the achievement tests. Formal assessment of academic achievement levels with standardized tests is also important with respect to qualifying for special education assistance in most jurisdictions in Canada. Most education departments have set quantified criteria for identification of learning disability based on performing below specific levels (often at below the 10th percentile) on one or more academic test areas, using a recognized educational achievement test.

Some of the most commonly used educational batteries include:

• the Woodcock – Johnson Psycho – Educational Battery – Revised (WJ – R)
• the related Woodcock Reading Mastery Test – Revised (WRMT – R)
• the Kaufman Test of Educational Achievement (K – TEA)
• the Wechsler Individual Achievement Test (WIAT)
• the Wide Range Achievement Test – 3rd Edition (WRAT – 3)
• and the Canada Quick Individual Achievement Test (C – QUIET)

Each of these tests employs a battery approach to educational testing, employing a number of individual subtests that assess specific skill areas, allowing for the performance to be compared across subject or skill areas, and providing normative data that allows the individual’s scores to be compared to standards established at a national level. All of these tests also correlate quite highly with one another, and the results obtained on one tend to be similar to the results obtained on another, such that selection of the specific test is often a matter of personal preference by the specific consultant.

In my own practice, I most often employ a combination of the WRAT – 3 and C – QUIET tests in combination with other measures as needed, such as the use of the Canada French Immersion Achievement Test (C – FIAT) that is produced by the authors of the C – QUIET to allow for a direct comparison of the student’s performance levels in English and French when the child has been enrolled in a French Immersion school programme. I also employ a variety of more selective tests such as specific tests of reading vocabulary and reading comprehension from the Gates – MacGinitie Reading Tests or measures of visual spelling recognition and resistance to various forms of reading errors with the Diagnostic Analysis of Reading Errors test or measures of writing skills using the Test of Written Language – 3rd Edition. The specific test battery selected is, however, of less importance than ensuring that the areas of identified academic weakness are systematically assessed with a reliable and valid achievement test. The test should provide standard scores and percentile rankings that can be contrasted to the intellectual estimates in order to identify discrepancies indicative of learning disability, and provide a breakdown of scores into functional areas for remedial planning purposes.

SELF-ESTEEM & EMOTIONAL STATUS

Another area that should be included in almost all psycho – educational assessments is a systematic evaluation of self – esteem and emotional status. Many students with learning disabilities have developed significant problems with self – esteem and emotional reactions to prolonged frustration. Negative self – esteem and childhood depressive reactions also seriously compromise the individual’s ability to apply themselves to programming in an effective fashion. Therefore, when such emotional interferences are present (whether as a primary problem or as a secondary reaction to the learning disability), it is imperative that we recognize these as problems in their own right and initiate some intervention or provide assistance to help them begin the process of developing improved self – confidence (e.g. encouraging the child to participate in some extracurricular activities for self – esteem boosting success and “setting them up for success” in some areas). In some cases, the emotional distress and disturbance may be of sufficient severity that formal professional counselling and/or medical treatment of depression may be necessary. A combination approach of rebuilding self – esteem as well as improving the educational programming at the same time is most often necessary and critical for either aspect of the overall plan to succeed.

Summary

What is most important is for the psychologist to be able to use the available information arising from the history, clinical interviews, test behavioural observations and objective test data to achieve an integrated or holistic picture of the individual and the specific needs for each case. Only with such a well detailed picture of the person as an individual can we begin to identify specifically what type of educational programme, supplementary assistance and educational modifications are appropriate for the specific situation. This places the psychological assessment findings well above the assignment of a simple label or diagnostic term. Through such a comprehensive evaluation process, the individual’s strengths and talents are also highlighted and brought into focus as a basis for preserving and enhancing self – esteem and personal development.