What to expect before, during, and after an evaluation
An evaluation for dyslexia or a language disability is a comprehensive assessment that provides clients and family members with a clear understanding of the individual’s competencies in the following areas: oral language, phonemic awareness, decoding, reading fluency (i.e., rate + accuracy), reading comprehension, writing, and spelling. Articulation skills, social skills, and/or oral motor difficulties may also be a part of the testing battery.
Evaluations should be performed by a professional with extensive knowledge in speech and language development as well as literacy disorders. Master’s-level speech-language pathologists who are certified with the American Speech and Hearing Association, are an excellent choice, as are your school or private psychologist and/or a learning disabilities specialist.
For children, school districts will often use some of the same assessment tools that private practitioners use, but schools are generally more inclined to focus on achievement testing. Districts will vary in their choice and use of tests and screening tools, as determined by budget and time constraints, certification requirements, and training. By familiarizing yourself with the available testing procedures and options, you can better understand how your child’s disability impacts his or her learning. Planning ahead can also help you avoid duplicate testing between schools and private professionals.
An evaluation can provide very valuable information, either for initial diagnosis or when you have baseline data from which to measure “change” or growth. But this is also why it is important to understand what a specific assessment tests for, because if it does not match the initial concerns or the baseline data already in place, then the information gathered may not be relevant or accurate. Here are some things to consider before, during and after an evaluation for dyslexia or language disability.
What to expect before the evaluation
If your child is going to receive an evaluation in the public schools, there is a process mandated by federal law under the Individuals with Disabilities Education Act (IDEA). You should become familiar with IDEA. You should also understand the IEP (Individual Educational Plan) process. As part of a comprehensive evaluation, you may be asked to fill out a checklist and/or language and behavioral inventory regarding you or your child’s current status, developmental and medical history, family history, and educational history. In many cases, the professional will also have observed your child in the home, clinic, or school setting and will have completed similar checklists or inventories. When you meet with the professional, she will offer her interpretations of the data and her initial impressions, which will inform the testing. The practitioner will be able to tell you which tests will be administered and why.
Here are questions that you might want addressed prior to agreeing to assessments:
- What is the purpose of the testing? Is it to establish a baseline of skills or to determine whether or not a child has a specific disability? Is it to measure ability or academic achievement?
- What is the assessment’s protocol and format? Is the test timed, multiple-choice or fill in the blank, oral or written? For what age is the test standardized? Is it administered individually or to a group?
- Is the choice of an instrument validated for the specific purpose for which the evaluator is seeking clarification or baseline data? Is the evaluator trained according to the publisher of the test?
- If a child has sensory or physical limitations, will the test provide accurate data relative to the child’s knowledge and performance capability or will it merely measure his or her disability?
- How often should children be tested? When is it important to vary the assessment tools so that the data are valid and not hindered by repetition?
- Will the whole test or only some of the subtests be administered? How are the professionals making their selections? If they are giving only part of a test, will this give you a standardized score?
It is important to have a conversation with your child before the evaluation so they know what to expect and are not surprised when they arrive. More than likely, if you have decided to have your child tested (or be tested) you understand there is an area of difficulty. Tell your child that the purpose of the evaluation is to help you both learn what he is good at, what things are difficult, and how to help him succeed.
What to expect during the evaluation
The length of time for a comprehensive evaluation will depend on the number of areas to be assessed and the age of the individual. A language and literacy evaluation for a younger child typically lasts between 3-4 hours; whereas for a teen or adult, it can take 6-8 hours. The school professionals will do the testing during the school day. At an independent center, depending on the age of your child, you may be asked to be in the evaluation room. The professional will use his or her judgment to determine what is best for your child.
Dr. Pierson recommends that family members observe the assessment from behind a one-way mirror if possible. This way parents can see their child in action with the test items and have a better understanding of what was asked of the child and how he or she performed (versus only getting that information in a report). You’ll want to be sure that the diagnostic tools are designed to assess the specific areas of concern, and that they are age-appropriate.
Everyone, regardless of age, should have a recent hearing screening and have passed a vision screening. Examples of appropriate tests in the areas of oral and written language are:
- Peabody Picture Vocabulary Test (PPVT-4) assesses one’s receptive vocabulary knowledge
- Clinical Evaluation of Language Fundamentals, Fourth Edition (CELF-4) assesses receptive and expressive oral language skills
- Comprehensive Test of Phonological Processing (CTOPP) assesses phonemic awareness and rapid automatic naming
- Gray Oral Reading Tests, Fourth Edition (GORT-4) tests oral reading decoding and fluency
Test of Written Language, Third Edition (TOWL-3) assesses writing a story, grammar, and spelling
What to expect after the evaluation
Following the evaluation, clients and/or families are provided with a report that gives a diagnosis, and outlines recommendations for therapy, activities for home practice, and school supports. Recommendations include the client’s present level of functioning, and clearly outline the path he or she needs to take to get the support necessary to succeed academically and in life. A typical diagnostic report from a professional might include the following:
- A statement about how or why your child was referred to this professional
- A one-paragraph summary of the professional’s initial impressions
- A comprehensive list of the assessments/tools used to reach a diagnosis
- Information regarding how the test is typically administered and scored
- A summary of findings and results related to your child
- A prognostic statement, which is the professional’s best prediction of long-term outcomes for your child
- A list or summary of needed interventions to accomplish short and long-term goals, with some descriptions of types of intervention as well as number and/or length of appointments
- Follow-up assessments, if recommended
Diagnostic reports will likely contain information and terminology that you may find difficult to understand. Prior to the delivery of a written copy, the professional will usually schedule a face-to-face meeting (i.e., consultation) to review the findings. This will give the client and family members insight into the next steps they will need to take to support the client’s academic success.
- During the consultation the professional will review all aspects of the report.
- He will respond to your questions/concerns.
- It might be a good idea to write down all questions that you would like to address at this appointment. Remember to take the questions with you and make sure that they get answered.
The period following the initial processing of this information can be emotional and confusing. Here are some suggestions to help you navigate.
- It is important for you to request clarification about any of the terms or results that you find unclear.
- Ask for resources and references so that you can begin to understand the nature of your client’s delay or disorder. You may need to do this more than once.
- It might be useful to pull out the section in your report on recommendations and print it separately to use as a starting point in the educational planning process. This section will help you negotiate the type of intervention needed, along with the corresponding levels of intensity and duration. Decisions about intensity and duration are critical aspects of early intervention planning.
- Setting up a binder in which to store all reports, assessments, and school documents in chronological order will prove useful. All written correspondence to and from the schools should be dated and saved for future reference. You will refer back to this information time and time again.
In the public school, an IEP meeting will be scheduled to discuss the results and determine a course of action based on your child’s individual needs. The term “professional” is a general term used and refers to any of the following: neuropsychologist, psychologist, psychiatrist, speech-language pathologist, pediatrician, neurologist, and all members of a school special education staff: teaching consultant, speech therapist, occupational therapist, reading specialist, etc.