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A Child’s Psychological Evaluation: Why, and What That Means

Photo via <a href="http://www.morguefile.com" target="_blank">Morguefile</a>

Psychologically Evaluating a Child: Why, and What It Means

When our son’s teacher told us that he’s been having trouble socializing with the other kids in his class, we weren’t surprised. Getting along with other children has been an issue since Felix became mobile. At the tot-lot and later the playground, Felix needed near constant supervision, otherwise he might toddle up to another child and pull their hair, or bite them, or scratch their face, or, as he learned how to run, latch onto their toy and then tear off with it. The winter right before he turned two, I hosted a playgroup at my house each week. I’d keep one eye pegged on him the entire time, my body tense, ready to jump in the fray and stop him when things got out of hand, as they often did.

It’s not that Felix is a mean kid, or heartless. He’s a sweetie when you talk to him, brimming with good intentions, always in the mood for a kiss or cuddle. He’s incredibly smart and loves holding leadership positions. He’s a great help doing chores around the house and running errands, and he’ll yap your ear off with his keen observations and wacky ideas. He even has a good sense of humor! Adults, by and large, love him.

Why, then, the problem interacting with other kids? We have theories — ideas about how other children make our anxiety-prone little guy nervous, and how his behavior gets him the adult attention he loves, and how his low frustration tolerance and lack of impulse control make for a toxic combination. Or perhaps he’s just not developmentally ready for socializing with peers. While Felix gravitates toward facts and science concepts, emotions, empathy, and morals sometimes confuse him.

We had hoped that he would grow out of these behaviors. He’s a bright little boy with a lot of physical energy! This is something to celebrate, not stifle. At two years old, he attended a morning drop-off program a couple of times a week. It didn’t go well, and his teachers advised a psychological evaluation, but we decided to give him a year off of school, more time to ripen on the vine. The following year, his babysitter loved him, but sometimes reported acts of aggression — hitting, or pushing, using hurtful speech — when things didn’t go Felix’s way. We experienced the same.

Hearing about his behavior, my therapist suggested we seek outside help, and when Felix’s pre-K teachers told us about the countless issues he experiences each morning at school, my wife and I decided to act. He’s four years old and kindergarten looms on the horizon, but at this point he’s unable to focus on academic tasks because his classroom behavior is out of control. My wife contacted the New York City Department of Education, and, upon submitting a letter stating our concerns and the concerns of his teachers, Felix was granted a free psychological evaluation. (Private evaluations can be conducted too, but I hear they’re pricey, costing several thousand dollars.)

For us, the psychological evaluation consisted of four things:

1. An intelligence assessment and play-based observation with a child psychologist. For a four-year-old, the IQ test is a series of games and puzzles. Felix needed his mom to sit in the room with him and the therapist to complete the tests, which was fine. This took a while — perhaps about two hours total, which he did in two visits.

2. A long interview with a social worker about Felix’s behavior history, our family history, our home life, even the pregnancy and birth. I handled this, which took well over an hour.

3. A meeting with an occupational therapist, which we found a confusing term. For little kids, the “occupations” aren’t jobs but the cognitive abilities necessary to complete daily skills. This means processing sensory data, fine and gross motor skills, and the child’s ability to soothe and care for himself when overwhelmed.

4. A school evaluation, in which an assessor (a psychologist) went to Felix’s school to briefly talk with his teachers about his behavior, and then spent an hour or so observing him herself.

At this point, all of the evaluations are complete, and so we’re waiting — mostly with hope, though a little unease as well — to sit down with the assessors and the Department of Education to hear their recommendations for Felix and for us, too. Ideas on what the best environment might be for him, and what kind of therapy will help, and how we can best support him at home.

I feel pangs of regret that we didn’t move on this sooner, that we resisted the advice of his first group of teachers to seek help. My wife and I thought that maybe in a different environment, with different teachers, and at a different stage in his life, he might be ready for school. We were reticent to label our son with some kind of behavioral disorder, or go down a path that might lead to a prescription for a Ritalin-like drug or child anti-depressant. However, this doesn’t seem to be the likely outcome. Instead, we’ve found ourselves relieved to hear that no, we’re not crazy (and neither is he!) and we’re not doing a bad job as parents (though like most parents we feel we can probably be doing a better one). The specialists and educators who have spent time with Felix all agree that he has some unusual issues, and needs extra help in order to function in a classroom environment. This doesn’t mean that he’ll never be able to do so, just that he’ll need assistance, patience, time, and care.

The professionals we’ve dealt with at every step of the way have been warm, smart people who obviously do what they do because they love kids and want to help them. Obviously, the process carries some amount of stigma to it — no parent wants to hear that their child has developmental problems, and fewer still want to admit it when they do. However, being honest and facing those issues feels better than ignoring them, or just getting by passively with the hope that they’ll one day disappear, poof! as if by magic. Our primary role as parents is to care for our children, and sometimes that means admitting that we’re not enough to care for them on our own; we need help. It’s ok to admit that. You don’t have to be alone when dealing with a child of special needs or challenges. Help is out there, if you want it.

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