speech and language

By: Cynthia Hess, PsyD
Pediatric Neuropsychologist

While both a school evaluation and a private neuropsychological evaluation often provide valuable information, there are some considerable differences. The primary purpose of a school evaluation is to determine whether or not a student presents with a disability that impairs their ability to access the curriculum and fully participate in the academic and social life of the school. Once a student has been referred for special education, the special education team convenes to determine if, when, and how the student should be evaluated. They decide which instruments will be used for the assessment and who will be responsible for administering them. For example, if a student is referred for a suspected disability, a school psychologist conducts a cognitive evaluation, and a special education teacher will administer an academic assessment. A speech and language, physical therapy, functional behavior, or occupational therapy evaluation may be requested as well. After testing, each specialist writes their report and presents their results individually.

When a student participates in a private neuropsychological evaluation, the parents and student work closely with the evaluator through the entire process, from the intake to feedback and beyond. While there are certainly very comprehensive school evaluations, the information obtained by the evaluators is rarely integrated and instead presented as separate evaluations. This does not allow for a complete understanding of how deficits (or strengths) impact functioning across domains, especially when the child has complex challenges. A comprehensive neuropsychological evaluation is comprised of many elements. Most evaluations consist of a detailed developmental and family history, cognitive, academic, learning and memory (auditory and visual) assessment, visual-spatial and graphical motor skills, and attention and executive function. Depending on the referral question, the evaluation may include reviews of social skills and adaptive functioning or specific measures to assist with making a differential diagnosis. Generally, the assessment is conducted by a single evaluator. The data, including data from prior testing, is synthesized into a detailed report with specific recommendations for school, home, and community life when appropriate.

There are undeniably circumstances when a thorough school evaluation is beneficial. School evaluators have opportunities to observe students at school and consult with their teachers, which can be advantageous (although observations may be requested or necessary to complete a thorough private evaluation, too). School team members also have many opportunities to collaborate when evaluating and working with students. However, school personnel are limited in their ability to integrate data across disciplines, provide diagnoses, and directly assess medical conditions, such as attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and complex challenges, such as dyslexia and nonverbal learning disability (NLD). Additionally, while some parents establish a good working relationship with members of the special education team, they do not have the opportunity to develop a long-term, collaborative relationship with the evaluator as they would when a private evaluation is obtained.

About the Author

Dr. Cynthia Hess recently graduated from Rivier University with a PsyD in Counseling and School Psychology. Previously, she earned an M.A. from Antioch New England in Applied Psychology. She also worked as an elementary school counselor and school psychologist for 15 years before embarking on her doctorate. During her doctorate, she did her pre-doctoral internship with RIT in Rochester, N.Y. where she worked with youth ages 5-17 who had experienced complex developmental trauma. Dr. Hess’s first post-doctoral fellowship was with The Counseling Center of New England where she provided psychotherapy and family therapy to children ages 5-18, their families and young adults. She also trained part-time with a pediatric neuropsychologist conducting neuropsychological evaluations.

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Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.