Psychological Assessments

Personality/Emotional/ Interpersonal Functioning

ADHD and Learning Disabilities

The etiology and continuation of learning, attention, and behavioral difficulties (both in children and adults) are often difficult to discern. Developmental disorders such as Attention Deficit/Hyperactivity Disorder (ADHD), learning disorders, Autism, Aspergers, or psychological difficulties such as anxiety, depression, trauma, substance abuse, interpersonal problems often have symptoms that overlap or mimic each other; understanding the true nature of the problem can be a complex process.

The Center for Integrated Psychological Services at MHCD can help with a comprehensive assessment process is tailored to examine all factors that may be contributing to the client’s difficulties. The goal is to help provide clarification of the client’s symptoms and provide an appropriate diagnosis, if applicable. Individual treatment recommendations are provided at the conclusion of each evaluation, as well as a series of brief, structured interventions (if deemed appropriate). These interventions often focus on achieving the behavior change necessary for academic, emotional, and social growth and development. As needed, CIPS staff will collaborate closely with the client’s physician, and also make appropriate community referrals, to help ensure continuity of care.

Attention Deficit/Hyperactivity Disorder

The diagnosis of ADHD often involves

a clinical interview;
cognitive testing;
self-report measures;
collateral discussions with parents, teachers, and/or physicians;
behavioral observations;
medical history review and/or medical evaluation; and
tests that evaluate attention and impulsivity.

According to the Diagnostic Statistical Manual of Mental Disorders-IV-TR (DMS-IV), ADHD falls into three categories

Predominantly Inattentive Type,
Predominantly Hyperactive-Impulsive Type, and
Predominantly Combined Type.

The following are some common symptoms you may notice

ADHD - Predominantly Inattentive Type

Difficulty sustaining attention.
Does not pay close attention to details; often makes careless mistakes.
Appears as though he/she is not listening.
Struggles with effective organization.
Struggles following through on instructions.
Often loses things.
Forgetful in daily activities.
Easily distracted.
Avoids and/or dislikes tasks that require sustained mental effort.

ADHD - Predominantly Hyperactive/Impulsive Type

Fidgets with hands or feet or squirms in chair.
Has difficulty remaining seated.
Runs about or climbs excessively or experiences subjective feelings of chronic restlessness.
Difficulty engaging in activities quietly.
Acts as if driven by a motor or is often “on the go.”
Talks excessively.
Blurts out answers before questions have been completed.
Difficulty waiting or taking turns.
Interrupts or intrudes upon others.

Learning Disabilities

Learning, attention, and behavioral difficulties, in both children and adults, are often difficult to diagnosis, understand, and manage. Learning disabilities fall into two broad categories: Verbal and Nonverbal.

Verbal leaning disabilities usually consist of general verbal and/or language deficits. Behaviorally, this may look like a person having difficulties with basic reading, writing, and/or oral language processes. Typically, they are functioning lower academically than one would expect, based on their cognitive abilities. In other words, their academic achievement is disproportionate to their cognitive abilities.

Conversely, a nonverbal learning disability usually consists of deficits with visual-spatial-organizational, motor, and social and higher order language functioning. Behaviorally, this may look like a person having difficulties with early speech and vocabulary development, math concept development, fine motor skills, special perceptions, and social judgment. On IQ testing, the client likely has a significant discrepancy between his/her performance and verbal scores, with performance scores being lower.

Historically, the diagnosis of a learning disorder often involved

a clinical interview;
cognitive testing;
achievement testing;
behavioral observations;
collateral discussions with parents, teachers, and/or physicians; and
specialized testing, as appropriate (i.e. adaptive functioning, language and reading tests, visual motor skills etc.)

This process utilizes the discrepancy model to diagnosis a learning disability, that is, identifying a significant difference between one’s achievement scores and one’s cognitive scores. Although many professionals still embrace this approach, the discrepancy model has been at the root of much debate and controversy regarding its utility and accuracy.

The 2004 reauthorization of the Individuals with Disabilities Education Act (IDEA) has allowed school districts the option of utilizing a Response-to-Intervention (RTI) approach to diagnosing learning disorders, instead of the discrepancy model. This alternate, school-based intervention utilizes evidence-based curriculum in a step-by-step fashion to help intervene with students who are struggling academically. The student’s progress is monitored frequently and the intensity of the intervention method increases if the student does not demonstrate appropriate progress in skill development. The students who are not responding to these specific interventions are then eligible for special education services.

Staff at The Center for Integrated Psychological Services at MHCD are continually working on the best way to integrate both the discrepancy model and the RTI model into the assessment process. Collateral interviews will attempt to evaluate the stages of intervention a student has been offered and the effectiveness of those interventions. However, because staff members are not school psychologists and not affiliated with any school districts, CIPS cannot predict or guarantee the response the school may have to the evaluation, diagnoses, and subsequent recommendations.

At the conclusion of evaluation, CIPS staff

Will assist in formulating an effective treatment plan to help clients reach their true potential,
As appropriate, will schedule brief interventions that are strengths-based and can assist with effective study skills, coping strategies, and processing the emotional impact of a learning disability,
Will collaborate, as needed, with the client’s physician, family, and teaching staff,
Make appropriate community referrals, to help ensure continuity of care.

Personality, Emotional, and/or Interpersonal Functioning

Personality assessment can help better understand the dynamic group of unique characteristics that influence how a person thinks, behaves, and reacts to certain situations. How people experience and respond to feelings is an important aspect of their personality. Understanding the role of emotion in the psychological organization and functioning of a client is often crucial, since feelings almost always have some impact on one’s judgment, cognitive processes, behaviors, interpersonal relationships, and general interactions in the world.

The use of objective and projective measures can provide excellent insight into a person’s personality structure, providing clarity around his/her thoughts, behaviors, and interpersonal relationships. The CIPS process focuses on identifying clients’ strengths and empowering them to look insightfully at their behaviors and thoughts, hopefully becoming an active agent in their change process.

Reasons for obtaining a personality assessment may include

diagnostic clarification,
symptom clarification,
treatment impasse,
medication non-compliance or non-response, and
improved clarity surrounding relational patterns and emotional experiences.

Behavioral Medicine