Health and Psychology

The test selection for a complex assessment is based on the referral question.  It's helpful to think of these in levels.  The first level is a very simple question that can be answered with a single test and history or a couple of tests and history.  Examples of these types of questions are:

• Can I read at grade level?
• Is there any evidence of a brain injury?
• Do I have any symptoms consistent with ____ (diagnosis)?

The next level up in complexity is one of specific diagnosis.  These questions require more than a single test but may not require an extensive battery.  Examples of these types of questions are:

• I've been told I might have a personality disorder.  Which one do I have?
• Do I have Attention Deficit Hyperactivity Disorder?
• Am I disabled/gifted according to the criteria my school uses?

The next level up in complexity requires multiple tests put together in a collection known as a "battery."  The questions requiring this level of assessment look at broad areas of functioning but usually not the etiology of a disorder or the exclusion of other possibilities.  Examples of these types of questions are:

• What functional impairments does this person have?
• What is their personality structure and defenses?
• What is their level of cognitive functioning?

The next level up in complexity looks at causation or looks at functioning over time or looks at differential diagnosis in a complex manner.  These are always full batteries and may involve novel techniques looking at duration, accommodation strategies, sequencing, and complex medical interactions.  Examples of these types of questions are:

• How will this person perform in a three day examination and what might help them do better?
• What types of strategies, devices, or treatment might help keep this person with a brain injury functioning at home?
• This person has vague medical symptoms and no diagnosis, their physician is getting frustrated what are the next steps?
• This person reports a brain injury.  Are the symptoms they have consistent with the car accident they were involved in?

Even more complex evaluations are possible.  They involve documenting how someone functions in a variety of settings and may involve videography, seeing them in multiple locations, and trying different intervention techniques to see if strategies are correctly implemented, working correctly, or can be tweaked to work better.