Dear David Coleman: Is three too young for a psychological assessment for my daughter?
Clinical psychologist David Coleman offers parenting advice in his weekly column.
Q. My three-year-old daughter was diagnosed with a global developmental delay when she was about one. We have gone privately for early intervention for occupational therapy, speech and physiotherapy.
The speech therapist is recommending I get a psychological assessment for my daughter. Since my daughter has a delay, is she too young for an assessment and will she just fail it? If we go ahead, I want to make sure the assessment is done properly to give us a correct assessment - so how do I choose a psychologist?
David replies: You have a number of questions exercising your mind with regard to psychological assessment. I can only imagine the extra challenges you face in bringing up your daughter, given the developmental delays that have already been identified. You have travelled a hard road, having to engage with different professionals in order to try to give her the best help in these early years.
I wonder how her "global developmental delay" was first diagnosed? I'd guess that some difficulties were noticed either by you, or by your PHN, at her scheduled developmental checks. Most areas in the country have early intervention teams (EIT), which comprise most of the professionals - occupational therapist (OT), physiotherapist, speech and language therapist (SLT) and psychologist.
Having a team approach to assessment and intervention with children often offers the most comprehensive service to children and families. It can be really helpful when the different specialists can easily meet to talk and discuss children and their needs, and it usually leads to the most accurate diagnoses being made.
For that reason, I'd suggest that in addition to any private services you choose to engage for your daughter, that you also either engage for the first time, or re-engage with your local EIT. At the very least, you may get the answer to your final question, as that team should have a psychologist on board and that person will be expert in assessing the needs of young children.
Even if you choose not to go back to your EIT, you can still ask them, or the other professionals in private practice that you have met, who they would recommend to carry out a psychological assessment of your daughter. As this suggests, I do think that you should take the guidance of the SLT and pursue an assessment.
Your daughter is not too young for formal psychological assessment. The kinds of tests that are used at her age are designed to show what a child is able to do, rather than to set them up to fail. The psychometric tests use materials that are designed to interest and engage young children. They are quite short tests (taking about 45 minutes to an hour in total to do) and they measure a range of verbal and non-verbal skills, as well as giving an indication of short-term memory ability.
Given that your daughter has a significant speech delay, the psychologist may choose to use other tests that don't rely on many verbal instructions, or may only choose to administer the non-verbal, or visuo-spatial elements of the tests. These kinds of assessments are designed to be able to be carried out with children who have a range of developmental issues. Observations from you, her preschool teachers and others that know her may also be included to get a full picture of her.
Some of the areas that a psychologist may be assessing will cross over with areas that an OT or SLT may also have assessed. This shouldn't contradict any information already gathered, but rather just add to the information about your daughter that is available. The goal of having this extra information is that it can assist you and others in helping your daughter.
Assessments also need to be considered a snapshot in time. They help to give us a picture of what a child is able for at a particular stage in their lives.
That is why reassessment at some future point is also important as we can then see in what areas they may have improved and where a child still may need significant support.
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