Philadelphia Community Services for Children and Adolescents

Appendix B: Types of Psychological Evaluations

The scoring and interpreting of psychological tests is a highly technical matter that requires years of training and experience. This is important to keep in mind when seeking a psychological evaluation, or when the school district or a hospital recommends one for your child.

A. Infant Development Scales

Early intervention can help children with handicaps reach their fullest potential, so it is important that handicapping conditions be identified as soon as possible. Several tests have been constructed to compare an infant's developmental level with the expected level for his or her age group. They identify children who are "at risk". The most commonly used infant scales include the following four:

1. The Brazelton Neonatal Behavioral Assessment Scale

This scale tests an infant's (1) neurological intactness; (2) interactive behavior (including control of motor functions such as putting the thumb in the mouth and remaining calm and alert in response to stimuli such as a bell, a light, and a pinprick); and (3) responsiveness to the examiner and need for stimulation. This test is administered during the newborn period only.

2. The Bayley Scale of Infant Development

These scales test mental abilities including memory, learning, and problem-solving behavior; motor skills; and social behaviors such as social orientation, fearfulness, cooperation, and language-both receptive and expressive.

3. The Gesell Developmental Schedules

These schedules test for fine- and gross-motor skills; language behavior; adaptive behavior including eye-hand coordination, imitation, and object recovery; and personal-social behavior including reaction to persons, initiative, independence, and play response.

4. Denver Developmental Screening Test

This test is used to identify problems or delays that should be more carefully evaluated at a later time. It measures four areas: personal/social, fine-motor/adaptive, language, and gross-motor skills.

B. Preschool and School Age Intelligence Quotient (IQ) Tests

1. Stanford-Binet

This test can be used with both preschool and school-age children and is usually given to children between the ages of two and eight. Examples of what is required include remembering where an object was hidden, building a four-block tower to match an existing tower, explaining the uses of common objects, and identifying by name pictured objects.

Some items on the Stanford-Binet are culture-specific so the test is best suited for middle-class English-speaking children. Depending upon the child's age, the test requires vision, eye-hand coordination, hearing and speech.

2. Wechsler

This test has separate forms for preschool and school-age children. The preschool form is called the Wechsler Preschool and Primary Scale of Intelligence (WPPSI), and the school-age form is called Wechsler Intelligence Scale for Children-Revised (WISC-R). The WISC-R is the test most likely to be used to assess the cognitive functioning of a school-age child. It has six verbal and six performance subtests.

C. Special Abilities Tests

In addition to IQ Tests, there are special abilities tests. Such tests can provide valuable information prior to a full-scale evaluation or can add to information obtained from an IQ test.

1. The Bender Visual Motor Gestalt Test

This test is used to assess visual perceptual skills and eye-hand coordination. The child is given nine geometric figures, one at a time, and asked to copy them.

2. The Peabody Picture Vocabulary Test, Revised

This test assesses familiarity with vocabulary words without requiring a child to speak. The child is shown four pictures at a time and must point to (or otherwise indicate) the one that corresponds to the word the tester says.

3. The Wide Range Achievement Test-Revised (WRAT-R)

This achievement test provides a gross assessment of the child's math, reading recognition and spelling skills.

4. Key Math

This test evaluates a child's grade level in the attainment of math skills including basic operations, time, money, fractions, etc.

5. The Peabody Individual Achievement Test (PIAT)

This test evaluates achievement in reading and spelling. The child's ability to recognize letters and words as well as his or her comprehension skills are assessed.

6. The Kaufman-Assessment Battery for Children (K-ABC)

This battery of tests is designed to assess the child's style of information processing. This can be very helpful in understanding a child's learning style and can be used by the psychologist or teacher to plan teaching strategies. An achievement scale is also included in the test. The test has been researched widely with minority populations.

D. Personality Tests

Personality tests can be used to help determine a child's emotional state. Tests of this kind provide the child with hypothetical situations based on real life. The child's responses to these situations allow the psychologist to gather information about the unique features of the child's personality. The results of personality tests should be considered in conjunction with the observations of those familiar with the child (particularly parents) and the results of other psychological tests. Generally there are two types of tests: objective and projective.

1. Objective Tests

Objective tests are pencil-and-paper tests containing several hundred items designed to determine the child's predominant personality traits or behavior. The best known objective test is the Minnesota Multiphasic Personality Inventory (MMPI), which was originally designed for use with adults but can be used also with adolescents. The Personality Inventory for Children (PIC) is one of the few objective tests for younger children, but questions are answered by the parents or the results are based on the parents' view of the child's behavior.

2. Projective Tests

Projective tests provide the child with a stimulus-such as inkblots, a set of pictures, or incomplete sentences-with the idea that the child's responses will reveal his or her unique view of the world, including issues of concern and emotional needs. Another type of projective test provides instructions for the child to draw a picture, again with the idea that the drawing will reveal information about the child's inner self.

The Rorschach Test was the first inkblot test and the one still most commonly used. The Holtzman Inkblot Technique is another projective test that may be substituted for the Rorschach.

The most common picture-story tests are the Thematic Apperception Test (TAT) and the Children's Apperception Test (CAT). Other picture story tests are the Michigan Picture Test, the Tasks of Emotional Development Test, the Blacky Pictures, and the Make-a-Picture-Story Test.

Completion tests consist of a series of incomplete sentences or stories, which the child is asked to complete. One such test is the Rosenzweig Picture Frustration Study, which presents a frustrating situation in cartoon form. The statements of one character are left blank for the child to fill in.

Draw-a-Person, Draw-a-Man and Kinetic Family Drawing tests are also often used as projective tests. The child may be asked to draw pictures of a person, house, tree or a family. These pictures often reveal the child's feelings about himself and other important people in his or her life.

Each of these tests can provide useful information about a child's needs and concerns. Each test, however, relies heavily upon the interpretations of a psychologist, and thus requires that he or she be well trained, experienced, and competent in using the particular technique. The tests must be interpreted cautiously and used only in conjunction with other sources of information about the child.