What is a Cognitive / IQ Assessment?
A cognitive or IQ assessment involves a series of different activities to help identify a child’s specific learning style, strengths and areas of need. This knowledge helps to generate suitable recommendations for teachers, parents and other professionals that are used to meet those learning needs of school aged children.
The learning profile generated by an assessment conveys a great deal of information about a child, both educationally and behaviourally. Firstly, the assessment generates scores known as an IQ score. This can also be regarded as an estimate of the child’s general cognitive ability and can be used to help understand and predict how a child will function in a school context. Secondly, observations can increase understanding as to how a child approaches tasks, reacts to failure and praise, and their general attitude towards learning.
What can Cognitive Assessments be used for?
Understanding the findings of a cognitive assessment and following the given recommendations, assists teachers, parents and other specialists in better understanding a child/adolescent’s cognitive profile.
In general, an IQ assessment can be used to:
* Gain a detailed and comprehensive understanding of the child’s strengths and needs.
* Determine if a child is reaching their learning potential.
* Assess and understand fluctuations in concentration and attention levels.
* In collaboration with other appropriate assessments, diagnose specific learning problems.
* Once a diagnosis is made, appropriate recommendations and methods of intervention can be made.
Reasons why Cognitive Assessments are administered
There are many reasons why children may be referred for assessment. Each referral is looked at individually and the assessment process is structured accordingly. Referrals are often made from Parents, Teachers, Individual Learning Needs Specialists, other Psychologists, Occupational Therapists, Speech Pathologists, Audiologists, GPs, etc.
It is also common that a reason for a referral entails a re-assessment. If a child needs to be re-assessed some aspects must be considered. These include the purpose or reason for re-testing, the amount of time between the current test and the previous test as well as the age at which the previous assessment was administered. Whilst the WISC-IV / WPPSI can be administered to children of young ages, it is important to remember that language skills are still being acquired at preschool and early school stages. Thus, the assessment scores may not be as accurate when compared to the scores of the student in later years. The reason being that in the early years of primary school, children of this age are still developing language skills and as the WISC-IV / WPPSI are highly verbally based, the language component is a big factor, which determines success. Language acquisition is more stable and better developed as the child advances through school.
Types of Cognitive Assessment Tools
The main assessment used to measure general cognitive abilities is the Wechsler Scales. The choice of scale is determined by the child’s age. For children who are between the ages of 3years, 0 months to 7 years, 3 months, the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) is used. For children/adolescents aged between 6-16 years, the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV) is used. Both tools provide information about a child’s general IQ (or ‘intelligence’) as well as specific areas of intellectual strength and needs. It is the particular areas of strength and needs (the learning profile) that reveals the most helpful information as opposed to just getting a general IQ score.
Structure of the Assessment
The Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV) is an individually administered clinical instrument used to assess the cognitive ability of children aged between six years and sixteen years, eleven months. The test is comprised of ten core subtests and five supplemental subtests; each subtest belongs to one of four domains of cognitive functioning. A child’s performance can be summarised by the Full Scale IQ score and four Index scores (Verbal Comprehension, Perceptual Reasoning, Working Memory and Processing Speed). Process scores can also be derived from the results of three subtests (Block Design, Digit Span and Cancellation), providing more detailed information on the cognitive abilities that contribute to a child’s subtest performance.
The Verbal Comprehension Index (VCI) is composed of subtests measuring verbal abilities that utilise reasoning, comprehension and conceptualisation. These abilities are closely related to scholastic achievement and reflect the child’s learning experience. The Perceptual Reasoning Index (PRI) is composed of subtests measuring perceptual reasoning and organisation. The Working Memory Index (WMI) is composed of subtests measuring attention, concentration and working memory, while the Processing Speed Index (PSI) is composed of subtests measuring the speed of mental and graphomotor processing.
The WPPSI follows a comparable structure according to very similar supporting theories of intelligence.
How are results calculated?
The responses obtained from the child are recorded in a response booklet. The scores are added to produce a raw score. The raw scores are converted to scaled scores, according to specific numerical values, which are statistically normed (or calculated) according to children the same age as the student being assessed. In this way, results can be used to understand how a child is functioning in relation to children of the same age.
How are results reported?
Although the WISC-IV is considered to be a reliable assessment of thinking and reasoning abilities, it cannot measure motivation, interests, and opportunities for learning, all which can also influence an individual’s scores on this test. These issues are taken into account when reporting results and instead of reporting the results as a single score, they are reported in a range at a high confidence level, usually 95% confidence level (in other words, one can be 95% confident that the child’s true IQ score lies within the given range.
Often, a percentile rank may also be used when reporting results. A percentile rank represents the child/adolescent’s performance in comparison to children/adolescents of his/her own age. If a child has a Full Scale IQ score at the 80th percentile, it means that the child is superior to 80 % of children within the same age group.
Results are reported in table form with an explanation of the various subtests. This helps the parents understand the structure of the assessment as well as the implications of the results obtained.
Interpretation of Findings
The results from the assessment are initially presented in numerical forms – scores, ranges, percentiles etc. These scores are all important for gaining a better understanding as to where the child is functioning in comparison to most children his / her chronological age. This tells us if the child is average, below average, above average or other. Considering that these ‘cut-off’ points are arbitrary, it is more important that from these scores more can be said about the child’s individual and unique learning style, strengths and areas of need. This requires a comprehensive evaluation of the learning profile and the ability to relate underlying themes or issues, which often manifest in different ways throughout the assessment process.
An evaluation of the subtest results, which combine to form the four index scores, is most valuable as large discrepancies between the various subtests (or even between various indices) can indicate delays or problem areas. Awareness of this helps in directing teachers, specialists, parents and other professionals towards areas that may require assistance. The profile generated by the cognitive assessment as well as observations can isolate areas of difficulty and can indicate whether a further referral should be made to a relevant specialist who can then provide the necessary intervention, such as Occupational Therapy, Speech Therapy, and the like.
Cognitive Assessment Reports
The assessment reports contain detailed and comprehensive information about the results. Findings relate not only to the scores but also to background information, developmental history, previous assessments, prior interventions, observations and other relevant and applicable information that together will add clarity to the assessment findings. The report considers all aspects of the child when interpreting the scores and as such, is able to provide a clear interpretation. It is the interpretation of the results which is the most crucial part of assessment reporting because from the interpretation arises a possible diagnosis and implications thereof. Thorough interpretation allows for accurate and effective recommendations and intervention strategies and it is for this reason that parents acknowledge the importance of working collaboratively with other allied health professionals (such as Occupational Therapists, Speech Pathologists, etc).
In addition, a separate summary of findings and recommendations will be provided to teachers (with consent from parents). This summary contains no scores but rather provides an understanding of how the child learns best and a description of any educational problems as well as the necessary recommendations to follow.
Providing the findings to the necessary people involved with the child allows for consistency and encourages open and clear communication.
The assessment setting
The one-on-one assessment setting provides an opportunity to gather information about a child’s behaviours, attitudes, attention, concentration, all which are likely to impact on and influence learning. These factors can influence motivation and the desire to accept and approach a challenge. It also affects the manner in which a child approaches a task as well as the manner in which they structure their response.
The Assessment Process
The assessment process is structured to be a relaxed, welcoming and non-threatening experience for the child. Prior to scheduling an assessment date, the psychologist will communicate with the parents or other referral source to obtain referral information. This is necessary to understand why the child is being assessed. This often occurs as an initial consultation in which background information regarding the child is obtained. Once the relevant information is obtained, an appointment will be scheduled. On the day of the assessment, the psychologist will meet with the parent/s and child in the reception area and will then accompany the child to the assessment room. It may be the case that parents will be asked to complete a questionnaire regarding the child’s developmental history. The information obtained by the questionnaire often sheds light on child’s the presenting problem.
The psychologist will use the first half hour of the assessment session to establish rapport with the child. This helps the child feel relaxed and comfortable in the presence of the psychologist. A brief conversation will focus on learning about the child and his/her family. Other information may be obtained such as likes and dislikes of the child, information about school and about the child’s social circle. Following that, the psychologist will provide an age appropriate explanation of the purpose and structure of the assessment, and will avoid using words such as ‘test’. Once the child exhibits that they are relaxed, the assessment commences. All in all, it usually takes approximately two and a half hours, which includes a 15-minute break half way.
At the completion of the assessment, the psychologist will accompany the child back to the reception area. It is not likely that feedback can be given at this time. The reasons for this being that as the assessment is statistically structured and to obtain the learning profile, several calculations need to be done first and then the analysis and interpretation follows. This can be a lengthy and time-consuming process, as the interpretations have to be specific to each child as an individual. Included in this process is developing appropriate recommendations. Once this is complete, an assessment report is compiled and this document contains all relevant information obtained by the parent questionnaire, assessment findings and behavioural observations during the testing process. Other information may include findings from previous assessments and reports from other specialists. The report will follow within 2 to 3 weeks after the assessment. It is then recommended that parents schedule another session with the psychologist to receive feedback about the assessment and the findings. This follow-up consultation provides parents with an understanding of the structure of the assessment tool and the implications of the findings. Parents are encouraged to distribute the findings and recommendations to teachers of the student such that a collaborative effort is made to maximise the child’s learning potential. The psychologist also recommends communicating with the school and other specialists if the need arises.
How to inform your child about the assessment
Parents are encouraged to follow the preferred method of informing their child about the assessment. Information should be presented in a non-threatening manner that does not leave the child feeling anxiety about their performance. Words such as ‘test’, ‘pass’ and ‘fail’ should be avoided. Merely inform the child that they are visiting someone at the centre who works and plays with all kinds of children and that they will get to do all different kinds of activities and games together. Depending on the age of the child, parents might also like to state that the activities help to understand how the child learns best so that the psychologist can give teachers and the child strategies to use so that school work does not have to be so difficult. Remember that the way in which you tell your child also determines their attitude to the assessment, so try present it in an encouraging and positive way.
Informing the child about the assessment outcomes
Depending on the age of the child, the psychologist will provide a written letter to the child providing positive feedback about the assessment results. The letter also reflects observations made during the assessment, if these will assist the child to work and learn more effectively. Some strategies and recommendations are given to the child and all information is presented positively. No labels or scores are reported to the child, and parents are encouraged to avoid doing this too. IQ scores and ranges are of little value to a child and differentiating them further from their peers will serve no positive function.