pediatrics dpt semester 10

1. Psychological Assessment in
Pediatric Rehabilitation
Dr. Tehreem Anis
DIRS, DU

2. Learning Objectives
By the end of the chapter, students will be able to;
• Understand the importance of psychological assessment in pediatric
rehabilitation
• Acknowledge the significance of psychological assessment as a tool to
• Establish current levels
• Setting future goals
• Tracking progress overtime

3. What is Psychological Assessment?
• Process of testing that uses a combination of techniques to help
arrive at some hypotheses about a person and their behavior, skills,
capabilities and personality.
• Psychological assessment is also referred to as psychological testing,
or performing a psychological battery on a person.

4. Purpose of Psychological Assessment
Goal Driven
• Broad Screening versus Focused/Problem-Specific
• Diagnostic
• Differential and Comorbid Conditions
• Therapy Oriented
• Identify target problems
• Develop preliminary intervention plan
• Progress evaluation
• How well are ongoing interventions working?

5. Testing vs. Assessment
• Both involve
• Identifying areas of concern
• Collecting data
• Psychological Testing
• Administering tests
• Focuses solely on collection of data
• Psychological Assessment
• More broad goals
• Involves several clinical tools
• Uses clinical skill to interpret data and synthesize results

6. Psychological Testing
• Require standardized procedures for behavior measurement
• Consistency and use of the same
• Item content
• Administration procedures
• Scoring criteria
• Designed to reduce personal differences and biases of examiners and other
external influences on the child’s performance

7. Types of Psychological Assessment
• Main types of assessment
1. Norm-referenced tests
2. Interviews
3. Observations
4. Informal assessment procedures

8. Norm-Referenced Tests
• Tests that are standardized on a clearly defined group
• Normative versus clinical reference groups
• Goal: quantify the child’s functioning
• Scores represent a rank within the comparison group
• Examples
• Intelligence
• Academic skills
• Neurocognitive skills
• Motor skills
• Behavioral and emotional functioning

9. Norm-Referenced Tests
• Psychometric properties
• Demographically representative standardization sample
• Reliability
• Internal consistency, test-retest stability
• Validity
• Correlation with other tests measuring same construct
• Ecological
• Psychological tests are imperfect
• Examiner, the child, and the environment can affect responses and scores

10. Norm-Referenced Tests
• Percentile ranks
• Determines child’s position relative to the comparison group
• Age-Equivalent and Grade-Equivalent scores
• Frequently used on academic achievement tests
• Sometimes questionable validity

11. Variables Affecting Test Scores
• Demand characteristics
• Child may give a certain type of response
in order to obtain a desired outcome
• Response bias
• Child’s response to one item may
influence how they respond to
subsequent items
• Social desirability
• Tendency to present one’s self in a
positive light
• Misinterpretation of Items
• Misunderstanding directions
• Format of instructions
• Oral vs. written
• Response format
• True-false, written, oral, timed,
untimed
• Setting variables
• Location, time of day, medication status
• Previous testing experience
• Practice effects
• Reactive effects
• Assessment procedure affects responses
• Timed, anxiety provoking
• Examiner-examinee variables
• Individual characteristics may affect responses (e.g.,
gender, age, warmth)
• Research suggests that children of low SES and/or
ethnic minorities are more affected by examiner
characteristics
• Familiar vs. unfamiliar examiner

12. History/Interview
• Pediatric behavioral health concept of history is very broad
• History taking can take long periods of time, due to the need to consider the
multiple contexts and systems in which behavioral/emotional difficulties
occur.
• Home
• School
• Community
• Social

13. Challenges of Interviewing Children with
Behavioral Health Problems
• A developmental view of a child’s functioning requires a broad
perspective involving multiple systems.
• Children, based on their age and disability often cannot report
meaningful history.
• often leads to a lack of child’s perspective
• The need for multiple informants can be imperative.
• New parents often lack a reference comparison.

14. Behavioral Observations
• General Presentation – appearance
• Attention and activity level
• Observations of communication, expressive and receptive language
• Auditory and visual perception
• Affect

15. Informal Assessments
These occur with day to day interactions with the children
Provides continuous feedback about the effectiveness of a treatment
Helps determine the appropriateness and success of our formal
assessments
Provides clues about social, emotional and motivational factors
affecting classroom performance

16. Specific Instruments
• Neuropsychological Evaluation
• Nonverbal/Visual–Perceptual Function Tests
• Language Functioning Tests
• Memory and Learning Tests
• Sensory–Perceptual and Motor Tests
• Cognitive and Intellectual Measures
• Instruments for Use With Young Children
• Alternative Tests of Cognitive Function
• Achievement Tests
• Adaptive Behavior
• Psychosocial Evaluation
• Population-Specific Assessments

17. Ending Note
• Psychosocial interventions enables our patients and their families to
have the services vital to the optimum outcome of the rehabilitation
process.

18. References
• Pediatric Rehabilitation –
Principles and Practice.
Chapter 3