Entrevista Psicologica

Introduction to Psychological Assessment of Children

Gregg Selke, Ph.D.

PSY 4930

October 3, 2006

Purpose of Psych. 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?

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

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

Psychological Assessment

Main types of assessment

Norm-referenced tests

Interviews

Observations

Informal assessment procedures

Non-norm referenced tests

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

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

Most attempt to be normally distributed

Standard deviation: Commonly used measure of the extent to which scores deviate from the mean

In a Normal distribution, 68% of cases fall between 1 SD above the mean and 1 SD below the mean

The threshold for meeting “clinical significance” varies across tests, typically > 1 to 2 SDs above or below mean

Norm-Referenced Tests

Percentile ranks

Determines child’s position relative to the comparison group

Example: What does it mean when a child is in the 35th %tile on an Intelligence test??

Age-Equivalent and Grade-Equivalent scores

Frequently used on academic achievement tests

Sometimes questionable validity

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

Variables Affecting Test Scores

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

Variables Affecting Test Scores

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

Administering Tests

Administering psychological tests to children requires specific skills

Flexibility: breaks, time to warm up, establishing rapport

Vigilance: attend to child’s behavior while still correctly administering the test

Self-awareness: how do children typically react to your style, body language, mannerisms

Examiner Nonverbal Behavior

Other Testing Issues

Introducing yourself to child

Explaining what the child will be doing

Letting them know where their parent will be during the assessment

Providing adequate expectations

Developmental considerations

Younger children

Older children

Praising effort NOT performance

Setting limits on behavior

Establishing Rapport

“the sense of mutual trust and harmony that characterizes a good relationship”

Good rapport =

child/family perceives the clinician as caring, interested, competent, and trustworthy

Clinician feels positive regard, genuineness, and empathy

Necessary condition

Establishing Rapport

Use of communication skills

Acknowledgements

Descriptive Statements

Reflections

Praise

Periodic Summaries

Elaboration

Clarification

Establishing Rapport

Avoid:

Lack of interest or not attending

Sarcasm

Lecturing

Interrupting

Commands

No eye contact

Criticisms

Interviewing

Types of interviews:

Unstructured—allow child/parent to “tell their story”

Semi-structured—provide flexible guidelines, a starting point

Structured—most often used to make diagnoses or in research studies, standardized

May interfere with rapport

Does not provide info on family interactions or a functional analysis of behavior

Which types of interview require the most clinical skill??

Explaining Confidentiality

Parents sign releases of information

Review concept of confidentiality and its limits early in clinical interaction

Limits to confidentiality:

Specific threat to someone else (homicidal ideation)

Self-harm is threatened (suicidal plan/intent)

Sexual and physical abuse (history or current)

Insurance requests

Courts

Generally referral source

Interviewing Techniques

Establishing rapport is crucial

Moving from open-ended to closed-ended questions (general to

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