FREQUENTLY ASKED QUESTIONS
Frequently asked questions
What is your evaluation process?
The evaluation is a series of appointments. First, there is an intake meeting where we meet with the parents and review the student’s history in depth. When evaluating emerging adults, we like to meet with parents to gather childhood history either together with the patient or at a separate appointment, depending on the patient’s preference.
For elementary school aged children, we often observe in the classroom. We schedule the school visit prior to the first meeting with the child so that they do not know that we are observing them. Testing is conducted over the course of two full days, four mornings, or a combination of full days and mornings depending on the child’s age, attention capacity, and scheduling considerations.
The evaluation includes measures of cognitive/IQ testing, processing speed/efficiency, visual processing, visual-motor/fine motor skills, sensory processing, auditory processing, language processing, memory, attention, executive functioning, and academics (i.e., reading, writing, and math). We also do comprehensive social/emotional testing (i.e., personality testing), which is then integrated with the neurocognitive results to provide a comprehensive understanding of the patient as a whole person. Each test battery is custom-tailored to the individual so that we get sufficient information to understand the issues without wasting time and resources on unneeded measures. We like to consult with any providers working with the patient as well, such as teachers, tutors, therapists, etc.
About two weeks after the last testing session, parents (or the emerging adults) come back for a feedback meeting to review results and recommendations. There is a written report that is ready at that feedback meeting as well; our reports meet or exceed documentation requirements for accommodations on high-stakes tests. The recommendations section is typically divided into three subsections: academic recommendations, recommendations for outside help/therapies, and recommendations for home. We will also help to connect you with appropriate providers if needed. The last appointment is with the student, where we have a developmentally-appropriate conversation about what we learned about them.
What can I expect at my appointments?
Once you schedule an evaluation, you will receive a confirmation email with all appointment dates/times, directions to the office and parking information, information about insurance, and a form to fill out in advance of the intake appointment. Our intake appointments are for parents only and are usually about two hours long. We will go over initial paperwork and answer any questions you might have. We will then review your child’s history in depth.
If you child is in elementary school and we are conducting a school observation, we will let you know when it is scheduled for and send a brief email after the visit to let you know how it went. At the testing appointments, you will have the option to stay in the waiting room or to come pick up your child at the end of the appointment. We usually start the first appointment by talking to the student about why he or she is being evaluated and what they can expect. During the appointments, we take multiple breaks as needed and often offer the students snacks. The office is stocked with kid-friendly (i.e., junk food) snacks, or we can offer a healthier option that they bring from home.
There are several types of activities presented in the testing, ranging from academic tasks to brainteaser type problems to memory, listening, and drawing tasks. Many students are tired after their appointments, but often comment that it was not as boring as they had thought it would be. Many students actually enjoy the appointments (or at least the snacks!)
Approximately two weeks after the last day of testing, parents return to review results from testing. This is usually a two-hour meeting. We usually provide several suggestions for supporting the student as well as local referrals if needed. At the parent feedback meeting, we schedule a time to meet with the student for the child feedback meeting.
Within a few days of the parent feedback meeting, a PDF of the full report is emailed to the parents in addition to a one-page summary of strengths/weaknesses and any other loose ends (e.g., a superbill, additional referrals, etc.). We are happy to send the report and/or summary sheet to other providers if parents request it. Our strong preference is that parents be the ones to send information to schools. This ensures that parents have complete control over who receives information about their child. Our reports meet or exceed documentation requirements for accommodations at school/university and on high-stakes testing (e.g., ISEE, SAT, ACT, etc.).
What is the difference between a neuropsychological evaluation, a psychoeducational evaluation, and a comprehensive evaluation?
Navigating the world of assessment is confusing, especially because there is no standardization in how evaluations are classified. Further complicating the issue is that providers are generally all using the same tests (e.g., there are a handful of tests used to measure general intelligence, with most practitioners using the Wechsler IQ tests).
Generally speaking, a neuropsychological evaluation emphasizes brain-based processing and aptitudes, such as problem solving skills, memory, attention, and language. The pattern of strengths and weaknesses is used to explain academic performance. Social/emotional functioning is usually assessed in a cursory manner, using checklists that parents, teachers, or the students complete.
A psychoeducational evaluation is more educationally-focused, looking at specific academic skills in-depth as well as areas of processing that underlie academic abilities. There is a clear overlap with neuropsychological testing in that the student’s cognitive skills, processing, memory, etc. will be measured. Social/emotional functioning is also assessed, usually with checklists or interviews.
The comprehensive evaluations we perform at LACIA resemble a neuropsychological assessment in terms of very thorough testing in multiple cognitive, processing, and academic areas. However, what makes our evaluations comprehensive is the full battery of personality and social/emotional testing that we perform, as well as our ability to integrate what we know about a student’s processing with their social/emotional functioning. For example, a student might have a mild problem calling up math facts, but in an anxiety-provoking testing situation such as a “minute-math challenge”, the added stress and fight-or-flight response will exacerbate that mild issue and render the student completely unable to remember information that they knew inside-and-out the night before.
When is evaluation appropriate?
Testing is helpful when a student is having unexpected difficulty in school and more information is needed to help determine what the best supports will be. It is also indicated when a student has supports in place but is not making progress as expected. Testing is sometimes needed for documentation purposes, such as when requesting accommodations for standardized, high-stakes testing. Finally, testing can be very useful in transition planning, such as when moving from elementary to secondary school or when thinking about post-secondary options.
Do you ever perform consultations?
Dr. Kawa is available for consultations with families. She often meets with parents of children she has previously evaluated for check-ins or to help provide guidance when decisions about changing treatment need to be made. Dr. Kawa is also happy to schedule consultations when needed if a parent wants to have an in-depth discussion about their child and whether testing is warranted.
Additionally, Dr. Kawa is available for “second opinion and demystifying” consultations. This is appropriate when another assessor has evaluated a child, but parents do not understand the results and/or know how to speak with their child about the results. Dr. Kawa provides one hour of record review (i.e., reading previous testing, reviewing current report cards, etc.), a one-hour meeting with the parents, and a one-hour meeting with the child. Dr. Kawa strongly prefers to meet with the child at the office of a provider working with him/her (e.g., an educational therapist or a psychotherapist) to facilitate trust and rapport.
Why can’t you test my child for ADHD or dyslexia only?
In the past, we have found that partial batteries raise more questions than they answer, or the student lacks sufficient documentation to qualify for appropriate supports. Additionally, neurodevelopmental problems like ADHD or dyslexia are not the same as physical problems, like strep throat. There is no one “test” that can be performed to make an accurate diagnosis. Additionally, attention, learning, and processing problems seldom occur in isolation. There are high rates of co-morbidity (i.e., two or more issues occurring simultaneously), and it is important to have a thorough understanding of all the systems not only for diagnostic clarification, but also for custom-tailored treatment planning. Attention problems in particular are murky because they are like a fever—they tell you something is wrong but not necessarily what. Just like you would not go to the doctor with a fever and only allow her to examine the left side of your body, we do not believe that it is clinically responsible to examine aspects of cognitive functioning in isolation.
What age ranges and populations do you work with?
The youngest children we see are four or five years old, typically those in a Developmental or Transitional Kindergarten program. We work with students in grade school, college, and graduate school. Additionally, we evaluate emerging adults who might be struggling in college or even after having graduated.
We do not work with individuals who have moderate to severe developmental delays, which is beyond the score of our expertise. Additionally, we do not conduct evaluations for forensic purposes, such as Independent Educational Evaluations (IEEs) or testing to support a lawsuit. We are not trained in child custody evaluations and are unable to conduct these evaluations or comment on custody should this become an issue after we have performed an assessment for clinical purposes.
What forms of payment are accepted, how do fees work, and do you take my insurance?
We accept cash or checks. We charge a flat fee for the evaluation, with half being due at the parent-intake meeting as a deposit and the other half being due at the last testing session. Our fees have been established in consideration of the number of hours required for the evaluation, which is usually in the range of 35-40 including face-to-face appointments, scoring and interpreting, report writing, consultation phone calls, and follow up as needed.
We do charge a separate fee for consultations, such as if parents want us to come to the child’s school for a follow-up meeting. All fees are fully disclosed during the intake and are clearly spelled out in our consent forms. We believe in complete transparency with billing and there are no hidden or unexpected costs.
We are not contracted with any insurance companies, but if you have a PPO policy, your insurance may reimburse you for part of the evaluation. We are happy to work with you so that you can access any benefits you are entitled to, including filling out pre-authorization forms and providing a superbill at the end of the evaluation.