Lecture 12

Question 1

What are the 6 components of cognitive assessment?

Answer 1

• testing
• history
• report writing
• intervention
• feedback
• interpretation

Question 2

HISTORY

Answer 2

WHO

• the child
• family
• environment
• strengths/weaknesses

EARLY DEV HX

• pregnancy + delivery (FAS, low birth weight, cord around neck etc.)
• nutrition (in pregnancy + current)
• infant + toddler behaviour (eg. tantrums at age 8)
• sleep
• medical illness (recurrent ear infections > language)
• parent interaction (postnatal depression)
• social circumstances (SES > resources)
• toilet training (general development, marker of non-cognitive development)
• developmental milestones (parental concern)
• separation issues
• sensory deprivation
• transitions

OLDER DEV HX

• school life: academic progress, teacher interactions, performance under stress, adaptability to change
• social interaction: peer relations in and outside school (bullying, social media)
• extra-cirricular activities
• adolescent behaviour (risk-taking)
• interview parent and child separately
• ask about previous assessments

Question 3

TESTING: ENGAGING THE CHILD

Answer 3

• separation issues
• parent present during ax? (separation anxiety, language disorders)
• multiple sessions > think carefully about duration and timing of sessions
• demeanor: talking to children
• when to introduce ax + explaining ax to children, what ax to begin with (don’t start with something they struggle with)
• qualitative ax (drawing, play themes)

Question 4

ASSESSMENT considerations

Answer 4

• consider normal development (understand range of normal)
• use standardised measures
• cognitive constructs overlap
• tests inherently multi-factorial (eg. WM involves attention, memory and exec functioning)
• keep in mind the no. of diff cog/behav reason which a child may perform poorly on a test
• use hypothesis testing approach > sample key areas, IQ can help guide the rest of testing
• referral question
• primary or secondary deficits
• timing > are skills emerging or established at this age?
• context: opportunity to learn, family history

Question 5

8 component of cognitive assessment

Answer 5

• intelligence
• language
• visuo-spatial skills
• processing speed
• academic achievement
• exec function
• memory
• attention

Question 6

INTERPRETATION

Answer 6

• test scores + qualitative observations
• observations may help explain inconsistencies in test findings/performance
• avoid overstating sig. of a single test score (do other tests, explore this a little)
• KNOW YOUR NORMS
• identifying strengths is as important as weaknesses
• consider developmental context: need to understand critical periods in development, theoretical underpinnings, change over time (deficit v. delay; flow on effects from impairments)

Question 7

FEEDBACK

Answer 7

• vital > develop shared understanding of child with parents
• encourage 3-way communication, ask for each person’s view
• translate data into meaningful, clear, concise and practice recommendations
• being with child’s strengths (personal, psychosocial eg. fam/friends, environmental supports eg. school/community), followed by areas of concern
• very openly discuss IQ
• RECOMMENDATIONS for home, school, other situations
• give written report too as they won’t remember much of what you tell them
• finish on a positive!

Question 8

Cautionary Notes

Answer 8

• reliability of ax increase with age
• certain deficits may not be apparent in early childhood > follow high risk children, caution with providing feedback
• easier to determine deficits in skills that are established compared to those that are emerging/developing

Question 9

RECOMMENDATIONS

Answer 9

• ATTENTION: reduce distractions, focus on one aspect of task at a time, reduce amount of info, repeat info as necessary, take breaks
• MEMORY and NEW LEARNING: present info in meaningful contest, reduce volume + complexity + rate of presentation, support memory with repetition or memory aids
• EXECUTIVE SKILLS: routine!!!, allow extra time for complex activities, avoid multitasking, break complex tasks into stages, plan strategies and organise stage-by-stage to reduce WM load, encourage aides (eg. diary, phone)

Question 10

3 aspects of executive function?

Answer 10

• ATTENTIONAL CONTROL: selective attn., self-regulation, inhibition, processing speed
• COG FLEXIBILITY: shifting attn., divided attn., WM, using feedback
• GOAL SETTING: initiative, reasoning ability, planning + organisation, strategic decision-making

Question 11

REPORT WRITING

Answer 11

• consider audience > balance writing for med staff and parents
• if for parents/school, ensure you communicate in lay terms
• INCLUDE: background (early dev., parent complaints), presentation (separation, anxiety, response to failure, intelligibility of language), list tests, findings, summary + recommendations
• in communicating findings, do NOT use test scores or names > range of impairment okay, but explain (eg. James had difficulties with a complex visuo-spatial problem-solving task NOT James scored 6 on Block Design)

Question 12

Executive Function and Developmental Stage

Answer 12

• PRESCHOOL: simple errands, perform simple tasks, inhibit unsafe behaviours
• KINDER-Y2: 2-3 step tasks, bring info to/from school, greater inhibitory control (put up hand and wait)
• Y3-5: increase independence, keep track of belongings, plan simple assignments, keep track of changes in schedule, save money for later goal, self-regulate temper
• Y6-8: help with chores, organise own books/homework, follow complex routines, plan/finish long-term projects, structure own time
• Y9+: manage multiple deadlines, more complex long-term goals (job aspiration), make good use of leisure time, inhibit reckless and dangerous behaviour

Question 13

What parent/teacher info may you get? What can this tell you?

Answer 13

• BRIEF
• BASC
• often different pattern at home than school (better with structure? overloaded at school?)