Top 10 Things that Make for a Stellar Psycho-Educational Assessment

by Dr. Kyra Grosman 

As kids head back to school, we start to notice some struggle to learn more than others. Parents who take a closer look can make a big difference in the childrens’ education. Psychologists can give parents peace of mind through a psycho-educational assessment to help figure out why a little boy or girl is struggling in school. Such assessments or “testing” can help kids learn more effectively.

Not all assessments are equal. A good assessment should do the following:

1) Provide a neurodevelopmental profile, and not a label. Just giving a child a label is not helpful. It’s too easy to say that a child who struggles with reading has a Reading Disorder. That label doesn’t really tell us why the child has difficulty in that area. It’s really more important to figure out why he or she is struggling in a particular area. Is reading difficult for a learner because of weak active working memory (the size of a person’s mental desk) or because they struggle with phonological processing (oral language function involving identifying, distinguishing, and manipulating the individual sounds in words)? Obviously, different learning profiles are going to be helped by different strategies which should be designed by a good assessment.

2) Must include strengths as well as weaknesses. Too many kids who struggle in school don’t get to hear enough about the awesome tasks they can complete. These strengths need to be incorporated into the feedback session, so kids, parents, and teachers have a realistic sense of hope.

3) Assessments should incorporate multiple sources of information. They should include a broad range of qualitative information (review of work samples, interview with students, information gleaned from discussion with parents and teachers), integrated with quantitative information (such as one gets from psycho-educational tests). The person writing the report must look for a pattern of strengths and weaknesses that emerge across several tests.

4) The feedback provided should give both you and your child a much clearer understanding of what’s causing his or her difficulties in school. Students need to be given age-appropriate feedback about how they learn.

5) Must include specific learning strategies based on each child’s individual profile. This should include a customized learning plan. Avoid clinicians who provide boiler plate learning plans. If they’re giving boiler plate learning plans, they’re probably not really understanding the unique aspects of your child, and they’re not helping you, either.

6) The feedback must connect neurodevelopmental function and academic skills. It should explain why Johnny can’t read and why he’s so good at math.

7) For public school children, assessment should not be so focused on determining eligibility for services that the child’s profile isn’t revealed.

8) The process of assessment should be an ongoing process of consultation. The goal is to find strategies for better success. There’s the need for on-going follow-up and tweaking of strategies as needed. Your assessor should be available to help you with this process and make sure that you, your child, and the school stay on track.

9) It’s great when the assessor can provide feedback directly with the child’s school—their teachers, learning support teachers, school psychologist, etc. This helps ensure that everybody is on the same page and allows for brainstorming what is feasable within a particular school.

10) Prioritization of weaknesses. If a child has several weak areas, it can be overwhelming to try to address them all. A good assessment should let you know what are the really important areas to address first.

And another for good measure...Make sure the report has clear explanation of the technical jargon.  It's especially helpful if it uses metaphors to help explain the concepts.

Dr. Kyra Grosman is on staff at Southeast Psych and we think she does stellar psycho-educational assessments.  She also sees clients for therapy for a range of issues.

The Problem of Perfectionism: Part 2

by Nyaka Niilampti, Ph.D.

Last week, I talked about the problem of perfectionism and this week, I want to give you some practical tools for overcoming it.  There are a number of ways to begin to break the cycle of perfectionism:

· Knowing is half the battle: If you find yourself identifying with some of these symptoms, that’s the first step. Awareness is necessary in order to begin to change.

· Stop worrying and start doing: Many times, it is taking that first small step that seems to be an insurmountable task. Usually, once a task is started, much of the anxiety and worry decreases.

· Start small: Break the task into “bite size” pieces. This will actually help you to “stop worrying and start doing”, and makes the task as a whole more manageable and less overwhelming. If your challenge is beginning, convince yourself to sit down for 20 minutes rather than the entire three hours that the task will take to complete.

· Encourage acceptance of limitations, performance, and mistakes: Perfection is an impossible goal. There will always be areas of possible improvement, and there will be days when “good enough” is often “more than okay”.

· Be mindful of the conversations in your head: Our self-talk contributes to anxiety and depression and the internal drive for perfection more than we often realize. If the discussions in your head suggest that your entire self-worth (or my future, etc.) is based on how well you complete a task, your internal dialogue needs to be adjusted.

· Ask yourself, “Is it worth this amount of effort?”: Put your tasks into perspective. Is the paper that may be worth 10% of my grade really worth the significant number of hours I have already put into it? The effort put out should match the significance of the task at hand.

· Increase mindfulness: Finally, there is a great deal of talk about the benefits of mindfulness. Mindfulness allows us to be present and in the moment, less worried about yesterday (and the mistakes of the past) and tomorrow (and the fears about what may or may not happen). Being mindful will allow you to focus on the process rather than the outcome. Increasing mindfulness will help you begin, accept your limitations, and enjoy the process.

Perfectionism at it’s best may help you get the job done…eventually…but at it’s worst can contribute to depression, anxiety, and failure, and make the process of completing even a simple task much more difficult than it needs to be.

Dr. Nyaka Niilampti is a licensed psychologist at Southeast Psych who specializes in performance enhancement, as well as the treatment of anxiety and depression in teens and adults.

The Problem of Perfectionism: Part 1

by Nyaka Niilampti, Ph.D.

Today’s society continues to demand increasingly high standards in virtually every arena. Unfortunately, we often interpret “achieving excellence” as “it must be perfect”. While maintaining a high standard is important, when it becomes confused with perfectionism it actually fails to lead to the desired consequences of success. The idea of achieving perfection is a goal that is impossible to meet, and the more we demand perfection from ourselves, the more the “finish line” moves, and the more overwhelming the task becomes.

It can be difficult to find the line between ‘perfectionism’ and ‘excellence’, and healthy motivation and striving. Burns (1980) defines a perfectionist as someone “whose standards are beyond reach or reason”, and “who strain compulsively and unremittingly toward impossible goals and who measure their own worth entirely in terms of productivity and accomplishment”. For perfectionists, thoughts and behaviors may be maintained by a number of factors, including fear of failure, inadequacy, or fear of disapproval and disappointing others. One way of locating that line is by asking yourself: (1) Is my goal attainable? (2) Are my beliefs in my ability to do this accurate? (3) Am I able to adjust my standards when necessary?

Perfectionism may look different in different individuals. For some, it is the attitude that “I’ll do it by myself…because no one will be able to do it as well as I can”. Other individuals may not take risks or try new things because they may not be good at it, while others become chronic procrastinators. Perfectionism may also look like overcompensating, excessive checking and seeking reassurance from others, difficulties making decisions, and avoidance of some activities and situations all together. The struggle to be perfect makes it difficult to recover from mistakes, and often leads to social and performance anxiety, depression, anger, and/or low motivation. It can also contribute to body image problems and eating disorders. 

Next week, I'll give you seven ways to break the cycle of perfectionism.

Dr. Nyaka Niilampti is a licensed psychologist at Southeast Psych who specializes in performance enhancement, as well as the treatment of anxiety and depression in teens and adults.

The Importance of Early Diagnosis for Autism

by Lauren King, Psy.D.


1 in 110 children have Autism based on a report in December of 2009 (Centers for Disease Control and Prevention.)  Currently there is not a single known cause for Autism, although many theories are being investigated. Additionally, there is not a “cure” for Autism at the present time. Early intervention and diagnosis are the best tools at our disposal. Research reveals repeatedly that early treatment for Autism makes the biggest difference. When therapy is introduced at an early age, due to the brain’s plasticity (ability to change), the child is likely to progress more than if their therapy starts at a later age. 


Obviously, no matter what the age, children can still change and make progress. The issue is really that we now know the earlier the therapy, the more likely it is to have a large impact on the child’s life. For example, research shows that children who are provided intervention before 3-years-old are impacted more than children provided therapy after 5-years-old (Harris & Handleman, 2000). Research also consistently shows that diagnosis of Autism prior to 24 months is not as reliable as it is after 24 months because it can be easily confused with other developmental problems (Lord, 1995). However, some children with more clear markers are diagnosed at earlier ages.  

In order to access early intervention for children with Autism, a prompt diagnosis is needed. If you are concerned about Autism Spectrum behaviors in your child, the first step is a thorough assessment.  Oftentimes, the signposts of Autism are the lack of typically developing behaviors such as coordinating attention between people and objects, sharing emotions with others, following the point or gaze of another person, playing symbolically, using appropriate gestures, and having appropriate language development (Woods & Wetherby, 2003). However, these behaviors can also be signals of other developmental problems besides Autism, which is why it is important to have a professional in the field of Autism conduct a full assessment.  The assessment should include recommendations on where and how to access early intervention for your child. At southeast Psych, we perform such assessments, and we are passionate about getting families in touch with the services and support they need following their testing.  

Dr. Lauren King is a therapist at Southeast Psych who specializes in working with children with autism spectrum disorders and their families.  She also has a specialty in the treatment of eating disorders.  You can contact her directly at lking@southeastpsych.com.  

References

Harris, S.L., & Handleman, J.S. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four to six year follow-up. Journal of Autism & Developmental Disorders, 30, 137-143.

Lord, C. (1995). Follow-up of two-year-olds referred for possible autism. Journal of Child Psychology & Psychology & Psychiatry & Allied Disciplines, 36, 1365-1382.

Woods, J. J., & Wetherby, A. M. (2003). Early identification of and intervention for infants and toddlers who are at risk for autism spectrum disorder. Language, Speech, and Hearing Services in Schools, 34, 180-193.

Are Most People Good at Multitasking?

Many people think they are good multitaskers, but are they really?  Actually, no.  Several studies have demonstrated that it is very difficult or impossible for most people to do two or more things at once very well, even if they think they are doing fine.

In a recent study, 200 volunteers were asked to drive in a driving simulator and concentrated on information given to them on a cell phone at the same time.  The majority of the participants did poorly on both tasks.  they were 20% slower to hit the brakes and also performed worse in responding to the information given to them over the phone.

However, the researchers uncovered a surprising discovery:  1 in 40 excelled at performing both tasks at the same time.  That's right, a whopping 2.5% of adults seem to be good at multitasking.  The author of the study, David Strayer, called these folks "supertaskers."  These supertaskers seem to be able to take on two or more things at once and do really well on them.

It's not clear if this is a skill that has only recently developed in human brains, thanks to the demands of our ever-increasing tech-culture, or if it is something that some people's brains just naturally have the ability to do.  Either way, it's still a rare skill.  You might be a supertasker, but it's a safe bet to say that the odds are against you.

8 Ways to Combat Performance Anxiety in Competition

by Nyaka Niilampti, Ph.D.

Regardless of how we feel about it, anxiety is a necessary part of any competition situation. While it’s necessary, as it is often our level of arousal and anxiety that gives us the needed “adrenaline rush” for competition, it does not need to get the best of us. Research suggests that one of the differences between successful athletes and those that may not be as successful is in how they experience the symptoms of anxiety—elite athletes are more likely to interpret the symptoms of anxiety as excitement and the feeling that gets them “pumped”, while for less confident athletes, those same symptoms may create issues such as doubt, tension, and negative thoughts. 

For most individuals, anxiety related to competition is what we call “anticipatory” anxiety—the thoughts and worries that flood us before a situation or event.   Once the event, performance, or competition begins, that anxiety may disappear, or the level may drop.  For others, anxiety can remain throughout the entire event, resulting in increased heart rate, loss of breath, hands shaking, tension, concentration difficulties, not being able to “shake off” mistakes, and ultimately, a decrease in performance.  

There are several ways in which you can work to decrease your anxiety level in a competition situation, rather than allowing your anxiety to control you.  Here are just a few of them:

1.  Differentiate between “playing well” and winning:  Don’t focus on the outcome.  Focusing on winning increases the pressure you place on yourself and puts you in a “future” mindset.  Focus, instead, on those small things that you need to do that will allow you to perform well (“I know I need to focus on bringing my knees up in the last fifty meters”…“I need to make sure that I follow through with my shot”.) Focusing on the small things will contribute to the likelihood of creating the outcome you want:  winning.

2.  Set realistic goals to improve specific skills:  Goals should be measurable, challenging and attainable.  Vague goals such as “play well” do not offer much structure or direction.  Similarly, you don’t want them to be too easy…you want to have to work for them, but you also want them to be within your reach.

3.  Reduce uncertainty by preparing for “worst case scenarios”:  one of the biggest contributors to overwhelming performance anxiety is a lack of confidence, which can happen for a number of reasons—feeling unprepared or fearing repeating a previous mistake, for example.  One of the ways you can reduce uncertainty and increase the feeling of “being prepared” is to practice “worst case scenarios”.  Have a ‘back-up’ warm-up that you can do relatively quickly in the case you are ever short on time, for example…things happen…buses break down, matches run late,  meets run early. 

4.  Use “cue” statements to refocus:  Develop a ‘cue’ statement that you can practice as a means of helping you to regain your focus.  A cue statement should be short, personal, and positive.  It should be a short phrase that creates a visual image of the athlete you want to be, and allows you to return your focus and concentration to the task at hand.     

5.  Cognitive rehearsal and visualization:  Many athletes find that visualizing themselves successfully performing or completing a certain skill contributes to an increase in confidence, and therefore a decrease in anxiety.  Cognitive rehearsal and visualization can both contribute toward feeling more prepared.

6.  Positive self-talk:  You may surprise yourself to realize how often the dialogue in your head becomes negative when you make a mistake. Recognize critical self-talk and the mistakes or actions that trigger negative conversations with yourself, and work to challenge those automatic negative thoughts and make them positive. 

7.  Breathing:  This sounds like such a simple strategy, but it is one most often overlooked.  Taking a deep breath during competition (or before certain moments—at the free throw line, for example, or before the race begins) can often be used as an opportunity to refocus and re-center.  In the middle of stressful situations or when anxiety runs high, there is often the tendency to resort to shallow breathing, which results in even more anxiety.  Taking a deep breath may allow you a moment to use additional strategies (positive self-talk, cue statements, goal reminders) that can also decrease anxiety.

8.  Prepare properly:  A significant contributing factor to performance anxiety may be the fear of being unprepared.  If you feel confident in your preparation—for example, you know that you have taken practice seriously and consistently given your best effort—the result is often a significant level of confidence that you can “trust your training”.  

Some degree of ‘performance anxiety’ is a necessary and helpful component of competition.   However, if you can turn your worry and anxiety into positive action, you increase your chances of success. 

Dr. Nyaka Niilampti is a licensed psychologist at Southeast Psych who specializes in performance enhancement for athletes and other top performers, relationship concerns, diversity issues, and the treatment of anxiety and depression.

Violent Video Games Do Not Cause Violence in Most Children

by Frank Gaskill, Ph.D.

Parents continue to ask me on a regular basis if playing violent video games will cause their children to be violent.  The answer is usually, "no."  Most kids--millions and millions of them--will have no increases in any meaningful long-term violent behavior because they played Modern Warfare 2 or other violent games.

In a recent Reuters article, one expert noted, "Recent research has shown that as video games have become more popular, children in the United States and Europe are having fewer behavior problems, are less violent and score better on standardized tests."

However, this doesn't mean that it is always a good idea to let your child play violent video games.  You have to take developmental maturity into consideration (i.e., your 7-year-old might not be ready to play Halo Reach when it comes out, but your 14-year-old probably will be), as well as your own child's unique temperament and personality traits.  Parents need to know their child and make specific judgments about whether it is good for him or her to play.  Engage your child, play video games with them--or at least show interest in observing from time to time--and talk non-judgmentally about them. 

Here are some likely risk factors for negative reactions to video games include the following:

1.   Low tolerance for frustration - If your child gets very quickly overheated and can't manage upsetting emotions well, especially when compared to other kids of the same age, then it's probably wise to limit the exposure to certain types of games.

2.  Frequent depressed or dark moods - If your child is prone to dark moods, isolation, or feelings of hopelessness. By the way, if this is true, you will probably want to consider seeking out professional help for them, as well.

3.  Indifferent to the feelings of others - Lack of empathy and lack of remorse are big risk factors that should not be ignored.

4.  Often breaks rules or promises to others - Again, you need to compare this to other children of the same age, but if your child breaks rules more frequently than his or her peers, especially big rules or does things that may negative affect other people (stealing, bullying, etc), then you will want to set some limits on certain types of gaming.

The best analogy I have heard thus far is that of a peanut allergy.  Most people aren't allergic to peanuts, but a few are.  The vast majority of kids who play video games are doing great, but a select few are “allergic.”  If you are allergic, then just don’t play or let your kids play.  At the very least, limit their exposure to too much gaming if your child has any of the risk factors.

Dr. Frank Gaskill is a licensed psychologist at Southeast Psych who works with children and their parents.  One of his specialties is helping parents understand and skillfully navigate the new technologies that are part of their children's daily lives.