Monday, 26 May 2008

Psychoeducational, not Psycho-Educational—Part III

This post could be an entire blog, book, or career. I will try to do it justice. The cognitive/intelligence portion of the pychoeducational assessment is the keystone to determining whether or not a student has a learning disability, understanding the potential for learning, and/or knowing how the student learns best.*

First, lets start with some definitions. Try this activity. I want you to think about the word “LOVE” and try to define it. Go ahead….do it in your head.

Now, quick quiz. What is LOVE?

a) Never having to say you’re sorry
b) A deep, tender, ineffable feeling of affection and solicitude toward a person, such as that arising from kinship, recognition of attractive qualities, or a sense of underlying oneness.
c) Something people whom play tennis do not like.
d) A variety of different feelings, states, and attitudes, ranging from generic pleasure to intense interpersonal attraction.
e) Blind
f) Determined at first sight

The answer is: g)Yes. “Love” is a psychological construct that can be defined in any number of ways, depending on the context, culture, and what aspect you want to measure. The same goes for “Intelligence.” It can be defined in any number of ways, depending on your theoretical orientation. Each intelligence test given by a psychologist has a slightly different way of defining and measuring the construct of “intelligence.” In general, school psychologists will look at two to four aspects of intelligence.**

1) Verbal Reasoning
2) Nonverbal (Visual-Spatial) Reasoning
3) Working Memory
4) Processing Speed

Each one of these deserves a new post. Each one of these areas can also be described as areas of “Processing.” A low score in any one of the categories can be called a “Processing Deficit.” To confuse matters, the above processing areas do not necessarily map onto what special education law calls “Processing Deficits,” the presence of which is one criteria for eligibility for a student with a “Learning Disability.” The law defines “Processing Deficits” as Auditory Processing, Visual Processing, Visual-Motor Processing, Attention Processing, Conceptualization/Association.*** Each of these loosely map on to dimensions of “Intelligence” as measured by IQ tests, and also have their very own test.

A school psychologist’s job is to carefully examine the results of the IQ test and do further testing in “processing” areas to confirm that low results on one type of learning are due to actual deficits in cognition, rather than any number of factors such as fatigue, low effort, poor attention, malingering, social-emotional distraction, test anxiety, depression, etc. One cannot look at an IQ test and determine anything without testing observations and the larger context.

One word of caution for parents about seeking an assessment for a Learning Disability: Make sure the person is qualified. There are a number of inadequately trained people diagnosing Learning Disabilities whom are not psychologists and do not have the larger picture. Some have only bachelor’s degrees and took a summer or two of courses and call themselves “therapists.” They give an IQ test and a test of academic achievement, and based on scores alone diagnose disabilities. I have seen gross misinterpretation of scores, such as clearly average scores being called “deficits” and normal variations in processing called “disabilities.” I have seen computer printouts of scores as a “report” and no other factor is taken into consideration. Meanwhile, the parent has forked over thousands of dollars for a potentially wrong diagnosis. Think of it this way. It would be like taking your kid to the hospital with a symptom of “fatigue” and having someone with a B.A. in Biology who has had a little extra training in one specific medical problem diagnose him/her. You might not get an accurate diagnosis, because the symptom of “fatigue” can be caused by any number of medical problems, but they only have training in one.

Be sure that the person who is assessing your child is at minimum a Licensed School Psychologist or (in California) a Licensed Educational Psychologist (not “Educational Therapist”). Clinical Psychologists are the “gold standard” of assessors if you are also concerned that your child has a potential psychiatric disorder in addition to learning challenges. I would argue that a School Psychologist or Educational Psychologist would be more school/context/practically oriented and a Clinical Psychologist might be more psychological/interpersonal focused, though there is overlap depending on the person’s training. This was a bit of a digression from defining “Intelligence” and how to assess it, but I believe a diagnosis is only as good as the assessor’s clinical skills to interpret the test results.

*Cognitive=intelligence=IQ=ability=potential depending on what test you give. Same idea, used interchangeably in most psychoeducational reports. In California, it is state law that IQ tests cannot be used with African American students, but I think that is wrong. That is another post.

**Sorry, forget about “Multiple Intelligences” such as musical, interpersonal, kinesthetic, etc. Schools may give lip service to multiple intelligences, but the only ones that “count” grade-wise are basically Verbal and Visual reasoning, heavily emphasis on the Verbal learning. Sorry kids who think outside the box. Get your creative musical self back in that box if you want to graduate and go to college.

***If you find one school psychologist who knows what “Conceptualization/Association” is, I will give you a prize. It is barely used to qualify students as “Learning Disabled” because no one has really defined it well. That’s what you get when the law doesn’t match the research.

Monday, 19 May 2008

Psychoeducational, Not Psycho-educational—Part II

I started a series on psychoeducational assessment to help clarify the information in school psychologists’ highly specialized reports that are presented when students are tested for special education. In Part I, the importance of the background information section was detailed. Enjoy.

It is so tempting to jump ahead to the good stuff, like the cognitive and processing skills or the social-emotional and behavioral assessment. But I would be remiss if I didn’t talk about another favorite section of the report that is probably just as important: Observations. I have done a few prior posts on observations in the classroom, but this is more about observations during testing.

Consider these two students, both earning the exact same score on an IQ test. Note use of third person. That is because “The examiner observed the student to make facial expressions at a peer” sounds much more objective than “I saw him making faces at his friend.” That’s just how we school psychologists roll. We try to be as objective as possible. We now come back to our students earning the same IQ score:

In the one-on-one setting, Student X presented as an energetic, eager, curious, and friendly eight year old boy. He readily engaged in conversation and appeared eager to please with the examiner. For example, on the way to the first testing session, he reported that he was a gymnast and did a cartwheel into the splits in the middle of the hallway. During the testing situation, his effort and attention to tasks was variable. On easy items, he guessed quickly. When items became more difficult, he engaged in a variety of behaviors, including asking the examiner personal questions, dancing around, pretending to fall out of his chair, or showing the examiner his cat impersonation by crawling on the floor and meowing. At times, he also showed positive techniques, such as talking through difficult items and refocusing himself by closing his eyes to think.

***

Student Z is a eight year old boy who came accompanied by his teacher to the testing room. When Student entered the examiner’s office, he was observed to slump in a nearby chair and mumbled negative comments about his teacher in front of her (that she was fat and mean). When she left, he stated that he had been up all night before playing video games and was tired. He also reported that he had a headache, and would periodically put his head down on the table and close his eyes. A low energy level was predominant during testing, with the exception of during timed tasks, when he appeared to be more engaged with the task. Student did not respond positively or negatively to praise. One strategy that appeared useful for Student was verbalizing his thought processes on more difficult items.

So despite getting the same scores on their IQ tests, the interventions will be extremely different for Student X and Student Z. And that, my dear readers, is why I didn’t jump ahead to explaining Cognitive/IQ score section of the psychoeducational assessment without talking about the testing observations. Observations during testing are arguably the most important part of the assessment and a good psychoeducational report will tell a “story” about the student’s approach to learning and problem solving in addition to the scores.

Wednesday, 14 May 2008

Games Pirates Play

One time, I went on a blind date with a pirate.

Ha! Bet you didn’t see that coming from a blog about education. It’s true. He had just returned from a month long trip on the “Black Pearl” down the coast of California, all in the name of 5th grade science instruction. He had dressed like a pirate and taught students about life on the seas. But that was not his day job. In real life, he was a video game editor.* On our second (and final) date, he showed me a pirated *ahem* version of the newest Grand Theft Auto. There is a reason it was our last date. In any event, so many of my students have told me about this game and so I felt it would be a good quasi-experiment for me to try it out. So we played this game, which was replete with car-jacking, fighting, and general morally offensive behavior.

In general, I disdain violence. I am the type to leave a movie if it gets too violent (or I spend the hour and a half like an ostrich burying my head in my sweatshirt). I left the theatre after approximately 4 minutes of “Fight Club” and I think I lasted 2 minutes in that dumb movie where Rose McGowen’s leg is a chainsaw. I have repressed the title of that one. My friends now realize that I’m more of a “27 Dresses” kind of movie-goer. But I have to say, that video game we played was pretty entertaining. The first 10 minutes I was horrified, but then I got a little excited when I found out I could not only car-jack, but plane-jack! As I was “flying” my stolen plane, I saw the allure of such a game. I felt vicariously powerful. Driving home that night, I think I even drove a little more rapidly and aggressively.**

This all comes full circle because 99.9% of my students I work with who are referred for anger management counseling are obsessed with violent video games. There are many metaphors in these games that could explain the obsession. Typically, one earns points (status) and power (strength) with each subsequent fight or misdeed. I have pointed out this metaphor to help students understand why they fight in real life. I use the video game as a talking point for anger management, and they’re happy to do it, because it’s about their favorite topic. Through this process, I can also ascertain if the games are "appropriate" sublimation of aggression or by playing them, the student has reached a disturbing level of fascination and desensitization to violence.

Recently, a fellow blogger asked the question What is the Deal with Video Games and Violence? The post provides some good links into recent studies and books on the longstanding query about the causal relationship (if any) between video games and aggression. It also offers advice for parents and therapists about the context in which the games are played as a factor in the possible effects. Check it out. And in the meantime, I will lament about whether or not the person who stole my car was a Grand Theft Auto aficionado.

*So was he Captain Hook, or was he Peter Pan, the boy who never grew up? Discuss.
**Was it the game, or to get away from someone who thinks playing video games is an appropriate date?

Monday, 12 May 2008

Psychoeducational, Not Psycho-Educational

Okay, it’s really the same thing, but when you hand a report to a parent, it’s unsettling to see the word “Psycho” in isolation like that. If I had a nickel for every time I have typed the word “Psychoeducational,” I would have not that much money because a nickel isn’t really that much. But, I have done hundreds of Psychoeducational Evaluations and while they make perfect sense to me, a common complaint is that they are not reader-friendly.

A Psychoeducational Evaluation is a school psychologist’s bread and butter. It is the culmination of all background information and current testing in a lengthy report that in the end makes a statement about special education eligibility. Ideally, it should also detail how the student learns and how s/he thinks and feels about school, and provide recommendations tailored to a student’s needs. I say “ideally” because it is often completely unreadable to non-school psychologists. It really is its own genre of writing that blends educational jargon, obscure psychological terms, carefully crafted wording of facts and interpretation, and of course, special education legalese.

This begins my 5782975983475893 part series on explaining the contents of a Psychoeducational Evaluation for the real world.

Let’s start with the background history. This section takes one million years to write if you are testing a high school student.* A good background history details the developmental, medical, health, school, mental health, and family history of the child. It’s always a bit weird to ask a parent of a 17-year old about the child’s birth weight and when they said their first words or if there were problems in toilet training, but it really does need to get that specific. Why? Because you never know. Some of the most interesting things come up when you delve into a developmental history, and the child’s history culminates into who they are as a student.

The types of questions I ask about the child’s history depends in part on the referral question. If the referral question is Autism, I ask about social communication, and if its ADHD, I always ask about injuries or hospitalizations (many of my little ADHD friends have broken many a body part in their joie de vive for trying things without thinking). If the student is bilingual, I ask about learning in the native language. If the child is suspected of having an emotional disturbance, I ask about family history of emotional problems. The list goes on.

The point I’m trying to make is that the history is one of the most important parts of the assessment. I learn all kinds of things about the kid and build rapport with the parent too.

Zzzz…oh sorry I just fell asleep at my own post about Psychoeducational Evaluations. Maybe that’s why no one reads these reports in detail except other school psychologists and lawyers**


*I am envious of psychologists who work with preschoolers because their history is “They were born and had a cold when they were 2.”

** Lawyers who are armed with red pen, ready to sue the hell out of the school district (who can barely afford teachers), resulting in one child getting a $60,000 a year nonpublic school, OT, PT, private therapy, speech therapy, transportation and compensatory education, and kids at the less litigious areas of town get 30 minutes a day of help a week, if that. I have some strong feelings on the inequity of service delivery in special education. Don’t get me wrong, I’m all for giving each kid what s/he needs, but in a system set up with inadequate resources, it can widen the gap between the haves and the have-nots.

[steps down from virtual soap box]

Friday, 9 May 2008

Free the Kids!

I wrote a while ago about the overprotection of children. Turns out, this is a hot topic. You simply must read this article called Why I Let My 9-year old Ride the Subway Alone.

My reaction is mixed. I try not to subscribe to the culture of fear, but it is all around and so difficult to combat. When I arrived at my new district, I got a list of the 10,000 things that can go wrong and the correct emergency procedures. As I thumbed through the list, alphabetically ordered, (not by severity of disaster) I actually laughed out loud. When will I ever need to know the procedure for an emergency aircraft landing on school property?* Then, my amygdala, center of fear, and my frontal lobe o’ reason had a debate.

Amygdala: Wait. What if there WAS an aircraft that had to land in an emergency? Our school yard is kind of spacious...

Frontal Lobe: When was the last time an aircraft had to land at a school? It would only be newsworthy because it would be extraordinarily rare.

Amygdala: AAAAAAHHHH! Can’t you just see the 747 screaming toward the innocent little kindergartners? And there you are, personally responsible for not ushering them to safety.

Frontal Lobe: Would I even have time to react if a 747 was screaming towards us?

Amygdala: Better safe then sorry. I’ll be ready for the burning inferno of terror.

The real questions I have are: What impact does paranoid adult culture have on our children? Are we teaching them that the world is a scary and unpredictable place? How can educators take appropriate precautions to keep our kids safe without going overboard?

*Some other delightful scenarios included Antrax, Bioterrorism, Hazardous Material Spill Near Campus, and Snipers (Must. refrain. from. Hilliary. Clinton. joke.)

Wednesday, 7 May 2008

Color Me Badd

Don’t fret. This isn’t a post about the 1990s R&B group that infused mild rapping into their vocal styling that was so “bad” it had to add an extra “d.” It’s about graffiti.

As some readers who have been with me a while may recall, my introduction to one of my middle schools involved some delightful graffiti. Adventures in graffiti continued when my “Positive Graffiti Wall” went awry. My general rule with the students regarding graffiti (and most behaviors) is to attempt to channel it for good, not evil. Graffiti is an extremely powerful way for my budding adolescents to express themselves. My main task is to make sure that the “art” occurs on paper, no spray cans make their way on campus, and kids can’t claim anything but their school.

I am presently fighting a losing battle with the graffiti outside my office.

It all started with a small “Money Over Boyz!” marking on the wall outside my office.* In one week, it has exponentially multiplied to cover not only the wall outside my office, but the door as well. And while I’m mildly curious about who loves whom and who rules, it is clearly not “graffiti art.” Luckily, middle school kids are kind of impulsive, so they don’t think twice to put the same tag on their backpacks and every notebook as they put on the wall. So our school policy is to have the tagger clean it up, and our investigation process takes 2, maybe 3 seconds.

We have a mystery on our hands though.

My friend and I were examining the graffiti and have used our super sleuthing skills to narrow down the possible culprits.** We know the following:

a) Tagger is likely a 6th grader, as there was a diss of a current 6th grade teacher
b) Or, tagger is a disgruntled 7th or 8th grader who still holds a grudge (less likely)
c) May or may not have a Learning Disability as does not know how to spell a certain four letter F-word, nor a certain 5 letter B word.
d) May or may not be like Color Me Badd, purposely spelling thigz wrong 2 be kewl.

Basically, I am not a very good detective, so I opted for Plan B: Offer rewards to my counseling group if they agreed to clean it up as a community service project. Surprisingly, they agreed. In an effort to teach executive functioning skills, I let them try to figure out how to go about it. Needless to say, we spent the entire hour trying to figure out where to get the paint, who to ask to get it, locate brushes, ask the Principal if it was okay, etc etc. The bell rang and there we sat with a can of paint we couldn’t open, no brushes, and a giant wall of graffiti. I was delighted.

Why?

I was pleased because an unintended learning experience occurred. When we processed their experience of group, they all said something along the lines of “It’s hard work to paint over graffiti and it’s frustrating.” Now I cross my fingers that they think of this the next time they want to exclaim that in fact, Money is over Girlz.

*In hindsight, I should have pulled a NYC Transit Strategy and taken care of the small things before it set up a context in which graffiti is ok, and segues into more problems, the so-called “Broken Window” theory. It is not the case that I believe money should come over boyz, I just got busy.

**Finally, an opportunity to wear my newsboy cap and use my pocket spectacle.

Thursday, 1 May 2008

Star Testing

There’s this corner store by one of my schools that is called “2 Star Groceries.”* I smirk as I go by it every day, imagining the conversation that occurred when the owners were coming up with their business name.

Business Person #1: What should we call our corner store?

BP #2: How about 5 Star Groceries?

BP#1: No, I think that’s being optimistic. We’re not that great.

BP#2: You’re right, we’re really more of a 2 Star kind of place.

BP#1: “2 Star Groceries” it is!

My curiosity got the better of me today and I decided to see what a 2 Star Grocery would look like. So I popped in to get a snack. I’m not gonna lie, it’s not a place I’d go to again. There was wilted produce and dust on the tops of the cereal boxes, leading me to believe Captain Crunch was probably now Sir Stale. So the name 2 Star was true to form. But what if it had been called 5 Star Grocery? Would that have made a difference in their store pride? Would they have stepped up to the plate and made it a fancy store? Would I have had a different view of the store if my expectations were higher?

I once worked in a school that changed its name 4 times and it was still the same under-funded chaotic school year after year. Does it really make a difference to call a school “High Expectations Elementary” or “We Believe in You Middle School?”

The high expectations movement in education has gotten a bit out of control. We are now holding kids to sometimes developmentally inappropriate standards under the guise of “high expectations” and not providing resources equitably to help the students achieve these goals. I’m not advocating low standards for urban kids, I’m just saying that schools should be given resources to help children who have had unequal developmental conditions and are yet still expected to achieve at the same rate as advantaged peers. High expectations are necessary, but not sufficient to raise achievement. That’s like telling 2 Star Grocery to change their name to 5 Star Grocery, demand better products, but then not do one thing differently. Magically, will their produce turn fresher because we expect it to?

This all begs the question of what resources are needed for students to meet high academic expectations? I am biased toward providing mental health services so the students can focus on academics in the first place. But I don’t know the answers. All I know is that writing into an IEP (special education plan) that a borderline mentally retarded kid will be striving for an “adapted” 9th grade Algebra standard is ludicrous. I also know that it is that dreaded time of year where we do STAR testing (California Standardized Tests). Every year, I deal with the fallout of giving kids with learning disabilities a grade level test that they cannot do, because by definition, a kid with a learning disability is behind academically. As a result, I see the “Better to look bad than stupid” acting out. And I can’t blame them for wanting to save face.

I just hope our high standards don’t make them feel like 2 Star Students.


*Many of my school sites do not have any commerce near them other than corner stores or liquor stores. Luckily many of the liquor stores have deli sandwiches, burritos, and such in addition to their fine selection of alcohol and tobacco products. The only up-side is it makes me save money because I have to bring a lunch, or I get to say point-blank to the Principal, “Um, I am going to the liquor store for lunch, do you want me to get anything for you?”
Girls Generation - Korean