Academic Testing

 Academic and Learning Problems
 When a child is struggling in school without any obvious reason, then there may be a learning disability. A learning disability is a difference in the way the brain is processing information that makes it more difficult for a child to learn or perform certain academic tasks, despite receiving the same instruction that is working for all of the other students. Unfortunately, it is not currently possible to scan a brain and identify a learning disability. However, psychologists who are trained in this type of assessment (such as "school psychologists") can conduct a systematic evaluation to identify the possibility of a learning disability.

Recent changes in federal regulations (IDEA) and the diagnostic manual (DSM-5) also allow for the use of a Response to Intervention (RTI) process to assess the possibility of a learning disability. Under this new model, a child is not directly assessed, but is instead provided with multiple forms of additional instruction to determine if the difficulty to learn may be the result of a learning disability. More information on this procedure is also included below.

These types of assessments are often done in a school, where the service is provided for "free" (because it is paid for by the school). Because the school pays for the service, insurance companies will not pay for achievement testing. Assessment of academic and learning problems is typically used to identify learning disabilities (such as dyslexia, dysgraphia, or dyscalculia). More information on assessing learning disabilities is provided elsewhere, but when an evaluation is conducted in a clinic it usually includes the following parts:

- Cognitive Test (also known as an "IQ Test")
This might include tests such as the Woodcock-Johnson (Cognitive Test), the Wechsler (Intelligence Test), Differential Ability Scales, or the Stanford-Binet. It is a test designed to measure "basic cognitive processes" such as short-term memory, long-term memory, processing speed, verbal reasoning, problem solving, and visual processing. The test typically lasts between 1 to 2 hours, but depends on how quickly the child completes items and the child's interest and willingness to complete the test.

- Achievement Test
 This might included tests such as the Woodcock-Johnson (Achievement Test), the Wechsler (Achievement Test), or the Kaufman Test of Educational Achievement. It is a test designed to measure a range of basic academic skills (reading, writing, and math) as well as some of the basic skills and processes that affect a child's ability to learn and perform well in school. School performance is significantly affected by a child's ability to hear the different sounds that make up language (phonemic awareness) and ability to tell different shapes apart and identify them (orthographic awareness). Achievement tests examine basic skills (such as sounding out words, writing letters, and doing arithmetic) as well as their fluency with these skills (how quickly they can do it) and in some cases their comprehension. An achievement test is also usually between 1 to 2 hours long, but can be longer if a child has significant difficulty, needs many breaks, or needs additional accommodations when completing the test.

- Supplemental tests of specific abilities related to academic performance
Though the achievement test is generally very good at measuring basic academic performance, it may not provide additional information that can be helpful in identifying and understanding a learning disability. For example, a child with a reading disability (dyslexia) may have significant difficulty with sounding out words because of poor phonemic awareness, in which case they would tend to rely more on simply recognizing words when they see them. Alternatively, a child with a reading disability may have good phonemic awareness, but have difficulty with recognizing the words on sight (poor fluency). In this case, their difficulty should show up very clearly when presented with an irregular words list (words that do not follow the normal rules of English), such as "read", which can be pronounced as 'red' and 'reed'; or "hour", which features a silent /h/.  

- Emotional/Social/Behavioral Questionnaires
The tests above address the main task of measuring a child's ability and identifying a problem. However, a child may have difficulty for reasons other than a learning disability (such as inattention, anxiety, depression, or non-compliance). Therefore an evaluation usually includes screening for emotional problems (such as anxiety or depression), behavioral problems (such as non-compliance or inattention), and social problems (which can produce social stress and impair performance at school). To make sure the child's difficulty is actually due to a learning disability instead of one of these other factors, parents and teachers may be asked to fill out some forms about the child's behavior at home and school. These forms do not take very long to score, but provide extremely useful information. 

- Reviewing the child's academic history
A child with a learning disability should have a history in school that shows some of the signs of struggling for a long period of time. If a child has a history of doing well academically, but suddenly begins to have difficulty, it is a good idea to first make sure it isn't something going on at home or school that is making it difficult for the child to do well. For example, if a child is experiencing a lot of stress due to divorce, then the child's academic performance is expected to drop. By reviewing the child's academic history, the psychologist will have very useful information about the child's history. This may also give some insight into how to help the child be successful again. 

- Checking family history
Lastly, learning disabilities tend to run in families. Therefore the psychologist is likely to ask if there is any family history of learning difficulties. There may not be previously diagnosed learning disabilities in the family, but if some family members had more difficulty in school than was expected ("he seemed really smart, but was never very good at math!"), then that may be an indication of a family history of learning difficulties that have simply reached the point that it is producing more clear difficulty for the child.

-Response-to-Intervention (RTI)
Many schools have begun to use a process known as "response to intervention" (RTI) to identify students with learning disabilities. The RTI process takes a different approach than the assessment described above. All children in a school are given a short test multiple times per year (usually early in the year, around the middle of the year, and near the end of the year) to see if they are performing within the expected range. The students that are not within this range are referred for a little extra help (typically called "Tier 1" or "Tier 2"). This help is extra instruction in the subject area, and the instruction has been shown to be effective for most students. If the student does not improve with this instruction, then they are moved up to the next tier, in which they receive even more help. This process usually repeats for a total of 2 to 4 times, after which the student is then referred for special education due to a learning disability. Parents will be informed if the child is being referred for special education.

There are definite benefits to the RTI process: children may begin to receive extra help much more quickly and they may not fall as far behind (because all children are screened frequently, problems are caught sooner). There are some potential drawbacks as well, because the process can take a long time to be completed. Because the procedure is relatively new, many schools are still figuring out how to use it for math and writing, and how to keep parents informed about the process. Schools may refuse to complete the systematic assessment described above (with the cognitive and achievement test) because of the RTI process. Parents may seek an evaluation outside of the school because of this (typically from a private clinic), and then bring the evaluation results to the school. Federal Regulations require schools to accept these evaluations or conduct their own systematic evaluation if they reject the outside evaluation. This process can be challenging and frustrating for the parents and the school, and it is recommended to try to keep a "cool head" and work through the process cooperatively. Ultimately, children benefit more from cooperation between home and school.