Developmental Testing

Developmental testing is usually reserved for young children (ages 5 and under) to determine if there is a significant delay in the child's development. In fact, this kind of evaluation is heavily encouraged for problems in children ages 3 and under, because early intervention can greatly improve the child's abilities and outcome. Developmental evaluations may include a variety of professionals, not just a psychologist, depending on the nature of the problem. For example, delays in speech and language usually involve a Speech & Language Pathologist (sometimes called a "Speech Therapist") and delays in motor development usually involve an Occupational Therapist or Physical Therapist. A psychologist may be involved in these evaluations as well, especially if there are other concerns about the child's cognitive development, social development, emotional development, or the development of "adaptive skills." A psychologist also may be requested to act as a "case manager", which means they help identify other professionals to conduct necessary evaluations, put all of the information together, and help develop a plan for the child.

Developmental testing may be used for a wide variety of early childhood developmental disorders, including:

- Developmental Delay
- Autism Spectrum Disorder
- Intellectual Disability
- Neurological Impairments
- Brain Injury/Trauma
- Evaluating the Effects of Genetic Disorders (such as Down's Syndrome) 
- Evaluating the Effects of Childhood Trauma (such as Abuse)

Because there are many different reasons to conduct a developmental evaluation, the procedures used can also be quite different. Some of the common components of a developmental evaluation might include:

Cognitive Evaluation
The cognitive evaluation is intended to measure development of a variety of different basic cognitive processes. This includes things such as how quickly the child can process information, how much information they can hold in their immediate awareness, the child's ability to store and retrieve information for a long period of time, the child's ability to process visual stimuli and coordinate that with actions, the child's ability to solve new kinds of problems, and the child's ability to make sense out of speech sounds. A cognitive evaluation typically lasts anywhere from 45 minutes to 2 hours depending on the child and how extensive the evaluation needs to be.

Adaptive Skills Evaluation
Adaptive skills is a term used to describe many different things that are done on a day-to-day basis. For a very young child, this might include things like: helping to dress himself, washing his hands, helping to bathe himself, feeding himself, holding and using a cup, or using the bathroom. It also includes things like asking for help from other people when needed, being aware of potentially dangerous things and avoiding them or responding to them appropriately. Adaptive skills are usually not evaluated in the clinic directly, but instead are evaluated by information provided by the child's parents or education professionals (such as daycare teachers or pre-school teachers).

Social Development Evaluation
Early social development is an area about which we are still learning a great deal, but there are many things that are already well-understood and that we can look for in a child's early development. These include things such as: social referencing, responsive smile, responding to voices, discriminating between familiar and unfamiliar people, shared play, seeking reinforcement, and imitation. Evaluating early social skills may take two forms: collecting information from parents and educators, and direct assessment. Depending on the reason for the evaluation, the psychologist may use one or both methods.

Direct assessment of social skills is usually conducted in a clinic where the psychologist engages the child in a series of activities. The activities may look primarily like some form of play, but they are actually carefully selected and structured activities. They are designed to get the child to show certain social behaviors and test the child's social response to the psychologist's actions. For example, the psychologist may block the child from accessing a desired toy to see how the child reacts and requests the examiner to move. The child's behaviors are compared to what is considered typical for a child of a specific age.

Emotional Development Evaluation
Emotional development includes developing a wide range of emotions (happy, sad, angry, scared, surprised, worried...) as well as the ability to identify those emotions in others, control one's emotions so they are not overwhelming, and learning how to identify one's own emotions. Young children are not likely to exhibit quite the same precision in their emotions. When a young child is upset, that may include being angry and scared at the same time. As they get older, they learn to tell the difference between these emotions though. Evaluating a child's emotional development usually focuses on determining if the child is showing behaviors that may indicate an emotional disturbance. Emotional disturbances commonly include "depression" and "anxiety disorders." However, the way that a young child expresses these is quite different from how an adolescent or adult would. A young child may frequently appear angry because she is actually feeling very sad or "depressed."

Fine and Gross Motor Evaluation
A detailed evaluation of motor development is typically conducted by a specialist, such as an occupational therapist or physical therapist. However, a psychologist may conduct a brief evaluation of motor development as part of a developmental evaluation. Fine motor skills refer to small, coordinated muscle movements necessary to do things like tying shoes, writing with a pencil, using buttons or zippers, manipulating food, or picking up and holding objects. Gross motor skills refer to large muscle movements necessary to do things like walking, running, jumping, or throwing. Evaluation of motor skills typically involves a series of tasks that my look like play activities (for example, playing catch with a ball). If a psychologist determines during the course of evaluation that there may be delays in motor development, then they will likely refer the child to a specialist for further evaluation of motor development.

Receptive and Expressive Language Evaluation
Similarly, detailed evaluation of language development is typically conduct by a specialist, such as a speech-language pathologist or speech therapist. A psychologist may conduct a brief evaluation of language development as part of a developmental evaluation, during which the child's expressive and receptive language skills are checked. Expressive language refers to the child's ability to communicate through speech, speech-sounds, or gestures. Receptive language refers to the child's ability to understand what other people say to her. The evaluation of a child's language skills will likely involve a series of requests and activities intended to produce speech or other forms of communication (such as gestures).

Behavioral Language Evaluation
A psychologist may further evaluate the child's ability to use different functions of language, such as identifying objects, making requests, responding directly to the speech of others, understanding non-literal language (such as sarcasm, jokes, or figures of speech). A child may exhibit good expressive language with respect to identifying objects in the environment, but have very little ability to make requests or respond to the speech of others. Similarly, a child may appear to have generally appropriate language ability, but fails to understand or respond appropriately to sarcasm, jokes, or figures of speech. Children typically develop the ability to understand non-literal language later in childhood.