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When would you use psychological testing on children…

By on February 16, 2014
Question “We have heard psychological testing is time consuming and costly.When would you use psychological testing on children and what are its pros and cons?”

 

Answer 

This depends on what the purpose of the testing is, and whether the results are intended to guide educational interventions or mental health treatment.

Educational issues would include having trouble with reading or math, inability to conceptualize ideas appropriate for a specific age, etc. Instances of a behavioral problem, i.e., depressed mood, inattention, rebelliousness, lack of energy, distraction, fighting, insomnia etc., would mean there is a mental health issue involved.

For educational issues, psychological testing that focuses on specific learning functions or IQ may help guide the educational needs of the child.
For mental health issues, a psychiatric interview of the child and the parents that is about an hour long will usually allow the psychiatrist to narrow down the major problem(s) at hand into a “provisional diagnosis” that can be further refined in subsequent meetings as necessary, and psychological testing is generally not required. A psychiatric examination is less time consuming and costly than psychological testing which may take many hours, cost a few thousand dollars, and also require refinement in further meetings.

Mental health disorders can not be proven or disproven by a test like an illness in medicine can be proven by a blood test or x-ray. Diagnostic suspicions in mental health can only be empirically tested by a combination of direct examination, seeing a person longitudinally over time, and seeing how persons respond to treatment and/or withdrawal from treatments.
The next issue is whether a “to treat or not” decision will be made based on psychological testing. In medicine or psychiatry, treatment decisions should be based on what a patient seems to need, not the result of a test which may not be definitive. For example, if a child is writing suicide notes, is irritable and has insomnia (and no family or peer-stress reasons to be depressed), we would want to treat this child with an appropriate intervention rather than withhold treatment and chance they may have a bad outcome regardless of the outcome of psychological testing.

Treatment itself gives information whether a child may actually have a problem or not if they respond to the treatment, and relapse if treatment is stopped. This information strengthens or weakens the suspicion of the provisional diagnosis, i.e., response to treatment is the test. Psychological testing is also often requested by a school and may follow a child until adulthood in their educational record regardless of the validity of the results.

In summary, the objective of a test, the time and costs, how that test’s results may be archived, and how they may be used for treatment decisions, all need to be considered carefully before deciding to have a battery of psychological testing.

The topic in this column is meant for advice and information only. Please consult with an appropriate professional in the case of an actual mental health need.

About Douglas Berger, M.D., Ph.D.

Dr. Douglas Berger and his staff at the Meguro Counseling Center in the Shibuya-Ebisu area provide mental health care for individuals, couples, and families, in both English and Japanese. www.megurocounseling.com