We try to collect data from as many different sources and contexts as we can, to build a full and well-rounded picture of who someone is, with all their interconnected parts.
First, we start with a lengthy interview with you or with a child’s parents. We want to know as much about the person (their development, their strengths/weaknesses/tendencies, their family environment and history) before any testing starts. Then, testing will be scheduled for 1-2 days, usually lasting about 8-10 hours total. For kids 5 and younger, we’ll do this in 1-2 hours chunks instead. Testing is interactive and often fun, where we use games and puzzles to keep people engaged but also to collect data on baseline cognitive functioning, academic skills, visuomotor skills, language, memory functioning, executive functioning (attention/concentration, problem solving, cognitive flexibility, inhibition of impulses), social cognition, and personality and coping style. We also conduct interviews with teachers and any other professionals providing services, will request questionnaires from parents/significant others and teachers, and will conduct a classroom observation (if appropriate).
After all this data collection is complete, we’ll write up everything we found, including all strengths, weaknesses, and idiosyncrasies. It’s important for us to understand how all of someone’s facets work together in their dynamic system to produce the specific current situation– then we want to fully explain that understanding to you. If a diagnosis is needed, we’ll give it, but we’re also focused on helping you know what to do with this information. This isn’t just academic exercise– what are the actionable steps you can take to help you or your child reach your goals? Who are the right service providers to help you get there? And how can you fit these myriad recommendations into your daily life? The last step of the process is the feedback session, where we’ll talk all that over and make sure you’re confident of what your next steps will be.
Can you do evaluations during a pandemic?
Yes! Just not in the traditional way explained above. Because our neuropsychological assessments have always integrated data points from many different sources, there’s quite a lot of the evaluation process that doesn’t involve in-person testing. We’re conducting several parts of the whole process via telehealth platforms, which includes parent background interviews, interviews with teachers and service providers, and questionnaires. For actual testing, however, we prefer that we meet face-to-face with you or your child. We feel that we get the richest data in person, and we’re incorporating a lot of risk-reducing measures to minimize transmission risk.
These methods have worked very well for families, and we’re confident in the quality of the data we’re getting this way. In certain circumstances, we’re also open to conducting some remote testing. However, it’s critical that this data truly reflect someone’s abilities, so we’re going to err on the conservative side, to make sure that our evaluations meet our high standards for accuracy and utility.
Is testing conducted during the pandemic going to produce valid and reliable data?
Researchers around the globe are doing everything they can to answer this question with solid, evidence-based information. The American Psychological Association (APA) and the Inter Organizational Practice Committee (IOPC), as well as test publishers, like Pearson, have summarized existing research on the validity and reliability of conducting testing remotely, and they have also provided information on the logistics of how to carry out testing in this way. Some data collected remotely can be just as good as what’s collected in person. However, decisions about remote testing will always need to be made on a case-by-case basis, depending on the needs of the particular person and the discretion of the particular neuropsychologist. Other factors, such as the impact of anxiety on test performance, will also need to be taken into account. In the end, our neuropsychologists will need to integrate all of the unusual factors involved in this unique situation and make their best clinical judgments on what a person needs, despite the unusual factors at play.
How will I/we benefit from an assessment?
After the evaluation is complete, we will create a report for you and your family (if appropriate) that will describe our findings in detail, in easy-to-understand language. This report will also make concrete recommendations for treatment and various services and local resources, if needed. We will also meet with you (and your child, if appropriate), to explain the data and to answer your questions. Through this process, you will learn more about your or your child’s strengths, weaknesses, and unique characteristics and about how those abilities and characteristics interact with the environment, for better or for worse. You and your child will learn more about how this specific person processes and responds to the world, how to anticipate potential challenges in the future, and how to use their strengths to mitigate their weaknesses. Using the data we collect throughout the course of the evaluation, we will make suggestions as needed for targeted treatment, accommodations at school, and strategies on how to help them at home.
Can my child get an IEP or 504 Plan after this evaluation?
If a child’s evaluation suggests the presence of significant deficits and the likelihood these deficits can be helped by services provided by the school district, then your neuropsychologist will recommend an Individualized Education Program (IEP) for school-provided special education services or a 504 Plan for accommodations. In many cases, a school district will accept our recommendations and put the services or accommodations in place. However, schools districts are not required to accept our recommendations and may still require that their own testing be completed. In practice, this is rare, but it can happen. It’s also possible that the Committee on Special Education (CSE; the body responsible for creating IEPs for NYC schools) may not agree that recommended services are necessary. We will try to guide you through understanding this process as much as we can, but parents always have the right to engage the services of an advocate or special education attorney.
Can I get extra time and/or other accommodations on high-stakes tests, like the SATs, LCATs, or MCATs?
If your evaluation suggests the presence of significant deficits and the likelihood that extra time or accommodations on testing would allow you to fairly demonstrate your skills, then we will request these accommodations. In many cases, these requests are granted, but this is never guaranteed! We won’t exaggerate our findings to make a stronger case. Boards typically require a fair amount of time to make their decisions, so make sure you’re getting the evaluation well ahead of when you’ll need to take the exam.
Are you just looking to diagnose me or my child? If you go looking for a problem, won't you find one?
Many people are rightfully worried about the stigma associated with a psychological diagnosis, and they worry that an evaluation will pigeon-hole them into an ill-fitting set of static symptoms. At Small Brooklyn Psychology, our primary goal is to describe the complex, interconnected systems and characteristics that make them who they are. We want you to understand where behaviors and tendencies come from and how they might impact someone throughout their lives. If a diagnosis truly fits a someone’s presentation, then it can be a powerful communication tool to help others know the kinds of challenges that someone may be experiencing. But we always work hard to help others know how a specific person is experiencing these specific challenges and how they play out in this environment. We try to focus on a person’s strengths as much as his or her weaknesses.
I just want Such-and-Such diagnosis, so I can get special services. Or I don't want Such-and-Such diagnosis because it might keep my child out of a school program I want for him. Can you write up my report that way?
Our responsibility is always to produce accurate, valid, and reliable data about a person’s abilities; this tenet is a bedrock of the work we do, and we take it very seriously. We will always do our best to highlight strengths over weaknesses and to help you find the best services and programs to match a particular person. However, we won’t report something inaccurately, either by commission or omission. Our ethical stance starts, at its core, with the idea that we will Do No Harm, and this would not be in the best interest of you or your child. Instead, we’d love to help you learn more about what we did find and to help you work with that.
What age ranges do you work with?
We can see individuals of almost any age. Parents of babies and toddlers (12 months and older) might seek an evaluation to evaluate for developmental disorders, including autism spectrum disorder (ASD). School-aged children can benefit from evaluations for any academic, emotional, or behavioral issues. Young adults may want an evaluation to uncover issues that may be impeding their life goals, such as Attention-Deficit/Hyperactivity Disorder (ADHD) or a learning disorder. Older adults might need to assess functioning following an injury or other life event. People of all ages can benefit from knowing more about their unique strengths, weaknesses, and idiosyncrasies.
How long does it normally take to get an evaluation?
Our process is typically 4-6 weeks, from the first interview session until you have a report in hand. We normally try to get reports back to you within 2-3 weeks of collecting the last piece of data, whether that’s final testing, a teacher questionnaire, or a conversation with a service provider.
How do I pay for services?
Although we are not in-network with any insurance companies, we will work with you to provide you documentation for out-of-network benefits. If your insurance plans include out-of-network benefits, you may be able to receive partial reimbursement for all services. Please contact us for a full explanation of fees. We can accept payment through personal checks, credit cards, cash, Venmo, or Zelle. Payment from clients is expected at the time of service.
What if I'm not ready for a full evaluation?
Sometimes, someone would like the opinion of a psychologist, even if they’re not ready for a full evaluation quite yet. We are happy to listen to your concerns and answer your questions. If you decide to move forward with evaluation, then we’ll be happy to set that up! We are also available to offer a second opinion on diagnosis and treatment recommendations, if testing has recently been completed by another professional.
Additionally, we are available for consultation to schools and other organizations and can present lectures and workshops on topics of interest.