Assessment Services

Comprehensive assessment is a process of testing that uses a combination of techniques to help arrive at an understanding about an individual and their behaviour, personality and capabilities. 

Psychological assessment is also referred to as psychological testing, and is nearly always performed by a licensed psychologist, or a psychology trainee (such as a provisional psychologist). Psychologists are the only profession that is expertly trained to perform and interpret psychological tests.

Prevention is better than cure and research consistently supports the importance of early intervention in long-term wellbeing, achievement, adaptation and skill development.

Without an accurate understanding of the origin and causes of developmental, social, communication and behavioural problems, any intervention or assistance is ill-informed, can be detrimental and may have long-lasting negative consequences.

For both children and adults, the specific benefits of psychological assessment include:

1. Clarifying the existence of specific cognitive disorders – for example, whether a child has an underlying learning / developmental disability; or whether an adult shows evidence of ADHD or memory loss, etc. For those who do struggle with certain types of cognitive disorders, these evaluations will also help inform the types of treatments that may be beneficial (for example, medications targeting inattention or memory loss), as well as the kinds of accommodations / supports that are implemented at school or at work – as a means of helping the person better thrive in their environment.  
2. Elucidating the specific type and/or combination of psychiatric conditions that may be present, which in turn facilitates more effective approaches to treatment (e.g., pharmacotherapy, psychotherapy, etc.). For example, in cases where someone is struggling with both depression and anxiety, as well as concurrent substance use, isolating these conditions in treatment may be necessary as a means of decreasing their level of interaction. Similarly, in situations where someone may be diagnosed with more severe bipolar disorder and polysubstance use, symptom stabilization and abstinence may need to be jointly prioritized in treatment as a means of preventing relapse.
3. Assessing for certain types of personality characteristics / disorders that may impact functioning and /or treatment.

Parents can be reluctant to ‘label’ a child and teachers often resist implementing interventions that may make a child look ‘different’ to peers, however many children already know they are ‘different’ and without a ‘label’, they tend to develop negative thought patterns around their own perceived inadequacies.

Psychological testing can reveal underlying mental health disorders, learning disorders, developmental disabilities, or giftedness. Getting a formal diagnosis helps parents decide on the best course of action for their child. This could include seeking mental health treatment services, requesting a formal individual learning plan at school, or enrolling the child in a specialist school program.

In addition to informing the various types of medical / psychiatric interventions that may be helpful, these types of assessments also play a critical role in directing the kinds of academic / social accommodations that are provided within the school system itself. With these types of treatment and support systems in place, children are much more likely to thrive academically and socially.

The findings from this type of evaluation will let us know where the child excels and which areas he or she might need to address (for example: an undiagnosed learning disability).  Having your child evaluated can promote improvement in academic and emotional functioning.

For adults, insight into the aetiology of patterns of behaviour can offer relief and acceptance of strengths and weaknesses in a non-judgemental manner and direct future assistance-seeking in specific skill areas.

Psychological assessment can also be extremely helpful with adults who may be struggling in different areas of their lives, particularly in situations where past treatments have been sub-optimal or ineffective. These evaluations provide important information not only about where someone may be struggling specifically (e.g., depression, substance use, impulsivity, personality disorders), but also with respect to comorbidity / complexity. For example, research has suggested that roughly 6 in 10 people with a substance use disorder also struggle with other forms of mental illness. As the latter remains untreated, the likelihood of successfully treating the former declines considerably.

Allowing a child or adult to understand and embrace their differences in a context of a diagnostic profile can facilitate the development of a more balanced self-image as part of a strength-based approach, access targeted and effective intervention supports, feel ‘understood’ by others and develop tools for self-regulation, self- monitoring and advocacy.

Assessment and diagnostic information can facilitate access to intervention and support in areas of funding, such as the NDIS, Carers Allowance and Carers Payment, Disability Pension, school disability support programs and specialist education.

Generally, assessment takes between 4 and 6 sessions and for children, may involve parent/carer consultation, child testing over two or three sessions (below), and follow-up consultations (with parents/carers and teachers) as required.

For adults, assessment can involve an initial interview, formal testing over one or two sessions and follow-up consultations as required.

Parents or carers of child clients are required to accompany the child to the consultation room for the initial interview and the follow-up sessions, however if the child is comfortable, it is preferable that the child attends assessments sessions alone.

Bromley Psychology offers a broad range of psychometric and diagnostic assessments, including:

• Cognitive/Intellectual (IQ) assessment using the Wechsler Adult Intelligence Scale, Fourth Edition (for adults) and the Wechsler Intelligence Scale for Children, Fifth Edition or the Wechsler Pre-school and Primary Scale of Intelligence, Fourth Edition (for children aged 6 – 16 years)
• Educational/academic assessment, using the Wechsler Individual Achievement Test, Third Edition (WIAT-III)
• Behavioural assessment, using the Achenbach Child Behaviour Checklists (CBCL’s)
• Adaptive Behaviour and functioning assessment, using the Vineland Adaptive Behaviour Scales, Third Edition and
• Pragmatic language assessment, using the Child Communication Checklist, Second Edition (CCC-2)

As well as assessment tools to support a diagnosis of Autism Spectrum Disorder, including:

• The Autism Diagnostic Observation Schedule, Second edition (ADOS-2) and
• The Autism Diagnostic Interview, Revised (ADI-R)

The purpose of the Autism Assessment is to determine whether an individual is on the autism spectrum and to provide information about their presentation and support needs. This assessment is suitable for individuals 6 years and over who have never been diagnosed with autism before or where there have been conflicting opinions expressed by professionals and clarification is sought.

Bromley Psychology conducts comprehensive evidence-based assessments for Autism Spectrum Disorder (ASD) in children, adolescents and adults. The assessments are provided by Clinical Psychologists and Allied Health Professionals with experience and post-graduate training in the diagnosis of autism.

When diagnosing ASD, Dr Simone and other health professionals refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This tool breaks down the signs and symptoms of ASD into categories. It also states how many of these must be present in each category to confirm a diagnosis of ASD in children.

Most children will also have a speech and language assessment by a Speech Pathologist and an assessment of their sensory profile by an Occupational Therapist.

Diagnosis of Autism requires a determination as to whether the child has Autism or whether the observed behaviours are the result of a medical or other condition. In the clinic, we use a structured procedure as described below. Often families are referred to us after a diagnosis has been made or suggested by another health professionals. In which case we will use the information already gathered by these professionals and conduct other tests if necessary.

Dr Simone can diagnose an individual with ASD and determine where on the spectrum the individual falls (Level 1 – 3).

As part of an autism assessment, health professionals use activities like puzzles, games and pretend play to observe a child’s behaviour, social skills and communication. They also talk to parents to find out about the child’s early development.

The assessment process for children and adolescents includes:

• Comprehensive parent/carer interview using the Autism Diagnostic Interview-Revised (ADI-R) and Child Communication Checklist, Second Edition (CCC-2)
• Formal observation of the child using the Autism Diagnostic Observation Schedule (ADOS-2)
• Assessment of adaptive and functional skills (everyday living skills and independence) and cognitive functioning, using the Vineland Adaptive Scales and Wechsler tests
• A feedback parent/carer session outlining the assessment outcomes, including an opportunity for questioning and clarification
• Provision of a diagnostic report outlining assessment results, interpretation, and recommendations for intervention and follow-up
• Follow-up appointments to monitor the effectiveness of recommendations

For adults, the assessment process involves:

• An initial interview to determine symptom history using the Autism Diagnostic Interview, Revised (ADI-R) and the presence of current symptoms using the Autism Diagnostic Observation Schedule (ADOS-2)

• Assessment of functional skills (everyday living skills and independence) and cognitive functioning using the Vineland Adaptive Scales and Wechsler tests

• A feedback session outlining the assessment outcomes, including an opportunity for questioning and clarification
• Follow-up sessions to monitor the effectiveness of recommendations

Children and adolescents who have already been diagnosed with ASD can also be referred to Bromley Psychology for review assessments at times of transition (e.g. when commencing primary school or high school or post-school planning) or to assist in applications for funding (e.g. NDIS eligibility, Disability Support Pension, school supports). They are designed to provide updated information about an individual’s strengths and challenges and include recommendations to assist with support planning and management of comorbid symptoms.

WPPSI/WISC/WAIS

Cognitive assessments or intelligence tests are used to determine a child’s learning capability by identifying their cognitive strengths and weaknesses. When interpreted in combination with comprehensive background information, parent and teachers interviews, the results of cognitive tests can provide a profile which can assist with the development of individualised intervention and learning plans for children.

Cognitive assessments with children require the administration of standardised psychometric tools by experienced and accredited psychologists. These tools can assess various areas of cognitive capacity, for example:

• Verbal Comprehension: the ability to use a range of vocabulary to understand and express general knowledge and explain concepts
• Visual Spatial: the ability to evaluate visual details and understand visual spatial relationships
• Fluid Reasoning: the ability to use conceptual information from visual details and apply that knowledge
• Working Memory: the ability to learn, manipulate and retain information to complete new tasks
• Processing Speed: the ability to quickly process and make judgements about visual information

Cognitive assessments with children help assist in the examination of:

• Intellectual Giftedness: a cognitive assessment will help to assess whether a child can access gifted and talented programs or special classes e.g. admission to selective schools, acceleration or opportunity classes, or guide teachers in the provision of extension activities in the classroom setting.
• Diagnosing learning difficulties or disabilities in children: a cognitive assessment in conjunction with an educational assessment can assist in identifying the presence of a learning difficulty or disorder in children and to help teachers make appropriate accommodations for students in the classroom. This information can be used to manage and minimise negative experiences at school such as poor academic results, school avoidance and low self-esteem.
• Intellectual difficulty or disability: an assessment will assist in identifying children with an intellectual disability, which is characterised by an IQ test score at least 2 standard deviations below the mean (this often equates to an IQ score of 70). Following an assessment, children and parents will have a better understanding around how an intellectual disability impacts the child’s ability to learn. It will also help to provide information to develop effective plans or accommodations in the classroom that are tailored to meet a child’s specific needs. Results can also assist in making applications to access government or school disability funding, special needs teachers or special provisions (e.g. scribe) in formal school examinations.

Assessment Tools

There are various cognitive assessment tools that are used for various purposes and age groups. We commonly use the following cognitive assessment tools:

• Wechsler Intelligence Scale for Adults – Fourth Edition (WAIS-IV, Australian Standard) for individuals aged 16 – 90 years.
• Wechsler Intelligence Scales for Children – Fifth Edition (WISC-V, Australian Standard) for children aged 6 to 16 years.
• Wechsler Preschool and Primary Scale of Intelligence – Fourth Edition (WPPSI-IV, Australian Standard) for children aged 2 years and 6 months to 7 years and 7 months.

The assessment usually requires between 1.5-2 hours and the WAIS and WISC are administered using iPads, while the WPPSI is a paper-based administration.

WIAT

The Wechsler Individual Achievement Test (WIAT-III) is a comprehensive, individually administered test for assessing the achievement of children, adolescents, tertiary students and young adults who are aged 4 years through to 19 years, 11 months or in preschool through to Year 12.

The WIAT-III can assess age-equivalent levels of:

• Oral Expression
• Word Reading
• Reading Comprehension
• Written Expression (Spelling)
• Mathematics

The Oral Language score indicates how well a child performs on tasks measuring the ability to listen for details as well as verbal word fluency.

The Total Reading score indicates how well a child perform on tasks which assess word recognition skills, as well as reading comprehension abilities.

The Basic Reading score indicates how well a child performs on reading tasks using both real and made-up words.

The Reading Comprehension and Fluency score indicates how well a child performs on tasks requiring accuracy of reading and comprehension of texts.

The Written Expression score indicates how well a child performs on tasks assessing basic skills such as letter formation and spelling as well as more complex skills such as written word fluency and essay composition.

The Mathematics score indicates how well a child performs on tasks evaluating one’s ability to identify and write numbers and solve mathematics calculations, problem solve mathematical worded questions, and compute answers in a given timeframe.

The Maths Fluency score indicates how well a child perform on timed tasks using addition, subtraction and multiplication assessing ability to compute fluently.

The Total Achievement Score indicates overall academic functioning.

The WIAT-III is often requested by parents and school counsellors as the detailed results are invaluable for teachers developing Individual Learning Plans (ILPs) for the school setting. It is usually conducted in conjunction with the WISC-V for a comprehensive academic and cognitive assessment.

CHILD BEHAVIOUR CHECKLISTS

Behavioural assessments are used to examine whether a child exhibits challenging behaviour which falls outside the range of expected age-appropriate behaviour. Such behavioural concerns may include difficulties around hyperactivity, impulsivity, aggression, sustaining attention and/or disruptions to peer relations or learning.

Behavioural assessments involve a detailed process. To help formulate an accurate diagnosis they typically require parent interviews to attain a developmental history, coupled with diagnostic questionnaires, teacher interviews and/or school observations and a clinical session with the child. With this knowledge, children and parents can start to better understand the underlying causes of challenging behaviour and formulate treatment plans to modify both the behaviour itself and its impact on everyday life.

The Achenbach System of Empirically Based Assessment (ASEBA) offers a comprehensive approach to assessing adaptive and maladaptive functioning. The ASEBA provides useful information to design and monitor intervention. The competencies component examines a child’s participation and skills in certain activities, whereas the adaptive and maladaptive functioning component examines problem behaviours such as aggression, hyperactivity, bullying, and defiance.

Forms for children and youth aged 6-18 years are completed by parents/caregivers and teachers. There is also a Youth Self Report for 11–18-year-olds.

The forms provide scores on each of these syndromes:

• Anxious/Depressed
• Withdrawn/Depressed
• Somatic Complaints
• Social Problem
• Thought Problems
• Attention Problems
• Rule-Breaking Behaviour
• Aggressive Behaviour

The six DSM-V oriented scales are:

• Depressive Problems
• Anxiety Problems
• Somatic Problems
• Attention Deficit/Hyperactivity Problems
• Oppositional Defiant Problems
• Conduct Problems

VINELAND ADAPTIVE BEHAVIOUR SCALES

The Vineland Adaptive Behaviour Scales, Third Edition (Vineland-3) the leading instrument for supporting the diagnosis of intellectual and developmental disabilities such as Autism Spectrum Disorder.

The Vineland-3 is used with people aged 0-90 years to measure a range of functional domains and subdomains. The results provide valuable information for developing educational and treatment plans and to monitor and measure growth over time.

Vineland-3 Assesses The Following Five Skill Areas:

• Communication – receptive, expressive and written communication skills
• Daily living – personal (e.g. hygiene, dressing), domestic, numeric (using numerical concepts in practical ways), community (functioning in the world outside the home), school community
• Socialisation – interpersonal relationships (caring, conversation, friendship), play and leisure, coping skills
• Motor Skills – gross and fine motor skills
• Maladaptive behaviour – undesirable and atypical behaviours that interfere with adaptive functioning, e.g. internalising (anxiety, depression), externalising (hyperactivity, disruptive behaviour) and critical items (self-injury, aggression, suicidality)

The Vineland-3 assessment involves a structured interview the parent/caregiver and teacher complete separate question forms independently.

CHILD COMMUNICATION CHECKLIST

Pragmatic language skills refer to how effectively children use words and gesture to communicate with others. Evaluation of the child’s communication skills should include a comprehensive assessment of the oral motor and speech motor systems. This may include:

• Non-speech motor functions posture and gait, gross and fine movement coordination; oral movement coordination, mouth posture, drooling, swallowing, chewing, oral structures, symmetry, volitional vs. spontaneous movement
• Speech motor functions: struggle and strain during speech attempts, visible groping of mouth, deviations in prosody (rate, volume, intonation, etc.), fluency of speech, hyper/hyponasality, speech diodochokinesis involving alternative and sequential speed on consecutive repetitive attempts at utterance, volitional vs. spontaneous attempts.
• Articulation and phonological performance: amount of verbal output, sound repertoire, reluctance to speak, interactive ability, intelligibility and type of errors, effects of performance load and increasing complexity; connected speech sampling.
• Language performance: comprehension and expression, type of utterances, semantic and syntactic ability, effect of increased length of input, conversational abilities.
• Others: ability to sustain and shift attention, reaction to speech, distractibility.

AUTISM DIAGNOSTIC OBSERVATION SCHEDULE AND AUTISM DIAGNOSTIC INTERVIEW

The Autism Diagnostic Interview, Revised (ADI-R) is a structured interview conducted by a Psychologist with the parents or carers of individuals who have been referred for the evaluation of possible autism or autism spectrum disorders. The interview, used by researchers and clinicians for decades, can be used for diagnostic purposes for anyone with a mental age of at least 18 months and measures behaviour in the areas of reciprocal social interaction, communication and language, and patterns of behaviour.

The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) can be used to evaluate almost anyone suspected of having autism: from toddlers to adults, from children with no speech to adults who are verbally fluent. This semi-structured assessment consists of various activities that allow a specially trained Psychologist to observe social and communication behaviours related to the diagnosis of pervasive developmental disorders. These activities provide interesting, standard contexts in which interaction can occur.

The ADOS consists of four modules, each requiring 35 to 40 minutes to administer. The individual being evaluated is given just one module, depending on his or her expressive language level and chronological age.

Module 1 is used with children who do not consistently use phrase speech, Module 2 with those who use phrase speech but are not verbally fluent, Module 3 with fluent children, and Module 4 with fluent adolescents and adults. The one group within the autism spectrum that the ADOS does not address is nonverbal adolescents and adults.

Cut-off scores are provided to determine a broader diagnosis of PDD / atypical autism / or autism spectrum, as well as the traditional, narrower conceptualisation of autism.

Offering standardised materials and ratings, the ADOS gives a measure of autism spectrum disorder that is unaffected by language. 

Once the assessment is complete, results, interpretations and recommendations are discussed with the individual and/or parents/carers.

Follow-up sessions are scheduled to develop emotional communication tools for children and adolescents that can be used to monitor symptoms and the effectiveness of recommendations.

For individuals with a Mental Health Care Plan, a report is provided to the referring health professional and the client or parents/carers at the conclusion of 6 sessions outlining results, interpretations and ongoing recommendations.

A diagnostic report will be provided if appropriate and this report can be used to access funding from the NDIS if a diagnosis of ASD is reached and/or to support therapeutic goals and ongoing intervention.

Reports can be provided to schools for funding/intervention purposes, however if more comprehensive reports are required the preparation and writing of such documents is charged at the non-rebated rates outlined in the Fee Schedule.

You can view our current fee schedule here