The Clinical Practice of Child and Adolescent Assessment

The use of tests and measures to understand our patients is one of the hallmarks of applied psychology. Unlike the practices of psychiatry, social work, and other allied mental health disciplines, psychologists rely on measurement to quantify patient cognitive functioning, psychopathology, behavior, strengths, neuropsychological performance, aptitudes, attitudes, and social contexts. Following the empiricist’s creed, much of applied psychological assess­ment rests on the assertion of Thorndike (1918) that “whatever exists at all exists in some amount” (p. 16).However, the clinical practice of psychological assessment with children and adolescents is different from the mere nomothetic measurement ideal proposed by Thorndike. In fact, a distinction must be made between psychological assessment and psychological testing. Although psychological assessment includes testing, it is far more complex and rife with clinical challenges. Handler and Meyer (1998) clarify the important distinction between psy­chological testing and psychological assessment, and they emphasize that these are hardly synonymous activities. They state: Testing is a relatively straightforward process wherein a particular test is administered to obtain a specific score. Subsequently, a descriptive meaning can be applied to the score based on nor­mative, nomothetic findings. For example, when conducting psychological testing, an IQ of 100 indicates a person possesses average intelligence . . . Psychological assessment, however, is a quite different enterprise. The focus here is not on obtaining a single score, or even a series of test scores. Rather, the focus is on taking a variety of test-derived pieces of information, obtained from multiple methods of assessment, and placing these data in the context of historical information, referral information, and behavioral observations in order to generate a cohesive and compre­hensive understanding of the person being evaluated. These activities are far from simple; they require a high degree of skill and sophistication to be implemented properly, (pp. 4-5)

A comprehensive psychological assessment includes information from the referring individual; from the child’s or adolescent’s parent(s) (including a thorough interview and his­tory); from the child or adolescent himself or herself; and from his or her teacher(s) and other relevant informants, such as physicians, relatives, or friends. In addition, to complete a thor­ough and meaningful assessment, the clinician must help the child’s or adolescent’s care­takers, the child or adolescent, and perhaps the referring individual to formulate relevant referral questions to be answered by the assessment. After all this activity, including testing the child or adolescent, the clinician then aggregates and integrates the data, writes the report, and provides feedback to the referral source, as well as to the parents and the child or ado­lescent tested. Compared with this complex series of activities, psychological testing is a far more simple procedure.