Combined Developmental, Neuropsychological, & Educational Assessment

Newsletter #115 for Internationally Adopting Parents
July 30, 2009
PAL Center Inc.

New Articles

Jennifer Broadley
Equipping your children for a bright future: 5 simple rules
When we have to be both mother and father for our children in their primary residence it can be a challenge to know how to supply nurture, encouragement, protection and provision in the right measures. Our children will continue to evolve physically, emotionally and spiritually over time and their biggest influences, in their most informative years, will come from their home environment.

Jennifer Broadley
How to communicate with your children’s other parent
I heard a journalist say recently that “there’s a vicious and respectless way of communicating that’s reserved exclusively for the ‘divorced with children’”. Ouch, that hurt! Probably because it’s so true. It doesn’t have to be like that and for the sake of building a bridge with our children’s other parent here are some ground-rules for practicing how to play fare.

Internet Digest

Kerstin Lochrie
Childhood abandonment
Child abandonment is the practice of relinquishing interests and claims over one's offspring with the intent of never again resuming or reasserting it (Wikipedia). To children who have been abandoned, it means so much more.

Anne Marie Hayes
Enjoy your child for who he or she is!
When families adopt, they often want the child to be similar to the birth family

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Dr. Gindis answers the questions

Combined Developmental, Neuropsychological, & Educational Assessment

Dr. Gindis, on your website I read that you perform
a "combined developmental, neuropsychological, and educational assessment" as
the most appropriate for internationally adopted school-age children
with suspected neurological disorders.
What does it mean and what are the advantages of such "combined evaluation"
for my daughter?
From a message of the mother of a prospective patient.

Ideally, each and every psychological assessment should be developmental in nature: every child is a growing and rapidly changing individual, and the goal of a psychological assessment is not only to describe your child's current psychological "profile" (what your daughter is now), but to discover the tendencies of her development. The only way to do this is to consider the child's current functioning in the context of her past development.

In the case of internationally adopted child like yours, a correct understanding of her developmental history is of crucial importance. It includes not only "knowing" the facts of her life before the adoption (in this respect our knowledge is usually limited to incomplete information contained in the legal and medical documentation available for the examiner's review), but it also includes proper "interpretation" of what is known. That's where the intimate understanding of the child's cultural background together with a proper orientation in contemporary research and practice in international adoption issues make a difference in the outcome of the assessment.

Unfortunately, too often even a good specialist may either overlook or dismiss some important developmental indicators in a child affected by institutionalization and brought up in foreign culture and language. When an internationally adopted child is brought to the office of a psychologist, the professional sees a well-groomed and nicely dressed kid accompanied by a middle-class, well-educated parent - a typical family with typical issues that may be serious, but still "typical." Even when the specialist is informed that the child is adopted from abroad, it may still be difficult for anyone who never dealt with post-institutionalized children to change the mindset and re-examine the ways of assessing and interpreting the results. This becomes especially obvious in the assessment of developmental disabilities and issues related to language processing in international adoptees. For example, after two or three years in the new family, a child adopted at a pre-school or elementary school age can completely blend in with the peers in terms of spoken language, appearance, mannerisms, attitudes, preferences, patterns of behavior, etc. However, this superficial similarity contains deep-seated differences, and the distinction is in the past experiences of these children. Some had lived through severe trauma, deprivation, abandonment, and abuse. Some may have neurological weaknesses, sometimes subtle, sometimes significant, initially mentioned in their medical documentation from their motherland and in many cases ignored or dismissed by medical professionals unfamiliar with foreign medical notation. Some may have developed what is known as "cumulative cognitive deficit" as the result of early childhood cultural deprivation and a lack of remedial efforts in the new family and school setting. Some will reveal language difficulties that have nothing to do with "bilingual issues" but are originated in the abrupt native language loss and the idiosyncratic way of its replacement by the English language.

Many current behavior excesses and learning difficulties of international adoptees are rooted in their developmental history, and that is why I emphasize this part of my assessment and even highlight it in the title of the procedure and follow up clinical report.

A neuropsychological component of my combined assessment refers to application of specific neuropsychological tests and procedures enabling the in-depth evaluation of major psychological functions involved in learning and age-appropriate adaptive behavior (such as processing speed, cognitive efficiency, executive functions, language, auditory-visual integration, etc.).

An educational component includes the application of major achievement tests relevant to the age and school grade placement of the child. An educational assessment part often incorporates "trying teaching" in a "dynamic assessment" format: test-teach-test to determine the child's mental modifiability, intrinsic motivation to achieve in learning activity, and ability to transfer the learned skills and knowledge to other contexts and situations.

Finally, a major task and the goal of my combined assessment is to interpret all findings as a whole in the context of current understanding of brain-behavior interaction, developmental norms and deviations, cultural and linguistic specificity of the case and educational and remedial implications for the child. Any assessment is as good as it is comprehensive enough to become a foundation of any further remedial work with your child.

B. Gindis, Ph.D.