[0:00]Hi, today I'm going to go through the amazing benefits of getting a cognitive assessment for your child.
[0:13]My name's Dr. Shelly Louise Hyman, and I'm a clinical neuropsychologist and the director at the Sydney Cognitive Development Centre. There could be several reasons why you've sought out having an assessment for your child. It could be that the school have raised issues, potentially the teacher or the school psychologist. Or it could just be that you feel your child isn't reaching to the best of their potential. Whatever the reason, a child neuropsychological assessment is going to be able to assess very carefully the strengths and weaknesses that your child might be facing. There can be many reasons as to why a child does not perform to potential. Sometimes at a basic level, it can just be some sort of emotional behavioral blockage, and it can be treated by a standard psychologist. But sometimes there's a processing weakness, which can really be affecting your child, and it can look like a behavioral weakness. But it's actually a core issue that that child can't actually control. It's really important to understand all the different forms of cognitive processing and which aspect in particular is affecting your child. At the Sydney Cognitive Development Center, the first stage in the process is a very in-depth clinical interview, where we go through a full developmental history and medical history, and really understand the behaviors that you're actually concerned about. We'll try and understand where your child's at academically. We can do assessment to 10 different domains as part of a comprehensive assessment. But all our assessments actually based on what we call a flexible battery. That is, we're not going to put your child through 10 hours worth of assessment just because we can. The assessment process starts with a clinical interview where we determine what areas of cognitive ability or general ability need to be assessed as part of the assessment. The assessment times vary greatly. Sometimes it might just be a one-hour assessment where we're looking at very fine detailed attention and memory processing. For example, your child might need an IQ test, academic achievement testing, as well as very specific tests of attention, memory, planning, organization, visual processing, and auditory processing. These tests may take up to 3 to 4 hours and may be split over several days. There are many different forms of learning assessment that we offer at the Sydney cognitive development center, but our assessments are a little bit different. Whilst we do all the normal tests of reading, spelling, writing, and numeracy, we also do more processing based assessments, not just to understand overall how your child's achieving compared to their peers the same age. But also looking at why certain areas are falling to be a little bit weaker than would be expected. For example, if we do a reading assessment and we find that your child has dyslexia, the next goal is actually to understand why they're actually exhibiting that disorder and try and pinpoint the cognitive issues that might be creating this. For example, we might be looking at working memory tasks, auditory processing tasks, language tasks, and even visual processing tasks. We might be looking at visual memory, the site words. We might also be looking at phonological processing. There are lots of different skills that could be creating the dyslexia. Even basic attention issues such as a visual sustained attention or an auditory sustained attention, may have created weaknesses within the classroom, which may have affected your child's ability to learn. Our job is to look at all the different cognitive skills and really pinpoint which aspects have been affected and are creating the learning disability. One of the key things when looking to have someone assess your child cognitively is to make sure that they're not just performing a basic IQ test. IQ tests can be very important as it gives us some idea about a person's verbal reasoning skills, nonverbal reasoning skills, working memory, processing speed, even visual spatial skills. But it's not actually representative of a full cognitive assessment. There are so many different types of cognitive assessment that can be done. It's important that your assessor has a very large test library. At the Sydney Cognitive Development Center, because we are a large team of clinical neuropsychologist, we have a very extensive test library. This means we can assess many different types of cognitive ability. We have full memory batteries of auditory memory and visual memory, short-term memory, delayed long-term memory. We also have tests of executive functioning, planning, organization, time management, self-monitoring, perseverance. We also have tests of auditory processing. How well you can discriminate noise and speech from background noise. We have large batteries of visual processing. How well you can discriminate different forms of visual information. How well you can remember visual information. How well you can see information when there's a complex background. When it comes to attention, there are so many different types of skills that we can have. For example, there's attention for things that we look at. How long we can visually sustain our attention on visual material. There's also auditory sustained attention, which is the ability to listen to information for a long period. Then, of course, you have divided attention. How well you can look and listen at the same time. This is a really important skill in the classroom as children often have to listen to a teacher while they're looking at some form of visual materials. Then of course, there's switching attention, the ability to be focused on one thing and then be able to switch to another. There's also attention span, the ability to take in information in a short period. So for example, if I gave you three or four items to remember, could you remember them all? There's also working memory. This is really reliant upon your attention span, but working memory takes it a step beyond. It's the ability not just to take in information but also to be able to manipulate it in your mind. So for example, if I gave you a list of animals, and I asked you to put them in order from smallest to largest. Could you then order three animals? Could you order four, could you order five, six, seven? Working the memory is the ability to be able to manipulate large amounts of information in your mind. A working memory deficit can have very, very significant effects on learning. It's actually one of the most highly correlated cognitive skills with academic achievement. And it really is an essential skill to measure when doing a cognitive assessment. I believe that at some point of a child's development, it's really worthwhile having a comprehensive neuropsychological assessment to really be able to understand if your child is reaching to the highest level of potential. Sometimes it might not actually be that obvious. For example, a child that's performing at a very average level at school might actually have an intellectual level which is much higher. At our center, we also have a speech therapist. And our speech therapist will often assess children if we find on the IQ test or just generally during assessment that there could be some language issues which could be impacting upon performance. The two main areas that our speech therapist assesses are receptive language skills, which is how well your child can comprehend language, as well as expressive language skills, which is how well your child can express themselves with words. Our speech therapist has many different programs which can be used to improve both receptive and expressive language skills, as well as a wide range of programs used to treat things like dyslexia and writing disorders. Sometimes learning issues can be created by actually having issues either comprehending language or expressing yourself in words. Other children are actually very good at expressing themselves in words, but they actually have difficulties getting their ideas down on paper. Our job is to really pinpoint the reasons for this. It could be a working memory problem. It could be a language-based disorder. It could even be a simple writing disorder. Our job is to figure that out so that then we can pinpoint areas of remediation that are required to help your child perform to their highest level of potential. As part of our team, we have an opthoptist. Our opthoptist looks at vision at three main different levels. The first is basic acuity, which you can get assessed by any optometrist. Can your child see or is what's written quite fuzzy? After that, the opthoptist then measures functional eye skills. This includes skills such as how well the eyes team up together, how well they can track information across the page, how well the eyes can fixate on a certain visual information, as well as how well they can actually converge and diverge when needed. These skills are really important because if there's any ocular motor movement issues or any issues with the eyes not working well together, this can create large levels of cognitive fatigue, which can actually look like attention problems and even be misdiagnosed as ADHD. The next level that the opthoptist can assess is actually higher-level visual skills. And this is really how the brain processes visual information. It includes things like visual discrimination, visual memory, all the different visual skills that are needed to actually take in information well from the eyes and then actually process it well with the brain. A very large percentage of what children learn is actually very visual based. And we're finding more and more an increase in the amount of visual processing disorders that we see in children in the assessment. Visual processing disorders are one of the most commonly missed aspect of a cognitive assessment. Visual processing issues can really affect the way that children take in information in the learning environment. For example, for young children when they're learning to read, the teachers often hold up large books or flash cards with words or letters on them, and at the same time they say a certain word or sound. If children have visual processing issues, they may struggle to take in the visual component of this learning, and this really affects their ability to read. It can also affect spelling in that when we learn to spell, we often look back at the word to see whether it matches a word in what's called our orthographic lexicon, which is basically our site words for written words. And it's our ability to see whether the word looks right. Often when the word doesn't look right, the child or even adult will then go back and correct that word. But if someone has a weak visual memory or weak visual self-monitoring skills, then this is really affected in this process. Auditory processing skills are another key skill required for your child to reach the level of potential. Auditory processing is the ability to be able to understand and make out speech when there's some form of background noise. There are also other forms of auditory processing weakness. However, it's this key skill, which is really important in terms of how well a child can take in information in the classroom. If your child's having issues being able to make out speech when there's any form of background noise, this really affects the ability to learn. Our cognitive assessments at the Sydney Cognitive Development Centre are done by an expert team of psychologists who all have endorsement and a master's in clinical neuropsychology. Clinical neuropsychology is a very specific field within psychology which requires an additional four years training in addition to the standard four years psychology degree. There are several different areas of endorsement that you can have as a psychologist. Clinical psychology is one that we've probably heard a lot about. Clinical neuropsychology though, is one which is a little less well known. Clinical neuropsychology is all about cognitive based assessment, and all the training is all about understanding the different types of cognitive issues that people, both children and adults can be facing, as well as different ways to remediate those cognitive processing issues. When choosing someone to perform a cognitive assessment, it's really worthwhile looking at a clinical neuropsychologist.
[14:56]As part of any cognitive assessment, we also look at the emotional state of your child. Sometimes children don't perform to potential just because of basic emotional issues such as low mood, depression, anxiety, or poor self-esteem. Our job is to identify any issues in mood, which may also need to be treated as part of a comprehensive treatment plan. Many parents come to us because they're unsure of whether the children's behavioral issues in the classroom are related just to a pure behavioral issue that needs to be dealt with just by a psychologist, or whether there's a cognitive issue potentially underlying these problems. Many children who suffer cognitive-based issues will start to act out in the classroom. For example, a child with attention issues who is struggling to take in information in the classroom will actually over time potentially develop behavioral issues because they're not really taking in the information and they're not understanding it that well. They often may get bored in the classroom and that's why you see certain behaviors arise. Kids who are hyperactive who struggle to sit still, don't necessarily have a behavioral issue. It's actually a brain-based neurophysiological issue that needs to be treated. The teachers need to understand it is a core issue and it is not a chosen behavioral problem. And that these kids shouldn't be looked at and punished for their behaviors, but rather they need to be understood in terms of their disorder and they need to have certain modifications done in the classroom. One of the aspects that makes the Sydney Cognitive Development Center so unique is that if we find there's any form of attention issue or cognitive processing issue, any signs of any under or over arousal, we can actually perform qEEG brain scans to look at the brain neurophysiology and see how the brain's firing in relation to these skills and actually brain performance.
