The Importance of Comprehensive Evaluation & Diagnosis
Originally posted by Danielle Bronk, Ph.D., ABPdN
Neurodevelopmental Health Services, Utica, NY
At every age, children are mastering a set of developmental skills and for some children a developmental stage may pose particular challenges. These challenges may manifest in delayed acquisition of developmental milestones, learning and academic struggles, behavioral concerns, or changes in the child’s social-emotional functioning. For instance, concerns related to compromises in a child’s communication, play, socialization and/or motor skills may be present for the parents of a two or three year old child. The parent of a four or five year old child may express behavioral or social concerns at home or in preschool. For the elementary school age child, concerns of difficulty learn academic concepts may be present.
Parents may recognize their child’s struggles, but they may not know what is causing these issues and how to help their child. This is the time when parents should consider an evaluation for their child. The decision to have your child or adolescent undergo evaluation can be a difficult one for parents to make. The importance of an evaluation includes informing the parent of a child’s abilities and developmental status, and the presence of and level of symptom severity that may reflect a diagnosis. Obtaining a diagnosis through a comprehensive evaluation should help parents understand the reasons for their child’s struggles, the various treatment options available for their child, and how to advocate for their child. Here are some of the more common reasons to pursue an evaluation:
An independent evaluation to help with the identification of a student’s cognitive profile as well as their social, behavioral and emotional functioning. The independent evaluation should provide clarification on the presence of parent concerns and identify a neurodevelopmental disorder diagnosis such as ADHD, LD or autism spectrum, behavioral disorder, and/or an anxiety or mood based disorder. The evaluation findings will guide school and treatment planning by pinpointing the specific strengths and challenges affecting a student’s learning. By deeply understanding how students learn, recommendations regarding strategies and supports to improve academic performance, increase self-confidence and develop success in school may be provided.
Transition planning for middle/high school, college or graduate school
Many high-achieving students find themselves struggling for the first time in middle or high school, college, or other graduate/professional program. To qualify for accommodations, most colleges and universities require a comprehensive evaluation that samples the domains of a neuropsychological evaluation. A comprehensive evaluation will pinpoint the source of a student’s difficulties, identify their strengths, and provide strategies and support to help their success.
My child has already been diagnosed
Most neurodevelopmental problems (reading disorders, learning disorders, attention deficit disorder, etc.) have symptom overlap. For example, the inability to sustain one’s attention to a boring task is a symptom of many neurodevelopmental problems not just ADHD. Without taking a thorough history and systematically sampling cognitive domains (i.e., attention, executive functions, memory, among others), your child might receive a misdiagnosis. A good neuropsychological evaluation integrates the findings from cognitive domains assessed, to arrive at an understanding of the brain-behavior relationship and the impact on academic, behavioral, and life skills performance.
Parents of children with a neurodevelopmental disorder may be puzzled by the fact that their child appears to be so smart and competent academically, yet struggles in school. Children with a mild autism spectrum disorder may experience subtle learning issues or difficulty with those behaviors that support academic success (organization, planning, remembering, problem-solving, initiation, focus, and/or social skills). These behaviors, which are referred to as executive function skills may be weak for students with an autism spectrum disorder, ADHD, or learning disability. It is the role of the neuropsychologist to understand how problems in executive functioning may interact with other weaknesses or deficits to impede academic and life success.
Parents should talk with their child’s pediatrician, mental health counselor and/or school district regarding their concerns in order to learn about evaluation resources in their area. Many professionals can identify deficits for a child, but a well-trained and experienced evaluator can determine the underlying factors to a child’s presentation, the circumstances that may exacerbate or lessen symptoms, and those evidenced-based treatment options and educational resources available. As part of the evaluation, parents should be provided with a written report explaining the results and a feedback session in order to discuss the findings and any concerns and questions parents may have.
Dr. Danielle M. Bronk is the Director of Neurodevelopmental Health Services. Dr. Bronk has dedicated her career to improving the well-being and development of young people. She works primarily with students from preschool through graduate school and beyond, bringing her depth of experience and neuropsychological perspective to struggling students.
Prior to the establishment of Neurodevelopmental Health Services in 2014, she served as the Director of Clinical Services at the non-profit Kelberman Center for six years. There, she worked closely with the Center’s professionals to deliver a multi-disciplinary model of evaluations and personalized treatment to hundreds of students in Upstate New York.
In 2014, Dr. Bronk created Neurodevelopmental Health Services to expand a model of developmental evaluations. As part of the comprehensive evaluation services offered at NDH, Dr. Bronk conducts independent developmental, psychological, neurodevelopmental and neuropsychological evaluations for individuals across the lifespan using assessment techniques that are current with the latest scientific research.
Dr. Bronk began her career as a pediatric neuropsychology fellow, at the North Shore-Long Island Jewish Healthcare System in Manhasset, NY, where she performed comprehensive outpatient pediatric neuropsychological evaluations addressing various referral questions, including: behavioral and learning disorders; autism spectrum disorders, among others.
Dr. Bronk is a native of New Hartford. She received her bachelor’s degree from Syracuse University. While studying for her doctorate in counseling psychology with a specialization in neuropsychology from Seton Hall University, Dr. Bronk completed training experiences at the NYU Comprehensive Epilepsy Center, Youth Consultation Services, and the Rusk Institute of NYU Medical Center. Dr. Bronk remained at NYU Medical Center’s Rusk Institute for Rehabilitation Medicine for her APA accredited clinical psychology/neuropsychology predoctoral internship. She is board certified in pediatric neuropsychology. She and her husband have two children.