Psychological Evaluation 101: Learning Disorder Assessments

When I was a graduate intern, I did about 200 learning disorder assessments for school kids in Arkansas, to the point that I could pretty much complete one in my sleep (and if dreams count, I often did). Learning disorders (like dyslexia) occur when someone struggles to take in and comprehend new information like they ought to. Usually, someone is diagnosed with a learning disorder in childhood because it interferes with their academic performance, but since it is a lifelong condition, adults can be diagnosed as well.

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In recent decades, we have gotten better at screening kids for neurodevelopmental issues, and so a child in 2021 is more likely to be diagnosed with dyslexia than a child in 1995. This is good because kids with learning disorders often think that they are just not smart enough to learn, even though “gifted” kids can also have learning disorders. A correct diagnosis helps inform how to play to individual strengths.

Since a learning disorder occurs when someone isn’t able to learn as well as they “should,” a learning disorder assessment consists of two parts: an intelligence test and an achievement test. These scores are then compared to determine whether your learning deficits are accounted for by another cognitive issue and whether they are severe enough to meet the criteria for a learning disorder. These kinds of tests have known cultural and racial biases, which is why psychologists need to be culturally informed if we are going to administer them.

Learning disorders are different from other diagnoses because, in the United States, the criteria for receiving academic accommodations varies by state. For example, when I worked in Arkansas, we had to use a statistical analysis of whether a difference between scores was “significant,” but in South Dakota, there is a chart that essentially says, “An IQ score of X has an achievement cutoff of Y to qualify.” It saves me a lot of time.

If you suspect a learning disorder, you can do a full achievement test or only test the areas where you suspect a deficit (for example, only reading tests if you think you might have dyslexia). The benefit of a full achievement test is that many people have more than one learning disorder, and more information is often better.

Testing for learning disorders is time-consuming – an IQ test can take more than an hour, and achievement tests can take several hours, plus the psychologist’s time interpreting the results. In addition, many insurance companies in the United States don’t think these tests are “medically necessary” and so refuse to cover them. (If you’re not familiar with the term, “medically necessary” is insurance-speak for “you can’t make us pay.”)

If you’re seeking testing for your child, often you will want to go through the school system, as many districts require testing be completed by their evaluator for accommodations. This typically means the district has to pay for the evaluation, which helps if the cost is prohibitive. Your child’s teacher or principal will be able to tell you who to talk to about getting a testing referral from the school.

As an adult, you can still be tested for a learning disorder, though it gets expensive. If you’re thinking about going to college, the diagnosis can qualify you for accommodations like extended time, recording lectures, or oral administration of exams. If you suspect you have a learning disorder but are at a point in your life where it isn’t affecting your work or relationships, you might not need to get a diagnosis – it’s an individual choice, and you get to decide what’s right for you.

Published by Dr Marschall

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. Her clinical interests are varied and include child and adolescent therapy, TF-CBT, rural psychology, telemental health, sexual and domestic violence, psychological assessment, and mental illness prevention. Dr. Marschall presently works in the Child and Adolescent Therapy Clinic at Sioux Falls Psychological Services in Sioux Falls, South Dakota, where she provides individual and family therapy and psychological assessment to children, adolescents, and college students. She also facilitates an art therapy group for adolescents and college students with anxiety and depression. Dr. Amy Marschall is certified in Trauma-Focused Cognitive Behavioral Therapy and Telemental Health.

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