Gifted Issues Discussion homepage Forums Twice Exceptional Screening questions to find the right evaluator?

Please help me brainstorm. DD11 with just about every possible LD is due for a new evaluation and I'm having trouble locating the right person. My district will pay but it will be easiest if I stay in state. I could probably get them to pay for a true expert elsewhere but it might be a fight and not sure it will be worth it. 2 years ago they paid a *hefty* price for an eval by someone specializing in 2E recommended by the Eides. We had some issues with the eval, though, so don't want to go back there. So what screening questions to ask when looking for an evaluator when you have a kid as complex as mine?

Background: First identified by in district school psych the summer between K and 1st. Striking numbers psych had never seen before along with very significant anxiety. Onset of migraines a few months later (at the ripe old age of 6). Telephone consult with Paul Beljan - concern about bizarre numbers plus sudden onset of headaches led to self paid eval by very prominent neuropsych in nearby big city. Numbers didn't make sense and this eval was deemed "invalid". $3000 down the drain. Neurological work up ruled out brain damage or brain tumor. The next year district paid for neuropsych by local well respected "general" neuropsych recommended by our consultant. He used all the right words - gifted, twice exceptional, truly exceptional, learning disabled, etc - in his report and at IEP meeting to get district on board to provide high level of services. He was significantly off the mark on a few things, though. At the time we were looking for in school services, though, so it served the purpose. Placed OOD in special Ed school. Excellent job remediating reading deficits and introducing AT, math remains a total disaster. High level comprehension addressed by 8th grade reading group in 3rd grade followed by 1-1 high school curriculum starting in 4th grade. This year - 6th grade - placed in district's one day per week TAG program. Trying to figure out what to do next year. At time of last testing DD was on a strong medication to control migraines and tester did not take it into account when writing report so we had a protracted battle about actually allowing the report into DD's school file with severely depressed numbers. Finally agreed to allow it in file along with a parent statement and letter from neurologist explaining the depressed numbers.

DD is now off the migraine meds and seems to be firing on all cylinders for the first time since preschool. She is reading at grade level, no longer qualifies for an anxiety diagnosis and is a dream student - focused, attentive, eager to learn. We need an evaluator who will get 2E, see the big picture as well as be able to tease out the complexity of so many interconnected issues. (11 current diagnoses ranging from dyslexia, dysgraphia, math disability and dysarthria to CAPD and vIsual processing issues. Also the migraines and eosinophilic esophogitis thrown in.) I become irate when I see a bad FSIQ or GAI number printed as if it's real, even if there is a statement somewhere in the report about it being "not a valid representation" of DD's abilities. In the last report not only was it not asterisked but the evaluator wanted to include a chart of all the "invalid" numbers generated by all previous evaluators.

So how do I screen for the next evaluation? I'm pretty sure I want a neuropsych eval not another psychoeducational eval. I want to be sure that if there are 3 and 4 standard deviations between DD's high score and her other lower scores that the person writing the report knows how to address that - and that it doesn't mean calculating numbers and including them as if they are usable even if somewhere else in the report they state this shouldn't be done. I have had numerous problems since the last report of people - even supposed experts who are experienced with 2E - commenting on how low (I mean *really low* ) DD's FSIQ was recorded. When I point out that the number is not valid and shouldn't have been used they always agree, and almost always also then point out the GAI isn't valid for her either. But their first reaction is to see the number, take it as real and possibly to want to disqualify her for eligibility for whatever they are reviewing her for. I need to find a way to address this and think it could be a good screening tool on selecting the next evaluator but how to do it? What questions to ask?

I would have liked to take her to the Eides but of course their clinic is closed. Does it pay to fight to get the district to cover someone like Paul Beljan for a full eval (I would have to pay the travel expenses.) Or can I come up with a list of solid, comprehensive screening questions to be sure someone local - even if a "general" neuropsych - will provide a quality report?

Also the last evaluator used the WISC V even though it did not focus DD's areas of strength as well as the previous use of the WISC IV. I really don't know a lot about different testing instruments but wonder if I need to ask about this as well. Are there instruments that would be better or worse for a kid like this? I understand that they are expensive and many evaluators use what they have. Can I rely on that in this kind of situation? Can someone give me a primer on which tests would or would not be good choices in this scenario?

Please let me know what questions you asked when selecting your evaluator. Or what to look for that led you to a good - or bad - experience. DD absolutely hates these evaluations so I want to make sure it's worthwhile if I have to put her trough it.

Thanks in advance!

I know you didn't actually ask about these, but reading about your DC reminded me. FYI:
"Center for Technology & Disability Studies" has educator resources and direct services (AT eval). There appear to be some resources about AT tools on the site.
https://uwctds.washington.edu/consultation Similar center exist at a number of major universities.

"Center on Technology & Disability" is a DOE site with instructional modules for educators, advocacy resources, etc. on AT.
http://www.ctdinstitute.org

As to your actual questions, in no particular order:

I would hesitate to use the WISC-IV at this point, as its norms are quite old. I actually think the WISC-V does a better job of picking up strengths for most 2e children (although your child may be one of the exceptions). There are supplementary subtests on the -V, though, that can be used to fill in some of those gaps. For example, the VECI is an expanded VCI that adds back in some of the verbal subtests that were part of the -IV. Most of the old -IV subtests are still around on the -V, as optional subtests. A thoughtful evaluator should have reviewed her old testing, noted places where the change in subtest contributions to index scores might affect her new composite scores, and considered whether to add some of those subtests back in, in order to do a closer one-to-one comparison, and to be able to interpret current testing in the context of previous testing.

To be fair, I always want to see all old testing numbers, not because they necessarily represent that child's "true" potential, but because they track changes (or stability) through time in function on standardized tasks. (Though I rarely put them in a chart in my eval reports, unless there's a TBI, a neurodegenerative disorder, or marked improvement after an effective intervention, and I'm trying to demonstrate a trajectory.) Any standardized test is only a sample of a small subset of skills, at one moment in time.--As to how this applies to evaluator selection: I would want to know that clinical interpretation was driven by sensitive assessment of the child as a whole, including history, interviews, and clinical observations of test and naturalistic (e.g., classroom) behavior, and not purely by numbers.

An evaluator who is part of a larger clinical group might be preferable, so that the audiologist, OT, neurologist, and gastro all communicate with the person doing the neuropsych. That would point to a hospital-affiliated group.

I think screening by running her past testing by the evaluator might be a good idea, as it will tell you something about how they interpret test data (numbers-driven or child-driven).

I would ask how they design evaluations, and especially what they do when "odd" test results emerge during the course of testing. Do they follow-up on these? Test limits? Do further testing? Ask confirmatory questions about IRL (in school/home/community) behavior/performance? (By which I mean, do they spontaneously come up with these further actions. If you ask any reputable evaluator if they do these things specifically, of course they will answer yes!)

What's their experience with low-incidence profiles? Multiple disabilities? See if you can get a bead on how they feel about unusual, creative, or quirky kids--those evaluators who enjoy originals often are more able to pick up on their strengths, and to get optimal performance from them. (After all, most people perform better when they feel liked and appreciated.)