What follows are responses to some of the most common questions in submissions to the webpage. It is hoped that the Reader can refer to these FAQs to understand all of the key facts about the assessment process. There are many questions and the responses will take time to fully address in order to provide a proper context. Therefore, this page will be updated on a regular basis. Let’s begin with the high frequency questions.
Fee. There are two fees: one for a comprehensive educational assessment and one for a combined educational assessment and “SEB” assessment - - social - emotional - behaviour (which includes AD/HD, ASD, mental/emotional health - - anxiety/depression, and ODD).
The range of fees for a comprehensive cognitive assessment is somewhere between 650 and 750. The appointment time is usually 3 hours, 2 or all 3 with the child/young adult and the remaining time with parent. Young children finish the protocol in 90 minutes whereas a 17 year old can take 3 hours - - more tests, longer time to complete due to having to start with easy items and continuing to the end of the measure. Of course all this is dependent on how skilled the individual is - - less skill quicker time to complete and more skill longer time to complete. With inflation and the rising cost of materials and office expenses, most individuals would be at the upper end of the range, this Psychologist included.
As for a cognitive and SEB assessment, the ranges are more dramatic, depending entirely on what tests are used, how much data is collected, and how much time is spent with child/parents (or adults who self refer), whether a home/school visit is part of the process, etc. For example, a comprehensive autism assessment for a non - verbal or minimally verbal child could take several days and involve several professionals. I hesitate to guess but the fee for this type of assessment would certainly be no less than 1,500 and possibly 2,000.
When I assess a child or adult for AD/HD or Autism, the time is usually no less than 3.5 hours and no more than 4 hours. For children the time is divided 50/50 with parents - - child appointment first then adult. For teenagers the ratio is usually 75/25 in terms of total time.
Fees may seem quite costly but the total time to complete a report and post the document is never less than 4 hours for a comprehensive cognitive assessment and never less than six hours for a cognitive/seb assessment. A Doctorally trained and highly experienced Psychologist usually has an hourly fee of 150 so you can do the maths from here.
Waiting time. Over the years, the waiting time has increased. In the late 1990s and early 2000s, the wait was about one month. From around 2005 to 2010 this increased to two to three months. Then from 2010 to 2020 about four to six months. Now, it is one year. This appears to be the standard wait time for assessments, both publicly and privately.
A waiting period is complicated to manage. I have a wait list folder with 200+ contacts on it. Eventually, when individuals on the list are contacted, roughly 75% of the families do not need the appointment or have already had the assessment completed. At other times, the individual cannot be contacted which means leaving a message and so on. The process is time consuming and not productive. As a result, wait list individuals linger in a kind of purgatory. My advice to anyone on a wait list is to regularly make contact with the provider because timing is critical. An opening might occur and can be filled immediately by someone who is making new contact or someone who wishes to know the status of the his/her case on the wait list.
Assessment Process. The process is dependent on age and type of assessment. The type of assessment is usually determined in the first contact and submission to the website. As an example, a parent is concerned about the reading and writing levels of a seven year old. This requires a comprehensive educational assessment and requires the child to complete about 2 hours of standardized tests. The results are provided during the parent meeting with recommendations for supports and methods to address.
A parent writes that her 16 year old daughter cannot focus or concentrate in class and this is a major issue for the student. The student wonders is it AD/HD. This is a educational and SEB assessment and involves about 2.5 to 3 hours of student time and an hour parent meeting. There are rating forms to be completed before the assessment and these require time to input, analyze, and summarize, all of which occurs before the appointment.
An adult wonders if he is on the autism spectrum (ASD). This is a four hour appointment with the adult, preceded by forms that are completed and analyzed before the meeting. As part of the assessment the ADOS -2 is used (this test is also used for most teenagers and adults when there is a query about ASD).
The assessment is completed when the report is received. I send reports two or three days after the appointment. My modus operandi is to share the outline of the report at the end of the meeting so there are no surprises and no need for follow up.
In a small minority of cases, there are issues with the recommendations. For example, there may be different wording regarding Assistive Technology. Another possible hitch is when a student meets the circular guidelines for a language exemption and the exemption is denied. In this case, the wording has to be as strong as possible and cover all angles. Nonetheless, all recommendations are just that - - recommendations. The implementation requires the provider to agree with the recommendations. This is the most likely scenario but it is sometimes the case that the school or educational authority have another plan. When this happens, there is an appeal process but this does not involve the assessing Psychologist who has already made the recommendation and provided supporting documentation (in Leaving Certificate cases, a Psychologists’ Certification form).
Also, many of the reports I submit will come with attachments (handouts attached to the report) which detail specific strategies to assist with the main difficulties encountered (e.g. comprehension, mathematics, slow speeds, etc.). Also, when relevant DARE documents are attached. These are forms submitted with the CAO application or a psychometric summary in dyslexia/dyscalculia cases).
Preparation. Again, this depends on age and type of assessment. For all younger children it is best to say that a person will do various activities (shy away from “tests”) that show how children “learn.” Knowing this will help us (parents and teachers and tutors) to know how to help you with “homework” “school” and also to know what you like so we can do more fun things (something along these lines).
The only paperwork required is that directed by the assessing Psychologist, usually rating forms or dedicated qualitative narratives. Previous reports, letters, and other documents are optional.
Further intervention/further investigations. The assessing Psychologist typically does not provide further intervention (e.g. CBT/DBT, Coaching, Counselling, etc.). Psychologists can define their brief as they see wish and in line with best practice standards. Personally, I only do assessments and this is more than enough (refer to previous waiting time section).
Further interventions and/or specialized investigations are often required. For example, an adult with AD/HD may need a medication trial. As a Psychologist, I cannot write prescriptions so a referral will be made to adult psychiatry. Likewise, specialized “AD/HD Coaches” may be recommended and this requires contact with these specialists (contacts are provided in the recommendation section).
For children, with AD/HD and/or ASD, most recommendations are implemented at the school level. Outside sources will be recommended as necessary. There are certain diagnoses that require cross professional investigations, particularly in the case of specific verbal/language expression/comprehension difficulty. In these cases, a Speech and Language Therapist assessment may be recommended. In some cases, a submitter to the website will query “dyspraxia.” This diagnostic evaluation is done primarily through Occupational Therapy. There may be “peripheral” collaboration via Psychologists’ testing - - slow writing speed, illegible writing, good oral language, good comprehension.
Who gets the report/how is the report provided. A single hard copy of the report is posted to the receiver. The receiver can then determine who needs to see the report - - school, GP, tutor, CAO Office, Psychiatrist, Psychologist, Speech and Language Therapist, Occupational Therapist, Counsellor, etc. The receiver can scan the hard copy and create a pdf for all further electronic transmissions (or copy the hard copy and post as required). In this way the receiver is in control.