Test Battery Construction

If the referral questions vary widely, so should assessment batteries. Referral questions should be doggedly chased using methods that match the problem in question. If memory impairment is suspected, various tests of memory are used, including memory of narratives, designs, faces, working memory, rote memory and tests of learning. This will describe memory function most exhaustively. If the patient is being referred in order to rule out or confirm dyslexia, the assessment will employ measures of word reading, pseudoword decoding, intelligence, and the like. The point is that the testing battery used will vary as a function of the referral question to increase the likelihood of answering the referral question. In addition to intensively measuring the problem area, other areas are screened to rule out alternative explanations. A child recently referred for conduct problems illustrates the point: This boy showed willfulness, opposition and refusal of work. Of course, these conduct problems were measured and described; but his reading and intelligence were also screened. Upon finding weaknesses in reading, further measures of phonetic and reading ability were administered, which resulted in a diagnosis of a learning disability. This child could not sound out words like other children, though he was of average intelligence. This learning disability turned out to greatly contribute to his conduct problems. Because he could not read, he refused the work and became generally disruptive. In this case, with proper screening and diagnosis, the focus of intervention changes from behavioral modification and counseling to special education and tutoring.

In conclusion, assessments 1) focus on problem areas, 2) screen to rule out alternative explanations, 3) use a range of instruments to gather needed information, 4) are always designed to answer the referral question.