School Neuropsychology: A Practitioner's Handbook

By James B. Hale; Catherine A. Fiorello | Go to book overview

CHAPTER 3
Neuropsychological Approaches
to Assessment Interpretation

DEVELOPMENTAL NEUROPSYCHOLOGICAL ASSESSMENT

Developmental Differences in Practice

The developmental differences among children can be significant and can have tremendous implications for neuropsychological interpretation of assessment data. Moreover, children are not merely small adults; their test performance is both quantitatively and qualitatively different from that of adults (Fletcher & Taylor, 1984). As a result, applying neuropsychological principles in school settings requires not only substantial training, skills, and clinical acumen, but an awareness of the broader developmental context. In working with each child, developmental criteria should shape the nature of the assessment, interpretation of results, and recommendations for intervention. Therefore, it is critical that different assessment practices should be used for different children, and that interpretation should vary depending on children's unique patterns of performance within the context of their current developmental level.

This is not to say that we should deviate from standardized test administration practices. Instead, it suggests our rapport building and maintenance activities will vary from child to child, and that summative scores (e.g., global IQ) provide little insight into the developmental nature of the child's performance. For instance, it would be inappropriate to conclude that a 7-year-old girl who gives only 1-point responses on the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV) Similarities subtest has good “abstract verbal concept formation,” just because her score is above average. This suggests that clinical observations and idiographic interpretation must be developmentally sensitive as well. This flexibility in observation and interpretation is important, but some people think that it is contrary to a neuropsychological approach to interpretation. Indeed (and unfortunately), many view a neuropsychological orientation as one that focuses on static, intractable brain problems (Rourke, 1994), and that views all strengths and weaknesses

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