Psychological Assessment

We are able to provide a range of developmental and psychometric assessments for both children and adults. For children, all assessments include a clinical parent interview that forms a critical part of the assessment, taking into consideration a child’s developmental history and other important factors (e.g., Cultural background). Assessments offered include (but are not limited to)

Autism Assessment

Sometimes a parent may be concerned that their child is having ‘social’ difficulties. Sometimes, another professional working with your child may also express concern. The term ‘Asperger’s Syndrome’ or ‘Autism Spectrum Disorder’ might be used to explain these difficulties. However, Autism Spectrum Disorders are more than just a child’s difficulties in the social arena. Here are some symptoms related to Autism:

1- Repeating certain behaviors or having unusual behaviors

2- Having overly focused interests, such as with moving objects or parts of objects

3- Having a lasting, intense interest in certain topics, such as numbers, details, or facts.

4- Getting upset by a slight change in a routine or being placed in a new or overly stimulating setting.

5- Making little or inconsistent eye contact

6- Having a tendency to look at and listen to other people less often

7- Rarely sharing enjoyment of objects or activities by pointing or showing things to others

8- Responding in an unusual way when others show anger, distress, or affection

9- Failing to, or being slow to, respond to someone calling their name or other verbal attempts to gain attention

10- Having difficulties with the back and forth of conversations

11- Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond

12- Repeating words or phrases that they hear, a behavior called echolalia

13- Using words that seem odd, out of place, or have a special meaning known only to those familiar with that person’s way of communicating

14- Having facial expressions, movements, and gestures that do not match what is being said

15- Having an unusual tone of voice that may sound sing-song or flat and robot-like

16- Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions.

Assessment of a child for Autism Spectrum is complex and is comprised of a clinical interview and a formal psychometric assessment. Unfortunately, there is no single test which covers the whole spectrum of strengths and weaknesses as shown by children who may qualify as having a diagnosis and accurate diagnosis relies on the opinions of experienced clinicians such as, but not limited to, psychologists.

Assessments that we use that contribute to the decision relating to the diagnosis:

Interviews with parents
Discussion with Classroom teacher
Interviews with previous and present professionals working with the child
Observation of the child and the completion of The Childhood Autism Rating Scale (CARS)
Completion of other questionnaires by parents and teachers such as Gillian Autism Rating Scale 2 (GARS-2)
A cognitive assessment (e.g., WISC-V )- This is based on the judgment of the clinical psychologist, it may not be necessary.

Dyslexia Assessment

Dyslexia is the common term for Specific Learning Disorder. Specific learning disorder is a developmental disorder that begins by school-age, although it may not be recognized until later. It involves ongoing problems learning key academic skills, including reading, writing and math.

Specific learning disorder is not simply a result of lack of instruction or poor instruction. Key skills that may be impacted include reading of single words, reading comprehension, writing, spelling, math calculation and math problem solving. Difficulties with these skills may cause problems learning in other academic subjects, such as history, science and social studies. But those problems are attributable to difficulties learning the underlying academic skills.

Specific learning disorder, if not treated, can potentially cause problems throughout a person’s life, including lower academic achievement, lower self-esteem, higher rates of dropping out of school, higher psychological distress and poor overall mental health, as well as higher rates of unemployment/under-employment.

To be diagnosed with specific learning disorder, a person must have difficulties in at least one of the following areas.

The symptoms must have continued for at least six months despite targeted help.

1- Difficulty reading

2- Difficulty understanding the meaning of what is read

3- Difficulty with spelling

4- Difficulty with written expression

5- Difficulty understanding number concepts, number facts or calculation

6- Difficulty with mathematical reasoning

Reading problems can include difficulties with reading accuracy, reading rate or fluency, and reading comprehension. Dyslexia refers to learning difficulties related to word recognition, decoding, and spelling. Problems with written expression can include difficulties with spelling, grammar and punctuation, and with clarity or organization of written expression. Dysgraphia a term used to describe difficulties with handwriting. Problems with Maths can include difficulties with number sense, memorizing math facts, math calculations or math reasoning/problem-solving. Dyscalculia is a term used to describe difficulties in learning math facts and performing math calculations.

Here are some symptoms to look out for:

1- The child’s test scores or grades are significantly below what would be expected given his/her thinking and reasoning ability (cognitive ability).

2- In their preschool years, children with specific learning disorders often experience delays in attention, language or motor skills.

3- Kindergarten-age children with a specific learning disorder may not be able to recognize and write letters, may have trouble breaking down spoken words into syllables and may have trouble recognizing words that rhyme.

4- Children in elementary school may have difficulty connecting letters with sounds, may read slowly and inaccurately, and may have difficulty with spelling or math facts.

5- Adolescents and adults may still read slowly and with much effort and may have problems with writing, understanding what they read or with mathematical problem-solving.

6- Adolescents and adults may avoid activities that demand reading or arithmetic (reading for pleasure, reading instructions). They may use alternative approaches to access print (e.g., text-to-speech/speech-to-text software, audiobooks, and audiovisual media).

A diagnosis of specific learning disorder is not based on a single source of information. It is based on a combination of an individual’s medical and family history, observation, interviews, history of the learning difficulty, school reports, educational and psychological assessments, and standardized tests. Furthermore, a comprehensive assessment is needed to make sure that a child does not have any other accompanying problem with his/her learning difficulties.

In Malaysia, currently, many parents do not know where to seek help for getting an assessment for their child who has reading and writing difficulties. The assessment for SLD should be conducted by a clinical psychologist using standardized testing. This includes a development assessment and an IQ Assessment with another informal testing of a child’s reading, writing, and mathematical skills.

To make a determination of Specific Learning Disorder, a child’s behaviors and functioning are evaluated in terms of the diagnostic criteria set out in the international guidelines of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-V).

Assessments that we use that contributes to the decision relating to the diagnosis:

Interviews with parents
Discussion with the Classroom teacher
Interviews with previous and present professionals working with the child
A cognitive assessment (e.g., WISC-V )
A developmental assessment
Informal testing of reading, writing, and mathematics skills.

ADHD Assessment

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common disorders among young people. It affects attention span and concentration and can also affect how impulsive and active the person is. Most young people are, at times, inattentive, distractible, impulsive or highly active. They may have ADHD if such behaviors occur more frequently and are more severe than is considered average among young people of the same age or developmental level. A diagnosis of ADHD might also result if the behaviors persist over time and negatively affect the person’s family and his or her social and school life.

The symptoms of ADHD fall into two main groups: inattentive behaviours and hyperactive and impulsive behaviors. Young people may be diagnosed with ADHD if, for the past six months or more, they have displayed six or more symptoms of either inattentive behaviors or hyperactive or impulsive behaviors.

People with symptoms of inattention may often:

1- Overlook or miss details, make careless mistakes in schoolwork, at work, or during other activities

2- Have problems sustaining attention in tasks or play, including conversations, lectures, or lengthy reading

3- Not seem to listen when spoken to directly

4- Not follow through on instructions and fail to finish schoolwork, chores, or duties in the workplace or start tasks but quickly lose focus and get easily sidetracked

5- Have problems organizing tasks and activities, such as what to do in sequence, keeping materials and belongings in order, having messy work and poor time management, and failing to meet deadlines

6- Avoid or dislike tasks that require sustained mental effort, such as schoolwork or homework, or for teens and older adults, preparing reports, completing forms, or reviewing lengthy papers

7- lose things necessary for tasks or activities, such as school supplies, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and cell phones

8- Be easily distracted by unrelated thoughts or stimuli

9- Be forgetful in daily activities, such as chores, errands, returning calls, and keeping appointments

People with symptoms of hyperactivity-impulsivity may often:

1- Fidget and squirm in their seats

2- Leave their seats in situations when staying seated is expected, such as in the classroom or in the office

3- Run or dash around or climb in situations where it is inappropriate or, in teens and adults, often feel restless

4- Be unable to play or engage in hobbies quietly

5- Be constantly in motion or “on the go,” or act as if “driven by a motor”

6- Talk nonstop

7- Blurt out an answer before a question has been completed, finish other people’s sentences, or speak without waiting for a turn in a conversation

8- Have trouble waiting for his or her turn

9- Interrupt or intrude on others, for example in conversations, games, or activities

Diagnosis of ADHD requires a comprehensive evaluation by a clinical psychologist or psychiatrist with expertise in ADHD. For a person to receive a diagnosis of ADHD, the symptoms of inattention and/or hyperactivity-impulsivity must be chronic or long-lasting, impair the person’s functioning, and cause the person to fall behind normal development for his or her age. The psychologist/psychiatrist will also ensure that any ADHD symptoms are not due to another medical or psychiatric condition. Most children with ADHD receive a diagnosis during the elementary school years. For an adolescent or adult to receive a diagnosis of ADHD, the symptoms need to have been present prior to age 12.

ADHD symptoms can appear as early as between the ages of 3 and 6 and can continue through adolescence and adulthood. Symptoms of ADHD can be mistaken for emotional or disciplinary problems or missed entirely in quiet, well-behaved children, leading to a delay in diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships.

The assessment involves a detailed interview of parents and also teachers. It also involves a standardized test that will pinpoint the severity of symptoms.

To make a determination of ADHD, a child’s behaviors and functioning are evaluated in terms of the diagnostic criteria set out in the international guidelines of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-V).

Assessments that we use that contributes to the decision relating to the diagnosis:

Interviews with parents
Discussion with Classroom teacher
Interviews with previous and present professionals working with the child
An ADHD assessment (e.g., Conner’s Parent Rating Scale)

IQ assessment/ Intellectual Functioning Assessment

Measuring a child’s intellectual functioning is sometimes referred to as measuring a child’s “IQ”. These measures help us to identify a child’s pattern of intellectual strengths and weaknesses across a range of areas. The most common measures used to assess intellectual functioning in children are the Wechsler Preschool and Primary Scale of Intelligence™ – Fourth Edition (WPPSI-IV) (age range 2-6) and the Wechsler Intelligence Scale for Children, Fifth Edition (WISC–V) (age range 6-16).

An assessment of intellectual functioning can assist in a better understanding of a range if presenting issues including (but not limited to):

academic difficulties/strengths in the classroom
behavioral difficulties in the classroom
developmental issues (e.g., Intellectual disability, Autism spectrum disorders)
assessment of children with high intellectual potential

Developmental Assessment

A developmental assessment is done for children to assess whether their development is normal and uneventful. This assessment can determine the delays that a child has in their development. This assessment covers three domains which is the Socialization Domain, Communication Domain and the Daily Living Skills Domain.

This assessment will let you know whether your child’s growth and development is at par with other children his/her age. Furthermore, it will let us know what type of skills your child is lacking, and we will be able to suggest to you the right types of intervention for the development of your child.

Depression

Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.

Some forms of depression are slightly different, or they may develop under unique circumstances, such as:

Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.
Perinatal depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with perinatal depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany perinatal depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.
Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.
Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.”

Examples of other types of depressive disorders newly added to the diagnostic classification of DSM-5 include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD).

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:

Persistent sad, anxious, or “empty” mood
Feelings of hopelessness, or pessimism
Irritability
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities
Decreased energy or fatigue
Moving or talking more slowly
Feeling restless or having trouble sitting still
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, early-morning awakening, or oversleeping
Appetite and/or weight changes
Thoughts of death or suicide, or suicide attempts
Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment.

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.

To make a determination of depression, a person’s behaviours and functioning are evaluated in terms of the diagnostic criteria set out in the international guidelines of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-V).

Assessments that we use that contributes to the decision relating to the diagnosis:

Interview with the person
Interviews with previous and present professionals working with the person
Assessments such as the Beck’s Depression Index, Becks Hopelessness Scale, Becks Suicidal Scale.

Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two.

Anxiety Problems

Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The feelings can interfere with daily activities such as job performance, school work, and relationships. There are several different types of anxiety disorders. Examples include generalized anxiety disorder, panic disorder, and social anxiety disorder.

1- Generalized Anxiety Disorder

People with generalized anxiety disorder display excessive anxiety or worry for months and face several anxiety-related symptoms. Generalized anxiety disorder symptoms include:

Restlessness or feeling wound-up or on edge
Being easily fatigued
Difficulty concentrating or having their minds go blank
Irritability
Muscle tension
Difficulty controlling the worry
Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep)

2- Panic Disorder

People with panic disorder have recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom. Panic disorder symptoms include:

Sudden and repeated attacks of intense fear
Feelings of being out of control during a panic attack
Intense worries about when the next attack will happen
Fear or avoidance of places where panic attacks have occurred in the past

3- Social Anxiety Disorder

People with social anxiety disorder (sometimes called “social phobia”) have a marked fear of social or performance situations in which they expect to feel embarrassed, judged, rejected, or fearful of offending others. Social anxiety disorder symptoms include:

Feeling highly anxious about being with other people and having a hard time talking to them
Feeling very self-conscious in front of other people and worried about feeling humiliated, embarrassed, or rejected, or fearful of offending others
Being very afraid that other people will judge them
Worrying for days or weeks before an event where other people will be
Staying away from places where there are other people
Having a hard time making friends and keeping friends
Blushing, sweating, or trembling around other people
Feeling nauseous or sick to your stomach when other people are around

Evaluation for an anxiety disorder often begins with a visit to a doctor. Some physical health conditions, such as an overactive thyroid or low blood sugar, as well as taking certain medications, can imitate or worsen an anxiety disorder.

When all medical conditions have been ruled out to be the cause of the anxiety problems, your doctor will then refer you to a psychologist/psychiatrist for further evaluation. A thorough assessment is needed because anxiety disorders often co-exist with other related conditions, such as depression or obsessive-compulsive disorder.

At WeCare Allied Health Center, to make a determination of depression, a person’s behaviours and functioning are evaluated in terms of the diagnostic criteria set out in the international guidelines of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-V).

Assessments that we use that contributes to the decision relating to the diagnosis:

Interview with the person
Interviews with previous and present professionals working with the person
Assessments such as the Beck’s Anxiety Index etc.

Other Assessments

We also provide assessments for:

Emotional Problems
School bullying
Eating Disorders
Play Therapy
Social Skills Training
Anxiety/Depression
Self Harm
Self Esteem Problems
Preschool difficulties (Eating, Sleeping, Toilet training, tantrums)
Learning difficulties
Anger & Aggression