Frequently Asked Questions
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1. Why should parents consider private testing instead of having testing done by their local school district?
Having had almost twenty years of experience working (part-time) as a School Psychologist for over two dozen school districts in Pennsylvania and New Jersey, I am clearly aware that the central and primary goal for testing completed by public schools is determining eligibility for Special Education services. Thus, if a student is truly struggling academically, but his or her skills do not meet state or federal criteria (e.g., fall 1 ½ standard deviations below their peer group), the work of the School Psychologist/Child Study Team is essentially done. They may make some suggestions, in some instances, for possible areas of intervention; but, even when they do, these tend to be quite limited, in my experience. In fact, those students who generally have received (again, in my experience) almost no support have been those who are perceived by Child Study Teams to be "average" or low average, even if such an observation is not actually correct about a student. Public School Child Study Teams have tended, especially in more recent times of shrinking budgets, to focus most of their efforts/interventions on students in the extremes (i.e., very high, or very low functioning).
2. How does the goal of the comprehensive testing conducted by Dr. King differ from that of most school districts?
The goal of my testing is to determine how a student learns the best, and what types of interventions and strategies are needed for a student to achieve his or her true personal and cognitive potential. Thus, while many students do leave the testing process with a diagnostic formulation, not all do. While I evaluate dozens of students each year with more serious learning disorders, one of the many areas of specialization I have maintained over the years is the "kid in the middle" who is struggling with learning issues but does not necessarily have problems which school districts consider serious enough to evaluate or develop interventions for.
3. What if Dr. King does not find anything wrong with my son/daughter?
As the response above suggests, the goal of my comprehensive assessment process is to determine a student's unique learning style and learning needs, not "what's wrong." So, no one finishes the assessment process without a detailed set of interventions and strategies.
4. How is Dr. King's testing different from that of School Districts?
If a clinician aims to generate detailed and practical information about a student's learning needs and not just special education eligibility, the testing process becomes substantially more lengthy and complex, especially for students who have significant areas of cognitive strength that they can use to offset their areas of weakness. It is not uncommon for their learning issues to "pass under the radar screen" if only a conventional school district assessment (e.g., one IQ test and one achievement test ) is utilized.
5. So, what specifically does Dr. King evaluate in his longer, comprehensive testing process?
The comprehensive assessment process I utilize examines four areas of functioning: Cognition, Educational Achievement, Perception and Emotional Functioning.
6. What is examined and what tests are commonly used in the assessment of cognition?
Because more recent educational and clinical research has made it clear that conventional measures such as the Wechsler scales can do an excellent job of measuring areas of "crystalized intelligence" (e.g. , stored information in a student's long-term memory) and selected types of problem solving, they do not effectively or comprehensively evaluate many types of information processing and retrieval. For example, the Wechsler Scales do not include "controlled learning activities" which enable a clinician to actually teach a student a task and then measure how effectively they learn it. Also, the underlying theories of intelligence of the Wechsler Scales have not sufficiently addressed all of the complexities of the human mind. For this reason, I always use at least two full IQ/cognitive batteries (e.g., Kaufman Assessment Battery for Children II; DAS II, Woodcock Johnson Tests of Cognitive Abilities), and sometimes part or all of a third, in every comprehensive assessment. This method not only provides parents with a more detailed and comprehensive analysis of a child's learning style, it also offers them the assurance that multiple observations of cognitive functioning, at different times and on different days have been compiled about their son's/daughter's information assimilation processes. Ultimately, more accurate and more precise data about a student provides me with the clinical evidence to develop more practical and more specific recommendations for a student.
7. What tests are commonly used in the assessment of academic skills?
In the realm of reading, skills in the area of word analysis, decoding and recognition are measured. Comprehension skills are measured for sentences and paragraphs on both a timed and untimed basis. But, even more importantly, different types of comprehension skills--those involving summary analysis, inferential and deductive competencies in the reading process--are assessed at different times and on different days. Further, word, phrase and paragraph-reading fluency are all examined. In cases wherein the initial phases of reading testing suggest the possibility of Dyslexia, a comprehensive analysis of a student's phonological processing skills (CTOPP) is administered.
In the realm of mathematics, fluency, problem solving and computation skills are all examined, with the option of using multiple tests if inconsistent or grossly uneven skills ratings emerge.
In the realm of written expression, spelling, fluency of writing short phrases, sentence and paragraph (and essay, if appropriate) skills are all evaluated. When appropriate, writing skills are evaluated not only on tasks completed by hand but also on those completed on a computer/word processor.
Again, the point of doing more extensive testing of a student's academic skills is that different tests in an area like reading, such as timed vs. untimed, multiple choice versus single word versus narrative response comprehension tests, conventional decoding vs. pseudoword decoding tests--all have the potential to generate completely different ratings. The implications for recommendations and interventions are, of course, quite important.
(Academic skills measures include, but are not limited to: Wechsler Individual Achievement Test, Second Edition; Woodcock-Johnson Tests of Achievement (Revised Normative Update Version); Gray Oral Reading Test (Fourth Edition); Test of Word Reading Efficiency; Kaufman Tests of Educational Achievement, Second Edition; Nelson-Denny (timed reading comprehension assessment).
8. What measures are used in Perceptual testing?
I administer a variety of measures at different times and on different days to address visual perception/visual motor coordination, accuracy of visual processing, auditory processing and speed of information retrieval. Two separate sets of neuropsychological measures are administered, at different times and on different days, to address selected facets of a student's capacities for attention and concentration. Behavioral data from teachers regarding a student's attention and impulse regulation skills are collected, unless teachers cannot be reached (e.g., in the case of summer testing). In cases involving the potential of language-based learning disorders, supplemental language testing (OWLS; CELF-4) is also conducted.
(Commonly used perceptual measures include, but are not limited to: The Cognitive Assessment System; The Integrated Visual and Auditory Continuous Performance Test; Minnesota Card Sort; Comprehensive Trail Making Test; Wide Range of Assessment of Memory and Learning, Jordan Left-Right Reversal Test, Oral Directions Test from the Detroit Test of Learning Aptitude)
9. What measures are used in testing a student's emotional functioning?
Because the testing process is so lengthy and because I administer all of the tests myself, data for a critical component of the emotional evaluation is gathered through the time I spend with the students, and their response to the complex production and problem-solving activities of the assessment. Also, a variety of formal and informal measures from structured response tasks, to drawings, to story response formats are used. Newer emotional assessment tests which students complete on a computer are used for pre-adolescents, adolescents and adults. Issues such as self-concept, self-esteem, motivation and drive level are all examined, with the amount of depth varying, of course, depending on the age of the student.
10. Is it true that administration of the entire comprehensive assessment can take as long as 16 hours?
Yes, that is correct. Twenty-eight years ago, when I first began conducting more intensive testing in my practice, a comprehensive battery took only 5-6 hours. However, every time a test is revised/updated, the newer version is typically longer. For example, cognitive measures which took 40 minutes over two decades ago, now, in their newest form can take as long as an hour and 45 minutes. Achievement tests which used to take only 20 minutes can now take well over an hour and a half. Further, fatigue cannot be a competing hypothesis for any of the test results so testing sessions cannot be longer than two hours. This time frame keeps the students fresh and reduces resistance toward the testing process; it also allows me to be fresh for each student I work with throughout the day. Further, the reality that the same type of test can be administered on different times and on different days allows for a student's test findings to be validated, or offsets the potential for a student's results to be the product of "faking" or "having a bad day."
Finally, the two hour time frame has been one that (combined with a friendly atmosphere, my efforts to make the students feel comfortable and accepted, and a fully stocked snack closet) has enable most sessions to "come happy and leave happy," when the testing process is underway.
Also, the testing process for older students includes vocational interest testing. Since clinical research has repeatedly emphasized that the happiest and most productive individuals in this country are those who are in jobs/careers that are best suited to both their intellectual strengths and their interests, generating such information during a comprehensive evaluation has been critically important and very meaningful to students.
11. Does the testing have to
be completed in 8 consecutive meetings?
No, reliability and validity requirements indicate that as long as the total time for the assessment does not violate a 3 month window, that the findings are still valid. Also, for secondary level students, some of the meetings can be scheduled after school.
12. Does every student need the entire comprehensive assessment?
No, absolutely not. Not only because of the current economy, but also because of variable student need, assessments can be tailored to address the needs of different students in different grades and in different school settings. Also, in some instances, I have actually recommended that testing not be conducted and that alternative interventions such as therapy, tutoring, or psychiatric consultation be utilized first, or in place of a comprehensive testing process.
13. Why is private testing so expensive?
While part of the reason private testing is expensive is simply the cost of the tests themselves, the most important reason why the cost is high is time. For example, the comprehensive battery requires the following: at least 16 hours of testing time (and, in more than 20 percent of the cases I see each year, even more time, for which I have never charged) is needed; at least 4-6 hours are needed to score and interpret all of the tests as well as make follow-up phone calls to teachers: at least 4-6 hours are required to dictate the results; the diagnostic intake session with parents usually takes at least two hours; the follow-up/feedback session with parents requires 2-3 hours; the follow-up feedback session with elementary and middle school students is one half hour and the follow-up feedback session with high school and college students is at least one hour; typing of the 24-34 page final report is done by a professional transcriptionist whose fee must also be factored into the report.
Thus, each comprehensive assessment typically involves more than 30 hours of my time if all of the above factors are included. It involves at least 24 hours of time to administer and interpret the test, and dictate the final report. So, fees due at the time of each testing session are not just for the two hours of testing, they are payments toward the testing process.
14. So, why don't you just shorten the testing process?
As noted above, when that is appropriate for a child's needs, I do. As I also mentioned, I sometimes recommend that testing not be conducted at all, until other interventions have been attempted.
15. Why don't you just write a short report?
I tried that too, but teachers, principals and , most especially, parents felt that short reports did not give them enough information. One of the many important roles I must maintain as a clinician is to protect the children I evaluate. If written reports do not contain enough scientific support to justify a student's need for interventions, and enough explanatory data to guide teachers and parents about how to intervene, then students are not protected. Shorter sounds simpler, but it's not necessarily better when it comes to protecting and supporting students' needs.
16. Why not do the testing in one day or after school, or all in one day, so that children won't have to miss school?
Both my own experience and clinical research have emphasized that fatigue cannot be a competing hypothesis for critical conclusions about a child. When I tried to extend testing sessions to more than two hours, even college and graduate school students got tired. Even when I tried to have older students come in for a testing session in the morning and then one later in the day, they called mid-day to say they couldn't return.
For almost twenty years I was required, as a school district consultant to pull students out of class, who were usually unprepared for my assessment, and finish them within one school day, before the janitor locked the school building door at 4:00. Parents always asked, "How can you be sure what you saw in that one day was truly my child, and not the day?" My answer was always, "I can't." But, if the only judgment a clinician must make is whether a student falls outside of a broad range of normal, time restrictions can be managed by the use of scientifically validated diagnostic instruments. But, as mentioned previously, if the question is: "How does my child learn the best?"—the solutions are more complex.
17. What else is different about the private testing you provide?
In more than two and one half decades of doing testing, there have been only a few instances wherein students have indicated that they have received feedback about their performance from the psychologist who actually did the testing. Yet, students very consistently seem, in my experience, to be more open to participate in tutorial/remedial programs and make constructive use of their accommodations if they understand why such supports are important for them and their learning needs.
18. What about the written report?
School district diagnostic reports are usually 3-5 pages in length. My reports are 26-34 pages in length. My reports are longer not because I am more verbose at this point in my career, but because I have learned that if suggestions are not spelled out in length, teachers and parents may not be certain of how to implement them. Also, if recommendations are not full length, students are not protected.
19. Why not make evaluations shorter?
As mentioned previously, shorter evaluations may be appropriate for some students. However, for the typical student coming into my practice, shorter is not necessarily better. In fact, more than 40% of the students I evaluated during this past year had been evaluated in the past two years, yet their performance in school had not changed and the supports available to them had not improved.
20. Why not make reports shorter?
I tried that also. Teachers were insulted and angry, feeling that clear guidelines about how to respond to a student were not provided to them. Parents were angry, feeling that if they wanted to help their children or transfer them to another school district/school that they would not have enough information to maintain a helping role.
21. How do your fees compare with those of other psychologists in private practice?
The fees of other experienced psychologist and hospital/clinical settings in the area run from $3,500-$6,000, so my fee structure, while higher than some
practictioners, is not out of line with what a number of expereinced practictioners and agencies charge. Further, in all of the 28 years that I have been doing testing in private practice, I have never had a parent report to me that they felt that the testing wasn't worth the price. In fact, in most instances, parents have reported—"It's the best money I ever spent: I'd do it again." Actually, many do. In the years that I have been in private practice I have tested more than 275 siblings, multiple cases of twins, and dozens of parents of patients (who see their own issues when their children are tested.)
22. Why are some fees for private testing lower than yours?
It is not always clear why some psychologists doing testing charge less than I do. But, what is clear to me is that some psychologists keep costs down by utilizing shorter batteries, using less experienced psychologists who are supervised or doing only a part of the testing themselves. In fact, most psychologists who, like myself, have more than 25 years of doing diagnostic work, are not willing to do testing in private practice because of the amount of time it consumes.
23. Will other psychologists/clinician be involved in the testing process?
No. I have experimented with a variety of diagnostic models in private practice and continue to feel that I learn as much from the time that I spend with a child as the tests I give to them. Since I was trained extensively in neuropsychological, educational, cognitive and educational assessment interventions, it has always been my experience that being the sole diagnostician not only helps me to get to know a student better, but also helps me to have students and parents feel more confident about accepting my recommendations/interventions because I have established credibility with a student. My individualized work also allows me, at the final meeting to show examples of a student's learning issues to parents and teachers
24. Do you do therapy/counseling?
Yes, about 49% of my practice has always been therapy cases. I see a number of students each year that I have tested. However, when students live a distance from my practice I usually try to help them find a therapist closer to their homes.
25. Do you advocate for children in schools, at IEP or Annual Review meetings?
Yes, parents have hired me, in the past to accompany them to school meetings if the controversy surrounding their children has been significant or if their child's learning issues are complex. I have also been hired by parents to testify as an expert witness at Due Process meetings in both Pennsylvania and New Jersey.
26. What if I am just not sure? Where should I begin?
My recommendation to parents who are unsure about whether to have the testing process completed is to schedule a diagnostic testing intake (2 hours in length) and forward all of their child's records to me so that I can review them before the meeting takes place. At that meeting, I will gather critical developmental, educational and emotional/social data as well as gain a full understanding of the issues which parents wish the testing process to address. My responsibility is, by the close of the meeting, to formulate a specific plan of action/next step. As suggested previously, that "next step" could be suggestions for tutoring, alternate educational planning, therapy, a brief evaluation or a comprehensive evaluation.
27. How much can I expect my insurance to reimburse me after I have paid for the testing process?
When I first began doing testing privately over two and one-half decades ago, insurance companies frequently reimbursed 80% or more of the testing cost. In the past 5-10 years, but most especially in the past 5, parents have reported some reimbursements as low as $200 and some as high as $2000. Unfortunately, some have also reported that their insurance company refused all reimbursement. I am always willing to help in any way that I can (e.g., by completing pre-certification forms) but insurance companies have not tended to be responsive to my lobbying efforts and too often insist that parents return to their local school districts to have their children evaluated.
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Phone: (215) 493-7380
Email: info@drkingtesting.com
