::Attendees visible::

BONNI GOODWIN: 
Welcome everyone. We apologize for the delay in starting our webinar today. We were having some technical difficulties with Zoom, but we are on now and we are excited to see you. And, I'm going to go ahead and put some information in the chat. And just to let you know, we are recording. So, remaining on this call is your consent to being recorded. All right, Lacey, I'm going to turn it over to you.

LACEY SORRELS: 
Okay. So I'm going to go ahead and just share my screen real quick. Can you guys hear me okay? Okay. Let's see here. We're moving a little slow this morning,

::Slide - Psychological Evaluations::

and that's okay. Okay, so today we're going to be talking about psychological evaluations. So this is not meant to be a deep dive into psychological evaluations, but more of kind of an overview just to kind of help you understand,  some different types, what they're for, all of that kind of stuff. So we're just going to hop right in, to this information.

::Slide - Agenda::

So our agenda for today, first we're going to talk about kind of a general overview of what is a psychological evaluation. We're going to talk about why psychological evaluations are needed, and why you might be referred for one. We'll also talk about, the different types of evaluations. What is it being assessed during those, some logistical things you might need to know if you are taking a kiddo for one of those evals. Some insurance information, just some logistical stuff. And then at the end, I would like to have a time of sharing of some resources. So I have a resource guide that I have put together of some different providers who do psychological evaluations, kind of in the different areas of the state. But also I would really like some input from you guys on if you've had really good experiences with provider. So we're going to make sure and leave a little bit of time so that we can share that information in the chat. And just kind of resource share together. And I will be adding anything that you guys share, to that guide and sending that out with the certificates by the end of the week.

::Slide - Psychological Evals

So a general overview of psychological evaluations. A psychological eval can be, helpful in identifying the underlying cause of an individual's symptoms and provide a basis for developing a treatment plan that is tailored specifically to their needs. It can also be used to monitor an individual's progress, and treatment, and make any necessary adjustments. So sometimes you'll hear about, these evaluations being repeated every year, every couple of years. And that's just kind of to monitor that progress.

::Slide - Referrals::

So referrals for a psych eval generally you're not going to need a referral to a provider to get a psych eval. You usually can just call right to the office and say, hey, I would like to have this assessment done. Sign me up, and they'll get you set for a date. But there are times that other providers or professionals you're working with may refer you for a psychological evaluation. And those providers that may refer you are a counselor or a therapist, and maybe they're working on some treatment with your kiddo or individual. And they would like some further information or some a further deep dive. They could refer for that. A school system also might refer for a further evaluation. Your primary care provider or a social worker that may be working with your family. And so some of the things that you might be referred for, to determine the source of emotional or behavioral symptoms, to determine if a learning or developmental delay is present, and then to obtain recommended recommendations for further treatment options.

::Slide - Exam Preparation::

So for the exam preparation, and this sounds really scary, and a lot of people are kind of worried about, you know, what do I do on that day? What does that day look like? It does often take quite a long time. So eating a good breakfast before you go is essential. We don't want hungry kiddos trying to complete some different tests and puzzles and things like that,
and just being distracted. Taking your medication as usual, unless instructed otherwise. So this is something you want to make sure you ask that provider ahead of time so that they can best instruct you for your situation. Bringing any corrective medical equipment with you such as glasses, hearing aids, etc.. And then if you've had any previous testing, make sure you're bringing those reports with you, because that's all going to be part of that assessment process. And then last, ensuring any self-report or other written surveys or measures are completed. So they may give you something as a parent or as a teacher to complete. And you want to make sure that those are all brought in as well.

::Slide - Things You Will Learn::

So what are some things that you might learn in the process of getting a psychological evaluation? So first you might learn about any mental or behavioral health diagnoses for your kiddo. Generally, all of these types You might learn about therapeutic intervention recommendations. So maybe there's some additional therapy ideas that haven't been tried yet that, as a result of this assessment, they may feel like would be helpful. Caregiver psychoeducation. So this could be something like some recommendations on maybe a book that would best help you to understand your kiddo's situation or something like that. And then lastly, the home and school adaptations. So this could be something like being in a smaller class size, having a visual routine at home, things like that that could better help their daily functioning.

::Slide - Blank with 3 boxes::

So on these next several slides,
we're going to kind of talk about some very specific types of evaluations you might encounter. So in this first section here, every slide is going to look the same, just for your reference. This first section here is going to be the things that are being assessed in the process of that evaluation. The second little box here is going to be the logistical pieces of information for that evaluation. And then the third box is going to be what type of provider is able to complete that evaluation.

::Slide - Psychological Eval (3 boxes)::

So first we'll get started with just a general psychological evaluation. Generally they're going to ask for a description of behaviors and symptoms by the caregiver and or self-report. And that just means if your kiddo is old enough, there's going to be some level of self-report about what they're experiencing. A description of how those behaviors and symptoms
are impacting their functioning. So maybe little Johnny is having anger outbursts. They're going to want to know what those anger outbursts look like, but they're also going to want to know are those things, or this behavior, excuse me. Those anger outbursts, are those impacting his functioning at school? Are they impacting his functioning at home? What does that really look like? They're going to do clinical interviews both with the client and the caregivers. And then that's going to include some structured testing as well. And then lastly they're going to gather historical information. So this historical information is going to include things like the child's developmental history, the child's medical history any adult history. So maybe their biological parents, mental health history, their medical history. It's also going to want to know about, you know, any like family-type settings. What does the current family structure look like? What does their previous family structures look like? Just to get a whole idea of what is happening for this kiddo. These evaluations typically last between 2 and 8 hours. And this really depends on the complexity of the situation. And what all things they're going to be looking at. 
Most general psychological evaluations are covered by insurance. Soonercare covers
that at a rate of one time per year. And that year spans from 365 days from the last time you had one, not per calendar year. These results are usually received in 2 to 4 weeks. And you're going to receive those results in the form of a fairly lengthy report, which later on we're going to talk about that and look specifically at an example. But you're going to get a report, but you're also likely going to have a follow up appointment with that psychiatrist, or psychologist
to be able to go over those results. And they will really help you get a solid understanding of what their findings were. One of the most common things I get asked by parents is, can you help me find somewhere that doesn't have as long as a wait? Can you help me get in sooner? It is really common for a psychological evaluation to have a fairly lengthy wait time. On average right now, we're seeing anywhere from 4 to 8 months, 6 months being pretty typical. I've seen up to 12 to 18 months if it's for kind of a specialty situation. One of the things you can do to be able to access those earlier is to get on a cancellation list. Basically, what happens with that is you get on the list, and if somebody cancels their appointment last minute or is not able to show up, they'll call you and say, hey, are you able to come in today? And if so, you're able to get in ahead of your scheduled appointment time.
So who can do a psych eval? Basically, it's going to be a licensed psychologist at a masters or doctorate level.

::Slide - Neuro-Psychological Eval (3 boxes)::

So next we're going to talk about neuropsychological evaluations. So we started very broad. And now we're going to narrow it in super specific. Neuropsychological evaluations cover a lot of the exact same things that psychological evaluations do. And then they have some added pieces that go a lot deeper. So they're going to talk about intellectual abilities any learning disabilities cognitive abilities, sensory perceptual information, motor function, executive functions and problem solving, behavioral concerns, language abilities, visual-spatial skills, abstract reasoning and analysis, information processing. And so these are typically going to take between 2 and 8 hours and are going to be happening in 1 or 2 sessions. So sometimes depending on how long it's going to take, they may have you come back for a whole separate session. So these evaluations are specific and that they're usually done when there is either a brain injury or some other neurological condition present. Those neurological conditions could be something like Alzheimer's, a stroke, Parkinson's disease, epilepsy, brain tumors, infections of the brain or spinal cord. And then there's some other medical conditions that aren't necessarily neurological in nature, but that they can also be impacting functioning. And so in the same way that we want the psychological evaluations, and providers to be viewing our kiddos and clients through a, an adoption competent lens and a trauma lens in these clients' situations, they also have to have that medical lens added to be able to get the full picture of what is happening for them. 
The reports of these are also going to include tips to improve cognition and possibly referrals to other professionals. So tips to include or to improve cognition basically means maybe they're having some memory struggles. It's going to include some skills or tasks that can help improve that memory, and then referrals to other professionals. Maybe they need to refer to a neurologist. Maybe occupational therapy would be beneficial. So sometimes they're going to include those additional referrals. Results for these evaluations typically take about 2 to 4 weeks. And it's also going to include that lengthy written report as well as a follow up appointment to explain all of the things included. 
A very specific, person is able to do these evaluations. So it's a clinical  neuropsychologist. So someone who has gone to school specifically for neuropsychology and then has undergone, specialized postdoctoral training, specifically training in how to do these evaluations. That's why for this particular evaluation, the wait long issue wait list is usually fairly long. Because there aren't a lot of people that do this specific type.

::Slide - Learning Disorder Eval (3 boxes)::

Next, we have a learning disorder evaluation. So testing is going to vary on this depending on what it is it's being evaluated for. So if you're having kiddo evaluated just for a general learning disability to see if there's something present there, they're going to do a wide range of testing. But if you have concern, say for dyslexia, they're going to do some very specific targeted tests aimed directly at determining if that is a factor. The whole point of a learning disability evaluation is either ruling out or providing a diagnosis of learning disability, and it's going to include
clinical interviews with both the client and caregivers and teachers. Those are going to be really critical. These also might include observation of a child in class. So we're going to talk in a minute about the different settings that these happen in. So some private providers will also do an observation in kiddos in class, but this is most common when it's done on a school-based level. It's also going to include standardized tests in various academic areas, including math, reading comprehension, and all of the sorts of things to see where kiddo is functioning compared to peers who should be of a similar level. 
These evaluations can take between 3 and 9 hours, and can span across multiple sessions and or settings, and it usually takes between 1 and 3 weeks for the full report to come back. Like what I mentioned, these are often done in a school setting, but can also be done with private providers. And they provide educational accommodation recommendation. So they're going to talk about specifically things like maybe if class size would be helpful or more time on a test, they're going to provide some of those targeted recommendations, aimed towards kiddo's education. These are essential for obtaining an IEP. And insurance coverage can vary on this. So if you're having a general learning disability evaluation
with a private provider, it is often covered. But it really depends on what your private insurance is. But if you're doing something really specifically targeted, like dyslexia, I've heard of multiple families where they have a lot of struggle in getting that to be covered with their insurance. So that's something you would check on individually.
So who can do a learning disability evaluation? A developmental pediatrician, a school psychologist, or a clinical psychologist. And so on the clinical psychologist, that's basically just an outside provider, outside of the school,
just in a basic office setting.

::Slide - Parental Competency Exam (3 Boxes)::

A parental competency exam is something that I included in here because it is very specific kind of to this population
that we're all connected with, so the foster care and adoption population. It's not really something that happens
outside of that other than sometimes in like a, a custody agreement or a custody case. So what happens in our parental competency exam is a clinical interview with the parent, psychological testing with the parent, a records review of any prior records, gathering a lot of historical information specific to the parent. So their mental health history, their
medical history, substance use history, and then they're going to want to know about their parents as well. They're going to obtain collateral info. So nobody's really going to walk into a psychiatrist office and say, hey, I would love to see how I'm doing as a parent. That's not really a thing that happens, right? So these referrals are only going to be, from a DHS worker, an attorney, or something like that. So whoever's doing this evaluation is going to obtain that collateral information from that referral source. 
And really this whole evaluation is trying to gain a basic understanding of does the parent understand and able to, execute the kiddo's safety and understand their child development. So that's not similar, really to like what child welfare would do in saying, you know, are parents using substances? And that's causing a safety issue for the child. This is more, do the parents on a cognitive level understand what it means to be safe? Are they able to be able to respond appropriately in crisis? So, for example, if a parent has some sort of disability, whether that be mental health or a cognitive delay, or maybe their substance use is so significant that it has altered, the way that they're able to think and process things. So they might be referred for this, and they're going to look at something like, say the house is on fire, is the parent, do they have that understanding of, oh, we need to get out of the house, or are they going to take kiddo and hide in a closet? Those are the kind of safety things that they're going to be looking at. Can they process through and understand what is going to happen in a safety-type situation?
Also, they want to gather information on, the parents' understanding of child development. They're going to ask the parent some information about their child, about their birth experience, about, the developmental milestones of the child,
because they're really trying to gather does the parent understand this information that is a basic need of the kiddo? So like I said, these are fairly specific to DHS cases, but also sometimes occur in custody cases.
These typically take four hours and are almost always in an office. And different places have slightly different names for this. So in our general area, it's kind of a regional thing, but in our area, they're referred to as parental competency exams. Other places they're referred to as custody evaluations, things like that. And this report is provided directly to the requesting party. So like I said, maybe DHS or an attorney is going to request this evaluation. They're going to get a copy of that report directly, but that provider's also going to sit down with the parent in-office and make sure that they're reviewing those results with them. Make sure that they understand, the recommendations and the overall, you know, decision of that provider. 
Just like with our other evaluations so far, this is going to be a licensed psychologist who is approved to do this.

::Slide - ADHD Assessment (3 boxes)::

Next up, we'll talk about an ADHD assessment. So these are going to include structured psychological testing, including standardized objective measures. Really they're looking at where kiddo is testing on these areas, compared to other kiddos
of similar age and development. It's going to include a heavy information from both caregivers and teachers. 
This typically looks like rating scales that they asked both be filled out ahead of time, and it's also typically going to take about four hours, with that report being available in 1 to 3 weeks. And this is often covered by insurance. 
So for an official ADHD evaluation or assessment, those are done by licensed psychologists. However, others like pediatricians, licensed therapists, and licensed social workers, are able to make a diagnosis of ADHD. They're just not doing this full, like, ADHD evaluation that would be done by a licensed psychologist.

::Slide - DDS "Evaluation" (3 boxes)::

Next, we're going to talk about a DDS evaluation. And I put this in quotation marks because this is not an official type of psych or psychological testing that you're going to see on most providers' websites. This is something very unique
to our population as well. And I included this more so for the purpose of if we do have any current foster parents on here who have kiddos with special needs, this may be something that you hear your worker or other professionals asking about. Really, it just boils down to, it's IQ testing. So DDS is Developmentally Delayed Services, and in order to apply for and sign up for their program, for a kiddo, that kiddo's IQ has to be below 70. And so the whole purpose of this evaluation
is to determine where that kiddo's IQ is. Oftentimes this can be obtained in a full psychological evaluation, but maybe you're on a time crunch or you're needing to get it done quickly. There are certain providers who will simply do just the IQ testing for this purpose. This also might include aspects of developmental functioning in the evaluation, but most commonly, it's just the IQ testing.
This can last anywhere from 1 to 3 hours and can be done in a variety of locations. It can be an in-office visit. There are also some providers who will travel to, different settings, like the child's placement. Maybe they're in some sort of congregate care setting, and they can do that evaluation there if that's easier. Insurance does cover this. But a word of caution. If you plan to do just some IQ testing, say, in February, and because you want to hurry and get this done and get the application submitted, but later in the year you want to do a psychological evaluation, if that full eval is also going to include IQ testing, Insurance may have some difficulty with that. So just a word of caution, if you intend to
utilize this at some point.
So a trained psychologist with an advanced degree is who would be doing this type of evaluation.

::Slide - Autism Testing (3 boxes)::

Last, we're going to talk about autism testing. So any time a kiddo is being tested for autism, they're going to be, observed during a diagnostic play session. And that is guided by the Gold- Standard Autism Diagnostic Observation Schedule, Second Edition. Basically, that's just a guideline, of some things to be aware of and be observed during that play session. It's going to include a caregiver interview as well as intellectual testing. And one of the most significant parts is that adaptive behavior assessment. So how are they adjusting to and adapting to their environment? How are they functioning? All that kinds of things.
These evaluations or testing are typically 3 to 5 hours in length. And most insurances do cover it. And the whole point of autism testing is either to provide a diagnosis or rule out whether or not a kiddo is on the autism spectrum. And like all the other things we've talked about so far, pretty much the reports are ready in about 1 to 3 weeks. 
Very similar here to ADHD, a full evaluation is going to be done by a child psychiatrist or psychologist. However, other professionals such as a doctor, pediatrician, social worker can provide this diagnosis. They're just going to be doing that based on symptomology instead of doing a full autism testing.

::Slide - Diagnoses::

So we're going to talk a little bit about some diagnoses that are common during psychological evaluations. These are going to be, it's just a super quick overview of this. We've kind of talked about it in some previous Lunch and Learns. And I think we're going to do another Lunch and Learn in the future that's going to go into this in a lot more depth. So be on the lookout for that.
But some of the diagnoses that we commonly see. Oppositional Defiant Disorder, ADHD, DMDD. And I know these are a lot of radiations. OCD. and I'm not going to read them all. This is just kind of the laundry list of things that we kind of commonly see with our kiddos.
So do we feel like these things are over diagnosed? Yes. That is not to say, that these diagnoses do not occur, because we know that there are very real situations where they do. But it is definitely something that has been studied and determined that kiddos that come from a foster care setting are disproportionately diagnosed with these diagnoses compared to the general population. And a couple of reasons that that happens. And these are just four very broad reasons, that kind of encompass a lot of different things.
So first, most testing is going to combine some mixture of office evaluations and caregiver and school reports. So say for example, you have a kiddo that is in foster care. When some sort of evaluation is done, maybe they've just moved to a new placement. That placement is not going to have an accurate representation to be able to report to the provider about what's happening with that kiddo. Another thing that could be is that medications are already introduced for the kiddo. We know that lots of kiddos that come from a foster care setting have quite a few medications. And with those already being introduced, often their mood stabilizing medications or behavioral-type medications that could alter the result of an evaluation. And so like we mentioned earlier, talking to that provider about those medications is a good reason, to make sure that they have all that information and understand what kiddo's experiencing. 
A revolving door of providers. Basically, this is, for those kiddos who receive these diagnoses while in foster care. Maybe they're in a shelter and they are in a different shelter every few weeks. Maybe they're, in some different inpatient settings. And so as they're going to each of these providers or each of these settings, oftentimes they're adding diagnoses and they end up with this laundry list of diagnoses because they've seen so many different providers at different times. Things just kind of keep getting added along the way.
And last, kind of a lack of a holistic approach. So only viewing the kiddo and their behaviors, and symptoms through what's currently happening in their life and what they're currently experiencing, and not looking at the whole picture of we're paying attention to, instead of just that behavior and symptoms.

::Slide - Understanding Reports::
[several minutes of referenced document not being visible]

So next I'm going to pull up. I'm going to stop, screen sharing this PowerPoint for just a minute, and I'm going to pull up a sample of a psychological evaluation report. So this is obviously a made up report. It's not real client information talks about little Johnny, but I want to kind of go through each section of this and explain what each section is and, what all of the parts are important, but what specific parts that may be more beneficial for you to look out for. And I just found this on Google. But I've received multiple evaluations for different clients, and this is pretty solid. Like it looks pretty close to what you would receive if your kiddo had a psychological evaluation.
So in the very top section here, it's just going to have all of that identifying information that you would have provided
to the provider. Next it's going to have the reason for referral. So they're just going to lay out what things were being experienced by the child or family that caused them to come in for the evaluation. 
This next section just shows all of the different, assessment measures that were administered. So it shows each individual thing that they did, what date they did it on, and how long that particular piece took. And this is, important because they're going to break this down in like a lot of detail later below. But this just shows how long each one took. 
Then it's going to list all of the current medications and then the biopsychosocial history. This is going to be a large chunk. It's all of that historical information we talked about earlier that those providers are seeking on the family to get a whole picture of what's happening. So a developmental history that's going to be things like, when did they start talking? When did they start walking?  Potty training, that kind of stuff. Were they doing all of those things in normal time limits? Were any of those delayed? Next is family history. So that's going to be things like, you know, the family dynamics, information about the parents
or other extended relatives,

TRENA BOSWELL-HELGERSON: 
Excuse me, are you showing us something? 

SORRELS: 
Yes. Can you not see it?

BOSWELL-HELGERSON: 
No.

SORRELS: 
Hmm okay. Let me see. What do you see on your screen?

BOSWELL-HELGERSON: 
Just this slide that says understanding reports.

SORRELS: 
Okay.

BOSWELL-HELGERSON: 
And not anything else.

GOODWIN: 
It looks like maybe it came out of presenter mode, Lacey.

SORRELS: 
Okay, let me stop sharing and then I'll go back.

::Attendees visible::

Let's try that again. Thanks for making me aware of that.

::Document - Sample Psych Eval::
[presenter scrolls through document, describing each section]
I very much appreciate it. Can you see a document now? Perfect. Okay. I'm not going to retell you all the pieces, but I'm going to scroll up so you can see what I was talking about in each section. Okay.
So this the top, that identifying info, reason for referral. So this is what I was mentioning. The different assessment
measures, how long it took. And then this is where it starts that biopsychosocial history. So we talked about family history, some medical history, that's going to be medical history of the kiddo. It could also be medical history of the parents, if there's anything significant there. Educational history, that's going to be things like, how's kiddo doing in school? You know, do they interact well with their peers? Are they able to complete their work? All of those kinds of information that was gained from talking to both caregiver and teacher. Family psychiatric history. So this is going to be any mental health diagnoses or symptoms of either parents, potentially grandparents as well. Psychiatric history and course of treatment. 
So this is going to be about little Johnny. So what things have you tried in the past? What therapies have you tried? Have you done any different medications? What were the symptoms of those medications? Has he been inpatient at any time? Any previous diagnoses? So all of that is information they're going to gather together just to get a picture of what have you done so far and has it been beneficial or has it kind of made things a little bit worse? Substance use history. So in this example, this is about little Johnny. But this could be about the both the client and potentially their parents, if there's some significant substance use history with parents. This could also potentially include things like substance exposure as a newborn, or any side effects that would come from that.
Next we're going to add things like behavioral observations. So this is going to be in the course of the psychological evaluation. What did they observe? So is Johnny participating? Is he just laying back like, you know, being disrespectful? Is he doing the tasks well? Does he seem bored? All of those kinds of things. Is he alert? Is he sleepy? Is he talking positive or negative about himself? Really, just anything that they observed about the client in the process of evaluation. 
And then it's going to move into the test results section. So this is very sciency. It's a little difficult to read, at times, because there's just so much information in each of these sections. But each piece of this is going to start out with what is the test that they did? Some information about it. So for example, this particular test, it's for use with kiddos between the age of 6 and 17. It's the Weschler Intelligence Scale for Children. And this is going to be one
that's included on all of them. That's where you're going to get your full scale IQ. You're going to get your percentile. So for those of you that are like, this is overwhelming, This is so much information. All of these number pieces
are going to be in a chart down below. So it's okay if this part is overwhelming. But it's going to talk about each individual piece of this test, how they did. And then what is the, what is the result of how they did? So not only the numbers of it, but what does that equate to in real life? What does that mean? So I'm going to scroll a little bit
because there's a lot of, like I said, a lot of information in this section. This is all the same. So for that particular test, here's that lovely chart. I'm a numbers person. I like to read the information. It's important, but I need it broke down in this chart. So his verbal comprehension 127, he's superior. He's in the 96 percentile. Perfect That's the base information to know. This is just all the reasoning behind it and how that was observed. And then that's just going to repeat for each individual thing.
So the next one, the Minnesota Multiphasic Personality Inventory, it tells you what it is. It's a 478 item self report
measure, adolescents from 14 to 18. And then it's going to talk about how he answered the different pieces of it, what those answers mean for his real life. And I won't tell you about each individual one, because they're all basically
that exact same format. And it just goes through each individual test that they administered with kiddo. So I'm going to keep scrolling past all of these for a minute.
Summary. So this is where it just ties it all together. So all of the things that are listed in great detail above are just going to be summarized in this section. Why was kiddo referred? What was the, you know, reasons behind it? What was the symptoms? What was the behaviors? It's going to give a brief overview of how things went during the testing. And then it's going to hit really specifically on the results of the test, and what that means for everyday life in detail, with combining all of those sections above together into one big chunk. And this is usually one of the longest parts, just because it gives that really solid overview of everything that happened in the real life application.
And then we get to the next to last section here. This is the diagnostic impression. So basically this is what was the diagnosis out of this evaluation. So usually the top one here that's going to be your primary diagnosis. And then the next one is just going to be any secondary diagnoses. That doesn't mean that they're necessarily you know, one's more important to the other. But this is the primary thing maybe that he was referred for, or that was observed during the course of this testing. And there may be multiple below this. There may be more than two, but usually there's going to be, somewhere
between 1 and 3 diagnoses listed here. And it may be, that you've had a psychological evaluation before. And they're going to put the same diagnosis here because they confirmed that diagnosis. They don't see anything different. That hasn't gone away. Nothing else has been observed. So maybe sometimes it's just confirming what you already know and that there's not
anything additional happening.
Then the paragraph below the diagnosis is a summary of how they came to that diagnosis. What of all that information listed above, lead them to these diagnoses? And this is a very, reader friendly. It's not a bunch of sciency stuff like above. So it's very easy for caregivers to understand. And then the last part is the recommendations, which I think is the most significant part. So this provider has it broken down into cognitive recommendations and emotional/social recommendations. Some places just have it all in one big list. Some have it divide it out. It really depends on the provider. That part's not super important. So, for example, Johnny has a strengthened a preference for auditory learning. So they're going to tailor their recommendations to what Johnny is good at to help him deal with the things that he struggles with. So let's use his strengths to help address his challenges. And what realistic things can we do to help that happen? So although Johnny possesses a strength in verbal comprehension, he has a personal weakness in utilizing nonverbal reasoning skills. So let's give some ideas of how we can help that. Emotional/social are going to be things like struggling with making friends. He's he's smart, he's creative. But let's work on building his self-esteem. So again, it's that same format as above. Let's use his strengths to help address his challenges. And that is the end of that.
So that again, it's long. This particular example was 12 pages. I've seen them as long as 20 pages for kiddos that are having a lot more, struggles happening.

::Attendees visible::

So it really just depends on your provider, your kiddo, and all of the things that they were experiencing. So that's all of that part of the presentation. So I wanted to leave a little bit of time for first, any questions that you guys had,
any comments you wanted to share? But also, if you have any providers you've used that you really loved? I would love if you would drop those in the chat box, so that we can kind of resource share. And then like I said, I'm going to be sending out that resource guide of some different providers for psych evals, when I send out certificates by the end of the week. So I would love to add any recommendations you guys have that have worked well for you guys to that.

BOSWELL-HELGERSON: 
So does insurance pay for the parent competency one? Does insurance cover that, typically?

SORRELS: 
It depends on what insurance they have. But so, I've had a few cases where, I had one parent who had a private insurance, and they were able to get it paid for, similar to just a normal psychological evaluation. But I've had a lot of parents
that their insurance would not pay for it. I think I've had more that wouldn't pay for it than would pay for it. So it really depends. But I would say err on the side of not many cover that specific, situation. And a way that we got to not got around that, but a way that we address that because it is expensive. It's not something that parents can often pay for. So sometimes the judge would, you know, order that DHS be responsible for paying for it, or we would be able to utilize things like Care Portal, you know, local churches, willing to donate to be able to pay for that for the parent. So we were just trying to see how we could address that if their insurance would not pay for it. Not necessarily something that we wanted. You know, it's not a punishment that you're not able to complete this. We want to make sure you're able to get it done.

BOSWELL-HELGERSON: 
Okay.
So is adaptive behavioral assessment, is it the same thing as an adaptive functioning assessment? Or are those two different things? 

SORRELS: 
Yeah. Yeah. Depending on what provider. Some of them used a little bit different language, but that is, yeah, those will be the same.

GOODWIN: 
It looks like you got one recommendation of Commander Counseling and Wellness in chat. Thank you, Darian.

SORRELS: 
Yeah, thank you for that. Any other questions that you guys can think of? I know that was a lot of information very quickly.

BOSWELL-HELGERSON: 
So if you have a kiddo that has special needs and let's say they have significant behavioral issues, what eval would typically be used for that child?

SORRELS: 
I would say just the general psychological evaluation, unless there is any sort of medical component, there. So any neurological condition or other medical condition, that plays a part in their functioning. So I had a kiddo that had, multiple sclerosis once, and that was a significant impairment to her function. So that would be a neuropsychological evaluation. But if it's more of a, like, cognitive delay, then just a general psychological evaluation will cover all of those pieces because it covers the IQ testing, as well as the behavioral, as well as the learning pieces, that general psychological evaluation will cover all of those, unless there's some sort of medical component, then you would bump it to that neuro psych eval.

BOSWELL-HELGERSON: 
Okay. So the eval that's done like, through the school to get an IEP, would that be sufficient to do all of that? If a kiddo does have like special needs and behavioral issues? Or would the parent seek like an, an a different, a different evaluation outside of what the school does?

SORRELS: 
That's a really good question. So sometimes it could be both. So that, in-school evaluation that they're going to do is going to be primarily focused on, like educational aspects and behavior at school. And how they're able to, you know, behave in the classroom. Are they able to maintain in a regular classroom? Are they disruptive or are they having difficulties? So it's really going to be targeted to, improving their overall like functioning and like success at school? So if you would like it to be a little bit more extensive, you would potentially get that outside, evaluation just at a regular provider. But for the most part, for the purpose of obtaining an IEP, school evaluations are generally sufficient. There have been times where parents did not feel like a school evaluation was maybe thorough enough or did not capture their, their kiddo's needs, well enough. And they have sought an outside evaluation and just provided that evaluation to the school. So that can happen as well.

BOSWELL-HELGERSON: 
So, at what age can I a make, the youngest age for a psych eval? Where does that start? At what age?

SORRELS: 
Generally about 18 months. So every provider is going to have a different, you know, minimum age that they see. But the lowest I have seen is 18 months.

DARIAN HUFF: 
And for those younger ones, would that be covered under like Sooner Start?

SORRELS: 
I'm not sure. That's a really good question. Bonni? Do you know the answer to that? Did you hear that, Bonni?

GOODWIN: 
I did not.

SORRELS: 
Sorry, sorry. She said for those younger ones, would that generally be covered under Sooner Start? Would they address
some of those same things? Do you know the answer to that?

GOODWIN: 
I don't know the answer to that. That's something we could bump up to our clinical team and ask them if they know the answer to that.

SORRELS: 
Yeah for sure I can write that down.

HUFF: 
But it's not. So it's not a bad place to start, though?

SORRELS: 
Not at all. No. They're going to provide kind of, so Sooner Start will come in and do an evaluation of kiddo's like developmental functioning, see where they're at, see what things they might need to improve on, any areas they have a challenge with. And they'll start some services based on that evaluation. So definitely not a bad place to start. It's going to be one of those situations. On if you feel like that there's a piece missing, maybe like a behavioral piece
that they're missing. Then you could go beyond that. But it's definitely a great place to start.

BOSWELL-HELGERSON: 
How often one should do one? And so let's say you had an eval for your kiddo at four years old, and now your child is 12. Do you still, do you need to redo it? I mean, or how often should you do one for, you know, for kiddos or even for adults?

SORRELS: 
Yeah, for sure. So it's often as needed, but, once, more than once per year, it's not really going to be beneficial because maybe not a ton will change in that time, right? But definitely from 4 to 12, I would say maybe, because you have a fairly significant experience at four versus 12. Development is a lot different. You know, life situations that they're
experiencing are a lot different. So that would definitely be beneficial. Once a year is typically if there's a lot of challenges happening and, you know, providers are requesting an update or you're really looking for an update to, you know, see if any changes need to be made to your current course of action. So that's a little bit dependent on kiddo and situation, but definitely from like younger childhood to early adolescence would definitely be a good time for an update.

GOODWIN: 
Yeah, and I would just add to that, that it really depends on the need for the child, right? Like if the child is, is doing really, really well and, you know, then I don't think there's necessarily a need for an updated psych eval. Unless there is something, you know, that is, you're picking up on some different types of symptomology or behaviors that that you're wondering what's going on. We got some good questions, Lacey.
Thank you so much for some excellent in-depth information. I need to rewatch it because there was a lot in there, but it's so, so good. And I appreciate it. And we will have, have it, the recording available on the OKFosters page as well as on our YouTube channel. If you haven't yet subscribed to the YouTube channel, we've got all of our, gosh, how many do we have now? Like 12, I think on there, somewhere around there, it's in the teens for sure. It's some good stuff, some really good content. We have not even, repeated one, focus yet, which I think we will in the future to add on to things.
But, I'm excited for, part two of this, Lacey, where we can go a little bit more in-depth about some of the diagnoses as well. I think you said some really excellent points, about them today, and I appreciate it. Alright, I got all everyone who wrote oh, good question. Trina is asking.

SORRELS: 
I would yes, I will grab that real quick.

GOODWIN: 
Thank you, Lacey. I've got everyone who has already put in the chat that they're needing a certificate of attendance. If you have not yet done that, please shoot that to me in the, chat, and we will get you that certificate by the end of the week. Thank you guys so much and thank you for your patience as we started a bit late this, morning, today, I guess it's morning still. But we we hope you guys stay well and cool. Have a good rest of your day.

UNKNOWN:
Thank you.