First, I will concede that these reports are necessary. It’s important to identify areas of strength
and weakness, to determine whether a child qualifies for services, and which
skills should be targeted in the future.
That all makes sense. But then things
start to break down.
Evaluations are often conducted by people who have never met
Maya prior to said evaluation. These
well-meaning people tend to greet her enthusiastically, which makes her clam up
and withdraw a bit, smiling shyly. In
turn, the evaluator lays it on a bit more thickly, lots of cheerfulness and
toys laid out and “show me your talker!” and “maya-do-you-want-to-play-with-blocks-or-maybe-a-doll-or-maybe-this-school-bus-or-maybe-do-you-like-crayons-better-do-you-know-your-colors-maya-do-you-like-pink-do-you-want-this-pink-crayon-maya-maybe-can-you-say-crayon-with-your-talker-no?-yes?-well-maybe-you-can-say-pink-or-if-you-don’t-have-pink-you-could-say-red-I-guess-maya-do-you-know-how-to-turn-your-talker-on-is-it-with-this-button-here-hmm”. And Maya just smiles. Or maybe tries to hide her face with her
coat. And maybe sits on the floor. And
maybe knocks over a toy or giggles and tries to swipe a crayon.
If the adult is putting on a show, Maya is generally content
to watch.
I know this, but can’t get over the awkwardness of saying
what I really think needs to be said . . . “Hi, I’m Dana. If you want her to pay any attention to you,
your best bet is to start talking to me and ignore her for a few minutes.” (because then she’ll act like a typical
preschooler . . . hey, what about me? Don’t
you want to see my talker? Hey---is that a school bus?!?! I want it!)
Typically, I sit back. It’s the scientist in me. I don’t know what protocol evaluators are
following and I don’t want to skew results.
I imagine that they, as professionals, have a big bag of figurative (and
literal) tricks, and that they will present them in some sort of interventional
and motivational hierarchy. I imagine
that they are masters of body language and social intelligence, and will push
in and pull back until they have figured out how to dance with Maya through the
evaluation. I imagine that they are
skilled experts.
As it turns out, sometimes they are. Sometimes they are decidedly not.
In the category of
decidedly
are not, let’s revisit Maya’s psychological evaluation from 2010.
This evaluation, required for determining
whether she qualified for a therapeutic preschool, was also our first attempt at
cognitive testing.
This evaluation, and
the report that came as a result of it, had been so abysmal that I wrote a longer
piece about it---here’s an excerpt, so that you can get a look inside the
appointment:
I think back to the afternoon of Maya’s psych evaluation. Oh wait, I mean the evening of the eval, as the psychologist arrived 45 minutes late,
only getting down to business at 6:15, thirty short minutes before the girl’s
bedtime. I eyed her suspiciously, as she
looked to be about sixteen and appeared to have never interacted with a young
child. She handed me a survey to
complete and I sat off to the side, dutifully penciling in bubbles, as Maya
laid face down on the floor and eyed the psychologist suspiciously through one
eye.
Maya! Do you want to play with the DOLL? Which toy is the DOLL, Maya?
(Maya made no motion.
I think she even willed herself not to blink.)
Here-can you see them,
Maya? She carefully moved her line
up of toys closer, now an inch from her nose. Which one is the DOLL? Do you want to play with the pretty DOLL,
Maya?!
Maya turned her head away, saw me sitting across the room
and smiled at me. I stifled a
laugh. I wouldn’t want to play with that crazy lady either, silly girl.
And so it went for the next forty-five minutes. Toys were presented and ignored. Requests were made and ignored. At some point it struck me that this woman
might end up writing that Maya was catatonic unless I intervened, so I made her
sit up and engaged her in some play with a few blocks. See,
she listens, I thought, you are just
very boring and now it’s bedtime.
When she left I joked to Dave “Well, it shouldn’t be a problem getting
into a specialized preschool. That lady
most likely thinks that Maya is a vegetable.”
But now, on paper, it didn’t seem funny anymore. The typed words looked official, the opinion
of a professional, and this professional said that Maya’s cognitive functioning
was abysmal. I skimmed her observations
and then this gem jumped out at me: Alexandra
was not able to stack blocks.
Who the hell is Alexandra?
You mean to tell me that the late, unengaging psychologist
was also not yet proficient at copying & pasting? Really, lady?
Your report is bringing me the news that my child is severely impaired,
and you can’t even do a quick proofread?
I imagined her quickly printing off the report and running out to the
bar with her young, unburdened friends.
I hated her.
Further on, she wrote that Maya’s “expressive language
skills were slightly stronger than her receptive language”. Translated, this meant that she could speak
more words than she understood. Since
she could only say one word (bye!), this meant that the psychologist assessed
her to understand zero words. Zero. How would she explain what I saw as I peeked
into the living room, where her OT was saying “Maya, pick up the yellow duck
and put it in the box” . . . and Maya did, of course.
That psychologist didn’t know Maya. Not at all.
That psychologist was not a skilled professional (professional,
yes, skilled . . . eh). She did not have
a big bag of tricks, figuratively or literally or even imaginarily. And lest you think that I am unfairly bashing
the therapist, let me say this: I know Maya can be a challenge, a little puzzle. But she was 2.5, and toddlers are
tricky---she should have been prepared to coax her out of her shell. And if she couldn’t---no worries! I was
sitting right there, and would have happily, accurately, unbiased-ly answered
questions about what she could and could not do. But she didn’t ask. And so I fault her, fair and square.
The report from this evaluation contained one sentence that gave
me pause: Maya’s cognitive functioning is in the Extremely Low Range as compared
to her same age peers. This score is in
the 0.4th percentile, meaning that she performed as well as or better than 0.4%
of children her age.
Given the inaccuracy of the observations about her receptive
language, I should have dismissed it outright.
And eventually, I did, but for the first hour or so after I read it, it stung. And I doubted Maya, and I doubted myself,
and I wondered if this lady could have seen something that I haven’t been
seeing. And then I shook it off, but a
little dark shadow lingered . . . because no matter how sure of yourself and
your child you are, when you see terrible things written about them on official
letterhead from an official professional a dark shadow of doubt lingers, at
least temporarily.
And that brings us to December 2012. Two years later. A new evaluation team (2 people instead of
one), a new psychological evaluation (this time for kindergarten), a new
report. This time, with truly skilled
professionals---two women who were ready for a challenge, who sat on the floor
when Maya sat on the floor, and climbed up to the table when Maya wiggled into
a chair. Women who turned to me when
Maya was shy, giving her a break. When
they weren’t getting far they asked me what I thought might work, welcoming my
input and encouraging me to pull things out of my own perpetually stocked bag
of tricks . . . m&ms and stickers and a juice box, oh my! And Maya worked for them, answering questions
and taking breaks and playing games, and 90 minutes later we had more accurate
data than anyone had ever collected about Maya, ever.
I waited anxiously for the report. Weeks went by. I was nervous, and mad at myself for being
nervous. My hopes were up and I hate getting
my hopes up. I have a file full of
reports that have taught me that they will not be accurate (in my opinion) and
I will be agitated by the results. And I’ll
end up with lingering shadows that take weeks to clear away.
The report arrived, via email. I saw it on my phone. We did dinner and bedtime and I sat at my
computer to open the file and read it, 10 pages of details and data and
recommendations. I skimmed it first, to
see if it was worth reading, and then went back to read it carefully. And finally, someone got it right.
I don’t generally talk about the numerical details of Maya’s
reports, because –quite frankly- they are nobody’s business but our own. However, I share the details below to boost
the confidence of others who are receiving reports during this evaluation
season and deflating. I deflated a little
when I got the 2010 report, even though I was pretty sure it was
inaccurate. The numbers made me scared
and sad for Maya: 0.4th percentile, 1st percentile, 0.3rd
percentile. These are not good numbers.
The new report has better numbers, but it has bad numbers
too. The bad numbers roll off my back
now, as we’ve seen them before. The good numbers, though, those are new . . . and
even more important than the numbers are the qualitative observations that are
embedded throughout the report.
75th percentile: Her receptive language is “high average” among her same-aged
peers. (yes)
50th percentile: Her academic readiness is “average” among her same-aged
peers. (yes)
While certain tasks were attempted, it is felt that scores
are likely an underestimation of her capabilities and potential. (yes)
Her performance on the current evaluation should be
considered as a baseline of her functioning at this point in time, but should
not be used as a long-term prognostic indicator. (yes)
It’s been almost 4 years since we entered the special needs
world, creeping nervously into Early Intervention. I was scared in the beginning, and worried
too much about assessments and milestones and where we were and the
future. As time passed, I understood
Maya more and more, and I saw her strengths and her cleverness and I believed
in her, so much so that I knew the reports were not gospel . I’ve listened to many scared moms tearfully
speak about bad reports and I want to tell them---don’t worry, your child is
the same child that they were before you opened that envelope. That report might not be accurate. Keep the faith.
Until now, I had no data to back up my “keep the faith,
ignore the reports” general stance . . . I could have just been a biased, delusional
mom. But now I have a report that
confirms that the other reports were clearly inaccurate. I have a report that says that she is smart
and she understands, as much as an “average” kid her age does. I have a report that says that I was right to
trust my gut. And with this report in my
corner, I’ll say now what I wish someone could have said to me back in 2010:
The truth of the matter is that reports are just opinions on letterhead. Some reports are informed, thorough, intelligent, professional opinions on letterhead, that should be valued and reflected upon and future decisions should take their findings into account. Some reports are mis-informed, inaccurate, not-correctly-spell-checked, best-used-for-sticking-in-a-file-and-forgetting-about opinions on letterhead.
Reports are a means to an end. You need them to get services, and you should read them to get details
that you might need to use to fight for services, but read it as if it’s
written about a stranger. Don’t take it personally. Bad things in reports are actually good, as
they’ll help you to get additionally therapies/interventions/support for your
child. Note any weaknesses that you actually agree with, so that you can target them with your child in the future. After you highlight what you
need, file it and forget about it. Your
child is the same person as they were before you opened the envelope. You know your child better than the
evaluator. This evaluation does not have
any power to predict your child’s future . . . and it shouldn’t have any power
over you.
Breathe. Cry about it
or laugh about it or do both. If it
helps, make a photocopy and shred it up, or burn it. Then do something special for yourself (because
if you have to read these reports, you deserve something special for
yourself). Then, move on. And keep the faith.
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